A wide, leafy tree in a field filled with fog and one person walking.

Depressed Again Despite IV Ketamine Treatment: The Ketamine Chronicles (Part 10)

Genevieve7 Comments

When I started this series, I promised to be as honest as possible for anyone looking for information about getting IV ketamine treatment for depression. So, what can I say? I’m depressed again.

I’m sluggish, I’m sad, and I’m hard on myself. I’m really struggling to get through work, to the point where I actually get pretty behind on some tasks. When that happens and I refuse to let myself nap in favor of catching up, I take frequent breaks. Want to know what those breaks consist of? Sitting with my eyes closed. Forcing myself to keep working is so draining that I have to just stop and close my eyes for a few minutes. And then I get frustrated because why can’t I just bang out this edit or work through the day like other people can? Because I’m depressed again.

To be honest, I’m finding this hard to write. Just from a purely functional level, gathering my thoughts is proving to be challenging. I have a sense of the kind of message I’m trying to convey, but the words for that are slow to appear.

Here’s what I’m thinking:

  • I really want to stress that this kind of decline in progress with ketamine for depression is not common. Don’t let my weird experience deter you. You deserve optimism.
  • Some words I want to include about how to treat yourself when you’re faced with a setback:
    patience, kindness, honesty, determination.
  • I feel the need to express that I’m kind of nervous about this post. I don’t want it to seem like as much of a failure as it feels like. I guess I should practice the previous bullet point.

My last ketamine treatment seemed no different from any other (in how it felt, at least), but hasn’t seemed to have much of an effect on me. In trying to figure out why, we considered whether any of these applied:

  • illness (like a cold or the flu)
  • not going to therapy
  • not sleeping enough
  • not exercising
  • life stresses
  • medication changes

It was this last one that checked a box. Initially, I said, “Nope, they’re all the same,” but we later remembered that I recently had an issue with my birth control and stopped taking it. (Sorry if this is a weird topic, but really, it shouldn’t be. No biggie.) Everything else seems like it’s been the same, so I guess that looks like the explanation.

I’m working on figuring out my prescription issue with my pharmacy, and I’m going to go in for a booster ketamine infusion sooner than we had scheduled. I didn’t want the Ketamine Chronicles post that will go with that infusion to be super long, so I thought I’d dedicate an extra one to explain myself.

So, that’s the update. I’m hoping that we figured it out and getting back on birth control will even things out. I’m also trying not to let my brain’s automatic thoughts bully me into believing that it’s my fault and that this is a repeat of all those medications that didn’t work out. Catastrophizing is not allowed, brain!

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.

woman running shoes running up concrete staircase

December Resolutions: Mid-Month Update

Genevieve2 Comments

Last month, I decided I’d get a head start on my New Year’s resolutions by treating December as a sort of trial run. I set myself four goals:

  1. Start volunteering
  2. Run regularly
  3. Re-establish skincare routine
  4. Begin relearning German

We’re roughly halfway through December, so I thought I would check in with my progress. Currently, I give myself a 2.5/4. I have been running almost every day, persisting despite the weather. I think I’ve surpassed my goal of establishing enough endurance to (somewhat comfortably) go five miles, so maybe I should aim higher for the end of the month.

I’m diligently maintaining my skincare regimen with topical steroids, a giant light, and a lot of sarcastic jokes about how great I look in UV-protective goggles. I’m not seeing much benefit yet, but it’s not an instant fix.

My efforts to begin volunteering have been temporarily halted; it turns out the organization I was interested in has recently moved (still nearby) and stopped their volunteer orientations until mid-January. I am signed up for the first orientation in January, though, so I think that counts for at least half credit.

That brings us to number four: begin relearning German. I have not started this yet, and I’m trying to decide if I want to push forward with it and see where it takes me by the end of the month, or replace it with a different goal.

All in all, I’m feeling pretty satisfied with my December resolutions.

 

Anonymity and Mental Health Stigma

Genevieve6 Comments

IMG_2405

When I started this blog, it was deliberately anonymous in an effort to avoid any mental health stigma from reaching my real life. I didn’t have my name anywhere on it and I made a conscious effort not to mention anything about my life outside the sphere of mental health. I don’t think I even told my immediate family about it until a few months in.

I liked the freedom of writing anything I wanted without overthinking it. Those fears of what will people think? were almost nonexistent because nobody knew who I was. Over time, I began sharing it with people I knew. My immediate family and friends, then my extended family, my therapist, and others involved in my treatment.

