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.

Tuesday, June 6, 2017

Ketamine Infusion #2

As my friend drove, I tried to be with her in the car in conversation. It was difficult. I felt very anxious about my treatment. I walked into the treatment room upon arrival as they were ready for me. I sat on the bed and shivered as I took off my shoes. The room was freezing! I jokingly complained and the nurse agreed with me. I was asked some questions by the doctor and then completed a self-report about my mood. The IV was inserted and the infusion began. The lights were dimmed and after a few minutes I started to feel that sense of slowness.

It was quiet and aside from the nurses checking on me, I was left alone. While I was fine with that, after a little while, I began to cry. I had so many thoughts in my head which were heightened. The nurse brought me tissues and kept checking on me. There was a point when I had an itch on my head and the process of taking my arm from under the blanket and moving it up in order to scratch felt so slow and odd. I almost asked the nurse if I was okay as if I could not gauge myself. It was a little scary.

The infusion finished and within a few minutes I started to feel a bit clearer. I spoke with the doctor who assured me that crying during the treatment is no indication of whether the infusions will help or not. He said there are some patients who sob during the infusions but a few hours later feel good. That allayed my fears.

It's been several hours since I completed the infusion and I feel tired and sad. I am hopeful and ready to feel sparks of feeling better.

Thursday, June 1, 2017

Ketamine Infusion #1

We drove in almost silence. His hand in mine while he drove. I felt numb and nothingness. We arrived and I felt such sadness. Walking into the hospital, where I have been inpatient and received ECT, I felt traumatized and scared. We took the elevator to the basement to check in and as we walked out of the elevator, the smell overcame me. It sparked my memories of walking down the same hall for ECT. I checked in and then underwent cognitive testing for 30 minutes. I had to remember a bunch of words, over and over again and then remember cards simulating different games. I did not do terribly but I did not do too well.

After they walked me to the room where I would receive the infusion, which happens to be the same room where ECT is done. I had to say goodbye to Ken and his hug and kiss was what I needed. The doctor walked me in but the bed was actually not ready. He led me to the waiting area and I began to sob. Ken had already gone out to get some breakfast and I sat alone. Luckily it was only a few minutes and the doctor retrieved me and I walked in to the room where I received ECT treatments, the room that had the same smell. The two nurses who greeted me were known to me as they also work with ECT patients. That helped. As they hooked me up to monitor my heart rate and blood pressure, I continued to sob. I was so sad and so scared. It felt as if this were my very last hope at feeling well. Doctors came in and out and when the medical director came by, who has always followed me when I have been inpatient, I felt a bit of relief. I told him I was scared. He said the only side effect would be that I would feel better. I laughed. It was typical of something he would say. I was so glad and thankful he came to talk to me.

They started the IV infusion and I clenched the dirty tissues in my hands. After a few minutes, everything felt slow and unreal. The nurses and I talked and it felt as if I could not stop talking. I hadn't been that talkative in months! The doctor came by and said I seemed to be very talkative and he said some people experience that during the infusion. People (nurses, doctors, medical student) came by and talked to me, treated me as a human, supported and comforted me. I could not move my head too much as it felt as if my head was stuck. It was not upsetting just strange. There were some quiet times and I was aware of my surroundings but also felt like an observer of my own experience. Time felt slow but before I knew it, the IV finished and I was done. Within minutes I started to regain myself. I was able to turn my head normally. My blood pressure went down. Then I was released. I will return on Tuesday. I may feel a positive reaction after this one treatment or it may take more. I am trying not to put too much pressure on myself.

As Ken and I walked out of the hospital, the medical director was also walking out. He was glad my treatment went well and it seemed fitting to see him as we left. He is not just a very intelligent psychiatrist, he is such a genuine human being.

It's only been a few hours since my treatment ended. I have eaten and taken a walk on this beautiful day. I am feeling a bit sad right now but I am here and I will continue to do everything in my power to get better.

Sunday, May 14, 2017

A Mother's Day Message to My Daughter

It was dry heaving as the morphine took hold. It was seeing this wet, screaming, angry face. It was sobbing while trying to have you latch on. It was listening to your screaming as I tried to soothe you. It was staying with you in the hospital at 5 months old and worrying that I had damaged you in some way. It was being with you in a treatment room at midnight while the doctor inserted a feeding tube through your nose. It was struggling to teach you to drink formula at the same time as teaching you to drink from a bottle. It was hearing you throw up through the baby monitor and then thinking through how to manage the clean up of you and your crib. It was being with you in the hospital at 8 months old and worrying about your weight. It was worrying about you reaching your developmental milestones. It was worrying about strengthening your legs to be able to walk and it was worrying about your feeding therapy. It was laying with you when you had a 102 degree fever. It was holding you tight while you kicked and screamed when you got your flu shot. It was holding you and reassuring you when you got your ears pierced.  It was talking with you while you cried about an incident at school.

These are the times that truly made me and make me a mother. The love and care came at that first second when I took that pregnancy test and saw two lines. The full heart, warmth, joy and excitement are the easy parts of being your mother. It is the hard times, the times that test my very being, will and strength that really make me your mother. You make me feel humbled, proud and speechless. You are my child and I am your mother.

Sunday, April 30, 2017

Deeper Facts of My Depression

Most people have some level of understanding of depressive symptoms: sadness, hopelessness, sleep issues, appetite issues, etc. There is so much more though that people may not realize.

Firstly, the person with depression may not be thinking clearly, for example, a friend told me how hopeful she is that I will feel better soon and my interpretation of that was that she did not actually care about me. One plus one does not always equal two in the mind of someone who is depressed. My cognition is greatly impaired and while I can be aware at times of this impairment, the thoughts and feelings feel very real to me. It leaves me in a constant struggle internally which is heartbreaking and energy consuming. This is on top of those “known” symptoms of hopelessness, helplessness, extreme fatigue, low appetite and feelings and thoughts of worthlessness.

