Reaching Out

Today I would like to share a poem. I hope everyone reading this will consider the importance of reaching out. There are times in each of our lives, no matter who we are, when we need to reach out. It may because of depression or other mental illness. It may be a physical illness. It may be due to a family or relationship issue. It may be something you are struggling with.  It may just be a part of life. There are as many reasons to reach out for help as there are people in this world. I encourage everyone to reach out for help when you need it. Even if you feel like you should be able to get through it on your own, reach out. There is no shame in reaching out. It makes us stronger. We are not meant to live in isolation. So, please reach out whenever you need to.

 

 

Reaching Out

 

Reaching out for help

When the darkness becomes overwhelming

Is not an easy task.

It requires strength when we feel so weak.

We often think we cannot reach out.

We fear we will be rejected.

Afraid others will not understand.

Unsure of who to seek out.

One word is all it takes, or even

A simple phrase,

“I need help”.

 

The darkness is real.

Depression lies to us,

Makes us believe the darkness is all there is,

But that is a lie.

We may not see the light, but

The light is there.

Waiting to embrace us.

Welcoming us into healing.

While it is not easy,

We must reach out.

 

One hand emerges from the darkness.

Reaches out to you.

Grabs hold and strengthens you.

Extend your hand and hold on.

Accepting help is okay.

Reaching out should be our norm.

Others have been there.

We are not alone.

 

Reaching Out for Help

                  So many people with depression or other mental illness live in the darkness unable to reach out for help. For most of my life that was me. I didn’t reach out because I didn’t know I could. I feared being ridiculed. I thought I would be unheard. These fears are a reality when you live with mental illness. I have faced stigma from family, friends, in the workplace, and in the healthcare setting. 

Perhaps the worst was when I was ridiculed by a physician’s assistant because of my mental health. I wrote about that in a previous post (https://depressionbentnotbroken.blogspot.com/2024/01/turning-hurtful-words-into-healing.html ). Fear of stigma and ridicule and the lack of understanding of mental illness make it difficult for people who are suffering to reach out. It shouldn’t be that way.

We need to create an atmosphere where it is okay to say, “I need help,” or “I am struggling.” We have come a long way. Back when my depression started in the late 1980s, I couldn’t reach out for help. There was no understanding. Today, society is more understanding, but we still have a long way to go. 

My intent in this post is to encourage anyone who is living with mental illness to reach out when they need support. Is that hard to do? Yes. Is reaching out worth it? Definitely. Reaching out means taking a risk. It is hard to know where to start. Who do you trust? How do you know who can provide the help and support you need? Those are individual questions, but I think there are some commonalities that we can rely on. In most cases, if the depression or other mental illness has never been addressed, I would recommend starting with your primary care provider. Most are going to be responsive. I believe the primary care provider who hurt me is an exception. Today most primary care providers understand they have a role in mental health. Let this provider refer you to psychological care. 

You can also contact organizations such as NAMI (National Alliance on Mental Illness) To find your local chapter click here: https://www.nami.org/. They provide resources and have groups that can make a difference. There is also the 988 helpline. They can connect you to resources and provide assistance in mental health emergencies.

What if you are already diagnosed and you have mental health support? Reaching out for help can still be difficult at times. You may feel like you must wait for your next appointment to get support. Maybe you are having difficulty expressing what you are going through. It is okay to reach out to your mental health provider when you are struggling. It is normal to feel like maybe you should handle it on your own or to think you are taking up their time. However, most mental health providers would rather you reach out than struggle in silence. There are times when you need help. Be honest with yourself. There is no shame in not being able to handle mental illness alone all the time. Sure, there are moments when we might have to push through on our own, but that doesn’t mean we can’t reach out. One thing that helps is to have a safety plan. For more on safety plans, check out my article on the NAMI Glendale website (https://namiglendale.org/how-a-safety-plan-can-ease-a-mental-health-crisis/).

