Experiments/Things we can do...

So, firstly, let me say that I am tremendously grateful to the response my blog has thus far received. I get so excited every time someone posts a comment saying that they relate or that it's helping them in some way, and writing last night's entry helped me more than I can express.
That said, I thought I should follow up with some of the things we can do that are recommended for helping to lift out of a deep depression, or for what's called "Recovery Maintenance" or "Relapse Prevention". And I thought that being in an episode currently, it might be interesting and useful for me to put some more effort into trying them, and then letting you all know how it goes for me.
When you're sick for years and years, you hear these things all of the time. The professionals suggest exercise, eating "right", yoga, communication/human contact/social interaction, journaling, whatever. Being me, I have about a million books on mental health and illness (research, self help, memoirs, whatever) as I tend to, as many do, search for The Answers in books. I'm going to draw on one of them in particular for this entry that I've been flipping through over the last few days to remind you of some of the simple suggestions we often ignore (or, at least, I do) in our belief that we've simply tried everything. And it's true - these aren't things that are going to "fix it" if you're sincerely in the midst of a major depressive episode - but they might ease it, take the edge off. And I've been trying some of them as of late, and for the sake of this blog and myself, am resolving to try to try (because you understand that if you're like me) to experiment a little bit more with them.

The book is: "Managing Your Depression": What you can do to Feel Better (by Susan J. Noonan, M.D., M.P.H)

I'm quoting directly...with some commentary and links added.

The Basics of Mental Health

• Treat any physical illness.
• Sleep

                     - Aim for 7 to 8 hours of sleep each night.
                     - Keep a regular sleep routine.
                     - Follow Sleep Hygiene principles to promote restorative, restful sleep. (Click Here to read some basics of "Sleep Hygiene")
                      - Use a sleep diary to track sleep patterns.

• Diet and Nutrition (now obviously this is complicated for those of us with eating disorders, but bear with me for a moment)

                       - Eat balanced, healthy meals regularly, 3 times a day.
                       - Do not use alcohol, street drugs, or excessive caffeine.

• Medications

                        - Take all medications as prescribed, even if you are feeling better. (Yes, even if you are feeling better, kids! That means they're working! Don't fuck with it. Meds for the win - if they help)
                         - Discuss with your physician all over-the-counter medications, herbs, and other supplements you take.

• Exercise regularly (as able); balance cardiovascular, stretch, and strengthening activities.
• Maintain regular social contacts and connections with others.
• Avoid isolation.
• Have a daily routine and structure your time.

That's it for the moment from "Managing Your Depression", but I'm going to add a few things that are also kind of no brainers for veterans of mental health treatment (and for newcomers, too of course - if this is your first time reading about mental health/illness, you are more than welcome, and I promise my attitude does not mean that this is hopeless - just hard).

• Mindfulness/Meditation (I highly recommend Pema Chodron's books as an introduction)
• Yoga
• And well, duh, therapy.

I actually laughed when I was looking through that list initially because my life lacks so many of those components. I'm incredibly fallible, and for someone who is depressed (or anyone) those are hard guidelines to follow! Personal health maintenance isn't easy, for some of us (or all of us, I don't know because I can't get into the brains of the Healthy Peeps) for some reason. But it's IMPORTANT. On the morning of my 25th birthday, I took the suggestion of a good friend and went for a walk. Just a walk. I usually can't make myself just Go For A Walk unless I'm walking somewhere; I didn't get my license until I was 21 or 22 due to my general fuckupery, so I love my car. I used to have to walk EVERYWHERE. But going for that walk seemed, in the moment, to generally improve my mood. I noticed the birds and the trees and the nice feeling of the air on my skin.

