yearly calendar on table with cup of coffee and dish of paper clips

December Resolutions

The yearly frustration that most of us can likely relate to is that our New Year’s resolutions only last a few weeks, or at best, a few months, and yet we continue to make them. It’s relatable because change is hard, and the excitement of turning over a new leaf soon gives way to the stresses of normal life and the reality of breaking old habits. But there’s something so attractive about starting fresh; new calendar, new me.

Clearly, I like the idea of making a deliberate change on a specific date. Something about marking your resolution with an external, cyclical change makes it feel more decisive. Unfortunately, I am so put off by the pressure of an entire year ahead of my resolutions that I simply don’t make any. I’ve made New Year’s resolutions in the past but petered out before they really formed habits. Then, the internal shame of having failed a New Year’s resolution discourages me from trying again mid-year. Because really, why can’t I just resolve to change whenever I want? Because human brains like to impose order on things like arbitrary laps around the sun.

Instead of griping about the pitfalls of New Year’s resolutions and why I can never seem to make it work for me, I’m going to try something different.

~*~*~*~December Resolutions~*~*~*~

This sounds incredibly silly and I think that it’s a little bit sad that it’s come to this, but I think I need to trick myself into meeting my goals. Instead of making a list of resolutions and waiting until the new year to begin, I’m going to have a trial month for my new habits. December will be my 31-day behavior test, and if I hate the goals/habits I come up with, no big deal. I won’t feel bad about quitting because it’s only my December resolutions, not the monumentally more important New Year’s resolutions.

(Yeah. It’s exactly the same thing, but shhh, don’t tell my brain.)

Bonus, if I do like my resolutions and am happy to keep going with them, I won’t have to face the overwhelm of a brand new year stretching ahead of me. I’ll already have a whole month under my belt.

I really think this is going to work for me, at least better than the usual resolution schedule does. Here’s my list of December resolutions, but remember, it’s low-stress, low-commitment, so these can change without me feeling like a failure. At least, that’s the theory.

  1. ACTUALLY start volunteering. Somewhere. Anywhere. Don’t just think about it.
  2. Keep running regularly (yay, I’ve already started!) See if I can reach a comfortable 5 miles by January. I’m more than halfway there, so this seems very doable.
  3. Reestablish a skincare routine, aka get my psoriasis under👏 control👏.
  4. Welcome the hostile Duolingo owl back into my life and start re-learning German.

These seem reasonable to accomplish within a month. The one that I’m definitely most apprehensive about is volunteering. At this point, I’ve thought about it for so long and looked at opportunities in such detail that I really have to just go and do it, and try not to worry about all of the unknowns (thanks, SPD).

Ok, internet, hold me accountable.

white sign with black capital letters reading "you are worthy of love" near telephone pole, green bush, and asphalt walkway

Considering Worth and Achievement

I’m going to therapy tomorrow morning. Last week, there was a moment when we were talking about my goals and I became very quiet. Something in my thoughts had made me feel emotional, but as I was enjoying having a normal conversation with my therapist, I pretended nothing happened. (Haha, nice try. I think she knew.) Now that I’ve had a week to think about it, I’m planning on bringing it up when I go to my appointment tomorrow.

Here’s the issue: there were parts of me that I had thought were stemming directly from my depression. Feeling worthless, after all, is a symptom of depression. But now that I’m feeling better, I find that I’m still thinking of myself as less valuable than other humans. Whether that’s a product of having been depressed for a while, or it was there all along, I’m not sure how to change it. Talking about my goals led me to this realization because I started thinking about the value of my accomplishments and the cost of my depression. Treatment for my depression has become expensive, and when I pondered that in therapy last week, I suddenly concluded internally: “I’m not worth that much.” Reaching my goals and accomplishing what I want to is, in my mind, the way for me to become “worth” the expense.

