This And That

I wonder sometimes what people's impression is of me especially those that come from a search engine or what have you and read only one post before taking off. The comment section gives me a pretty good idea sometimes as people send forth advice for that one small segment of my life and my battle. Normally the suggestions are pretty good and may actually help if that was the only situation but of course it is not.

When I started this blog some seven months ago part of the intention was to give a realistic view of what it is like living with a multitude of mental disorders and to hopefully show the complexity of the situation. I am not someone with major depressive disorder or borderline personality disorder or generalized anxiety disorder or even post traumatic stress disorder but my illness is a combination of all four. On their own each disorder has a somewhat standard treatment plan but when they are combined the answers become a lot more hidden. The depression aspect is complicated by the borderline diagnosis for at least in my doctors opinion stands in the way of any sort of talk therapy as I may be too busy looking for a personal attack then concentrating on the actual work needed to be done. The borderline diagnosis on its own is difficult enough but again it is shifted into a difficult monster by the post traumatic stress disorder as the negative self image can go through archives of old traumas to really put me into a hole that is difficult to get out of which then adds to a depression level that borderlines on danger. The generalized anxiety disorder is fueled by the borderline and post traumatic demons as it keeps me on my toes waiting for the next onslaught to hit. Spend all of your time waiting for something bad to happen and guess what something bad will happen.

Each disorder has its own stigma and the majority of them are completely off base. I would imagine when someone hears my diagnosis they can not decide which box to put me in and that is the point of this blog. Yep I have four concurrent mental disorders and they play a huge role in my life but if you can take the time to see past all of the fancy words and see me for who I am then you might be pleasantly surprised with what you find. For whatever the reason this situation has been put on me so I do what I do best which is fight and the decision to make this a public affair in the hopes that people will stop looking at the disorders and start to look at the human being behind the labels battling to get their life back on track. Take care.

Free Writing June 25

I woke up this morning and I wanted to go back to bed. The sun is shining and there is very few clouds in the sky yet my world seems so dark. I scour through my thought processes looking for a reason for this shift in mood and perception yet I came up with nothing. Could it be that my depression is more of a chemical issue then one of poorly developed coping mechanisms and emotional skills? Effexor, Paxil, Remeron, Wellbutrin, Nardil and Celexa have all taken a shot at figuring out the chemistry of my brain with no success at least not long term success. I could sit here for hours coming up with a million and one different reasons what is at the soul of the monster yet the one which would ring the truest is some days I control my illness and some days it controls me.

(Free writing is basically an exercise that I use to clear my brain, a literary punching bag if you will. All I know is after the exercise is completed I normally start to feel better)

The Approaching Storm

When my major depressive episode started I felt that it came out of no where but when I looked back I realized there was a number of signs that either I ignored or missed that may have led to a different outcome if I did something then and not waited til it was to late. This list is some of the indicators that I was about to run into a storm:

1. Sleep - Sleep became my biggest enemy for either it would take hours to actually fall asleep or once I was asleep the nightmares made me wish I was still awake.

2. Sick - I have no idea how many times I called in to work sick but the number should have been an indicator something was wrong. Seemed every week it was a new cold or bug and the bout with shingles that kept my body constantly fighting.

3. Patience - Or lack of. No matter how small the incident was it would get under my skin in a heartbeat. Too much energy was spent trying to keep my temper under control.

4. Major Events - I think my depression really started to gear up about two years before the major breakdown. In a matter of six months I buried my father, grandfather, graduated college, got married and started a new career. The events in themselves were probably not to blame but the habit of ignoring the stress and trying to plow through is more then likely the guilty culprit.

5. Disconnected - Nothing felt real. No matter what happened it felt like I was watching it on a television screen and not actually living it. Moments that would normally bring some joy into my life barely registered.

6. Death - It started as stupid little thoughts but before I knew it this topic seemed to be the only one running through my head. Strange conversations in my brain basically planning how I would react if someone close to me passed on and then it turned into my own fear of death except there was no fear.

7. Pushing People Away - I was so preoccupied with the growing battle in my head that I started to separate myself from others. Was stuck on the stupid belief that I was going to beat this thing on my own but soon found out the hard way that this was not possible.

There are many signs and they are going to differ a bit from person to person but the one lesson I have learned is that the easier it is caught the easier it is to treat. I should have recognized what was taking place as it happened but instead of trying to extinguish the flames I added gasoline to the fire. Take care.

Mental Health Journey

With my blog being featured over at The Experience Project I think this is a good time to reintroduce myself. Many of the major areas of my life have been detailed to a certain degree throughout the brief history of this blog but I will use this post as a way to summarize my journey so far.

I have been dealing with depression for as long as I can remember. My family history has mental illness on both sides going back for generations. Chances are I was depressed the day I came out of the womb and have been unable to get rid of this silent monster since.

Self harm started when I was seven or eight with the intention of punishing myself so I would be a "good" child and maybe people in my life would finally leave me alone. Needless to say this did not work. When I was twelve or so I tried to end my life and somewhere in the process I realized that as the blood left my body a sort of cleansing occurred which seemed to make me feel better. What I did not realize is this new monster would stick around for the next two decades.

To be honest I have no idea why I am still alive and there are pieces of my past that are a complete blur. Sometime in my mid twenties I seemed to have found the ambition to get my life back on track. I enrolled in college in Social Service Worker program with the intent of not only figuring out my own mind but also to be in a position to help those in need. The material of the course came very easy to me and I seemed to be flying through the program. In the last semester of college my father passed away and I did what I have always done which is completely ignore the emotional turmoil by throwing myself into another aspect of my life.

I graduated from college in May near the top of the class, in June I started to work at a group home for troubled teens and in July I married my long term girlfriend. For a while I thought my life was finally on track and everything seemed to be perfect. About a year and a half after we were married we were blessed with a beautiful baby boy.

