Saturday, June 16, 2018

The Wrong Door

It started and I kept going along, ignoring yet feeling it. It came on more slowly than before which fooled me into believing it would come and move on its way. Then, things piled up...symptoms piled up: irritability, trouble sleeping, severe anxiety, fatigue, difficulty feeling connected to others, decrease in appetite...I wanted to keep ignoring it and only described my symptoms to my therapist but never used the word "depression." My therapist did and questioned if I was falling back but I told her I wasn't, that I wasn't totally under water and could still be around people. That held true but not for long and then I could no longer ignore it. I could not say the word out loud though. I emailed my therapist and simply said, "I am depressed." Of course when we saw each other next, the word was voiced and owned by me.

In the past, my depressive episodes would come on very quickly, sometimes within days from 0-100. Feeling the symptoms pile on one another so quickly is terrifying and does not allow you any time to breathe. This episode is different, certainly not better, but different.

This feels as if I walked through a door and realized it was the wrong one to go through but once I turned around the door was gone and I was stuck in the wrong place. I entered the wrong door to the wrong time to the wrong place with no way out. I walked into utter darkness and even though I can't see anything, this isn't the only phenomenon that scares me. It's not just about being alone in the darkness, but feeling alone. I cannot conjure up feelings, thoughts and memories of those I love very often and hold onto them. The frustration of that only leads to more fear of being and believing that feeling alone is my destiny.

This door has led me to the wrong world and I am seeking an exit. This world is vast, empty and scary. Not only is it desolate but it is not allowing me any comfort. It is not allowing my brain to think clearly and to picture my loves, hold on to them and use those images and visualizations in my head to calm me.

This fucking sucks. I'm anxious with no precipitant. I am numb. I am sad. I am scared. I am irritable. I am so very tired. I feel so alone. I feel I am a burden. My inner dialogue is terribly rude and offensive toward myself (and these are only a few examples): I'm stupid, a bad person, a bad wife, a bad mother and this reel goes on and on in my head throughout the day and now feels normal. My body is in the world but I am not. Life is happening around me but I don't feel I am a participant.

As I work with my therapist on talking through the many aspects of my current experience, I am also working with my psychiatrist on a medication increase. There is no easy fix and it can take 3-4 weeks to begin to feel a positive effect from this increase which is not easy to tolerate when I feel so stuck.

I didn't mean to walk through this door into this world. I simply didn't know. The writer, Dejan Stojanovica, wrote, He tries to find the exit from himself but there is no door. I think I walked through that door because I believed it would rid me of my inner pain, that I could "exit" my self but once through that door, it turned out to simply be a mirage. It wasn't real. There never was a door to walk through in order to leave my self. This world that feels wrong is actually my world. It wasn't a mistake, I was merely taking the next step that I had to take as it was the only way to go. I, somehow, need to keep walking though, not to find an exit, but to find an entrance.

Thursday, May 31, 2018

A Message for My Nephew Before He Goes to College

Dear J,

While I am asking myself, how could this be happening? (with tears in my eyes), I know you are saying, YES!!!

Well, you have done it! You made it through, what is for many people, the most stressful four years of their lives. I do not know how to express how proud I am of you. You are one of the hardest working people I know. I don't know anyone who attacks each assignment, whether in school or in life, with such energy and with such strength.

Your summer will be yours to live, laugh, have fun and be a role model for your campers. When the summer ends you will embark on an entirely new adventure in an entirely new environment.

My Advice: SOAK IT ALL IN!! From the moment you walk into campus, soak in it. Look around, take a breath, notice the people, notice the other students who probably look just as overwhelmed as you may be. Look at the buildings, even notice your parents. This moment will never be re-produced for you and it is monumental. Beginning college life has so many branches but this first moment, I think, is the most meaningful. You get to separate from your parents in a way you never have before and while that can be sad and overwhelming, it is also, simply, fucking awesome. This is your time. Take it. Make good choices. Use it. Breathe it in.

