Archive Page 2

24
Sep
16

Back in the leadership role in my dance: a call for understanding

In the last post I mentioned the psychiatric treatment that I received. It was called DBT or Dialectical Behavior Therapy.

I knew that in my past blogging, I talked about DBT and what it had done for me. I had to go back to 2008/2009 to find those blog posts, but it was worth it…I saw, yet again, how very far I have come in my living with depression and being the leader in my dance.

To give you some background, DBT therapy was designed by Marsha Linehan in the late 1980s to treat borderline personality disorder and is now being used for several different mental health diagnoses. This article is a wonderful description of the therapy. The therapy progresses through a series of skill development modules over the course of 8 weeks. NO, it is not a miracle quick fix program; it takes commitment and a lot of work AND you really do need to move through the cycles more than once. I was in active therapy for two full cycles (for me, that meant being in therapy three days a week- both group and individual therapy). AND, if you are honest with yourself, you do NEED to go back periodically for what I like to call “tune-ups”.

I STOPPED taking medications and began the DBT treatment in 2008; Here is what I LEARNED from this therapy:

I have learned to live every single minute in the here and now and to be MINDFUL and focused. This is hard people. It is so easy to look back at things and get disturbed by memories or to look forward in anticipation of things that may not even happen. IF you stay in the moment, you can use all kinds of skills to maintain your mental and physical health.  #1 skill-BREATHING, solid meditative breathing. Nothing centers you faster and makes you feel better faster, for real!

I have learned to use what DBT calls ‘Wise Mind’…equal amounts of emotion and logic…you don’t get overwhelmed when you use ‘Wise Mind’.  You can make decisions that follow your heart AND your head. Again, this can be so challenging. It is so easy to get wrapped up in an emotional response over an event or to be so headstrong stupid in a response. It takes mindfulness to be aware that you are responding in that way and then calm resolve to use the ‘Wise Mind’ skill to stop the inappropriate response patterns.

I have learned to use EMOTION REGULATION strategies. When I begin to think about something stressful, I DISTRACT myself by listening to a great song on the radio or a CD. When I feel myself becoming stressed I SELF-SOOTHE by petting my kittens, chewing a piece of cinnamon gum, listen to relaxing music, getting out my coloring book and crayons, and BREATHE. These strategies immediately reduce your heart rate and reduce anxiety and stress. This is a biggie for me. When I get stressed adrenaline surges through me almost instantly (something I learned about myself through mindfulness) and it is especially important for me to breathe and self-soothe immediately. Once I get calm, I can distract myself and get past whatever triggered the response.

I have learned more effective INTERPERSONAL EFFECTIVENESS skills. I always thought I was pretty good at these skills, and I am. But there is always something you can learn.  DEAR-MAN is an acronym for a sequence of behaviors that are very effective in getting what you want and need out of relationships with others. NO GUILT, NO FEAR, NO EMBARRASSMENT.

I have learned DISTRESS TOLERANCE skills that allow me to stay very calm in the face of activities or people who I used to allow to cause me tremendous distress. The best strategy I learned here is RADICAL ACCEPTANCE or another way of saying it is: It is what it is. For me, that meant learning how to walk away; how to say no to requests and not feel guilty about it; how to really accept that there are things that cannot or will not change and move on. Radical Acceptance is a skill that I find a need to re-tune with my therapist. Sometimes, I have tremendous difficulty dealing with things in my life that are completely out of my control (I already admitted how much I need to control the things that CAN be controlled  to keep me in my happy dance), and Radical Acceptance is THE major cog in my wheel for distress tolerance.

These skills were literally life changing.  I  found a wholesome natural way to really gain control of my life and my depression. I have been MEDICATION FREE since 2008. I recognize more quickly when I start to slide towards a trough and can see when my responses to situations are out of line. I know that I need periodic tune-up sessions with my individual therapist and call her for the help. It actually improved my communications with family (better than isolation).

So, this brings to a close my series of posts about depression.

What do I want you to get from this series?

