What Does Your Brain Tell You When You're Depressed?

One of the fun parts of hypomania for me (I use the word "fun" sarcastically) is that not only do I get depressed, anxious, and revved up at the same time, usually my depression and anxiety are the things that get revved up.  So my brain goes a mile a minute, but it's going a mile a minute about how horrible I am, what a bad person I am, and how I'm going to hell.  See?  Fun.

The hell thing is a recurring thought; every time I get hypomanic, that's what I tell myself, over and over again.  I'm  lousy person, a lousy parent, ugly, fat, and worthless, and my ultimate punishment (as if having these thoughts isn't punishment enough) is an eternity in hell -- whatever that is.  I know a lot of this can be chalked up to Catholic guilt, but I think it's more than that, too.

I think when you're depressed or anxious, your brain seizes on the most convenient negative thought possible and replays it and replays it like Elf on TBS at Christmas. I'm still working on how to get it to stop the replay; as far as I can tell, it's not as easy as pushing a button.

Does your brain tell you something over and over again when you're depressed?  Is there a thought on replay in your head?  Have you figured out how to turn it off?  If you have, more power to you.  If not, join the club.

But You Look So Good!

A while ago, I sat in a room listening to one woman tell another that even though she was depressed, she looked so beautiful and professional and "together."

I know this woman was trying to make the other feel better; I mean, who doesn't want to hear they're beautiful?  But having been on the receiving end of the same kinds of compliments (not recently -- recently I look like I've been beaten by the ugly stick), I know that when you feel ugly and crappy on the inside, usually the last thing you want to hear is that you look good on the outside.  I don't speak for everyone; I know there are people that this kind of compliment would make them feel better, and more power to them.  But for me, this kind of compliment is not helpful.

I think there's something about someone saying, "But you look so good!" when you're depressed that can minimize your internal suffering, at least in my experience.  It's like the complimenter (is that a word?) is saying, "But you look so good -- you can't feel that bad!"  Unfortunately, you can look beautiful and feel like complete shit on the inside.  Look at all the celebrities with eating disorders, drug and alcohol problems, and horrible relationship trouble.  Of course they look beautiful.  That's what they do.  But they probably don't feel beautiful.

I had a doctor's appointment this morning, my fourth in three weeks.  I actually considered putting on mascara this morning, and then a little voice told me not to, because, while I've been feeling somewhat better, I still don't feel great -- and I didn't want her to see mascara and think, "Oh, she must be better."  I would think I could expect more from a doctor, but you never know.

It's just another example of how we can't judge a book by its cover.  I think a lot of people still have the mental picture of depression and mental illness as a disturbed person on the streetcorner raving about academic fraud (a nod to my UD friends) or the end of the world, a person you cross the street to avoid.  That woman in the three-inch-heeled boots at Starbucks, the woman pushing her baby in an expensive, pristine stroller, the woman in the office next to you that always has her hair done so nicely, they may all be suffering from various forms of depression or mental illness.  Just because they "look good" doesn't mean they feel good.  It also doesn't mean they don't rant about the end of the world, but that's a different issue.

The AM Crunch

I hate mornings.

Like, with a passion.  Detest them.  I hate them even worse on the weekends, when my husband, who knows I hate weekends, still won't get up on Saturdays to deal with them (in his defense, he usually does get up Sundays).

I hate waking up to a kid standing next to my bed, staring at me. I hate being exhausted, but having to drag myself up anyway.  I hate trying to go to the bathroom and get dressed while a mobile child stands whining that they want breakfast/want to watch TV/want to go to the zoo/whatever, while the baby lays in her bed, screaming to be changed/fed/whatever.  And then I hate having to hit the ground running, once I manage to pee and pull my hair back I have to practically move in super-speedy motion to get breakfast, change clothes, do hair, make beds, and all the rest.

So, yeah, like most moms, I hate mornings.

The last couple of weeks, courtesy of my therapist and a friend (thanks Robyn), I've been reading some books on trying to take control of your life and live more zen.  One of the suggestions made by my therapist, coming from the book The Artist's Way by Julia Cameron, is to try to journal three full pages before I get out of bed.  Pretty much, I wake up, sit up, and start to journal.  The idea is to try to purge all the "to do" type stuff in your head before you get out of bed, and to try to start the day fresh and open.  Incidentally, The Way of the Happy Woman (the other book I'm reading) suggests, similarly, to get up early, before anyone else, and engage in some sort of ritual that will energize you for the day (like journaling or doing yoga). 

I'm happy to report that for the last few days, I have been taking this suggestion and journaling before I get out of bed.  The first day, it seemed to help; I felt a little more calm and mentally "clean."  Yesterday it also seemed to help; I got up, then my kids got up at separate times, and I even played some nice, relaxing ambient music in the kitchen to try to keep everyone calm.

Today, well, was a different story.  I calmly wrote in my journal, but then my baby started hollering, so I had to deal with her.  After I got her out of bed and then dressed, my three year old immediately got up, doing this irritating cry/whine/shriek thing that she sometimes does.  The sound is the audio equivalent of someone sticking an ice pick in my eyeball.  Then my five year old got up, demanding to watch "The Octonauts." (seriously, is anyone else's kids totally addicted to this show?  I don't get it.)  The whole time, I could feel the calm I'd established like a nice, warm blanket draped over my brain.  By the time I got the baby her food, the blanket was on fire and I was bitching at my kids like a snapping shrimp (sorry, too much "Octonauts").

The one good thing I'll say about today is that I think it did take me longer to get to my tipping point with my kids than on normal mornings, so I think I was still getting benefits from journaling and trying to create a calm start to the day.  But nothing will stand up to my three year old's shriek noise, so I should just give it up.

I'll keep journaling before everyone gets up, and maybe the benefits will accrue.  Even better, after I journal, maybe I'll leave the house and go get coffee and stay away for about an hour.  I think THAT would create the best calm I can think of.

