Little Changes Add Up

My depression tells me that I have no power to change my life, that things (my thoughts/employment/job/career/finances/relationships) will always be the way they are, which is unsatisfactory,  and there is nothing that I can do about it, so I may as well die. 

That was a year ago, and things are starting to look better... in small ways that seem oh-so-huge when compared with the bleak, black future depression likes to lay before me.

A year ago, or maybe just eight or nine months ago, I hated my life.  I couldn't imagine how I was ever going to have a profession again, or even a job where I could just make money.  I could hardly do anything at all.  Taking a shower was an insurmountable task.

Ever so slowly, with medication and therapy, I started making little changes that I can see now have built upon themselves and given me the strength to make bigger (albeit still smallish) changes.  I was amazed to have the insight the other day that I do have the power to make changes.  I have a long way to go and I'm going to need a lot of help getting there, but change is happening.

I think it started with helping my friend with her one-year-old baby.  Her husband got a good paying job (hard to do these days) on the road six weeks out of eight.  She needed a hand, and something told me that helping her out would help me out of the house.  And it did.

Through her, I heard about a small room for rent.  Something told me that room could be my office, and if I had an office to go to, I would start writing again.  At first I just worked on the office, painting it and furnishing it.  That got me moving, too.  Once it was ready, I decided to write this blog, which has the double bonus of getting me to put words in print and keeping me focused on my recovery.

Then I decided that I needed a job in the neighborhood of my office to give me some money to pay for it as well as structure that will get me there every weekday.  To my amazement, I think I have a job now.  After two years of not working.  It's a part time job in the neighborhood.  It took me two days to write a resume and cover letter, but I did it.

So here I am now - probably (not yet definitely) employed and writing.  All of those little changes are adding up.  Now if I can just apply this theory to exercising.

Stigma busting!

This week in the U.K., during a debate in Parliament on mental health care, several members came out about their struggles with mental illness.  Can you imagine a Senator doing the same in the U.S.?

MPs Reveal Their Battles with Depression

I've read several great blog posts from the U.K. on the subject.  My fave is THIS ONE by James Rhodes.  He gets it so right.  "What is necessary to combat the stigma surrounding depression is a humble and honest relating of the experience of it. Nothing more, nothing less."  


Sing it, Sistah!  

Cognitive Behavioral Therapy for $16.99

Somewhere in the dark morass of my lowest points last year, I reached for a hold of sanity that has been invaluable throughout this year of recovery, David D. Burns's workbook for cognitive behavioral therapy.  It has an unfortunate title, in three inch tall letters, no less.  One that I cannot proudly display on the subway.  Here it is:
TEN DAYS TO SELF-ESTEEM.

The title aside, this workbook has been a great help to me.  Dr. Burns is the psychiatrist who popularized CBT in the 1980's with his book Feeling Good: The New Mood Therapy.  In a nutshell, CBT helps one to find, name, and reframe the distorted thinking that is at the core of a depressed mood and depressive (sometimes suicidal) thinking.

It's a write-all-over-it kind of workbook, with charts, checklists, and inventories as you progress through the steps.  While my work with my therapist is not on a strict CBT regimen, I would share my work with her and get her validation and insight on my distorted thoughts.  Even though I have only worked through about 3/4 of the book in the last year, I can see the progress that it has helped me to make.

In the beginning, in my suicidal panic, I was having horrible difficulties dealing with people.  I learned to grab a pen and work through my thinking before saying and doing things that would bring on regret and shame and only make me feel worse.  It was miraculous how feelings of intense anger could disappear in a few minutes of scribbling down my thoughts.

More recently, I used the workbook to do some deep work on how I feel like I am a failure because I didn't finish my master's degree.  (Mental breakdown was the cause.)  The workbook helped me see how it is my own distorted thinking that is punishing me and holding me back from moving ahead.  I didn't feel that miraculous lift from the feelings of self-blaming that I did from the earlier work, but over the last few weeks, I have felt my thoughts and feelings shifting closer to self-compassion and understanding.  Not all there yet, but making progress.

Low Cost Therapy, or, How Therapy Saved My Life

Here’s an ironic story.  In my first Composition class in college, I was assigned Kay Redfield Jamison’s memoir of manic depression An Unquiet Mind to read.  When she lists all the famous artists and authors who may have suffered from the illness – people like Virginia Woolf, Van Gogh, and Ernest Hemingway – I remember being disappointed that I didn’t have this disease.  Damn, I thought, I could make great art if only I had that mental illness.  Some people have all the luck. 

Be careful what you wish for.

But I still don’t have manic depression, or bipolar disease.  I have major depressive disorder, and even though they put ‘major’ in front of it, it still sounds like one just has a situation that will pass, not a serious mental illness like manic depression or schizophrenia.  But it is, and it’s taken me years and years to come to that realization.  It even took four years after I was first diagnosed by a psychiatrist (who was amazed that it had taken me so long to get medical help).  The illness had to almost pull me under the water line before I could scream for help. 