I don’t want to get too philosophical- that’s not my area- but I’m comfortable declaring all human life inherently valuable. Let’s exclude those variables like violent crime and abuse, and consider everyone without any actions in their past. John Locke considered the mind at birth a blank slate, which experience acts upon to form our beliefs and knowledge. This leaves us with two possible conclusions, I think. Either the “blank slate” of human life is worthless until some positive attributes or achievements earn that person value, or all people have innate value by virtue of simply existing with potential.

It’s clear to me, and to most people, I think, that human life is innately valuable. So, why am I so stumped when it comes to believing in my own value?

Sometimes, I try to trick myself by arguing that because I think I am fairly average, there is no reason that I would be special enough to be an exception to such a universal rule like “all people have value.” Then I reach some kind of does not compute error in my brain and start the whole thing over again.

Aaand this is probably the point where my therapist would tell me that I’m very cerebral and maybe should return to feeling feelings. Yeah. I get stuck in existential loops a lot.

Week 23 of Working on Us: Medications

Working on Us is a wonderful series over on Beckie’s Mental Mess, where each week has a new prompt meant to get people talking about mental health topics. Check out the original prompt for week 23 and click around to find participants of previous weeks’ topics!

mental health matters

When you first were diagnosed with your mental illness/disorder, did it take a while to get used to your medications that were prescribed to you?  If you answer the question, (YES), How did you feel initially?

It took me a while to get used to the idea of taking medications for my depression, but the first antidepressant I tried had very little effect on me. So, from a physiological perspective, no- nothing wild happened at first. But from a psychological perspective, it definitely took me a while to get used to it. I was a college student when I sought psychiatric help, and I had all kinds of negative beliefs about what it meant for me to be taking medication. It took me a while to accept that I was depressed, instead believing that I was simply not working hard enough. I even believed for a while that I was taking resources away from other students who really needed them by going to my appointments at the student health center. That’s a sad memory.

Depending on how long you have been on medication, how many times do you think it has been adjusted to make you feel stable?

Gosh, I don’t know. Dozens? Counting each medication I’ve tried, there’s been a lot of adjusting. Ketamine infusions have been the most effective treatment for me, but I still take my medications to keep me stable.

Have you ever had a bad reaction to medication?

Twice.

A couple of years ago, I started taking Wellbutrin and almost immediately felt my depression improve. Unfortunately, I also almost immediately had an allergic reaction and had to stop taking it. I developed an intensely itchy, blotchy rash on my chest that spread to my face, back, stomach, and eventually started to cover my arms.

Somewhat recently, I tried adding Abilify to my other medications. I didn’t notice any improvement to my mood, and it made me incredibly shaky. Going down stairs started to feel a little dangerous because my legs were like jelly!

Have you ever suffered withdrawals from a certain type of medication, and if so… What type was it?

No, I was worried about coming off of Effexor because I had heard it could be difficult, but I didn’t have any withdrawals from that or any other med I’ve stopped.

Do you work closely with your doctor in regards to your medication intake?  (In other words, do you have a good relationship with your doctor?)

Yes! Finding a provider I really like has helped enormously. I had such a hard time speaking openly about my symptoms with doctors, so the first year or so of my medication treatment was tough. Once I switched providers and found someone who helped me be honest and upfront, medications have been much less intimidating.

Since your diagnosis, have you ever tried to not take medication and see if you can handle your symptoms of mental illness/disorders on your own?  If so, how did that work out for you?

Nope. I recently tried to decrease my lithium dose and didn’t get the outcome I wanted. I think I’ll be leaving my meds alone for a while.

Tell us briefly how medication has affected your life?

While medications haven’t helped me nearly enough that I would consider myself fully functioning, they have helped me way more than I could do on my own with talk therapy. That is, they haven’t been wildly successful in treating my depression, but they have saved my life and continue to allow me to live with my symptoms and find other treatments.

white bell-shaped flowers pointed down during dusk light

Setbacks in Depression Recovery

Lately, I’ve been excited to begin going in the other direction with medications as part of my depression recovery- reducing rather than adding. Through years of treatment, it seemed like I was always either increasing a medication or trying a new one. I never got much relief from antidepressants (except the one it turns out I’m allergic to), and lithium, the mood stabilizer that has probably saved my life, comes with the risk of kidney damage if the levels of it in your blood creep too high. I still take an antidepressant, two mood stabilizers, and Deplin (because I’m a mutant). These drugs help me function, and although they don’t kick my depression completely out the door, they are important.

