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Having Good Days with Depression

Every time I have a sudden improvement in my depression, I’m blown away by how much easier life is. When you live with something every day, you get used to it. It no longer catches your attention when your symptoms don’t stand out from the daily noise.

Yesterday, I had a good day. I called a friend, went for a run, attended a virtual writing group, and only napped for one hour! This is a dramatic improvement from recent weeks. I can’t believe that such a mundane day could feel so novel and exciting. Today, I woke up and thought, “What am I going to do today?” Not in my usual “I’m tired, every day is the same, and I’d rather stay in bed but I have to do something.” way. More of a “I could accomplish something today” way. I actually feel slightly enthusiastic about it. I’m looking forward to the near future but nothing in particular, which is a foreign feeling to me. It’s a kind of vague “the day is full of possibilities” feeling that is a dramatic change for me. I attribute this shift to a second ketamine infusion I had just a few days after my regularly scheduled infusion. The goal was to sort of trampoline-double-bounce me, and hooray – it worked!

I had a conversation somewhat recently about how easy it is to doubt yourself when you have a chronic, “invisible” condition. You might start to forget what “normal” feels like, which makes it hard to tell if you’re there or not. For instance, I often find myself questioning whether I’m being sluggish because of depression or because I’m not putting in enough effort. When you check in with yourself often (“Am I feeling better yet? Is _____ working yet?”) it’s easy to get bogged down in minute details and lost. But a sudden shift in my mood shows me that I can easily tell when I feel better. It’s a change that I notice right away. It’s somewhat validating, actually.

I also try not to dwell on the anxiety that this improvement could be short-lived. I’m accustomed to the very slow seesaw of my moods, which makes a worsening of my depression at some point in the future seem likely. It’s an exercise in mindfulness to focus on the day as it happens. Right now is pleasant and noticeably easier than just a few days ago. The future will unfold as it will, so I may as well appreciate the present.

Here are some things I appreciate: As I’m writing this, my dog is asleep with her head on my legs. I can feel her twitching as she dreams of canine life. I’m astonished at how much she helps me – how important she is to my mental health. I’m grateful beyond words for her. It’s almost noon and I am still awake, having made it several hours past my usual nap. I’m getting tired, but that’s ok. I’m going to enjoy the improvements and be kind about the symptoms that remain. I appreciate comfortable clothing, raspberry tea, and the flexibility my job provides. I recently learned that clams have internal organs but mussels do not, and I’m thankful for Wikipedia. I appreciate my curiosity, both for random facts and for how far I can go with this newly lightened mood.

Mental Health is More Important Than Academic Success

Growing up, I was always motivated by grades. I liked having that definitive mark to indicate whether I did well or not. Clearly, the beginnings of my perfectionistic tendencies go way back. Even in middle school, I remember carrying around a lot of anxiety about tests and grades. When I got to college, I was excited to be focusing more time on my interests – biology and anthropology – but the pressures of academia and my budding mental health issues wore me down.

Still, I was determined to do well. I had learned that I could earn good grades if I just put in enough work, even in subjects that didn’t come naturally to me. School was what I knew, and I felt tantalizingly close to the finish line. So, when I was diagnosed with major depressive disorder in the middle of my college career, I didn’t slow my progress down. Like many students, I simply forced myself to put my mental and physical health behind academic success.

At its worst, I went back and forth from my bed, desk, and class, taking naps when necessary but skipping meals and forgoing social interaction to conserve emotional energy. I thought about suicide a lot. I had several plans in mind, and I kept the worst of it from my therapist, fearing that she would force me to go to the hospital. The worst part of that potential event, in my mind, was missing class and falling behind. When I look at photos of myself from this time, I remember how forced it often felt to smile. Even on graduation day, I didn’t look happy; I just looked exhausted.

I hoped that if I could just make it to graduation and go home, I could rest and recover, and my mental health would improve. Instead, the sudden lack of structure combined with my admittedly fragile emotional state made things much worse. I tried – for months, I went diligently to therapy and attempted to pull myself out of my depression, but ultimately slipped back into suicidality. I was hospitalized for over a week, then released on condition that I do a partial hospitalization program for two more weeks.