Depressed Parenting

This week I've been a little grumpy.  I've been working on changing my medication so I am not so tired all the time (400 mg of Seroquel will make anyone a little sleepy), and I think it's having a somewhat negative effect on my mood at the moment.  I think it's one of those things that when I get over the hump, I'll be better for it, but it kind of sucks right now.

So as a result of being in a bad mood, I've been a little short with my kids.  Nothing horrible, but I'm just a little quicker to snap or yell at them than usual, and have been engaging a little less.  It's nothing that's going to scar them for their whole lives (at least I don't think), but it's still not good.

The worst part, though, is that all three of my kids (the 10-month-old included) have all been grumpier and more difficult all week.  I find that so odd.  There's a respiratory thing that keeps bouncing around between all of us, which isn't helping matters, and the weather has been typical Ohio in February -- cold, gray, depressing.  So there are a lot of reasons why they may be in bad moods that don't necessarily tie back to my mood.  Or maybe we're all grumpy for some of the same reasons, I don't know.

I just know that more often than not, it seems like my kids' moods reflect or match my own.  A while ago I wrote a post wondering if babies can read their mothers' moods; I think kids have to be included in this question as well.  In theory, they should be happy -- I usually let them watch more TV than usual and cook them stuff that I know they eat (like hot dogs) rather than cooking something that they may or may not eat (nothing kills my mood more than getting up the energy to cook, and then having everybody turn up their nose at it).  But it doesn't seem to work that way.

This article at HealthyPlace.com talks about how children of depressed parents are more likely to not only be depressed, but act out and have other behavioral problems.  So I guess there are studies that show that parents' depression can affect kids.  Another reason to feel bad, right?  My depression is making them depressed -- how depressing. 

For now, we'll just keep muddling through and hope my med changes do what they're supposed to do.  Until then, let's watch Mulan for the fiftieth time and just feel good that at least she's a strong female role model.

Owning Our Antidepressants

On Saturday, I happened to read this guest blog post at OwningPink.com, about how the author believes that, contrary to what most modern medicine tells us, depression and anxiety are not physical ailments.  Instead, they really are "in the head," and, unlike a physical ailment like diabetes, medication is not the answer.  In her words, "attributing anxiety and depression to a chemical imbalance is horribly disempowering," and by prescribing antidepressants we're "throwing in the towel" and abdicating responsibility for our mental health.

The author, who is a Ph.D. in Psychology, cites some interesting statistics from a few "anti-antidepressant" books.  She says one doctor believes that as many as 75% of the people taking antidepressants could "significantly reduce" or eliminate their meds with the help of a doctor and lifestyle changes.  She also mentions one doctor who believes the whole "serotonin deficiency" approach to depression is a sham, and is based on some questionable, at best, science.

When I first read the article, I was irritated and a little mad.  I though her attitude was a little too simple, and a little too self-serving.  I also took some issue with her "research," as all her information seemed to come from the same two sources, and she goes on to contradict some of the research she presents.

Okay, so let's talk about the author (it's all about ethos, people).  Her name is Bethany Butzer and she has written a book called The Antidepressant Antidote, is a speaker on the topic, and is also a yoga instructor.  On her website, she classifies herself as a "Mental Health and Wellness Advisor."  The topic of getting off of antidepressants is obviously her passion and her platform.  She does say that she thinks antidepressants are good in some circumstances, and if they've helped someone get through a bad patch then fine, so she's not exactly "anti-antidepressants," she's more "uncomfortable" with antidepressants.

The more I thought about the post, the less irritated I got and the more reflective.  There were a few things she said that kind of made sense, that I think I agree with.

One point she made that I do, more or less, agree with:  she says, "I think our acceptance of this [idea that depression/anxiety are a result of a physical problem] reflects our longing and desire for a simple solution." I think most people who are depressed enough to consider going on antidepressants would love a "quick fix" -- who wouldn't?  And I think that in our society we tend to demand fast, easy solutions.  The irony here, I think, is that antidepressants usually take 3-6 weeks to work, and that's if they do work.  They really aren't that quick-acting.  

I think my biggest issue is with her general hypothesis, the idea that antidepressants are "disempowering."  I can see where the idea comes from; that if we have a medical problem, there's nothing we can do about it other than take medicine and wait for it to work.  But that's not entirely true.  If we think about diabetes, the go-to comparison illness for depression, there are lots of lifestyle changes a person can make that can improve their medical condition; the same goes for illnesses like heart disease and arthritis.  You may never be able to cure these problems, and these lifestyle changes usually have to work in tandem with medication.  But a person who manages their diet and exercise and takes insulin is going to be a much healthier diabetic than someone who takes insulin alone (something I'm trying to make my diabetic cat understand, but he's not buying).

My other thought is, what if we view antidepressants as empowering, instead of disempowering?  Rather than looking at medication as something that strips us of responsibility, it is something that enables us to be responsible. When someone is at the point where depression or anxiety has gotten so bad that they are visiting their doctor or a psychiatrist, the last thing they want to hear is, "It's all in your head.  It's up to you to fix yourself.  Start going to yoga and get on the treadmill."  Hell, I'd wager that 9 times out of 10, that's going to make someone more depressed.  But if the doctor says, "Okay.  I can give you this medication, but it's going to take a while for it to work.   It'll help you, but it will help more -- and quicker -- if you start going to yoga and get on the treadmill."  If you feel like you have a little bit of help, that you're throwing fixes at the problem from more than one direction, you are going to feel better faster -- regardless of if the antidepressant is really working on a serotonin deficiency or not.

In general, I kind of waffle about antidepressants.  I do think they are over prescribed, but I think they also help a lot of people.  I also think you'd have to be living under a rock to not know that exercise, a healthy diet, and other lifestyle choices help fight depression (that doesn't mean that people always make those healthy choices, but hey -- free will's a bitch, right?). 

