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

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

When Things Went From Bad To Worse

A question came up in the comments in a prior post about when my illness stepped up to where it is now and I have a couple of different theories.

1. Key Losses - I lost my father and then my grandfather in a time frame of three months. Instead of talking and exploring the issues that were surrounded to the two deaths I did what I usually did when I was overwhelmed and buried everything that surrounded the events then through my self at work. Problem is when something is buried it is not dead and sometime in the future it will have to be dealt with.

2. Accepting Being Mentally Ill - I knew I was having problems but I kept pushing them away. I was barely sleeping, constantly getting sick from a variety of different physical illnesses and it was becoming harder to keep my stability level in check. I decided it was time to act and I went to my family doctor laying everything all on the table. The mistake I made is I put complete faith into the health care system and stopped fighting for my own survival. I figured I was now on medication and was being seen by a mental professional so it was now there problem and not mine. It didn't take long for my brain to complete spin out of control and end up on a psch ward where I then realized I had to do something or else I was going to be dead. The best medial care in the world means nothing unless you are willing to fight for yourself.

3. Long Term Illness - I have been dealing with depression for as long as i can remember at a lower level and to be honest I just accepted the fact that my world would appear t be a little bit darker then others. Post Traumatic Stress Disorder is another long term illness that has always been present I just did not realize what it was or capable of. The Borderline Personality Disorder diagnosis may be rather new but the garbage that goes with it I have been dealing with for a long time. These areas of mental illness have always been there but they had not had the control or impact that they would later on and I guess it comes down to ignorance is bliss. What I thought was normal and had put on the back burner were not sitting there waiting for me to address them but slowly morphing into a monster that when my mind hit its weakest point would attack with full vengeance.

If I had learned how to properly express emotions and was allowed to do so from the very beginning chances are my life would be completely different at the moment. But instead I took it all in and tried to figure out a way to deal with it on my own and failed miserably. When my father and grandfather died that is the moment I should have entered counseling to deal with it instead of the way I dealt with it.

There really is no concrete reason why my life went in this direction but a combination of a lack of proper coping mechanisms, two key losses, a substantial increase in strength and the dumb notion that as a man I am capable of fighting this battle alone. I kept filling up the bottle of repressed emotions then one day the cap popped off.

A reader going by the name Polar Bear also asked a question regarding psychosis that I will attempt to address later on today but until then go visit him at his blog "Polar Bear Blog"

Shock Therapy Part Two

I found this video on YouTube that talks about depression and electro convulsive therapy which to say is controversial is like saying Bill Gates makes a decent living. I have written about this before and the article can be found here about my own experiences and a step by step guide to the session. For some people this procedure is literally life saving but for others it makes no difference at all so it has one heck of a gamble to it but when you have nothing to lose you are willing to go to any level to get back to the surface. The link at the end of the three minute program is www.shockdoc.tv

You Want To Put Electicity Into My Brain?

During my first admission the doctor told me that he believed that ECT might be good for my situation and he said 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 so I said what the heck thinking I would just pull out at a later date if things became to hairy.

First things first they need a second doctor to check you out to make sure that you are a good client for this treatment. The guy 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 positive one I believe is somewhere over thirty seconds or so. 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 TV 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 asked the nurse if I came around fast enough 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.

ECT or Electro Convulsive Therapy is a last resort treatment as the odds are not great that 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 so they will try anything to bring you back out of that hole of despair.

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. Like I said if you feel that your on your last legs and will do what it takes to survive then look into ECT and try to picture this post and not "One flew over the Cuckoo's nest" as it is a hell of a lot safer then it use to be.

Borderline Personality Disorder

Ever wanted to know what it feels like to be treated like a leper? Get a diagnosis of Borderline Personality Disorder (BPD) and you will come really close. Doctors, therapists and other people see those three little letters and they run like hell. BPD automatically gives you the reputation of someone who is a master manipulator, only cares about themselves and views the world though a black and white perspective with nothing lying in between. Is this accurate? It depends on the day.

A long time ago a small child became fearful of expressing his emotions to the so called grown ups that were in his life in fear of a response that is far from being pleasant. So what is this child to do? He learns how to survive and the first step is to keep all emotions bottled up inside then to present an image that will keep him safe. This new image begins to create a new personality where on the outside it looks like he is a strong stable person but on the inside it is constant turmoil. This new self image becomes the most important factor in the child's life so he learns how to keep this image appear in a positive light and develops a system to make sure that this image is kept in tact, for the better state of the new personality the better the child feels about himself. Some people are able to let this figure be put to rest when they enter a more positive stable enviroment where the rest of us allow this imaginary person to become very real and dominate all aspects of our lives and end up with the BPD diagnosis.

