Making the Most Out of the Therapy Experience

                  Fortunately, people are more willing to go to therapy today than in the past. Therapy is an important aspect of treatment for mental health disorders. I am not a therapist, but I have spent my adult life in therapy to help me cope with major depression and anxiety. While that doesn’t mean I know everything about therapy, I think it gives me some perspective on how therapy works, how it is beneficial, and how patients need to do their part. Today I would like to talk about making the most out of the therapy experience.

                  I first saw a therapist when I was in college many years ago. It was the start of a healing process for me. In my twenties I went a few years without therapy. Those were very hard years. I found my way back to therapy when I was 29 because of a significant worsening in my depression. It was the most important thing I could have done.  I am lucky, I have been with the same therapist, a psychologist who understands me and supports me, since then. 

                  It’s hard to think back that far and remember the details. I know that one of the first things he helped me was to quit drinking. As a teenager I learned to self-medicate my depression with alcohol. It was not helpful, but it is how I coped for about 15 years. Dr. K, my psychologist, guided me through the stages of becoming sober, while also addressing my depression, which had become intense. I am proud to say that with his help I am 22+ years sober. 

                  I learned early on that I had to do my share of the work. Healing takes place through the interaction between patient and therapist. We’ve talked a lot over the years as my depression has ebbed and flowed. I lean on him to make sense of a lot of what I am feeling. What helps is how he reflects my words back to me. This enables me to play an active role in my therapy experience. One way I have worked on this is through journaling. I write in my journal after appointments. It helps me remember his advice and allows me to delve further into our conversations. Writing helps me process my world. So, it makes sense that I would write after therapy appointments. Sometimes I share what I have written with him. Doing so provides affirmation of what I am thinking. 

                  It is important to do the work necessary to process what you talk about with your therapist. I do that by writing. There are other ways to engage in this process. Meditation might be a way some people process their sessions. Something as simple as going for a walk and thinking about your conversation can help. The important thing is to hold onto what you work on in therapy. It won’t be as beneficial if you just think about it while you are in session. Processing should take place in and out of the session. 

                  One think Dr. K has taught me is self-hypnosis. We end every session with a bit of hypnosis. It is only a few minutes, but he always gives me a hypnotic suggestion that I can take into my week. When I am struggling, I use self-hypnosis to recreate the relaxation created during the in-session hypnosis. This allows me to approach whatever is weighing on me with a clearer head.  Often, I use self-hypnosis when I can’t sleep because my mind is whirling with thoughts. I take what I have learned in the therapy session and use it to help me when I need to cope on my own. 

                  Another way to enhance therapy is to become involved in mental health activities. I choose to do this through NAMI (National Alliance on Mental Illness). Through this organization I have learned to speak about my mental health in a positive way. I have shared my story with others. In doing so, I support myself and let others know they are not alone. Dr. K has encouraged my involvement with NAMI. It has allowed me to grow in my understanding of my mental illness and in my ability to help others. 

                  Reading about mental illness or listening to mental health podcasts, like The Giving Voice To Depression Podcast can also help. I find this enables me to understand that I am not alone. So often depression isolates us. It tells us we are alone. When we are struggling it is difficult to see that it is an illness causing us to feel the way we do. I find that by listening to podcasts like this I feel more connected and less alone. The Giving Voice to Depression Podcast has a wealth of episodes that can help individuals who are living with depression. 

                  My point in this post is that therapy in isolation is not enough. A therapist can help us, but we must do our part. We need to be active participants in the therapeutic process. That is the only way to heal.  Unfortunately, there is no magic cure. Healing takes effort. I know it is difficult to make that effort when we are struggling. I have been there. I have struggled. The work we do when we are feeling a little better can help with this.  If you are not sure how to get the most out of your therapy sessions, ask your therapist for support with this work. It can make a difference.  

Eeyore – A Character with Depression

                  Last week’s Giving Voice to Depression Podcast episode, “Inviting the Eeyores” inspired today’s post. Check out the podcast at https://givingvoicetodepression.com/ or wherever you listen to podcasts. 

                  Depression is more present in society than is generally acknowledged. Gratefully, that is starting to change. We are seeing mental illness portrayed in a more positive light. Today I would like to share a character that has been “living” with depression for quite a long time. 