I know that putting my name on my blog doesn’t change much for you, the reader. It does, however, signify a big change for me in the context of internalized mental health stigma. I’m finally coming to terms with my diagnoses and feeling more comfortable talking and writing about them as myself, with my real name attached.

Everyone has their own reasons for keeping their online presence anonymous. My reason was rooted in shame. I was afraid that if people knew I was writing about topics like depression, self-harm, and suicidality, they would never again see me for the things that make me, me. The reality is that people I know tend to notice the things that shine through the overarching topics. They comment on my love of writing and my sense of humor before they mention the content of my posts. And when they do broach the subject of my blog, they express their happiness that I’m still working towards stability. It helps, of course, that my family and the people surrounding me are very understanding. Not everyone has that, and I’m so thankful that I do.

Anyway, there you have it. My name is Genevieve (Gen), I’m 23 years old, and I live in Colorado. I got my bachelor’s degree from the University of Michigan, where I studied Ecology and Evolutionary Biology as well as Evolutionary Anthropology. I work from home as an editor and freelance writer (not at all related to my degree, but whatever). On my blog, I write about my diagnoses of sensory processing disorder and major depressive disorder. I like reading, making art, and being in nature. This is starting to sound like a cross between a cover letter and a dating profile, so I’m going to wrap it up.

Lumpdates is still lumpdates, but I’m pretty dang proud of myself for standing up to mental health stigma by typing the nine letters of my name into my username settings.

Wishing you curly fries,

Genevieve

Colorful peanut M&M candies in a white ceramic bowl.

The Sound of Peanut M&Ms: The Ketamine Chronicles (Part 9)

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Part of figuring out what your individual limit is between ketamine infusions for depression is to stretch it out bit by bit until you find the length where it wears off. My daily mood metrics show a drop a few days ago that stayed steadily lower than my previous (good health) average. However, there were several possible factors that may be to blame, so it’s not clear to me whether three weeks between ketamine infusions is actually an accurate time frame to use. That said, we’re going to go another three weeks and see what happens.

Technical Difficulties

I had a lot of trouble with my music this time. The playlist I chose stopped playing shortly after I started to feel the ketamine, but I kept thinking that it was just really quiet. It was like when the radio is on in your car on low volume, and part of your attention gets sucked into it and you’re going, what IS that? I just kept turning the volume up again and again over the course of several minutes before realizing that no, nothing was playing. My brain was just making something up that was barely audible because I expected to hear something. I managed to find a different playlist that I’ve heard many times, so it was comforting but not very interesting.

An Octopus and an Ominous Shadow

Maybe because I listened to something familiar, I didn’t have any sustained scenes like the very memorable fish wedding in a previous ketamine infusion. But, like always, I sank into flowing images that seemed to come from my subconscious. A deep red octopus slithered around my mind, only one day after I marveled at a captive one in a butterfly pavilion. Under the influence of ketamine, I tried to imagine what it would be like to be an octopus; how would it feel to have eight limbs, each one a sensing individual capable of independent reactions?

A red octpous with blue-ringed suckers and gills nestled among rocks in the dark ocean.
Photo by @sigmund on Unsplash

At some point, a vibrant green light was disrupted by a dark shadow moving up from the bottom of my internal “visual” field. Like when someone stands up in front of a projector, this vaguely ominous shape rose up again and again. As it reached the top and had obscured all of the green light, the bottom thinned out and the light shone through again. Then, the shadow started again from the bottom.

Ketamine Infusions Make My Hearing Sensitive

I have no idea how far into the infusion this happened, but at some point, my doctor sat down at the desk in the room and began preparing something with plastic bags and vials. It sounded exactly like he had taken an enormous bag of peanut M&Ms and dumped them out on the desk, then rolled them around with his hands. The sound reminded me of how on road trips, my dad used to stop at the gas station before we left and get “a duffle bag” of skittles, peanut M&Ms, whatever was the largest bag available.

Grey and white sediment layers representing sound waves to a recipient of ketamine for depression.
This image reminds me of how sounds feel while on ketamine. (Photo by Scott Webb on Unsplash)

I tried not to laugh at this memory, as that might sound weird out of the blue, and then I’d have to explain it with my too-big tongue. Instead, I cracked my eyes open and tried to discern what he was actually doing, because I knew, rationally, it definitely wasn’t the M&M thing. Too blurry. I got distracted and started looking around the room.