Then things started to go wrong. I was constantly sick and had a lot of problems getting to sleep at night then when I did get to sleep the nightmares made Freddy Kruger look like Big Bird. When my son was about a year and a half I booked an appointment with my family doctor for at this point I knew I was in trouble and was very quickly losing control over all aspects of my life. After a brief meeting with the doctor I admitted that on the way there I was tempted to pull in front of every eighteen wheeler that passed on the opposite side of the road and the suicidal ideations were becoming a normal part of my life. The doctor immediately pulled me off of work, prescribed an antidepressant and made a referral to a mental health doctor. I honestly thought at this point that the med would kick in and I would be back to work in a matter of months but that was not the case.

I met with the mental health doctor a couple of months later and was diagnosed with severe Major Depression Disorder with psychotic features. He switched my medication and so began the experimentation of mental drugs that I have been on over the last few years. A couple of months later Paxil was tried and it effected me in a negative and dangerous way. Within a week of being on this med my self harm behavior went through the roof and it was impossible to tell which mood state I would be in from one moment to the next. With my wife basically threatening to leave if I did not enter a hospital setting plus the push from the doctor I agreed to be admitted into the hospital.

For the next two months I went through talk therapy numerous times per week, a variety of medication was tried and I went through five sessions of ECT. ECT is Electro Convulsive Therapy or what use to be known as shock therapy. After the fifth session it was stopped as I was taking a very long time for me to regain consciousness plus there did not appear to be any real positive changes. At the end of the two months I convinced a floater doctor that I was perfectly healthy and he signed my release papers which pissed off both my doctor and my wife.

A few months after the hospitalization all of the negative behavior had reappeared and the medication that I left the hospital on was beginning to lose its effectiveness. My wife took our child and left as my behavior was to unpredictable. My now ex wife did not make this decision hastily and in a lot of ways I basically pushed her out the door (thats another post).

I went through a number of mental health "professionals" in this period with the first one being arranged by the therapist in the hospital. This is going to sound terrible but it is the way it was and is, I admitted in the third appointment that during a rough period I resorted to self harm to get through the situation. Once I told the therapist this she basically ended the session as she felt I was not stable enough to treat. The next few therapists would reach the same conclusion and stopped treating me.

Fast forward a couple of years and another bad self harm session that through the doctors eyes looked like I tried to take my life again. So back on the psych ward I went but this time it was located in the city's main hospital that did not have a full time therapist on duty because of budget cuts and it makes too much sense. Some time during this admission I decided to tell my mental health doctor absolutely everything that I have been though during the course of my life. The first version was basically just the facts with little to no detail and due to his positive reaction stating he learned more about me in those few pages then he had in the two and a half years prior. I wrote out the second edition which gave details to the facts but still not disclosing everything. Again the doctor encouraged me to keep writing so I started the final version. This last version was pretty intense to say the least and an example would be I talked about my grandfather which is one of the best relationships in my life and a couple of pages took hours to write for every single detail I tried to include in the section. Each day I would submit a new section to my doctor who would read it carefully then gave his take on it. When I finally finished this last book on my life he advised me to give it to every mental health professional that was trying to help me so they would be able to treat me more effectively.

So I figured that no one knew my brain like I do I decided to create a treatment plan that would lead to recovery. I wrote out all of my issues and what would be the best way of treating them. I handed the paper over to my doctor who completely agreed about my plan but then stated that this city's mental health system would be unable to provide the specialized help that I needed. Another part of the treatment plan was to list out the diagnosis that I felt fit me and to this day I wonder if this was a mistake for everything was about to change.

The diagnosis that I listed were Severe Major Depressive Disorder with Psychotic features which had already been diagnosed a couple of years earlier. Post Traumatic Stress Disorder which was rather obvious if you look at the amount of abuse I have been through plus the flashbacks and nightmares. Generalized Anxiety disorder which tends to go with PTSD. The last diagnosis I listed was Borderline Personality Disorder and the second my doctor saw it his face lit up like a light bulb and declared it a perfect fit.

Due to the hospital not being able to provide the type of treatment that I needed I decided I would be better off back at home and seeking more specialized help in the community which my doctor agreed to. After a month of trying to contact every therapist around plus using a variety of mental health agencies for assistance I returned to my doctors office very frustrated. I told him about my problems finding help and he replied "Your too Borderline for treatment to be effective". Over the next couple of months he would add "Your going to have good periods, then your going to have bad periods which will cause you to crash and a hospitalization will be needed to stabilize you and then the cycle will repeat". Basically the goal is not to "cure my problems" but to avoid the hospital as long as possible. In my doctors eyes I am untreatable.

Do I believe the "untreatable" label? It really depends on the day. Over the last six months I have worked through various aspects of my life and I do see a light at the end of the tunnel but at the same time there are times when all of the movement I make seems to be backwards.

This blog was created so I would have a place to empty out my brain instead of trying to swallow the emotions/turmoil, a place where I can write everything down so I could analyze and try to correct any faulty thinking patterns. This blog is my therapy and for whatever the reason a lot of people seem to relate to it so at the very least I know the last three years has not been a complete failure.

Sorry for all the jumping around and like I mentioned earlier most of the above has been broken down in other posts that I have written. Any comments or questions do not hesitate to ask and I wish you all the best in your own journey. Take care

Defining Depression

I remember the first time that I met my mental health doctor he asked me to tell him what I was feeling. I sat there for what felt like forever and finally replied that I did not feel anything at all which was the only thing that I could come up with. Thinking back I realized that a very simple question required a rather complex answer.

The goal of this post is to come up with a list of examples of answers that I could have used when my doctor asked that simple yet very important question.

1. I feel that I am watching my life like it is a movie. Trapped in a theater seat unable to change the outcome of what is taking place in front of me.

2. That I am dying. That pieces of my soul are slowly leaving my body and soon there will be nothing left of me.

3. That I am in a battle for my life, a life I have no interest in saving.

4. It hurts. Every aspect of my life is being ripped away and there is nothing that I can do about it. Trying to put a smile on my face feels like I am stabbing myself in the heart.

5. I am tired. Seems like every waking moment I am battling against the negative thoughts that are rushing through my brain at an unbelievable rate of speed. I just want it to stop. I just want to close my eyes and make it all go away.

