What Is Healing?

                  The other day I was asked what I mean when I talk about healing. It is a good question and it got me thinking. I have a picture in my head about what I mean, but I don’t think I have ever really shared it. Maybe that is because I don’t see healing as something concrete. For me healing comes in different forms. The ultimate healing is the absence of the darkness created by depression. I’m not completely convinced that it is possible to erase all the darkness. I’ve never experienced a total healing that includes the permanent removal of the darkness of depression, but I have felt the light of healing in varying degrees.

                  Medication has never brought me healing. At best it has put a Band-Aid on my depression. Unfortunately, that Band-Aid always fell off easily.

                  Therapy brings a semblance of healing. Talking about the effects of depression and learning coping strategies helps. Therapy has been a consistent tool throughout my depression.

                  Non-traditional treatments have been beneficial. Both TMS and esketamine have certainly brought aspects of healing into my life. These treatments have allowed me to experience times where the depression was absent for a while. 

                  Still, this doesn’t define healing. I could say healing is being able to function in my day-to-day life, but sometimes I can function when the depression is heavy. So, what is healing?

                  Healing is when there is more light than darkness. The heaviness dissipates, and color comes into the world. Healing comes in shades.  I don’t feel the weight of depression when I am experiencing healing. That weight is feeling that everything is barreling down upon me. When I am trapped in the darkness, I can’t see the positives in life because the depression is smothering me like a blanket. Healing is when that blanket is lifted. 

                  Healing comes in shades as if it is on a continuum. Some days healing is the small victories. It is getting out of bed and showering. Other days it is interacting with the world and being able to work.  Healing can range from having less suicidal thoughts to the complete absence of those thoughts. Just as depression impacts each of us differently, healing arrives differently for each of us.

                  Healing is feeling better. Sometimes it is difficult to explain the feeling. It is being able to live life without being dragged down by the weight of depression. We each need to define healing in relation to our own experience. For me, TMS and esketamine have shown me the light of healing. I have had distinct experiences where I have been able to notice the depression being lifted as a result of these treatments. With time the depression has returned. When that happens, I go back to the treatment and wait for it to ease the depression again. Healing requires effort. Unfortunately, that effort is not easy to summon when we are struggling with depression. For me having a mental health team allows me to make that effort. I need to rely on them to guide me through treatment and to provide a place to discuss what I am feeling. 

                  I cannot tell you what healing will look like for you. Healing varies for me. Outside factors can often impact how you feel. Relationships, work issues, other illnesses can all impact healing. My healing looks different now that I am living with cancer in addition to depression. Sometimes the depression and its buddy, anxiety, affect me differently than before cancer, which results in a different appearance to healing. I have learned to change my expectations. I think healing is affected by our expectations. I understand that I can be doing well and still have suicidal thoughts pop into my head. I can be doing well and still have days when I don’t want to get out of bed. That is part of the continuum I mentioned. Depression may impact us differently from day to day. It is somewhat like a roller coaster. There are ups and downs and even straightaways. 

                  Ultimately, I think healing is feeling the darkness lift. It is feeling better than the norm depression creates. Healing requires acceptance of our illness. We cannot experience the light of healing if we don’t acknowledge the illness. I did not experience times of healing until I allowed my inner voice to say, “I have depression. My darkness is from an illness. It is not something I caused.” 

                  We must remember that healing is a continuum. There will be bad days. There will be better days, and there will be good days. We fight through the bad days. We enjoy the good days. We lean on our mental health providers to guide us, and we make decisions with them. We use the tools and treatments that work for us. Healing will look different on different days. Healing is unique to each one of us, but healing is possible.

 

Mental Health Stigma

                  As Mental Health Awareness Month nears a close, I would like to address mental health stigma. This month has seen more positive attention placed on mental health. One month is not enough. Mental health needs positive attention focused on it throughout the year. I think increasing positive attention requires decreasing stigma. As someone who has lived with mental illness most of my life, I have experienced stigma. It hurts. It negatively impacts healing.  I have felt the sting. Stigma has caused me to deny my mental illness at times, especially in the work setting where I feared my depression would be met with mockery and a lack of understanding.

                  The Mayo Clinic states, “Stigma is when someone views you in a negative way because you have a distinguishing characteristic or personality trait that’s thought to be or actually is, a disadvantage (a negative stereotype).” Mental health stigma is when a person is looked at negatively because of his/her/their mental health.  Stigma leads to discrimination, which can be painful.