A Phrase You've Never Heard: Antenatal Depression

As I mentioned in my last post, I'm working on a book proposal about depression in pregnancy.  For the entire time I've been working on this project, I've struggled with what to call "depression in pregnancy."  Is that the best phrase?  Is "depression during pregnancy" better?  Is "perinatal depression" right?  Is "prenatal depression" better?  As you can probably see, the phrase "depression during pregnancy" is kind of clunky and gets unwieldy when you're using it a lot, so I was getting kind of desperate to find an alternative.

I happened to have an appointment with my psychiatrist this week, and I thought maybe she'd know, so I'd ask her.  She told me the appropriate phrase is "antenatal depression," while "perinatal depression" means any kind of depression during or after pregnancy (i.e., it includes postpartum depression as well).  I was quite excited to actually find a phrase for what I've been talking about.

The only problem is that I didn't ask how to spell it.  I wasn't sure if it was "antinatal" or "antenatal."  So, like most people, I decided to turn to the most authoritative reference around:  Wikipedia.

And, wouldn't you know it -- Wikipedia didn't have a page on either "antenatal" or "antinatal" depression.  Can you believe it?  It wasn't on Wikipedia.   I still figured out how to spell it (it's "antenatal," fyi) because there were a few other pages that had links to information about antenatal depression, so I still accomplished my goal, but I was kind of stunned.  I was thinking that maybe all this time I just couldn't find the right resources because I didn't have the right phrase, but I was wrong.  I did find a page on postpartum depression, of course, and just about everything else I looked up while testing the theory that Wikipedia has a page on everything (random crap I looked up:  Dr. Zoidberg - a character from Futurama; Susan Stafford -- the original letter-turner on Wheel of Fortune; and a page listing all the Salute Your Shorts episodes).

So that's all I really wanted to say today.  That there is a clinical phrase for depression in pregnancy:  antenatal depression.  And that it's such an obscure topic-- despite estimates that as high as 25% of women suffer from it -- that it's not even listed on Wikipedia.   But now you know the phrase, and you can pass it on.  Don't you feel educated?

New Project & Old Whineyness

I looked back through my old posts to see if I'd written about what's on my mind recently enough that I shouldn't write about it again, and I couldn't find anything, so I'm going to go for it.

I've been in a serious funk lately, and I'm not sure why.  Post-Christmas crap, lovely Ohio weather, difficult children, drug side effects -- you name it, I probably am dealing with it.  What's hard for me is not to just throw my hands up and let myself slide down that slippery slope from feeling "funky" to being all-out depressed.

Because, let's face it, everyone has bad days, right? Even bad weeks.  Hell, bad months.  That doesn't mean they're on some sort of collision course with full-on depression.  It just means life isn't all that easy at the moment.  I have to try to remember that even though today may be a crappy day, tomorrow doesn't have to be. 

It's just that -- and this sounds really negative, but it's true -- for people suffering with mood disorders, I think if today is a crappy day, it may be a little more likely that tomorrow will be one, too, or maybe even crappier.  I'm honestly not sure how I'm supposed to tell the difference between a legitimately disintegrating mood and a bad day. It seems like, in the past, I've gotten stuck with my pants down, so to speak; I've thought that maybe I was just in a funk for a while, then all of a sudden I realize that my mood, usually depression, has gotten pretty far out of hand -- and that has meant, at least recently, hello hospital.  I would like to avoid that at all costs, since my one goal for 2012 was to stay out of the hospital.

So, in an attempt to keep my mood under control, I've started working on a few projects that may help.  For one, I've started to run again.  Okay, I've started to jog.  Okay, I've started to shuffle.  I am the world's slowest, ugliest, sweatiest, floppiest runner, but luckily we have a treadmill, so nobody really has to see me. 

I've also decided to try some craftherapy.  I got the bright idea to try to build a dollhouse with my girls.  I've been reading a lot about recycled crafts, so I've been wanting to try some different projects, and a dollhouse seemed like a good idea -- especially since we have a ton of old moving boxes just sitting in the basement crying out to be re-purposed.  And of course I have my knitting projects I started working on this weekend that I talked about yesterday, so those should keep me busy.   

Here's to hoping my different coping mechanisms will help my mood stay above the "danger" line...and if they don't, maybe my last ECT treatment tomorrow will.

More Thoughts (Mostly Negative) on ECT

Yesterday I had my second weekly ECT appointment, and it occurred to me as I was waiting that I really, strongly dislike these treatments.

Did you ever have a person that you'd known for years, and one day it just hit you that you really didn't like them?  This has happened to me a couple of times recently, and I kind of liken it to how I suddenly came to feel about the ECT treatments.  I'm not saying that I don't think they're doing some good -- I do -- but just the whole process is really not my cup of tea. (Here's an article from PsychCentral.com about ECT side effects).

My first dislike (and I'm going to sound like a total baby here) is that every time I go they run an IV.  Obviously, they have to do that to administer the general anesthesia, and you'd think it would get easier the more frequently they do it, but it doesn't.  And every so often they kind of botch it up, and I'm left with a massive, painful bruise on one of my hands for a week.

My second complaint is the anesthesia itself.  I'm going to be clear and say, unequivocally, that I do NOT want to be awake for these treatements.  I want to be asleep.  I do not want to be conscious of being shocked into a seizure.  However, that weird "Lost Weekend" feeling you get after you go under general anesthesia really freaks me out.  Like, you remember being in the procedure room, then all of a sudden you're sitting in a chair drinking a Sprite with no recollection of how you got there, and no sense of passing time.  I think that's really the worst part, that it's not like going to sleep where you have some sense that an hour or so has passed; instead, you close your eyes and then (feel like you) immediately open them and an hour has passed.  For some reason, I think that must be sort of like being dead, or at least a close approximation.