I have a love/hate relationship with lithium. It dramatically reduces my suicidal thoughts, and that’s amazing. If I were to describe how it felt when I was at my highest dose of lithium: it’s like you’ve been gritting your teeth for years, and then all of a sudden you realize you’ve stopped. All of that pressure, the wear on your teeth every single day as you work your jaw muscles without cease, suddenly vanished. Like the peace you feel when static background noise shuts off, and you’re left in silence. When I got to a high dose of lithium, I was floored when I realized that I hadn’t thought about suicide all day. In fact, lithium makes it a little bit difficult for me to think about suicide in the same way I do without it. Focusing my thoughts on the idea feels a bit like trying to push the same poles of two magnets together. But when I had to reduce my dose because of the risk of lithium toxicity, the suicidal thoughts started to come back. Not to the degree that they once were, but it was clear that the change in my lithium dose was to blame. Still, I’ve enjoyed a lesser degree of suicidality than I experienced without lithium.

Lithium restrains my thoughts from straying into suicidal ideation, but it comes with some unpleasant costs. Because it’s processed through your kidneys, it has a tendency to make people thirsty. If I go too long without water, I feel like I’m shriveling up like a dry sponge. It also makes me feel absolutely exhausted, napping excessively (even more than I normally do when I’m depressed). So although it does some wonderful things for me, I’ve always hoped that I wouldn’t need it forever.

Overall, I’ve been enjoying a recent improvement in my mental health. This is because of IV ketamine infusions, which treat, among other conditions, treatment-resistant depression. When I started to feel better and my depression recovery seemed to be on track, the spark of hope that I might someday be able to come off some of my medications began to grow. I was excited- why stay on meds that are only half-working if you have something better?

I talked to my psychiatric nurse practitioner about reducing my lithium dose by about a third. Within a week, the consequences of reducing my dose were becoming clear. I started to feel less interested in things again, tearful, and guilty about my depression. The slip was minor; I wasn’t feeling much worse, but it was compounded by my thoughts about the situation. I was looking forward to reducing my medications so much that when it went badly, I let disappointment carry me into catastrophizing. I thought that I’d never be able to leave lithium behind me, and would always rely on it to keep me safe from myself.

I quickly went back to my previous dose and waited for my symptoms to subside. Honestly, if it turns out that I do need it forever, that would be okay. There’s nothing wrong with needing medication. For now, though, I’ll tell myself that I was just too hasty, and try again someday soon.

It’s tempting to beat myself up for “losing progress,” but that’s all just part of life. When I feel trampled by my mental illness, I try to reframe the “progress” I think about as being more about the time you spend living and the things you learn along the way than about the state of your mood. Progress is existing each day and surrounding yourself with ideas and actions that keep you going. You’re living along the course of your own life- whatever that might be- and that’s progress.

lamb sleeping in profile against wooden boards

Let Yourself Dream

Months ago, I made a draft document full of blog ideas. One of those ideas simply read “Let Yourself Dream”, with a brief list of my own lifelong dreams. It sat, unused, for months until, two days ago, my therapist suggested that I let myself dream this week. The words stuck, niggled in my brain for a few hours, and finally clicked. I had already written it down as a blog idea!

My depression is finally starting to lift, thanks to IV ketamine infusions and my rock-solid support system. Over the last few days, I’ve found myself thinking about all of the things that I want to do, now that I’m feeling better. Actually wanting to do something is an unfamiliar feeling, and is honestly a little overwhelming. There’s so much I want to do! Where do I start, and will this newfound mental health last? Rather than getting bogged down in all of the what ifs, this week, I’m going to dream.