                  There are several results of stigma. These include a person not seeking treatment, a lack of understanding of what mental illness (and mental health) is, and bullying among other things. These are painful.  Not seeking treatment can lead to a worsening of symptoms. Mental illnesses are just that, illnesses. They require treatment. There is no going it alone.  Whether it is therapy, medication, or non-traditional treatments such as esketamine and TMS, treatment is necessary.  Our mental health will not heal itself. Unfortunately, too often stigma interferes with getting help.

                  We see stigma when mental illnesses are used as adjectives. I’m sure you have heard things like, “She’s so OCD. She keeps everything so clean,” or “He’s so schizophrenic.”  Mental illnesses are not adjectives. Being neat is not OCD. Being sad is not depression. Having different moods is not bipolar disorder. These mental illnesses are much more complicated than their use as adjectives would have people believe.  

                  I have major depressive disorder. This does not mean I am just sad. I experience happiness at times. What I live with is a mood disorder that makes it difficult for me feel good about myself and the world around me. I can experience sadness separate from my depression.  Sadness and depression are separate things. I can be sad that my favorite basketball team lost a game. That loss does not depress me. Depression consumes me and affects how I carry out my daily life. Sadness is an emotion that a person experiences in relation to an event. Sometimes depression is stigmatized as someone dressed all in black and crying. I don’t wear black any more than I wear other colors. My mood colors how I view myself. It results in a draining feeling coming over me.

Many times, I have heard, “How can you be depressed when you have so much to be happy about?” Again, here is stigma. Depression and happiness are not opposite emotions. Happiness is an emotion. Depression is an illness. Depression affects every aspect of my life. It colors my view of myself and the world around me. Happiness is something I feel when I something good happens like watching my niece get a hit in one of her games or when my nephew makes a joke. These things don’t erase my depression. They just allow me to feel the emotion of happiness.

So, how do we cope withstigma? First, as I stated earlier, we need treatment. We need to seek out help or allow ourselves to be helped. This requires seeing mental health professionals. When we recognize that mental illnesses require health care, we are better able to receive the care we need. We are also talking back to that stigma that denies mental illness is an illness. 

We need to remember we that we are not our mental illness. I am not depressed. I have depression. There is a difference. Again, depression is not an adjective. People are not bipolar. They are not schizophrenic. People have bipolar disorder. People have schizophrenia. We need to resist the tendency to use mental health disorders as adjectives. There is enough of that around us. If we ensure that we are not using them as adjectives other people will notice. 

As difficult as it is, we need to try not to isolate. When we keep to ourselves and push others away, we are not allowing them to see that we live with an illness that can be treated. I understand how hard it is not to isolate.  There are times when I isolate. I have been afraid to let others see my depression and anxiety. I have lied about my illness, blamed it on a physical ailment. Stigma caused me to be afraid. I didn’t want my boss to know I struggled with my mental health. I feared it would affect my employment. But the truth is people can work with mental illness. Sure, there are times when we need time off, when we need care. That doesn’t mean we can’t be productive employees. If we can reduce the stigma surrounding mental health, more people can be successfully employed. 

Reducing stigma requires awareness. Recently, I participated in NAMI Walks. People came together to raise awareness about mental illness. There was a sense of community and desire to help people. I have found that being involved with NAMI (National Alliance on Mental Illness) has given me opportunities to connect with others who understand what I live with. It has given me the opportunity to share my story and hear the stories of others. The awareness NAMI generates is healing. NAMI works to tear down the stigma through awareness. Awareness means saying, “This is mental illness. People live with it. People succeed with it.” 

By its nature mental illness is difficult to live with, but we need to remember that we are more than our illness. Stigma be damned. My hope is that through this blog and other writing, I can reduce stigma. I want people to be able to live without the negativity of mental illness. I want to live without that negativity. I want young people to discover that even if they are struggling with depression, anxiety, or another mental illness, they can live full lives. There is help out there. Sometimes we have to look harder for it, but help is out there. If we make mental health awareness a yearlong effort, we can reduce stigma and make a difference in many lives. 

 

Fertilization and Purple Lights (Esketamine Treatment)

                  Stephanie Debnath, PMHNP, discussed esketamine in Monday’s post.  Today, I will share my perspective as a patient.

