Speak Up!

This is my story that I told at Speak Up in Hartford on 12/6/14. It is not word for word, but close enough. The theme was “reunions.”

“You’re back?”
Those were the first words I heard as I stepped back into the psychiatric unit this past July. This did not come from a patient who wasn’t in touch with reality…I was there just the week before.
I had only been gone a week and I was not too happy about being back. So, not only was I reunited with this patient, but I was reunited with other patients, mental health workers, nurses and doctors whom I had spent 5 days with the week prior. The “fuck you” I heard from another patient directed at no one in particular was truly my welcome back onto the unit.
My depression was relentless and I needed more than the initial 5-day stay had given me. The “I remember you” my nurse told me that first night back was not reassuring as she looked up my evening meds. I didn’t want to be remembered since I felt ashamed that I had to return and was already feeling so horrible that I had let down my outpatient therapist who made the call to hospitalize me for the second time. So, I was just oozing with guilt.
The next reunion was with my attending psychiatrist, whom I really liked. He was none too pleased with me as I had convinced him the week before that I was better and ready to go home. Trust was lost and I needed to mend our relationship. As I worked on that I spent my time locked in to my treatment. This involved taking my medication, having open communication with my nurses and doctors and also reuniting with my ECT nurses. I had started Electroconvulsive Therapy (yes, that is what is also known as shock therapy) the week before and I needed to continue with this treatment. My first ECT treatment as a repeated inpatient was very difficult. You see, the nurses who work in ECT are the most warm, loving and caring people and I felt I had let them down, as well by returning to the inpatient unit. I actually sobbed that first treatment back. On their end of this reunion, they were just as warm and consoling as they had been before. I was cared for with no judgment.
Returning to a psych unit after having been there just the week before is a humbling experience, to say the least. I was there for 5 days and then was sent home to the open arms of my husband and four year old daughter. I was severely depressed and that first hospitalization did not change that. So it was back to being “checked” on every 30 minutes and being watched while I shaved my legs. It was asking for a staff person to input a code into the phone in order to make a long distance call so I could reach my husband and daughter. And it was back to daily visits with my husband which were full of sadness and longing and a bit of hope. Each time he was let in to the locked unit, I would cringe a bit, due to the guilt I felt at putting him through this difficult time. But once we hugged, I could let that go and focus on him… and his phone which he would sneak in to the unit to show me pictures of our daughter.
When it came time to discuss discharge after seven days, my doctor said to me, “you fooled me once…I don’t want to make that same mistake again.” How could I blame him? I told him I was really ready to go home and truthfully, I was.
It all ended on discharge with the most emotional reunion of all…seeing my 4 year old daughter again…this involved literally smelling her skin, using all of my senses to take her in, kissing her all over and simply not letting go. I had missed her in the most intense way a human can miss another human. And when we were reunited, I simply could not imagine anything feeling so important or real. This little girl who looks more like me than me and who can melt my heart with one brief look. This was the most poignant reunion of all.
So, while I was initially not too happy to be back in the hospital, the truth is, there were people I worked with there who helped to save my life. These reunions were necessary for my recovery, including my reunion with my outpatient therapist after my discharge, which felt just as significant. For this I will always be thankful: to all of those who believed in me the second time around.
If someone were to ask me that question now, you’re back? My response would be,  “I am back…back to feeling better with the people I love.”

The Truth

Wednesdays are difficult for me. I stay over the night before in MA and then head off bright and early to see my psychiatrist for a double session. After that, I hit the road and head back to CT to go to work. I work until 5 PM and then have to pick up my daughter and endure the evening ordeal that all parents deal with each evening: the dinner debacle. I go through my day emotionally exhausted and in somewhat of a fog. I go over the session in my head and try to come to some understanding of what was discussed. What happens in the hour and a half can be described as difficult, hard, hurtful, sad, happy, pleasing, painful, settling…you get the picture. It is truly an array of feelings. It is the most difficult hour and a half of my week and I would not change that for anything. The work that is done there is helping me in ways I can’t even describe.

The truth is…I still feel depressed sometimes. I didn’t just have ECT and wake up all better. That’s not how it works. The combination of the ECT, medication and therapy have pulled me out, but it is a process. During the past week all I have thought is how happy I am to go for my monthly maintenance ECT this Friday. I feel like I need it. This past week I have felt a bit off…a bit flat. The feeling is familiar and is one I am not happy about. Although my psychiatrist is increasing one of my medications, I am hopeful that I will feel a bit better after Friday’s treatment.

I had such a tremendous change in mood shortly after my hospitalization and since then that has remained steady. This past week serves as a reminder that recovering from depression is truly a process that takes time. It does not simply go away; it is a process and I am still in it, working harder than I have ever worked on anything in my entire life.


Consultation Results

I’m not writing this for advice as this is my decision (and my family’s)…what I do want is to keep everything real. I have been writing about my struggles with depression for several months now and even though this is intense stuff, it is reality…my reality. I have been real in my writing and updating and I don’t want that to change just because things are more acute.

Yesterday was incredibly difficult. I first saw my psychiatrist for a double session and then went right to meet the psychopharmacologist. I was emotionally spent and nervous, but I went. The doctor was very nice and I felt comfortable. He definitely knew what he was talking about and formulated various possibilities after hearing my history and my current state. These are the options:

Most Aggressive: ECT (that’s right, shock therapy). Once you get the “Snake Pit” image out of your head, it is very helpful for people where medications are not. It is also not barbaric as it once was (or what you see on TV/movies) and you are under anesthesia for the treatment.
More Aggressive: MAOI medication. It is helpful but I would need to go off all of my current meds and be off of them for 2 weeks. There is also a special diet I would need to follow if I take these meds.
More Aggressive: TMS (Transcranial Magnetic Stimulation) This is relatively new and is very different than ECT. There is no anesthesia, you are awake for the 40 minute treatment, it is not harmful and studies show it is very helpful in people who have not had luck with medications. There is no memory loss as there could be with ECT and no anesthesia to deal with.
Conservative: Another class of medication.

Where I stand (along with my husband and my psychiatrist): stop one medication that is not working and then try the “Conservative” medication and at the same time look into TMS. I am at bottom right now and I feel like we need to do something aggressive. I simply cannot continue to live my life like this. It’s not fair to my family and it’s not fair to me. The biggest worry will be insurance coverage for the TMS. Mine is not listed as one that accepts it as a treatment for major depression. I will do my due diligence though to find out. Where is the mental health parity? This just adds another level of stress and if I had diabetes, there would be no problem with treatment coverage.
Depression sucks.