Signs Depression Is Resurfacing

            I have lived with depression long enough to know it has cycles.  There are times when I am doing better, like when I am receiving esketamine treatment or transcranial magnetic stimulation (TMS).  During these times I must be alert for signs that the depression is resurfacing.  It is best to act early when it does.  Even during my better times, I continue with therapy and employing my coping skills.   These allow me to stay on top of my mental health and continue to heal. 

            One way I know the depression is starting to resurface is I feel myself dragging to do things.  I feel a heaviness weigh down upon me.  The thoughts in my head turn negative and become louder.  The running dialogue in my head is negative.  I tire easily but can’t sleep.  I become easily frustrated.  Another thing I tend to do is disengage.  I back out of plans with friends.  I feel a need to be alone.  

            Often, I can tell my mental health team when I realize that depression is coming back.  When I do this, treatment gets underway quickly.  However, there are times when I go into denial.  I try to push myself through the resurfacing depression until it is too late.  I hate that I do this.  I’ve gotten better about not doing it.  Depression has taught me that it is an aggressive foe.  Sometimes it comes on too quickly for me to see the warning signs.  When that happens, I am in for a difficult episode.  I know I must rely on my mental health team when the depression gets like this.  I must remember, though, that I am a member of that team.  The treatment works best when we fight as a team.  

            If you notice any signs of depression in your life, I urge you to act quickly.  Don’t be afraid to seek help.  If you have never experienced depression before, you may want to start with your primary care provider.  He or she can screen for depression and provide you with a referral to a therapist or psychiatrist depending on your situation.  Be aware that some primary care providers are not good with mental illness.  I am lucky. Mine is great.  However, I have seen others who just do not care.  If you run into one who is not taking your needs seriously, be assertive.  Request to see someone else or demand a referral.  Depression is an illness and everyone who suffers from it deserves treatment.  

            You may not fit with the first mental health provider you see.  Do not be afraid to “shop around”.  It is important to find a therapist or psychiatrist who is a good fit for you.  Be honest with him or her about your symptoms.  I would recommend writing your symptoms and what you are feeling down so that you don’t forget anything.  

            Depression affects everyone differently.  I have shared my warning signs, but these may be different for you.  Even though we have different symptoms, it is still depression and needs to be treated. If you feel overwhelmed and can’t explain your symptoms to the provider, try giving him or her your list.  That way they know what you are experiencing and are better able to ask questions to evaluate your illness.

            Sadly, depression is an illness that often requires us to advocate for ourselves. As I have said before there is a stigma surrounding depression.  Know that depression is an illness, and you deserve treatment. There are organizations out there to help you.  One that I support and believe in is the National Alliance on Mental Illness (NAMI). They have chapters throughout the United States and offer great support and programs. I encourage you to check out NAMI. 

            Be aware of your mental health.  If something doesn’t seem right, trust your instincts, and ask a doctor.  Depression is an illness, but with the right help, it can be battled.

 

 

 

 

Moving Forward

                 I am sitting here wondering what I will write about today. Coffee sits on the table next to my computer. My thoughts are slow today, likely a result of the esketamine treatment I just had. The slower thoughts are indication treatment is working. The anxious thoughts that often fill my mind are at peace right now. Depression is being held at bay. I do not feel the darkness. Colors, mostly purples and greens, filled my awareness as the esketamine did its work. I emerged from the dissociation calm and feeling lighter. The weight of my mental illness lifted. 

                  Over the last few decades depression and anxiety have ruled my life, but treatments like esketamine and transcranial magnetic stimulation (TMS), bring relief. It took so long to reach this point. For too long I took medications that did not help. Sometimes the medications would mask things, but they never brought me healing. Medications were ineffective at best. At times they likely did more harm than good, especially when I became over-reliant on a benzo. I should not say “over-reliant”. I should call it what it was, an addiction. It was an addiction that tore me down and left me unable to function properly. Now, I have emerged from the failures of medication. I have a mental health team that understands my illness and more importantly, my needs. 

                  Today I am different than I was a few years ago. The gratitude goes to my mental health team. They pulled me out of the darkness by thinking outside the box. No more ineffective medications. Therapy and alternative treatments lead me into healing. I am able to live with my mental illness. Depression and anxiety are a part of my life, but they no longer rule it. At moments like right now, I can think clearly. I can acknowledge the positives that are a part of my life even though there are still challenges I must face. 

                  While I do not fully understand the science behind it, somehow esketamine enables my brain to function without the darkness of depression. Before treatment I set an intention. It is an intention I have been using during most treatments recently. That intention is simply three words: “Let it go”. As I am waiting to start treatment I write these words in my journal. I add some particular things I want to let go. Then I read the words a few times before the esketamine allows me to drift into a pleasant dissociation. By doing this I have given my mind the intention it needs to process during this time. My mind can work and prepare me to me to let things go. When I begin to emerge from the dissociation the words are still there, reminding me that I need to let go of all that hinders my ability to live fully. 

