EGBOK

                   Last year I learned something from Stephanie, the psychiatric nurse practitioner who has overseen my treatment with esketamine and TMS (and has written guest posts on my blog (Gardening the Mind -Esketamine Treatment and Renewed and Recharged - TMS) She taught me to remember this simple acronym: EGBOK. It stands for “Everything’s Going to Be Okay”.  She shared this with me at a time when I was really struggling with depression. It was just before my cancer diagnosis. EGBOK took on even more meaning for me as I battled both my mental illness and cancer. When you fight illness, whether mental or physical, you spend a lot of time worrying about the worst. Often, you feel like you won’t get better. Over the past year I have had to fight hard. EGBOK has carried me through my battles.

                  On the surface “everything’s going to be okay” seems like simple advice, but it is really quite deep. Its deepness lies in its simplicity. When I am reminded to focus on EGBOK, I can take things down to a basic level. It allows me to focus on one thing, the fact that I am going to be okay. I don’t need to focus on the darkness of my depression or the seriousness of my cancer. I tune my mind into one thing, being okay in the moment. If I take things one moment at a time, I am better able to cope. I am learning to focus on being okay in the moment. I’ll admit that I need help remembering this at times, but that is okay. We all need help at times.

I have learned that depression is going to run its course. It is going to cause me to experience darkness and make me want to give up. In those moments I need to allow my mind to see EGBOK. The letters are a light giving me hope. At times I become overcome with depression. The darkness becomes too much for me. If I reach out to Stephanie in these moments, she reminds that everything’s going to be okay (EGBOK). Those five letters remind me to take a deep breath and trust in my healing. 

                  The same thing happens when anxiety about my cancer builds up. I need to trust that everything’s going to be okay. I have a medical team that is doing everything necessary to bring me healing. For that reason, I can believe in EGBOK. I often worry that scan results are going to show new tumors. I am learning that even if the results show tumors, my doctor is ready. Everything is going to be okay. Even if I need chemotherapy again, I am going to be okay. I just need to be ready to fight and believe that I will be okay. 

                  EGBOK doesn’t mean that I can always do it on my own. Rather, I often need to accept the help of my mental health and medical teams. I need to trust that with them by my side I am going to be okay. 

                  What do you do if you do not have a team or others you can rely on? That is a difficult question. Even though it can be hard, I believe reaching out is a key to healing and being okay. Maybe you can join a support group. NAMI has groups and classes for mental health. I have found support in NAMI. There are support groups for physical illnesses. I attend a support group through the Cancer Support Community. We can all find a way to be okay. That doesn’t mean the illness will go away, but we can come to terms with it, learn to battle the illness, and live our best lives. 

                  Even though I understand EGBOK, I still need reminders. That is okay. We are not alone in this world. We are not alone in our illnesses. At times we are going to feel like we are alone. In those moments, we need to remind ourselves that everything’s going to be okay. Maybe write EGBOK on a Post-It note and stick where you will see it. I wear a bracelet that Stephanie gave me with EGBOK engrained on it. Let EGBOK serve as a reminder that you can get through whatever you are facing.             

 

Beautifully Imperfect

“We are all wonderful, beautiful wrecks. That’s what connects us – that we’re all broken, all beautifully imperfect” – Emilio Estevez

 

                  A friend of mine shared this quote with me. It immediately struck me. What does it mean to be a “wonderful, beautiful wreck”? I think it means we are all human. None of us have it all perfectly together in life, but that is okay. Often, I blame my depression for the struggles I experience. This quote made me pause and wonder if my depression is solely at fault.  Maybe I struggle because I am human, and the depression is just an added difficulty. 

                  Being human means we can experience life with cognition. That cognition separates us from animals.  We can understand the joys and pains of life. Well, maybe not completely understand why they are happening, but we can understand that they do happen. Those pains are the broken parts of us. The pains are different for each of us. Every one of us experiences life differently. Still, we are beautiful in our humanness. 

