Friday, July 14, 2017

Welcome Home! You're All Better?

I have been home from the psychiatric hospital for a week now and, at times, I am overwhelmed by very small things. It is a wonderful thing to be discharged from the hospital particularly when there is a good plan in place and one feels safe. That was certainly my experience. To be honest, though, it is not easy. One may think being back in the comfort of one's home would feel soothing and relaxing but for me, I have not consistently felt that. I certainly sleep better in my bed with my life partner by my side and I certainly like not being checked on every 15 minutes. The stresses that brought me to the hospital are still there although dulled. I am still experiencing weird occurrences of remembering different aspects of being in the hospital as brought on by smells or sounds. I need to be careful when that happens not to allow it to take over my thoughts in those moments as it will not accomplish anything positive.

I am still not feeling great so I still need to monitor my symptoms. That can be difficult at times. There are times when I feel like everyone in the entire world is texting or calling to check on me and it feels too enormous to respond. That then brings on tremendous guilt and its own version of negative self-thoughts. The truth is nothing about this is easy for anyone involved in my life.

My therapist had used the term that I needed "a break" and classified that as me going to the hospital. I told her this week that I could not continue to describe my hospitalization as "a break" as it was not as if I took off a few days to go to Canyon Ranch (I wish!) or took a few days at the beach. In my mind, it was not really about taking a break but rather keeping me safe. That was the bottom line and the reality of my hospitalization. That is the new language now that I will be using. While I may have also needed a break from reality, the intention of going into the hospital was to keep me safe, simple as that. I talked with my husband about this language and he agreed. I am learning a lot right now about how important it is to let others in. It was important to tell my therapist that I did not agree with her language and we were able to talk about it and come up with a solution. Also, just as important, I knew to bring this to my husband's attention in order for us to be on the same page. Semantics can carry a lot of meaning and it is so important for me to be understood. It is a very empowering feeling.

What would be helpful right now? Certainly hearing from my family and friends is important, I just may not respond if I am not up to it. It is not personal. I need to let others into my world a bit more as I have been unable to do so for months. This is very hard for me as I have not felt others "with" me in that emotional way in several months as my depression has fought against those feelings. Cut me some slack while I find my way. Yes, it is great to be home from the hospital but there is still a lot for me to acclimate to socially, emotionally and rationally. I need to try to give myself a break, too, during this process and for me that is like delving into the unknown. It scares me but I can intellectually see how important it is to my ongoing recovery.

My new medication is holding a lot of hope and during this waiting game of a few more weeks as it kicks in, I have chosen to have a couple of ECT (electroconvulsive therapy) treatments to help me get through. This was not an easy decision to make and although I originally told my doctor in the hospital I would not have more treatments as an outpatient, I came to it on my own once I was home for a few days. I felt empowered and terrified making this decision as there is so much anxiety for me before each treatment. It was helpful though while I was in the hospital and I need to give myself every opportunity to feel better. As my very eloquent therapist said to me this week, "it's enough already!"

Yes, it really fucking is.

Thursday, July 6, 2017

Hospitalization: One Week

A week ago today I went for my early morning ketamine treatment at the hospital and never left. The plan was set in motion last Wednesday. I needed to be hospitalized and I needed to be safe. I was not thrilled with the idea but was the one who made the call to push things forward.

I met with the doctor who always follows me when I am inpatient and we came to an agreement: I would have 3 ECT treatments before beginning my new medication which I could not begin until today. I had the ECT treatments which brought back a level of anxiety in me I would not wish on anyone. They seemed to help my mood though so I am holding on to that positive. The first ECT was difficult though as ketamine was used as the actual anesthetic which I had never had before. I had difficulty walking after the treatment and even required 2 counselors to help me in the bathroom which was one of the most humiliating moments of my life. I was shaky all day but was told that they would go back to using the anesthetic they used in the past for future treatments.

I went to groups, talked with other patients, counselors and doctors and took care of myself. It was a difficult 7 days. I was away from my daughter, whose only understanding of me being away was that I went somewhere to get new medicine for my depression. I missed her more and more as each day went by. My husband visited as did my parents.

Evenings were the most difficult for me. I felt desperately alone and ached to hold my daughter. I worried about the burden I had become to those I love. I perseverated about these things over and over again.

I knew I needed to be in the hospital and did not waste time going over that. I needed to be in a safe place with little responsibility.

I am home now and very happy to be here. I feel exhausted and a bit overwhelmed. I still need to take things slowly and moment by moment. No extra pressure needed here!

I began my new medication this morning which comes in patch form (MAOI). I pray for positive results. I only agreed to a few ECT treatments to lift me up enough out of my misery in order to hold me until this new medication kicks in. I am terrified of doing more because of my memory issues and because of the great anxiety that is conjured up prior to each treatment. Again, I am focusing on moments at a time right now while I transition back to home life.

I will say it again: depression is a mean and horrible illness and I will continue to fight it with everything I have. I am lucky to have my treatment team in place and my family and friends are right by my side. It will take me some time to thoroughly process the past 7 days and I know I need to give myself that time and opportunity. Honestly, it's a lot. A lot transpired during the past 7 days and while some was inspiring, some was downright terrifying and brought me to a place of pure despair and loneliness.

If you see me, if you want to contact me, just be positive and be supportive. I honestly cannot handle anything more or less right now. Just be real.

Tuesday, June 20, 2017

Ketamine Infusion #6

The past few days have been very difficult. I am almost completely off of my anti-depressant and I feel it (need to go off of it and then wait 2 weeks before starting new anti-depressant). I have been extremely irritable and anxious. I have had brief moments of brightening, especially yesterday when I picked up my daughter from the camp bus stop. As we drove home, I blasted "Dancing Queen" and we sang at the top of our lungs. That was a good moment.