Also, my experience is that there is no rhyme or reason in terms of the severity and timing of symptoms. Yesterday morning I felt okay whereas this morning I woke feeling a lot of anxiety. Each day is different right now which is also exhausting. I have no idea what to expect.

I also need what I call “babysitting.” My husband does not want me to be alone for a long period of time. While I can understand this from his perspective, from mine it simply means I am needy and weak and have to impose on others when my husband is not around. I feel like a child and embarrassed. I do not like to put people out and I do not like changing people’s schedules in order to benefit myself. I realize this may not sound like someone who is grateful to have such wonderful people supporting her but this is how my cognition is currently running.

I also feel as if every slight and every unfortunate life incident is my fault, whether it be dropping and breaking a glass or tripping and falling. My inner monologue: Of course, these are all my fault and if I weren’t so stupid these things would not have happened.

What my friends may not realize is that the quick text checking in or the quick call is so helpful. Even if I am not talkative in that moment, I know they are there and will be there to help in any way they can. This may not be well conveyed by me but I mean it. There are not any grand gestures they need to do. Just knowing they are there is extremely supportive and helpful for me.

This is my life right now, every hour, sometimes I feel it every second. It is relentless and to say it is exhausting is not giving it the power it has. My negative thoughts can be terrifying at times and only adds another layer to this experience that I am fighting with all that I can.

This is hard. This is scary. This is real. This is more of what my depression does to me and my life.

Wednesday, April 5, 2017

It Really Is What It Is

Relapse, deteriorating, worsening…symptomatic, sick, not well, dip. What should this be called? It came on so quickly, I am simply not sure how to label it and yet it feels like it needs to be labeled as something. It needs to have a name so I can feel some validation of my experience. It’s not a big deal but it kind of is, to me, in my head. Within one week I went from a relatively normal mom and wife, with everyday worries about my family and life in general to a woman with such darkness inside, self-hatred, no self-compassion, difficulty sleeping, eating just to eat and not really enjoying the food, extreme fatigue and hopelessness. Damn, it came so fast. I envision depression as a black ink blot that can fluidly move wherever and whenever it wants. When it wins, which it did as of last week, it is bolstered with more energy and more stamina while mine becomes depleted.

Lessons learned: Last week my husband told me to call my psychiatrist and my TMS (Transcranial Magnetic Stimulation) nurse. Each day I would give another excuse as to why I did not call. Honestly, I thought with each new day that I would begin to feel better. I also did not want this to be real. Who can blame me? It’s been a trying few years and if I were to call this #4 (4th depressive episode within 3 years) it would give it too much power even if that was my reality. My husband now knows he should not believe me when I say I will reach out at these times, because, most likely, I won’t. I am usually not thinking clearly and should not be trusted. He has permission to contact any of my treatment team on my behalf. In a way, it is empowering for us both as he can play a vital part in my treatment and recovery.

I had TMS this afternoon after returning to Hartford from Boston where I saw my therapist. While I felt numb and negative this morning, following my therapy session, I felt a bit more clear about what I need to do. I need to jump on this shit and beat it down. I am worth it and even when I do not believe that, I will still be worth it. My husband and daughter are worth it. I can do this. I can try not to wallow. I can advocate for myself and am ready for a battle with my insurance company re: TMS treatments, if necessary. It basically comes down to the TMS. That is what will pull me back out of this and that will be my ongoing treatment to ward off any further episodes.

So, what do I want to call this? Well, it’s depression and it’s being treated very early on. It could be a relapse or a deterioration but why can’t I call it what it simply is? I have depression. That fits and that feels right. I don’t want to get too caught up with semantics but one thing I have learned from DBT (Dialectical Behavioral Therapy) is the importance of having one’s thoughts and feelings validated. My thoughts and feelings are mine and they are experienced by me. I feel depressed. I am not comfortable calling it my relapse, my deterioration, my dip. It does not feel right for me. There does not need to be any fanfare and I am now doing what I am supposed to do to get better. I am depressed. There it is. That is what it is so let’s just go with that.

Tuesday, March 7, 2017

What Happens in Therapy Doesn't Stay in Therapy

Imagine sitting in a room which is comfortable, sitting across from the same person for years. Imagine doing this once or twice a week for 45 minutes for years on end. Imagine sitting in front of this person and looking at her, noticing her, listening to her. Imagine thinking you have a relationship that, for what it is, is normal. Imagine questioning this person's care and attention over and over and over. Imagine believing what you think about this person, how you perceive this person is normal...reality based. Imagine being blown away 23 years after first meeting this person to realize you never actually were sitting across from her and seeing her, really seeing her. Imagine having this realization over the course of several weeks, maybe months and having to process this intense and emotional realization. Imagine feeling this in your head, your heart, your upset stomach and not completely understanding what is happening to you. Imagine talking to this person, in that comfortable room, and explaining these confusing and amazing thoughts and feelings. Imagine recognizing that what was believed before was not quite the reality. Imagine looking to someone for constant reassurance that what is happening is okay and safe. Imagine seeing someone for the first time after only looking at them for 23 years. Imagine feeling a new sense of safety in that comfortable room and a new sense of calm as well as utter fear. Imagine experiencing something that is slightly confusing yet emotionally amazing at the same time. Imagine feeling uneasy and terrified while feeling emotionally amazing. Imagine feeling as if you accomplished something so big, so important and so vital, not only for this relationship but for others in your life.
Imagine this. Imagine this is what can be accomplished in therapy. Imagine doing the work, hard work in order to get to this point, this point of unknown. Imagine seeing someone as real, positives and flaws and all. Imagine the relief.