Then there's other little things that just make the whole experience less-than-pleasurable.  Weird aches and pains from the seizure itself, the time involvement, and the draggy post-anesthesia feeling I get.  In the past, the anesthesia hasn't been so bad, but for several treatments I had this horrible feeling when I woke up that I was suffocating.  The doctor explained to me that it was because the sleep medication was wearing off before the muscle relaxers, so the heaviness in my muscles was making it hard for me to breathe.  The anesthesiologist fixed this problem by giving me more sleep medication,  It worked -- I haven't had the suffocating feeling since then, but I've also wanted to sleep for a full two days after the treatment.  I know my husband thinks I should just tell them to take away the other sleep medication, but if you've ever felt like you were going to suffocate or drown (even if you weren't), you'd know that there are very few reasons you'd voluntarily experience it. (Here's an article from MayoClinic.com about the risks of general anesthesia).

But, as I said, I do think they're working, at least on some degree.  I feel generally more mellow, and it's helped a lot with my "racing thoughts" (the bane of a bipolar person's existence) and overall suicidal feelings.  Well, at least till the last few days when I think my "normal" mental issues are vying for attention with some serious PMS problems and I'm just a not fun person to be around.

On a more positive note, I got a really cute book for Christmas called Itty-Bitty Toys, by Susan B. Anderson (her blog is listed at the left).  There are some adorable knit critters in there, and they look like pretty quick hitters, so I've dug in and started on a little bear.  Gotta keep the hands busy -- it helps the mind shut up!

A Brief History of ECT

Yesterday morning, I found myself waiting on my third electroconvulsive therapy treatment.  The procedure center was backed up, so I waited for a while, and the longer I waited, the more I kept wondering, "What the hell am I doing here?"

I looked around at the other people waiting (though most of the people in the waiting room were family members who were there to transport their loved ones to and from their shock treatment), and tried to take comfort in the fact that if all these other people were having ECT, it can't be that crazy.  But then I started thinking about people who have lined up through the years for other treatments that promise to make them thinner, younger, happier, healthier, stronger.  And how most of those treatments didn't have nearly the negative stigma that "shock therapy" has ("shock therapy," as a name, is passe -- ECT is the politically correct name of choice).

It's no wonder that ECT has such a negative connotation and stigma, based on its origins.  According to Andy Behrman, aka "Electroboy," an advocate for people with depression and bipolar disorder, most doctors know that ECT was dreamed up in the early thirties by an Italian physician named Ugo Cerletti while watching pigs being electrocuted into unconsciousness before being led to slaughter to make them easier to work with.  Cerletti figured the same technique could be applied to mental patients to make them more malleable for their doctors (from electroboy.com).

The practice was introduced into the US the next year (1935) and was used to treat a whole host of mental "illnesses" -- from schizophrenia to homosexuality, from mania to truancy (truancy is a mental illness?  Sometimes I thank God I live in the era I do).  So, obviously, as most new, fabulous medical treatments are, it was grossly overused -- and grossly under-regulated.

According to the doctor administration my treatments, ECT began to be refined and specialized in the 1950s and 1960s, not incidentally along with the growth of the specialty field of anesthesiology (from SUNY Downstate Medical Center).  Concurrently with the improvement of ECT treatments, though, public opinion of the treatment began to plummet.  With the book One Flew Over the Cuckoo's Nest by Ken Kesey (released in 1962) depicting the treatment as barbaric and punishing, and the movie (released 1975) further solidifying that image, ECT all but faded into the background as a treatment of last resort for catatonic or extremely suicidal patients.  Sylvia Plath, the poet, didn't help much, either, with her poem "The Hanging Man":

By the roots of my hair some god got hold of me.   

I sizzled in his blue volts like a desert prophet.

The nights snapped out of sight like a lizard’s eyelid:   

A world of bald white days in a shadeless socket.

A vulturous boredom pinned me in this tree.   

If he were I, he would do what I did.

Written shortly before her death by suicide, Plath described what her ECT treatmenents were like to her.  And it didn't sound like anything anyone else really wanted to repeat.

With all the bad press and negative images in the media of ECT, it's not surprising that most people just assume that ECT is no longer practiced on a larger scale.  But since conditions in which the treatment is administered are more humane and streamlined now than it was 40 years ago, it is again becoming a legitiamite treatment.  According to the University Hospital in University, New Jersey, upwards of 100,000 adults receive ECT a year in the US alone.  

Even though the popularity of the treatment is increasing, there is still a fair amount of argument about whether ECT is more helpful than harmful.  I plan to look in to personal and doctors' accounts of the treatment and write more about that later.  The fact that doctors still don't really understand how it work -- though they can cite different brain imaging technicques to show that it does work -- is also a cause for concern.

But for now, I'm three treatments down and three to go.  Usually, the doctor prescribes 6-12 treatments upfront over a 2-4 week period.  I have to say, they're not really fun.  If nothing else, they're nerve-wracking and wearing on my psyche.  Buy physically, they take their toll as well -- muscle aches (especially the backs of my legs and my back and shoulders), jaw and facial pain, brutal headaches, and a general feeling of being "blunted."  Though maybe the "blunting" is the treatment working, I don't know.

Part of me wants to fight that "blunting."  Is it worth feeling dumber, duller, at the price of feeling less sucicidal and self-injuring?  I have to remind myself that it's not exactly like I'm Van Gogh, or Mozart, or even Plath - the world isn't losing anything if my intellect falls off a few notches.  But if I can spare my kids a mom who is in an out of the hospital, who cries less and plays more, who takes more of an interest in their doings, I guess it's worth it.

Where is My Village?

If you follow my posts at all, you'll know the last few weeks have been somewhat of a challenge for me, mental-health wise.  I've talked about coping mechanisms like humor and crafting, and I've been pretty good (in my opinion) trying to use these things to feel better.  I even managed to drag my butt to my mom's group at church on Tuesday and to yoga on Wednesday.  Alas, to no avail.  Some days seem to go okay, and then there are days like today, when the devil is whispering in my ear horrible things about myself, I keep screaming at my kids, and I can't get the image of running my car into a tree out of my mind.