So...that's that for now. Again, I'm just launching this blog and I am sooo not a professional or anything of the sort, so pardon my general incompetence. I'll come back to this, though. Promise. And in the meanwhile, I will try to practice some of these things and get back to you :-)

Thanks again for your time,
Sofia

What does Depression feel like? : Part 2

My days go like this:
I wake up. The depression is a tiny seed again, something manageable. I brew coffee, I feed the cat, I feed myself. I am currently unemployed and not in school, so the content of the day - and whether I have plans - is entirely dependent on the availability of the few people I have in my life.
I make sure to get out every day. On many days, I have appointments - therapist, dietitian, psychiatrist, doctor...they help sometimes, but always temporarily when I'm in a depression.
I try to give my cat the attention he deserves and I do my best to connect with other humans. I have learned that this is vital for my mental health and my will to be alive. My relationships are my highest value, and they are the reason I choose to stay alive, even when my brain turns on me.
Which it always does by nightfall, when I'm in a depressive episode, as I currently am. That seed grows into a worm, and then a tumor until it takes up almost all of the space inside of me. Sometimes I can't cry - that's how it was for years. Lately sometimes it feels like crying is all I CAN do.
I curl into the fetal position on my couch with my computer and cell phone visible and within reach on the coffee table, hoping to hear from someone. Sometimes I reach out myself, but I rarely communicate what demons are overtaking me. They have no names and the majority of the time there is no rhyme or reason to them. They simply come; roaches in my skull.
Tonight I was brave. I dragged myself into the shower, holding onto the curtain for support, and somehow managed to get dressed and drive to the only open coffee shop in my neighborhood at this hour. That's where I am now. I am waiting to feel tired enough to go home, type this up, and (hopefully) fall asleep within a few hours.
Because as though the depression weren't agonizing enough on its own, it is often accompanied by unresolvable insomnia. For many chronic insomniacs the sleeping meds stop working as they develop a tolerance, as I apparently have, yet again. Add that to the mental checklist of things to tell my psychiatrist next week.
Years of depression have dulled my ability to hope. Years of treatment have somewhat revived it, but when I am depressed I also become incredibly irritable at times, which makes it very difficult to Stay Positive.
I have, like many who struggle with mental illness, read endlessly about it. I have read that Resilience is the difference - to oversimplify things - between those who Make It Though and those who don't. My personal experience, though, has shown that even some of the most resilient people I have known lose their lives to mental illness in some form or other. My best friend joined their ranks in July, and I have many friends whose lives I fear for.
When you have been sick for as long as you can remember, you know (and love) a lot of very sick people, which is further depressing. My personal belief is that this does not mean a person should stop loving or caring for their also sick friends - but perhaps, as I have to decided, to not make any more as much as is possible, and to attempt to make some healthy friends as well. I'm lucky. I have a few.
But most of the people in my life that I love, value, respect, and trust are extraordinarily busy.
The harsh truth is that people don't always have time for you - even when you need them the most. Your mental illness is not their responsibility. This is not to say that they can't or shouldn't love, care for, and support you - or that you don't deserve it - it just means that at the end of the day it's you and yourself and your demons, whenever they may choose to show up.
There's a sense of injustice. For me at least. I am a good person and I know it. Andrew Solomon stated in his TED Talk on Depression (see the previous blog entry) that "Our needs are our greatest assets. It turns out I've learned to give all the things I need."
I love that and it rings loud and clear and close to home. I am the person who will show up for you when you need someone but can't ask. I am intuitive in that way.
And this comes from my intimacy with my own unmet needs.
In the car on the way here I recalled something stupid I said to someone whose opinion I highly value over a YEAR ago and I flinched and my entire body tensed. This is not uncommon in depression - obsession and rumination over insignificant past interactions. I've had enough therapy that I quickly remind myself that I am powerless over the past, that I am human, and that the other person probably doesn't even remember it.
So how to wrap this up? I haven't expressed even a fraction of what I hoped to, but I guess this will have to suffice for the moment.
Part 2 of "What does Depression feel like?" is complete, and I am going home to type this up soon.
Thank you for your time,
Sofia

Andrew Solomon: Depression, the secret we share

I had to share this when I watched it today.

What does Depression feel like?