6. Nothing. I am not happy and I am not sad. I am no longer a human being but a machine that is stuck going through the motions.

7. I can't see tomorrow. It is like my entire future has been erased and the only thing that exist is the hell I currently occupy and this will be my life from here on in.

Lots of different answers to one simple question. Take care.

The No No List Regarding Treatment Of The Mentally Unwell

First day of the exercise program is in the books and my legs are currently on fire. Anyway it is another busy house day with people wanting to come and view plus I have to make everything spic and span so I need to get at it. One of my favorite posts from the past:

What Not To Do When Dealing With Someone Who Is Mentally Unwell


1. Baby us - I understand that I am sick and you are trying to help but by treating me like an infant reinforces my own thoughts that I am basically useless

2. Speak louder then normal - I have severe depression, post traumatic stress disorder, borderline personality disorder and generalized anxiety disorder none of which effect my hearing or will get your advice/suggestion/support through quicker

3. Speak to me slower then normal - Again I have multiple of disorders that at time distorts my thinking or perception but none of which affected my intelligence level. Treat me like an idiot and I will make you look stupid.

4. Treat me like I am going to break - A wrong comment or a slight slip is not going to send me running for the deep end. Trust me the garbage I tell myself is a hundred times worse then anything you can say.

5. Use cliches - Telling me to pull up my boots and charge forward or to just focus on the positive reinforces the idea that I need to surround myself with smarter people who understand the difference between a case of the blues and severe depression. If it was that easy do you really think I would still be in the same position.

6. Forget who you are talking too - The person that you remember from five years ago is the same one standing in front of you. When the diagnosis was dropped on me with borderline personality disorder the only thing that changed is now I am fortunate enough to carry a suitcase full of stigma with me. Hate to break it to you but I have always been borderline and the only difference is the way you now look at me.

7. Leave me alone - When a person enters the dark world of depression the first thing they do is isolate themselves to simplify their own world. By giving me space to figure out things on my own reinforces the negative thoughts in my head saying I am alone fighting a battle that I am positive that I will lose. A simple phone call reminds me that there are reasons to keep fighting and that when I need it someone is there.

8. Focus on the disorders - The best part of dealing with other people means I can allow my attention to go elsewhere for a while and not the battle in my head. The story of your child's trip to the library is as helpful to my recovery as any med.

9. Ignore the warning signs - If I am doing something that appears to be negative and on a path that leads to nothing good then be my friend and speak up. I spend so much time in a bad head space that at times I do not realize the danger that I am in as it all seems normal to me.

10. Believe the stigma - According to the borderline stigma I have no heart and I am incapable of appreciating the needs of another human being as I only care what effects me. If this is so then can you explain to me the reason behind this blog where I am literally exposing my soul in order to make life a little bit easier for someone else. I am not an exception to the rule when it comes to borderline but the portrait the stigma portrays is the exception. Always look for the human being and then the disorders not the other way around. Remember mental illness effects one out of five people so tomorrow someone you love could be in my shoes and how would you like people to treat them?

Well there is my top ten and I am sure if my brain was working I could add to it. hope you enjoyed it and take care.

PBS's Depression Special

This program (link to the site) has been pushed by a number of different organizations over the last couple of weeks and it finally aired last night. I will always support programs such as these that promote more awareness about mental illness but to say it was worth the hype would be a lie.

One of the doctors summed up part of my concern when he said "Depression is used to describe a little boy on a rainy day and an adult who has been stricken to the point where he is unable to do the simplest of things (not an exact quote but you get the idea). The thing is to me is there is a difference between depression and major depressive disorder which this program could have done a great service by separating the two which would have gone a long way of reducing the stigma attached to this condition. To me it is very simple depression can cost you a box of Kleenex where as Major Depressive Disorder can cost you your life. The people showcased on this program suffer from Major Depressive Disorder and the difficulty of their struggles showed through pretty clearly which at times made it difficult for me to watch as I have been done the same path once to often.

When it came to treatment the program did a good job by showing a wide variety of options with the warning that not all methods work for everyone. For awhile when they were discussing the various medications a part of me was beginning to wonder which pharmaceutical company was sponsoring the program but PBS did a good job talking about the length of time it takes for an antidepressant to work plus the difficulty of finding the right med. Part of me smiled when the doctor said prescribing the right med is basically like flipping a coin for if you have been through the trials of finding that right drug will swear that is what the doctor is doing.

The two other treatments that came up were Electro Convulsive Therapy (ECT) and Deep Brain Stimulation (DBT). ECT has been around for a long time and yes it is a lot safer then what it use to be and no longer completely resembles the scene from One Flew Over The Cuckoo's Nest the program put too nice of a shine on it. I believe they used the stat that eighty percent of people will have positive results from the treatment is no where near the actual results. They mentioned the main side effect of ECT is possible short term memory loss but they failed to bring up the other side effects that the hospital will have you sign a waiver on to clear their legal responsibility such as broken bones, chipped teeth and of course death. Those who have been following my blog for a while can probably recall where I stopped breathing after my last and final session of ECT which is not exactly a common occurrence but it does happen. Deep Brain Stimulation has been on the outside looking in for a number of years now and even though the show does admit it is highly experimental they seemed to push it a little bit too hard for my liking. DBS is still in the testing face and depending on where you live is probably a least a decade away if it is ever fully approved. To be honest I would volunteer for this procedure after watching the program but there are also days when I believe a lobotomy is a viable option.

A strange part of this program is they kept repeating how talk therapy is a key to a lot of peoples success but other then showing clips of the participants in treatment really did not devote much time to why it works or the number of available therapies out there. I would imagine if you look at the numbers talk therapy success numbers are higher then medication, ECT and DBT. Medication does not cure people but it may put them in the place where talk therapy is possible and even if ECT or DBT is effective if the way the brain handles thoughts is not corrected your just asking for a relapse but that is just my opinion.

Anyway this show was okay and it did a good job of showing the power of depression, the many ways people are effected, the difficulty of finding the right treatment and the potential options that are out there. Take care.