I was definitely not looking forward to today's infusion. During the infusion, I was more "with it" and felt part of my surroundings. When the nurses and doctors talked to each other, I could hear them and felt I was in the room with them. It was the last 10 minutes or so, though, when the tears flowed and I felt alone and terrified. All of the negative thoughts that I have on a daily basis were magnified X1000. I sobbed thinking the terrible things I think of often they were just swirling in my brain all at once: I am a terrible wife, my husband chose the wrong woman to be with, my beautiful daughter is losing out with a mother like me, I do not deserve to feel better, and so on...

I was relieved when the infusion machine beeped signifying that I was done. As I came back to myself, the nurses kept checking on me, cleaning away my used tissues and reassuring me. I felt better as the minutes passed and was happy to be done.

The plan is to have one infusion next week and one the week after, to make up for the two weeks without an anti-depressant. As of this exact moment, I feel better, more aware, focused and my mood is definitely a bit elevated. Of course, I have little stress to fuel my negative symptoms today as I am home and on my own schedule for the rest of the day.

And so it goes...

Thursday, June 15, 2017

Ketamine Infusion #5

I was not looking forward to today's infusion, but again, I am holding on to hope so it was worth it. Today's experience was slightly different. I felt more aware of my surroundings than in my prior infusions but the last 10 minutes or so were similar to before. I cried and felt isolated and paralyzed. I could see the people and surroundings around me but I felt completely separate. That terrified me. Luckily, the nurse was right there for me. Even as the infusion ended and my IV was taken out, I continued to cry, feeling nervous and scared.

As I came back to myself and had something to eat, I felt more stable as my head became clearer. My husband and I then met with the doctor. We discussed my progress and the necessary med changes. He gave us some options and I will be trying a medication class I have not tried before. I left the meeting feeling a spark of hope. I am eager for this change but it involves slowly tapering off of one of my medications and then waiting 2 weeks before starting the new one. The next few weeks may be difficult. It is only now, in this moment, that I see that I will get through this transition...there is no other choice. My therapist and my doctors at Yale are right there with me and even though I still can't feel it, I see them. Their experience and expertise have guided me thus far and I trust them implicitly. Most importantly, my husband is right there beside me and I know I am very lucky.

I will have one more infusion on Tuesday and then the medication changes will continue. I am nervous about the next few weeks, but since I have already come this far, I can make it through this.

Tuesday, June 13, 2017

Ketamine Infusion #4

I had a few days where I felt clearer, more with it and actually part of life. It felt good. I wasn't "cured" as my mood was not greatly improved but it was certainly a difference. By Saturday late in the day, however, I started to feel more out of it and the past couple of days, while I have felt more in touch with my surroundings, I have felt more sad and irritable. I went in early this morning for my treatment and reported all of my updates. I was not necessarily looking forward to today's infusion but the prospect of feeling some relief was my motivation.

Again, as the heaviness hit me, the tears flowed. I became frightened as I felt so alone. While the ketamine enters my brain, it forces me more into the bubble I already feel stuck in. I see everyone around me, hear voices and sounds and can make sense of them, but I feel cut off and as if they cannot see me. I asked the nurse for tissues and she asked if I was ok. I responded asking her, "am I okay?" She touched my arm and said, "you are okay. I am here with you." While that made me cry more, it was the most comforting thing to hear in that moment.

I then started thinking of my beautiful daughter and was focused on her face. I missed her. I also thought of my husband and how much I wished he were sitting with me holding my hand, reassuring me. I thought of the conversation I had last night with my therapist who told me that she and my other doctors are there for me, in it with me. I cried more. I focused on the fact that I would see her tomorrow. I reverted back to thinking of seeing my husband once my treatment was over. I cried more.

The infusion ended and I was relieved. I drank water and ate some graham crackers and watched my blood pressure decrease (the ketamine increases it). I was a bit wobbly as I walked to the waiting area to my husband but was so glad to see him.

I go back for infusion #5 on Thursday and then we will meet with the doctor to discuss long term plans. This will involve medication changes as there are actually some meds I have not yet tried! For now, it is one day at a time.

Thursday, June 8, 2017

Ketamine Infusion #3

Yesterday I had several hours where I was more alert, involved and could formulate and explain my thoughts. My therapist told me I seemed a bit more together. By the early evening though I began to feel irritable and sad. I knew those hours when I felt clearer were a good sign and my doctors confirmed that this morning before they began my infusion.

I was nervous before they started and once it began that heaviness came over me and I felt as if I were watching everything from outside of myself. I began to cry as I looked at the clock and saw it was the time when I would wait with my daughter for the school bus. I did not see her this morning as I had to be at the hospital very early. I cried more when I thought of her and missed her so much. I focused on her face and what it feels like when I kiss her cheeks, her soft, perfect skin. I focused on her smile. I cried harder. The nurse asked if I was okay and I told her I was but I was aware that I felt scared and not okay. The doctor reassured me.

I then thought of how I am such a burden on my husband, daughter, family and friends. I felt trapped in the bed in the room as if this is my life now and my existence consists of being outside of myself. I cried more.

I looked around and all I wanted was comfort and while the doctors and nurses provided it to me, it wasn't enough. I wanted and needed more. I could not feel it. I started to imagine my therapist coming toward me and reassuring me. It felt slightly real although I was not hallucinating. I think I was trying to feel a connection to someone or something. I then cried more, feeling so unsatisfied.

The infusion ended and I was glad as I regained myself. It really is such an odd experience and while it is not terrible, it is certainly not enjoyable. Some do enjoy it, some sob throughout, it depends on the person. I do think it is beginning to help me though and that is all that really matters. I have a life, a beautiful life that I want to live in from inside of myself, not outside looking in.