  • PLEASE know there is a real need for people to understand what those of us with depression deal with, how we feel, how we try to help ourselves and need help (read that as compassion) from you as well. We can’t just pull ourselves up by the boot straps and tally forth! It takes a village!
  • PLEASE know that this is an illness that does not go away but can be well controlled and that doesn’t make us bad people or problem people or selfish people or disgusting people. We are just people like you!
  • Please know that there are likely many, many people in your lives who have some form or level of depression and that

your willingness to understand and offer help may just save a life one day.

Thank you, for taking the time to read these posts. I am back in the lead position with  my dance partner, heading for my latest tune-up, and ALL is good in my world! Here is a little giggle for you…I was featured (2009) on a local television program whose focus was on DBT…be kind in your reviews (I have already corrected the “ummm” issue…LOL!)…

 

22
Sep
16

2000-2010 Decade from Hell

It’s funny how a relatively brief period of time can have so many highs and lows. I mean, in the grand scheme, 10 years is a spit in the bucket. My bucket, during that decade was full of spit, and loads of other things as well.

I don’t want to bore you with a play-by-play; instead, I will simply give an accounting of the time from a pro and con perspective…

Cons: (the big stuff)

  • my mother died of lung and metastatic bone cancer
  • my uncle (her brother) died of colon cancer
  • my aunt (her sister) died of lung cancer
  • we lost our house to a fire
  • my father suffered massive third degree burns on both of his hands from a kitchen fire and was found to have lung cancer when he was being evaluated for his skin grafting surgery…oh, he also had a blood clot in his heart (this was immediately after our fire)
    • and ALL of that happened between 2000-2005
  • I had two major depressions that required me to take a medical leave from my job and also had a place in my needing to resign from a very prestigious position at my University
  • I had shoulder surgery for a frozen shoulder and knee surgery for a torn meniscus I got in class doing jumping jacks!
  • my husband lost his job and was not able to find another one, ever

Pros: (the big stuff)

  • both of my children graduated from college with degrees and a future ahead of them
  • my dad survived and just celebrated his 91st birthday
  • I was promoted twice…to Associate Professor and then to full Professor
  • I was appointed the Director of the Center for Teaching Excellence
  • my first text book was published
  • I was able to take my husband on the trip of his dreams to Hawaii, twice
  • I traveled the Mediterranean, Alaska, and my first trip to Australia and New Zealand
  • I was humbled to be the recipient of the most incredible generosity and kindness from our neighbors and the University community and so many strangers in response to our fire…the clothing and money that was collected in my family’s behalf had me in tears for days
  • I began intensive therapy and counseling in Dialectical Behavioral therapy (DBT), which changed my life, forever (more on that next posting)
  • I decided to retire
  • I survived in one mentally and physically intact piece

DBT was, and continues to be, the reason.

16
Sep
16

I just want …

to die.

The feeling was overwhelming and complete. I thought very long and hard about that…I truly did.I thought about all my alternatives and none of them were going to relieve the constant horrible pain I was feeling inside. My insides churned constantly and burned, heavy in my core. Every piece of my skin hurt. It was a constant fight with my brain to stay as calm as I could be…to hide 24/7 what I was feeling and what I was planning.

A NOTE for those of you who scream about suicide being the coward’s way out.  DON’T YOU DARE. Until YOU walk in the shoes of deep depression or disease, or addiction where the pain is overwhelming and all encompassing and there is no physical or mental or emotional respite, don’t you dare even think that this kind of act is cowardly. It is the most heart wrenching decision one could ever make and trust me when I tell you that it is NEVER done lightly and without tremendous forethought. That individual needs to stop being in permanent pain and there is certainty in one’s death being the end to personal pain.

I would peek over at my husband at night as he slept and hoped, with all my heart, that he would carry on well without me and without feeling any guilt. There was nothing he could do…he DID try to keep communications open, but I closed him off. Isolation was better. My kids were already adults and pretty much on their own either in college or finishing up. They had figured out that I had demons to fight, but, I certainly would not drag either of them into the trough of despair that I was engulfed in…no, they needed to not think of me as some damaged person who couldn’t hold it together.  My parents…well, they would probably be beside themselves, wondering what they did wrong or might have done differently, but, they too, would be OK in the long run. There would be no notes left because this was going to be a horrible accident…it was important for the family to be able to collect on all of the life insurance. Oh, they may figure out after a time that it might have been a suicide, but, if I did it right, they wouldn’t be able to prove it for sure.