I have lived with treatment resistant depression most of my life.  Not long ago I was in a very dark place. It felt as if I was buried underground. I couldn’t work. I could barely function. Suicidal thoughts haunted me. I needed some type of “fertilizer” to grow out of the darkness. 

                  With the help of my mental health team, I made the decision to try esketamine.  I was nervous. I had a false image in my mind. As someone who has always enjoyed listening to music from the late 1960s like Jefferson Airplane and The Doors, I envisioned esketamine causing something similar to the acid trips those musicians described.  I would find out that my vision was incorrect. Yes, I would experience what could be called “trips”, but it was really a healing dissociation.

                  As Stephanie described in her post, esketamine is self-administered through a nasal spray in an office setting under the observation of a psychiatric practitioner.  The first thing I felt was a floating sensation. It was very peaceful. In my first session, I drifted and felt a heaviness being lifted off me. I knew was safe but was not really aware of the room around me or the nurse observing me. 

                  Starting with my second session I began to see purple lights while I was under the effects of the esketamine.  These purple lights had an inviting warmth to them. It was as if I was floating through these lights.  There were different shades of purple, each inviting me to float further into them.  I soon came to associate these purple lights with healing. At times other colors would join the purple. There were greens, blues, and pinks. Each of these colors drew me further into the purple lights. Not everyone sees colors. The colors were my experience. Everyone has their own experience.

                  Before each treatment I would meet with Stephanie.  We discussed an intention for the session. We decided what needed to be “fertilized”.  I would focus on the intention as I was waiting for the esketamine to take effect.  My mind would follow these thoughts as I dissociated and floated into the purple lights.  In this state I could process thoughts as if I was an observer. There were times when revelations struck me. These were always accompanied by the purple lights. My mind was able to work without the depression tearing me down. 

                  As I came out of the esketamine, I would retain the thoughts and revelations. I kept a journal by my side.  When I regained awareness of the room and my presence in it, I would write in my journal. Whatever came to me while under the esketamine became clearer and more concrete in my journal.  

                  I was being “fertilized”. My roots grew stronger and emerged from the darkness of depression’s soil like tender shoots of a plant reaching for the sunlight.  I was growing. It took time. You don’t just spread the fertilizer and have a garden overnight. Still, my mental health improved. The suicidal thoughts diminished. Esketamine was allowing me to process the thoughts depression fills my mind with. It allowed me to go within my mind and make observations. I saw my thoughts as what they were, just thoughts, not reality.

                  I am grateful that I have treatment options. For years I have struggled with treatment resistant depression. I needed something different than the traditional medication approaches. My mental health team provided me with options that led to healing. I will likely need esketamine treatment again at some point, but I understand that is normal. Gardeners periodically fertilize their gardens. I need to do the same for my mind.

                  I’d like to share a poem I wrote after one of my esketamine treatments. 

 

Esketamine Treatment

 

Iridescent purples,

Translucent greens.

The colors fill my mind.

Replace the darkness even if only briefly.

I float through the colorful display.

Watch in awe as shades of green and purple drift through my awareness.

Bright pinks and vibrant blues appear,

Summon me. 

Lights behind the colors remind me that healing is possible.

I ride the waves of color as my mind is illuminated.

The dark thoughts that so often consume my mind are paused.

I feel a sense of peace. 

It is a sense I am unaccustomed to.

I am safe in this space filled with bright colors.

My fears suspended,

My pain soothed.

Only the colors exist.

I float as if on clouds.

Aware only of the colors.

I name them, reach out to them.

I feel the colors comfort me. 

In these moments I have been set free,

A part of a different reality.

Time passes and I am returned to my usual existence,

But pieces of the colors remain with me,

Healing me.

Battling with the darkness for my awareness.

 

 

 

For more information on esketamine or TMS treatment:

 

SoCal TMS: https://socaltms.com/

SoCal TMS on Social Media: 

                  Instagram: @socaltms

                  Facebook: Southern California TMS Center

 

 

Gardening the Mind (Esketamine Treatment)

  

Today’s post was written by Stephanie Debnath, PMHNP.  She is a psychiatric nurse practitioner who works with esketamine (Spravato) and TMS (transcranial magnetic stimulation) at SoCal TMS.  Full disclosure: Stephanie has treated me with both TMS and esketamine. There is a link at the end of this post to the SoCal TMS website and their social media for more information on esketamine.  To read Stephanie’s post on this blog about TMS scroll back to October 20, 2023, Renewed and Recharged. Check back on Thursday for my perspective on esketamine treatment.