I Need To Get Out Of My Head

My mind is similar to a haunted house as you never do know what is waiting around the next corner or that closed closet door. Every time I think I have found the way out it turns out to be an illusion for the path that leads to recovery is full of smoke and mirrors. Opening the wrong door leads to the past coming straight at me like a runaway train. Images from the past that I am still unable to justify after three long decades. The power and strength that I have built up throughout this battle are shattered as easily as the mirror that hold my self image. Crawling through glass trying to make sense out of the broken pieces while my soul is slowly being torn apart.

Who I was, who I am and who I want to be is a puzzle that has to many false pieces. I keep working away trying to figure out what this picture will finally look like if it is ever completed. The self image that I created to keep me safe can no longer stand on its own for I recognize it for what it is which is who I wanted to be and not who I was. The little boy who was shoved deep into a closet in order to keep him out of harms way never had the change to grow and develop like he should have. Emotions that should make complete sense by now still appear like a mystery for all that mattered was what others thought and not what my heart was trying to say. The real me seemed to bring up the wrong emotions in the people entrusted with my care and well being so I did the only thing I could and became what they wanted me to be.

Now I am lost and searching for who I am suppose to be according to me. What parts of my personality are real and which ones are just an illusion to keep others away. Why do I stick to the "I do not care what others think about me" yet seem to be constantly searching for some kind of confirmation that I am a good person who is worthy. The fear that I will finally figure out who I am right down to the smallest particle then come to the realization that I hate who I am. Tired of spending every waking moment trying to make sense of the garbage that runs through my mind. Tired of using all of my energy fighting this invisible monster known as mental illness and I am tired of trying to convince myself that one day I am going to win. I need to figure out a way to stop living in my head. Take care.

Keeping The Monster Quiet

Since I have started this blog one of the main purposes was to hopefully lessen the stigma that surrounds mental illness for the main reason is that it is killing people. Depression and I am talking about Major Depressive Disorder hits with such a force that it literally sends you spinning for a long time to come but it is treatable. The problem is there is so much garbage out there regarding depression that a lot of people are basically ashamed that they are ill so they try to keep the battle a very private one and in some cases this leads to suicide.

I have been fighting depression for the majority of my life and for the most part I keep it a quiet one. Year after year I tried to figure out why I was never happy and why the smallest thing would send me to an awful place. I went to college for Social Work and the two main reasons were (1) To help others (2) To help myself. I thought if I could learn all of the counseling techniques, a strong understanding of mental illness and the "secrets" to getting people over that hump I would be able to fix my own situation. It did not work and if anything it made it worse.

I went back to the old pattern of any difficult emotion instead of dealing with it I just would push it way back into my brain with the dumb belief that it would just disappear which obviously did not work. I was recently married, a father to a very young baby and I spent my work week with teens who were dealing with a high volume of problems both behavioral and emotional yet for a long time I put forward a image that I was in control and stable but I was far from it.

During the six months before my eventual break I was having nightmare after nightmare and it was becoming increasingly difficult to control my emotions. I knew I needed help and made an appointment with my family doctor to get a prescription for an anti depressant which I thought would fix the problem. The days before the appointment I was still trying to convince myself that the problem was small and ignoring all of the signs that I was in a battle that had the ability to destroy me.

My family doctor lives in on the outskirts of the city I live in so I had to drive on a highway to get to his office. On the way there my thoughts went from this is a small problem to if I swerved in front of that eighteen wheeler then my problems would be gone. By the time I reached his office I was a complete wreck. This doctor who has known me for a long time realized that even though I was trying to put across a small problem the situation was much larger. The doctor pulled me off of work, prescribed an anti depressant (Celexa) and referred me to a mental health doctor. It has been three years since this appointment.

*Bonus* Here is the website that is putting out a documentary detailing the battle of the high rate of suicide of doctors (Struggling in Silence)

How To Make Depression Worse

I was thinking that there are a lot of blogs and lists out there on how to overcome depression but I do not remember any on how to actually make your depression worse. The whole reverse psychology thing comes to mind here that or maybe I have finally lost my mind anyway on with the list.

1. Completely isolate yourself - One of the worse things that you can do is complete cut off all ties with society so your completely alone with your own thoughts. Wonderful idea and boy does it leave a mark.

2. Believing the depression is going to go away on its own - This may work with cases of the blues where the person just needs a little bit of time and a Kleenex box to work through it but this will not work with Major Depressive Disorder. The solution might be medication or therapy or a combination of the two but the second you sit back and wait the illness is going to kick your butt.

3. Refusing to accept there is a problem - Ever had a car that was making a funny noise up front that you pretended was not there then the next thing you know it your in some garage with the credit card out and tears running down your face? Yep mental illness works the same way. Push to the side all of those little warning signs instead of catching it early will cost you in the long run.

4. Don't tell anyone your fighting - Facing these demons on your own may seem like the manly thing to do but it is also one of the dumbest. A major difference in recovery is how strong your support system is and it is okay to reach out asking for help as it may in the end save your life. Can't tell your friends of your struggle then reach out to the online forums and groups where there are tons of people who understand what you are going through.

5. Believing medication alone is going to solve your depression issue - This one is bound to piss someone off but at least in my opinion it is true. Medication is good for making the symptoms have less impact where then you can get the real work done either through a therapist or even on your own through various blogs, websites, groups and the list goes on. Like I have always said medication makes therapy possible.

Well that is it for me as the game is about to begin. Just keep in mind depression is a very real life threatening illness but it is also treatable. Take care.

A Depression Cure?

I found this article on MSNBC tonight and decided to pass it on:

‘Brain pacemaker’ could ease depression
Two large studies show deep brain stimulation helps severely depressed

CHICAGO - Two of the largest and longest studies so far show a “brain pacemaker” can effectively treat depression and obsessive-compulsive disorder, researchers said on Friday.

Devices implanted in the chest, with leads that send electrical impulses to parts of the brain, have already been approved to treat movement disorders, such as Parkinson’s disease, essential tremor and dystonia.