I don’t know that all of that was caused by the stress of college. I am in my early twenties, when many mental illnesses make their presence known, so it’s possible that my symptoms would have been just as severe had I not gone to college at all. But I suspect that my perfectionism surrounding academics and the pressure I put on myself to succeed made an already risky situation worse.

When I can find compassion for myself these days, it makes me sad that I treated myself so poorly. Yes, I got a good GPA, but at what cost? To imagine anyone else doing what I did – valuing their academic success over their own life – is unbelievably sad. There is no grade that matters more than your wellbeing. I’m not exactly sure how my perspective was so narrow for so long. I knew that I could have taken a semester off – my mom suggested it, once – but I was vehemently opposed. I didn’t want to fall behind my peers. The thought of returning to campus without my friends made me anxious, and it left a vaguely shameful feeling in my chest. To take a semester off felt like a failure to me. That was my perfectionism speaking. There is absolutely nothing wrong or bad about taking a semester off. Or two. Or however many you need.

If I could go back, I would do things differently. I did love my majors – I would keep those. In fact, finding subjects that sparked my curiosity was a positive force on my mental health. Knowing that I had something to use in a career gave me a sliver of hope that was enough to let me imagine a future in which I wasn’t depressed. But two majors in four years is hard. I took a lot of credits each semester, and there was no way to avoid pairing difficult classes together. If I could go back, I would do it all more slowly. I’d take fewer credits per semester and accept that it would take me longer than four years. I’d also apply for accommodations. Beyond the assistance of longer exam times, it would have been nice to have my professors in the loop about my depression.

A lot of my perfectionism surrounding academics existed long before college, but there is something to be said for the culture that permeates my alma mater. There’s a sort of competitiveness among perfectionistic students for who can push themselves the hardest. If you say you’re stressed, people ask you how many credits you’re taking, as if your stress doesn’t count unless your course load is full. It’s not stated outright, but the general atmosphere is one of suffering-related humblebragging. If you’re stressed, it means you’re pushing yourself. If you’re not stressed, you might be slacking. Again – I love my university, and I’m proud to have gotten my degree there. People are motivated to achieve at Michigan, which is wonderful. That said, the limitless pressure to succeed can be dangerous.

Suicide is the second-leading cause of death for college-age people in the US, and its rate is increasing. Around 1,000 college students die by suicide each year. When young people are off at college, often away from home for the first time, they’re vulnerable to the prevailing ideas. Submerged in a competitive culture, it’s easy for students to believe that their future will be ruined by a bad grade. And I get it – students have plans beyond college that require top-notch GPAs. For a while, I thought that veterinary school would be my next step. Instead, my plans seemed to come to a screeching halt after college. Depression has altered my life enormously. If I could talk to sophomore me, I’d say, “I haven’t gone to grad school, but my life is not ruined.” Through the waves of depression, I catch glimpses of what really matters, and none of it is a letter grade or a GPA. I think I have a healthier perspective on life and academics now.

I sincerely believe that most of my depression is biochemical. That said, I’m pretty sure my college experience sped up the decline in my mental health significantly. Again – I don’t regret going to college, but I do think that if I had taken time to consider my innate traits, really thought about the stresses of being a highly introverted person at a university with more than 40,000 students, things might be different for me today. I did my best at the time, but I wish that I had honored those parts of myself; the quiet parts, the parts that need calm and routine, which were frazzled and burnt out after four years of high pressure. My sensory differences made the pace of life I’d chosen at university unsustainable, and by the time I graduated, I had an almost constant low level of vertigo, loud noises made me cry, and lots of movement in my visual field (like in a busy dining hall or a crowded hallway) made me disoriented.