 

Gardening the Mind 

 

 

As many of us try to balance out our busy lives, stress, worries, and interests, we gravitate towards a vice. For some it’s reading, others it’s exercise, and for a lot of people it is something less healthy—regardless, we all have a thing. I garden. I like to plant something in the ground and care for it. Pruning the damaged leaves makes me feel like I’m caring for wounds, watering it reminds me of how good I feel after a big drink of water on a hot day, and watching buds form tells me it’s growing. I make many mistakes in the garden. Neglect, sun scald, drought, poor choice of area in the garden. Some are not wins, but others are decent. I like to get my hands in the dirt and see the worms, because seeing worms equals healthy soil, usually. I always have my eye on the prize of a fruit or vegetable to come. That’s my goal. It will mean that my plant is thriving. Often, I work hard. Take the courses. Follow the steps. Sometimes, I pour blood, sweat, and tears into growing something. It can still fall short. I do a lot in the garden, but I do forget to fertilize.

 

Treating patients with Treatment Resistant Depression, means treating patients who have put a lot of effort into their mental health. It means people have tried many, many medications. Some for years, some just once, but there is usually a long list. They have done countless therapy sessions, sometimes with many therapists, sometimes just one. They have had alternative or interventional treatments, sometimes multiple, sometimes just one. What these patients have in common is that they have worked hard and made mistakes; Not tending to their wounds, not nourishing their bodies, and stunting their growth. They work hard, they take the courses, they follow all the steps—year, after year, after year. They often pour blood, sweat, and a lot of tears into trying to regain power in this area, trying to take hold of their mental health. So, what if for some people those things are almost enough? They are helpful but keep them falling short of their goal. The plant grows, but there is no crop. Their Treatment Resistance makes it harder for them to flourish with just the basic. For some…perhaps they need to fertilize.

 

Esketamine is a newer treatment, FDA approved in 2019 for Treatment Resistant Depression and 2020 for Major Depressive Disorder. It is essentially a derivative of the molecule Ketamine, something used largely across the medical field for amnesic (short-term memory loss), analgesic (pain-relieving), and hypnotic (sleep-producing) purposes. It is a nasal spray/medication that is self-administered by the patient, in office, with the psychiatric provider on site. The sessions last about 2.5 hours for proper monitoring, and vitals are taken along the way by a nurse or technician. During the peak of the medication in the first hour, there is some light dissociation which allows the patient to go “within”. It gives patients the opportunity to switch to observation mode and evaluate things that are challenging to do in everyday life. The drug wears off about an hour in and the second hour is spent recovering. These sessions have been described by patients as “inward therapy”, but it is different for everyone. 

 

The way I see esketamine therapy is like this: it is the fertilizer to our roots when it comes to the brain (and neurons). It boosts the elements and chemicals that cause excitation, strength, bonding, and growth, and it sends signals to the base of the “plant” (brain) that encourages it to produce the nutrients it needs. Patients often say, “I’ve tried so many things, so many meds, so many therapies. I feel like my brain needs a jumpstart.” Well, they are probably correct. A lot of people are putting in the effort, the blood, the sweat, and tears but they fall short. Like when I forget to fertilize, I am only getting a minimal growth, with almost no fruit. 

 

While not all treatments and therapies are right for people, I can say that esketamine is an option that will help many. It still pains me to hear patients say, “I wish this would have been around 20 years ago.” I do, too. I wish the advancements of today were present decades ago, and everything was further along. I wish if we wanted to take up gardening, we just knew everything there is to know, and did it all correctly each season. We can still wish, but we must try along the way, too. This emerging treatment has helped many, many patients in different ways than traditional medications for depression. It has stimulated the brain differently than electromagnetic waves, and it has restored hope for those who feel they go season after season with no crop. As a clinician in psychiatry, my intention is never to push one treatment over the other, but to inform and encourage a new way of pruning, tending, and nurturing a garden. After all, the right amount of fertilizer can bring a bountiful harvest.  

 

 

SoCal TMS: https://socaltms.com

SoCal TMS on Social Media: 

            Instagram: @socaltms

            Facebook: Southern California TMS Center

 

Self-Compassion for Depression

                  Depression tears people down.  We live with painful thoughts.  Our minds often fixate on the negative. We tend to see darkness all around us.  Living like this is not easy.  Therapy, medication, and alternative treatments help, but depression is always lurking. How do we live with this darkness?  How do we get through our day-to-day lives? Having a support person or team helps, but we need to play a role in our healing, too.  One of the most effective ways to do this is practice self-compassion.