Dr. Ali Rezai, head of neurosurgery at the Cleveland Clinic, who led the studies, said the technique known as deep brain stimulation helped the most severely depressed patients improve significantly.

Researchers from Butler Hospital/Brown Medical School, Massachusetts General Hospital and Harvard Medical School were also involved in the depression study.

Seventeen paarea of the brain and is likely to generate similar findings.

He said there were no serious side effects in using the Medtronic device.

The trial treating OCD included 26 patients who were followed for three years and also showed marked improvement.

Butler Hospital/Brown University, University of Florida and University of Leuven also contributed to the OCD study.

Medtronic has an application before the U.S. Food and Drug Administration for approval to use deep brain stimulation for OCD.

A clinical trial using the treatment for severe depression will be initiated this year.

The FDA in 2005 approved Cyberonics Inc implantable device for treatment-resistant depression. It sends signals to the brain via the vagus nerve in the neck.

Original post on MSNBC

To be honest I am not sure this is something that I would be willing to try but heck catch me on the right day you never know. I have gone through countless amounts of different meds and numerous sessions of Electro Convulsive Therapy with nothing really being effective long term. Maybe this is the missing piece of the puzzle but the chance of this treatment being available north of the border is probably not very likely especially in the area that I am currently living in.

So the question is my wonderful readers is if your doctor offered you this treatment would you accept? Take care.

Suicide

Suicide has popped back up into the landscape of my family as someone who is connected at a distance made the choice to take his own life. I hate talking about suicide and there are a couple of reasons for this: A) Suicide is a reality in my life and when you look at the statistics I am definitely in the at risk group. B) Part of my illness is the constant suicide ideation which is pretty much a daily occurrence and has been for a long time so I spend a lot of time trying not to think about it. That being said this is a topic that really needs to be brought more out in the open as the numbers of people taking this route off the planet is not getting any smaller.

For a lot of people who deal with mental health issues suicide may be a step away. One major event or one major loss may be all it takes to make the ultimate decision. Through the years I have gone down the list of the thousand reasons not to end my own life and I am down to one that I am not able to justify. Thankfully that one reason will keep me going for a very long time and it is I am not willing to drop that bomb on my child as I know the rate of suicide is substantially higher for people whose parents took their own life plus the damage it can do to a persons psyche will follow them around for a very long time to come.

Hope also keeps me going and at times makes this battle with the demon a little bit easier. The belief that tomorrow may be a better day and I need to be part of this life to find out.

A while back on a health forum someone asked why people with specific mental illnesses talk about suicide so often and are almost joyful when they do so. The simple answer is suicide seems like the best answer to make the pain stop and to stop the tornado that is ripping through their soul. Suicide is not about giving up it is about making the pain stop but unfortunately it is a decision that has permanent consequences.

When suicide becomes the best option it is a clear indicator it is time to hand over the reins of your life to someone else for awhile. Visits to the psych ward are not exactly fun filled events but if the trip is going to help you get your life back then it is well worth the effort.

The things that mean the most to us are those that we worked the hardest for. Life is full of ups and downs but it is the downs that make us appreciate the ups. Like I said earlier tomorrow may be a better day but you need to be apart of this world to experience it. Take care.

SUICIDE HOTLINES

ps - I do apologize for this post being all over a place but as I mentioned this is a topic I normally try to believe does not exist.

The Extreme Treatments

Once you get to a level where medication and therapy are not doing the trick there are some options left on the table.

The first one is Electro Convulsive Therapy or what use to be known as shock treatments which I tried to cover through my experiences yesterday "Shock Therapy Still Alive And Well". The video below shows this treatment and how it is done today:



Another option in some ares is Deep Brain Stimulation which is a surgical procedure where a device is placed in the patients brain. The battery is placed just below the clavicle with a special wire joining the two. This therapy has been used with good success with people suffering from Parkinson's, chronic pain, dystonia and tremors. There have been studies showing success with DBS and chronic depression but the studies were small inside so an accurate success ratio is really uncertain. I think in the years I have spent online in various forums there have been maybe a handful of people that have undergone this procedure. This short video (under thirty seconds) shows the layout of the device, battery and wire.



The third rather extreme treatment is Repetitive transcranial magnetic stimulation. Where rather large magnets stimulate certain areas of the brain which helps some people over come depression. The drawback to this therapy is that it can be expensive, not a lot of places over it and the mental health professional community has not been overly acceptant of it. This link is a company that offers the service and they claim the success numbers are high but actual numbers are a little bit harder to find.

So there you have it. If any of my readers have gone through the second or third option I would love to hear from you and the results that you had. Take care.

Shock Therapy Still Alive And Well

During my first psych admission the doctor said that he believed that ECT might be good for my situation and that I should go forward with it. I replied that is good what the heck are you talking about? ECT is Electro Convulsive Therapy or shock treatments and when he said this all I pictured was the scene from "One flew over the Cuckoo's nest" so I was not exactly thrilled with this suggestion but the mental place I was in at the time was eating me alive.

First things first they need a second doctor to check you out to make sure that you are a good candidate for this treatment. The new doctor met me and a minute later he stamped his sign of approval. Then they get you to watch the movie on how the procedure works and what to expect, it is not a pretty picture but I was really glad to find out I would not be conscious for it. How it works is your brought down to the room where they give you a combination of meds, then you are told to bite down on this piece of rubber and then you breath the sleeping gas until you fall asleep a few moments later. There are two types of ECT one is bilateral which is they put two pads on each temple and the second is unilateral where both pads are on one side of your head. There are a number of people in the room and they each grab a limb then the doctor nods his head and a short blast of current is passed between the two pads putting your body into a convulsion. There are apparently good convulsions and bad convulsions determined by the time they last. The patient wakes up a while later and after the first one you swear that you had just been run over by a mack truck.

Most people undergo a treatment every Monday, Wednesday and Friday for three to four weeks so between nine to twelve sessions is ideal but some people require less while others need a few more. It is a lot safer then it use to be and the injury rate is very small but of course you need to sign a waiver that basically says there is a chance bones or teeth may be broken, bruises may appear and of course there is a chance you may die. Oh by the way your memory around treatment days if not hazy have disappeared and don't come back but why would someone want to remember a day in a mental institution is beyond me.

