psychiatrist

How am I doing with what I’m supposed to be doing? part two

Peggy Rice6 Comments

As I mentioned before, there are things that I can do, even with depression, to help ease its symptoms. If I’m in remission, those tasks are much easier to carry out. Here are some more thoughts on the steps, and how I do (or don’t do) them with depression in remission versus when it’s full-blown.

  1. It’s important not to isolate myself – to keep up social interaction and positive supportive relationships. This is near to impossible when I’m in the middle of a depressive episode, since all I want to do is be alone, preferably in the dark with the covers pulled over my head. I’ve learned to lean on the folks who know about my struggles, and admit to these friends that I’m having a tough time. They know what to say and when, and how to gently push me to reach out or when to leave me alone.
  2. If I’ve learned anything in my years in and out of depression, I’ve learned the importance of making space in my day, and not pushing myself too hard. It’s critical that I reduce my stress, make my to-do list shorter, and pace myself. I am already my harshest critic (that comes naturally to me, and is amplified with depression) and it’s easy to beat myself up about the things I should do that I don’t get done. But I’m learning to cut myself some slack, practice some relaxation techniques, and even nap if I need to.
  3. A piece that is very important to fighting depression is adopting an “attitude of gratitude.” It’s been proven in studies that folks who practice daily gratitude, perhaps writing things to be thankful for in a journal, have reduced depression and anxiety. It’s impossible to thank God for blessings and be anxious at the same time! Gratefulness also combats negative thinking, which is a huge issue for me when I’m depressed. I ruminate, mull, dwell and judge myself very harshly, and the negative thinking spirals quickly downward. But if I can stop myself, take the negative thoughts captive to Christ (from 2 Corinthians 10:5), and focus on His blessings right now, living in the moment with gratitude, I can slow the negative thinking and self-condemning thoughts before they get too far gone.
  4. I’m told repeatedly by my therapists and doctors to do the things that I used to enjoy, even though depression means that I don’t want to do anything. This is actually a diagnosing symptom of depression – not wanting to do things that used to be enjoyable. Other ways to combat this inertia are to reach out to others – recognize someone else’s need and offer help, maybe even volunteer in a serving capacity. I’ve found it true – thinking about someone else takes my mind off myself, and I can be distracted from depressive thoughts as I try to meet someone else’s needs.
  5. Maintaining an active faith life is critical in my fight against depression. I have to regularly remind myself that Jesus knows and understands how I feel, and He loves me completely, unconditionally, anyway. I’m not always able to concentrate well enough to read my Bible, so I have several other tools that help. I have a couple of books that are simply Bible verses to read “when you feel … (sad, anxious, depressed, lonely, etc.).” I listen to a lot of praise and worship music, and even have made some playlists appropriate for my moods. Lastly, the Holy Spirit will bring Bible verses to mind that I have read or memorized over the years. I may not be able to find and read them from the Bible, though, so this is a reminder to me to hide God’s Word in my heart (Psalm 119:11) – I never know when I might need it!
  6. It’s important to continue to take my medications as prescribed, and to avoid alcohol (a depressant). There’s really only been one time when I really wanted to quit taking my medicine – I think I felt like it was all useless (that’s the depression talking). It’s important, too, to follow my treatment plan and meet with my doctor and therapist – they will encourage me to keep taking these steps. It’s important to have their help to stay on track.
  7. Finally, I need to really listen to myself, and have those closest to me help me identify if I need immediate help. If I feel like hurting myself, if my mood worsens quickly, if I descend and can’t get back up, I need to get professional help. My therapist has been great to be available when I need help quickly – I am grateful for her!

So, that’s a lot to do to keep healthy – a total of 10 steps to take when including the top three from my earlier post (sleep, healthy diet, exercise). And it’s a lot to be intentional about, so it is helpful to form these habits when I’m in good mental health, so they aren’t completely impossible when I’m fighting a depressive episode.

What are some steps that you take to fight depression? What advice do you have to others who struggle?

 

 

 

Remembering Sadness: A Christmas Party

Peggy Rice7 Comments

I was telling my therapist yesterday that I want to go back and read my old journals, written over the past 9 years, covering the times where I’ve been in and out of depression. But after I blogged about my stay in the hospital psych ward, I read about a work Christmas party that happened shortly after my release, and found myself crying. Sometimes, the stories are sad.

Typically on Holiday Party day,  I would work longer into the afternoon, and we would help Leanne in getting ready for the evening. She would have planned every detail of this party for weeks. She’s incredibly creative and clever, and she chooses the menu and theme and creates the fun game time for the annual event. We’d get tables set up and decorated, gather and set out supplies for coffee (the meal is catered), fluff the Christmas tree and check its lights, set up the sound system, move the piano out, and do whatever else we could to help her with preparations. The party is for Board members present and past, and the staff is invited to attend. I liked going, and my husband and I often served beverages before the meal. I had discovered this as my favorite way to meet and thank Board members without making tons of small talk! I don’t think I fulfilled this service in December 2009, and I’m sure that’s a good thing.

