Tag: Depression

ink drawing of dandelion seed heads growing in grass

Observations From the Garden

Genevieve2 Comments

I got up at 6 and walked through my routine because that’s what I always do, depressed or not. I fed the dog, made the coffee, poured a bowl of cereal, and then stared into it while the dog did her rounds in the yard. But by 8, I was beginning to wonder why I ever got up in the first place. So, back to bed with the window open and my blankets pulled up to my chin.

Lately, depression has overtaken my days with sleep and restless boredom. What time is it? Doesn’t matter; every day feels like a week. At night, the anxiety comes. I feel like I’m crawling out of my skin. Or like I want to reach inside my chest and pull out my lungs, let them spin out the twist in my trachea. Maybe then I could breathe.

To pass the time when the sun is up, I move between sleep and hobbies. Sitting outside in the backyard, my sketchpad page is still blank. Pen or pencil? I pick up the pen but am unable to draw more than a few dandelions from the scene I’m observing. A flock of house finches has found our backyard – it’s more dandelions than grass, and they’ve all gone to seed. The birds are foraging, bobbing their heads and moving among the unmown grass. One finch struts up to a tall dandelion, and, with an almost imperceptible flutter, attempts to perch on its vertical stem. The dandelion head begins to bow to the ground, and the finch rides the bending stem to meet the grass. Foot firmly planted to hold the flower down, the finch returns to bobbing and pecking.

There’s a sound behind me, and I turn to see a five-foot garter snake glide through the raspberry bushes, following a taste in the air. A busy robin chatters while it gathers last year’s grape leaves for nesting material. Stella digs a layer out of the hollow she’s claimed as hers, then situates herself in the cool dirt she’s uncovered. A hummingbird trill draws near, then it whizzes by on its frenetic journey. Everything around me moves, yet I feel like I’m in stasis. Animals and plants follow their daily rhythms, foraging, hunting, racing the sun to get enough calories, and I feel disrupted – out of sync.

I don’t know how to fix it. Usually, I keep up with my treatments — meds, therapy, ketamine — and simply wait for it to pass. I use what coping mechanisms I can—preferably the good ones, and let the turning of the Earth carry me from one day to the next. This time, I can’t help but feel the uncertainty of the time we’re living in. The disruption is not just to my mind, but to the world. When will this sense of weightlessness, of falling through empty space be soothed? When can we once again feel the ground beneath our feet, knowing by its predictability that it is moving us inexorably from today to tomorrow?

My MTHFR Gene is a Problem. Again.

Genevieve4 Comments

You would think I had learned my lesson. Refilling my medicines is not something I find easy to do if a phone call is involved. I waited until the very end of my supply to refill my Deplin, and now, because of shipping delays, I’ve been without for several days. Deplin contains l-methylfolate, which fills a metabolic gap caused by a mutation in the MTHFR gene. Essentially, it helps my antidepressant work. Not taking my Deplin is what pushed my suicidality to new lows last year when I was hospitalized. It seems like I can feel my brain slowing down. I sleep all day like I’m hibernating in reverse by starting in spring. There is nothing to get me up except the dog, who stands by my bed and huffs at me, threatening to wake me with a full bark if I do not move. I accomplish the necessary and return to bed, already sinking into sleep. The occasional diversion brings some welcome entertainment, but it’s just a momentary distraction.

tired raccoon lying on platform with black container on its back and foliage in background
Me. It’s me. (Unsplash user @successfullycanadian)

I took some time off of work when my grandfather passed away last week, but then I decided it would be more helpful to have something to do. So, I went back to work (which I thankfully do from home under normal circumstances) on Monday. Unfortunately, it’s shaping up to be a slow week, anyway. I suppose I should turn to hobbies to fill my time. I’m partway through a drawing that I promised to someone, but like many of us judging ourselves for not utilizing all of this time to finish household projects or write a sonnet or whatever we think we should be doing, motivation eludes me.

My shipment of Deplin is finally at my local post office and should be delivered by the end of the day today. It couldn’t come too soon. I plan to rip it open right there at the mailbox and throw one down the hatch. Well, okay, maybe I’ll go inside for a glass of water.

