Celebrate with me!

I had a realization a couple of days ago: I’ve been an entire year without a depressive episode! That’s the first time in eleven years!

Yes, I had some bumps. And some down days. But that’s part of living; that’s not depression.

I attribute this milestone to several factors.

  1. I take my medications faithfully. And if I feel myself dipping towards depression, I tell my psychiatrist so he can modify my meds.
  2. I was actively involved in a support group: Fresh Hope. We met weekly – folks who struggle with mental health issues and loved ones – and we talked and encouraged one another. More importantly, we reminded each other of the hope we have in Jesus – hope that allows us to live well in spite of a mental health diagnosis.
  3. I wrote a WRAP – a plan that outlines my triggers, my indicators, my “plan of attack” if depression should resurface.
  4. I told my husband and friends if I was feeling low for more than a couple of days. Just saying it out loud helped.
  5. I prayed for strength. And my family and friends prayed for me too.
  6. I stayed in God’s Word each day. The Bible is full of the hope we have in Christ and how much God loves us.
  7. I talked to a therapist regularly. I know myself well enough to recognize that I really benefit from talk therapy. In fact, I’m without a therapist right now, due to just having moved here a couple of months ago, and I can tell by my mood that I really need to talk to a counselor.
  8. I got out my gratitude journal again, and resumed recording those things for which I’m thankful. Studies show that counting blessings is effective in fighting depression.

I’m celebrating this victory, and hope you’ll join me!

Wellness Plan Toolbox

The first step in writing my wellness plan is determining the helpful steps I already have in my daily life. When I am healthy, what is it I’m doing to make me that way? What are my day-to-day activities that signify health and wellness for me? “What things do I already do to help myself be well, stay well, and live in the way I want to live?” (reference: WRAP Plan app)

This toolbox of activities is critical to my Wellness Plan, as I’ll draw from this list at different stages along my path from wellness to illness and back again. When I feel stressors, or triggers, that might signify a depressive episode is coming, what can I do to alleviate it? Are there any tools in my toolbox that I can pull out and implement to avert an episode?

If I’m further down the path toward depression, and an episode is imminent, which activities can I use to lessen the severity of the episode?

If I’m on my way out of a depression, which tools will I use first to help me post-crisis?

My initial list was 14 wellness tools:

  • time alone with God in Bible reading and prayer (TAWG)
  • taking my meds
  • journaling
  • eating well
  • good sleep hygiene
  • spending time with friends
  • sufficient down-time
  • seeing my therapist regularly
  • keeping my psych doc appointments
  • blogging or writing
  • taking naps
  • reading
  • watching movies
  • Fresh Hope Support Group

But as I thought about steps I can implement in a pre-crisis, I realized I have several more tools, even though I’m not currently using them. Things like savoring a cup of tea, or coloring, or taking a walk in nature. I certainly need to tell my support team that I’m struggling, so they can help me watch for warning signs.

One thing I’ve learned about depression is that it clouds my thinking. I can have this wellness toolbox, but in the midst of a crisis, I’m paralyzed and don’t know how to get out of it. That’s the reason for writing a wellness plan when I’m mentally healthy: so when I’m not thinking straight, I can look back and see what I recommend to myself.

I intend to share my wellness plan with my support folks (husband, sister, therapist, friend) so that they can help me remember to reach into my toolbox when I need to. As soon as I’m done writing the whole thing, I’ll pass it on to my care team.

The role of therapists in my life.

from my therapist’s office

My first therapist was Bill, and I saw him a few times when I was in college. I distinctly remember visiting him before I graduated from school. I was moving back home for some surgery, and wanted his help in learning how to navigate old communication patterns. The tools he gave me were very useful as I adjusted from independence to needing help. I was grateful for the techniques I learned, and I think it made my stay at home a smooth one in an otherwise difficult time.

Ted was my next therapist, about 20 years later. I first started with Ted in April 2008. His practice was recommended to me by someone at the church office. I dialed three times and hung up before I finally let the call go through and scheduled the intake appointment.

I remember “clicking” with him almost immediately. Good thing, because I was in desperate need of someone to help me with my jumbled emotions. I was in my mid-40s, we had just moved back to town, and I had expected to pick right up with old friendships and circumstances. But instead, I was feeling incredibly sad and couldn’t shake it. I tried, but was unable to explain to my husband what was wrong. I could only cry. We both agreed that I needed to talk to someone.

So Ted has been with me from the beginning of my depression, which started that summer, and for all the years since. He was with me through the very worst. When I was at my lowest. When I didn’t think I could go on living. Through my hospitalization. He helped me through the trauma and drama of deep depression, during the days when it was overwhelming and suffocating. He helped me navigate through the darkness and slowly back into the light. And he did this several times as I repeated my depression over seven years.

Ted knows me so.well. Maybe even better than I know myself. He can take the words I say and make them make sense. He finds the thread between my random thoughts, puts order to them and gives them back to me. And he’s done this for me for years.

Ted has served as my coach, as my educator, as my mentor, and as my confidant. I didn’t share with him in place of sharing with my husband, but he helped me to formulate my thoughts in a way that my husband could receive them. So that I could say what I wanted my husband to hear, instead of getting lost in my emotions or randomness. He always pointed me back to my husband.

Ted’s a Christian, and he prays for me at our appointments. He helped me sift through the spiritual battle versus the mental illness, and reminded me regularly that Christ is with me in my depression. He was the first one to really help me see Jesus standing alongside me as I struggled to fight for my mental health.