Looking back, I had no business being there that evening, not with my mental health fragility and the physical exhaustion I was experiencing as I was recovering from the serotonin toxicity. I wish someone had told me I couldn’t go. But I’d always attended before, and felt like I needed to this year, too. I think I just wanted to prove to myself that I was back to normal, even though that was far from true. My husband agreed to meet me there when he got off work.

I honestly don’t remember many details, but I do remember catching my reflection on the way to the bathroom. What I saw shocked me.

There was a short round woman, hunched over a little, her body being pushed hard toward the floor by gravity, her feet splayed for balance. Her hair was messy, but not cute-messy, and her face was drawn and tight. Her eyes were flat, and her lips turned downward. She looked horrible. And then I realized it was me.

I don’t think we stayed longer – I wanted to get out of there before anyone else saw me. I cried as we drove home – so sad for the woman I used to be. I didn’t think about how I would be her again someday – standing taller with confidence, attractively dressed, smiling with eyes sparkling. I could only be sad that at that moment she was gone, and in her place was this woman who had been beaten down and showed it.

Healing from the serotonin toxicity took way longer than I expected – months of me not feeling back to myself. My psychiatrist kept urging patience, reminding me that I had been through a major traumatic event. Everyone but me seemed to understand that I wasn’t weak, just healing, and it was going to take lots of time and rest for full recovery.

I cried a little as I retold this story yesterday to my therapist. And I realized that even though I really want to re-read all of my journals, it will not be easy. I am inviting myself back into sadness and sad memories, and I will mostly likely cry. She encouraged me to take my time – I don’t have to hurry – and I can stop at any point. She even offered that I could bring the journals to our appointments, if I feel that I don’t want to handle the emotions by myself.

At least I know what to expect. Some tears, definitely. But I’m also eager to read the evidences of God’s faithfulness, about the tools my previous therapist gave me, of verses of Scripture that sustained me. I will read expectantly, with my heart soft and ready to absorb the written emotions again, yet reading the journals with strength, knowing that I have come through difficult times and am the person I am today because of them. And I will cry.

Psych Ward, part 3

Peggy Rice5 Comments

(I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Even today, lots of it are just fuzzy memories.) 

I checked into the psych ward on Sunday. I know that on Monday, I went to the nurses’ station near the Commons area. This area was enclosed by glass windows, and there was always someone standing outside of it, like a guard. I asked to use the phone and called my church. I think I told the receptionist that I was in the hospital and asked if Pastor Andy could visit me. As clergy, he wasn’t restricted to visiting hours, so he came and met with me later that day, I think. There was a small room off the Commons area where patients could meet “privately” (with as much privacy as is allowed in a psych ward, anyway.) My pastor met me there; I have no idea what I said. I asked him a few weeks later, just to be certain that I hadn’t done or said anything to embarrass myself or him. He assured me that I hadn’t. I had wanted to see him so that he could assure me I would be ok, that Jesus understood and was with me, and I’m sure he prayed for me.

I had two friends who visited one evening. They brought me cozy fleece pants, and confirmed to me that I was doing the right thing by getting help. I remember feeling very comforted by good friends who cared enough to see me in an uncomfortable place.

My husband came for every visiting hour.

And my kids came once, I think one of them came twice. I don’t remember asking my husband to bring them, but it seems that I did. Very quickly, I regretted that I had. I still wish they had never seen me there. The trauma of going through two locked doors was too much – and my flat affect, my lack of energy or any enthusiasm whatsoever – I don’t think they had known how sick I was, but they couldn’t miss it when seeing me on the psych ward. It must have been pretty awful for them. I’m very sorry I put them through that.

At some point, I remember seeing Dr. Larson. It might have been the first or second day – I’m not sure, since time blurred together. He was in my room, and I was looking right at him but couldn’t see his face because he was leaning up against the window and all I could see was his silhouette as the sun shone through from behind him. He was completely in shadow. But I know it was him – I knew his gentle voice. He was telling me about the different medicines we were trying. I remember thinking that I just wanted to go back to sleep. I’m still not sure what I said “Yes” to.

My last night there, I had a roommate. I was in bed when she came in – she laid down and was crying. I tried to say Hi, and she responded, but I ended up leaving the room for a while so she could have some privacy. When I came back in, I packed my things and went to bed.

I slept almost the entire time I was in the hospital. I later learned that’s exactly what has to happen for the brain to heal. The over-saturation of serotonin created a type of brain injury – there is no way to help it get better without sleeping. Dr. Larson gave special permission (Karen told me this later) to sleep all I wanted – no more group attendance requirements. No wonder everything blurs together – I think I slept through it all. But I know I didn’t dream it.