Eeyore is well-known character from the “Winnie the Pooh” stories. Many people believe that Eeyore suffers from depression. According to the Florida State College at Jacksonville Pressbooks, Eeyore exhibits five symptoms of a major depressive episode. Those symptoms include “…depressed mood most of the day, markedly diminished interest or pleasure in activities, fatigue or loss of energy nearly every day, feelings of worthlessness, and diminished ability to think or concentrate.”  Based on the stories Eeyore has experienced these symptoms for several years. The symptoms Eeyore exhibits lead one to believe that he struggles with depression. If we diagnosed fictional characters, Eeyore would likely have a diagnosis of major depression.

I can relate to Eeyore. His symptoms match mine and countless others with depression. I have felt the low mood and feelings of unworthiness. I struggle with diminished interested in activities that at other times I enjoy. I can relate to Eeyore’s difficulty concentrating. We both live with depression.

There are no psychiatrists or therapists in “Winnie the Pooh”, but Eeyore does have a group of friends who support him and keep him around despite his depression. I think society can learn a lot from Eeyore’s friends. They accept him as he is. They don’t try to change him. They don’t force him to do things he is not up to doing. Instead, they treat him with care and are just happy to have him around. Eeyore’s friends let him hang out with them even when he is struggling with depression. They accept him as he is. We can learn a lot from these fictional characters. 

I know when I am not up to engaging in activities, I appreciate friends and family who text to check in on me. It means a lot to me when they show an interest in how I am doing, but don’t force me to act in a way I am not capable of acting because of my depression. The understanding is the important part. Understanding that a person with depression is not able to do things you may want them to do helps. When someone with depression cancels plans or says no to an invitation, it is not because we don’t want to do things with you. Rather, it is because we can’t. Depression paralyzes us. It leaves us unable to engage in activities. 

Eeyore’s friends understood this. I don’t know if A.A. Milne, the creator of the Winnie the Pooh stories, intended to have a character with depression, but I am glad he created Eeyore the way he did. Even though he is a children’s character, I can look at him and see myself reflected in Eeyore. Maybe when I am struggling, I should tell my family and friends to check out Eeyore and his friends.  These characters who were intended to entertain, are really teaching a valuable lesson.  Accept people with depression as they are. Don’t try to change them. Don’t force them into activities they are not able to engage in.  Eeyore’s friends may not have known that he had a mental health disorder, but they understood him and what he needed from them. Life would be easier for those of us with depression if more people were like Eeyore’s friends. 

What It Is Like to Live with Depression

                  I write a lot about depression. I have shared my story of a lifetime of depression and anxiety. I have shared healing tools and coping strategies. I have posted about alternative treatments for depression. I think I have covered a lot in the past year plus. One thing I don’t think I have done is provide a picture into what depression looks, feels, and sounds like. So, here goes.

                  As I have shared in the past depression started for me when I was 14 years old. That is over three decades ago. I have had more experiences with depression than I can count. There are many commonalities. However, depression can express itself differently at different times. What is common, at least for me, is the darkness. It seems like there is no way out of depression. When depression blankets me, I feel trapped. I can’t see the light of healing. 

                  I guess if I were to describe what depression looks like, I would say it looks like a dismal rainy day. No light peeks through the clouds. Everything is dark. That darkness can be viewed as a lack of hope. When depression has me in its grips, I don’t see anything except the depression. It is painful. Depression has varying degrees. I have experienced levels of depression in which I have wanted to end my life. Everything has seemed so hopeless that living didn’t seem worth it. I have also experienced levels of depression in which I can function. The darkness comes in varying shades. I don’t know if functional depression is the correct term for it, but there are times when I am depressed, but I can still function. I have been able to hold down a job despite my depression. It has never been easy, but I learned how to hold the darkness aside during the workday. That usually meant the evening would be rough, but I did it. You may be surprised at how many people function with depression. There have been other times when I have been unable to work due to my depression. Just like with any serious illness, I need care.

                  What does depression feel like? For me this varies. Sometimes it feels like I am consumed by lethargy. I don’t want to do anything. I have no motivation. Just getting out of bed in the morning is a struggle. At times it feels like I am stuck in vise grip. I feel like I am being suffocated. I can’t escape the depression. It is scary feeling. The stronger the grip of that vise, the more I want to end my life. Depression may be a mental illness, but the physical pain is real. 

