Picture Wiley Coyote digging in his claws to delay plummeting to the canyon floor

     Surely you've all seen the Roadrunner cartoons--we loved them as kids.  Wiley Coyote was forever getting a new Acme product in the mail with which he could finally, once and for all, vanquish the Roadrunner.  At least, that was how it was supposed to work.  The super-duper roadrunner-killing machine always backfired, leaving Wiley clinging to the canyon wall for a few gut-wrenching seconds before spiraling down what looked like a hundred miles to the bottom of the pit.  But in every episode Wiley miraculously avoided death to plot the Roadrunner's capture once again.  Wiley was amazingly resilient and persistent.  All the audience ever saw of the Roadrunner was a big speedy bird blithely zooming his way through all the snares set by Wiley.  Wiley's strategems only ever caught Wiley.
     I try everything that's suggested to me to vanquish the depression.  I keep ordering that depression-killing Acme kit.  The more I try to fight the depression, the more depressed I become because it is proved to me that nothing works.  Nothing works except to ensnare me deeper into the depression.  If I'd had a physical disease for eight years that caused me constant, unrelenting, excruciating pain that was visible for all to see, no one would think me selfish for wanting to die.  I would be able to tell the people I love goodbye; maybe even have some help in dying and not have to worry about the future harm my dying would cause my children. 
     I am tired of this continual battle, but the cartoon's director insists on more and more episodes.  He promises a feature-length show to be released directly to DVD and profits for everyone! 
  

Manifesto

     In many ways I feel much better equipped to cope with my depression now than I did during the episode that lasted from 1988 through 1994.  The depression itself is more profound now, more full-bodied, more insidious, and I have less energy to fight it.  Yet for all that, I believe I've gained valuable tools and personal insights that have increased my ability to compartmentalize the depression and at least some of the time, keep it from being the ruling influence in my life.  I now refuse to believe that God doesn't love me.  I choose to believe God is a loving God who sorrows in my pain and exults in any headway I make against the depression.
     I no longer believe the depression is my fault.  I refuse to take any responsibility or blame for being depressed--exactly as I was not to blame for getting cancer.  I refuse to believe my thought patterns are responsible for my continuing to be depressed.  My depression is neither situational nor subject to the whims of my mood.  It is as ineffective to school me on "mindfulness" or "cognitive behavioral therapy" as it would be to force these concepts on me in order to recover from cancer.
     Nevertheless, in my own way, dealing with depression for 35 years has taught me the value of being able to focus entirely on some action outside myself.  I may have to be somewhat obsessive in order to keep my focus on a project, but it accomplishes the goal of living in the moment and gives me some respite from the depression, at least part of the time.  Learning how to rethink situations that once caused me emotional pain is a valuable tool in combating some of the side effects of depression.
     I believe I am quite healthy emotionally and mentally and if I am ever relieved of the depression, I have every advantage to live a productive and satisfying life.  I am fortunate not to have any traumas that must be worked through in order to recover from the depression.  Twenty years ago I wrote that not having anything to blame the depression on made it worse because it left me with only myself to blame.  I have decided this reasoning is faulty and I refuse to accept blame.
     I believe I am Zena, Warrior Princess, because I have a backbone of steel and am as tough as rawhide.  A loser wouldn't have the stamina to withstand the years of unrelenting depression that I have battled through.  I am still here and fighting for my self.  I may be bruised and bloodied, but I am not defeated.  I may often believe there is no hope for me to conquer depression, but I still keep fighting.  That makes me a winner.  I face a desire for death every day.  I feel like slices of me are whittled away as the depression continues.  But I still have my core.  I am a loving, forgiving and empathetic human being, shaped in part by the depression.  I have turned bad into good.  My sense of humor enables me to see all the funny aspects of life and take pleasure in it.  I can enjoy a perfect nearly-autumn  afternoon in Rochester, Minnesota.  Twenty years ago I had forgotten pleasure even existed.
     This is progress in the face of overwhelming battering to my psyche.  Even if I eventually do kill myself, I will never be a loser, because I didn't bow under; I fought the good fight and struggled to win.  I have used everything in my power to overcome the depression.  I remain HERE.  Every day I remain is another successful day.

A child of my own

If I had a child to call my own, we would laugh, sing, play all day, and have adventures in the park all day long.  As a baby and toddler nap time and bedtime would be filled with favorite lullabyes galore.

If I had a child to call my own, I would tell you how much I love you each and every day.  I would also tell you just how special you are in each and every way.

If I had a child to call my own, I would teach you shapes, colors, numbers, and letters.  I'd also help you learn to read, write and do math.

If I had a child to call my own, I'd help you learn to ride a bike and roller skate.  We would have picnics in the park, go to the zoo and learn to swim.

Most of all, if I had a child to call my own, I'd want him or her to be just like you!

By Stacia Osiecki

The Dream

A dream forever washed away, carried away like sand out to sea.
Days once brightly filled with sunshine and dreams are now filled with nothing but a gray, dewy haze.

I now suffer a pain too great for the human ear, so I alone must face this pain I bear.
I turn to you to save me from myself, to save me from the depths of despair.
I bare my soul to you as you promise to give no suffering greater than one can bear.
I beg of you, "Just how much is one to take as they stand alone in this world?"
I do not wish to despair for I know there is a better way, so beg of you some more, I shall.

By Stacia Osiecki

Tear-soaked Pillow

I awoke to a tear-soaked pillow this morning as I sobbed for hours in desperation, begging for you to allow me to feel your presence as you've done for me in the past.  Why can't I have that now?

As I sit on my steps watching the sun rise with its awesome hues of pink, blue and gray I look back on my life and wonder what it was that had me so upset last night.

I was looking back at my life, a life of unfulfilled and broken dreams, wishes and broken promises galore.
I pray to you for the strength to face another day.