Sneaking a Peek Around the Room

The walls looked sort of like I was looking at them through a big sheet of cling wrap. Subtly shiny, a little distorted, and slightly moving. The edges of things were indistinct, and trying to focus on any one thing produced a weird motion that was like looking at something far away with one eye, then switching to the other eye. It felt like a very subtle change in perspective, despite looking at it from up close with both eyes open. The M&M noise had paused momentarily, so I looked over at Dr. G, who motioned for me to close my eyes. Ah yes, I’m not supposed to be looking at things. That’s how you get a bad case of nausea. I shut my peepers and was swept away by…something. I don’t remember.

Later, I laughed about the M&M sound with my mom, who apparently didn’t even notice it, despite sitting directly next to my feet. I’m sure Dr. G was actually being very quiet, but something about ketamine can make your hearing sensitive while the infusion is going.

Knowing My Pattern with IV Ketamine for Depression

I’ve been noticing that, for me, it’s the second day after an infusion when I wake up and feel better. The day after an infusion is usually a pretty sluggish day, but then the day after that is when things start to look up. If I didn’t know that, it would be pretty discouraging to wake up the day after an infusion and feel crummy. Now I know to wait it out and not let that first day throw me off. Experience is a great teacher.

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.

Oh No. More Depression Naps

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The irony of my recent post about unnecessary sleeping in the form of depression naps is glaringly obvious. Yesterday, I got up at 6, took care of Stella’s morning routine, then took a four-hour nap. Then, I fell asleep at 7pm, woke up at 2am still wearing my clothes, took my meds and brushed my teeth, then went back to sleep until 6. Big oops.

At this point, I don’t think I can still use the “I’m tired from traveling” excuse, much as I would like to. Sleeping too much is, for me, a big indicator of depression. I’m really hoping this is a fluke and not the ketamine wearing off. If it’s the latter, that would make my time between maintenance infusions about three weeks, which is a little short for my liking.

I had errands to do today, which I managed to do after an entirely too-long nap. I’m putting my foot down. Time to drag myself outside and go for a run, because you can’t sleep if you’re moving. Curse you, depression symptoms!

Update: My run was lovely, despite stepping in an icy puddle and getting my socks wet. Also nearly ate it on some ice deceptively camouflaged with snow. It definitely woke me up. I saw some cute dogs, though, and the mountains were pretty. All in all: would recommend, minus the puddle and the ice.

woman in orange jacket holding flowers in front of face

5 Tips for Therapy Clients Who Don’t Like Talking About Themselves

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If you ever feel like a deer in headlights when asked to talk about yourself, I empathize. Whether it’s one of those dreaded get-to-know-you icebreakers or your therapist asking you a question, having to talk about yourself is uncomfortable for many people. By now, I’ve been in mental health treatment for several years, and I have a few tips for therapy I’d like to offer.

When I first sought therapy for myself, I found it extremely difficult to engage with it fully. If you don’t like being the center of attention, beginning therapy can be overwhelming. After all, the entire point of it is to focus on you. Early on, talking about myself in therapy felt, at times, nearly unbearable. Too many questions too fast made me shut down, and too loose of a structure lead to lots of awkward silences, both of us waiting for the other to say something. Over time, however, I’ve gotten much better at it. Here are some of the ways I’ve found to help me feel more comfortable about talking about myself in therapy.

The essentials

Any list of tips for therapy wouldn’t be complete without a soapbox moment about the therapeutic relationship. It doesn’t matter if you’re just starting therapy or you’ve been in it for a while; it’s vital that you like your therapist. The struggle of talking about yourself will be even worse if you don’t feel understood or accepted in therapy. In fact, research shows that therapy is much more effective when you and your therapist click. Don’t feel bad about shopping around or about switching therapists if it’s just not working out.

Secondly, remember that therapy sessions are for you. Push yourself out of your comfort zone, but go at your own pace. Therapy is your time to do with it what you will.

Communicate what you want to get from sessions

This is a tough one. There’s a lot that falls under this umbrella, but mostly what I mean by it is: tell your therapist if you would like to direct the topic of each session or be given more structure. Maybe it’s hard to talk about yourself because answering questions feels too probative, and you’d rather start off with a narrative. I prefer to have more structured questions because if I’m given free rein, I go blank and have absolutely nothing to say. Regardless of which end of the spectrum you’re on, your therapist is always there to help direct you and keep you on track.

