Tag: TMS

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Having Depression is NOT a Choice – This is Why

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I saw this on Twitter and read it about a dozen times. I thought, “this is me, this is what it’s been like during too many major depressive episodes over the past 5 years.” I shared it on Facebook and realized that simply sharing it only reaches a very small group of people. This scares people. This is honest and open. This is scary. But the part that is missing are the answers. I want to share my answers, my experience, my reality. Personal experiences are the missing link in order to gain understanding about those suffering with what can be a debilitating illness.

1. How would it feel to wake up and not having the emotional strength to face people?
I’ll tell you how it feels. I have felt it on and off over the past 5 years. It is daunting, sometimes an insurmountable goal that you know you can’t reach. I would get myself going on certain days, like days I would see my therapist and the days I work. It is not easy. I have worked in retail for the past 2 1/2 years and people is what it’s about. My mask is sometimes put up and while it has slid off at times, I have always done my best. At times, I choose not to go to synagogue with my husband and our daughter. It’s sometimes been too scary to bring my daughter to a friend’s birthday party. It can be exhausting.

2. To think that time is passing by with no reason?
I felt that strongly today. I had a session with my therapist where I felt misunderstood. While she meant well, it felt as if she were trying to convince me to see things realistically in order to not beat up on myself. I felt my feelings were not being heard. After that, the rest of the day felt odd and I am not even sure how time has actually passed.

3. To feel so alone even when you are sitting in a room full of people?
This is why I have stayed away from people when I have been depressed. Feeling alone when you are alone is one thing, but feeling alone while in a room full of people, even close friends, does not always make a difference. It is a terrible feeling.

4. To have to put on a face and hide your feelings because in your mind you think no one would care anyway?
This is almost automatic for me when I am in a depressive episode, unfortunately. I think to myself that I don’t want to burden my friends any more than I already have. There have been times I have asked my past 2 therapists over these past years, why do people care about me? Their responses were the same: a list of my attributes, reasons why people like me, love me, care about me. Sometimes I believed them, but others I didn’t.

5. To lose friends because you can’t find the strength to go out and you can’t physically be ‘happy’?
Fortunately, I have not lost one friend due to my illness. I don’t know what the odds are of that, but I am aware that it is not necessarily usual. I have heard from others, very sad stories of dear friends who literally disappeared on them because of their mental illness. 

6. To cry yourself to sleep, hoping that tomorrow will be a better day, then when you do try you are exhausted from the night before, and it all starts again?
This may sadden many, but there have been many nights I have cried just as I fall asleep over the past 5 years at the times I have been depressed. I pray for a better day, that I will wake up a bit refreshed and feel better able to tackle whatever the new day brings. The fatigue that my depression causes is the enemy of this hope on some days. It has taunted and paralyzed me. This cycle is more than exhausting, in terms of physically feeling tired, it is emotionally draining as well. This combination can be depleting and debilitating.

7. You try to hide your feelings hoping no one would notice, and more.
This is also a challenge, yet something I can do well, at times. When I am anxious, I can talk a lot. People then believe I am feeling better or well, when what is really happening is that I am not feeling great but masking it with my anxiety. I am actually not always aware I am doing it until I feel my heart beating a bit faster than usual.

8. Now tell me why someone would choose that?
This is truly the million dollar question. Would any of you choose any of this, as well as all of the treatments I have endure(d): therapy 3x per week, medication trials, ECT (Electroconvulsive Therapy), TMS (Transcranial Magnetic Stimulation), ketamine infusions and psychiatric hospitalizations? Any aspect of my experience mentioned above? I can’t imagine so.

Depression is an illness, not a choice.
Saying it is a choice is the largest form of stigma I can think of. It’s cruel. I would move mountains and do anything possible to be rid of my depression, anxiety and OCD. I have tried and will continue to try. To say I would choose to have these illnesses is shortsighted and ludicrous.

I have said this before:

My mental illness is treatment resistant, but erasing stigma doesn’t have to be.

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My Piece on OC87 Recovery Diaries

https://oc87recoverydiaries.org/treatment-resistant-depression/

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What’s Good for the Body is Good for the Brain?

I have sacrificed my body for the sake of my mind and I have mixed feelings about it. I have taken medications to combat my depression since I was 19 years old. They have either helped me feel better or they have made me feel nothing or they have given me stomach issues, a severe dry mouth, headaches, anxiety, irritability, insomnia, weight loss, etc. It has truly been luck of the draw. Additionally, I have had treatments that were quite invasive and terrifying at times.