A brown fuzzy moth with its wings outspread

Moth Wings: The Ketamine Chronicles (Part 15)

Genevieve6 Comments

As I was pulled into mesmerizing moving images of purple and white half-circles, I remember pouring the words “please fix me” over and over into my mental space. Maybe if I asked it nicely, it would last longer. In a strange mixture of thought and vision, the words became part of the image, and they fanned out and seeped into the fabric of my mind. Ketamine infusions continue to be the best treatment for my treatment-resistant depression I’ve tried, but like anything else, it’s not perfect. Arriving at each appointment feeling depressed once again gives me a sense of hopelessness all its own. I know the ketamine infusion will help, but it may not last. We’re still trying to arrange the best combination of dose, timing, and medications that could help things remain more stable. 

Puzzles, Puddles, and Skyscrapers

I closed my eyes and settled back, listening to the “atmospheric piano” playlist I had chosen for yesterday’s ketamine infusion. Eventually, my awareness of my hands and arms disappeared, and I spent some time wondering where they had gotten to. The gentle piano music was relaxing, and tucked under my blanket and weighted lap pad, I began to feel like I was being enveloped in something. I imagined myself being zipped into a giant pea pod, and the image was comforting. “Nothing can get me in my pea pod,” I thought. There were times during the infusion when noise outside the room intruded on me, so I just imagined my soft pea pod and retreated within it again.

There were at least two scenes involving puzzle pieces and building skyscrapers in this ketamine infusion. We’ve been working on a 2,000 piece puzzle of Monet’s garden, and the pink, purple, and white pieces are haunting my subconscious. The puzzle pieces came together to form an endlessly tall building; I craned my neck back to see it disappear into the clouds.

At some point, everything dissolved. I was “looking” at a computer screen, and as I tried to read it, the contents of the page began to melt. The lines ran together, words sagged under the force of gravity, and eventually, the entire laptop softened and melted into a puddle. I began to melt, too. I slipped into the puddle of digital sludge – it looked like an oil slick – and soon accepted my new form. I was too tired and heavy to do anything.

I was far, far, far away when I heard the PA, Erin, ask if I was ok. Finding my mouth and giving it words to say was too difficult, so I nodded and hoped that my head was actually moving. It must have been, since she seemed to accept that as an answer. A little later, she sneezed, which startled me. At the sudden noise, I instantly saw moths with shattered wings, like glass with spiderweb cracks. They fluttered around and came closer until their soft, broken wings were all I could see.

Post-Ketamine Infusion Confusion

Coming back to the room was much harder than usual. I felt a little like I was wearing 3D glasses; everything was in relief with subtle red and blue auras. When asked, I said I felt like “someone else is talking,” meaning the words were mine but the sensation of talking seemed foreign. This is something I experience every time I have an infusion of ketamine for my depression. Erin said I seemed pretty lucid, to which, in relief, I said, “Great – I’m pulling it off.”

Walking down the steps to the first level of the parking garage was challenging. I clung to the railing and stepped carefully, feeling like I was walking on pillows. I’m usually fine to walk after a ketamine infusion; I could fall asleep at any second, but I generally feel pretty with it. This time, though, I felt a lot like this:

stoned fox

Tracking Adjustments to My Ketamine Infusions

In an effort to make the effects of the ketamine infusion last longer, I took some Tagamet before yesterday’s infusion. It’s an H2 blocker used to treat heartburn, but it might also slow the metabolism of ketamine and give patients more time between infusions. I’m usually tired after ketamine infusions, but this was different. I got home around 4 (I think) and by 6:30, I still felt like I was periodically dissociating and then coming back to the room and remembering I was in the middle of something. Walking was hard for a couple of hours. I was off balance and wobbly and had mild vertigo. I think it’s safe to say that the Tagamet is doing something. This morning, I woke up with a mild headache and am still incredibly tired, but the sun is out and our near-impossible puzzle will provide hours more entertainment.

P.S. I remember making a mental note that Shrek appeared briefly during my infusion, but I cannot for the life of me remember how/when. It’s such a bizarre thing to remember, though, that I am sure it really happened.