By Stacia Osiecki, a fellow patient at Mayo Clinic

Mayo Clinic

I will be going to the Mayo Clinic September 12 for three days.  I don't know if it will do any good, but I'm trying to explore every possibility for learning how to live with this godawful depression.  I just had my 59th birthday.  I never wanted to be 59, or 39 or 49 for that matter.  I think I am not going to post any more until I can write something positive.  I really am trying, but I just can't get a handle on this and it is suffocating me.  I think if I'd had a physical illness for 35 years that was causing me untold pain, my family would give me permission to die.  That's what I need from them; just let me go.

William Styron

William Styron writes  “. . .the word [depression] has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.”     He recounts that in most instances of physical pain, one knows if one sticks it out eventually it will end, and things will go back to normal.  Not so with depression. 

“In depression this faith in deliverance, in ultimate restoration, is absent.  The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come. . .If there is a mild relief, one knows that it is only temporary; more pain will follow.  It is hopelessness even more than pain that crushes the soul. . .The sufferer from depression finds himself thrust into the most intolerable social situations.  There he must, despite the anguish devouring his brain, present a face approximating the one that is

associated with ordinary events and companionship.  He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile.”   Darkness Visible

Resurrecting the Dream in 2005

            “I think you’ve lost your dream”, said the doctor.

            “I’m depressed because I’ve lost my dream?” the patient asked.

            “That’s what I think.”

            She glanced at him hopelessly and said, “Medication won’t fix that.  I don’t know how to get the dream back.”

            “Start by writing.”

                We have a goal to get out of bed by 9:00 am, but it’s only a goal, not a rule, she thinks as she watches the minute hand move toward 11:00.  “C’mon, get up”, she urges herself.  “You’ll feel better if you get something done.”  No wonder she has no energy to do anything—it takes all the will power she possesses just to get up in the morning.  No face washing, no teeth brushing, no hair brushing, no shower; drag on same dirty clothes from the day before—why put clean clothes on a dirty body?  Does she still hold any bargaining chips to spur her to accomplish any task, no matter how small?  The actual housework that one would expect from any fifty-three-year-old wife who has the luxury of staying home all day is far beyond her.  She can’t remember the last time she cooked, or mopped, or vacuumed, or swept, or dusted, or grocery shopped, or had sex with her husband.  But surely there’s some insignificant chore that might lend a sense of accomplishment.  She could allow herself some pleasure in trade, except there are no pleasures left.  What once were pleasures have become chores—more things that need doing.   She does have one new activity in her life however:  television viewing.  Even in her deepest bouts of prior depression she never stooped to wasting time watching the boob tube.  But now she reads carefully through the tv guide, checking the blurbs about each movie, figuring out when Law & Order is on, what programs would best fill in the gaps  between Law & Order, Law & Order Criminal Intent, Law & Order Special Victims Unit.  What a good thing her family wanted cable television.  How about one hour of yard work in exchange for all the Law & Order episodes for the rest of the day?  Too hot, too muggy, too wet.  Run the dishwasher?  No detergent.  Do laundry?  Maybe she could sort the laundry today and it wouldn’t be such a big chore tomorrow.  Or maybe she could put all the dirty clothes in the vicinity of the washer and dryer today, sort them tomorrow, and wash them the next day.  Baby steps.  What a worthless, lazy sack of shit you are, she thinks as she pulls the covers back over her head.    

                                                        

         The patient can remember two times when she comprehended why life seemed so worth living to most people.  One was fourteen years ago, in September of 1991.  She’d just been prescribed lithium.  It wasn’t a “happy pill”; it just made her feel wonderfully normal.  Like wouldn’t it be nice to make a loaf of cheese bread?  Didn’t the sun feel good shining on her shoulders?  She thought maybe God did love her after all.  But the effects of lithium didn’t last.

            So the new doctor prescribed lithium again fourteen years later, on the theory it hadn’t been tried long enough or in the right dosage or with the right complement of other drugs.  It worked for about three days, but those three days were enough to convince the patient that it wasn’t that she wanted something extraordinary out of life; that she couldn’t be content with the boring mundane routine of most days.  No, the day just felt right, good to be alive, good to laugh.  Life was sufficient in itself.  Until the lithium failed her again.   So now the patient is trying to write.  She’s nothing if not persistent.  A lesser person would have given up long ago, but the patient is stubborn and strong.  She knows her death will cause grief; she worries about the effect it will have on her children; she can’t stand to hurt her mother or her sisters; she hates to take one more person her husband loves away from him.  But she wishes, more than anything in the world, that she would die.

            “How does one live in the absence of significance or meaning?” the doctor asked the patient.   “Write about that.”

            The patient asks her philosopher son the question.  He advises her to read Sartre.  The patient thinks she isn’t living—she is only existing.  That’s how one lives in the absence of significance or meaning; one doesn’t.  What’s the point?  Why should she continue dragging herself from one day to the next?

           

               I only noticed it the other day.  How odd that a quote so apropos to how I feel would be Beth’s signature e-mail.   A television writer sums it up for me:

            "If we could live without passion, maybe we'd know some kind of peace. But we would be hollow.  Empty rooms, shuttered and dank. Without passion, we would be truly dead." - Angelus, Buffy the Vampire Slayer

           So there’s no significance, no meaning, no passion, no hope, no peace.  Ain’t life grand!  I am dead already and just can’t stop walking around. 

-----------  2005

Water Boarding

It's 3 am and yet another sleepless night.  I think taking sleeping pills for 20 years to counteract the effects of anti-depressants that kept me awake, has destroyed my sleep cycle.  I've already adjusted to the newest pills so they're no longer working. 
The depression has metamorphosed from a heavy lump on top of me to a miasma that pours in through my ears and nose and chokes me so I can hardly get a breath.  I imagine chunks of my insides dying off as the depression floods through me.  I think someday there will be nothing left of me but dead lumps that used to be organs.  If it would kill me, that would be one thing, but I don't look forward to living as a necrotic mass of my former self.
I am amused by physicians who scold me for not having "a primary caregiver" to tend to my physical health.  Do they really not recognize the drugs I've obediantly listed on the multitude of forms I've filled out prior to seeing them?  Hey, doc, I have Major Depressive Disorder, chronic and severe.  My biggest regret in life is surviving cancer.  Do you really think if I got another shot at a natural death that I would do the slightest thing to prevent it?  I've learned my lesson well.  Dying is the alternative I choose, the sooner the better.  I am sick of living like this.