                  Other people can’t hear depression, but it is loud in the minds of people with depression. I hear a negative dialogue running through my mind. It tells me many things that are simply not true. I hear depression tell me I am not worthy, not good enough. I hear it tell me life will never get better. I hear it tell me I am trapped. I hear it tell me that no one wants me around. At its worst I hear depression tell me I don’t want to live. What makes these messages even more painful is that I hear them in my own voice. It sounds as if it is me talking when really it is the illness. It is hard not to listen when the voice is your own.

                  From this description I think it is obvious how painful depression is. What people on the outside don’t understand is that depression is not a choice. It is an illness and must be accepted as an illness if it is to get better. I have learned through a lifetime of struggle that I have an illness. I am not my depression. Rather, depression is an illness that has attacked me. I don’t like being depressed. I would do anything to be done with it. 

                  There are treatments that ease the depression. There are times when I feel better because of those treatments. Right now, I am going through esketamine treatment. It is helping, but it takes time. I must trust that the esketamine will lift the depression. I can’t rush it. Treatment needs to run its course. At some point my days will be easier. They are already starting to be. 

                  You may ask how I am able to write this blog when I am depressed. That is a good question. I think I have lived with depression for so long that I have learned coping skills that allow me to function most of the time. There are still times when I can’t function. During those times I need to allow myself the space to heal. There are times when I am away from this computer keyboard that the thoughts are too much for me to handle. I know I need to reach out during those times. Tuesday is an example. I reached out to a member of my team because my head was in a bad place. A few words from that member of my team and some writing about those words on my part helped me. Everyone with depression is different. We all need to figure out what we need to do for ourselves when times get difficult. If we are lucky, we find those ways and are able to use them. 

                  Depression is an ugly illness. We need to learn to fight it. Fighting depression includes accepting help. We shouldn’t expect ourselves to go it alone. I have two illnesses. I am also fighting cancer. I would never be able to fight my cancer on my own. The same is true of depression. I should never expect myself to fight depression alone. No one should fight depression alone.

 

 

                  For more on esketamine treatment, read these earlier blog posts: 

Gardening the Mind: Esketamine Treatment by Stephanie Debnath, PMHNP or one from my perspective: Fertilization and Purple Lights: Esketamine Treatment

 

 

I’m Still Here

                  My life has been a series of battles. Most often I have battled depression. It first started when I was in my early teens and has continued for over 35 years. Depression and I are old sparring pals. We have had knockdown, drag out fights. Depression has tried to take my life many times. Despite depression’s efforts, I have fought back each time. I have not always been able to fight back alone, but I have fought back. I have stared depression’s death threats in the eye. 

                  I have learned to live with depression and its partner, anxiety. By no means has it been easy. In fact, it has taken a lot out of me and cost me a lot. I have missed out on a lot in life because of these two foes, but I continue living. There have been good times and there have been bad times. Unfortunately, there have also been some really bad times. At times I have felt like I was being dragged through hell. Despite this, I am still here.

                  Cancer joined the fray a little over a year ago. It burst into my life at stage 4, poised to kill me as it spread. It was a diagnosis I was unprepared for and not expecting. Even though I was scared and unsure about my opponent, I fought. My years of fighting depression and anxiety taught me that I had a fight inside of me. The fight with cancer was different.  It made me physically sick and very weak. Of course, depression and anxiety loved this and piled on. 

How did I fight mental and physical illness at the same time? It doesn’t seem possible that I have emerged from the battles. But I’m still here. First, I must credit the people around me. My aunt was by my side from diagnosis on. Other family and friends were there. My mental health team was there throughout. My psychiatrist, psychologist, and psychiatric nurse practitioner lifted me up and helped me keep the depression and anxiety at bay as I focused on fighting cancer. They encouraged and empowered me. I was blessed with an amazing oncologist who put my cancer in the crosshairs and attacked it. My primary care provider was there to encouraged me and keep me fighting. Two nurses stepped into my life and taught me how to fight. One, my oncology nurse navigator, showed me how to dance atop cancer. She helped me find a rhythm in this battle and gave me a reason to smile. The other nurse, my primary’s nurse, lifted me up with encouragement and reminded that me I would be okay.