Living with BPD is all about maintaining that self image that is rocky at the best of times. This inner personality only cares about how the situation is going to effect him. If someone attacks me in the verbal sense my number one priority is to protect my self image so I do what it takes and unfortunately this means entering a "rage" that will send a message to the person that what they are doing is a very bad idea. A rage looks like the person is completely out of control and has the potential of doing anything but like the self image it is meant to protect it is an illusion as the person with BPD is in complete control. The rage is used to send a very clear message that the person has crossed the invisible line that puts my self image in jeopardy which is not allowed as the better off my internal personality is the better off I am overall so I do whatever is necessary to keep it safe .

Manipulation is used to get the response you are looking for either positive or negative. I rehearse every conversation that I may potentially have to make sure that I am ready and that no surprises will arise. A classic case of manipulation is when ending a relationship is I prepare a conversation that will have the other person set off a rage in me then giving me the excuse I am looking for to make the other person go away. By doing this I have no guilt about the relationship as it was the other persons fault even though I controlled every step of the way it ended. My self image is still stable as I did nothing wrong and if the other person knew me better they would not have allowed them selves to be manipulated so I did the right thing by doing it this way. A long as I can justify it from a logical standpoint then I am fine.

Emotions don't exist for the most part in the BPD world and everything comes down to logic no matter how faulty it may be. BPD sufferers deal in a world that consists of yes or no or black or white with nothing that lies in between. The area that is avoided is where emotions exist and it is an area we do not understand as when most people were being taught how to express their feelings we were in a position where the emotions had to be buried so they never had a chance to grow and understand. What we do know is what other people expect from us in an emotional capacity so we learn how to fake it. I can appear as the most loving boyfriend in the history of the planet but like a lot of my life it is an illusion as I learned how to express my so called emotions by reading Cosmo so I know what each gesture is suppose to mean but for the most part it is an act like an actor playing a role.

Everything comes back to the self image. When my self image is at a good level I see the world in a rather positive way and my behavior reflects this. When my self image is having a rough period my depression kicks in to high gear and I have to deal with all the garbage that comes with it. Needless to say for the longest time I would do what ever was possible to make sure that my self image is kept up high and it justifies most of the actions that I take to ensure my inner personality is protected.

The problem that comes with living your life in this fashion is that nothing is real. My inner self image is a perception or how I view myself the confusion is which version of me is looking. Is it my upper self image or my lower self image that is taking it all in but the problem is neither one of them is based in reality but a series of boundaries, limits and rules that were created to make me appear as someone else not who I really am.

A couple of years ago I realized that every thought and behavior I had was not based in reality but what I perceived it to be. So very slowly I went through my head and picked every thought apart to see where it came from then tried to slowly implement change to bring out the real me which has been a royal pain in the ass because basically I had to start over from scratch and at the same time ignore the impulse that is saying if I let the BPD take control my life would be easier and it would be but not very fulfilling.

The medical and therapeutic community treat BPD like it is not treatable and once your beyond a certain point your destined to live the rest of your life in this fashion. Therapy is ineffective or at least BPD is very difficult to treat as someone who has multiple self images quickly switches from one to the other depending on stability. The goal is to finding the real self image then going to work on it. My doctors have called me untreatable but I have full intentions of proving them wrong once again. I have learned how to stop and analyze the situation before responding which has been a massive step that has made the world of difference as before my response would be to best serve my false self image now I see it from a different light and have realized not everything is a an attack so there is no reason to act as such.

A lot of people with BPD will never be diagnosed for the simple reason they do not believe anything is wrong with their logic. People with BPD run huge companies and corporations with success for everything is based off of logic and emotion never comes into play. This is perfect for a lot of work settings but the problems they cross is outside of work as they feel unfulfilled so they end up working way to much or start abusing substances to fill the void inside of them.

I made a decision to become a better person and to get the life that I deserve but to do it I had to admit that everything in my life was faulty and I have been living a lie since I was three years old. It is unfortunate that the battle is that much harder trying to overcome the stigma that comes with the Borderline Personality Disorder diagnosis. I am trying to fix myself and a little help would be appreciated not the medical community writing me off as too difficult to treat.