As hinted to in my first blog entry, I am currently in the midst of a severe depressive episode. This one has lasted longer than most - generally my moods are "rapid cycling", but I've been this way for over a week. Granted, the last two weeks have been shitty, but there's a difference between sadness and depression, and this is - without a doubt - depression. Capital D. Depression.
It's been a cloud over my head all morning - for me, mornings are better than evenings - and about an hour ago, maybe a little more, I felt it begin to envelop me, I felt my mood crashing again. It seems to happen out of nowhere. I was sitting on my couch with the TV on for background noise perusing Facebook when I suddenly had to close the computer, lay down, and tears came. I felt my stomach curling in on itself. I felt my limbs grow heavy.
And so I stayed like that, for about ten minutes. Knowing better and being in a place where I am sincerely putting in serious effort to manage my depression and get myself through this episode, I managed to drag myself up off of the couch and into the shower, where I first stood, and then became so exhausted I had to sit. I managed to shampoo my hair but not condition it. Whatever.
Then, knowing myself well, I thought I needed to get out of the house. I have plans to meet someone I don't know very well at 8:00 (it's nearly 6:00 now) in a town a bit away from here, so I thought I'd figure something out, do something with myself until then. Anything but sit at home and feel like shit.
I climbed into my car and put some music on that I hoped would cheer me up, but in a deep depression, often for me, "happier" music simply irritates me and makes me feel worse. So I found a compromise in Ingrid Michaelson's version of "Over the Rainbow". I was out of gas (to the point where I couldn't avoid going to fill up) so I went to the closest gas station and sat in my car while I filled my tank. Then I drove to the intersection of the highway and realized there was absolutely no way I could get myself to drive to a different part of my city right now - I had completely exhausted myself showering and getting gas.
So I came home, resolved to write about it. I questioned whether it was wise to write a blog entry while extremely depressed, and whined internally that I didn't want to, and then thought "Hell, I don't know if it's exactly the right time to write, or the worst time to write, but I'm going to do it."
Depression feels different each time for me. There is no one way to describe it; it is progressive, in some cases, such as mine. With age my own depression has worsened (and I will at some point be writing an entry about the differences between childhood, adolescent, and adult depression/mental illness and the progression of such, but not today). In my case, we have tried nearly every psychotropic medication under the sun, and nothing works for long. I have what is termed "Recurrent, treatment resistant depression". Major. I'm looking at ECT (Electro-convulsive Therapy, which is much different these days than what they portray in the old movies - much safer with less side effects, and I'm sure at some point I'll write about different treatments for Depression as well. Again, not today.)
Solitude is something that I personally covet. I need my alone time like I need air. But when I'm depressed, it can be extremely dangerous. And so I try and I try to put plans in place, and I do have some extraordinarily supportive people in my life, but unfortunately years and years of being in treatment has limited my ability to form long term supportive relationships and has limited my social life. Most of the people I have connected with are from treatment centers, or are treatment professionals themselves. This is not unusual; this is the case for many. Aaand again, I'm sure I will elaborate on that another time. There is so much ground to cover, Jesus Christ.
Depression, for me (as it is different for everyone) as of late feels needy. I think of suicide all of the time. I hesitate to share details in a blog, but I want to expose the truth of this illness, the darkness that the sufferer experiences; do not pity me, please, because it's neither here nor there; this is simply my reality right now.
Last week, during a particularly alone, depressive moment, I began to write a Will. Just in case. Just in case I do not survive myself.
In the worst of my depressions I couldn't function at all. I couldn't take the trash out. I had roaches, mice, and ants in my apartment. My father had to fly across the country to help me clean up. Of course, that was depression partnering with Bulimia. Which is a fucking mess.
Depression feels awful. A quote I shared on Facebook today from a book I highly recommend on the subject, "The Noonday Demon" by Andrew Soloman, states that:

“You are constantly told in depression that your judgment is compromised, but a part of depression is that it touches cognition. That you are having a breakdown does not mean that your life isn't a mess. If there are issues you have successfully skirted or avoided for years, they come cropping back up and stare you full in the face, and one aspect of depression is a deep knowledge that the comforting doctors who assure you that your judgment is bad are wrong. You are in touch with the real terribleness of your life. You can accept rationally that later, after the medication sets in, you will be better able to deal with the terribleness, but you will not be free of it. When you are depressed, the past and future are absorbed entirely by the present moment, as in the world of a three-year-old. You cannot remember a time when you felt better, at least not clearly; and you certainly cannot imagine a future time when you will feel better.”