The problem with ECT is that it does not work for everyone and the so called experts of the field are not really sure why it works at all. The best explanation I have ever heard is that it is like a computer that is on the fritz so you unplug it and then plug it back in hoping for what ever reason it has fixed itself. My ECT sessions were stopped after five or six as I was not showing any signs of improvement and for whatever the reason it was taking a long time for me to come back to consciousness, this is a genetic thing as a number of family members do the same thing even when electricity is not involved. I know people that ECT has worked for and basically changed their lives, I know people where the effects of the treatments only last a short time so they undergo maintenance treatments about once every couple of months to keep on the positive track and I know a lot of people that the treatment did nothing for at all. I was not happy that they stopped my sessions so soon as I thought I was feeling a bit better but the hospital did not want to take a risk when the benefits were not that clear so I lost that argument.

Two years later I am back in the hospital coming off of a number of drugs to start a new med class plus a few other reasons. I figured that since I was in the hospital anyway they might as well try ECT again. They ran every test in the book to make sure I would not have any problems with the meds and then they booked the operating room to ensure nothing went wrong. I remember waking up that morning then waking up in the recovery room with nothing in between. The first thing I did was ask the nurse if I everything went well to which she lied to me and nodded her head. I was informed the next day that the ECT sessions were now off limits as I posed to much of a health risk and for a while all my doctor would say is that it took you too long to wake up again. My brain does not let things go that easily so I pestered the heck out of him for the next few days until I got the real story. Everything went smoothly with me falling asleep, I had a great convulsion and then I stopped breathing for about a minute so they had to "bag" me for awhile until my brain remembered I was suppose to be breathing. I didn't ask any more questions about ECT after that.

Long term effects I really do not have any except for a few hazy days and a couple of missing hours. After the first couple of treatments the mack truck is down graded to a golf cart that ran you over but within hours after the session you would never know I had it done. I started writing a book in the hospital as a way to basically kill time and I was always able to remember after a session what I had wrote the day before.

ECT or Electro Convulsive Therapy is a last resort treatment as the odds are not that great it will work and there is a bit of danger that goes with it, my stopping breathing is not normal and they are unsure whether it was the meds they gave me or the meds that I was taking at the time that was responsible for this. ECT is meant for people whose depression has hit a point where quite honestly it can't get any worse and is not responding to normal treatment methods such as medication and therapy. Take care

The Wall

It is an amazing day outside with the temperature at the highest level since late fall. I spent the afternoon with my son which is always the highlight of my week. For the last three days I have gone inline skating for at least a half hour per time. My diet has unbelievably healthy with no junk what so ever. So how come I have the urge to go back to bed and stay there until this cloud passes. Every time I think that the storm is finally leaving there stands the monster with a bat in front of a wall so high that I am unable to see the light.

The chemical theory of depression thrives on days like these as there is no logical answer to the quicksand that is quickly sapping my energy and the will to fight. I woke up today and whatever chemical is responsible just failed to show up or stick around. Why was yesterday a pretty good day yet today is the polar opposite and I have no idea what tomorrow will bring or the days that follow.

To me the worse part of depression is that it is never stable and more then one occasion I have told the doctor that I do not care if I am miserable as long as it is consistent. For the ups and downs are what does the most damage. If I was twenty four seven miserable eventually I would just adjust to it and would be able to carry on but the way it is now I never know what is around the corner and constantly reminded how good life can be before it is snatched away.

An anti depressant seems to be the logical option but there are other factors at play that cloud the clarity of this answer. I am med resistant but my doctor is not sure if this is just due to the way my body adapts way too quickly to meds or does it indicate that maybe my depression is not real but the result of the Borderline Personality Disorder operating from the bottom perspective where everything I take in will seem negative. Mind you the BPD theory does not explain why I have no energy and all I want to is crawl back to bed and hide but then again maybe it does an my distorted perception just can't see it. So many questions with very few clear answers. Take care.

Antidepressants

There has been a lot of talk about antidepressants in the media and how effective they really are for certain groups of people effected by depression. The main gripe I have with this particular class of medication is that doctors hand them out to easily without exploring other methods such as therapy first but what can you do as we live in a world where people want results fast.

Most people believe for some reason that an antidepressant is going to make them happy and this is not the case, not even close for that matter. What antidepressant may do is provide that kick in the ass to get you motivated and hopefully reduce the symptoms of depression to make the battle a little bit more easier. The problem is not every person reacts the same way to medication so finding the right med requires a little, or a lot, of trial and error. So lets look at the variety of antidepressants that are out there.

Selective Serotonin Reuptake Inhibitors (SSRI)

- This class makes the serotonin that your brain produces to hang around longer then usual basically. By keeping the levels sustained then technically this will overcome the depression.
- Paxil, Lexapro, Celexa, Prozac are the most common of the SSRI class

Multiple Reuptake Inhibitors

- This class effects a number of chemicals within the brain especially serotonin and norepinephrine. Basically the same theory as SSRI but with more then one chemical at play
- Effexor, Cymbalta, Wellbutrin are the big three.

Monoamine oxidase inhibitors (MAOI)

- This group prevents the breakdown of the main chemicals in the brain. Not used as often as the before mentioned classes as the side effects can be rather dangerous and a pretty strict diet needs to be followed. This drug class is known for breaking through depressions that have shown little progress with other forms of drug therapy.
- Nardil, Parnate and recently a MAOI patch are the common ones.

There are the big three so the question becomes which one is right for you and this is where the guessing game begins as for whatever the reason there is no test to tell the doctors what chemicals you are lacking or if there is one I have never seen or heard about it being used at least with any regularity.

It takes up to six weeks for a med to hit its full potential but the side effects tend to show up after a day or so. For some people the new med may be the piece they had been looking for, for others you just wasted six weeks for nothing and for a select few the new med may send you to a very bad place rather quickly. Paxil put me into the hospital in under a week and the guess why would be is that my serotonin levels really did not need to be adjusted so the manic state was a nice little warning that too much of a good thing can be rather unpleasant.