Depression, anxiety and cancer have all taken aim at me. They have pushed me to the edge. At times I didn’t believe I had the strength to fight. I thought I would lose the battle. The people around me wouldn’t let me give up. I took their belief in my ability to fight and did just that. I fought. I have won battles, but I know this is a war. I will need to continue fighting. That’s okay. I’ve learned there is a fight in me. I hope others see it and find the fight within themselves. That would give my fight more meaning.

Good things have come out of my fight. For one, I’m still alive. Obvious one there. But there are other things. I’ve learned to live in the moment. Tomorrow isn’t promised. We need to do what we want to do and say what we want to say while we have the opportunity. Two things I want to do are go to Italy and write. So, I’m doing them. In October, I will head to Italy with a friend. I will explore the towns my family came from. I will see beautiful works of art and eat incredible food. Every day I write. I have submitted pieces for publication, and I post on this blog twice a week. In addition, I am working on two books that I hope to publish before the end of the year. 

The illnesses I fight chose me. I didn’t choose them. Despite how much they have torn me down, I have learned from depression, anxiety, and cancer. I have learned the value of life. I have learned who is important in my life and I know I have some wonderful people supporting me. Depression, anxiety, and cancer tried to take me life, but I’m still here.

 

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.             

 

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. 

 

My Pen – Writing as a Healing Tool

                  Having lived with depression most of my life has required me to develop coping strategies and healing tools. I have a great mental health team, but I can’t lean on them 24/7. So, I need tools to rely on in those moments when I am struggling on my own. Some of these tools have become a part of my daily life. The most significant tool I have is writing. 

I write every day. I write more when I am struggling. I write in different forms. Poetry has always been my go-to writing form. It is the type of writing that I discovered first in my battle with depression. I started writing poems as a teenager. I filled notebooks with these poems, which expressed what I was going through. I still write poems decades later. The poems seem to just pour out of me especially when I am struggling. I don’t know. Maybe I think in poetry. Many of my poems are dark, which makes sense. Depression is dark. As I have found healing, I have been able to write poems that evoke that healing. I am proud of both types of poems. They express who I am and what I live with. 

My writing has taken other forms over the years. You are reading one of those forms. This blog keeps me going. It provides me with a space to write about depression, which is healing for me. I hope that my posts bring healing to others. I also hope that it brings an understanding of depression to those who do not experience it. It is through understanding that we can help each other. 

Before I share a poem, I would like to invite readers to learn about the healing power of writing. I will be giving a talk for NAMI Glendale next Thursday, June 20^th at 7:00 pm. It is on Zoom. The link to register for this free event is at the bottom of this post. It will be an interactive talk that provides attendees with the opportunity to try writing. 

Now, for the poem. This poem can be found in my book, A Light Amidst the Darkness: Illuminating Mental Illness and Suffering. The poem is titled, My Pen. It explores what is happening inside of me as I write. Rather than explain the poem, I’ll let you draw meaning from it. 

 

 

My Pen

 

When my mind is full of turmoil I turn to my pen,

Reach for my journal and begin to write.

Words take the form of lines.

The poison pours out of me.

My pen is an instrument of healing.

The ink gives life to the words I cannot voice.

Line after line, page after page filled with my thoughts.

I feel each thought as it leaves my mind to make its mark upon the page.

The page soaks up my memories;

Becomes stained by my pain.

Dark thought after dark thought is released

And allowed to breathe on the page.

In these moments I feel lighter.

A sense of healing envelops me

As my turmoil escapes

My pen provides this passage to healing.

Each poem I write gives me the courage to continue.

My journals hold the reality of my pain.

Relieving me of my pain

And allowing me to live.

 

 

                  If you are interested in joining my talk, Writing as a Healing Tool, use the link to register.

 

https://namiglendale.org/event/writing-as-a-healing-tool/

 

Self-Care Ideas for When You Are Struggling with Depression

                  We all struggle at times. For some of us that struggle is more frequent. It seeps into all aspects of our life. When you have depression, the struggles become harder to pull yourself out of. Regular self-care can help ease some of the darkness. It is not going to cure it, but it can help.