Obviously, Soloman is more practiced at articulating himself than I, and I am thankful to have his work to draw upon. I suspect this will not be the last time I quote that book.
Depression is real. Don't get me started on people who don't believe in fucking medication or that the disorder is real - I will shriek from the rooftops that DEPRESSION IS A FUCKING THING if I have to. Not that it would do much good, because ignorance is a form of self protection, among other things.

Do I want to go and meet this girl at 8:00? No, I don't, because I'm depressed. Am I going to? Yes, because the only way to remedy the situation is to "Act Opposite", which is a "skill" often referenced in Dialectical Behavior Therapy, which I will also cover at some point.
Depression feels inescapable. Sometimes, it is. But it passes. I started this blog to be honest, but to provide some hope as well. I suffer every day right now, but I have had periods of my life that weren't as bad. And I am hoping that with the appropriate treatment (which I, personally, am BLESSED to have access to, thanks to suing my mental health insurance company - yes, I will cover that someday too - thanks for nothing, United Behavioral Health), which my doctor is saying is ECT, that I can have days where I feel less miserable, more content, and more alive.

Depression is a reality, but it is not the only reality.

That's the best I can do today. More later. Thanks for reading.

Where to begin...

Happy Thursday. Or not. Whatever. :-P

I've been thinking about this blog on and off since I wrote the first entry; there are so many topics I would like to cover, so many people to interview, so many books to revisit and source; I have so much inside me to say and I don't know where to begin. Do I begin with "What is mental illness?" - that feels a little daunting and elementary to me. Do I start by trying to illustrate how pervasive and relentless chronic mental illness is/can be? Do I reference friends I have watched die, do I take you through the doors of the psych wards I lived in for years? Do I tell you what a day in treatment is like? Do I tell you what works and what doesn't, in my experience?
I just don't know where to start.
Just wanted to check in. I'm thinking about it. If you have any questions or curiosities or suggestions, please comment and let me know. There is so much information that I have gathered over the years that I feel now is worth sharing, but where the hell to start is something else.

Hi.
I'm Sofia, and I turned 25 years old yesterday. For many years, the thought that I would make it to 25 didn't cross my mind because it seemed so unrealistic.
I've tried to start blogs before; primarily blogs about eating disorders and recovery. Last night, I went to my mom and dad's house, and my father suggested I start a blog, to combine two things I love; writing, and helping others. I told him I felt hypocritical doing so for a number of reasons.
I am in far, far better shape than I have ever been before concerning my 16 year ordeal with anorexia and bulimia, but my mental health (to massively understate) leaves something to be desired. I struggle with severe, treatment resistant depression. Sometimes it gets better; lately it's been worse.
Last night I politely declined my father's suggestion; today, I thought yet again about the dyer straights our mental health treatment system is in (and I'm not just talking about in the USA, there are problems everywhere) and I thought...what if I started a blog not just about eating disorders, but mental health and illness and treatments in general? What if I wrote a blog that appealed to a larger audience than simply those who are able to access mental health care? What if I wrote about how many who have been ill for years and years, unable to work, no longer have access to mental health insurance and therefore find themselves in a seemingly impossible situation with regard to access to care? Those with eating disorders who live on disability and Medicare, when almost no specialists in the field accept Medicare? What if I wrote about the chronic cases, and got people thinking, and got people who actually give two shits together to think about and try to change the situation we have found ourselves in?
I need to think more before I elaborate. I have some people I'd like to contact and ask if they would be willing to share their stories here. I have some books to revisit that touch on these subjects.
So my intentions for this blog are broad, and it's likely that it will be (as I am) all over the place. Initially, as I am in the throes of my own depression at the moment, the entries may be far and few between. I hope that if I develop an audience you will be patient with me, and help me to formulate what it is I'm trying to say and get out into the world.
Thank you for reading this, if anyone has, and allowing me to take some of your time. I will come back to this.
Sofia