Maybe it took those four years because at first I was only treating my depression with antidepressants, which worked great at first, until my life got ridiculously stressful and I found myself seriously planning my own demise.  I needed more than 60 second meetings and prescriptions.  This time I sought therapy as well.

Therapy has helped me immensely.  I am on medication as well, and I’d say the help is about 50/50 therapy and medication.  The medication takes care of my physical symptoms, while therapy helps me to reframe my depressive thinking.  She was also, I felt, the only person who got that I was suffering from a serious illness at the time that I first started seeing her.  As I went through hating myself for my symptoms, thinking I was hopeless and useless, she constantly reminded me that I was recovering from depression.  Having her on my side against the onslaught of self-hating thoughts and misunderstanding friends and family was and is invaluable to my recovery.  Probably saved my life.

Therapy can be expensive for those without the resources (read money or mental health insurance).  One thing to note is that many therapists state on their website that they will work with you on the fee, so while their normal fee is maybe $200, maybe they will see you for $100, or even less.  As a doctor at the NYS Psychiatric Institute said to me, “You’re worth it.”

I know of one place in NYC that offers psychotherapy on a sliding scale: The Washington Square Institute.  I went there myself years ago for a while, and was charged $30 per session.  It did me some good, although I wasn’t ready to accept that I had a mental illness or needed medication at the time. 

Their website is here:  Washington Square Institute 

I'm sure there are other options for low-cost therapy in NYC, but I don't know them yet.  I'll keep my ear to the ground, though, and post anything else I find.  For those who don't live in the city, try googling "low cost therapy your city here," or "low fee psychotherapy your city here,"or some combination of those words.  Of course, the bigger the city, the more available resources.  

There is also the Psychology Today website that can help you find and shop for the right therapist.  That is how I found my therapist that I see today.  Go to their website and do a search for your city.  The psychologists listed have a short blurb about their practice and philosophy, and many have links to their own websites, as well.  

That website is here:  Psychology Today Therapy Directory.  

On The Mental Illness Happy Hour this week, Paul had a guest, Mike Carano, who questioned whether therapy really worked because he knows some people that it hasn't seemed to help.  I'm here to say that it works for me.  I've had many therapists over the years – some better than others.  It's a lot like my search for the right psychiatrist, if one wasn't working, I had to find someone else.  There are good ones out there.  This time around, I chose three from the listings and saw each one for one session before making my decision.  Many (not all) will see you for a free consultation, or have one with you over the phone.  

You're worth it.

The Chillout Song

A few months ago I discovered this TED talk with Ze Frank talking about all the ways he tries to truly connect with people over the internet.  "To feel and be felt," he says, "Really connecting with people isn't easy."

That is more than true for me when I am in a depressive cycle.  I say, 'more than true,' because it's nearly impossible unless it's with a professional who understands depression because most laypeople who are untouched by the disorder just.  don't.  get.  it.

Anywho - I was and am touched by this 18 minute TED Talk.  So here it is for you:

Ze Frank TED Talk

The main reason I'm so moved by this talk is because of the "Chillout Song" at the end.  Ze writes a short song for a follower because she sounds like (to me anyway) she's going through some anxiety and depression after moving to a new city.  Then he has followers from across the world record themselves singing it.  He puts their voices together to create a soothing, choral hug for this woman.

I've downloaded the song and listen to it every now and then when I'm feeling down.  It has not yet failed to make me feel a little better.

The web page showing the story of the creation of the song is HERE.

You can download the song for $1 HERE.

And hey – you're okay.  You'll be fine.  Just breathe.

The Mental Illness Happy Hour

I can't let another day go by without sharing about Paul Gilmartin's podcast The Mental Illness Happy Hour.  I just discovered this a few months ago when there was an article about it in The Atlantic Monthly, and it has helped me on so many levels that I'm afraid of not doing it justice by describing it.

Paul Gilmartin is a comedian and recovering alcoholic who also has depression.  In this free podcast, he interviews other comedians (many of whom, it turns out, are nutjobs) and the occasional civilian, encouraging them to talk about their mental illness and share their worst fears and childhood memories.

Here's a link to his website:  www.mentalpod.com

You can download the podcasts from there or from iTunes for free.  He also has a blog on the website and forums for people to talk about mental illness.

"You are not alone," is proclaimed at the top of the home page at mentalpod, and that is certainly the greatest gift I have received from listening to his podcast.  The candor with which Paul and his guests share about the crazy thoughts that go on in their heads is a balm to my lonely disease. 

It's also helped a great deal on my journey towards accepting that I have a mental illness.  Mental illness is discussed with such frankness that one would think that there is no stigma attached to the proud ownership of a mood disorder.

Thanks to Paul and all who make this podcast happen.  I think you are doing a great service.

Melancholic Monster

A huge part of my getting on the road to recovery from depression has been the seemingly simple, but truly formidable, problem of accepting that I have a serious mental illness.  Without that, I cannot take responsibility for my mental health.    