                  We are connected in our brokenness. Each of us has experienced some type of struggle in our lives. The struggles vary in intensity, but we all struggle at times. Even the seemingly perfect lives we see on social media experience struggle. I think people spend too much time trying to connect to the good things we see in people’s lives, even though we are more connected in the struggle. The social media influencer who shows all their “perfect” moments isn’t sharing their struggles. Not every moment is perfect. If I took a picture of myself right now, I would look happy. I am in my favorite place writing. What you wouldn’t see in the picture are the thoughts created by depression and anxiety that are filling my head. The same is true of most social media posts depicting “perfect” lives. They give us a false image. Where are the posts showing our brokenness? That is what makes us human. In overcoming the brokenness, we demonstrate our beauty. 

                  So, often we try to connect to each other’s perfection. Where we are connected is in our brokenness. We are connected in our striving to be whole. Our imperfections make us who we are. I think about my depression. It is a negative, an imperfection. At the same time, it creates my worldview and makes me who I am. I am “beautifully imperfect”. I have struggles in life. It is in striving to overcome those imperfections that I create the life I was meant to live. 

                  I have been sharing my story of life with depression for many years now. When I first started sharing, I was afraid. I didn’t think people would understand. I thought I would be looked on with derision. I didn’t want to be pitied. I wanted to be understood. What I found through sharing my story is that I am connected to so many more people than I could have imagined. As I shared my story, people responded. People understood and told me they had similar experiences. It was the brokenness that connected us. But that brokenness turned out to be beautiful. We shared pain and in doing so found healing. 

                  Sharing my story has taught me that I am not alone. Depression and other mental illnesses impact the lives of many people. Each one of us is a “beautiful wreck”. It makes me think of the ancient Japanese art, kintsugi.  In this artform broken pottery is repaired using gold to fill the cracks. This creates a beautiful object. Even though the piece of pottery is broken, it can be put back together and become a work of art. This is true of our lives. When we work on healing, when we connect to others who are broken, we become “beautiful wrecks”.  Perhaps, there is nothing more beautiful. 

 

 Kintsugi

Get Cancer Screenings - (Formerly titled Fear)

                  I just learned that the actress, Shannen Dougherty passed away. She lost her battle with stage 4 breast cancer. Her death hit me because not only was she battling the same illness I am fighting, but she was also around my age. I read about her battle. She had been fighting for years. She chose to live as she fought. It sounds like she had a very positive approach to her battle. In the end, the cancer took her life.

                  I know this is a depression blog, but reading about Dougherty’s passing has entered my thoughts and my depression and anxiety are already at work finding similarities and making doomsday comments in my head. Maybe those thoughts would be there without the depression, but my mental illnesses intensify the thoughts. 

                  Obviously, I didn’t know Dougherty. I do know her struggle. My cancer battle has not been as long as hers, but I still understand. I am sure we shared the fear the consumes you when you hear the words stage 4 breast cancer. I would assume we both shed tears when we learned the cancer had spread to other parts of our bodies. Fear of dying likely consumed both of us. I read that she was working to raise money and awareness for cancer. She was using her fight to help others. I admire that. Even though I have cancer I have chosen to spread awareness about the mental illness I fight. Now, I wonder if I should do more for cancer awareness. This blog is my platform. So, I figure it is okay to step aside from the depression for one day and write about cancer. 

                  Let’s start with early detection. I encourage everyone to have the tests recommended by their doctors. Women, get mammograms and cervical exams. In most cases these tests will detect cancer early. You need to get these tests regularly. If you experience unusual symptoms see your doctor. It is better to check than to wait until it is too late. Early detection allows doctors to treat cancer in its beginning stages, which increases survival chances. Cancer can be an aggressive bitch. Do all you can to catch it early. 

                  Dougherty lost her battle at a young age, but she shared her story and in doing so likely encouraged some women to get mammograms. Sharing stories is important. I share my story of life with depression, anxiety, and cancer in the hopes it helps someone. We are all in this life together. If my story helps someone than it has served a purpose. My fight will not have been in vain. 

                  Reading about Dougherty while I am waiting for pet scan results scares me. I’m not going to pretend that I don’t think about my own mortality. I have pains that I can’t explain. My head tells me the pains mean more cancer. Even though my oncologist has told me that the pains are not likely cancer, my head won’t let go of those thoughts. I hope to get the results in a few days. I’m waiting for my phone to ring, hoping it is my oncologist with good news. What if it is not? Well, then I guess I jump back into fight mode. Fighting cancer is not easy, but fighting depression hasn’t been either and I’ve done it. 