ECT (Electroconvulsive Therapy):  I began ECT three summers ago while inpatient on a psychiatric unit. I was as scared as I have ever been about anything as I began these treatments but I was desperate to feel better after suffering for months with a severe major depressive episode that was medication resistant. I did 24 treatments over the course of 5 months and it brought me out of my depression and kept me well for several months. Unfortunately, another major depressive episode took over which prompted another course of ECT. I had 21 treatments over the course of 5 months and was well for a few months after this. The aftermath of having ECT consisted of short-term memory loss where I was not be able to find the words during conversations and would think a thought only to forget it seconds later. This went on for years and while it decreased in severity over time, it still lingers. Additionally, the experience itself of having ECT has traumatized me, not because I received poor treatment, on the contrary my doctors and nurses were stellar and I always felt safe and cared for. What was traumatizing was going under anesthesia for each treatment and seeing other more severely ill patients. These memories linger and there are times when I need to discuss it with my therapist in order to move on.
I also underwent 6 more ECT treatments just over a month ago which was prompted by another psychiatric hospitalization as a result of my 4th severe depressive episode within 3 years. My memory issues and word-finding difficulties resurfaced but not to the same extent as in previous treatment cycles.

TMS (Transcranial Magnetic Stimulation): In the fall of 2016 I began a new treatment during my third major depressive episode which does not requite anesthesia (bonus) and allowed me to drive myself to each treatment. Magnets are used while pulses knock on one’s head for about 40 minutes. I underwent treatments five days a week for 6 weeks and then had maintenance treatments before finishing after a total of 8 weeks. I would sometimes have mild headaches after a treatment but otherwise I did well. I began to feel better after 4 weeks of treatments and was brought out of this 3rd episode. Unfortunately after only a few months, I was overcome by another major depressive episode. I began another course of TMS but after a couple of weeks of treatments my thoughts started to change and not in a positive way. My therapist noticed and after consulting with my psychiatrist it was deemed in my best interests to stop all TMS treatments.

Ketamine Infusions: Directly from there, I began ketamine infusions. I began with four treatments which consisted of receiving an IV infusion for 40 minutes. I ended up having 6 treatments where the one positive effect was feeling more focused but they did not help my mood. They also were emotionally painful during the treatments as the medicine heightened all of my negative thoughts and feelings which resulted in some traumatization. After my last infusion I was immediately hospitalized on the psychiatric unit. That’s when I agreed to a few ECT treatments as I had to wait while my old anti-depressant was being washed from my system before starting my new anti-depressant which comes from a class of medicine I had never tried before due to dietary restrictions. Luckily the form of this new medication is a patch that I change daily and because it is transdermal and it is a lower dose I do not need to worry about the food restrictions.

So what has my body been through in just that last 3 years? I have had numerous induced seizures, magnetic pulses to my brain, a hallucinogenic and many medications all of which have affected my brain and every other organ and part of my body. When it comes to psychiatry there are many mysteries that remain but I am sure of a few things most of which involve having the best and most appropriate care:

1. I have received the best care possible from my first therapist in New York City to my current therapist whom I have seen on and off for well over 20 years. My current psychiatrist and the doctors, nurses and social workers who helped and guided me these past few years are simply the best of the best.
2. My body has undergone a lot and there have been consequences, medically and emotionally, but I ask myself was it all worth it and I honestly can’t give a straight answer. I wish I responded easily to medication and I wish I did not have to have any of these invasive treatments but the bottom line is this: there is no cure for depression. What choice did I really have, especially when I have a husband and daughter to consider, not to mention myself and the rest of my family and friends?
3. I can’t say I would do it all the same if I had to do it over but I would still trust my doctors just as I have over the years. Even while at my sickest, I would only tolerate excellence on the part of those who treated me. My therapist who probably knows me better than anyone else is the best of the best, hands down, no question. She is highly intelligent, witty and can read between the lines like no one else. With each depressive episode over the past 3 years she has cared for me in the most humane and attentive way as one would want to be cared for during such a threatening illness. The nurses and doctors in the ECT suite were warm, friendly, smart and always tried to create a sense of peace while I was internally fighting my anxiety. The psychiatrist who follows my care whenever I am inpatient is quite brilliant but he is down to earth and he not only works with me, he considers me as a team player. My outpatient psychiatrist listens to me and takes into account my experience and never takes over as the “expert.” I would not have it any other way.

While every inch of my body and being has been through more than anyone should have to endure I am now recovering and as I am I am reclaiming my body and soul in a way I haven’t before. I am taking yoga classes that incorporate mindfulness and after only a couple of weeks, I am starting to feel more in charge of my self, more like the captain of my being. It makes me feel strong and forces me to stay in the moment when that can be very difficult as I try to deal with thoughts and memories of the past 6 months of a horrific illness. By no means am I saying that yoga is my savior but for now it feels good at a time when not much has felt good. My body and brain have suffered unimaginable terror and it is now time for a well deserved break.

I can’t say what the future will hold in terms of my depression but for now I am taking over and I am the one making the decisions regarding my being. This is what is good for my body and my brain.