There are myriad social and psychological reasons why this is has been so difficult.  The name of the disease doesn't help matters.  I'm with William Styron, as he says in his memoir of depression, Darkness Visible,

                    "Melancholia would still appear to be a far more apt and evocative word for 

                  the blacker forms of the disorder, but it was usurped by a noun with a bland

                  tonality and lacking any magisterial presence, used indifferently to describe an

                  economic downturn or a rut in the ground, a true wimp of a word for such a 

                  major illness."

It seems like everyone is on antidepressants these days, and they may be overprescribed, but that doesn't change the fact that some people have a serious and potentially fatal physical illness and need the drugs.

One of the first steps toward acceptance for me was taking a simple online depression test.  I took a few.  All of them said I was severely depressed.  The questions read like a list of problems I'd had all of my life.  

Chronic insomnia, suicidal thoughts and actions, crying all the time, procrastination, oversleeping when I finally do get to sleep, weight gain from trying to comfort myself with food, isolating from friends and family, never feeling like I'm good enough or even am enough to have the things I want in life, feeling like I'm imprisoned behind a brick wall in my mind while desperately wishing to connect with and be comforted by other people... the list can go on, but I'll stop here...  It seems like I've had these symptoms in some form since I was ten years old.  I have Major Depressive Disorder.  I'm not just overly sensitive and take things too seriously.  My brain does not always produce the happy chemicals like normal brains do.

Oh, and P.S. – My grandfather committed suicide.  Hello.

More free help:

I was at NYS Psychiatric Inst. yesterday for my follow-up interviews and found some info that will simplify looking for a clinical trial.  Columbia/NYSPI has a website just for the depression trials.

You can find it here:  Depression Trials

They have medication and non-medicated trials listed here.  There's one trial that's for people with treatment-resistant depression, which is great. 

It looks like you can also just call the phone number on the page to find which trial would best suit your needs. 

Free Psychiatric Help #1

Every time I start writing this post, I either start talking too much about myself or giving too much advice. I can see it's going to be a balancing act to keep myself away from both of these tendencies.  I want this blog to be about sharing things that have helped me get better without telling people what they should do or blabbing on and on about my life.  So, with that in mind...

Last year, when I found myself planning my suicide, I also found out that my insurance company had dropped my mental health coverage, ironically, as a result of the Mental Health Parity Act.  (The irony compounded by the fact that I'm desperately seeking help whilst being obsessed with ending my life.)  

After the fog of frustration lifted, I had the thought that I do live in New York City (which some consider a socialist city-state), so there must be low-cost or free mental health care out there somewhere.  I googled "free mental health care nyc" and got a link for clinical studies at Columbia and the NYS Psychiatric Institute.  

Here it is for you:  Free Clinical Studies

Click on "Find Clinical Studies" and you will be taken to a search screen.  Check "Studies Offering Treatment" and "Outpatient" and click on "Search."

This will show you all the relevant studies available today.  Read through until you find one that you think can help.  I was lucky to find one that was testing the efficacy of Paxil vs. Wellbutrin on suicidality last year.  That study seems to be over, but I notice that there is one that is studying brain imagery before and after antidepressant medication, so that must mean that you will be given antidepressants for free for a period of time and brain scans before and after the treatment.  If you are only looking for psychotherapy, there are different trials for that, too.  If you're not sure what will help you, they have a hotline number on the webpage that you can call and someone can help you find a trial.

There is usually a phone interview to see if you are eligible for the trial.  During my trial, I was given great care by the doctors in charge.  I was definitely cared for like a patient, not an experiment.  I am still here because of their care.

Now:  If you don't live in the NYC area, you can do the same Google search wherever you are: "Free mental health care yourcityhere."  There are teaching hospitals and university programs all over the country.

I know how hard it is to fight for your life and ask for help when your mental illness is telling you that you're better off dead.

Do it anyway.  Depression is real.  Get help.  You are worth it.  

Intros

Who am I?  I am a forty-something woman in a long, slow recovery from depression.  I have major depressive disorder with chronic suicidality.  If you feel like you should call the police and send them to my place, then you don't get it.  Don't worry.  I'm taking responsibility for my mental health these days.  I'm finally on a medication that seems to suit me, I eat a healthy diet, and I'm in private and group therapy (much of which is free). 

I also place my ear on the interwebs to find anything that can help me stay afloat.  I find myself sharing these things with friends who are also struggling to claw their way out of the abyss.  While there are many well-written and valuable blogs where the author shares their experience of depression, I felt that I could add my voice to the sphere by sharing things that have helped me on my road to recovery. 

Depression tells us we are alone in the depths, but like the proverbial teacher who shows up when the student is ready, the more I look for help in the world, the more lifejackets I find being thrown my way.  I don’t think I’ve completely recovered from this last, worst depression, but I am so, so much better than the suicidal panic I was in a year ago.  I am mostly better, but after being incapacitated for a year, I am slightly at a loss as to how to proceed with my life.  This blog is one way I plan to get moving.  I need all the help I can get.  I bet you do, too.  

I'm not a doctor or therapist.  I'm an unemployed crazy person who could have died last year, but made it out alive somehow.  I may be woebegone, but I am somehow optimistic that I will find a way to have a happy life with my dysfunctional brain chemistry.  Maybe we can do it together.