                  What is self-care? Simply put, self-care is doing things to take care of yourself. It can be things that address your mental health. Self-care can also address your physical health. It involves doing things that make you feel better. These activities can range from simple activities to enacting more elaborate plans.

                  For me self-care includes taking walks and writing. When I walk, I usually listen to music, which is another self-care activity. Writing allows me to release the thoughts that build up in my mind. I also like to be creative. Painting is a form of self-care for me. I enjoy watching the colors transform into something.

                  What are some other self-care ideas? 

                  

·      Meditating

·      Spending time in nature – think walking on the beach or in a forest

·      Deep breathing

·      Cooking

·      Reading for pleasure

·      Yoga or Pilates

·      Talking to a loved one on the phone

·      Having lunch with a friend

·      Dancing

·      Making a gratitude list

·      Getting a massage

·      Practicing affirmations

·      Taking a class to learn something new

·      Watching a movie

·      Sitting under the stars

·      Lighting some candles 

·      Playing an instrument

·      Doing something special for a friend or family member

·      Doing something you loved as a child

 

Self-care can be anything that makes you feel good about yourself. It takes practice.

You may do something and not get the lift you were expecting. That is okay. Don’t give up. Sometimes it takes time for self-care to affect you. The idea is to make it a part of your routine. You want to build up a repertoire of activities that you can lean on when you need a lift. 

                  When depression gets heavy, I sometimes have difficulty turning to my self-care activities. Sometimes I need a reminder. It is hard. Depression can be paralyzing. That is why it is important to prepare a list of self-care activities when you are feeling a little better. Maybe write them down. Put the list in your phone. Set a reminder to look at the list.  That might make you more likely to try something. You can also share your list with a friend. I have a friend that reminds me to listen to music. Sometimes we listen to live music together. It helps both of us. 

Whatever you choose to do as self-care, remember to give it a chance to help you. Also, give yourself grace. It is okay to feel down and to struggle with depression. You are not alone. Remind yourself about that. As lonely as depression feels, you are not alone. There are so many of us who go through what you are going through. Joining a support group is another self-care strategy. If you think this might help you, I recommend checking with your local NAMI chapter for a group. 

Self-care is not easy. Nothing about living with depression is easy. Take it one step at a time. Try one of the above self-care activities or search for other activities online. Don’t be afraid to take a mental health day from work or school to engage in self-care. I used to be afraid to take mental health days, I thought my mental health wasn’t a legitimate reason to take time off. I learned the hard way that I should have taken days off. I should have put myself and my mental health ahead of my job. Please take the time to engage in self-care. Allow yourself to heal. Remember mental health days are a part of self-care. 

Whatever self-care activities you choose, remember that they are for you. Engage in the activity in whatever way feels best to you. Give yourself the grace to search for the activities that help you most. 

There Is Hope

“There is hope, even when your brain tells you there isn’t.” – John Green

 

                  The above quote is powerful. When you live with mental illness, or any illness for that matter, hope can be difficult to hang onto. I have struggled with hope in my battle with depression and anxiety and in my fight against cancer. What is hope? The Merriam Webster Dictionary defines hope as “a desire accompanied by expectation of or belief in fulfillment.” 

                  Hope has been tricky for me. Decades of living with depression make it difficult to believe that there is freedom from depression’s darkness. At the same time, I have had healing experiences that allow me to believe that I can get better. At times I lose sight of the healing periods. My mind gets caught up in the hopelessness depression creates. It tells me that the depression will win. My view is clouded by darkness. When I am feeling hopeless, I know I need to hang onto the hope of my mental health team. Their hope for me  sustains me when I cannot believe in hope myself.  

                  I know I am struggling beyond my ability to cope on my own when my thoughts turn to thoughts of ending my life. Suicidal thoughts are a sign that I have lost hope. Despite a lifetime of those thoughts, I am still here. I think that is because hope can exist even in the darkest of moments. I don’t really understand how it happens. It just does. I have been lucky that I have been able to reach out in my darkest moments. I’ve been told that takes strength and means that there is hope somewhere inside of me. When I have suicidal thoughts, my brain is trying to tell me there is no hope. However, as Green says in the quote above, there is still hope. Our brains get talking and try to mask that hope, but it is there. 