Psychiatrist Redux

     In hindsight I should have fired my shrink after the April commitment fiasco, but she'd been so helpful at first, I decided to forgive her and carry on.  It is not an easy thing to have to start over with a new psychiatrist--you have to bare your soul, try to get them to understand what's going on with you, hope they will understand you need a drug that will work, not psychotherapy.  But after her refusal to help with any pain medicine when my surgeon refused to help (via his staff, admittedly) or even refer me to a pain management clinic (the surgeon and shrink must have both skipped the class on helping your patient by referral), I'd had all I could stand of her.  I called my old shrink back and asked him for an appointment.  I saw him within a few days; he started me on pain meds and sleeping pills that actually worked for more than a night or two.  Within less than a week, I was no longer in agonizing pain 24 hours a day and I was sleeping through the night, after six weeks of just catching an hour or two every now and then.  Amazing what a little TLC can do!  Just don't put up with being mistreated by your doctor.  Fighting your depression takes all your energy.  I'm on a new anti-depressant now, but all I can tell it's doing is making me nauseated 24/7.  I hope before the dose doubles next week my body will have adjusted to it.  See why Carrie Fisher said if depressed people are just making it through the day they deserve medals along with the steady stream of drugs they're subjected to?  I wish believing that made me feel any better. 
        When I fired my shrink, I asked if she would give me the names of the three anti-depressants she believed I could metabolize.  When she'd first done the blood tests, she'd told me there were four anti-depressants not metabolized by the enzyme I didn't produce.  I was on one--it obviously wasn't working.  No, since I fired her, she wouldn't tell me.  I had tried to hold on for two more weeks and not fire her until after the appointment I had scheduled on July 12 (when I would ask for the names), because I suspected she would have that kind of attitude, but I couldn't bear any more pain.  The same day I fired her, the second pain managment clinic I'd contacted had called and told me my surgeon's office claimed they'd referred me to my shrink.  They wouldn't have known her name if I hadn't given it to them in an attempt to have the surgeon call her about my problem metabolizing drugs.  I had asked her to give me the names of what pain meds I could metabolize when I'd had my last appointment, but when I asked the surgeon's office for specific meds, they apparently thought I was a "drug seeker", and told me I'd reached my pain threshold.  This is why I said I'd lost all respect for the medical profession in my last post.  Just a bunch of mismanaged crap while I suffer.

What's the Point?

           I've lost all faith in both the medical profession and pharmaceuticals.  I've been in six different hospitals in six months; I've been on more than a dozen new drugs and yet mentally I'm in exactly the same spot I was in on January 2, 2011.   Physically I'm in worse shape because of rotator cuff surgery, but that will get better with time.  The depression never gets better.  It sits on top of me and is so heavy I can't move a leg or an arm or anything to help me try to crawl out from under it.  If I could identify some reason for this overwhelming desire for death, then I could confront it.  Maybe I'd be able to work out a path back into the enjoyment of life.  It seems I have an entire staff of medical personnel, especially since the surgery.  I even have my own case manager with my insurance company.  None of them help. 

           My shrink keeps telling me to write.  I write, but it is so dark and hopeless that I don't post it.  What would be the point?  People could see the pain I was in after the surgery.  They could see how frustrating it was to not be able to get any relief from the pain.  What makes doctors sacrosanct?  I've been refused a referral to a pain management doctor by scheduling secretaries.  I've been denied pain meds by receptionists.  When I finally see my surgeon in person, in all his glory, he claims to know nothing about pain or referrals.  He asks why didn't I call if I was in so much pain. I tell him he needs to have a long talk with his staff.  Multiply that pain, frustration, and hopelessness by 100 and try to imagine feeling that way every day for the last 8 years.  Of course I want to be dead!  That is the only reaction a sane person could have.  My arm is better now, my depression is worse.  At least the physical pain gave me something to focus on besides the depression for a few weeks.  I would trade the depression for the pain in a second.  Don't tell me to find something else to focus on besides the depression; that thought has occurred to me in the last 35 years.  Depression is unrelenting.  It tells me what to do; I don't tell it. 

        

Other Sources

     You can find out more about the DNA testing I had done [see Post: Why Your Anti-Depressants May Not Work, May 18, 2011] at MayoClinic.com/health/cyp450-test/MY00135.  They also have a blog where people can post comments that everyone can see immediately, so I don't know why my blog won't work that way.  If someone who is computer savvy knows how, please help.  The help support this particular blogsite provides is of no help--they said it is working like it's supposed to.  So maybe I just have to have something the Mayo Clinic has that my little laptop doesn't.  The Mayo Clinic's Blog also contains posts on why anti-depressants quit working, treatment resistant depression, and other questions of interest to people who suffer from depression.
     An article written in the Washington Post, April 18, 2006, also gives some basic information about how your liver works with medications.  The website for the article is binf.gmu.edu/jafri/chem579-binf739/LiverSuccess.pdf.
     Thanks to "Delle", the other contributor I've listed in my blog, for doing all this research for me.