Very few people know about this part of my depression and the fact is, those that do know found out way after I had been saved from my certain demise.

So, I had a plan; a very nasty and completely deadly car accident. I only needed to determine when to put it in action.

As I sunk deeper and deeper into the trough the time began to feel right to do it. Then driving home one early afternoon from school (it was 40 miles one way, so a good amount of time to process) I began to think, “Would anybody care enough to try to stop me?”

Maybe that was my waaaaaay deep inner voice saying, “Whoa, hold on a second, are you sure about this?” I don’t know. All I do know is that this time period was well before EVERYONE had cell phones (and the ones out there were still bag phones pretty much!).

I got home and called my mom. No answer. Called my sister. No answer. Called my aunt. No answer. Thought while laughing to myself…”There isn’t anyone…see!” And I began to cry, quietly…tears slowly slipping down my cheeks because, well, it WAS time. One more call…I called my best friend (ya know, the one I said was the ONLY person from high school I stayed in touch with)…I called Judie…she answered the phone and I can’t remember the exact words I said to her, but I was crying, crying hard and she said, “I am coming to get you RIGHT NOW.”

And she saved me from myself. 

She took me for a long drive. We talked, I cried, a lot…I shared what I was going to do and how I had been feeling, and I think she wanted to die at that moment! She could not quite believe what I was going through and that I hadn’t shared with anyone…she stuck with me like glue that day. She helped me get my shit together that day just by being the ONE PERSON who answered the phone.

I know, without a doubt, that I would not be here right now had it not been for Judie answering the phone that day.

Now, what to do…

14
Sep
16

not just blue…it was more of an indigo

It was happening and I didn’t know it…wasn’t tuned in to it…the trough was beginning to form again…my partner had taken back control and was changing the rhythm of the dance.

As I said in the very first post, it is insidious…ya know how they say that some cancers or heart disease are silent killers…well, depression is the same way. It doesn’t show on the outside normally until it is really REALLY bad and sometimes, too late.

You look the same, try to always act the same..like everything is just fine. You carry on and do your best to live your life the way you need to. I do my very best when I have a tight schedule. I’m not sure if that is a part of my Type A personality or an internal need I have because when I have a schedule and follow it and get my stuff done and do it well, I AM IN CONTROL.

I’m actually sitting here laughing as I write this because I JUST REALIZED THAT! Being tightly scheduled for me WAS and still is a means of control!

So, I taught a full course load of 15 credits a semester; I was the Coordinator of Student Teaching for our program; I was on several college-department-university committees; I was doing presentations all over the country (both requirements for tenure and promotion); I advised approximately 40 students (and I DID meet with every single one of them for no less than 45 minutes at least every semester for scheduling if nothing else); I went to my daughter’s in-house and traveling soccer games; I went to my son’s choral performances; I tried to do the best I could with dinner preparation (kudos to E for taking over so much of that during this time); I did the laundry; and I drove a 2 hour commute each day I traveled to work–usually 4 out of 5 weekdays. I was also on a number of professional committees outside the University. I also started writing my first textbook and became a regional coordinator for a multi-million dollar grant…my region was the west coast- Washington-Oregon-California-Utah-Idaho-Nevada-Arizona-New Mexico (remember that I lived on the east coat, in Pennsylvania) so I was traveling…a lot!

Yes, a bit tightly scheduled, but, like I said, PRODUCTIVE and brilliantly so…I accomplished every single thing I wanted to get accomplished during this period of time and unbeknownst to me

the trough was deepening and deepening and DEEPENING.

And suddenly, and I do mean suddenly, it hit.

Chest pains, could not breathe, started crying for no reason at all. The pain was screamingly tangible and all internal, burning, searing, throbbing pain.