                  What is compassion? The Merriam-Webster Dictionary defines compassion as “sympathetic consciousness of others’ distress together with a desire to alleviate it.”  Most people are able to show compassion to others.  The difficulty arises when we need to show that same compassion to ourselves.  I know I struggle with being compassionate toward myself.  I don’t give myself the grace I need to feel good about myself. Depression tries to quash self-compassion. It fills us with negative thoughts; tells us all that is wrong with us. How do we learn to be show ourselves compassion?  I wish I had an easy answer. If I did, I would be better at talking back to my depression.  

                  I think self-compassion starts with how we talk to ourselves.  Practicing positive affirmations can be helpful with this.  I think it is helpful to write these down, perhaps on sticky notes.  That way you are reminded to use the affirmations.  I am not very good at this.  My mind gets going and I struggle to talk back to it.  I am going to try to place some affirmations around my house today. Realistically, I’ll probably only write a three or four, but that is a start. 

                  We need to acknowledge the painful thoughts that enter our minds. As we do this, we need to be kind to ourselves.  Perhaps, say something like, “I know I am struggling right now, but I am worthy of kindness.” No matter what our depression says, we do not deserve to feel bad.  We need to tell ourselves that we deserve love from ourselves and others. 

                  Talking back to the negative thoughts is hard.  I believe this is true for everyone no matter how confident they are.  It is especially hard for those of us who live with depression.  The voice of depression can be loud and domineering. But what if talking back to it could confuse the depression?  Would that quiet the depression enough for us to say something compassionate to ourselves? It is worth a try. 

                  Many of us have heard the advice, “be your own best friend.” On the surface this has always seemed like trite advice to me.  However, we really do need to be our own friend.  If we are going to talk to ourselves, we should talk to ourselves with the same compassion we would use when talking to a friend.  We deserve that compassion. Most of us would give a friend the grace to make a mistake or to feel down.  Why is it so hard to give ourselves the same grace? I wish I had an answer.  I just know that despite how hard it is, we need to find a way to do it. 

                  Self-compassion might be as simple as saying to ourselves that it is okay to feel the way we do.  When we talk to our mental health provider or take our medication or receive an alternative treatment, we are practicing self-compassion because we are doing what we need to do to fight the depression.  How much more powerful would these healing tools be if we also accepted our feelings without judgement?  

                  I have been working on talking back to thoughts in my head.  It is hard work, and I am not always successful.  Still, I keep trying.  I would encourage a friend to have positive thoughts.  I must do the same.  I try to find the good in a loved one.  I need to find the good in myself.  Depression is going to try to get in the way.  That is okay.  We need to keep getting back up.  There is a saying about it not being how many times you fall, but how many times you get up. 

                  Let’s give ourselves the gift of self-compassion.  Embrace yourself as you would embrace a loved one.  Remember, you are not your depression.  Depression lies.  That is how it controls us. Giving ourselves grace and love can fight the depression.  It can show us that we are worthy humans who deserve to feel good about ourselves.  

                  

                  

Physical Versus Mental Illness

                  Most of my life has been spent living with mental illness.  I know the ups and downs well.  The loneliness of mental illness is something I have felt intensely.  I have often hidden my mental illness to protect myself from stigma.  The platitudes that are spoken when someone finds out I have depression are seared into my mind.  Living with mental illness has frequently been a solitary battle.  Many times, I have feigned a physical illness to hide my mental illness from people who just don’t understand. 

                  I shouldn’t need to hide my mental illness.  No one should. Unfortunately, the society we live in still doesn’t understand that mental illness is an illness.  I will acknowledge that society has come a long way.  It is easier now than it was 30 years ago.  Still, it is a challenge to live with mental illness.

                  People understand when you have a physical illness.  When you are in bed with the flu, people will text you and tell you to feel better.  People are quick to assist someone in a cast or on crutches.  Sometimes flowers are sent, or a meal is brought to you.  These things usually don’t happen with mental illness. Often, people who know exactly how to empathize with someone who has a physical ailment, lacks the words to say to someone struggling with a mental illness like depression.  