I would encourage anyone who is pursuing a degree now or considering doing so to remember that it’s your education and your life. Everyone goes at their own pace, and what anyone else thinks about your pace doesn’t matter. Furthermore, what you think other people are thinking is likely more harsh than the reality. Taking care of yourself and your mental health is not always easy, and going against the grain takes courage. Think about the resources and environments that would support you and seek them out. Make friends who understand you, and above all, put your health first.

(There were parts of college that I really loved. The friends I made and the things I learned were priceless. Football games, waffles, fancy events at my dorm, exploring campus – there are tons of great things about college! I didn’t intend for this post to turn out so dark. It’s all about moderation.)

Watching rotund squirrels eat nonspecific trash was always fun, too.

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Changing My Depression Medication

It’s come to my attention that my depression medication doesn’t seem to be doing much. IV ketamine infusions are also doing less than they used to, unless it’s the case they they’re doing just as much but my brain is kicking its level of stubbornness up a few notches. Who’s to say what the cause is? Maybe it’s just the curse of 2020.

I got sidetracked. The point of this post is this: I’m about to start taking Wellbutrin, a medication that I tried a few years ago and really liked. I was only on it for about a week, though, because I promptly broke out in a blotchy rash that spread from my chest, up my neck, and all over my face.

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(the rash of 2018)

It seemed like a cruel joke played on me by the universe. The only oral antidepressant I’d ever tried that made a sudden, discernable difference in my depression is one that I’m allergic to.

Cut to now – I’m once again finding myself floundering in the soupy mashed potatoes of my depressed brain, looking for some way to change things. I’ve always carried a little bit of disappointment about my failed Wellbutrin trial, especially because I was taking the generic at the time. What if I wouldn’t have a reaction to the brand name version? Would it be stupid to try?

You know those prescription medication commercials that include a disclaimer like “Don’t take [name of drug] if you’re allergic to [name of drug],” and you’re like “Well, DUH”? I am now the person that those disclaimers target. To me, the risk of an allergic reaction is worth the potential benefit of taking Wellbutrin. I think it’s telling that when faced with the possibility of a rash, swelling, even anaphylaxis (unlikely), my reaction is “sign me up.”

I remember being so amazed at how motivated Wellbutrin made me feel. It was the only oral depression medication that’s ever given me that “I didn’t fully realize how depressed I was until I wasn’t” feeling. I was in my last semester of college when I took it. By that point, I had tried several medications and was struggling to get through the last few months before graduation. I was over the moon when I realized that Wellbutrin was working for me. It was SO much easier to get my work done and interact with people, even just for the few days that I was on it. When I got the rash, I stopped taking it abruptly, and the sudden changes did not do good things to my mental health. I had already been utterly overwhelmed by classwork and worn down by the near-constant suicidal thoughts that had plagued me for over a year. I canceled my trip home for spring break because I wanted to be alone, and I reluctantly started yet another combo of meds. I just remember the whole thing being bitterly disappointing. It was like Wellbutrin had swooped in, showed me how much easier everything could be, and then ditched me with the gift of an itchy, burning rash after just a few days.

So, I’ll take the chance of a rash if it means I might feel better. That said, if I let myself get too hopeful and the result is a letdown, I know I would feel incredibly defeated. I’m trying to temper my expectations. If I get a rash or if it doesn’t work, at least I’ll finally know for sure if it’s an option for me. I’ll write an update soon.

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The Subtleties of Water: The Ketamine Chronicles (Part 27)

I’m always looking up at the sky when the water closes over me. This time, it was cold, and an eggshell-thin layer of ice formed above me while I watched. Gentle waves followed one another, freezing over the previous layer and leaving a frosty texture on the surface. Darkness spread from the periphery of my vision until I strained to see through the last window of light, the only notable image being the shadow of a person standing above me on the ice.

I didn’t put a lot of effort into remembering this infusion. I know there were graceful, disembodied hands dancing amid blue and red lines, swirls, and dots. There was more water – ripples and waves, mostly. There was a pyramid with a circle above it, which turned into a blinding white light. I’m certain that there was a lot more, but it’s faded away from me by now.

