Thursday, April 10, 2014

The Upward Climb, One Step at a TIme

Obviously, I've been sort of absent here the last few weeks. Sorry about that.

I would much have preferred that the reason for my neglect was due to a long, quiet, and peaceful spa vacation...but, no. I wasn't anywhere exotic, peaceful, or quiet.

Except for when I was at Symphony. While not exactly exotic or quiet, it was definitely a treasured respite! And our concert was the most fun so far!

Otherwise, I've been here, sort of. Dumping what little energy I could manage to muster into finding a way back to where I really want to be. Back to me, and my family. To energy, vitality, and being able to fully function again.

It's a dig I've made before, several times in fact, but this time has definitely been deeper, darker, and more disabling than ever.

I really don't like the term Depression.

In the clinical sense.

As in the name of this condition which an ever rising portion of the world's population is suffering from.

The word depressed has a few, specific definitions.

depressed [ dih-prest ] adjective 1. sad and gloomy; dejected; downcast. 2. pressed down, or situated lower than the general surface. 3. lowered in force, amount, etc. (from dictionary.com)

The illness, however is not so specific. Defining it is more challenging. There is not exactly a one size fits all description. Nor is there a specific look to it. It isn't caused by a simple, traceable, virus or bacterium.

No, it can take multiple forms.  Can vary in severity from person to person, and from one period in an individual's life to another. Individuals can manifest a vast array of symptoms. And each person responds differently.

I want it renamed. I want it to have a medical terminology.

How about Chronic Pervasive Neurochemical Dysfunction? Or Effective Emotive Imbalance? Pervasive Neuroemotive Disorder?

Scientists don't call them germs anymore. They are viruses and bacteria and fungi and pathogens.

It is considered extremely insulting in multiple ways to refer to Down Syndrome as Mongolism.

And Tuberculosis hasn't been called Consumption for several generations.

Heck, even an ingrown nail has a medical term - Onychocryptosis!!

How is it that this condition, which is clearly an illness, a true malfunctioning of brain chemicals and hormone imbalance, often coupled with mild to severe emotional imbalance, is still referred to by an archaic and inept term that has created and prolonged a stigma that keeps hundreds of thousands of individuals from seeking help? Even from accepting the possibility that what they are experiencing is real, legitimate, and treatable? And keeps those who don't have it from really understanding?

Why do I care?

Because a not so tiny number of people I love and/or are close to suffer or have suffered from this condition.

And so do I.

I have suffered from it to a larger or smaller degree for at least thirteen years.

I didn't know I had "depression" for many years. Why not? Didn't I have symptoms?

Yes I did. But the few times I did seek medical care for it, other things were investigated. Other things were blamed. 

Because I wasn't sad.

Because I didn't cry all the time for no reason.

Because all I really felt was exhausted and angry. In fact, it was hard for me to feel much of anything because I was so tired all the time or irritated about everything!

And headaches. Horrible headaches that turned into body aches. They were almost migraines, in that light caused a great deal of pain and sounds were awful.

It first happened very shortly after we got married and I tried birth control pills. This was my first stint in the void.

Shortly thereafter we decided we wanted to start a family after all which was great because I was done with those pills of horror. My condition improved considerably.

Not long after Zak was born I started feeling exhausted all the time. Beyond exhausted. I couldn't think strait. I couldn't stop thoughts about things happening to Zak from just popping into my head at the most random times. So I HAD to check on him ALL the time, even though I knew he was fine. But I blamed my overactive imagination and first time motherhood paranoia. It didn't occur to me to mention this to my doctor. But the exhaustion was seriously concerning me.

So my thyroid was checked. Normal.

My iron was checked multiple times. Better than normal.

I was asked if I felt depressed. Or sad? No, I was not sad. I did not feel depressed. I felt exhausted!

I was told to get more sleep.  Exercise and lose weight.

But I couldn't sleep, no matter how tired I was. And when I finally did sleep, it never felt like enough, no matter how long I slept.I tried to lose weight. And had limited success. Exercise was exhausting. Everything was exhausting. I was in a constant fog that wouldn't clear. I couldn't remember the days events, and it took enormous concentration to attend to basic tasks.

I began to believe that this was my new normal. That I would just have to live there and deal with it.

The slip into the void that time started about four months after Zak was born, maybe before. About eighteen months after Zak was born I started another attempt at loosing the baby weight. I made some minor dietary changes like switching to whole wheat products, started cooking more homemade meals, and more fresh fruits and veggies.But mostly I focused on walking. I took my dog for a walk to the end of our road and back at least two to three times a week. We bought a treadmill for the times I couldn't walk outside, which for me was most of the summer.