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.

blue and pink mountains illuminated by sunrise over snowy plains

Why Self-Care Can Be Hard For Me

Genevieve2 Comments

Taking care of yourself comes in many forms, some easier than others and some more pleasant than others. Throughout my years of depression, self-care has meant several things to me. In times of severe symptoms, self-care focused on basic skills; eating, bathing, and taking my medications. When I’m doing better, self-care looked more like the conventional meaning of the term; taking time to relax, allowing myself tasty treats, watching a favorite show, etc. But no matter the state of my mood disorder, self-care has always included a mental component that can be particularly difficult: being nice to myself.

I know, that sounds so obvious it’s ridiculous, but you can absolutely do the actions of self-care without believing you deserve it. I run into this issue a lot; I spend an evening in sweatpants and a cozy sweater, absorbed in an episode of [insert ever-changing favorite show here]. Great self-care, right? Except I finish up the whole endeavor with terrible self-criticism for having let myself waste time and be lazy when I could have been getting work done. Somehow, it seems like that negates all the good that the action of self-care does for me.

Don’t get me wrong; I’m sure there are plenty of benefits of self-care even when you’re not feeling it. If you’re doing something essential to your survival, like eating food, of course that outweighs whether or not you think you should do it. Plus, there’s likely some neurological benefits of taking care of yourself- dopamine, less cortisol, heck, there’s probably benefit to just practicing those neural pathways and making them feel more natural. But it also seems logical that the benefit of self-care itself would be even better if you let yourself have it guilt-free.

Sometimes, the hardest part of self-care is believing that you deserve it. And that’s usually when I need it most urgently. It’s a work in progress, but I’m trying to be less critical of myself. Deliberately being nice to myself sometimes feels like a big lie, like I’m only humoring the part of me that thinks all my negative self-talk is pretty crappy. Living with depression makes it complicated because I know that I need to do things like exercise, take time to relax, and let myself say “no” to things. But the part of me that fights tooth and nail to appear “normal” resents the fact that if I’m not gentle with myself, I might end up debilitated by depression again. I don’t want to need anything, and certainly not anything pampering. I’m fine how I am.

“I’m fine,” she says stubbornly.

Sometimes you’re not fine, and that’s ok. And it doesn’t matter how long you’ve been not fine- you still deserve to take care of yourself. Sometimes I feel like having been depressed for a long time means that I’ve been indulgent in my sluggishness and I need to be hard on myself to get out of it. I would never tell someone else that. Be as kind to yourself as you would be to a friend in the same situation.

Stress and anxiety abound right now, so take care, stay busy, and get some fresh air when you can.

-G

 

An abstract blue and red painting with wide brush strokes and vertical red lines

What Noise Sounds Like in IV Ketamine Treatment: The Ketamine Chronicles (Part 14)

GenevieveLeave a comment

Yesterday, I had another ketamine infusion for my treatment-resistant depression. It had been almost five weeks since my previous infusion, and while three weeks was our best guess for my interval, it seems like now I can actually go something like four weeks before really noticing it wearing off. I’m hoping that if I keep doing the behavioral things that help my depression (running, volunteering, therapy, etc.), I can at least maintain this amount of time between IV ketamine treatment appointments.

Linguistic Confusion During IV Ketamine Treatment for Depression

Most of my ketamine infusions have been visually focused, and usually what stands out to me are snapshots of images and colors. However, some of my ketamine infusions are much more auditory-heavy. Throughout it, conversations in the hallway and the other room sounded loud and close, and I felt as if I were being crowded around in the room I was in. Strangely, conversations outside the room sounded loud but were completely unintelligible. The boundaries of words and sentences disappeared and I was washed in streams of unending verbal noise. Nothing made sense, but I still strained to understand. The sounds of English words were familiar, but I just couldn’t parse them enough to grasp their meaning.

A messy spread of wooden typography letters in dark and light wood.
Photo by Raphael Schaller on Unsplash

This theme of linguistic confusion stretched throughout the infusion. I remember a filing cabinet stuffed with folders that I couldn’t read. The letters were there; I could pick them out, but putting them together and reading them as words eluded me. Later, messy papers with gibberish words filled my internal vision. I felt confused, I was upsidedown, my arm with the IV ached. The room seemed loud, and I saw stampedes of paper animals painted with pastel watercolors. They piled up and tumbled around me, threatening to knock me over and crush me. The fan in the room added noise that pushed it all to an intolerable volume, so I asked Erin to turn it off. I got ready to speak, opened my mouth, and seemed to just think the words out loud.