Reaching out for help is not a sign of weakness. It is a necessary part of life when you live with mental illness. These illnesses can be overwhelming at times. We can’t expect to be able to handle it on our own all the time. All illnesses require care. Mental illness is no different. Stigma can make it hard, but reaching out can make a difference in our lives. 

I think if we asked our family and friends, they would rather us reach out to them when we are struggling than speak at our funerals. That may sound extreme, but in many cases, it is reality. As hard as it can be at times, I encourage people to reach out when the darkness of mental illness is heavy. Know that it takes courage to reach out, but that courage is in you. Even though it is not easy, reaching out is worth it. 

Talking Back to Depression

                  Depression brings with it many difficulties.  One difficulty that can be particularly troublesome is negative thoughts.  I have struggled with negative thoughts my whole life.  The depression takes control, and it tells me things that are either not true or are overexaggerated.  These negative thoughts can easily take control and put me in a tailspin.  The tailspin can lead to suicidal thoughts, which then puts me in crisis.  I know I am not alone in this process.  People with depression struggle with negative thought patterns.  We need strategies to stop these thoughts.  

                  Over the years I have had a lot of help learning how to tell the thoughts to stop or to talk back to the thoughts.  Therapy has played a key role in teaching me these strategies.  I have learned these strategies from each of the members of my mental health team.  I am not perfect at using them.  Knowing the strategies is not enough.  They must be utilized in time to avoid a downward spiral.  I would like to share some of the ways I talk back to the negative, depression-fueled thoughts.  I would caution you that this is just what I have tried.  Sometimes I still struggle with it.  Depression is an illness.  It doesn’t just go away because we tell it to or because we want it to.  It requires constant effort.  Sometimes there will be failure.  That is okay.  As with any illness, depression requires constant care.  If one of these phrases doesn’t work, try another.  Remember there will be times when you need to reach for support either from loved ones or mental health professionals.  That is okay.  I can’t stress this enough.  It is okay to reach out when you are struggling.  

                  My go-to word when I notice the negative thoughts is simply, “stop”.  I say it in my head.  I try to tell the thought to stop.  I don’t try to argue with it or persuade it to be different.  I simply say “stop”.  This is an interruption strategy.  I am trying to interrupt the negative thought to get it to stop.  This is most effective if I catch the thought early.  When this works, I then try to replace the thought with something more positive or at least something neutral.  

                  The single word “stop” is sometimes not enough.   This is when I try to tell my thoughts that I know it is the depression talking and I am not going to listen.  This is a little harder than just saying “stop”.  I find myself saying something like, “I hear you telling me that life isn’t worth it, but I am not going to listen this time.”  I usually need to repeat it a few times to get the message across.  Sometimes I pair it with the word “stop.”  I may repeat that I am not listening.  At times I say, “Depression, I know you are trying to take control, but I am not going to allow that to happen.”  This is by no means easy.  It is often frustrating.  The voice of depression is loud.  It is also strong.  

                  Another phrase I use in my head is “Hey, Depression, I know you want control, but I can’t let you have control.  This is my life.”  I know it sounds strange to have conversations in my head. I am not talking out loud.  These are my thoughts talking back to the depression in my head.  It is a strategy that can be employed when the thoughts get strong.

                  When these phrases don’t work, I try writing.  If I can write my thoughts in my journal or on my computer, I can give them a sense of control.  I can also get the negative thoughts out of my head and make them concrete.  Sometimes just getting them out on paper is enough for me.  Other times I need to share what I have written with someone.  I usually share these written thoughts with one of the members of my mental health team.  If this strategy sounds good to you, know that you could also share your written words with a trusted loved one.  However, if the thoughts turn suicidal, I would recommend reaching out to a mental health professional.