I am also drug resistant which basically means in my case that I respond well to most drugs but my body very quickly becomes adjusted to it so the med either has to be continually increased or another med needs to be found. To say I felt like a human lab rat for a while is probably an understatement. The best combo for me so far has been Effexor, Wellbutrin, Remeron, Lithium, Zyprexa and Temazapam which lasted for about nine months before it was discontinued (the Zyprexa was stopped six months in for it made me fat really quickly). The problem with drug combos is when it stops working it is difficult to figure out which med is to blame so my doctor stopped them all and I moved on to the MAOI class for a while.

Of course when it comes time to picking an antidepressant side effects should be kept in mind for some of them can seem like more of a pain in the ass then the actual depression plus a few of them are rather dangerous. Instead of listing out the long list of potential side effects I am just going to list the ones associated with Effexor but keep in mind this list comes from the maker of the drugs and they have a tendency of underplaying the dirty parts of the medication.

Important Safety Information

Suicidality and Antidepressant Drugs (Black Box Warning)

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, teens, and young adults. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. EFFEXOR XR® (venlafaxine HCl) is not approved for use in children and teens.

* People taking MAOIs should not take EFFEXOR XR.
* All patients taking antidepressants should be watched closely for signs that their condition is getting worse or that they are becoming suicidal, especially when they first start therapy, or when their dose is increased or decreased. Patients should also be watched for becoming agitated, irritable, hostile, aggressive, impulsive, or restless. Such symptoms should be reported to the patient’s doctor right away.
* Before starting EFFEXOR XR, tell your doctor if you’re taking or plan to take any prescription or over-the-counter drugs, including migraine headache medication, herbal preparations, and nutritional supplements, to avoid a potentially life-threatening condition.
* EFFEXOR XR may raise blood pressure in some patients. Your blood pressure should be controlled before starting treatment and should be monitored regularly.
* Mydriasis (prolonged dilation of the pupil of the eye) has been reported with EFFEXOR XR. You should notify your physician if you have a history of glaucoma or increased eye pressure.
* When people suddenly stop using or quickly lower their daily dose of EFFEXOR XR, discontinuation symptoms may occur. Talk to your doctor before discontinuing or reducing your dose of EFFEXOR XR.
* Pregnant or nursing women shouldn’t take any antidepressant without consulting their doctor.
* Until you see how EFFEXOR XR affects you, be careful doing such activities as driving a car or operating machinery. Avoid drinking alcohol while taking EFFEXOR XR.
* In clinical studies, the most common side effects with EFFEXOR XR (reported in at least 10% of patients and at least twice as often as with placebo) were constipation, dizziness, dry mouth, insomnia, loss of appetite, nausea, nervousness, sexual side effects, sleepiness, sweating, and weakness. Ask your doctor if EFFEXOR XR is right for you.


Nice eh. Anyway my normal reminder which is anytime your doctor wants to put you on a med make sure that you do your homework first and know exactly what your getting into. My favorite med resource is www.crazymeds.us Take Care.

The Why Me Syndrome

You hear this a lot when time is spent with other people with mental quirks "How come I have depression? Why me?". This is something I don't do for the most part and the closest I will come is figuring a past life of mistakes is now responsible for my present but there is no logic there so it does not last long. The other reason I do not fall for this syndrome is I am pretty sure I know what the answer is.

1. Genetics. Both sides of my family have cases of severe depression in more then one person. A number of my aunts and uncles have been on prescription medications for the last decade. So my brain is pretty much hard wired for depression.

2. Coping Mechanisms. Most people get a problem thrust upon them then they handle it then and there. My tendency is to take the problem and swallow the damn thing then later on release the inner turmoil with the help of a razor. Not healthy and the breeding ground for mental illness.

3. Brain design. I analyze every single thing that comes into my brain purely by habit and where most people are able to justify and let go I continue to dig until there is nothing left. I doubt this is scientific fact but i would bet people with a higher intelligence are more at risk then someone with a lower IQ score. Take a tragic event: A person with a lower IQ sees the event and just shrugs it off then is able to move on but someone with a higher IQ tends to see the same event from every possible angle and needs it to be fully justified before letting it go. I would love to see the statistics of people returning from war with PTSD and what the brave men and womens IQ level are and chances are it will prove my theory. There has been recent studies done showing the link between highly creative people and mental illness.

Anyway there is my three reasons on Why me. I don't think it was ever a question of would I have to deal with mental illness but the question was when. Take care

A Break For Poetry

My world is dark and full of pain
A tragic epic with nothing to gain
The endless battles and numerous pleas
I am unable to bury my broken dreams
No matter how hard I try to be
I can not handle another tragedy
The fight for happiness is almost lost
Maybe I will win but at what cost
Tomorrow is yet another new day
But the sun is down and the sky is grey
I can not wait to be happy again
Maybe it will cure my heart of pain
Please someone help me from this nightmare
I need to escape show me with care
Grab my hand and pull as hard as you can
Or else I will go down as a broken man

- I wrote this one about ten years ago.

Three Different Posts Same Story

On Healthboards.com part of the depression board is an area to tell your story so I guess others can see similar cases to their own and in some cases stories of success. This post I am going to repost three posts from that thread that I wrote at different times for I think it shows the frustration that goes with living with a mental illness. I am going to warn you they are a bit intense in some areas so if your not in a great place mentally then you should probably skip this post.