I didn't actively notice the fog lift. And I didn't lose a whole lot of weight. But one day I realized that I was in the clear again. I wasn't exhausted all the time.  I could pack my days full of activities and go to bed tired in that "ahh, what a good day" way. I was reading again. Writing again. Living again, instead of just surviving days.

Around that time, an issue of AWAKE! came out on mood disorders. And on one of the pages it had a list of symptoms of depression, and for the first time ever I saw the things I had felt most but the doctors had ignored, excessive fatigue, unexplained feeling of slowing down, insomnia, and inability to concentrate. 

Though at the time I was finally feeling more like myself, I felt pretty sure that I had suffered from prolonged and untreated postpartum depression, despite the seeming lack of "sadness".  And I felt that now that I knew my signs, I could better prepare and have a plan of action the next time around.

What I tried not to think about was the year and a half that I have relatively few memories of  except for what was captured in pictures. The year and a half that Zak had a mom who was "depressed" and just forced her way through day after day because she had a baby who couldn't take care of himself. Thinking about that time still makes my heart a little heavy. I don't get that time I missed back.

When Grace came along my doctor and I were better prepared. She started me on the Progesterone-only birth control pill as soon as my milk came in and we were nursing well. Not so much for birth control as hormone balance. She didn't want my hormone drop after birth to be too severe.

It helped. I only skirted the void then, but managed to avoid getting sucked in. It helped enormously that I'd had an easy birth and I healed quickly.  I was able to resume a walking routine fairly quickly.

Things were pretty good in my brain for a while. Kind of. I'd slip into a funk for a while, remember that I needed to exercise, and start to feel better for a while. But I always felt the fog nearby. Sometimes closer, sometimes farther, but always somewhat on the horizon.

When Grace was about two and a half I decided to try regular birth control again because the mini-pill is not forgiving if one forgets to take it, and I wasn't so great at remembering that I had forgotten within the three hour window. :/

Birth control pills are NOT good for me. This time even Victor seemed astounded at how I had plummeted into the void and begged me to throw them away and not take another single one. I did throw them away. But it took me a few months to regain my stability.

I was shaky for a while. I would get a good routine going in the fall and winter, but nearly every summer I collapsed.

Kit was a surprise. A huge surprise! I called her a phrase I learned from my mom, "our Blessing we weren't praying for."

I had a very hard pregnancy with her. I was the sickest I had ever been and for the longest, well into the second trimester.  And my last three months of being pregnant were in June, July, and August! It was about a thousand degrees and five hundred percent humidity! I cried a great deal all those months, but I had many reasons for it. Not because I didn't want to have another baby, I really did. But timing was bad, we had to move, everything had to change. And I was dealing with some huge personal obstacles as well.

Since she was born, my fog has hardly lifted. For a long time I was driven purely by necessity and adrenaline (and vast amounts of coffee). Her challenges were intense from very early on and when one seemed to ease another quickly took it's place.

I managed to stay engaged. To keep the fog just a bit behind. I threw myself into fixing up the new house. School. Making new friends here.  And a passionate search for answers to ever growing challenges with Kit, and newly enlightened ones with Zak.

Of course, if that wasn't enough, here comes Grandpa into the mix. And yadda yadda yadda. I hit bottom in July. I couldn't read. I couldn't make another phone call. I couldn't blog. I couldn't think. I couldn't study. I struggled to pray. I couldn't go anywhere. I couldn't talk to anyone about anything happening in my life without ending up in tears. The void had me in it's grip once more and it was holing on tight this time.

I knew I needed to eat right. I knew I needed to exercise.  I needed to talk to other people. I needed to take care of myself. But I couldn't. I couldn't put two thoughts together. I couldn't do more than one thing a day, and the kids always were that one thing. I became somewhat numb to everything else in order to just be able to focus on that one thing a day.

Little by little, I could do more. When Miss V started coming and working with Kit, I started to climb up a bit. And then Symphony practice started up again and gave me an evening of respite and music which helped too.

Then came winter, usually my most active and most functional time. But not this time. This time winter brought a lot of pain and tragedy. And unlike all the rest of the world, I didn't get snow. I didn't get that blanket that forces the world to slow down. That makes a blank canvas for just a little while. Covering the deep cuts and insulating them so that they can heal just a bit. I have never craved snow more than this past winter and every time, it passed me over.

And now summer threatens. Spring is crawling in and the air is getting thick and my breaths shorter and harder to take, literally and figuratively. I do feel trapped.