                  There are times when talking back and writing are not enough.  Remember, depression is an illness.  It can vary in its strength from day to day or even moment to moment.  Another strategy I try is distraction.  For me music is a solid distractor.  When I am listening to music to distract myself from depression’s voice, I focus on listening to the lyrics.  Usually, I choose songs that I know resonate with me.  If I can get my mind to focus on the words of the song, those words can replace the thoughts in my head.  When I use this strategy, I like to lie in bed and close my eyes.  Other times I listen to the music while walking in my neighborhood.  I only do this when I feel safe enough to leave my house.  If the thoughts are too overwhelming or they are getting into that suicidal territory, I prefer to keep myself in my bedroom, where I have established a safe zone.  

                  Depression is often a solitary illness.  There is a lot of aloneness to it.  Despite this, it is important to remember that depression cannot be defeated alone.  So, when the thoughts get to be too much for me to handle on my own, I know I need to reach out.  For example, if I am having thoughts of hurting myself and they don’t respond to my initial attempt to stop them, I know I need help.  It is at this point that I will call my psychologist and leave him a voicemail, which I know he will receive because we have talked about this as a safety plan.  Depending on your situation, you might want to reach out to your mental health provider, a loved one, or to the 988 helpline. If the person you plan to reach out to is a loved one, you should create a plan in advance that lets the person know how to respond.  A simple safety plan might include what that person should ask you or say to you and who he or she should contact if necessary.  The plan should also include an explanation of when the person needs to reach out for professional help.  I have a plan and have shared it with the people in my life, who I would reach out to in if the self-harm or suicidal thoughts are in control.  

Reaching out is a sign of strength.  It took me a long time to realize that.  It is a lesson I needed to learn.  Often when we suffer with depression, we believe no one else understands.  To some extent it is true that people who don’t live with depression don’t understand, but that doesn’t mean they don’t want to understand or that they aren’t willing to help.  That is perhaps one of the greatest lessons I’ve learned in recent years.  Even in our darkest moment, those moments where the depression has taken complete control, there are ways to get help.  I encourage you to make plans for these times when you are not in the midst of depression’s stranglehold.  Discuss it with someone when you are in a place where things aren’t as bad.  This will allow you to have a plan for those darkest moments.  On the other side of the darkness, you will be glad you had a plan. 

Living with the thoughts depression creates is never going to be easy.  We need to make plans.  Think of it as a prescription for living with depression.  Not all prescriptions are for medication.  Knowing how to talk to depression and how to reach out are important parts of our treatment.  You might need to practice talking back to your thoughts with a mental health professional.  That is okay.  It is normal.  Your provider will understand and will help you.  Don’t allow depression to gain complete control.  Make a plan for dealing with the varying stages of the illness.  Ask for help.  Depression is an awful illness, but we can fight back.

I will leave you with this thought.  Depression is an awful illness, but it is one we can fight when we make plans and have strategies for dealing with it.  I encourage you to talk to your loved ones and mental health professionals about how you will talk back to depression and how you will reach out when necessary.

 

 

Experiencing a Sense of Loss with Depression

                  Depression carries with it a lot of difficulties.  Over the years I have experienced most if not all of them.  One difficulty that surfaces with depression is a sense of loss.  This sense of loss can make the darkness of depression worse.  The loss does not have to be a physical loss, although it can be.  

For me the sense of loss stems from all the depression has taken away from me.  I am very aware of all that I have missed out on in life because of my depression.  On an everyday level, I have often stayed home or hid under the covers in bed to avoid letting others see my depression.  Often, I have said no to invitations to spend time with friends or family because the darkness is too much for me to cope with in the moment.  I have spent many days and evenings alone hiding my depression.  I miss out on fun times.  I miss out events and experiences.  The depression tells me I am not well enough to join in activities with others.  Sometimes it tells me I don’t deserve to join in with others.  When the depression talks to me like this, I find myself staring at the walls in my house. I tell myself that I am safest at home alone.  I shed tears.  I question why my world is so dark.  Sometimes I wish I could be like friends and family who seem to be enjoying life.  The experiences I have lost are gone for good.  I can’t go back and relive moments missed throughout my life.  That’s where the sense of loss stems from.  I have lost experiences. 