I'm not talking about this stuff simply to whine, but to bring up a larger problem:  why do we mother alone?  A friend of mine, a yoga instructor, once promoted a "Yoga Playdate" class by saying, "Come build your village."  That phrase has stuck with me ever since.  Regardless of if you're a Hillary Clinton fan or not (I'm referring to her book It Takes a Village), there's something to the thought that mothering (and parenting in general) should be a shared task.  It seems that almost every mother I know, at some time or another, has felt alone, vulnerable, and overwhelmed.  The vulnerable and overwhelmed feelings are probably just parts of being a mom, but the "alone" part shouldn't have to be.

Take me, for example. Today I keep wondering how the hell I'm going to make it through the day -- and, more importantly, how the kids will make it through without me totally losing it.  I am truly blessed that I know I could call my mom or father-in-law and, if they could, they could help  -- but my mom works, and my father-in-law has his own stuff going on, and I feel like it's not their job to parent my kids.  Plus, that makes me feel like I'm failing -- why can't I "stick it out" or "suck it up?"  And I feel horribly, painfully alone.

I've often wondered why there isn't some sort of emergency babysitting service available.  Why don't we have services or groups for women, with help available 24-7?  If our society could pull together to offer services like this, I would almost guarantee that child abuse, infanticide, and maternal suicide (not to mention depression and other mental illnesses) would become less prevalent.  Unfortunately, I think the reason these services don't exist is the same reason that I feel guilty calling someone for help.  Mothers are expected to be able to do everything, to be everyone, to cook everything, to work anywhere, and still maintain some sort of sanity.  And for those of us that don't work -- well, what the heck is OUR problem?  We don't even have the stress of a real job, so of course we should be able to deal with whatever comes along (I hope my sarcasm comes through here).

How have we gotten so isolated?  I'd blame it on technology, but I think it started well before the advent of the internet and social media.  I'm sure there's lots of scholarly research on the topic, and I think I'll check it out, but I just don't have the energy today.  Right now, I'm just throwing out the questions to hopefully start some thinking on the topic.

Okay, my baby is shrieking in her crib, so I guess that's enough writing for me today.  In the meantime, if you're a mom and feel overwhelmed, check out this "Tonglen for Mothers" by DeLona Campos-Davis. My favorite line:

I breathe in the loneliness of days spent mothering on my own.
I breathe out connection, community, compassion.

Just breathe.

Tis the Season: Seasonal Affective Disorder

If you live in the Eastern part of the U.S., you are probably experiencing the wonderful phenomena of Time Change Hangover.  I know I am.  It seems like when the clock falls back an hour in the fall, everything in my life gets thrown off a little bit -- and even more so, now that I have kids.  Kids tend to ignore the time change altogether, which makes sense since they can't tell time (this logic, however, does not make it any less irritating when they're yelling at you at 6 a.m.).  

This time of the year, I hear a lot of people talking about how the weather and light (or lack thereof) affects their mood.  I found an article at PsychCentral.com talking about things you can do to combat the "winter blues," or mild seasonal depression, which is probably what most people experience.  The suggestions are nothing earth-shattering:  exercise, light therapy, that kind of stuff.  

Unfortunately, a lot of people experience a lot more than mild seasonal depression; studies estimate that 4-6% of people suffer full-blown SAD, and 10-20% have a more mild form of the condition.  For these people who suffer from seasonal affective disorder, fall and winter mean a lot more than feeling cranky and lethargic.  I think a lot of people think they have SAD, or throw the term around somewhat carelessly, when SAD is actually a pretty severe condition. In addition to "normal" depression symptoms, like feeling hopeless and anxious, people with SAD may crave carbs, oversleep, and gain weight.  The feeling of depression is also gets progressively worse throughout the winter, only letting up when the seasons change and days become longer.

Interestingly (well, probably not for the people who have it), some people with seasonal affective disorder can get their symptoms in the summer.  These people usually have trouble sleeping, rather than oversleep.  It's more rare to have SAD in the summer, but it happens. 

Treatment for SAD can include light therapy, meds, and psychotherapy.   If you think you have full-blown seasonal affective disorder, the best thing to do is call a psychiatrist or psychologist, or -- if you have a problem getting to see one of these doctors, which you may -- see your family doctor. 

Luckily, I don't really think I have SAD -- just sort of some mild "winter blues" brought on by the fabulous Ohio fall and winter.  Having said that, everything lately is an effort, so I may go buy myself a light therapy box or light bulb for a little at-home light therapy.  If nothing else, it's probably good light to knit by.

Coping Mechanisms: Humor

From awkwardfamilyphotos.com

Still feeling pretty funky.  I'm working on a post about medical testing on mental patients, which is really fascinating, but it's requiring more energy than I'm capable of right now.  So, in the meantime, I thought I'd talk about another coping mechanism:  humor.

It's pretty self-explanatory.  Read, watch, or hear stuff that's funny, and usually you can't help but smile.  I was feeling pretty low yesterday, but when I started reading some of the entries over at DamnYouAutocorrect.com, I was laughing so hard I was crying.  It's nice to cry over something other than crushing hopelessness.

I don't subscribe to the whole "Just turn that frown upside-down!" school of depression triumph -- in fact, I want to stab people who say stuff like that with a sharpened broom handle.  But I do think that humor can offer a temporary respite from some pretty crappy feelings.  Interestingly, a lot of comics and humorists suffer from depression and other mental illness, so maybe there's something to humor as a way to cope.  As Erma Bombeck said, "If you can laugh at it, you can live with it."

Here are some other amusing links. 

The Institute of Offical Cheer, from James Lileks.  I love James Lileks; his writing style is witty and intelligent.  My personal favorites at the Institute are a tour of The Gobbler, a fabulous (yet, sadly, gone) Wisconsin motel, and  Art Frahm:  A Study of the Effects of Celery on Loose Elastic.  Art Frahm was an illustrator that painted pin-up girls who usually:  a)  were carrying groceries, including celery; and b) were losing their underwear.  It's very weird.

Love, love, love the site AwkwardFamilyPhotos.com.  Hilarious.  You just have to wonder what the hell some of these people were thinking.