A Few Good Things

     I said in an earlier post that there were a few good things that happened after I finished the daily out-patient program.  One was finding out my liver just didn't metabolize my anti-depressants, because there were times of despair when I thought I must be crazy or something would work.  The other was when my psychiatrist told me I had "an intact personality".  Most people who have suffered from depression for as long as I have become warped.  But she said I had fought the depression mostly with my sense of humor and also by maintaining close personal relationships.  She said I wouldn't need any psychoanalysis after my depression was cured (a bit unhappy about the "cured" thing not going so well) because there was nothing wrong with me mentally.  You cannot imagine how validated that made me feel.
      I never believed behavioral therapy did anything for me.  I have not experienced dramatic changes in my life through the creation and repetition of positive affirmations.  I don't have obsessive thoughts of being of no value, of not accomplishing anything, of being plagued by mistakes I've made, of not being loved.  Of course I deserve to live.  And if I could live without depression, I would choose life, but if the depression is to continue for years without end, then I choose death.  The psycho-babblers who urge you to choose life because something good could be right around the corner, don't understand depression.
      I originally wanted this to be a place where ideas could be shared, but not being technically literate, I realized too late that that would be a forum, not a blog.  A forum is way beyond my skills, and even trying to make people "authors" doesn't seem to allow them to post, but maybe this idea would work:  If you want to say something, do it under "comment" and then I'll turn it into a new post so it will be more easily seen.  It doesn't really have to be a comment about what I've written; just whatever you're thinking about your own depression.

Confession Time

I guess it's time to confess why my psychiatrist put me in the mental ward again in April.  And if you only listened to the bare facts and not to the entire situation, you would probably agree she was right.
Because my liver was eating my sleeping pills, I was only sleeping about five hours every other night.  I was going to the pharmacy every two or three days to pick up new prescriptions that consisted of only two to four pills.  Her office faxed these to the pharmacy; I couldn't take them.  Once before she hadn't gotten the fax to the pharmacy before it closed, so that meant another night without sleep.  On April 28 I got home from my TMS therapy about mid-afternoon and found a crew of yard workers at my house.  They petrified me.  I couldn't turn into my driveway with all those strange people there.  Instead I drove to the pharmacy to wait for my prescriptions.  Around 4:30 the pharmacist told me to just go on home and he'd bring me the meds when the fax came in.  I went home, but the people were still there--five or six of them.  I knew they meant me no harm; it was obvious why they were there; but I could not make myself stop and go in my own house.  I started calling friends I knew who didn't work so I could go to their house.  The first one was getting her hair cut, the second said she was two minutes from my house and would be right there.  With her help, I was able to walk past the people into my kitchen.  Now I know I had a panic attack; I didn't recognize it as such at the time.   The pharmacy called later to let me know they'd never received my prescription.  Oddly enough, they called the next morning to tell me they finally received a fax cancelling all my prescriptions, even the ones for thyroid, depression, etc.  I have never figured that out and my doctor denies it happened.  But back to the wee hours of Friday morning.  It's 4:00 a.m. and I'm practically in a frenzy because I want to sleep.   It crosses my mind to take a whole bunch of aspirin, but I realize that's a bad idea.  I finally decide to go sleep in my car.  I would be foolish to deny there wasn't some suicidal ideation going on there, but the fact is our 100-year-old garage is too leaky, too many windows broken, too many boards termite-ridden to ever asphyxiate myself in that garage.  Just because I closed the door and left the motor running does not a suicide attempt make.  I compare it more to a person who superficially cuts herself--it eases the pressure of wanting to kill yourself.  You know you're not going to die from it.  My husband found me that morning around 8 and took me to my TMS appointment.   After the doctor heard "in the garage with the motor running",  I don't think she listened to another word or took any time to assess the situation.  She committed me.  As far as she was concerned, I was then no longer her problem.  The hospital said she sent no records and because she'd cancelled all my prescriptions, they weren't sure what to give me.  Neither she nor her office would return any phone calls.  Finally the doctor working the weekend shift decided to give me one-fourth of the amount of sleeping meds I'd been on before she cancelled them, but nothing else.  So I went cold turkey on all my other meds--outside meds are completely out of your control once you're in the mental ward.  On Monday I saw the regular hospital psychiatrist who listened to me and said he'd let me out as soon as my husband confirmed my story and could make an appointment with my psychiatrist to see me when I was released.  Dan was there within a couple of hours.  I'd been seeing my shrink pratically every day, so neither of us thought it would be any problem getting an appointment for the next day.  But now I was persona non grata.  She couldn't fit me in for eight days.
Hospital doc wanted to talk to her before releasing me; he said she wouldn't return calls, she said no calls were made.  I wouldn't know.  But I know Dan called, I called, I was next to the nurse reading her the extension for my shrink's office manager, I called her cell phone (yes, when I was in her good graces, she'd given me her personal number so I could get her any time) and suddenly no one was available.  Tuesday was a horrible roller coaster of  "you're getting out; oops, sorry, you can't be released yet" all day long.  I was alternately laughing and crying the entire day.  At 6:30 I decided to go to bed with a true romance paperback [see Post: Twice in Four Months?? for complete available reading selections].  Just as I'd reached the juicy part, a nurse came in and told me I was released and could leave as soon as Dan got there.  I called him--he was in the parking lot where'd he'd been waiting for the past five hours because he'd been on the same roller coaster as I had.  What a complete waste of time and money those last five days had been.  I went home with the clothes I'd come in on and seven sleeping pills.

Quick Explanation of what TMS is

Forgetting for the moment that the ordinary man on the street might be unfamiliar with the term "transcranial magnetic stimulation", I inadvertantly jumped right into my last post without so much as a hint of what the dang thing was even used for.  So I did get a few "whatthehellrutalkinabout?" questions.
TMS is the new electric-convulsion shock therapy (ECT).  Instead of using electric shocks on your brain, they use magnetic shocks, kind of like an MRI works (I'm sure a medical expert would beg to differ; I'm only interested in getting something to fix me, not exactly how it works).  I had ECT back in the early 1990's.  It didn't work.  In fact, it cut out huge chunks of my memory so if some of you who knew me then and wondered why I didn't seem to remember you'd moved back to Oklahoma City from Washington D.C. and we'd had lunch just a month ago, that's why.  I forgot lots of facts I needed for work.  Lots of life was as if I'd seen a preview for the movie, but never actually saw the movie.  So on to 20 years later:  TMS doesn't require any anesthesia.  You drive yourself there; 45 minutes later, you're on your way to work.  I don't seem to have forgotten anything; didn't even have a headache.  I had 14 or 15 of the minimum 26 treatments required.  I couldn't tell if they were helping--they say 20 treatments is kind of a magic number.  My psychiatrist refused to allow any more treatments because she decided I'd made a suicide attempt and protocol demanded that all TMS be stopped if the patient tried to off herself.  I did not make a suicide attempt, but hospitals and medical personnel really don't care about your explanation, especially when you seriously did try to kill yourself just 4 months back.  So that's how I ended up in the mental ward of the hospital now known only as "D".  I'll save the story of what is and what is not a suicide attempt for another post and you can all vote on which you think it was.