                  I have experienced this discrepancy firsthand.  When I was diagnosed with cancer, I heard from so many people.  People rushed to help me.  People asked what they could do to help me.  Don’t get me wrong. I am very grateful for this.  I just wonder why the reaction was so different from my depression. Cancer and depression are both debilitating illnesses.  They both have left me fighting for my life.  Yet they are treated very differently.  

                  Maybe some of the difference lies in the visibility of the two illnesses.  Both are inside of me, but the cancer has outward signs like my hair loss, my weakness, and the changes to my skin.  Depression’s outward signs can be mistaken for me being quiet.  These two illnesses present themselves differently.  People know that cancer is a killer.  The mere mention of the word scares people.  The ability of depression to kill is often misinterpreted as a choice.  That couldn’t be further from the truth.  As someone who has struggled with suicidal thoughts, I can attest to the lack of choice I have over those thoughts.  

                  People hear that you have cancer, or another physical illness and they want to help.  When people hear that you have a mental illness, they often turn away because they don’t understand.  For us to reach a point where mental illness is treated with as much empathy as physical illness, we need to increase knowledge about mental illness.  In my case, I accept some of the blame.  I am guilty of hiding my mental illness.  I have covered it up by blaming something physical.  That doesn’t help grow understanding.  Over the years, and especially this past year, I have learned that I must be open about my mental illness. There is no reason to hide it.  As I have fought depression and cancer side by side, I have learned that both need attention; both require treatment. I know that both cancer and depression can take my life.  Some people in my life understand that I am battling two illnesses. They have been by my side and supported me in both battles.  My wish is that all people who are struggling with mental illness receive the support and understanding they need.  

                  People send cards and flowers when you have a physical illness.  It is time we normalize sending tokens of encouragement to people living with mental illness just as we would when they are living with physical illness.  For this to happen, people living with mental illness need to be willing to be more open.  They don’t have to share every aspect of their illness. It is enough to just acknowledge it.  I don’t tell people everything about my mental illness just as I don’t tell people everything about my cancer diagnosis, but I do acknowledge both.  Acknowledgement can go a long way towards encouraging support and understanding.  Illness, whether physical or mental, does not need to be battled alone. 

                  If you know someone who is living with illness, whether physical or mental, reach out to them.  Send them a card. Offer to help them with something.  Maybe just sit with them and be present. Ask them how you can support them.  Knowing someone cares will go a long way for someone living with illness. 

                  

 

You Are Not Your Mental Illness

Mental health problems don’t define who you are – they are something you experience. You walk in the rain, but you are not the rain.

                                                        -Matt Haig

 

                  I saw this quote on a NAMI California social media post.  It really speaks to me as someone has lived most of my life with mental illness.  Depression and anxiety are a part of me, but they do not define me.  It took a long time for me to understand this.  When mental illness plays a dominate role in your life it is often difficult to separate who you are from the illness that you are diagnosed with.  I am no more depression and anxiety than I am the cancer that I am also diagnosed with. These are illnesses.  They impact how I live my life, but they do not determine who I am. 

                  Depression and anxiety make feeling good about myself difficult.  At times these illnesses affect the choices I make, but I am still making the choices.  I experience difficulties with my mood.  A cloud of darkness often hangs over me because of the depression.  My mood is often low, and I struggle to be a part of things. That doesn’t mean that I don’t want to engage with others.  Just like heart disease might prevent people from exerting themselves, depression at times prevents me from engaging with others.  It is a part of the illness.  I want to be a part of the life that goes on around me.  Depression, the illness, prevents me from doing so.  

                  In the same way that I am not cancer, I am not depression.  It is an illness I experience; an illness that impacts me. There are days when the depression is not as apparent.  There are days when I can act as if the depression is not lurking inside of me. Depression like the cancer cells is inside of me, but it doesn’t always make itself apparent to the outside world.  I have some control over what the people around me see.  By no means do I have total control. On the days when the depression is expressing itself more, I tend to hide myself within my home.  Still, I am not the depression.  It is impacting how I live, but not who I am.

                  Don’t get me wrong, depression and other mental illnesses impact us in ways we cannot always control.  Mental illnesses can drive us to isolate, to act out in pain, to be overcome with anxiety.  These illnesses ring loud in our brains.  At times they are debilitating. I think that is true of any illness.  Having cancer has taught me that there is a similarity present in illnesses.  I can have good moments and I can have bad moments with both illnesses.  At no time am I my illnesses.  