Like an aquarium dolphin or captured bird. I have everything I need to survive. I even have enrichment activities. Challenges to engage me. Nevertheless, my heart is in the ocean and air and everything else feels artificial. Only for me it's my mind that has been caged, and I'm trying so hard to set it free.

Depression has me. For months now I have felt like it's prisoner. For years we have battled.

I made one of the hardest phone calls a few weeks ago. To a doctor's office, for an appointment to talk with a therapist.

That one act gave me a boost. so I started doing something that didn't require anything but earphones and my phone. I started researching. It's what I do, after all. And what I found was answers. Clear. Completely doable steps that could help me dig my way out.

The next step simply involved going outside. Sitting outside for half an hour to an hour in the bright outdoor light. And within a few days, I had more momentum than I have felt in weeks. I was far from functional, but I was moving forward again.

This momentum came in handy when the day rolled around for my first meeting with the therapist. I was able to go and actually feel clear headed and purposeful, even though I was plenty uncomfortable.

Yes. It was uncomfortable. It was difficult. And overwhelming. But in a small way, it also felt like another small step in the right direction. I certainly didn't feel great. And it feels unsettling to think of allowing someone else access to this vault of mine. But if I learn how to fight this monster better, if I gain tools to help me climb back out, then it is a good investment. For myself and everyone I love and who depends on me.

For a long time, I thought that because I knew what it "looked" like in me, that I could fight it alone. That because I had chased it away before, I would be able to again. But it never really left. It just rested.

I didn't talk to others about it much. I kept it close under guard. But it has broken out and I am not able to pretend that it hasn't taken over. 

I'm still not sad. I have moments of sadness like everyone else. I've had some horribly sad moments this past year. But I don't keep on feeling sad. So why is my illness a synonym for sadness?

I don't feel depressed. That is how I feel when I realize the coffee pot is empty. It is short-lived and temporary. This is not anything like that at all.

But maybe I just don't really know what the different kinds of sadness are. Or maybe I'm in denial. I'm not above denial.

I do know what it feels like to hurt, inside and out. I was having headaches all the time again (though these have enormously improved since I've implemented the changes I'll discuss soon). I was irritated and short fused, but held it in, trying not to explode on others. I am beyond exhausted. I see a thousand things that need doing, and I even want to do them, but I can't. No matter how I try to will it. And that just makes me angry again.

So I'm enlisting help. To help me find a release valve. And to help me sort out the cumulative mess. And a major source of that help at the moment is in the form of implementing the steps in a program called Therapeutic Lifestyle Change. I will explain this in more detail in the following post, but I'm already experiencing a huge reduction in my depressive symptoms. In fact I went from a 42/60 (60 being bad) to a 23/60 in two and a half weeks. A good portion of this is also just due to the mental shift in feeling like my wheels are turning again, which is healing in itself.

Also we will see where my visits with my one-on-one therapist lead and what further tools or insights it might provide. 

Opening this box inside me has been hard and will continue to be hard. It means being vulnerable,  which I'm very afraid of. It means letting others help, which is overwhelming. It means a lot of things that cause me anxiety and fear.

But, I'm more afraid of further gaps in my memory. Of not being productive and totally engaged with my family. Of missing out on moments that will never come again. Of not really living. I am so much more afraid of my kids looking back and remembering sadly when mom was really "depressed" and we didn't go anywhere or do anything fun.

I hate that an illness this big and consuming and potentially damaging in so many ways is referred to by such a singularly defined term. Why isn't a "flare up" of this illness viewed, by people in general, as legitimate as sufferers of MS or Fibromyalgia?  Why are individuals, who are suffering physical pain and accruing brain damage due to depression when untreated, simply viewed as weak willed instead of ill? Why do we feel the need to hide our illness and our treatment choices, afraid of judgment?

It's not a weakness. It's not a woman's problem (men are quite susceptible but even less likely to seek treatment, mainly because of the stigma). It's not a matter of simply deciding to do something. I decided to call to set up one-on-one therapy over two months ago, but the entire process was so daunting, and demanded a measure of function which I simply couldn't summon.

Depression is a complex imbalance of multiple hormones and lack of appropriate regulation of chemicals in the brain that impairs brain function. It is caused by genetic predisposition, trauma, stress, inflammation, environmental and lifestyle factors among other things. It is an illness. And it is treatable.

So once again, I am starting treatment for my illness. A more intense treatment than ever before, that goes beyond eating better and exercise. (And also puts a limit on my consumption of coffee! Ahhhh!)

I will likely always have to continue my treatment regimen, though perhaps, I won't always have to include a therapist.  I may have this illness for a long time. But I know I'll be okay, as long as it doesn't continue to have me.



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