My mental health is declining. I’m not sure why. Ketamine doesn’t seem to be working as well for me, now. Every day, I have to rate my mood on a ten-point scale. It’s hard to capture how I feel in numbers. Potatoes are easier, but still not quite enough. Honestly, sometimes words themselves seem too limited. How can I describe how I feel? This morning, I woke up at 4. I got dressed in the cold – same clothes as yesterday – and went to the kitchen for some food. I walked the dog when the sun came up, but we came home quickly because of the sharp, cold air. My eyes feel heavy. Not the lids – the actual eyeballs; they sit heavy in their sockets, like wet marbles or enormous caviar. I wonder, if I tip my head forward, will they fall out? When my depression is worsening, I often notice this feeling in my face. Everything is heavy and hard to move, and I’m sure my expression is grim. I think the clinical term is RDF – resting depression face. At least my pandemic mask covers most of it.

Maybe the person above me on the ice in my ketamine dream is me. I’m on thin ice. Skating across a just-frozen lake in my wool socks at 4am. Someone else is waiting beneath the surface, straining to see through the darkness. Is she also me?

__________

My recent ketamine infusions have all featured water, and I’m often drowning in it. It’s not scary – it’s peaceful. It’s soothing. I’ve never stayed up by the surface before; always finding myself sinking into the dark, quiet depths. But this time, I was floating – pressed against the underside of the ice, trying to see through it to the person on the other side. I was curious about this person, but the darkness closed in before I could begin to unravel what was happening, and then I found myself in a different scene, which I do not remember.

I’m fascinated by this recurring theme of water, especially because in my regular life, I’m not a big fan of it.

I have sensory processing disorder, and as a young child, I flat-out refused to swim. I was overwhelmed to the point of tears by the splashing, the echoes in the pool, the temperature change from air to water, and most of all, the fear of people touching me. I eventually came around to the idea, but never enough to take lessons. So, having never properly learned how to swim, I nearly drowned at a friend’s birthday party when I was 8. I remember being uncomfortable going into the deep end, but my friend was insistent. I lost my grip on the side of the pool and began to sink. When people say that drowning is not a dramatic event – there’s no splashing or screaming – they’re right. My head tilted back instinctively as I went under, and I could see my hand, extended above me, slip under as well while the rest of my limbs flailed uselessly underwater. A panicked hopelessness overtook me as I choked on chlorinated pool water. Then, my friend’s hand broke the surface, reached down, and grabbed my wrist.

I have never felt relaxed on or in water, and it’s not just the near-drowning that explains it. The same sensitivities that kept me from participating in swimming lessons have persisted into my adulthood. I dislike the unsteadiness of water, the unpredictability of how it will splash, the feeling of water on my face. And yet, when I’m reclined in my doctor’s office, ketamine moving into my bloodstream, visions of water are soothing. I can feel the cool, constant pressure of being underwater without the anxiety or the sensory overload. I can feel myself standing on the deck of a boat, watching the foamy water beneath me leap forward and recede, and I feel peaceful. I’ve seen whirlpools, rivers, melting glaciers, and the unbelievable enormity of oceans. It’s a strange experience to suddenly realize what water might be like for other people, as those feelings are foreign to me in my waking life.

I feel as though, unhampered by the symptoms of my sensory processing disorder, I can connect to a larger, evolutionary interest in water that I am unable to find under normal circumstances. Humans have been fascinated with water for millennia. In fact, some evolutionary anthropologists believe that nearness to water supported the development of large brains – that we are, in part, the heritage of small, coastal communities of early humans whose lives revolved around the movement of water and the food within it. To this day, many island and coastal cultures retain great reverence for the ocean. When we gaze out upon a watery horizon, it is difficult to not be awed by the vastness before us. In my eye, to find our place in relation to bodies of water is akin to our struggle to find our place in the vastness of space. Questions of identity and survival are found in the depths, and I believe we carry the answers within ourselves.