                  For me finding that hope requires reaching out. I realize that reaching out can seem impossible for some people. At times it seems impossible for me. That is why it is important to plan for those times when the thoughts aren’t screaming at us. Whether it is just knowing who to call or having a concrete safety plan, it is important that we have a plan for when hope seems to disappear. It can still be difficult to reach out to those who will help us through the darkness. However, if we have a plan, we are more likely to try to use it.

                  What about those times when we feel hopeless but are not suicidal or thinking about self-harm. Those are still difficult times. Sometimes I get caught believing that I will never know anything other than the darkness of depression. For me that is a sign that it is time to return to one of the alternative treatments that help me. Whether it is TMS or esketamine, I know I need to get treatment. Knowing what treatments or medications work for you is important. Being able to openly discuss what you are feeling and experiencing with a psychiatrist or psychologist is crucial.  He/she/they will be able to listen to what you are sharing and provide the necessary treatment. Trust comes into play here. I believe it is vital to be able to trust your mental health provider not only knows what you need, but that they are willing to ensure you receive that treatment.  

                  Depression attacks hope, but hope is resilient. We possess it even when we are unaware of it. Hope is present when we get out of bed, when we spend time with a friend, or when we go to work. Hope is present when we reach out for help. It is present when we try one of our coping strategies or engage in self-care. Hope is a light shining in the darkness of depression. Sometimes hope is faint, but it is still there waiting for us to hang onto it. Hope whispers back when our brains tell us there is no hope. Sometimes it will be our voice. Other times it will be the voice of a mental health care provider or a loved one. Listen for the whisper of hope and hang onto it. 

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. 

                  

 

 

Things You Can Do to Support Your Mental Health

                  Living with mental illness is not easy.  Often, even the simplest of tasks weigh heavy.  Getting out of bed can seem to be a Herculean task.  The darkness of depression can shroud your world.  So, what can we do to ease this heaviness?

                  One thing I think is important is to practice coping strategies when the darkness of depression is not as heavy. This will make it easier to engage in these strategies when the depression is bad.  I have tried to develop several coping strategies for myself.  I am not always good at turning to my coping strategies. That is part of the nature of depression.  When it has you down, it is difficult to engage.  That is why it is important to practice coping strategies.  In a sense they need to be somewhat automatic at times.  The more automatic strategies are, the easier they are to turn to when they are needed.

                  Coping strategies are supports that can help a person deal with depression in a healing way.  Here are some coping strategies you can try:

 

·      Listening to music

·      Writing/Journaling

·      Drawing

·      Walking

·      Exercising

·      Yoga

·      Painting

·      Meditation

·      Playing with a pet

·      Sitting with a friend or family member

·      Taking a shower

·      Sitting on the beach

·      Getting out in nature

·      Gardening

·      Deep breathing or other breathing exercise

·      Playing a musical instrument

·      Going to a support group

 

These are just some examples.  Coping strategies can be unique to each individual.

What works for one individual may not work for another. That is okay.  The important part is finding what works for you.  Try different things out.  Don’t get discouraged if something doesn’t work.  I know that is a difficult task when you are depressed.  That is why I think it is important to try coping strategies out when you are feeling a little better.  Then you know what you can turn to when the depression is worse.  

                  I have learned that writing, listening to music, walking, and painting work best for me.  I do want to try other things.  One thing I am considering is learning to play a musical instrument.  It may or may not work, but I can try.  The important thing is trying.  If we don’t try out different coping strategies, there is no chance we will find what works for us and we will be trapped in our depression.  

                  Coping strategies are not the only answer to depression.  Rather, they are a part of our toolkit.  Our depression toolkit might include medication and therapy.  It might include non-traditional treatments such as TMS, ketamine, or ECT.  Depression is an illness.  It requires treatment.  We can help that treatment be more effective by engaging in coping strategies.  

                  You may find it helpful to share your coping strategies with people who support you.  My mental health team knows my coping strategies.  The friends and family members I am closest to also know them.  By knowing my coping strategies, they can encourage me to try one when I am struggling with my depression.  I have found this to be very helpful.  Sometimes it is difficult to turn to a coping strategy on my own.  Having someone gently remind me helps.  

                  I encourage you to discover your own coping strategies.  Maybe it is something from the list above. Maybe it is something totally different.  Share your coping strategies in the comments section below.  You might have a strategy that will help someone else.