                  Haig refers to walking in the rain, but not being the rain.  I get it.  I walk with depression, but I am not depression. This is where person first language is important. I am a person with depression.  I am a person with anxiety. I walk with depression alongside of me. It affects me, causes me to struggle, but I am not depression. Possession does not equate to being. I have depression.  I am not depression. When we focus on ourselves as individuals, we push the illness to the background and move ourselves to the foreground.  We are not our mental illnesses just as we are not our physical illnesses.  

                  Another aspect of this quote that struck me is Haig’s choice of walking in the rain as an image.  We usually think of rain as being dark and gloomy. Certainly, mental illness can be dark and gloomy.  I have lived with this darkness.  I understand the comparison between rain and mental illness. At the same time there is beauty in rain.  Without rain, trees and flowers wouldn’t grow.  We would be thrust into drought.  I believe that despite the darkness, there is beauty in depression.  It has brought people into my life that have enhanced who I am. Writing about depression has given me purpose.  This blog was born of the darkness of depression, but it offers hope. There are people with depression and other mental illnesses who are achieving amazing things. Depression is a dark cloud, but even rain clouds clear at times.  

                  We are not our illnesses.  We are people living with illness. That requires strength.  We walk in the rain of mental illness, but rainbows emerge after the rain.  I hope to focus on the rainbow that is hiding behind my depression. 

                  

 

 

Signs You Might Need to Talk to a Therapist

                Therapy.  The word conjures up many misleading ideas   There is stigma attached to therapy.  Often, people hide the fact that they go to therapy because of this stigma.  We need to break down the stigma.  Going to therapy should be as normalized as going to the gym or a yoga session for physical health.  Seeing a therapist should be seen as just as important as seeing a doctor for physical health. 

                  I have been in therapy all my adult life.  You may wonder if it works why do I have to continue to go.  I have a mental illness.  It needs to be treated.  Therapy is part of my treatment.  I work on different things with my psychologist.  As my journey with depression continues, I find that I need support with different things. Therapy provides that support.  It is a vital part of my treatment.  

                  What are some signs that seeing a therapist might be beneficial to you?  Having a mental health diagnosis is one sign.  Although not everyone with a mental illness finds it necessary to work with a therapist.  As with physical illnesses, mental illness is individualized, and treatment plans can vary from person to person.  

Some reasons to consider therapy include:

 

·      Depression

·      Anxiety

·      Feeling overwhelmed

·      Overwhelming emotions

·      Loss of interest in activities

·      Anger

·      Relationship issues/struggles

·      Mood affecting relationships and/or work

·      Grief

·      A specific phobia

·      Isolation

·      Destructive behaviors

·      Substance abuse

 

 

The above are just some reasons a person might need to consider therapy.  People

go to therapy for many reasons.  Sometimes it is short-term.  Other times it can be for longer periods.  Again, it is based on the individual.  

                  How do you get in to see a therapist?  One way is to talk to your primary care provider and ask for a referral.  You can also do a Google search for therapists in your area and start making calls to see who has openings for new patients.  It might be necessary to call your insurance provider and ask for a list of therapists in their network.  If you don’t have insurance, there are many therapists who don’t deal with insurance.  You can also contact NAMI (National Alliance on Mental Illness) for help finding a therapist.  If you are in a crisis situation, call 988, the mental health hotline.

 

                  What should you look for in a therapist?

 

                  I consider myself lucky because I have a great therapist. He is a psychologist.  Some therapists are psychologists.  Some are MFTs.  See my post my March 7^th post – Different Types of Mental Health Professionals for more information on the different types of therapists.  

                  A good therapist will listen to you.  They will give you the space to talk.  Therapists use different strategies to help you work on what you need.  You want a therapist you feel comfortable with. You should feel safe with your therapist.  Setting goals is an important part of therapy.  It is also important to have a therapist who is willing to work as part of a team, especially if you also have a psychiatrist or if your primary care provider is involved in your mental health.  I have found the team approach to be vital to my journey.  

                  Only you can determine if the therapist is right for you.  There is nothing wrong with deciding you need a different therapist if you feel one isn’t right for you.  It is important that you feel comfortable enough to open up to your therapist. If you can’t be open with your therapist, you won’t receive the benefits you need from therapy.  

                  I would be lost without my psychologist.  The therapy relationship is an important aspect of my treatment.  I know that I can talk to him about anything.  My comfort level allows me to trust, which in turn allows me to heal.  I know I can contact him when I am n crisis. Trust is key to the patient/therapist relationship.  