                  Finding the right mental health treatment is a gift. I know that I have two treatments I can rely on, esketamine and TMS, which also works for me. Treatment allows me to function. It allows me to embrace life in a new way. I recognize that I have my challenges. Mental illness will always be around. Cancer is there, lurking in the recesses of my life. Despite the presence of these illnesses, I am living. Sure, I struggle at times. That is part of life. I am moving forward. I expect some changes as I heal. Some changes will be challenging. Others will be just what I need. Being open to new treatments has allowed me to grow. I hope others read this, and if these treatments are right for them, I hope they take a chance on them. 

Finding Color in a World of Black and White

“I saw the world in black and white instead of the vibrant colours and shades I knew existed.”  

    ― Katie McGarry, “Pushing the Limits”

                  The quote above really strikes a chord with me. Much of my life has been in darkness, a black and white world, because of depression. Shadows have surrounded everything. Despite this darkness I have managed to reach middle-age. If you had told me I would be in my 50s someday when I was younger, I wouldn’t have believed you. Hope was something that I struggled with daily. And the future seemed bleak.

                  In the past few years, I’ve learned that hope does exist. There are colors in my world despite the darkness. My mental health team has taught me to see the colors. They have led me in the direction of treatments that provided those colors. That was an important part of healing because traditional depression treatment with medication doesn’t work for me. It started with TMS (transcranial magnetic stimulation). I didn’t see colors with TMS, but the darkness lifted, and I saw the world around me. I saw that there was a meaningful life in front of me. For more on TMS read these posts: "Renewed and Recharged: TMS Treatment"and "TMS: A Firsthand Account".  

                  TMS gave me a new lease on life. It gave me hope. I learned that I could heal, and that depression didn’t have to rule my life. There were still struggles. Depression is an illness.  Illnesses don’t just disappear. They can ease and we can learn to cope with them. I have received TMS treatment multiple times. Each time it has given me more light and allowed me to experience hope.

                  TMS alone is not enough. Therapy sustains me. It helps me maintain focus on the positive and reminds me to have hope. There are colors in hope because with hope the world is not dark. Engaging in regular therapy provides me with the tools to maintain hope. In that hope lies the colors of healing.

                  A couple years ago my mental health team and I decided I needed to try esketamine treatment. The darkness had re-emerged, and I was struggling. I was a little scared because I didn’t know how esketamine worked. I was afraid I would have frightening “trips” like I had read about hippies having in the late 1960s. My team helped me understand that I would not experience anything like that. So, we tried it. 

                  My experience was unlike anything I had experienced before. While under the effects of the esketamine I felt a floating sensation. I felt at peace. I saw beautiful colors with lights behind them. I floated through the colors. Purple and green were the most frequent colors I saw, but there were other colors, too. I began to associate the colors with healing. I felt safe. A change was occurring in me. The depression was lifting. The colors replaced the darkness.

                  Recently, my depression and anxiety have been creeping up. My team and I made the decision to try esketamine again. Much to my relief, the colors are still there. Purple is present every time. I think it is my healing color. I feel healing in the color purple so much so that I have written poems about it and painted with purple. 

                  For more on esketamine, read the following posts: "Gardening the Mind: Esketamine Treatment"and "Fertilization and Purple Lights: Esketamine Treatment"

                  I can’t explain why I see colors or why they are associated with healing for me. It is my experience.  I hope others can experience it, too. Maybe color is healing because colors represent an absence of the darkness. I don’t know. I just know that when I see the colors, I am healing. Hope returns to life, and I believe that I can heal. 

 

 

                  

                  

 

 

 

 

 

 

 

A Little More Gratitude and a Cancer Poem

            Last week I shared all the people I am grateful for in my life.  Today I want to share a few things I am grateful for and then leave you with a poem I wrote this past weekend.

            First, I am grateful for TMS (transcranial magnetic stimulation).  There have been two posts on this blog about TMS.  It has made such a difference in my battle with depression.  I don’t know where I would be without TMS.  It is a treatment that works for me, and I know will be a part of my life.

            I am also grateful for chemotherapy.  How can I not be grateful for something that is keeping me alive?  It may seem a little strange to be thankful for something that makes me feel like crap each week, but it is doing its job.  It is killing my cancer.  As sick as I feel I am grateful that the medical knowledge is available to treat my cancer and that I have a chance to survive.

            Another thing I am grateful for is the ability to write and experience the healing power of writing.  For as long as I can remember, writing has been a part of my life.  I would be interested in knowing how many poems I have written in my life.  Writing is a healing tool.  I am grateful that I can express my thoughts and emotions in writing.  I am grateful that I have this blog to share those thoughts and emotions with all of you.  My books are another source of gratitude for me.  Each one has brought me healing and allowed me to share my story with others.  