Transcranial Magnetic Stimulation (TMS)

TMS is still considered "investigational therapy" by insurance companies (or at least my insurance company) because insurance companies apparently prefer to spend thousands of dollars on hospital care, psychiatrists, therapists, and drugs rather than risk money on something that conceivably might help you after everything else has failed.  At least the insurance industry keeps the employment rate from sinking even further by following this policy.  The original idea was for me to have 26 daily treatments (Monday through Friday), although this was cut short after events I'll tell you about in another post.  The following is an extremely unscientific view of my impressions after my first two treatments: 
     While I was getting the TMS today, I decided it felt and sounded like a very robust woodpecker pecking my head, which is protected by a thin, tight, tin colander minus the holes so the beak doesn't actually go through.  I don't really have a colander on my head; I just had 37 minutes to think about it and decided that was the best comparison.  It's very loud; I have to wear earplugs.  The way they find the initial site is the tech starts shooting these magnetic pulses at your head.  When your thumb jerks, they've found the right place.  It can't be your index finger, just your right thumb.  If your whole hand jerks, then it's set too strong.  Next, they look at your skull as if it were surrounded by a webbing and they have to aim the pulse at the tiny space in between the webbing (which are actually nerves).  If it hurts, then they aren't in the right place.  The first day took an hour and a half, but then they can lock in your settings, so today was no big deal except it's hard to remain perfectly still for 37 minutes.  They put tape around your forehead and then from your forehead back behind your head and then this spongy thing against your right ear holding your head still.  The woodpecker strikes your head for 4.7 seconds (but he gets in about 20 very rapid pecks during that 4 seconds) and then you have a 23 second respite before it starts again.  Let me just reiterate this is a quite burly woodpecker who has been in training for a half marathon for months.  I asked the tech if other patients compared it to a woodpecker and she said, "A woodpecker on steroids!"  But it doesn't hurt; it's just annoying, and I haven't had any side effects.  Doesn't this sound sci-fi?  Maybe I can get them to take a picture so I can scrapbook it for posterity.

Why Your Anti-Depressants May Not Work

After I finished the out-patient clinic, I started seeing a psychiatrist who began by drawing a ton of blood from me, which she sent off for DNA testing among other things.  I'm sure I don't have this all worded scientifically correct, but basically we discovered I had a defective gene in my liver which prevented production of the enzyme which would metabolize the anti-depressants I'd been taking for over 20 years.
Almost every anti-depressant I'd been prescribed used that particular genetic enzyme to work, but I didn't have it.  I might as well have been taking a placebo.  These tests have only been widely available for about the last three years, so if you're experiencing the same frustration of one useless anti-depressant after another, demand your DNA be tested. 
An interesting side note to the defective gene:  Knowing I'd had breast cancer, the report cautioned that I should not be given Tamoxifin as a follow-up to chemotherapy.  It was metabolized by the same inoperable enzyme and would be useless.  Back in 1995 when I had cancer, my oncologist prescribed Tamoxifin for me.  My husband, who is one of the most mild-mannered of men, absolutely refused to let me take Tamoxifin.  My family was probably a little pissed at him, thinking the doctor knew best, but my doctor appeased him and prescribed something else.  The purpose of the Tamoxifin is to help in remission of the cancer.  My taking it would have been totally pointless.  Of course, the way I feel today, I'm not completely happy with that outcome, but I have to admit it kind of freaks me out.

Twice in Four Months??

Yes, I got too depressed to continue my blog.  Nothing good (except for meeting some wonderful fellow-patients) seemed to happen with the out-patient clinic and I couldn't stand writing nothing but negative stuff.  Some good things have happened since I finished the clinic, but I'm going with the dramatic first and then I'll back up and fill you in with later posts.  Maybe that will give me the incentive to actually write the posts and you the incentive to come back and find out what happened.  I wrote the following to friends and family one night when I couldn't sleep, so that's why it has references to things as if you know me.  The two things I should first explain, after managing to stay out of mental hospitals since 1988, I found myself in one again (after January  '11) in April.  Second thing--I no longer sleep.  Last count was ten hours and fifteen minutes in 144 hours. I can only sleep with drugs, and I metabolize them super fast so they only work for a couple of nights.  The condition is called tachyphylaxis.  Okay, so this is what I wrote a few nights ago after I just got out of the hospital for the SECOND time:

Since I'm not sure I'll ever sleep again, I've been lying here thinking about my experiences over the weekend at D and cracking myself up laughing (which as many of you know is one of the reasons I have an intact personality and won't need psychoanalysis once I'm cured of depression--oh happy day!) I wasn't always laughing of course at D--Dan knew it was me calling because there was either this long pause after he said hello where I was trying to quit gasping out sobs and begin talking, or I was already in the midst of hiccuping words trying to make myself understood. My first day's goal was to not cry. At the end of the day we were asked if we'd met our goals. I said yes, I hadn't cried at all, merely sobbed, gasped, and hiccuped. But that was just the first day. Things got better of course. We had art projects. There was a whole box (not the big one with the built-in sharpener) of crayons worn down to the nub. You may think you only need sharp crayons to stay inside the lines, but let me tell you, you can't do anything with a nubby crayon. Borrow one from a child and try it. Unless you write REALLY BIG you can't even tell what you wrote. There was plenty of evidence of this where people had written phone numbers in very big numbers next to the telephone. Of course, some of the numbers you couldn't still read beause people had knocked out the sheet rock with their fists, I assume in a pique of anger. I swear, I really am laughing about this now; I'm not just going for the sympathy vote. There were two phones, but the other one just hung from the wall where I guess someone had pulled it out. You could use it if someone would hold it up to the wall for you while you dialed and talked.
On Sunday this nicely dressed lady brought in a whole bundle of word search puzzles. I noticed later they were all Christian-themed puzzles and I'm sure she came straight from church. Of course there wasn't a chance in hell you could have circled only one word with those nubby crayons, but she didn't know that--she would probably have brought us more crayons. I asked her if she had the New York Times Sunday Crossword Puzzle. She gave me the oddest look and I was immediately repentent and said, "I'm sorry, I'm just a smart ass." And then I realized I should apologize for that but thought it would just make matters worse, so I shut up. There was quite a variance of inmates at D--we had a number of shaved and tattooed heads, necks, and arms, a couple of old geezers in wheel chairs, a few teenagers, a couple of schizophrenics, maybe a few alcoholics and druggies and then your usual crowd of the depressed and anxiety-ridden. One day in group we were supposed to be telling our talents (this is good for our self-esteem). The old geezer in the wheelchair behind me said he could hotwire a car in 24 seconds. How can you not get hysterical about that?
None of us had any belts so we were all "saggin'". The doors were always locked of course, but I had this vision of us making a break for it--two of us pushing the wheel-chair bound and everybody trying to hold up their pants while the security guard (no spring chicken himself) chased after us. It would have been a sight to behold.
All of you know that I don't leave town without at least one deck of cards, but not realizing my shrink was going to freak out on me and put me in the hospital, I had no cards. Neither did D. It was just sad. They had 4 UNO cards and two decks that contained about seven cards each. Inexplicably, there was an extra Jack of Clubs in one deck. But even expert card shark that I am, I could think of no game to play that involved fourteen cards and 4 UNO cards. Maybe if I'd had more time. My goal of teaching the card game of golf to every mental health facility in the state was stymied. After I'd been there a few days, I found out there were two sides to D--there was the side for the good kids and the side for the bad kids. The staff denied there was any difference, but I never let an opportunity go by to point out the lavish facilities on the good kids side. They had a piano and a book case of hymnals and many true romance novels. They had two phones, both attached to the walls. Their furniture had stuffing and ours was reduced to the boards with a bit of fluff and that fake leather stuff. They could have visitors. They even had a Jeopardy game. It didn't have any cards and I couldn't figure out how the pieces were supposed to go together so you could secretly read the cards had there been any, but by God they had an intact box. They had magic markers. They may have even had ink in them--I never tried them out. I think it was Monday night I actually got to move to the good kids side. I don't know what precipitated that unless it was that I finally took a shower. I said I was in protest not changing my clothes until they let me out of there, but really that big communal shower just freaked me out. I know there had to be spiders in the corners and all sorts of fungal growth, probably most of it microscopic. But by Monday I couldn't stand the stench of me any longer and broke down. Then I got scrubs to wear and my saggin' days were gone. Don't think you get scrubs with drawstrings, however--strictly elastic.
My first roommate was a kleptomaniac. The nurse warned me about her, but I said it didn't matter--all I had were the clothes on my back. The hospital gives you body wash, toothpaste, toothbrush and deodorant (I realized they would also give you a comb if you asked for it once my protest days ended and I finally washed my hair). But my second day there I noticed my toothbrush was gone. They give you the damn toothbrushes! Why would she want my used one? There is no explaining those crazy people.
Okay, I've sent almost all of you my Personal Affirmation (another exercise good for our self-esteem), but for those who have yet to receive it, here it is in all its glory. I might mention that by the time I wrote it all the tattooed, bald-headed guys had been discharged. I'm not crazy, after all. They could have mopped up the floor with me.
I am the toughest, Xena Warrior Princess in this place because I have fought depression for 35 years and 6 months and am still alive to tell you about it. The only time I broke was Jan. 2, 2011, and while it's true they had to bring me back kicking and screaming and I was mad as hell to be alive, I still got back up and started fighting again. So I think that makes me the biggest bad ass in here. And if you think you can top that, let me know and we'll go head to head.

Why Meds Are the Answer

These are things I wrote almost 20 years ago:

Saturday, 7/27/91
“Just make up your mind to be happy.”  Why is that about the
stupidest thing you could possibly say to a depressed person?  No,
really, I ENJOY feeling this way, so much better than such a
superficial feeling as happiness—this gut-wrenching pleading with God
to die.  I can’t stand life, I want out, why does God refuse?  Nothing
helps.  LET ME DIE.  I’ll gladly trade places with anyone.  I’m no good
to my children, no one understands.  Please let me come home.
But God never listens.  He does what he wants and letting me die is
apparently not in his game plan.  Ask and ye shall receive whatever God
wants to give so why bother asking.  Oh yeah, I forgot that other
jewel—“you can’t expect to grow spiritually if you don’t work at it.” 
You know where working at it got me?  In the hospital!  Because working
at it just proves you can’t have it—you can’t be close to God unless he
wants to be close to you.  He picks his people—I’m not one of them.  So
it’s better to ignore him and not feel the rejection.
Who do I blame—ME, ME you idiot, not everyone else. 
Concrete objects, people to blame are life buoys—hoping you can point
to SOMETHING SOMEONE WHY you feel this way.  So you can
believe it’s changeable.  Not just inevitably the way you are
PAINRIDDEN WITH NOTHING!  There’s absolutely nothing bad in my life to
cause this.  Don’t you see why that makes everything so much worse? 
It’s just ME.  INESCAPABLE.  Death is the only possible way out; only
way to escape ME, maybe it’s at least worth trying.  Anything would be better.