I love you so very much,
Auntie Risa

Thursday, May 24, 2018

Repressed and Remembered: Sexual Assault

My severe depression began to lift in August and it has been an interesting 9 months, to say the least. I did not simply start to feel better and life was great. I had to first cope with feeling better and being cautious about that experience. Then I had to mourn the loss of my therapist whom I had seen for the better part of 24 years as she was too afraid for me to become ill again and drive to Boston to see her (2 hours each way). While I understood this and it made sense to see someone locally, there were a lot of years of work there as well as a close relationship. It only came within weeks of beginning to feel better and while I transitioned to a new therapist over time, we last saw each other in November. There were several months of working through that loss which included disappointment and pain with my new therapist. Still, I lived my life. I enjoyed time with Ken and Iliana, enjoyed being at work and the little things that happen each day that we sometimes take for granted.

And then it happened. I had worked with children and adolescents with PTSD and it was difficult to hear their stories. I always wanted to swoop in and take it all away. I now have an idea of what it was like for them to experience those trauma-related symptoms. I dated a guy for about 2 months when I was 30 years old and always described a "bad experience" occurring with him but never thought about/wasn't aware of the details.

Two months ago, I remembered what happened. The first few weeks after telling my therapist and Ken were terrible. I had flashbacks (transported back to it without being aware of the present), I dissociated (checked out), I was constantly on edge - checking behind me when walking through the mall before and after work and my senses were on high alert ready for something "bad" to happen. I could not sleep, was extremely irritable and my anxiety was in a constant state of "high." I do not need to get into the details of exactly what happened to me, but I can say that I was sexually assaulted. The legal term is rape. This bastard forced himself on me and remembering this has changed me.

Many in the psychiatric world say that when an assault is repressed in our memory and we later remember it, it is due to having the mental ability to deal with it. I agree with that. I would never have been able to cope with this a year ago given my severe depressive state. At the same time, I do wish I never remembered it as it is so painful.

My therapist and I are working hard on the aftermath (PTSD) which can be typical: self-blame, thinking pejorative descriptions of myself, shame, having trouble catching my breath, difficulty concentrating, the level of hate and anger I feel toward this bastard that cannot be put into words. While I rarely have flashbacks at this point, the irritability is there but is better controlled, especially since my psychiatrist increased one of my medications. My sleep still requires more medication. I have told some friends and my siblings. I knew from the beginning I would need their support. I am very lucky that Ken is right by my side, as always, and is willing to listen and is reading a book my therapist gave me that explains the trauma reaction.

When I first remembered, I thought to myself, "woe's me" as I could not believe there would or could be more negative experiences. After some time though I have begun to accept it as there is no other choice. As with my depression, I am dealing with it in the best way I can. Some days are better than others but I am trying. It is taking a lot of my energy and some days I keep fighting and others I feel defeated. This is all I can do right now. It is hard but it is my life and it is the only one I have so I must continue the best I can.

Monday, May 21, 2018

I Am Honored, Grateful and Desperate

Last week I was given a Humanitarian Award from my local Jewish Family Services for my fight against the stigma of mental illness. To say that I was honored, humbled and overwhelmed would be a complete understatement. It's been 4 days and I have been experiencing a range of emotions. I knew I was receiving the award but I had no idea what I would feel after receiving it. I was extremely emotional the first couple of days, crying a lot, feeling so loved by supportive comments on social media that, again, felt quite overwhelming. I would walk by the award sitting on my kitchen table (we had not yet found a permanent home for it) and take a second, third and fourth look, always surprised to see my name on this gorgeous award. My anxiety would rise each time I walked by.

I began to question why I was given this honor. I asked myself, what have I really done to deserve this? I certainly am invested in my local Jewish Family Services and feel so grateful to be a part of their family. I write, I speak, I constantly post on social media. I share my experience of mental illness, of having a treatment resistant illness that has required invasive treatments. I am open, honest and do not shy away from any aspect of the topic of mental illness.

I then began to feel sad. I wondered, I have to do more, there is still so much more to do. How and what can I do to ensure that people hear me? It's not working! I need to not only convey my experience but have people hear me, react, do something to demonstrate that they hear me. I need people to see the stigma and do their part to fight it. I felt angry and defeated and even retreated a bit over the weekend due to feeling disheartened.

While that strong feeling has dissipated, I am still feeling a bit defeated. I am so desperate for people to understand and not be afraid of mental illness that I feel lost as to what to do next. I am out there, there is no question about that. I will keep writing and share that writing hoping to connect with people. I will keep speaking about my experience as it is so vast but giving one speech does not come close to covering all that experience entails, not even close.