My depression is a constant in my life. It is all-encompassing, lonely, and feels like drowning. I’m not one to find meaning in every dream, but the images of water that I experience during ketamine infusions have begun to feel profound. What does it mean? Certainly not that I should give in, wave a white flag and let the water crush me. Nor should I wait breathlessly under the ice, squinting as if to look through a frosted pane of glass, uncertain if I’m even above or below. Rather, I believe my visions of water are windows into the nature of the human experience. Perhaps they’re snapshots of how I feel – how depression feels to me. My mind is an ocean, and at times, it’s oppressive. I sink within myself, finding it easier to let the water cradle me as I descend than to keep swimming. At other times, I find comfort in accepting the changing nature of my illness. Like a river flowing downhill, impermanence is unstoppable, and the emotions of being a human move inexorably back and forth. When we crest the top of a wave and begin to fall down the other side, we wait for the next one, just as we take each arriving day. And when you are drowning, reach up. A helping hand may be just about to break the surface.

To start at the beginning of my journey with IV Ketamine for treatment-resistant depression, check out Part 1

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Self-Compassion When Living With Depression

I had a conversation the other day about the balance between recognizing that treatment-resistant depression is chronic and pushing oneself to do difficult-but-healthy things.

It started with a question: What advice would you give someone about dealing with depression?

Personally, I find it helpful to remind myself that depression gets in the way of my ability to think clearly. Depression brain is a liar. It makes me think that I’m a stupid, horrible burden and that everyone would be better off without me, even if they say otherwise. It makes me think that feelings are forever, and that I must be too weak to effectively change myself.

It’s really hard to change the way you think, especially when depression is sitting on you, yelling into your ear about how terrible you are. Sometimes it helps to remember that I have a disorder that skews my thinking. But that doesn’t mean that I shouldn’t push myself. It’s a difficult balance; to recognize that my symptoms explain my behavior, but they aren’t the be-all-end-all of what I do.

You know how frustrating it is when a well-intentioned but misinformed person tells you that if you’d just try barefoot ultra-marathon running or hot goat yoga at 5am, you wouldn’t be depressed? That person is inside my brain all the time, and because I know that it’s unreasonable to expect myself to just *poof* try harder and not be depressed, I’ve always struggled to write something on this subject. I don’t want it to come across in the same way that my brain talks to me, because I would never, ever talk to anyone about their depression in same the way I think about my own. My brain says stuff like this:

“Yeah, you feel pretty crappy today, and you know why? Because you only ran one mile. Maybe if you’d run THREE, you’d feel better. You only have yourself to blame.”

The example that I’d like to set as a person who writes about mental illness is something more like this:

“I still feel crappy, even though I went for a run. I’m glad I did it, though, because I know that it’s helpful – even if it doesn’t feel like it.”

That kind of thinking is really hard to implement, and I won’t lie – I’m pretty far from doing it naturally. It’s hard in part because we know that things like exercise, being outside, and social connection are helpful for depression. How much pressure should I put on myself? How much am I capable of when I’m depressed? Should I be expecting these things to “fix” me? Whenever I ask myself these questions and get bogged down in the details of how much I’m doing, my plans for doing more, why I should be doing x, y, z, I miss the obvious point.

I’m mean to myself.

I’m trying to convince myself that it doesn’t really matter how much I decide to do in miles, minutes, or step-by-step sequences. It only matters that I did a little bit more than I wanted to. It only matters that I did something because it’s good for me, not because I bullied myself into it. It’s good to set goals (or clams, if you’re being fancy) for yourself, and it’s fine to go at a pace that works for you under your current circumstances. I know that for me, I often fall into the trap of expecting myself to function at the same level that pre-depression me did. Sometimes I worry that if I don’t berate myself enough, I’ll get complacent and stop striving to improve. In reality, I know from experience that the motivation to grow returns naturally when I’m feeling better. It’s tough to believe it, but my first priority should be to treat my depression, and everything else will fall into place.