            So, I have a lot to be grateful for. Expressing my gratitude has helped me remain positive as I battle depression and cancer.  Don’t be surprised if you see gratitude pop up on my blog again in the future.  

            I also wanted to share a poem with you.  This poem is about the cancer, more specifically fighting cancer.  At times I get down because as much as I try to fight, I often just do not have the energy or stamina.  My body is weak from the fight.  When I start to feel down about needing so much rest, my Aunt Holly reminds me that even when I am resting, I am fighting.  As I thought about it made a lot of sense.  My body is in a fight for its life.  It needs time to heal.  That is what happens when I am resting.  So, even when I am resting, I am fighting.  That is where this poem came from.

 

Cancer Chose Me

 

Cancer chose me.

I did not choose cancer.

Cancer is ravaging my body.

Leaving me to fight.

At times I am weak, but still I fight.

Battling cancer takes all my strength.

 

Cancer chose me.

Its poison attacking my organs.

I fight back with a different poison, 

A poison meant to kill as it heals.  

My body is a battleground between cancer and chemo.

 

Cancer chose me.

Some days I must rest.

I cannot actively fight every day. 

Learning that it is okay to rest has been difficult,

But it is something I must accept.

 

Cancer chose me.

I did not choose cancer,

But I chose to fight back.

Meet the cancer head on

And fight for my life.

 

 

            Check back on Thursday.  I will be reflecting on how depression affects my fight. Depression can affect battles with any illness.  I will share my perspective. 

TMS: A Firsthand Account

    Recently, I shared a post by Stephanie Debnath, PMHNP-BC.  It provided a psychiatric nurse practitioner’s perspective and experience with transcranial magnetic stimulation (TMS).  Today I would like to share my experience as a patient.  

            My psychiatrist, Dr. S, first brought up the possibility of trying TMS in 2019.  I was struggling with depression.  Medication just did not help.  We discussed TMS and I was open to trying it.  

            When I first walked into SoCal TMS I did not know much about this treatment.  I had some basic information that Dr. S had shared with me.  I knew that she thought it could help me and I trusted that.  The SoCal TMS staff explained the treatment to me.  I filled out rating forms.  I completed all the necessary steps to get started.  Still, I didn’t know what to expect as we got started.  

            I was depressed.  I could not see my life outside of the darkness of depression.  I struggled with suicidal thoughts.   I was not sure anything could help me.  But Dr. S thought TMS was worth trying as did my psychologist Dr. K.  I was ready to give it a try.

            So, what is TMS like.  First, I sat in a large chair that reclined.  The psychiatrist and techs took measurements of my head.  They situated me in the chair and fitted a pad to the top of my head.  Soon I felt tapping.  It did not hurt.  There was a sort of rhythm to it.  They measured reactions to the magnetic taps in my hand. Quickly, they found the right settings and I was set for my first treatment.

            I attended treatment daily.  At first there were no noticeable changes, but the psychiatrist and techs encouraged me to be patient.  They said it would happen.  I just had to give it time.  Each session lasted about 45-50 minutes.   They were treating both my depression and anxiety.  

            After about three weeks I noticed my mood lifting. I felt lighter.  My thoughts were not as dark.  TMS was working.  I could feel the depression lifting.  I could not believe it.  I had never felt this type of lifting of my mood before.  Over the remainder of the treatment, my mood continued to improve.  I literally felt as if a weight had been lifted off me.  No medication had ever made me feel like this.  TMS was working.

            The psychiatrist explained to me that it was not a permanent change, but that I could expect to feel this way for several months.  He told me that the lifting of the depression lasts different lengths for different people. He promised me that when the depression came back, he would use TMS again to relieve it.  

            I could not believe how I felt.  I was not clouded in darkness.  For me it lasted several months.  When the symptoms of depression returned, Dr. S sent me back to SoCal TMS.  This time I was treated by Dr. Hutton, one of the leaders in TMS treatment and the head of SoCal TMS.  I learned a lot from him.  He set me up with treatment again.  My experience the second time was similar to the first time.  Again, around the third week, I felt the depression lifting.  By the end of treatment, I was feeling good.  

            TMS has been a godsend for me. I have lived with depression for almost four decades.  Noting had ever relieved it the way TMS does.  I do not understand all the science behind it, although Stephanie has explained a lot of it to me.  The one thing I do know is that TMS works.  

            Now, I monitor my mood.  I know when it is time for TMS treatment.  I am confident TMS will help me.  So, I will return each time it is necessary.  Based on my experience, I would recommend TMS to others struggling with depression.  If you haven’t already read Stephanie Debnath’s post on this blog, Renewed and Recharged (TMS),  from October 20, I encourage you to read it.  You can also learn more about how TMS works in my memoir, Traveling the Healing Journey: Finding the Light in Mental Illness. Check out SoCal TMS’s website and social media for more information and to connect with them.  See links below.