Now here's something I wrote just two months later, when lithium
started to work:

10-4-91
 On September 10 Dr. R. started me on lithium. Lithium is a metal, not an anti-depressant.
Eight days later I cooked dinner. I know this is no big deal to you--it
was a major step for me. I started planning things to eat, making
grocery lists and going to the store. Please bear with me--these are
things I was unable to do for over three years. I had to resuscitate
Dan several times for saying things like "Why don't we go to Homecoming
when the kids come Friday?" I made bread! Dan and I were both so scared
we'd jinx it if we mentioned these amazing changes that we didn't.
September 29th was a rebirth. It was a beautiful 80 degree day, and for
lack of a better word, I'll just say I took PLEASURE in it. I've barely
been able to sleep since, just remembering the emotion. I not only had
not taken pleasure in anything in almost 4 years, I had forgotten it
existed. I'd forgotten what it was that made most people want to live.
I had no more idea why people wanted to live than they did why I wanted
to die. I didn't know I could describe depression as a lack of pleasure
in anything and everything because I didn't remember it existed. I
almost cry every time I think of the sun, just remembering the pleasure
of sitting on our deck on a blanket with our ice chest and picnic
basket and kids. It was fun! You don't know how long it's been since I
experienced fun.
Another symptom of depression is the belief that God does not love you.
  Other people maybe, but not you. He doesn't like you either and would
just as soon you not have become a Christian. I had two amazing
thoughts pass through my head Sunday night. One, life is good, and two,
maybe God even loves me, maybe.  I have hope and can see possibilities.
You can't imagine what a miracle this has all been.

Back to the present time--
See why I think clinical depression has everything to do with your meds?  It's just not plausible that I worked through whatever mental demons were causing my depression and learned to overcome negative thinking and spiritual anguish in less than two months.  Unfortunately, the lithium worked for less than six months. 

Anger Turned Inward

Yesterday I had my second meeting with my new psychiatrist--the one connected to my out-patient therapy group.  I don't get to keep the one I had in the hospital because he strictly works with in-patients.  I knew when I came out of the meeting that I felt more depressed than when I went in, but it took my group digging at me to find out what triggered the slump.  I was angry at the psychiatrist and I had a perfectly good reason to be angry.  In fifteen minutes time, the doctor told me for the second time that I was on some very expensive drugs.  She told me I was taking less than one-half of the average dose of one of the medicines.  She told me I was in the 40-60 age group and that when she turned 40 her optometrist told her she needed bifocals, but she resisted because it made her feel old.  She told me she didn't have her son, who is ten years old, until she was 34.  And she told me while a physician only treats the body, a psychiatrist treats 33 facets of the whole person.  All I said was my glasses were trifocals and I didn't feel any better.  Oh yeah, she also demonstrated while scissoring her arms up and down that I needed balance in my life.  Do you see where I'm going with this?  She talked at me with no regard for my needs.  She did and said nothing of any use to me.  Instead of telling her what I needed--that I still wasn't sleeping, maybe I needed an increase in that very expensive medicine, that I fought depression for 35 years, so I was pretty sure it wasn't caused by my getting older, I turned my anger at her incompetence inward, at myself, because that's what depressed people do.  We don't even know we're doing it.  The professionals think if they can change our thought processes, we won't be depressed.  Maybe that's true; all I know is that when I'm on medication that's keeping the depression at bay, I don't have those negative thoughts.  I don't get mad at someone else but turn it on myself.  I've been unable to find a medicine for the last seven years that will keep the depression manageable, so maybe I'm stuck with trying to learn how not to think in a depressed pattern and that'll have to be good enough.  But don't you think it's a hell of a thing when your psychiatrist makes you worse?

No One's Fault

I planned my suicide for a year.  Nothing anyone did or didn't do had any effect on my decision.  Throughout 2010 I set dates to get past to help me make it until Christmas.  I wanted one last Christmas with my family, but once that was over I had exhausted all of my resources.  I didn't have the strength to climb over even one more day.  I'm posting this so my family can know for sure nothing was their fault.

This is something I wrote in July 2010:

       I’m not sure how I’m going to get through the weeks I’m staying with my grandsons.  Maybe just seeing them will cheer me up.  I think I probably should be in the hospital, but that doesn’t do any good except to keep me from killing myself, and I’m not sure I want to be kept from killing myself.  It’s not like some magical drugs will suddenly appear if I’m hospitalized.  There’re no other drugs to try.  I have nothing to look forward to except more years of this pain that remains incomprehensible to those who haven’t experienced it.  There is nothing to alleviate this sense of gloom and dread “that obliterates any enjoyable response to the living world.” [William Styron, Darkness Visible]  I copied Styron’s words about “presenting a face” and I wrote “Splintering” to try to make you see that I have 35 years of practicing how to be sociable when I feel like shit.  Yes, there are moments of gladness, but they are ruined by the knowledge that only pain will follow.   “What makes the condition intolerable is the foreknowledge that no remedy will come.” [Styron]  I already had six years of unremitting misery and now I’m expected to survive this additional seven plus God only knows how many more.  I’ll give the hormones a chance to act, but I don’t think I’ll have the stamina to make it to Christmas. 

If the depression is never-ending there is no answer but suicide.

Diametrically Opposed Sensory Input

My sisters were a huge help to me while I was in the hospital (and after my release) and would never really mean they'd hate me forever, but one way I coped with the pain was seeing the humor inherent in my situation:
On Sunday Sis One says "You aren't trying in here.  The nurses and staff tell me you're cheerful and friendly and smiling and one of their favorite patients.  Quit faking and show them the real you or I'll hate you forever!"
On Monday Sis Two says "You're going to quit using bad language to the staff and cooperate with the program and be nice or I'm going to hate you forever!"

Already having to edit this post--no, my sisters didn't really say they'd hate me forever.  And to their credit they immediately backed off the advice-giving the minute it was pointed out to them that maybe they could play a better role by just being supportive--which they did.  Nevertheless, I thought it was funny that they told me these two opposite things and I needed all the laughs I could get.