Patrick Kennedy was the guest speaker at the event and I am trying to use his words and follow his lead in terms of his never-ending fight against stigma and prejudice. His energy does match mine, I just need to look inside myself and recognize that familiarity. This is not an easy fight. Sharing myself so openly and without inhibition is almost natural and I plan to use that ease to continue my fight by sharing my experience. It's there...in my heart. I do feel it.

As Jewish Family Services would say, I am going to Embrace Possibility.


Tuesday, May 1, 2018

Reality: EVERYDAYISMAY


It is May 1st. To repeat, it is May 1st. Today begins a special month that highlights the struggle, stigma, information, stories and so much more regarding mental illness. It is a month full of education, personal journeys, pain and healing. It is one month. It lasts 31 days. It lasts for 744 hours. It is a special month and provides meaning not only for those who suffer from mental illness but for the family members and friends, co-workers and basically, society. It highlights the victories in science in creating new treatment models and it offers a space for personal stories of struggle, pain and health. It is an important month and I deeply believe in it.

I want to go deeper though. Those 31 days are just that, 31 days. In my life, 31 days can feel like a never-ending eternity or it can pass so quickly, I am in shock when the new month begins. When I was ill, my pain was never-ending just as was the time.

My struggle during Mental Health Awareness Month is that while I strongly believe in the extra social media posts, educational opportunities, web series and individual openness of one’s experience, I also struggle with the fact that this also occurs outside of May. One difference may be that people are more aware that there will be more buzz about mental illness during May, but the truth is, the buzz is everywhere all the time now. I think this is such an important and valid point to make. The current push for pediatricians to follow guidelines to screen kids for depression is an everyday affair at doctor’s offices, the woman who attends therapy twice per week to work on her anxiety and the man receiving ketamine infusions to alleviate his severe depression are all dealing with issues that abound not only daily but sometimes in an hour to hour basis.

One’s mental health is a constant. Anyone who has a mental illness deals with a minute by minute existence that does not revolve around a calendar. Mental illness does not begin or end just because it is May 1st and Mental Health Awareness Month has begun; it only continues.

My intention here is to highlight an important 744 hours during the year where there are many resources that are utilized to provide a voice to those with mental illness who may not have the ability to use their own. It is a month full of fundraisers for important organizations to continue their work to de-stigmatize mental illness and lobby political players to increase parity and availability of services. My family and I will participate in my local NAMI walk in a couple of weeks and we are proud to do so.

While I will blog, post pictures and quotes on social media during these 31 days, there is no substantial change to what I post in any given month. This is the point. I wish we did not need a special month to highlight the realities, struggles, political policies, treatment options, etc. when we should be doing this every month of the year.

My everyday life is all about my mental health. I start my days taking medications for my depression and anxiety. I have thoughts in response to these illnesses throughout my day. I may need to take Ativan if my anxiety reaches its peak which could be in reaction to almost anything happening. I see my therapist three days per week where I continuously deal with and work on me. I may put myself down for not making a connection to a customer at work and spin this in my head for hours. I may need to take an Ativan in the evening when my irritability soars. I may need to take deep breaths to calm my anxiety. I end each day taking my evening medications. This is every single day of my life. It is not merely in a bubble of time in the month of May. It is my always.

So, yes, let’s promote this very important month and do everything we need to do to affect others’ disinterest, misunderstandings and/or fears of mental illness, but, at the same time, let’s also ensure that people recognize that this is not merely a 31 day or 744-hour mission. This is life. This is certainly my life. This is not only about May for many of us; this is about our everyday existence. #EVERYDAYISMAY

Thursday, March 15, 2018

7th Inning Stretch

Here we are. It has been seven months since I began my recovery from my fourth back to back severe and treatment resistant depression. It is the longest span of time of relative health I have had in 4 ½ years. I never intended to count the time like this but it is so significant after what I have been through these past years. When you have been to hell and back and tried medication after medication, endured 4 psychiatric hospitalizations, intensive medical treatments which included ECT (electroconvulsive therapy), TMS (transcranial magnetic stimulation) and ketamine infusions, you do need to take a step back and recognize where you were and how far you have come. Time is important in this process. Seven months is significant. I have learned quite a bit in these past seven months and it doesn’t include thinking that all is better.

The process of recovery from major depression differs from person to person. During my briefer periods of recovery in between these past episodes, I was thankful and always felt that each one was the last. I felt too well to imagine anything obstructing that feeling. With this last episode, which was long, painful and haunting, I was cautiously optimistic. I tried a new medication from a class of drugs that I had never tried before. I had to stop my previous anti-depressant and wait two weeks before starting this new medication and began this process while hospitalized in July.