Another loss I have experienced is the loss of potential relationships.  I never wanted to spread my depression or let it impact others.  This desire led me to avoid seeking relationships.  It has been decades since I have gone on a date.  I never gave myself the opportunity to meet someone I could share my life with because I feared no one would understand my depression.  It was my way of protecting myself, but looking back on it, I probably hurt myself more.  I also prevented others from knowing me on a deeper level.  I lost potential relationships.  I lost the opportunity to have a life partner.  I never gave myself a chance to have a family because I didn’t want to pass the depression on.  Sometimes I find myself grieving that loss.  I know it is too late for me to have children.  That is one of my regrets.  Depression caused me to miss out on a family life.  

The sense of loss depression created in my life hurts.  I don’t talk about it much because I fear others won’t understand.  That is the voice of depression talking.  It tells me to keep my pain to myself.  Depression is jealous. It does not want me to reach out to others.  Depression wants to be in complete control.  I have lost so much because depression is a thief.  

If my depression hadn’t forced me to miss so many days of work, I would not be worrying as much now that I have cancer.  I would have sick days left to use.  Unfortunately, depression stole those, too.  As a result, I am facing some difficult choices that affect my physical health and my well-being. Again, depression has created a loss in my life.

I am also facing a possible loss that has triggered my depression to take me to a very dark level.  I am losing my health insurance. I fear I won’t be able to make the right decisions to maintain my level of care.  I fear losing the people who mean so much to me: my mental health team and my physical health team.  This sense of loss has invaded my thoughts.  The worry has been overtaken by anxiety and the depression, which makes it difficult for me to cope.  My depression tells me I can’t tell them how much I fear losing them.  There is nothing they can do to prevent it.  I must take care of it on my own.  The sense of loss is present again.  I have lost my ability to think and process information smoothly.  Some of that is from the chemotherapy, but a lot of it stems from my mental illness overtaking my brain.  This sense of loss leaves me overwhelmed. Depression is present as I fear this loss.  It tells me things I shouldn’t listen to.  It drags me into the darkness.  I am afraid I won’t climb back out of this darkness.  

I know I am not alone.  There are many people who experience loss because of depression.  Maybe someone reading this post has felt the sting of loss because of depression.  I write about it not because I want sympathy, but because I want to bring awareness to this aspect of depression.  I want others who suffer from depression to know they are not alone.  I want to encourage people to discuss loss and to discuss depression.  An open dialogue will help us deal with the sense of loss created by depression.  For my part, I am going to try to bring it up in therapy.  I realize I need to talk about this sense of loss.  I need to process how it is affecting me.  Just like with any aspect of depression, the sense of loss cannot be faced alone.  To heal, we need to have discussions.  We need to know we are not alone.  If you are experiencing a sense of loss because of depression, I invite you to reach out in the comments section of this post or reach out to a mental health provider.  There is a lot to discuss.  I know I can’t do it alone and I need to reach out.  If this sense of loss is familiar to you, reach out in whatever way feels comfortable to you.  

 

Struggling with My Illnesses

                 I am having a rough time.  I don’t feel well.  In the past not feeling well physically would not be a problem.  I would have just taken an over-the-counter remedy and moved on with my day.  Now, I can no longer do that.  My head, or rather my anxiety, won’t allow me that luxury.  Cancer changed my world in so many ways.  It has required me to relearn how to live.  I have learned to fight a terrible illness.  Cancer has made me more vulnerable both physically and mentally.  As a result, I have learned to accept help.  I now understand that my life has worth.  Those are just a few of the lessons I have learned on this journey.

