I Woke Up Cold: Thoughts From My Morning Coffee

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I put on a scarf at 5:30 in the morning because I woke up cold. It seems that I’m always cold these days. Months remain before the crocuses poke through the soil and the robins start to chirp. Months of ice and salt, of bitter wind and cracked skin. Of waking up cold. I step lightly on the wood floor in the dark and flick on the kitchen lights. It’s time for coffee, so I follow the familiar steps: a new filter, two and a half scoops, and enough water for a full pot. I don’t mind waking up so early; it gives me time to start the day slowly. If I try, I can get another half hour before I’m rudely awakened by a paw to the face– Stella has limited patience. So in the end, 5:30 is peaceful and silent, and I can sit alone at the table with my coffee while Stella smells the early morning air through the crack between the sliding door and the frame.

This morning is grey; the trees are grey, the sky is grey, the grass looks nearly grey. I can already tell that today will be a sluggish one. There will probably be a long nap, and I will likely struggle through work, only to wander aimlessly from one uninteresting hobby to another. I wonder if the ketamine is wearing off, but it’s only been two weeks since my last infusion. I want to will myself into a longer interval between infusions because two weeks seems rather short. I argue with myself when it comes time to rate my mood for the day on a scale of one to ten. (I get an automated reminder text on my phone and send the number as a reply. The results create a graph that my doctor can see.) I have this urge to fib- to make it seem like I feel better than I do. It takes some effort to not lie, and I always get a small twist of disappointment and shame when I send anything below a five.

What will today be? A four? Maybe if I get moving, I can make it a five or even a six. But frankly, today is grey and cold, and I don’t feel like doing anything. My depression is not seasonal; it stays all year. I’ve noticed, however, that the quiet arrival of spring sometimes tows along my missing optimism. The return of new growth and green things makes me feel a little more ready to come out of my shell. Anticipation tinged with anxiety will begin to stir in me as winter comes to an end. Anxiety because there will be more to do, and I worry that I won’t be able to drag myself out of bed to do it. Anticipation because I desperately want to.

For now, I am lost in January. Sometimes, the best I can do is curl up in the cashmere blanket my mother made for me, still wearing my scarf, and sleep. And hope that I won’t wake up cold.

What to Consider When Switching Therapists

Genevieve2 Comments

There are lots of reasons you might go from one therapist to another. You might be moving, looking for another perspective, or simply feel ready for a change. Or, it could be that your therapist is leaving; career change, maternity leave, any number of scenarios in which you must decide what to do with your treatment. And, pretty much no matter what, switching therapists is hard.

I’m in this boat right now, and I’m finding it more tricky than I expected. For one thing, I’ve had the same therapist for almost two years. We’ve gotten to know each other (in a heavily one-sided way), and when I’m not completely shut down with depression, I really enjoy her company. It takes me a minute to be comfortable with someone, so the thought of switching therapists and beginning that process again is daunting.

Online Research

When I began my search for a new therapist, I started with Psychology Today’s therapist directory. You can filter it by issue, insurance, gender, and other factors that might help you narrow it down. I also tried googling a combination of “therapist” with “depression” and my area.

Contact Method

Some therapists provide an email address with their contact information. Text, be it emails or SMS, is BY FAR my favorite way to communicate. Making phone calls is an arduous process, what with the scripting and practicing and heavy sweating. But, leaving a message on an answering machine is, in my experience, more likely to get you a speedy reply. [Pro tip: if you approach phone calls the same way I do, keep a list of potential therapists and the status of your contact. I can just imagine leaving the exact same scripted message for the same person twice and being mortified enough to cut contact entirely.]

Make Appointments with Multiple Therapists

I highly, highly, highly recommend that you make appointments or consultations with multiple people. It’s way more time-consuming, and I’m finding it difficult to tell my story again at each new appointment, but it’s the best way to find a therapist that you like. Your current therapist might give you a list of people to call, you can search the web, and if you meet with someone and it doesn’t work out, ask them if they have any colleagues they can recommend.

Therapists Understand that Switching Therapists is Hard

Switching therapists is an interesting process to go through after being in therapy for a while and having done the search a few times before because I feel much more sure of myself. I know what kinds of approaches I’m looking for and I know roughly what to expect at an initial appointment. But, I also have more of a history within the mental health treatment sphere to explain in a coherent manner. The sequence of events is too long to describe in detail at a first meeting, so I have to decide how to summarize in a way that gets everything across. I don’t always succeed, and then we’re left filling in important gaps that I forgot about. Fortunately, therapists understand that the transition can be a difficult process.

It can be hard to leave a therapist who has helped you through really tough times. They’ve supported you and listened to you, and it’s natural to be sad that your time with them is over. But, it’s not meant to be a relationship that lasts forever. I’m going to miss my current therapist, but I’m also looking forward to getting a new perspective. It might be just what I need to put all the pieces of my recovery together.

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Taking Stock of My Life with Depression

Genevieve2 Comments
text about not having energy for anything
Not my meme. Not sure whose.