If you’re hard on yourself for not meeting your own expectations while depressed, I relate. A lot of people relate. After all, feeling bad about yourself is itself a symptom of depression. And to be clear: trying to be nicer to oneself is not advice intended to invalidate that symptom. It’s not to say “you’re doing it wrong, just be nicer to yourself”, it’s that combatting negative self-talk with positivity (or at least positive-tinged neutrality) is a strategy intended to treat that symptom.

I’m not very good at it yet, but I’ll keep working on it. Gently.

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Working on Depression

Sometimes I feel like a bird that can’t figure out how to fly. I periodically get launched out of a cannon (in this metaphor, that’s ketamine), then flap and flap to no effect. I’m trying to make progress, but gravity is always there. Eventually, I sink lower and lower, just exhausting myself with all that flapping.

That’s how it feels, but I don’t think that’s entirely accurate. Yeah, ketamine wears off eventually, and yeah, my brain has a biochemical problem that means I can’t fix depression just by flapping. But the flapping is doing something. All that work I put into therapy and maintaining a routine and getting exercise must be functioning in tandem with the ketamine to push my little bird wings just a smidge farther.

I know this because my mood still dips pretty low sometimes, but on the whole, I’m in a better place than I was a few months ago. Perhaps it’s that I bounce back faster, now. Or maybe it’s just knowing that it won’t last forever.

And now, being able to look back and see that I’m flippity flapping on my own a little makes it just a little bit easier to continue. Chipping away at something day by day is tedious and frustrating, but all of that work adds up. If you can look back at where you were a little while ago, it helps to notice that you have made progress, even if it’s just in the personal growth or a skill you’ve learned or the support you’ve gotten.

Keep flapping, everybody.

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Therapy Code Words

Unfortunately for me and my therapist, my ability to write words does not always translate well to being able to speak them. I need time to think through an entire thought before I speak it, and I struggle sometimes to get the words out when the topic is something challenging. And not just for sensitive topics like self-harm or suicide, but even for topics like life goals.

In fact, the word “goals” makes my stomach twist. I feel so much internal pressure when it comes to my ambitions that any discussion of the topic overwhelms me. It’s as if I know that once I start really acting to reach my goals, I’ll have to go all out because I don’t know how to not do something 100%. And that’s overwhelming. And unrealistic. So I try to avoid talking about it or thinking about it beyond my daily sense of guilt for not “doing more”.

It goes without saying that I don’t like this. Goals are important, and they should be exciting, not something you dread. Yes, they often take hard work to reach, but I think the balance of work to reward should be worth it. I don’t want to put in work just to alleviate an unhealthy internal pressure; I’d rather work for something because I want the excitement and fun and pride of achieving the thing. Depression makes this hard. Excitement and fun and pride are not feelings that depression wants around. So, I find myself terrified of adding more to my plate and pursuing my goals, and terrified that I’ll do nothing and fall even more behind my self-imposed schedule. Trapped in between the two, “goals” is a scary word.

Here’s where the code word comes in. Instead of “goals”, my therapist and I talk about “clams”.

It’s groundbreaking, I know.

There’s no significance to clams, it was just the first word my therapist thought of, but it stuck. Much like the Potato Scale of Depression is useful in its humor, “clams” are somehow easier to talk about because of the silliness. It takes away the gravity of having a discussion about goals and replaces it with a lighthearted conversation about a bivalve often eaten with a lemon-butter sauce.

And this is how I want my goals to be. Not so scary. Not so enormous. Just little steps to bigger results, like shucking one clam at a time to make a chowder.

Photo: Andy Castille – @kikini

5 Ways I’m Reducing My Depression Naps

I sleep ok at night and WAY too much during the day. When I’m really depressed, I can get up early to take care of my dog and then go back to sleep until late afternoon. Sometimes, I can limit it when I have a lot keeping me busy, such as any work tasks I might have – which I do from home and largely on my own schedule within a day. But for the most part, I find myself frustratingly vulnerable to the sandman’s influence. Plus, now that Stella is no longer a puppy, she’s happy to spend hours on end with me, dreaming of whatever dogs dream of while we sleep on my bed. She used to wake me up every couple of hours to demand something from me, but now, it’s all snoozing.