                  What hasn’t changed is the control anxiety has over me.  The anxiety has increased in some ways.  The last several days my stomach has been upset and I have been somewhat nauseous.  I also have pain in my abdomen near my liver.  This is the same way I felt right before I was diagnosed with cancer.  So, of course my anxiety has latched onto that fact.  I know Dr. St, my oncologist, who I really do trust, has said the liver pain is not likely to be more tumors.  She examined me just last week.  My bloodwork is good.  She has explained all of this to me.  On an intellectual level, I believe her.  I can understand that she is right.  I know I have a pet scan coming up that will likely confirm what she has already told me.  Still, with every twinge of pain and every second of an upset stomach, my anxiety screams in my head.  It tells me the cancer is spreading.  

                  I find myself trying to believe my doctor. I know she is right, but still, I am anxious. I can reach out to my mental health team, to my oncology team, to my primary care provider and her nurse, to Aunt Holly, and to other family and friends.  The problem is none of them have had cancer.  As well-meaning as they are, they have never experienced what I am going through.  Part of me says that shouldn’t matter, but on some level that I don’t understand, it does matter.  Not only do I have cancer, but I also have depression and anxiety disorders.  Each of these three illnesses is difficult enough on its own.  Combined they are hell.  

The anxiety triggers the depression and vice versa.  Worrying about the cancer triggers both the depression and the anxiety.  Not feeling well physically is picked up by my mind, which jumps in and makes me feel worse.  I hate this. 

                  The nurse practitioner in my oncologist’s office called me last week.  She told me how to handle my upset stomach.  I am trying to follow her directions, but my mind wants immediate results.  That is not going to happen.  As I write this, my mind is questioning why the antacids I took ten minutes ago aren’t working.  Of course, I need to give them time.  I know that, but the anxiety that fills my mind tells me it is not going to work.  

                  The worst part is that I have not yet gone to bed.  That is when my mind loves to attack me.  As I lie in bed, I feel the pain over my liver.  My mind shrieks, “More tumors!”  Even though, Dr. St has assured me that is not the case, my mind’s argument is compelling.  I try to replay Dr. St’s words over and over in mind.  I focus my thoughts on hearing her voice.  Despite my efforts, I struggle.  

                  This is the part of being sick that doesn’t get as much attention.  The mind games. I know it happens to some degree for everyone who has cancer.  My depression and anxiety intensify everything.  I need constant reassurance, which makes me feel guilty.  I feel like I am reaching out for help too often.  I don’t know what else to do.  That reassurance is necessary for me.  I need a lot of reassurance.  It is something I cannot control.  I try to talk myself into being calmer.  I tell myself to focus on what Dr. St said.  It is a battle in my head that I can’t seem to win.

                  I am doing what I need to do to improve my depression and anxiety.  Every day I receive TMS treatment.  I believe it will help, but again, I need to be patient.  Every week I talk to Dr. Klein.  I talk to Stephanie weekly.  I have regular appointment with Dr. S.  My mental health is being addressed.  Depression and anxiety are powerful.  They overtake my mind making it harder to fight the cancer.  

                  I wish I could sit down with someone who has experienced what I am going through and just talk.  I attend an online support group for patients with stage 4 cancer.  It helps, but it is not enough for me at this point in my journey.  I am left with the question, “What can I do?”  Right now, I am not sure I know the answer to that question.  I’ll keep searching for the answer. I’ll try to keep reaching out to my mental health and physical health teams.  I know they are willing to help and that it is okay for me to reach out.  I need to remind myself of that.

Cindi, Dr. St’s nurse navigator understands what I am going through.  I find myself reaching out to her more often.  However, I can’t do that in the middle of the night when my anxiety is at its worst.  I struggle more at night, but the days are not easy.  

                  As for the physical ailments I am experiencing, I will follow the advice I was given.  I will eat soft foods when I can actually eat and take antacids and nausea meds.  For my mental health, I’ll keep going to TMS and trust my team to guide me through all of this.  I know that overall, I am doing fairly well.  It is never going to be easy, but I need to believe it can improve.