Sh*tMyKidsRuined.com.  Pretty self-explanatory, but for anyone who has had a kid screw something up, it's painfully familiar.

The fit & fabulous MerlinCat

MyCatHatesYou.com.  No, this is not another Icanhascheezeburger.com (also known as LOLCats) site -- I think this was actually around first.  It's funny because the cats all look so pissed off -- which is pretty much the natural state of a cat's demeanor.  Speaking of which, this is a hilarious cartoon about hating cats.  (And, yes, I have a cat, but that doesn't mean I can't make fun of them, too).

Fark.com.  In case you live under a rock and have never heard of Fark.com (it was on Jeopardy!, for cripe's sake), it's a "news" site that posts user-submitted current event links with user-submitted headlines.  Example:  "Naked guy wanders around Dulles airport, perhaps trying to beat TSA to the punch."

No discussion of internet humor is complete (not that this is a complete discussion, but whatever) without a mention of The Book of Ratings.  I mourn the loss of TheBookofRatings.com, which was an offshoot of The Brunching Shuttlecocks.  Lore Sjoberg, the writer, inexplicably commented on and graded totally random things -- everything from marsupials to the seven deadly sins to Dante's punishments.  Sadly, I can't find the ratings online anymore.  There is an actual book (book?  paper?  what's that?), which is a small comfort, and I do own it, but I could read ratings all day long and pee my pants laughing so hard.  And I mean that literally, now that I've had kids.

Since you can't find the ratings online anymore, I'll post one of my favorites that I managed to dig up:

From "The Ratings for Dante's Punishments":

The Blasphemers
Burning sand and rains of fire, all for those who said things like "Jesus f*ck, that's one God-be-buggered big-ass fajita plate," plus the entire London cast of Jesus Christ Superstar. It doesn't make it clear whether you can get away with phrases like "Gosh darn cripes," which would have been good to know. Anyhow, if you do these things you have to lay down in the sand. I think it would have been a more appropriate punishment for evil sunbathers, but that's why I'm not Pope. Among other reasons.  C

 I'll leave you with that thought.  Hope you're smiling.

That's Me Trying

Several years ago, a very odd musical collaboration occurred between William Shatner and Ben Folds.  If you are familiar with William Shatner's previous musical offerings (his version of "Mr. Tambourine Man" is my personal favorite), you'd be right to be skeptical.  But -- and I say this completely without irony -- the resulting album, Has Been, is actually not bad.  Shatner mostly does spoken word recitations rather than trying to sing, and Folds sets the tracks to music and does some backup singing (along with others, like Aimee Mann and Henry Rollins).  My favorite song on the album is called "That's Me Trying."

Anyway, the reason I mention this (well, really, who needs a reason to mention William Shatner??), is that I've mentioned that I haven't been doing so well in the mood department for the last week or so.  I've gotten a lot of help, thank God, but everyone just keeps telling me, "You have to try!"

I guess I understand what they're saying, but at this point, I really don't even know what "trying" is.  Is it not cutting myself?  Not bursting into tears every hour?  If that's trying, then I'm not trying.  If it's managing to make dinner (which didn't turn out great), managing to drag the kids to the store (which was a big mistake), then I am trying.  Is it updating this blog, and working on my knitting projects?  Then I'm trying.  Is it fighting the "I want to die" feelings?  Then I'm not trying.

You get the point.

My constant questioning has me coming back to that stupid Shatner/Folds song again and again.  Part of the refrain goes, "Above the quiet, there's a buzz/That's me trying."  I think, I made dinner.  That's me trying.  I took a walk.  That's me trying.  I feel like I want to write on the walls, "Look!  That's me trying!"  The only problem is that  I still feel like shit.

So now what?

Note:  part of "me trying" is continuing work on my little octopus.  Did you know that octopuses have eight freaking legs?  That's a hell of a lot of legs.  I'm tired of knitting legs.  But that's me trying.

Coping Mechanisms: Craftherapy

A while ago, I was proud of myself for coming up with a new word, "craftherapy."  Out of curiosity, I did a google search for the word, and it turns out some other people came up with the same word as well, so I'm not as great as I thought I was.  Darn.  Even so, I'm going to write about craftherapy today.

In my last post, I mentioned that my previous attempts to stave off a depressive episode weren't working, and I was doing kinda bad.  Well, the bad continues.  Bad enough that hospitalization has been mentioned, and I SO do not want that, if for no other reason than they won't let me have my iPod or knit (of course, there are lots of other reasons as well, but those are two very concrete ones).

So to avoid possible hospitalization, further self-injury, or any other kinds of serious badness, I'm trying to pull out some coping mechanisms.  And it's not easy.  All I really want to do is lie in bed all day and eat chocolate (and, after Trick-or-Treat, we have a lot of that), so getting up and sitting vertical and doing something is a major effort.  Man, you gotta love depression.

Of course, some of my coping mechanisms are forms of -- here's the word -- craftherapy.  I mentioned before about the entrelac scarf I was working on, and I'm still whittling away at that.  I also finished a zigzag scarf (pattern here) in Red Heart Boutique Swirl in Floral, then finished a pair of basic gauntlets (fingerless gloves) in some bulky rust colored yarn from the book Speed Knitting.

In addition, I ordered this cute little book from Amazon.com called Little Knitted Creatures by Amy Gaines, and started to make a little octopus.  I'm not a huge fan of octopuses (octopi?), but I had purple yarn, so there ya go.

Lastly, for a craftherapy task other than knitting, I bought a book called The Mandala Workbook, which is supposed to guide you through a twelve-stage mandala cycle for healing and growth.  I've started reading it, but haven't actually started any of the mandala exercises yet.

In general, I guess my coping mechanisms are working okay, in the sense that I'm not in the hospital.  I'm kind of funked out right now because I can't find a tapestry needle and I don't have the right sized needles for another project, so I'm sort of at a standstill.  It's irritating when your coping mechanisms piss you off more than your depression.  But I'll just keep plugging along.