                  My thoughts and prayers go out to Dougherty’s family. I hope they know that her openness about her cancer helped people. I have a much smaller platform, but I hope my openness can help others. Cancer is a terrible illness, one that hopefully doctors will eradicate someday. Until then we need to continue sharing our stories and encourage others to get the necessary tests to detect cancer early. Lives depend on it. 

Passive Suicidal Ideation

                  Today I want to discuss a topic that is close to my heart. It is something I relate well to because I have dealt it for most of my life. I want to talk about passive suicidal ideation. The word passive is misleading. It doesn’t feel passive. Passive suicidal ideation is a serious problem and one that needs to be discussed. 

Passive suicidal ideation is when someone wishes they were dead or has thoughts about killing themselves without making a direct plan. (source: GoodRx.com) Even though the person does not have a plan, passive suicidal ideation needs to be taken seriously. It requires the attention of a mental health professional. 

Thoughts that a person with passive suicidal ideation might have include:

 

·      “I can’t do this anymore.”

·      “I don’t want to wake up tomorrow.”

·      “Everyone would be better off without me.”

·      “I wish I could just disappear.”

·      “I hope I get in a car crash.”

·      “I just want to sleep and never wake up.”

 

These thoughts may include a desire to die or not exist. The person may feel

hopeless. They may also feel trapped. Giving up seems to be the answer. The person may talk of feeling numb to everything around them. 

The difference between passive suicidal thoughts and active suicidal thoughts is that with active suicidal thoughts there is an intent and a plan to die. Even though there is no plan with passive suicidal thoughts, it is important to get help. Those thoughts can become active. Passive suicidal thoughts become overwhelming. There seems to be no escape from the pain they cause. Without help passive thoughts can become active. 

I don’t want to get too personal with my passive suicidal thoughts, but I have struggled with them. I have a safety plan for when they enter my mind. One key is recognizing their presence. When I can identify the thoughts, I am better able to reach out for help. One thing I have noticed is that I need to reach out for help early. If I allow the thoughts to fester, they become more difficult to fight. I think having a safety plan is important. It allows me to get help when I need it. My designated friend knows what to do if I share with her that I am having these thoughts. The safety plan provides an opportunity for my mental health team to intervene.

Passive suicidal thoughts are difficult to share with others. When these suicidal thoughts enter our minds reaching out can be the last thing we want to do for many reasons. These include embarrassment, fear of hospitalization, feelings of being a burden on others, and frustration. I have learned that these feelings are normal. Just as important, these feelings are okay. Passive suicidal thoughts are a part of the illness. Not everyone experiences them, but those of us that do, need to know that it is not our fault. Creating a safety plan and having conversations with our mental health providers are keys to fighting passive suicidal ideation. For more on creating a safety plan see my article at: https://namiglendale.org/how-a-safety-plan-can-ease-a-mental-health-crisis/

I know that at times my mind is going to go there. It is something that my mind has been doing for as long as I can remember. It took a long time to learn how to deal with these thoughts and how to trust others to help me. If you only take away one thought from this post, I hope that you take away that the thoughts are not your fault and that you deserve help. Knowing this is not going to stop the thoughts, but it will make the battle easier. 

 

 

Experiencing a Red-Letter Day

                  Living with depression and cancer I find that my days are often difficult. I feel down and have a hard time seeing the good in my day. That is part of the nature of depression. Sadly, I am very used to my days being like this. Last week I had a day that was very different. I would even describe it as a red-letter day. A red-letter day is a day that is special, happy, or memorable. 

How did this red-letter day break through my depression? I woke up earlier than usual because it was a treatment day. Those days usually remind me that I am battling cancer. I am doing well in my battle, so treatment days have become easier, but they are still tough.  Shortly after getting out of bed, I checked my email. There was an email from a cancer website that I had submitted two essays to a couple weeks earlier. The email stated that both of my essays had been selected for their website. I had to read it twice to believe it. These two essays were my first submissions, and both were selected. I quickly clicked on the link. My words were on the page. Two essays chronicling my fight with cancer. The second essay shared how my depression and suicidal ideation impacted my cancer fight. 