I don’t regret going to the psych ward – I think it was the best thing I could have done for myself. I actually tried to go several years later, when another medication caused a negative brain chemical reaction. Because I had been helped the first time, I knew it was the right thing to do. (I was unable to enter the ward because all of the beds were full – but that’s for another blog post.)

Psych Ward, part 2

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(I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Even today, most of it is just a fuzzy memory.)

I checked into the hospital on Sunday. The rest of the four days are blurry: I slept a lot. 

I had to go to “Group” – twice, I think. The first time, Group was me and a young man, meeting at a low round table with a nurse who read through some pages and a booklet. All I heard was Charlie Brown’s teacher: “Waa waaa wa waaa.” The second time I went to Group, it was just me and the nurse, hardly a “group.” When she asked if I understood, I said, “Yes” so that she would let me leave and go back to bed. It was weeks after getting out of the hospital that I reread all of the materials I was given from my stay. As I was reading, I had a vague recollection of sitting at the table with her. Blurry memory, though.

I recall being awakened once by a nurse who seemed irritated that I was sleeping; she told me I had to get up and go to Recreational Therapy. As I stepped out into the hall, I was completely surprised to see Karen walking by – she was the Rec therapist! I greeted her like the old friend she was, and wondered if it shocked her to see me in the psych ward. We had become friends through our daughters and story time at the library 13 years before! I hadn’t seen her in a very long time – probably 4 years before this. It ended up being ok that I had to go to Rec Therapy, because Karen and I got to talk, filling each other in on our daughters’ lives. The young guy was there, too. I made a small stuffed fleece pillow – the tie kind (I gave it to my dog when I got home). Karen sought me out later in the day and gave me my lip balm (it had my name on it) – she had found my little pouch.

I remember a couple of meal times – my goodness, it was an odd bunch in the Commons. I didn’t see the young man, but I remember an older woman, an older man, a middle-aged lady, maybe another man, perhaps a total of six of us. I think we sat with two or three of us per round table, but I also remember being alone. Or maybe that’s just how we all felt – alone in the group. The TV was on, but no one was really watching – not even the nurses – I think they had their own TV. There was someone yelling, then screaming – down the hall. People rushed in his direction. Maybe it was the young man.

One time that I was out of my room and in the Commons, I tried to do some coloring. I think I worked on a puzzle too, but it was too hard to concentrate, and I couldn’t see well enough for the detail in the pieces. The young man was there, with people who I’m assuming were his parents, and he was crying hard. The man with him looked angry. The boy ended up yelling at them.

On the 6th Floor Behavioral Health Unit: Psych Ward, part 1

Peggy Rice13 Comments

I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Still, lots of it is just a blur.

It was Sunday, maybe mid-morning. I had packed a bag with some of my things, per Dr. Larson’s suggestion. I had also Googled what to pack to take to the psych ward, so that I knew to label everything with my name. I had some comfy clothes, my slippers, a toothbrush and paste. I had a small pouch with my name written in Sharpie, and my favorite lip balm, some lotion and cuticle cream. I remember that I was always putting on hand lotion and nail cream and lip stuff – my skin was so dry. Looking back, I wonder if it was a side effect of the medication withdrawal.

I was a little nervous as my husband and I drove to the hospital. I recall asking myself over and over if I was doing the right thing, but I honestly couldn’t come up with an alternative. Staying at home, moving from the bed to the couch, in tears and fear and feeling completely out-of-body was too hard to do anymore. I don’t remember talking much on the way. I don’t remember what we had told the kids. I just kept wishing we would get there so I could get started on healing. My reasoning was that if I was with my doctor, he could move my medicine changes along more quickly than what he had us doing at home.

I had to enter from the emergency room, so we parked and walked in together. I told the woman at the front desk that I wanted to be admitted to the psych ward. My husband and I took seats in the waiting area – he held my hand; I might have been shaking. It wasn’t long before I was called back to the triage nurse for assessment – I told her that I wanted to go to the psych floor because I was afraid for myself, and my doctor was there and I needed his help. I said goodbye to my husband, someone took my bag, and I was wheeled through indistinct hallways and an elevator to the 6th floor.

In my room, a nurse told me to put all of my clothes in a bag she gave me. She had two hospital gowns I could wear so that nothing showed out the back, plus a lightweight robe. I was told that I couldn’t have my things until the doctor had seen and approved them, which might not be until the next day. I remember thinking how much warmer my own clothes would have been, even with the hospital robe on top of the gowns.

I don’t really remember much else about that day. I do know I took a nap – I was cold and so tired. And my hubby came to see me for visiting hours that evening.