1. Train and Certify Stella as a Therapy Dog

This is a goal that I’ve had ever since I adopted Stella, and maybe even before then. I think it would be so rewarding to volunteer with her in retirement homes, physical therapy treatment facilities, and hospitals. When I was a patient in a mental health hospital, we were delighted when a therapy dog came to visit us. To be able to bring a little bit of happiness to people in a difficult situation I have experience with would be beyond gratifying.

2. Hobby Farm

THIS has been my dream for a good decade or so. I love animals, and there’s something about having a house with spacious property and a chicken coop, barn for some sheep and goats, maybe a dairy cow, and some alpacas (so my mother can have their wool) that just sounds perfect. I love routine, and the hard work of caring for animals every day and maintaining a garden and home seems like it would be therapeutic for me. This is a lofty goal, but hey, we’re dreaming, here.

3. Make Writing a Career

Yeah. Not sure how to go about doing this or even if I would do okay at it. But doesn’t it sound nice to wake up, go take care of my farm animals, then spend time writing in my sunny home office before harvesting some home-grown vegetables? Sounds wonderful to me!

4. Have a Regular Social Calendar

This is maybe not so much a “dream” as it is an eventual necessity. Depression combined with introversion has made me very isolated. The thing to do now is to find some groups that interest me and actually go to them. Not just bookmark it or download an app, but actually go to an event and meet people. Easier said than done, but the best things are worth working for.

5. Run a Half-Marathon

Yet another thing I bookmarked and set aside. I used to run almost every day, and at times, it was really beneficial to my mental health. Unfortunately, I stopped running entirely for a while, and since then, have picked it up only in fits and spurts. If I’m going to reach my goal of running a half-marathon (let’s be reasonable- a full marathon is too much for me) I need to run with more consistency and pick a race to train for. The good news is, it’s always easier to get back into than I think.

 

These are just a few of my dreams, and although some of them are distant, it’s nice to remember that I’ve already achieved so many of my old ones. Getting my own dog was number one on my list after college, and now the single greatest joy/irritation in my life is watching my canine friend slam her paw down on my keyboard when I’m not petting her enough. It’s so endearing.

What are your dreams? Have you thought about it lately? Maybe take a moment this week to revisit those goals that seem out of reach and reassess; how would you go about achieving them?

scrabble tiles reading Mental Health with sprig of greenery on side

What’s in a Diagnosis? MDD and SPD

This post first appeared on Mental Health @Home in Ashleyleia’s Emerging Blogger series.

Many thanks to Ashley for hosting me!


Diagnoses are a contentious topic. Logistically, they’re important for clinicians and insurance companies who need proof of your conditions. But for the individual, they come with pros and cons. I carry the well-known diagnosis of Major Depressive Disorder and the less well-known diagnosis of Sensory Processing Disorder. The effects of the diagnoses themselves feel very different to me, and I’ve spent some time reflecting on why.

Well-Known vs Little-Known

A diagnosis of Major Depressive Disorder made me feel much less alone in my suffering. Depression is astoundingly common and increasingly talked about. Stigma remains, to be sure, but awareness surrounding depression is thankfully improving. I can be pretty sure that when I tell someone that I have depression, they’ll know what I’m talking about. The same cannot be said for Sensory Processing Disorder.

Insecurity in a Diagnosis

Having a diagnosis of MDD, maybe more than making me feel less alone, makes me feel understood. Simply saying the word “depression” makes most people, I think, picture the same constellation of symptoms: low mood, lethargy, loss of interest, etc.. This is not to say that I haven’t encountered stigma or innocent ignorance- I have. But when I tell someone that I have depression and they tell me that their brother or friend or significant other has depression, too, it connects us for a moment, and I know that on some level, they know what I’m going through.