The Cruel Joke

  Once upon a time a girl woke up to find herself in a deep, dark pit.  It was so deep she couldn’t see even a glimmer of sky shining at the top of the pit.  No one seemed able to see the girl in the pit, yet she could hear them talking.  They said things to her:  “Why don’t you climb out of that pit instead of wallowing down there in self-pity?  I was in a pit once, but I just picked myself up and climbed right on out.”  She tried to climb out, but she couldn’t find any footholds; every time she made any progress up the walls of the pit, she’d suddenly slide back down and the floor of the pit would drop even deeper, if that were possible.  She grew more and more miserable in the pit and it was hard to remember a time she hadn’t lived there.  Occasionally someone would pass by and yell down at her, “What have you got to be miserable about?  I’d count my blessings if I were you instead of moaning about what you don’t have.” 

          One day the girl looked up and saw something light at the top of the pit.  Every day it grew larger until she finally recognized it as sky.  The floor of the pit had miraculously risen to the point that she could climb out.  She felt so much better to be out of that hole.  But soon thereafter, a doctor told her she was sick and began cutting off parts of her body and giving her poisons to kill whatever was making her sick.  The girl really didn’t mind at all, because compared to being in the pit, these were happy golden days.  Nobody said, “Everybody gets sick—get over it!”  To the contrary, people were kind and loving.  They asked how she was doing and didn’t appear to expect her to get better all on her own.  No one told her if she died it would be incredibly selfish of her.  The girl got better and was glad all that was behind her. 

But the day came when the girl looked around and noticed all her furniture had been moved back into the pit.  At first she could get out, but gradually the floor of the pit sank lower and lower until once more  she was stuck at the bottom of a deep pit with no way to climb out.  She would rather be dead than be back in this pit with no way out again.  How she regretted having survived the illness!  She would never have cooperated in being cut on and poisoned just so she could go back to living in a horribly dark and lonely pit.  She felt it was most unfair.  Years went by and the girl hoped maybe she’d get sick again and this time she’d know better than to seek any treatment to get well.  Yet she remained disgustingly healthy.  It was a cruel joke.

I had breast cancer in 1995 and went through a mastectomy and chemotherapy.  From about 1994 until about 2003 I was on medication that kept me from being suicidal and gave me enough strength to handle the depression.  Often anti-depressants work for a while but then stop.  It makes me compare all the stuff in my brain to cockroaches--always mutating to adjust to new poisons so they can keep scurrying around in the dark recesses of my mind.

From Carrie Fisher's book Wishful Drinking

“One of the things that baffles me (and there are quite a few) is how there can be so much lingering stigma with regards to mental illness, specifically bipolar disorder.  In my opinion, living with manic depression takes a tremendous amount of balls.  Not unlike a tour of duty in Afghanistan (though the bombs and bullets, in this case, come from the inside).  At times, being bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of.  They should issue medals along with the steady stream of medications one has to ingest.”

I was always jealous of the manic-depressives because they occasionally got to have some ups.  But after talking with some in the hospital, they explained the ups were not that great either.  One of the most common misperceptions about depression is that its sufferers are somehow weak.  The opposite is true--just living through the day takes, as Carrie says, stamina, courage and balls.

Fun Times on the Psych Ward

Oddly enough, I had some of the best times I'd had in the past year while I was confined in the hospital.  Mainly this was because I was able to talk with people like me.  I didn't have to try to explain something that's unexplainable.  We "got" each other.  It was the first time I met someone else who'd fought depression for years and years without any let-up.  One night we were playing cards.  We'd been turned out of the dining area, then the overhead lights were turned off in the lounge so we couldn't see to play where the card table was.  The only other tables were little round decorative columns about 15" in diameter and maybe 2 1/2 feet tall.  We pushed three of these together like a 3-leaf clover and crowded around them.  The game we were playing required each player to have 6 cards laid down in front of him/her in a 2x3 pattern.  With four of us playing, you can imagine it was impossible to keep our cards straight on three small circular spaces.  Every depressed person I've met also seems to have at least a touch of obsessive/compulsive disorder.  Someone finally said, "Is it really bugging you that we can't line our cards up equi-distant from each other?"  We all cracked up because everyone of us had been worrying with that same thought.  One guy volunteered his first wife had divorced him because she couldn't stand that his red shirts had to be on red hangers, white on white.  "I see nothing wrong with that at all!" another patient told him.  His mother could never send him to his room as punishment when he was a boy because he'd spend hours organizing his closet and drawers.  When I was a camp counselor one summer, the girls could never understand why they could never short-sheet me--I had a plaid bedspread and those plaids had to be perfectly in line when I made that bed.  Just a glance at the bed and I could tell if anyone had messed with it. 

Progress

I did make progress in the hospital.  One of the first nights I was there one of the alcoholics said something innocuous about tomorrow being better.  I just went off on her:  "You fucking idiot!  Tomorrow is never better!  You can say you have a day of sobriety, then a year, maybe five years of sobriety.  I never have an hour when I don't want to be dead!"  The day I was discharged a well-meaning patient (interestingly another alcoholic) said, "When I'm depressed I try to learn a new craft or get involved with helping other people."  I said nothing.  Maybe because I continued to say nothing (or did I have a deranged look in my eye?) she said, "I guess I shouldn't have tried to give you advice.  I'm sorry."  I very calmly replied, "I realized you knew absolutely nothing about depression.  You're forgiven."  But what I was thinking was "Wow, why didn't I think of that in all these 35 years.  If I'd only taken up macrame and been a Girl Scout Leader I could have been happy!"  All depressed people encounter well-meaning advice-givers fairly frequently.  My sister told me I should have said, "You have confused having a case of the blues with major clinical depression.  In fact, I've been a volunteer answering a crisis line for rape and domestic abuse victims for over twenty years and teach scrapbooking.  Too bad it does nothing to alleviate my depression."