Writing has always been an important part of my life as I have explained on this blog in the past. It has been a part of my healing toolkit. Having my writing selected for a website was a big step for me. The importance struck me as I read my words. I couldn’t wait to share this with my aunt who was taking me to treatment. She knew how much this meant. I was beaming when I told her. Beaming is not a word that would normally be used to describe myself. Sunshine was breaking through my clouds of darkness. My aunt pointed out the smile on my face. I walked into treatment smiling. Since my essays shared my experiences with those who care for me during my treatment sessions, I excitedly gave them the link. I shared it with my mental health team by email while I was receiving the infusion. For the first time in a long while, I experienced what it means to be on cloud nine. 

This red-letter day has given me encouragement to continue writing my story. As I sit here writing this post, I know that my words can reach people. My hope to write a memoir about this battle I have been waging is a real possibility. Experiencing this success has encouraged me to keep writing. I think encouragement is the key outcome of this red-letter day. Even though times get dark because of my depression, good days are possible. I now understand that I need to embrace these times when they come. 

In all honesty I will share that an email later in the day with an abnormal test result threatened my red-letter day. I almost allowed an email that did not contain specific information to steal my joy. Unfortunately, a lifetime of depression has taught me that the negative is always lurking. I needed help to push this result out of my mind. There was nothing I could do with it when I received it. I knew I would need to wait for my medical team to handle it. I am grateful that I had someone there to remind me it was a red-letter day, and I couldn’t allow a negative to steal it from me. 

That’s the thing about red-letter days. We must embrace them when they arrive. They don’t come often and if we allow negatives to interfere, we are missing out on moments that can have a positive impact on our mental health. Red-letter days are not going to permanently erase depression, but they can help lift it for a while. 

If you are interested in reading the essays that led to my red-letter day, they can be found at this link: 

https://www.curetoday.com/view/dancing-through-breast-cancer-taught-me-to-live

 

 

 

Connection

                  There are a lot of different treatments for depression and other mental illnesses. Some of these include therapy, medication, transcranial magnetic stimulation (TMS), esketamine, and ECT. These can each be effective. Some work better than others depending on the individual. Each are important treatments. These treatments are not enough in isolation. The person providing the treatment is just as important as the treatment itself. It is the connection between patient and provider that dictates the full efficacy of the treatment. 

                  While I have had the same psychologist providing therapy for a very long time, I have had several psychiatrists over the years. I have a strong connection to my psychologist. That allows my therapy to be effective for me. It plays its role in my healing. For most of us therapy alone is not enough to defeat depression. That is where psychiatrists enter treatment. Part of the psychiatrist’s role is to prescribe medication that will work in concert with the therapy. I first saw a psychiatrist over 20 years ago. Since then, I have seen several different ones. Something was always missing. It wasn’t until I started seeing my current psychiatrist, who I have been seeing for several years now, that I understood that there must be a connection between patient and psychiatrist. That connection makes a huge difference.

                  What do I mean by connection? It is the relationship between provider and patient The psychiatrist needs to listen to what is being said by the patient. Out of all the previous psychiatrists I saw only one listened. I only saw him for a short time because he moved away. His listening started a connection, but it wasn’t enough. It begins with listening, but there also needs to be a sense of interest in the patient’s care. I never felt like my previous psychiatrists saw me. Some of them never looked up from their computer or prescription pad. How can you know what a patient needs if you don’t look them in the eye? It was always a refill or a new prescription and see you next month.

                  Connection was missing. Whether it is a therapist/psychologist or psychiatrist there needs to be connection. What is connection? It is the sense that both sides are invested in what is being discussed. Connection drives the patient/provider interaction. It allows the interaction to be beneficial and lead to healing. 

The same connection is needed for other treatments. My experiences with TMS and esketamine were enhanced because of the connection between the psychiatric nurse practitioner providing the treatment and me. The trust that builds up makes the treatment even more effective. It is a part of human nature to seek out connection. Without that connection, treatment cannot be truly successful.