This is not generally the case for my diagnosis of Sensory Processing Disorder, at least in my own lived experience. A person with SPD has difficulty processing the information that comes in through their senses, including the usual five (touch, sight, sound, smell, taste) as well as the less well-known senses of proprioception (where your body is in space) and interoception (internal body sensations like hunger). SPD can make you over-sensitive or under-sensitive to these stimuli. I’m over-sensitive to most, just plain bad at proprioception, and relatively unaffected when it comes to taste. Sensory Processing Disorder is overwhelmingly common among people who have Autism Spectrum Disorder, but you don’t have to have ASD to have SPD. They are separate disorders that have a TON of overlap. Despite the growing body of literature from occupational therapists, scientists, and doctors, SPD is not included in the DSM V.  It is, however, its own diagnosis in the ICD 10. This discrepancy is what throws me off. I know that SPD is real. And yet, when I try to explain to someone what it is and how it affects me, I flounder. It’s challenging to describe how I’m affected by a diagnosis that not everyone agrees upon. It leaves me feeling vaguely defensive, or like I’m grasping at straws to explain my symptoms. In this sense, the label of SPD does not make me feel secure in my experience of the disorder.

Feeling Alone with SPD

While it is incredibly validating and relieving to have an explanation for symptoms that aren’t frequently talked about, the very fact that it’s not often discussed makes for an isolating diagnosis. I feel much more uncomfortable when I have to explain SPD than I do while explaining MDD. Once you grow up and leave behind the allowances of childhood, you’re expected to conform to a lot of social and institutional rules. I think this is why kids who have SPD grow up to be adults who hide their symptoms with willpower. They put themselves into situations that cause them distress because it seems like they “should” be able to. The problem here is not that you might push yourself to do uncomfortable things – that’s how we grow. The problem is that people with SPD often hide their discomfort and end up feeling alone and wrong for feeling how they do. It also leads to overstimulation and meltdowns, chronic anxiety, and exhaustion. Ultimately, I am so glad that I know about my SPD, not just because it explains all those sensory symptoms that make me think “why can’t I be like other people?”, but because it offers me room to advocate for others who feel alone in this diagnosis, too.

How a Diagnosis Can Hurt

For me, whether the diagnosis is well-known or not, simply having a name for what I’m going through is incredibly helpful, and I believe outweighs the downsides of having a label. That said, there are some potential dangers of diagnoses.

Mental Health and Identity

I’ve heard lots of discourse about the risk that you might allow diagnoses to seep into your identity until there’s no room for anything else. I enjoy writing about mental health, and at the moment, a lot of my focus is placed on managing my depression. Our experiences shape us, so it’s natural that I find parts of my identity rooted in depression and Sensory Processing Disorder, but I know that I am a whole person without them.

Is a Diagnosis Confining?

The risk that I don’t hear much about when discussing diagnoses is the ease with which a label can trap you in a definition. It’s subtle sometimes, but having a diagnosis of depression can make you perceive even mundane things as attributable to your disorder. For instance, I recently read a book for the first time in a long time, a hobby I abandoned when depression settled in again. The book was humorous, but I didn’t laugh out loud or even pause to appreciate the jokes. At first, I thought it must be because I’m still depressed. I didn’t even consider the possibility that maybe the book just wasn’t that funny. Feeling confined within my diagnosis, the sub-par experience of reading that book became a product of my depression.

A new diagnosis can, understandably, push you to look for information online. Reading case studies and statistics, while informative, might be discouraging. I think it’s very easy to slip into a set of criteria and forecasted outcomes because a diagnosis feels official. It’s easy to forget that a diagnosis is an explanation of symptoms, not a set of imposed rules. Not only is this likely to feel suffocating- like a diagnosis of depression means that any end to an episode will inevitably be followed by another episode (something I struggle with all the time)- but it makes any attempt to counteract it feel futile. I constantly need to remind myself that a diagnosis does not confiscate my agency over my life.

There is Always a Choice

Even within a diagnosis with symptoms outside of your control, there is always a choice. You can always take action, be it reaching out for help or making the choice to take your medications. I take solace in the fact that I’m not alone in my diagnoses, even if it sometimes feels that I am. At the same time, I work to recognize that I am an individual with my own course through life and my own opportunities to fight.