Did I Say That?

I notice this feeling often during my IV ketamine treatments, and it’s interesting to note how little deliberate control over our mouths’ movements we need in order to make coherent sounds. All I do is form an intention to say something, and it just…happens. It feels a little like I’m inhabiting my body separately from its direct controls.

A distorted glass with yellow and blue fractals approximating the experience of ketamine for depression
Photo by Jakob Owens on Unsplash

Ketamine is a dissociative anesthetic, meaning it creates a state of perceived separation from the self. Altered senses and seemingly “out-of-body” experiences are common when receiving treatments of ketamine for mental health conditions like depression and PTSD. In my experience, I can still talk during a ketamine infusion, but it feels like someone else is doing the talking.

In any case, my request apparently worked, as Erin then got up and switched the fan off. That lowered the ambient volume enough that I could focus again on my music.

I remember there being more visual scenes after that, but I don’t recall them very well. The only one I have much memory of is a scene set in a grocery store with a broken jam jar, shards of glass glinting under the fluorescent lights, and wine-red jam splattered on the linoleum.

IV Ketamine Treatment for Depression in Combination with Other Strategies

The rest of the day is a blur. I slept off and on, interrupted by Stella periodically. It wasn’t until about 6 P.M. that I started to feel more like a person, but I was still glad to crawl into bed at night and sink into sleep. This morning, I’m tired. I’d like nothing more than to go back to bed for the rest of the day, but I know it’s important to get myself up and moving. I do best with routine, so in the interest of helping my brain repair itself through the effects of ketamine therapy, I’ve already had coffee and been to the dog park. So far, so good.

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.

Thoughts on Perspective and Depression

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coin-operated-binoculars-with-raindrops-on-surface-and-red-knob-reading-turn-to-clear-vision
Photo by Chase Murphy on Unsplash

When I’m moving out of severe depression and into something closer to happiness, I’m intensely aware of the fact that I will soon forget what it felt like to be depressed. Not intellectually, of course. Having the experience of depression makes me forever able to empathize with others and remember, in objective terms, what it felt like. But the internal feelings– the heaviness, the soul numbness, the twisting slowness of being utterly squashed by life’s requirements- all of those will trickle away until I can only comprehend them from afar. Just as I can’t quite grasp the truth of happiness when I’m depressed, I can’t quite understand depression when I’m well.

It’s a problem I contemplate fairly often. Holding two perspectives at once isn’t fully possible, so I find myself slipping between two conclusions with different contexts. When I’m depressed, I vaguely remember feeling better. That memory, however, always pales in comparison to current pain. I eventually end up concluding that dragging myself back to mediocre happiness would not be worth the effort.

Inevitably, when the depression ends or at least improves, I understand how clouded my judgment was. Over time, I forget just how sharp and all-encompassing depression can be. I disregard its immediacy, letting healthy coping skills fall to the wayside. When I move beyond the basics– eating, bathing, stepping outside– to more advanced skills like socializing and nurturing my ambition, the basics are the first to go when stress hits. This is especially true when time has faded the memory of how quickly depression can return.

It scares me that depression so thoroughly warps my thinking, and recalling the cycle of depression and recovery makes me wonder if any number of episodes will teach me to ignore my depressed brain. It’s easier when each day is different; I can tell myself that this will pass– and I might believe it. But when I’m entrenched in depression, it stretches ahead of me until it’s all I can see. Then, the lies my brain tells me seem awfully convincing.

Right now, I’m going day by day. Things aren’t wonderful, but they’re not terrible, either. When I want to crawl back into bed in the middle of the day and not get up until tomorrow, I try to remember that I’ve been here before. I’ve been here before and I’ve done that before, and it never changes anything. Eventually, things will get better, and maybe I can get there faster if I make those hard but healthy choices. So, I’m back to the hardest self-care of all: doing what’s best for you even when it’s the last thing you want.