In my experience, severe depression creates a kind of tunnel vision whereby the non-essential tasks of life get shuffled to the edges and only the act of surviving can be focused on. It’s not that you don’t know what’s on the edges, you just don’t have the energy to expand your field of view and look directly at them. I’m in an increasingly healthy place right now, and I’m taking stock of the state of my life with depression. I always knew that I was “falling behind” in my self-imposed timeline. In fact, I’m acutely aware of how much time has passed without me accomplishing the milestones and achievements someone my age is expected to be doing. My life looks very little like what I hoped it would by this point, a fact that is heavy with self-judgment and regret.

I still struggle to believe that depression happened to me. That it wasn’t poor planning, laziness, or a lack of ambition that kept me from moving forward, but an illness. I think that there are two helpful ways of looking at this. In one, the state of my life is a result of severe depression, a disorder that has kept me from functioning at the level I used to. This view helps stop me from blaming myself for every perceived inadequacy and from expecting too much from myself too soon; I do, after all, still have a serious mental illness that requires daily management.

On the other hand, I try to consider the state of my life to be in spite of severe depression. I didn’t do nothing while horribly depressed, I fought for my life. I studied and graduated, I worked part-time, and I adopted a dog. I went to therapy and tried medications and pushed myself to do things when I just wanted to sleep. Most importantly, my life – even as a life with depression – has continued. The things that I consider important for young adults to do or have mean nothing if there is no life to be led.

If you’re struggling right now, give yourself some credit for the courage and persistence it takes for you to show up for yourself every day. There is no timeline.

A woman wearing a black one-piece swimsuit floating in dark water with her knees bent and her arms outstretched to the sides

Underwater: The Ketamine Chronicles (Part 12)

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Breaking through the thin boundary between water and air is easy, but the farther down you are, the harder it is to swim to the surface. Higher doses during IV ketamine infusions for depression make me feel like I’m sinking beneath vast volumes of water, and the barrier between my mind and the outside world is very far away.

I don’t remember much from this IV ketamine infusion, which I have every few weeks as a treatment for my severe, treatment-resistant depression. I remember sitting in the chair and closing my eyes. Then, a minute later, the machine beeped and the nurse reached over to me. She fiddled with the IV, smiled wryly, then said, “We have to have the clamp open.”

“That helps,” I replied with a smile.

After that, I remember very little. I was listening to classical music in my earbuds, which seems to create (for me) more memorable images than meditation music, but apparently not memorable enough to outweigh the sack of bricks that hit me when the ketamine kicked in. I do remember bursts of thin lines that became ripples on water, and finger painting a nature scene with varying shades of pink. I remember a crocodile, a puffy dress, and watching my inner set of eyelids close to darkness.

It always takes some work for me to come back to the room when a ketamine infusion is over. This time, I kept thinking that people were waiting on me to come out of it, so I thought I should hurry up and return to my body. But, when I dragged my real eyelids open and looked around, somebody said, “Just a couple more minutes.” Oh. That’s why it was so hard to pull myself back. It wasn’t even over yet.

Slow to Return to My Body and Mind

At lower doses of ketamine treatments, I generally feel normal within 30 minutes of the infusion ending, if a little tired. This time, though, it’s all a blur. I remember the rest of the day in jumbled snapshots. Returning to the room around me and talking to Sarah, who mysteriously took the place of the nurse at some point; telling Dr. G that I didn’t remember what I saw; pushing the footrest down with my heels, then walking to the car with my mom. Two kids sprinted past us, almost colliding– wait– was that before the infusion or after? That was before. When I woke up on my bed hours later, I was mildly unsettled that I could remember so little of the day. I know that I wouldn’t have said that I felt weird in the moment, but my memory of it all is so broken that I clearly was pretty impaired.

Four or five hours after getting home, I pushed myself out of bed and tottered to the kitchen for some food. When I turned or bent, mild vertigo briefly grabbed me. A can of soup and a clementine later, I pulled out my laptop to jot down some notes about the infusion, only to sit, stumped by my lack of memory. Listening to the music I chose over again prompted flashes of scenes and images, but I still have the sense that there are some rich plots that I’m missing. It’s like when you know you had a bizarre dream, but you just can’t quite remember what it was about. Ah, well. It’s entertaining to remember my ketamine dreams, but the important part is that it’s getting to work in my noggin to treat my depression as we speak.

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.

The Sensory Meditation of Flow

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When you’re reading a good book, playing a familiar song on your instrument, doing a word search or a jigsaw puzzle, or any number of absorbing activities, you might be experiencing flow.

A while back, my occupational therapist explained the concept like this:Flow

If the difficulty of whatever you’re doing is too high and you haven’t spent very long doing it (aka: have a low level of skill), you’re likely to be above the “flow” line and feeling stressed.

If the difficulty is low and you just started, you’re probably pretty close to flow from the start. The longer you do it, though, the more skilled you get and the more bored you become.