For anyone else out there having a bad time of it (I think the change of the seasons is a rough time of year), I hope you're engaging in some coping mechanisms yourself and staving off the really bad stuff.  Feel free to share your tactics for survival.

Knitting for the Holidays...and to Avoid a Crash

Since I'm back on the knitting train now, working on my entrelac scarf and another cool zigzag scarf, I was thinking of trying to knit some gifts for Christmas.  Last year I did a couple of scarves for my sister-in-law and for my mom (I'd post the patterns but I have no idea where they are), so I was thinking of doing some cute amigurumi dolls for my kids and for some other small family members.  I got one kit and I'll see how it goes, and how long it takes to make.  I made a cute "Sheldon" turtle a few years ago for one of my girls, and it took FOREVER.  I don't want to be too ambitious.

When I get in phases like this and have about sixty-seven different projects going, I really feel the brunt of my bipolar disorder.  One sign of bipolar disorder is having lots of unfinished projects.  Of course, lots of people have lots of unfinished projects and aren't bipolar, but I think with bipolar disorder, in a manic or hypomanic phase there's a certain urgency to start different things, all at one time.  I know I often start to feel pressured, and want to get lots of things done as soon as I can.  The problem is that after a little while of this kind of behavior (a few days, a week), I crash out and sink into a depressive phase.  This is a pretty common trait of bipolar disorder, too.

I'm trying to avoid that this time by pacing myself, doing a lot of deep breathing, and limiting my caffeine.  One of the most important lessons I learned the last time I had a serious depressive phase is that caffeine is NOT my friend.  I can have maybe one Diet Coke (my Achilles' heel) and a cup of coffee a day, and that's it.  It's better if I have none at all, but when my kids are demanding stuff and the baby is crying, I could do a lot worse coping-wise than grabbing a Diet Coke.

And I'm trying to make my knitting urge work for me, instead of against me.  Instead of getting frantic about finishing all these projects at one time, and starting sixteen new ones for Christmas/birthday/Tuesday gifts, I am trying really hard to focus on one (or two - let's be realistic here) things.  And if I can focus on a few things, maybe I can thwart the pressured thinking and thus thwart the coming depression. 


I guess what I really wonder is:  is the crash unavoidable?  Most of the stuff I look up online seem to just assume that after a manic or hypomanic phase, a bipolar person will inevitably fall into a depressive phase.  How much can I control, and how much does the bipolar disorder control me?  I guess we'll find out.

Mental and Physical Illness: What's the Link?

Tomorrow, I am to have my gallbladder removed because of some serious pains I've had over the past two or three months. I'm not looking forward to it -- let's face it, who looks forward to surgery? And in light of the surgery, I've been thinking about the link between mental and physical health.

A happy little green gallbladder

Doing a little research on the internet, it looks as though quite a few studies have been conducted on the topic of physical health in patients with schizophrenia. This article concludes that schizophrenic patients have more physical illness problems than those without schizophrenia.  It's not clear from the article, though, if schizophrenia causes the physical illness, or the other way around.

This web page from the UK talks about the link between depression and physical illness, discussing how physical illness can cause mental illness.  There's an entire book which is a collection of essays about the link between the two, called Depression and Physical Illness (Amazon.com has it listed at $108, so I wouldn't recommend picking up a copy).

Anybody that watches TV knows that there's also a link between depression, anxiety, and fibromyalgia.  Doctors consider depression and anxiety to be a symptom of fibromyalgia, And this study discusses a link between rheumatoid arthritis and depression.

I guess my question is, which comes first?  Is mental illness (depression, bipolar disorder, schizophrenia) more likely to cause physical problems, or vice versa?  With depression, it seems like it could be obvious:  you feel like crap physically, so mentally you start to feel like crap. In my post about World Mental Health Day, I mention that doctors estimate upwards of 50% of cancer patients suffer from depression.  Well, I'd be depressed, too, if I had cancer.  

Of course, physical illness isn't the only reason people suffer from depression (and sometimes, there is no reason -- it's an illness all to itself).  But is is possible for chronic mental illness to cause chronic physical illness?

I know in my own experience, when I am in a bad phase, I definitely tend to neglect myself.  I don't eat right, I don't exercise, I sleep a lot, I avoid doctors (and pretty much everyone else).  Inevitably, this kind of neglect leads to physical complaints.  I usually get headaches, muscle aches, and stomach problems associated with my depressive episodes.

I wonder, though, can the mere fact of having a mental illness can be linked to physical illness?  Like, are people with chronic depression more sensitive to pain?  We always hear about neurons in the brain being blamed for depression -- is it possible these neurons that are "faulty" could be causing physical pain, too?  Or, if I'm bipolar, could my weird chemical shifts that cause it also cause shifts in my physical feelings as well? 

Admittedly, I could probably do some deeper research to answer these kinds of questions right now.  And maybe later I'll look into it.  But I feel kind of lazy at the moment, so I'm just sort of reflecting. 

And, for the record, I don't think my anxiety or bipolar depression caused my gallbladder problems. 

I blame my kids.

Can my baby read my mind? Or, is a mother's mood transferred to her baby?

As most parents know, it's hard not to compare your kids to each other.  Since I now have a 5 month old, I keep finding myself comparing her habits to those of her older sisters (2 1/2 and 4 1/2).

Even to the most casual observer, it's obvious that my oldest daughter is more -- how do we say? -- high-strung than the other two.  She had colic as an infant, and has always had a very strong-willed personality.  My middle girl, on the other hand, was an easy baby and, while she's horribly stubborn, she's much more laid-back than her older sister. My baby seems to be taking after my middle girl; she's the easiest baby of all three, and is happy and, for the most part, content. 

What has me wondering right now is the old wisdom that an anxious parent makes an anxious kid.  My mom used to tell me so often, "Oh, she [the baby] is picking up on your mood, that's why she's upset," that I started thinking the kid could read my mind.  I'd get upset when I had a bad thought, thinking that she could hear it, like some sort of infant seer or something.  This was especially true with my first daughter, because I had horrible postpartum depression and anxiety for the better part of six months after she was born.  I've always kind of wondered if this has made her a more anxious kid, prone to more difficult behavior.