A hand with red nail polish holding a live shrimp in the air by the ocean

A Tower of Shrimp and Absurdity in IV Ketamine Therapy: The Ketamine Chronicles (Part 13)

Genevieve1 Comment

Having IV ketamine therapy for treatment-resistant depression is always a fascinating experience. This edition of The Ketamine Chronicles features a crime scene, a tower of shrimp, and a painting of a carnivorous giraffe. Folks, I couldn’t make this stuff up if I tried.

I remember feeling the ketamine almost immediately, and I closed my eyes as I lost track of my limbs. The music I was listening to was a lively classical piece, and my mind created intersecting lines to the notes that formed long evolutionary trees. There were noises around me that distracted me at first; something that sounded like hammering from the floor above us, then quiet conversation in the room, and a door opening and closing. Soon, though, the ketamine pulled me away, and I wasn’t concerned with anything outside my mind.

Absurdity in Ketamine Therapy Imagery

Silhouettes of a human face and a bull in profile, carefully stretched-out tape measures arranged in rows, and thousands of old family photos being sent on a conveyor belt to be turned into decorative pebbles were just some of the odd things I saw this time.

The Crime Scene

The crime scene was set in an arid landscape. There were shrubby bushes and reddish-brown caked dirt as far as the eye could see. Two or three people stood around a small body of water – what seemed like the only one for miles and miles. I got the sense that they were pondering something, as a detective would do when a puzzling scene presents itself. As I tried to read more of the scenario, my perspective began to shift. I zoomed out smoothly but quickly, like I had scrolled down on Google Maps with intention. Perhaps I’ve been watching too many police procedurals and true crime shows lately.

A desert landscape with red rock outcroppings and shrubs.
Photo by Agnieszka Mordaunt on Unsplash

A Tower of Shrimp

The shrimp tower stretched higher and higher, eventually reaching the edge of the atmosphere. The singular shrimp at the very top swayed back and forth, pondering the shrimps holding it aloft and balancing in the wind. Each shrimp interlocked with the shrimp around it, like that barrel of monkeys in Toy Story. I don’t know if you know this, but the sensation of perching on top of a stack of shrimps that stretches all the way to the edge of the atmosphere produces some stomach-dropping vertigo. If you’ve ever read the Dr. Seuss Book, Yertle the Turtle, the shrimp tower may remind you of that. Instead of an incredibly arrogant shrimp forcing the others to form the tower so that it could sit at the top, this was the reverse. The top shrimp wasn’t entirely sure how it got there and was not very comfortable with it.

Mixing of Identity and Observation During Ketamine Therapy for Depression

There are some interesting parts of my IV ketamine treatments that seem to blend my identity with strange scenarios and characters. For instance, how did I know that the shrimp at the top of the tower didn’t know how it got there? Was I the shrimp? Similarly, the funeral scene in the seventh part of The Ketamine Chronicles also evoked a sudden understanding. I was watching the scene, but when the coffin was set down, I felt like I was being pressed into the ground. Was I watching, or was I in the coffin?

Carnivorous Giraffe

The day before this IV ketamine infusion, my aunt and I did one of those paint-n-sip classes. The painting to emulate was a cute, cartoonish giraffe with multi-colored spots. We noticed that there were two kids in the back who had really taken their paintings to the next level. Their giraffes had blood-red eyes, thick, metal earrings, and gaping smiles filled with pointed teeth. One also had thick blue stripes rather than spots, but that’s neither here nor there. We got a big kick out of these kids’ creativity and confidence to go off-book.

Now, imagine that painting in the style of a ten-year-old’s artistic skills, and then imagine how taken aback I was when a dark silhouette in my ketamine dream revealed itself to have that giraffe’s face. It was both unsettling and hilarious at the same time.

A Mildly Creepy Scene

After the carnivorous giraffe, my brain may have opened the door to where the creepy images are held. I remember seeing dark forms standing over me, laughing. Thankfully, something in the room beeped, and I reoriented myself to my surroundings. That was probably the most disturbing thing I’ve experienced during IV ketamine therapy so far, and even that was not bad. I knew that it was creepy but didn’t feel especially scared.

Most of the time while I get ketamine infusions for my depression, I just see bizarre scenes like the tower of shrimp, marvel at how much my teeth feel like stale marshmallows, and wonder if I’m slowly tilting in one direction or another.

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.