Tall stalks with tiny purple flowers and a blurry background

Feeling Better with IV Ketamine Treatment for Depression: The Ketamine Chronicles (Part 6)

In Part One of The Ketamine Chronicles, I said that I don’t remember what it feels like to feel better, so it’s hard to imagine it being worth the effort. Well, thanks to IV ketamine treatments, my treatment-resistant depression is improving and I’m feeling better. For future reference, it is absolutely worth the effort.

When I got up to the dog park one recent morning, the skies were clear and there was fresh, deep snow on the ground. There was nobody there, so we had the place to ourselves. I let Stella into the empty park and swung my boots through the heavy powder. A gentle honking made us look up to find a flock of geese passing by on downy wings. With one glance, Stella took off after the flock, bounding through the snow with unbridled joy. My breath rose in clouds as I whooped, urging her on and clapping my mittens in the sharp morning sunlight. I felt like I was on a different planet. A new one, with bright, saturated colors and crisp air. This is what ketamine has done for me.

How IV Ketamine Treatment for Depression Has Helped Me

No antidepressant I’ve tried has had an effect on my treatment-resistant depression like IV ketamine has. With one infusion left in my initial series, I thought I’d check in with how it’s been progressing. I’ve been going to Boulder Mind Care for my infusions, and it’s been a wonderful experience. For a process you begin while feeling absolutely terrible, Dr. G and Sarah make a huge effort to make you feel comfortable in their clinic.

Incremental Positive Change

I think my strategy of detached curiosity was successful; I started to feel discouraged when it didn’t work right away, but I tried to just accept the process at whatever point I was at. It was subtle at first. I didn’t wake up and feel cured, but gradually, small things became easier. Getting out of the house, running errands, and just holding a conversation with someone became manageable, sometimes even enjoyable. I read a book, I went out to dinner, I bought more art supplies, and I even looked up the location of a support group.

For the first time in a while, I find myself thinking about the future in a positive way. It seems like surviving – maybe even conquering – depression is possible for me, something that even a month ago I would not have said. The fear that it won’t last is still there. The feeling that I shouldn’t commit to anything in case I can’t follow through is still there. But I feel strong enough now to push those worries aside and challenge myself to grow.


IV Ketamine Treatment #7

Ketamine infusion number seven went well. Rather than decrease the dose from last time, we did the same dose but slowed down the rate of the infusion. It hit me so subtly that for a while, I could barely feel it. I kept thinking that it wasn’t affecting me yet, but then Dr. G got my attention and reminded me to close my eyes. When I did, I saw beautiful, delicate golden bubbles that turned into raw corn kernels.

I guess it was affecting me, after all.

A hand holding an ear of shucked yellow corn in a cornfield on a sunny day with blue skies.
Photo by Jesse Gardner on Unsplash

The corn multiplied and moved until it was an ocean of golden-yellow kernels with people swimming in the sound of it shifting and pouring. I adjusted the volume of my music with the buttons on the side of my phone and noticed that my fingers felt like they were coated in suede. Someone knocked on the door in the waiting room, and Dr. G leapt up. I think maybe the door was not supposed to be locked, but I honestly have no idea. I was too busy with my visions of corn.

I know that I saw other things, but I don’t remember them at this point. I think it’s fascinating to guess why my mind comes up with certain themes during my ketamine treatments. On the way to my appointment, I thought about popcorn while my mom and I discussed seeing a movie this weekend. I can’t help but wonder if that influenced my ketamine visions of corn oceans.

Just before my first infusion, I suggested to my mom that she bring her knitting in while she sat with me. That ketamine infusion was heavily saturated with images of knitted materials and quilts. I think there’s something to this theory, and I wonder if you could deliberately seed your short-term memory with certain things that you wanted to contemplate during a ketamine infusion. Or maybe it’s a strictly unintentional process. That’s an anecdotal experiment that would take me a long time since I have one infusion left before my initial series is finished. So, if anyone is starting ketamine treatment for depression or anything else, do me a favor and read this post beforehand. Then let me know if you see lots of corn. 😉

If you’d like to read more about my experience with ketamine for depression, start from the beginning of The Ketamine Chronicles or visit the archives. Click here for mobile-optimized archives of The Ketamine Chronicles.