Monthly Archives: March 2013

see my psychiatrist tomorrow

second visit with my psychiatrist tomorrow. i hope to get more information on bipolar depression. I still know so little.we will be talking medication. likely down to lithium or lamictal. Also, it will be an opportunity to ask questions. mary, my wife will be there, too. it will her an opportunity to ask questions. hopefully, it will be an opportunity for education also. she still lacks information about depression.

 

i followup tomorrows.

clouds and sunlight

the three i’s of depression

my last psychologist, jacob mathew, introduced me to the three i’s of depression and anxiety. this is based on the works of kirk strosahl. the three i’s of depression are inescapable, interminable and intolerable. people dealing with depression and anxiety face at least one of the three i’s.

feeling as if the situation is inescapable means there is a feeling that one can not get away from the situation. feeling as if the situation is intolerable means that one feels they can not stand the situation any longer. the third nemesis, interminable, makes one feel like they are on a hamster wheel and can not get off, that the situation will never end.

myself, while i am in a depressive cycle, i usually face inescapable and interminable. i hate when i add intolerable and fall into the depressive trifecta. when that happens, i start to feel truly overwhelmed and thoughts of suicide start to creep into my head.

all of these i’s are forms of despair, or put another way, lack of hope. the challenge for depressive people is to somehow fight through the muck and find hope in their situation.

to fight through, it people struggling with depression and anxiety can:

start tunneling–make plans for an escape or have a glimpse of freedom from the situation.

tolerate this!–take steps to make your situation more tolerable. weaken the thoughts that make the situation so intolerable.

get off the hamster wheel–take steps to make your life less interminable, find a glimpse of the light at the end of the tunnel.

seattle japanese garden panorama

a reflection on shame

as i reflect on my recent post the choice is yours:guilt or shame, i realize much of my current depressive cycle is tied up in unmet expectations.

i am not the provider that my wife, or me for that matter, wants me to be.

i could not make a go of my first business endeavor.

i isolate because i don’t want to call my friends. perhaps, i have done something wrong and won’t meet, or haven’t met  their expectations.

i am not the brother my family wants me to be. i have seemingly alienated my brothers and sisters with things i have done or said. i am not meeting their or mine own expectations of what a brother should be.

all of this ties me to shame. shame makes the leap from i feel bad to i am bad. that feeling, “i am bad” ties me up and holds be prisoner. the stronger that feeling becomes the stronger the grip of depression becomes. i feel like the walls become thicker and thicker, like there is no way out. i fell like i am in an inescapable place.

That reminds me about the three i’s of depression, but that will have to be another post.

so, my challenge going forward is to explore these expectations. they seem to be the root of my current depressive cycle. perhaps some of these expectations are misguided. perhaps some of them need to be re–explored. perhaps some of them need to be re–adjusted. maybe some of the expectations are now truly unattainable.

i must truly face and hopefully defeat these expectations if i am to have a chance to break from this current depressive cycle.

fall on the way to kendall catwalk

the choice is yours: guilt or shame

this is a rework of an earlier post I wrote, written in a better time, but holds true more than ever.


i watched brené brown’s ted talk, listening to shame, a while ago.

it dealt with many aspects of shame. one thing she talked about is the difference between guilt and shame. to paraphrase: guilt is I did bad. shame is I am bad.

is it any wonder that children raised to value themselves as the gift to the world that they are, can stay away from shame. they learn just because they did bad doesn’t make them bad.

on the other hand, children raised to not value themselves, the jump from doing bad to being bad is so much easier to bridge. for them, it has been ingrained in their mind that they are bad, that doing something bad almost automatically triggers being bad. it’s what they know.

for those of us who fall in the second group, we are faced with an ongoing challenge; guilt or shame. falling into the I am awful, horrible, bad, whatever negative, is so easy to do. It is what i learned growing up. when I do I am snared in the trap of shame.

just like any trap, the longer the time spend in the trap, the more damage that is done. the trick is to find a fast escape from the trap. how can that be done?