                  As I mentioned at the beginning, there is a stigma attached to therapy.  The more we normalize going to therapy, the more we can break down that stigma.  If you find yourself in need of therapy, please reach out and find a therapist.

 

May Is Mental Health Awareness Month

                It is Mental Health Awareness Month, a time where we step up the awareness of mental health issues.  For me, every month is Mental Health Awareness Month.  I even have a t-shirt with that sentiment on it.  When you live with a mental illness there is no month off.  There is no being unaware of mental health.  It lives with you.  It is not who you are, but it is a large part of your life.

                  This month you will see more social media posts about mental health.  More people will share their stories.  Hopefully, more people will get the help and support they need.  Raising awareness must include getting more people the help they need.  Conversations about mental health are encouraged in May, but really, they need to be encouraged all year long.  Thankfully, conversations are now being held more often. Organizations like NAMI promote mental health and awareness about mental illness all year long.  There are mental health advocates all over social media. That is what we need.

                  There are many simple things we can do during Mental Health Awareness Month.  One simple thing we can do is check in our friends and loved ones.  Ask them how they are doing.  Listen beyond the quick “okay” response.  As someone with depression and anxiety, my go to response is “okay” when someone asks how I am doing.  Okay can mean so many things.  It may mean the person is fine.  It may also mean “I’m struggling, but I don’t want to bother you with what I am feeling.” 

                  There are alternatives to just asking “How are you?”.  I read an article on CNBC, “Don’t Say ‘How are you?’ Ask these 8 questions instead, says expert: ‘You’ll get a genuine response’”.  (https://www.cnbc.com/2023/04/14/dont-say-how-are-you-ask-these-questions-instead-says-happiness-and-relationship-expert.html) Here are the questions:

                  

·      How are you really?

·      How are you doing right now?

·      What’s been on your mind lately?

·      If you were being completely honest with me, how would you describe your feelings lately?

·      What’s feeling good, and what’s feeling hard?

·      What word would describe your life right now?

·      The last time we talked, you were dealing with [X problem]. How has that been lately?

·      What question do you wish someone would ask you right now?

 

When you ask these questions listen to the response.  Really listen.  Maybe repeat

the response back to the person to check that you understood.  Listen to their response.  You don’t have to have answers.  The important part is listening. Let the person share.  If appropriate, ask clarifying questions or questions that allow the person to delve deeper.  You don’t have to be a therapist to listen to a loved one or friend.  Knowing that someone is interested in how they are doing can really help people.  As you are listening you are showing the person that they matter to you.  Let them know you hear them and that they are important to you.  

                  Asking how a person is doing in this manner is a great way to make Mental Health Awareness Month more meaningful. Just remember that you need to continue beyond May.  This month is about getting conversations about mental health started.  It is a steppingstone to increasing our awareness that people live with struggles, whether a diagnosed mental illness or just a rough patch.  

                  Another thing you can do during this month is attend a mental health event.  NAMI offers many.  A simple Google search or maybe a search on Eventbrite should yield suggestions.  I am going to NAMI Walks on May 4^th.  It is hosted by NAMI GLAC (https://namiglac.org/).  

Try going to your local bookstore and getting a book on some aspect of mental health.  My most recent book, Traveling the Healing Journey: Finding the Light in Mental Illness is a memoir of living life with a mental illness. My book is a quick read and can be ordered in your local bookstore or on Amazon (Traveling the Healing Journey on Amazon)
  There are many books about mental health.  Add one to your To Be Read list.

You can also learn about 988, the mental health hotline.  Make it a point this month to familiarize yourself with this hotline and how it can help people with mental illness.  You never know when you might need it.  There is a saying, “Knowledge is power.”  Knowing about 988 could save a life.

Another thing you can do is recognize a mental health professional.  National Mental Health Provider Day is May 12.  If you have a provider acknowledge them for this day.  Let them know how they affect your life.  

Look for posts about mental health on social media.  Share a couple.  By doing this you are raising awareness about mental health.  We all share memes and other posts.  Give that sharing some meaning.

If you live with mental illness, try some different self-care practices this month.  I plan to try Tai Chi.  I am hoping it will ease some of my anxiety.  What can you try? 

Mental Health Awareness Month is just starting.  I encourage you to do something.  Start with checking in on someone.  You never know the difference you can make.