1. Running

Running is a two-birds-one-stone solution for me, because it offers both the physiological and biochemical benefits of exercise in addition to the incredible fact that you can’t sleep when you’re running. I’ve lost a lot of my endurance, but I’ve been maintaining at least some regular running, which is remarkably easier to do the more recently I’ve had a ketamine infusion. I recently noted that the day after an infusion, I ran three miles without stopping, which I hadn’t done in months. Then, a few days before my next one, I struggled just to run one mile. Why is it so different? I guess that as the ketamine wears off, I lose the mental energy to push myself very far, and I’m worn out as soon as I start. It’s frustrating, but I try to just be pleased that I got out there at all. Perhaps, if I manage to rebuild my endurance a little, it’ll be easier to keep it up even through the changes to my ketamine buffer.

2. Setting the Intention with No Nap Monday

No Nap Monday was created in response to the smashing success of Yes Day, both of which were proposed by my therapist. No Nap Monday has been far less successful, but I do try to at least sleep less on Mondays. Sometimes I set an alarm for something reasonable, which is definitely subjective and changes week to week. Sometimes, it’s an hour. Sometimes, it’s three. But no matter what, it’s good to at least have the intention.

3. Adding Activities

Ultimately, my goal is to not only sleep less, but also do more. It follows that I should attempt to add things to my routine. Volunteering is option that interests me. Over the years, I’ve volunteered or worked with animals in a few different capacities, and I always really enjoy it, so I tend to look for opportunities in that area. There’s an animal rescue near me that needs volunteers to feed the bunnies, and that sounds right up my alley. I just have to tackle my expert-level overthinking habit and then plow through my anxiety about new things and I’ll be right on track!

4. SAD Lamp Makes Me Happy (or at least less sleepy)

It’s now mid-October, so I pulled my seasonal depression lamp out of my closet the other day. The weather doesn’t affect me as much here in Colorado as it did in Michigan, but I can tell after a few cloudy days that I’m in need of some sun. Simulated sun will have to do.

5. Changing My Routine

Much as I hate doing it, deviating from my routine often keeps me from napping too much. I tend to get irresistibly tired as noon approaches, and my mood slopes downward in the afternoon anyway, so that’s my prime depression nap opening. By forcing myself to be busy doing other things during that time, I keep my brain on its toes. The downside to this is that I do well with routine for other reasons, so abandoning that makes me anxious and sometimes decidedly cranky. But at least I can prove to myself that I am capable of functioning without depression naps.

Things That Don’t Suck

The last two days have been washed in heavy winds. The leaves, just turned golden-yellow, are being stripped off of their branches to accumulate near the front door, where they’re much less pretty. It’s a small thing to be disappointed about, but it seems as though so many things in the world suck right now. For one thing, our Home Depot skeleton, David S. Pumpkins, is constantly buffeted by wind on the seat from which he offers a cheery wave. Every morning, I find him slumped over as if we force him to sleep outside on the park bench, when really, he just doesn’t have the muscle tone to stay upright. What must the neighbors think? He likes it out there, I promise.

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Up and at ’em, Dave!

You know what else sucks? Depression. I recently had my regular mental health bloodwork done to make sure my lithium level is within the appropriate range, as well as to measure my thyroid function. All is well. Lithium can cause hypothyroidism, which can cause fatigue. We thought it would be worth investigating as a potential cause of my excessive sleeping, but no – that’s just depression. Don’t get me wrong, I’m glad I don’t have to make adjustments or take new steps to deal with a whole new problem, but reducing my lithium dose or adding a thyroid med sounded like a simpler answer. Instead, the answer is just to carry on treading water in the sea of treatment-resistant depression. Just keep swimming, right?

So, let’s make some teeny tiny inflatable water wings to keep us afloat. Here’s what hasn’t sucked lately.