This is probably pretty intuitive to most people. To stay close to flow, you need to adjust the difficulty level to match your skill. Otherwise, you get either overwhelmed or bored. Everyone has unique sensory needs, so your nervous system might react differently to inputs that create a perfect state of flow for another person. For instance, my ability to follow a cardio dance video is atrocious, but someone with awesome praxis skills might think it’s exactly right for them.

Currently, my favorite leisure activity is embroidery.

embroidery-of-wooden-fence-and-red-poppies

I started out with those pre-packaged kits that have the image inked onto the fabric, like a paint-by-numbers but for stitches. That was great because I didn’t know what I was doing, but as I learned and got more comfortable with it, those kits became a little boring. Now, I make it up as I go, so it takes some focus and creativity but it’s also repetitive and relaxing.

If, like me, you have trouble with sensory discrimination and often don’t know what you’re feeling or what qualities of something you do or don’t like, finding an activity at the right difficulty to produce flow might be tricky. Trial and error is always a good way to approach this. Give the “trial” enough time that you’re able to decide whether you like it or not, and why. When you do find something that gets you to a state of flow, don’t forget to up the difficulty on occasion. The challenge is what makes it interesting!

envelope labeled 2020 with golden streamers and small potted plant

My Mental Health Resolutions

Genevieve2 Comments

In December, I gave myself four goals to test before the new year rolled around. I wanted to give myself a chance to work on some (mainly) mental health resolutions without the pressure of an entire year ahead. It wasn’t wildly successful, but it wasn’t a flop, either.

These were my goals:

  1. Keep running, be able to go five miles somewhat comfortably: Done!
  2. Reestablish skincare routine: Sort of done! Currently on track, but it wasn’t a straight line.
  3. Start volunteering: Sort of done! I’m signed up to start in January.
  4. Begin relearning German: Not at all done! Yeah, nope. Didn’t even start.

Even though I didn’t check all the boxes, it felt pretty good to have a list of actionable goals. My overarching goal with all of them (except maybe relearning German) was to improve or support my mental health. In that, I think I succeeded! It was motivating to remember that I only had one month to make progress on my goals, which helped me not get complacent and stuck in bed with depression. As with any vague intention like “improve my mental health,” setting out some well-defined steps is vital. I needed to know where to start and how to do it.

2019 was really, really hard. I plummeted even further into the pit of depression than ever before and ended up hospitalized. I continued on my quest to find medications that work for me, and most of the time, I felt entirely discouraged and worthless. But, I kept going. I kept myself alive, and that was a huge accomplishment. Now, with the assistance of moderately helpful medications and much more helpful IV ketamine infusions, I feel like I’m inching my way out of my blanket burrito of sadness. To continue that progress, I’m aiming to carry on my mental health resolutions from December into the new year.

Wishing everyone a Happy New Year’s Eve and a wonderful year ahead.

Claude Monet: The Truth of Nature

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Two weeks ago, while trapped in the ill-fitting, damp denim jacket of depression, I slipped into the airy expanse of the Denver Art Museum. We were there to see a once-in-a-lifetime exhibit that is visiting nowhere else in the U.S. besides Denver. It’s called Claude Monet: The Truth of Nature. While an art exhibit is not enough to cure my mental malaise, it certainly helped.

Monet’s art is just up my alley: nuanced, filled with light, and nature-focused. I could not choose a favorite if I tried. To some extent, each room was dedicated to a particular time period in Monet’s life. There were some parts that compared paintings of the same subject done at different times, but for the most part, the chronological organization helped show the progression of his style from something close to realism into distinctive impressionism. We saw the poplar trees, the haystacks, the waterlilies, and so much more. We saw the ice of the frozen Seine and the roses of his beloved garden. We saw the paintings up close, inspecting the details and sudden colors, and we saw them from far away, brushstrokes blending into a strikingly clear image.

monet roses

I was particularly taken with his ability to render water and reflections. At mid-distance, there is an overwhelming illusion of depth in the water he painted. It’s like you could just dive right in. Upon closer inspection, I marveled at the sheer number of colors and shades he used to achieve that effect, and the shapes that brought the water together. From a distance, I lost sight of the intricacies but was captivated by the image as a whole.

Monet was driven by a desire to capture specific moments in time, and to represent them as true to nature’s beauty as possible. Part of that beauty is how it looks, but part of it is how being in nature makes you feel. Monet’s art is about how afternoon light is different from morning light, and how the same scene makes you feel at different times. It’s about atmosphere: how ripples in water convey emotion, how cliff faces can be sinister, and how perspective changes everything.

waves

While in the exhibit, I overheard a mother and her young daughter discussing a painting. The daughter asked if there was glass covering it, to which her mother replied “No,” there wasn’t.

“Then why is it shining?”

“That’s just his painting.”

 

It was tiring but well worth it. I’m thankful that I got to immerse myself in this exhibit, and that my brain allowed me to enjoy Monet’s shining paintings.

lilypad