Once I began to feel better, think more clearly and feel more connected to people, I was hopeful but, again, cautious. With each month I have been able to really be “with” people, work and enjoy my life. At the same time, I do have struggles. If I do not sleep well for a couple of nights I become irritable and it can play out in a way that is certainly not fair to my husband and daughter. If I do not eat regularly I will not only get headaches but I will start to feel sad. I still have memory issues as a side effect of the ECT and sometimes I can laugh it off and others it is extremely frustrating and makes me feel angry. I am slightly traumatized by the experiences I had with ECT, TMS and the ketamine infusions. The ECT and TMS certainly helped and unfortunately the ketamine didn’t but the act of going through it all still frightens me when I think of it. It was terrifying and it was upsetting to be with and see so many other people struggling urgently with mental illness as these treatments are seen as the “last ditch” effort to ease someone’s symptoms and pain.

I have bad days as everyone else does and I have days that are “bad” but in a different way where my symptoms make themselves known. There is no cure for depression or anxiety. It is always there inside of me. I am working hard in therapy with a new therapist and this process brings up a lot of topics I have worked on in the past. It aggravates my anxiety and provokes in me anger, sadness and a bit of humility. It is hard. It is difficult. It is humbling. The positive of this experience has reminded me that I can feel better, even much better than when I was in a severe depression but there is always work to be done on myself. I’m not out of the woods and I have realized in the past seven months that I never will be. It is simply who I am and I am learning to accept it. I suffer from depression and anxiety and I own that. They will always be there in some form. I am not cured and I pray I do not have to endure another severe episode but I am doing everything in my power to care for myself. These past 7 months have provided me not only with better mental health but with more knowledge and understanding about myself. I will take this opportunity to stand up, raise my arms above my head and take that stretch.  Time is meaningful.

Friday, January 12, 2018

What Does it Mean to Be an Aunt to Young Adults?

My niece and nephew are my heroes and I do not think they have any clue about this. I was 23 when my niece was born and I fell instantly in love. The feelings were mutual and I couldn't be happier when she called me "Resee." Two and a half years later my nephew was born and he was full of mischief and love. I enjoyed visiting them when they were young and remember one visit where I became a yo-yo as they fought over playing with me. My sister-in-law actually had to time my playing with each one in order to ward off sibling war. It was hysterical. I felt such a connection to each one and watching them grow up has been not just a joy but an honor.

Each has his/her own personality, hopes and dreams but each is truly a wonderful human being. They both are loving, caring, enjoy spending time with family and friends and giving back to their community. I am full of awe as I watch them become adults. My niece is now almost 20 years old and a sophomore in college while my nephew is 17 years old and a senior in high school excited to begin college at his first choice in the fall. How and when did this all happen? Weren't we just circling around singing "ring around the rosie?" What the hell is happening?

The more I see them as adults I try not to yearn for the younger years when they fought over time with me and I felt such importance. Now they are busy as they should be. Growing up is partly about separating, developing oneself and learning and they are quite successful at this. I always say that my niece and nephew are rock stars and I stand by that. They are genuine human beings concerned with those around them and the world around them. They are hardest on themselves and actually over-work themselves in school. I do not think they realize that they are already wonderful in every way and do not need to really work at that.

I am always in amazement as I watch my 7 year old daughter, another hero of mine, grow up and cannot fathom her as a young adult, in fact I try not to even bring my mind to that place. I want her to stay seven, sassy and adorable forever. I obviously have different relationships with my niece and nephew especially since I was young, single and not responsible for anyone but myself when they were born. I consider myself extremely lucky to be a part of their lives. I am proud of my niece's love for her school and studies, even though I have no understanding when she tells me what she is working on in the lab; and I take such pleasure in my nephew's love of camp and everything that represents for him as I feel the same way about my own camp experience.

I cannot stop their growing up, just as I can't stop my daughter from growing and I feel so honored to call them "niece" and "nephew," such important people in my life. I am proud of each of them and I know I will always be along for the ride with them. My admiration of them will obviously continue and I cannot wait to see what this next chapter in entering adulthood will bring to them. Maybe now each will be clued in to my view of them and that it truly comes naturally. Love and appreciation for two amazing and impressive human beings abound.