Ted helped me navigate some difficult memories. He worked with me on abandonment fears. He let me sound off about things that made me angry and helped me learn to express anger in a healthy way, instead of squelching it like I used to. He pointed out my faulty thinking, and gave me a different story than the one I was telling myself. He challenged my all-or-nothing thinking. He showed me that I speak to myself in questions, and I “should” on myself a lot.

I remember one time in particular when he really pissed me off. It’s when he pretended to be me. He told me everything I was thinking, including the things I hadn’t said out loud. I was so angry! Or maybe I was just afraid, because I had been vulnerable enough for him to see through me, to know the way I think and how I form my opinions and thoughts, and he nailed it!

I don’t worship him, nor would he ever let me. But I do have a really hard time finding a therapist, because everyone gets held up to the measuring stick of Ted. And they often fall short. It’s not a fair comparison, I know, because they don’t have the years with me like he does. So of course they don’t know me like he knows me, which puts them at a huge disadvantage when I start comparing.

I found a Christian therapist when we moved to Florida, and she was kind and gentle and accepting. I drove 40 miles one way to see her, and it was worth it. She helped me through the grieving process of relocating, and together we navigated a depressive episode with faith in Christ as my healer.

I’ve tried three therapists here – one was a hit for a little over a year. We just “broke up,” as she is moving to her private practice and I’m looking for a Christian counselor.

But I know that I’ll always have Ted. He’s promised me many times that he’ll always “be there” for me, and he always has been. I haven’t needed him as much as I used to – I’ve found these other therapists over the years who have been helpful. But I suspect I will always reach out to Ted in my depressed moments, for just a word of understanding from him to ease me through the darkness again. And he’ll point me back to my husband, and remind me that Christ is with me.

Now that’s a good therapist!

Lies and My Latest Counseling Appointment…

I’ve met with this guy twice. This week was my second visit, and I cried through the whole session. I don’t think I’m going back, but my tears aren’t why.

My crying felt good, actually. There was an issue I wanted to discuss – a lie I have believed – that I needed help navigating. I knew going in on Wednesday that there might be tears. So why did I even bother with makeup?!

I’ve been blaming myself for several years for something that wasn’t my fault. And I’ve known it wasn’t my fault – in my head. But my emotions didn’t agree, and I couldn’t shake the accusation and corresponding guilt. So I knew this was what I wanted to discuss at my counseling appointment. I wanted help with seeing the lie – I’m to blame – and replacing it with truth – I did the best I could and it’s not my fault.

My counselor heard my request, and prayed with me. He asked God to reveal the truth to me about the situation, and to replace the lie with the truth. (See Wikipedia: Theophostic Counseling).

I cried. Tears streamed from my closed eyes as I prayed along. I felt my head knowledge move to my heart; it’s not my fault; I did the best I could; God loves me and them completely, and longs to pour blessings on us, if I will only let go of my desire to control the situation.

I cried as these truths finally sank in. And that is exactly what I had hoped for from the therapy session. To replace the lies I was believing with the truth I was having a hard time accepting.

And then the counselor said that he thought there was more – another underlying lie that I was believing. And I balked.

I know the lie – I knew it was a lie even before I saw the therapist. I just wanted his help to move the truth from my head to my heart. I don’t want to go diving for more lies. This was a specific situation. In general, I don’t want my every thought to be traced back to my childhood. Which was good, by the way!

I know that I benefit from talk therapy, especially when I’m experiencing a depressive episode (which I currently am). I need a therapist who will listen to all the thoughts I express, take them and reflect them back to me in a way that makes sense. Put reason and logic and order to what feel like random depressive thoughts. I want a therapist who will say, “Depression sucks,” and then help me make sense of my feelings, put them into context for me.

I need therapy to accompany my medicine, especially when I’m fighting depression like I am right now. And I’ve been at this long enough to know what I need from my therapist.

And this latest guy isn’t it. He helped me with the issue I needed, but that’s all.

I need to find someone else.

Red Flags

Over ten years ago, I was diagnosed with Major Depressive Disorder – Recurrent, which means that I’ve had multiple episodes of depression. It’s important for me to learn to recognize the symptoms of an episode quickly, because the faster it’s treated, the sooner it goes into remission.

According to psychiatry.org,

Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Thoughts of death or suicide
  • Symptoms must last at least two weeks for a diagnosis of depression.

Given these symptoms, it’s critical for me to know my red flags – my warning signs – that an episode might be lurking. These are my indicators prior to actual depression symptoms – they tell me it might be coming.

Here are some I’ve noticed.

  • Listening to music loudly –
    • in an effort to drown out my negative or ruminating thoughts.
  • Desire to be alone, or in the dark.
  • Not wanting to go to my regularly scheduled activities – anhedonia.
  • Saying “I’m sorry” a lot.
  • Difficulty concentrating when reading a book or even watching a t.v. show.
  • Wanting to stay in bed, even if I’m not tired.
  • Feelings of self-pity.
  • Crying – maybe. Sometimes I can’t cry, which is also a red flag for me.

When I see several of these characteristics, or if someone close to me notices, it’s time for me to contact my psych doc and let him know that I might be headed into a depressive episode.

[Side note: even though I know these things about myself, I am always surprised. You’d think that after ten years, I wouldn’t be shocked to discover the journey back into depression. I guess it’s a good thing – I don’t ever want to get used to it. I need to accept it, and make every effort to be mentally healthy, but I don’t want to be resigned to a life of depression.]

Over the 10+ years that I’ve battled depression, I’ve gotten better at seeing these things quickly, which means we can modify my treatment and get me the help I need so that the episode doesn’t deepen. Maybe that means adjusting my meds. Maybe it’s increasing my therapy sessions.  Maybe it’s simply monitoring them, being self-aware.

It’s a call to pay attention.