  • My houseplants are doing great. Man, they look healthy.
  • I learned how to use my new, short ChuckIt to throw a tennis ball like I’m skipping rocks rather than overhead. (My rodent-obsessed dog prefers to chase things that go along the ground.)
  • I unearthed two whole sets of flannel sheets that I forgot I had.
  • I swapped out the hummingbird feeder for the regular bird feeder, and it’s becoming quite popular.
  • The coyotes woke me up with their howling the other night. I always find it eerily mesmerizing. 7/10 spooky.
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Hi, little chickadee.

What hasn’t sucked for you, lately?

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It’s Been a Whole Month: Birthday, Anxiety, and Ketamine

I can’t believe it’s been a month since I last posted here. I have some in-progress posts that are languishing in my drafts folder, but none of them feel complete enough to be posted. So, to try to break through the stall in my writing, this is a rambling update that will have to be good enough for me.

Look at me, fighting perfectionism one disjointed blog post at a time.

Ketamine

I haven’t written about my most recent ketamine infusions because the propofol makes it harder to find anything about them to share. I think that going into it with the expectation that I won’t remember much makes it harder to grasp whatever snippets do remain. Having the intention to write about an infusion helps me pay attention to my experience; without it, the whole appointment just disappears from my memory in the hours following an infusion.

When I began my treatment with ketamine infusions, I was fascinated by the endless imagery that each infusion created. Every appointment held new associations and interesting scenes. But lately, they all feel the same. Of course, this is okay. The dose of ketamine that I receive would probably be too intense without the propofol, and I suppose I’d rather not remember much than have a terrifying trip. Still, there was something helpful about having something of the experience to hold onto.

I have the sense that I’m more able to remember things when I’m more present in the real world – like how you remember your dreams when you awaken in the middle of them. I wonder if the degree to which you’re aware of your surroundings during a ketamine infusion impacts its efficacy, if at all. Because if it’s not at all, I’d totally ask my doctor to poke me every 15 minutes and ask me what I’m thinking about so that he can write down whatever absurd, hilarious things I say. Although, my level of zonk is usually such that I probably wouldn’t answer.

Birthday

My birthday happened this month, and it caused a lot of anxiety about the future. It’s frustrating to be hindered by my own brain. I commonly hold myself to unrealistic expectations and judge myself harshly for not meeting them. I wanted a different path than the one I’m on now, and I’m having a hard time letting go of that vision. Not that I can’t eventually end up in the same place, but I didn’t see it progressing along such a challenging path. But that’s life, right? I’ve been trying to re-frame my birthday as just another marker of survival. If I can’t get myself to be pleased with my progress in the last year, I can at least be neutral.

Anxiety

Anxiety and depression often go together, and I’ve noticed a pattern in my mental health where I alternate between the two. As I start to come out of depression, the anxiety kicks in and I feel horrified by all of the time I “wasted”. I think about how far behind my expectations I am, and then I get a frantic sense of urgency to kick it into high gear. Unfortunately, I’m also easily overwhelmed and the prospect of “catching up” to my expectations triggers an avalanche of worries and insecurities. Ultimately, whether it’s depression or anxiety that is most immediately at hand, the result is still a barrier to my forward movement.

This flexible connection between depression and anxiety is not black and white. I wouldn’t say that I move completely out of depression and into anxiety – the Venn diagram has more overlap than that. My position within it just shifts into the middle so that I’m simultaneously slow, tired, and occasionally hopeless while also filling up with anxiety saturated with heavy judgement. Fun times.

At least the anxiety pushes me to do more than I otherwise would. I would rather be motivated by the reward of doing the thing rather than the fear of not doing the thing, but I also prefer being motivated at all over not at all (if that makes sense). I’ve been trying to run again, and have been somewhat successful in the last couple of weeks. The wildfire smoke in Colorado has intermittently lifted and returned, so I don’t always get clear air, but I figure the benefit to my mental health probably outweighs the damage.

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This is kind of a rambling post, but again, I can’t seem to write anything in this context that seems worthy of posting. So, this will have to do. In other news, this is not my kitten, but look at how cute she is.