On the other hand, I had pretty bad postpartum depression after my third daughter, plus major depression while pregnant, and she seems to be mellow and happy.  So maybe the prevailing wisdom is more of an old wives' tale than anything else.

Out of curiosity, I started looking online (because I know that if someone has thought about a topic, there's gotta be something online about it) for studies or information on the whole parent-to-kid anxiety/depression idea.  I found a few studies, but there wasn't overwhelming information.  Interestingly, most studies came from the UK, which leads me to wonder if maybe the US is a little behind with this area of research.  Here's what I found:

An article from USA Today about how anxiety and depression can pass from adults to kids, both genetically and through environment.  It centers more on adolescents and teenagers rather than babies, and discussess the benefits of CBT for kids.  

A posting on PsychCentral.com about the difference between normal perinatal anxiety and obsessive perinatal anxiety, but nothing really about how either kind affects the baby.

A few articles from Science Daily talking about sleep behavior in babies with depressed or anxious parents, relating babies' poor sleep to their parents' moods.  ("Babies Born to Women with Anxiety or Depression are More Likely to Sleep Poorly", and "Maternal Depression is Associated with Significant Sleep Disturbance in Infants")

Another article from Science Daily about how maternal postpartum depression is linked to depression in children, even into their teen years,

I went to the JAMA website (Journal of the American Medical Association) to see if they had any studies related to the issue.  I couldn't find too much, other than a lot of stuff about DHA and how it affects depression and anxiety. So if you want to know about fish oil, hit JAMA.

I'm not really sure what to take away from my very rudimentary research; it sounds like maybe there is a link between maternal anxiety and depression and that of the kids, but it's not hugely researched or documented.

I'm still sure my baby can't read my mind, though.  Well, somewhat sure.  A little sure.

Okay, I'm not sure at all.

Grief, acceptance, and understanding

Per the National Institute of Mental Health (NAMI), one of the most common forms of mood disorder is major depressive disorder.  According to one source, depression affects over 18 million Americans every year.  While many of these major depressive disorders are purely chemical, often, they are triggered by trauma, loss, or other significant life events.

Everyone who has lost someone close to them has experienced sadness and depression in some form.  It's unavoidable; grief and sadness is as much a part of life as joy and happiness.  Cliche, but unfortunately true.  Sometimes grief can turn into a major depressive disorder, or sometimes it can run its course and the individual can slowly regain joyous and positive feelings after time has passed.

I've been thinking about grief and loss lately because a friend of mine from high school's mother died suddenly last week.  I haven't really talked to my friend in a while, but I actually had talked with her mom -- not only was she a good friend of the family, but she was a realtor and helped me sell our old house and buy a new one last year.  I actually just got an email from her about a month ago telling me she wanted to come see what we'd done with our house and meet our new baby.

At this point, I need to say a few things about Janie, because, well, it's impossible not to say something about Janie.  She was one of the most joyful, fun, hilarious people I've ever met.  I've known her since I was probably 11 or 12, and I have some of the most wonderful memories of her from grade school and high school.  And, looking for a house with her was so much fun, as hard as that is to believe.  She took a stressful, potentially depression-inducing process and make it a wonderful, enriching experience.  From the time a dead mouse fell out of a ceiling fan onto her head, to the time my insane cat escaped into our garage during an open house (and I know cats definitely weren't her favorite), she took it all in stride, and with grace and humor.

There are few people I'd say this about, but the world is a little less colorful, a little less joyful, and a little sadder now that she's not in it.

During her funeral, I was thinking about the stages of grief and how the final stage is "acceptance."  It is so hard to accept when something so incomprehensible happens, like the sudden death of an otherwise full-of-life person.  Watching her kids grieve so much made it hard to say the prayers of the traditional Catholic funeral, to "lift up to God" and trust in His guidance.

But maybe acceptance isn't really about accepting death, and coming to the understanding that "this is okay."  Because death, whether sudden or slow, whether young or old, is never "okay."  It's not okay to the people left behind -- but maybe not being "okay" is okay in and of itself.  Maybe acceptance isn't being okay with what happened, but accepting that it sucks, and you hurt, and the bad feelings may lessen but life will never, truly be "okay" in the way it was before.

Maybe I just had too many "okays" in that last paragraph.  But that's okay.

Routine, Interrupted

I'm not OCD; far from it.  I'm not particularly clean or organized or particular.  That being said, we are in the process of  remodeling our kitchen, and oh my, it is driving me nuts.

I should state upfront that I am really excited for the new kitchen.  It's going to be great.  I've worked hard putting it all together, and it's not going to take that long to do -- just a couple of weeks or so, then I'll have a beautiful new kitchen to enjoy.

However...there's something about my routine being disrupted that causes me to totally crash.  I've gone through two bathroom remodels and various other smaller projects, and it's always the same -- it get irritable, depressed, and anxious.  I can't cook anything, I can't really wash dishes, it's hard to get to my refrigerator (at least I still have one, though), and all the contents of my kitchen are strewn around my living room and dining room.  I found my two-year-old trying to eat a beef bullion cube she found yesterday because she assumed if it was in a shiny wrapper, it was candy.  She was disabused of that notion pretty quickly.

Out of curiosity, I did a little web searching on bipolar disorder and routine, and found quite a few articles that talk about how people with bipolar disorder may be helped by regular routines.  I'm not surprised, because a disruption to my routine certainly wreaks havoc with my mood, so it would stand to reason that the opposite is true.  Here are the articles:

From webmd.com:  Daily Routine May Help Bipolar Disorder
From the American Journal of Psychiatry:  The Importance of Routine for Preventing Recurrence in Bipolar Disorder
From healthyplace.com:  Stability in Bipolar Disorder Requires Routine

At least I feel a little justified that I'm not just making up an excuse for my bad mood.  Here's hoping the reno goes quickly.