All I could think about was how badly it hurt, that my medication had apparently stopped working, and that if it continued to feel this way, I could not bear it. I wasn’t feeling blue; no, I was indigo, closing in on midnight.

And, nobody knew because I chose isolation. Don’t tell, don’t share, don’t let on. Stay away from any kind of interaction or conversation that might give you away. I sobbed in every shower I took. I sobbed driving to and from school and then washed my face with ice cold water to get rid of the swelling around my eyes and redness on my nose (damn nose always gives me away when I cry).

I just wanted to BE ALONE and left alone.

My lovely waltz had turned, slowly, but surely, into a moshing slam dance.

 

12
Sep
16

the dance

That really is a perfect metaphor for one’s relationship with depression. Think about it; what is a dance?  According to Merriam-Webster it is a series of movements that match the speed and rhythm of a piece of music.

The dance that you perform depends on the mood of your partner. Tarantella perhaps?

Legend states that between the 15th and 17th centuries an epidemic of tarantism swept through the town of Taranto in southern Italy. This was as a result of being bit by the poisonous tarantula spider. The victim, which is referred to as the tarantata, was almost always a woman but never a high ranking lady or one of an aristocratic upbringing. Once bitten the tarantata would fall into a trance that could only be cured by frenzied dancing. People would surround the victim while musicians would play mandolins, guitars and tambourines in search of the correct rhythm. Each beat would have a different effect on the tarantata causing various movements and gestures. Once the correct rhythm was found it was almost certain that the tarantata was cured.  http://www.italiansrus.com/articles/tarantella.htm 

LOL, how appropriate is that?!

Or perhaps my partner wishes to dance the Twist?

The point is that the way you learn to relate to your depression is by shaking its hand and discovering how to become the lead in the partnership. You become the leader in the dance…in other words, YOU take control.

For me, Prozac helped to start me on the path to learn those skills. It allowed my insides to calm down enough to focus more on the here and now and surprisingly, some of Dr. F’s relaxation strategies began to work more effectively. This was a really good thing because around this time, I had a major career change. Moving from the K-12 environment to the ivory towers of academe was going to provide all sorts of new and exciting challenges. YAY! I was moving in a positive direction.

And then, inexplicably, I wasn’t.

The hurt and anxiety returned. I still wasn’t able to identify in myself when this was happening. My family, specifically, my husband, was acutely attuned to what was happening to me and would sometimes ask me if things were still OK…hint-hint… another visit to my PCP (who was now in the Rx loop and prescribing the meds for me) and the dosage was increased. OK, that seemed to help again so maybe that was it; I just needed a bit more of the Prozac to keep an even keel and maintain my lead position in our dance.

But, of course, I was wrong, and the worst was yet to come.

11
Sep
16

round and round the mulberry bush…

That was how it was starting to feel. I had a diagnosis I thought was likely on target, but, when I spoke to my PCP he suggested that I return to Dr. F with the news of my visit to Western Psych.

Uh, no…didn’t particularly care for him the first time, why try him again. So, OK. D…bite the bullet…pull up your big girl pants and get on with your life. Deal with it. Other people do, you can too.

My husband knew the diagnosis but I did NOT share it with anyone else. Need I tell you, MENTAL HEALTH PROBLEM….I could see the flashing red lights and hear the sirens….wah-wah-wah…mental health—mental health—dirty little secret—mental health concern. I was even horrified that my physician now had the ability to write this in my medical records!

I soldiered on, but at least now I knew that when I hurt so badly, there was a reason…just,  fixing it was going to be really hard. Days of dealing turned into weeks of dealing and then months of dealing…oh, wait…I really should have said not dealing…because each and every day I hurt more, and more, and more inside. The happiest days, like birthdays and family holidays were torturous because I did such a great job pretending to be OK. The drama classes and speaking classes I had in high school and college paid off well.

Until I had my annual OB/GYN appointment. I am going to preface this part with an explanation of how much I adored my OB/GYN. If it was acceptable to be in love with two people at the same time (one being your doctor), I was in love with him. He was gentle with me, understanding, listened intently to me every time I had an appointment, had been through some ugly stuff with me as a young adult. I could talk to him about anything, bare my soul down to the bare bones…almost more than with my husband.