It is often difficult to trust others when you live with depression or other mental illnesses. Connection does not develop easily. We become used to the lack of understanding that surrounds our illnesses. We know the ridicule all too well. That makes it difficult for us to reach out or to trust. We need connection, but we fear the lack of understanding that we are often met with instead of connection. 

I believe that I would not have found the healing I have found if it were not for the connection I have with my mental health team. Being connected to them allows me to trust in their care. It allows me to share whatever I need to discuss and know that it will be met with openness and genuine understanding. 

I don’t know what training programs for mental health providers consist of, but I hope it includes instruction on how to develop connection with patients. Most of the providers I saw who I did not connect with were older. Maybe training programs are improving. I would like to share my experience with and understanding of connection with mental health providers so that those coming into the profession understand what is needed. I share my stories here in the hopes that they are read by those who can make a difference. My blog has a small audience right now, but I hope to grow it. I hope people will share my posts and that more people will understand mental health. I’ll continue to write. I will continue to be a voice in the hopes that it helps those with mental illness as well as those who provide care for us.

 

                  

                  

Letting the Light In

“We are all broken…that’s how the light gets in.” – Ernest Hemingway

 

                  The other day I saw this quote posted on a Giving Voice to Depression  social media page. I have heard this quote many times. It has always given me reason to think. It relates well to my view of depression and the ways I have expressed depression and healing in my writing. 

                  Depression is a darkness. It fills our lives with shades we cannot see through. Darkness has long represented how I feel when the depression is heavy. I have written many poems with the theme of darkness. I understand the darkness. I have lived within its shadows for so long. Darkness represents my brokenness. It is a brokenness that people who live with depression know all too well. 

                  Brokenness can be a symbol for the struggle in the dark that a person suffering with depression lives with. In a sense our life is broken. I think that is another way of referring to the illness that is depression. Depression breaks down what is considered a normal thought process. However, I’m not sure I would agree that there is a normal thought process. We each think differently. For some of us those thoughts turn dark. These thoughts turn in on us and leave us in pain. It can literally feel like we are in the dark. 

When we are in the darkness, it seems as if we will never see the light of healing. I have always expressed healing as a light in my writing and in my thoughts. When healing occurs, it is as if light is breaking through the darkness. Sometimes the light peeks through a crack. That is a small moment of healing, a brief reprieve from the darkness. At other times the light can burst through the darkness. I have experienced that with both TMS treatment and esketamine treatment. The burst of light is a shattering of the darkness, a lifting of the depression. 

I believe we experience light in varying degrees at different times in our lives. Extreme darkness, those times when suicidal thoughts are strongest, makes it seem impossible to experience the light of healing. Our thoughts tell us there is no light. It is in these times that we must hold on to the aspects of healing that are present in our lives. It may be a mental health professional, a friend or loved one, or a treatment. Holding on to whichever it is, allows light to break into our lives. By the very fact that we are broken, we have cracks to let the light in.  We just find it difficult to see this. It is difficult to understand how light can reach us when we are in the depths of darkness. 

I believe the light is there even when we struggle to see its presence. I need to believe this. If I didn’t, I would be completely without hope. Often, I need assistance remembering that the light is out there. That is okay. We shouldn’t face the darkness of depression alone, which is why conversations about depression are so important. As Glenn Close said, “What mental health needs is more sunlight, more candor, and more unashamed conversation.”

Darkness is going to be present with depression. The goal is to find ways to allow the light in. This can be a Herculean task. Don’t embark on this task on your own. Even if you are alone, reach out to someone. Reach into the light that is seeping through the cracks in your depression. The cracks are there. Everything that is broken has cracks. Some we can see, others we can’t. Those cracks allow the light in. The light can be a therapist or psychiatrist, a medication, a support group, a non-traditional treatment, or loved one. Find your cracks. Be open to allowing the light in even in your darkest moments. Depression is deep darkness, but the light of healing can seep in. 

At the beginning of this post, I mentioned Giving Voice to Depression. This podcast can be another source of light. I have found light in listening to the stories shared on this podcast and I would encourage you to check it out.