Practice saying how you feel

I struggle hardcore with identifying how I feel. Maybe it’s sensory processing disorder, maybe it’s Maybelline. Sensory discrimination issues have extended into the emotional realm and mean that I often don’t know how I feel about something. If you have a hard time verbalizing how you feel, my advice is to practice. It sounds silly, but just as if you were a little kid, practice saying “I feel ____” and then fill in the blank with something more specific than “okay” or “fine.” Even on your own, check in with yourself; am I feeling excited? Lethargic? Irritated? It really does start to feel more natural over time.

I also find that using metaphors breaks the tension and allows me to communicate more comfortably. For example, my therapist and I talk about “clams” instead of “goals” because the very mention of goals used to make me a sweaty, anxious tear factory. The Potato Scale of Depression is another way that I like to remove a little of the scrutiny from myself and package it up in a statement about mashed potatos or soggy gnocci. There are many ways to get used to talking about your feelings!

Make the Space Comfortable

Of course, it’s not your office. You can’t go swapping out furniture and changing the overhead lights. But you can do some things to make the space more comfortable for you. A therapist I saw in college noticed that I have a very wide bubble of personal space and offered to move her chair a little further away from me. You can ask to close the blinds if it’s too bright for you, bring a small blanket to help you feel cozy, and be sure to wear comfortable clothing.

Stay (Mildly) Busy

Something that I learned in occupational therapy but haven’t put into practice (maybe I should!) is that talking about difficult things is often easier when your hands are busy. Bring a coloring book, a fidget toy, or a craft- if you’re a knitter, crocheter, or have some other portable project. Of course, this is one of my tips for therapy clients that is only good advice as long as your therapist doesn’t need you to be completely present during your work together. It doesn’t hurt to ask.

For us reticent folks, therapy can be scary even just to think about. But, like so many things in life, working on what’s difficult often leads to the best outcomes. With time and practice, talking about yourself in therapy gets easier, especially if you find what will support you and then advocate for yourself.

grey cat in sunlight yawning

My Depression Naps are Unnecessary (Shocker)

Genevieve1 Comment

Over the last week, I have taken a grand total of one nap. ONE. This is grossly reduced from my usual minimum of six depression naps per week, each spanning roughly three hours. I cut back on naps this week because I was spending time with my family, instead. Between running errands, cooking, cleaning up, and catching up, there wasn’t much time to sleep during the day, and if there was, I prioritized family time.

The week is over, and I’m learning that I’m capable of being more active than I feel I am. My depression and the medication I take to treat it make me tired, and I might need a whole ‘nother week to recoup from this napless week, but I can function without naps. I think I should take this to mean that doing more is more sustainable than I thought.

I’ve been nervous that adding activities outside the house would be a disaster, because how could I go out and do stuff when I sleep for three hours every afternoon? This is probably a cart and horse problem; I’m worried that I won’t be able to fulfill my commitments if I still feel the need for excessive sleep. But perhaps adding more commitments to my schedule will make me less depressed, and therefore, I would sleep less. There’s bound to be an unhappy medium in the middle, but it would probably settle out eventually. In (wildly simplified) essence, be tired and have nothing to do, do more and briefly be more tired, then be a normal amount of tired and have fun doing whatever you want. This is something that everyone in my life has been saying forever, but sometimes it takes a while for you to come to the same conclusion, right?

A large part of my robust depression nap schedule is due to the lithium I take in the morning. However, I’m sure that another part of it is, at this point, a habit. My brain has learned that every day at the same time, we go to sleep for a few hours. It’s come to expect it. Breaking out of that habit is tough, but if I eliminate that and reduce my depression as much as possible, I’ll be left with just the lithium tiredness. That’s manageable, and as I’ve learned this week, very possible to function with.

Before I was even taking any medication, I slept as an escape. I went to bed before dinner because I didn’t want to be awake anymore, and I took long naps because I couldn’t stand the feeling of experiencing an entire day. Maybe this was what I needed, for a time. It helped me face my existence in more manageable chunks, but then it spiraled into something more damaging. I’m not going to stop taking naps entirely. I feel best when I give in and curl up on my bed for a few hours, sleep it off, and wake up partially refreshed. But I’m also going to remember that I don’t have to do that.