            I am not a mental health professional, but I can speak from my own experience.  TMS works for me.  I know it works for others.  I believe in this treatment, and I encourage others to explore it for themselves.

 

Links:

 

Get more information from SoCal TMS:

https://socaltms.com/

 

Learn about TMS in my book:

https://www.barnesandnoble.com/w/traveling-the-healing-journey-gina-capobianco/1142298691?ean=9798218067380

 

https://www.amazon.com/Traveling-Healing-Journey-Finding-Illness/dp/B0BFW7MVG5/ref=sr_1_1?crid=1U96Z0EWXCQ8&keywords=gina+capobianco&qid=1698627517&sprefix=gina+capobia,aps,143&sr=8-1

 

            

                           

Renewed and Recharged (TMS)

             Today’s post was written by Stephanie Debnath, PMHNP.  She is a psychiatric nurse practitioner who works with TMS (transcranial magnetic stimulation).  Full disclosure: she has treated me.  Today she shares her experience providing TMS treatment.  There is a link at the end of the post to the SoCal TMS website for more information.  There are also two links to my book, “Traveling the Healing Journey: Finding the Light in Mental Illness”, which includes an explanation of TMS and shares my experience.  

 

Renewed and Recharged

 

In my 18-year career in Psych Nursing I want to say I’ve seen it all. I’ve seen children with deep emotional disturbances, adults with intense psychological pain, and people of every age battling the extreme loss of quality of life. I’ve watched the recovery of addicts, disordered eating, and multi-faceted psychosis. I’ve seen a lot of lost wars. I’ve worked directly with the refugee, the rich, the poor, the unsheltered, and the celebrity. We all suffer from something. I’ve used my voice, my heart, my brain, and my hands. I’ve applied therapy, medication, electricity, and heavy bandages to try and heal my patients. I felt like I’ve seen it all.

 

The problem with thinking you’ve seen it all, is that you then assume a conclusion about people, the healthcare system, and the state of psychiatry. You assume you only can use what you have in front of you, or what others before you have used. You assume that the type of response you have gotten is exactly what you will always get. You have no desire to try something else, something new, or something different because, well—you’ve seen it all. 

 

In 2011, I started a new job at SoCal TMS Center to do TMS (Transcranial Magnetic Stimulation). I had no idea what I was getting into, but I knew I didn’t want to stay where I was. On my first day of training, I saw a woman, nearly catatonic. She was being walked into the treatment room by a caregiver and was stiff as a board. She had no life in her. It was difficult to get the treatment started, but we did. That repeated each day. Two weeks later, I saw her coming in again—this time, walking on her own. I asked her name because I didn’t recognize her. She was glamorously put together and had no caregiver. I was confused. How could this be? I saw this with ECT (Electroconvulsive Therapy), but this wasn’t as strong or severe a treatment. I then saw a man who had been in bed for 5 years come alive again. His wife even called me to ask for guidance, as she has never known this version of him in 20 years of marriage. I then saw a nurse who was hospitalized 22 times start doing her laundry, and baking a cake, and taking care of herself. She has not been hospitalized for the last 12 years. I then saw an elderly man who looked like my grandfather crying with relief, “I just wish this was around for me 40 years ago…”. I then saw a mother with postpartum depression able to care for her child again, and a woman with pregnancy psychosis almost abort her child for reasons she couldn’t fathom once she was better. I saw a doctor, and a teacher, and scientist, and an actor. I saw, I saw, I saw. Renewed, recharged. 

 

Day after day, week after week, year after year, I see. Twelve years later, I continue to see new things, new recoveries, new discoveries. It has left me renewed and recharged, too. When someone comes to me for help, I no longer view them through just the lens of my experiences—but through the lens of possibility. Instead of, “this treatment is not meant for that”, I can say, “perhaps, let’s see”. When someone is without hope and they think there is nothing left for them, I can lend them mine. I can honestly say we have not found a magic wand yet, but I am excited to know that I HAVE NOT seen it all.  

 

Stephanie Debnath, PMHNP

 

Get more information from SoCal TMS:

https://socaltms.com/

 

Learn about TMS in my book:

https://www.barnesandnoble.com/w/traveling-the-healing-journey-gina-capobianco/1142298691?ean=9798218067380

 

https://www.amazon.com/Traveling-Healing-Journey-Finding-Illness/dp/B0BFW7MVG5/ref=sr_1_1?crid=1U96Z0EWXCQ8&keywords=gina+capobianco&qid=1698627517&sprefix=gina+capobia,aps,143&sr=8-1