The Short Version Of My Story part one - Sept 13, 2007

What I thought this section was for I guess is wrong. I am diagnosed with severe Major Depressive Disorder with Psychotic features, Post Traumatic Stress Disorder, Generalized Anxiety Disorder and Borderline Personality Disorder. Right now I take Effexor, Wellbutrin, Remeron, Lithium and Temazapam. I deal with high levels of paranoia and will self harm when everything becomes to much. I had a rough childhood. All of the stresses, emotion, feelings and whatever I pushed down way inside. About five years ago my father died, my grandfather died, I graduated from college, moved to a new town, got married and started a stressfull career and I continued to push everything down and not deal with what was happening around me. I started to get sick a lot from stress and then my wife and I had a baby. About two years ago for whatever the reason my lid came off and everything came flying out. I spent two months in a mental hospital where they tried to get my meds regulated and I underwent ECT. I got out of the hospital and a few months later my wife left with our child. Its been about a year since that happen. My risk factor for suicide is way up there, I deal with suicidal ideation's on a daily basis, it is a constant battle to get up to do anything. On a emotion basis I don't feel anything which ends up leading to self harm. I have tried therapy but for whatever the reason they are not equipped to deal with someone like me so I stopped looking. Right now the goal is to get to tomorrow. With depression especially severe depression you have to force yourself to do everything and if you don't the depression gets worse. I am 33 and I need to tell myself what to do like I am a child or else I will not do it. I have to tell myself to eat, to go to bed, to shower and to leave the house for part of me would never get out of the bed unless I was forced too. I am going on two years dealing with this outbreak if you will and to be honest not much has changed from the beginning. The pills make it possible to get out of bed and to fall asleep at night they are useless for everything else.

The Short Version Of My Story part two - November 5, 2007

as my nightmare continues...

I checked back into the hospital as I was in a world of hell, loss control over self harm and was just tired of it all. They try ECT again but this time I stop breathing so that option is right gone, I came off of Wellbutrin, Remeron, Effexor within a five day to week period to get ready for a new class of drug MAOI. I am also borderline which according to the doctor hinders any progress I make with the depression as my so called personality guards the gates too tightly. I want to get better and I need to get better but the system and my brain are making it very difficult. So now I am back home because I feel safer and hoping my anxiety rates will drop down as they were going through the roof. Now I am on a high dose of Seroquel a couple of times a day to slow down the voice in my head, my thought patterns and what have you until Nardil has a chance to jump in to make an effect. The nightmares are brutal, the flashbacks are intense and it seems every time I turn around a new idea of suicide jumps into my head. Who the hell did I piss off in a past life to deserve this? It has to get better because I am way beyond as low as I can go. Every time I think I am taking the right positive step it blows up in my face

The Short Version Of My Story part three - Feb 11, 2008

I guess I should update this as it has been awhile. I am approaching my third year anniversary of the time I had my nervous breakdown which led to the situation I am currently occupying. Not much has changed in the last few months Nardil I guess was working to a certain level but no where near what I had hoped for. It was stopped due to the drug interactions and my need to get some dental work done and like usual I paid dearly for that decision. I am trying to figure out whether I am actually still fighting the depression or I have resigned to the fact this is how my life will be from now on so I might as well get used to it. I still keep track of my moods to discover any patters but I am really not sure why I continue to do this. Therapy has hit a dead end as the Borderline aspect has kept all of the so called mental health professionals away as I am deemed to difficult to treat so apparently there is different levels of being mentally unwell and if you pass a certain line your pretty much outcast. I still put effort forward trying to figure out my own head and to see if I can make sense out of it as I guess from a professional standpoint I am alone in this fight. When I first became ill I thought with enough work by me and the help of local community resources it would not take long to get back to where I thought I wanted to be but close to three years later I understand my illness to a much higher degree but I am no closer to that original goal. My favorite saying as of late is severe depression is like walking on water either you force yourself to move forward or else your going to drown. Well I am moving the problem though is its in circles.

- All of the above post needless to say I was not in a happy place when I wrote them but I think they show the volume of fight I am currently in. take care

A Mental Health Check Up

I guess it is time that I take a peak at how I am doing mentally to figure out what the next steps should be and if any major changes need to take place.

Mood Swings - It has been a long week and it is really beginning to show through. One second I am enjoying the experience the next I am trying to run away from it. Losing my temper way to quickly over the smallest things is never a good sign as it usually means the depression monster is beginning to gain more and more control. My brain is so use to the antidepressants to give it that extra kick that I am beginning to think that it is time to go back down that road again as the last two months without it have not exactly been pleasant. The question is which one. I still have dental work to be done so that basically gets rid of the MAOI class but problem is I have been through most of the others and none of them lasted long. With Seroquel, an anti psychotic, I am going from not thinking at all to thinking to damn much and neither state is therapeutic.

Sleep - Taking longer and longer to fall asleep but once I do then chances are I will remain in the comatose state for the next ten plus hours. This last week there has been dreams of psych wards and whether it is my brain trying to tell me something or there is no meaning what so ever I don't have a clue. Not really complaining as they are a heck of a lot better then the typical PTSD nightmares where I wake up feeling like I got my butt kicked all night.

Weight - Surprisingly there has been no change in the last month as I seem to be stuck at the 204 mark but mind you a lot of the muscle is beginning to convert back so this should be enough initiative to start exercising on a routine basis but of course the excuse is I need to have energy to do so which is just not there. Keep forgetting to eat outside of the main meal per day which is not good but I am never hungry. Guess the best thing I can do is make out a routine that includes meals and exercising and some how stick to the darn thing. I have a lot of good intentions it is just too bad I seldom follow through for very long. Major change needed here.

Self Harm - The streak still continues but the damn urges are growing more and more intense as time goes on. Mind you I know the reason why and it is pretty simple as there are emotions and situations I am basically ignoring with the stupid thought that it will just disappear. You would think I would know better and I do but that does not seem to make a difference. The BPD part of my brain is there to keep me safe and that includes from myself so when it sees an issue that is capable of causing mental damage it quickly tries to separate from it which is good on some levels but disastrous on others. Some how I need to figure out how to strengthen my emotional coping mechanisms so the need for self harm will go away. Again easier said then done.

Overall - It feels like I am spinning my wheels as I have the pedal pushed to the floor but I do not seem to be moving. One perspective is pointing to medication for that little push which may make all the difference but the majority is pointing towards therapy. Of course when it comes to therapy it is self therapy as every other door appears to be shut but it may be time to start going through different sites and use the resources that are available. DBT (Dialectical Behavioral Therapy) seems to be the most obvious starting point now all I have to do is actually do it. take care.