I sat in his exam room, in my hospital gown, waiting for his arrival, hands crossed…waiting. He walked through the door, took one look at me, got a concerned look and said “How are you?” and I burst into tears, sobbing, uncontrollably.

“Something is wrong with me. I hurt so badly. I cry all the time. Everything sets me off and makes me sad and hurt. I can’t breathe sometimes it hurts so badly. I want to die it hurts so bad. I can’t help it. I saw  Dr. F but he didn’t do anything. I tried to get into a study at Western Psych but they said I wasn’t bad enough. What is wrong with me!!!!???”

He listened, closely. He asked a couple questions. He gave me a big hug. And he said, “D, you are depressed, REALLY depressed and I can help.”

Magic words…”I can help.”

And he did. I started with a relatively mild prescription for Prozac and the change was marked and almost immediate. I felt less pain and less anxious, something I had not felt in a very long time. The relief was incredible.

I have learned, like others with mental health issues and with diseases like alcoholism and drug addiction, that your relationship with your ‘disorder’ is a lifelong relationship. And this was just the beginning of my learning to dance with my new partner.

Shall We Dance…

11
Sep
16

Elizabeth Vargas and me

It seems that each day, when I tune in to Good Morning America, I see another famous person discussing an illness/disease/condition that has lifelong affects on them and those around them. The other  morning it was Elizabeth Vargas. I had heard about her fight with alcoholism many years ago. It broke up her marriage and nearly destroyed her news broadcasting career. That morning she was talking to Diane Sawyer about how it felt, the downward spiral, the guilt, fear, anger, angst…

And she was telling my story….what she described in living and dealing with her disease, alcoholism, was nearly word for word what I have dealt with and continue to deal with in depression.

I am in good company…Bruce Springsteen and Elizabeth Vargas.

In my last revised post, I started to share about my road to discovery. Today I will continue along the yellow brick path.

I was talking about contacting the local mental health hospital to become a part of their depression study.

I got an appointment and one of the first questions I was asked was why I was there.  Good question.

I said I felt like something was always wrong. I explained that I guess people maybe called them mood swings. I felt I wasn’t bi-polar in the sense that I demonstrated super highs and super lows, no, I was inexplicably moody. It bothered me and it concerned my husband. I had that feeling deep down that something wasn’t quite right. Then I added that I was working on my doctoral degree full time, had a toddler, was busy like so many others, but the moods were starting to get to me and make me weepy. I immediately pronounced myself stressed from life in general…duh!

I also mentioned that  mental health services were, and still are, extraordinarily expensive and barely covered by health insurance. I thought this would be a good way to get help.

He listened intently then gave me a slew of forms. I went in a meeting-style room and filled out all of the forms, signed all sorts of releases, and was cleared to at least enter the first phase which was the actual entry interview and initial assessment. I took a test, in retrospect it was the same test I took before with Dr. F, and afterwards I sat with the intake therapist and we talked. He asked me very specific questions about my childhood and teen years, my responses to various things that happened during those years and all the time we talked he drew. It looked like doodling or maybe some form of note taking; I wasn’t sure exactly what it was until later.

At the end of the discussion he turned the paper around to show me what looked like a sinusoidal wave…like this:

waveform

and he had listed the events in my life and my responses along the wave,

and it was as CLEAR AS A BRGHT SUNNY DAY

…cyclical depression…

The highs stayed the same, but the depression troughs got deeper each time and it took longer to come out of the episode. I was dumbfounded, seriously…there it was, in picture form, so very easy to see, and understand. I was elated that just maybe, MAYBE, I had an answer to what was going on and that I might really be able to get a handle on it.

Now, here comes the really good part…

Ready? Are you sitting down?

I was NOT DEPRESSED ENOUGH TO GET INTO THE STUDY!

Jeez Louise.  Oh, yes…I WAS DEPRESSED, no doubt about that, but, oh, so sorry…not enough to get help here. They suggested I check with my PCP to see who might be able to offer me services. We know that didn’t work…

I left the clinic…

DEPRESSED

 




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