just as i have learned to have a hair trigger reaction from doing to being bad, I can also teach myself to go the other way. when i fall in the trap of being bad, i challenge the thought. i ask myself why that is true? what happened to make me bad? i know i am a creature of god and worthy of being good. this feeling bad must be a ruse. i ask myself why I am feeling that way?

most often it can be traced back to recent events. it is not hard to find where i haven’t lived up to my or some one else’s expectations. when I have done wrong, bad or maybe something worse. it is usually as plain as the nose on my face. that pathway has got turned around. it has gone from me doing wrong  to me being wrong, worthless, good for nothing, a loser.

i am left with the choice, guilt or shame. do I stew in this horrible feeling or do I challenge it? if I stew in it, i choose shame. if i challenge it, challenge those feelings that have been a part of me since my youth, those beliefs that just because I made a mistake  makes me a mistake, i choose guilt and i am better off for that choice. i am closer to being that creature worthy of love that god wants me to be.

believe me, that choice is not easy, forty some years of learning is difficult to challenge. but, challenge it i must if i am to be one of god’s creatures, one worthy of love, not a creature absent of love that has been too much a part of my life for to long.

i add the following:

somehow living in depression makes that jump from shame to guilt seem like a deep and wide chasm, one that is impossible to make across. it is as if the switch of guilt or shame is solidly and completely frozen in the shame position. there isn’t even a pang of guilt. a strong arc jumps the gap and seemingly permanently welds the switch to shame. every thing that goes wrong ends up with an, “i am bad feeling”.

perhaps that is why depressive people like me sometimes struggle with suicide; they feel no guilt, only shame. any and everything that goes wrong, they equate it with how bad of a person they are. after awhile that becomes both wearing and something one can start to believe.

that being wrong, worthless, good for nothing, a loser, awful, horrible, bad, pounds in our heads like a big bass drum; pound pound pound pound pound pound pound pound pound. one wants to be free of it. in that broken state of mind, taking ones life seems like the only way to be free of that endless beat.

as i reflect back on what i wrote about a year ago, i notice so much of my depressive struggles is tied to expectations, unfortunately unmet expectations. i am not the man i hope to be not in the place i wanted to be. because of the ingrained shame of most of my life the fact that i am not where i want to be, that i am not measuring up, turns into shame. this shame is powerful and seems to have a shame mind meld on me.

i also have a pang of  hope. i once had control over the guilt/shame switch, that same switch that seems broken now. perhaps, i can once again somehow break that bond that keeps me attached to shame and feel the ‘freedom’ of guilt again.

ps. as a finish this, a realize that catholic guilt, and any religious guilt for that matter, isn’t really  guilt, but shame. it is most often a manipulation to make use feel bad. so, don’t get the two confused.

reflections off the water

why’s it gotta be so hard

i hate depression. i’m in pretty deep right now. i know because self care is such a struggle. why’s is gotta be so hard? i know i gotta do stuff good for me, but i just can’t seem to do it. these are just some of the good things i’d like to do.

  • be open with my wife. that’s just to scary. she might no like where i’m at.
  • take a walk every day. my body seems stuck in molasses.
  • talk to friends. the phone feels like it weighs 500 pounds.
  • avoid sweets. the draw sucks me in like a black hole.
  • speak up for my needs. if i’m feeling down, i don’t feel important and my needs don’t feel important to me. i get clear formed thoughts in my head, but they seem to get lost on the way to the mouth.
  • take time to build resilience. its easy with something like superbetter.com. there seems to be a mental block  to doing that. it’s as i have already lost the battle, so why fight.
  • avoid being a victim. it’s so hard to battle from being the role of a victim. in a depressive state though, i feel like brer rabbit playing with tar bunny. stuck.
  • avoid isolation. on my deserted island, where i feel so alone, the nearest land seems miles away. why even try.
  • get out of the house. it as if all of the doors are locked from the inside. no way out.

i want to get back to a place where these are easy to again. I don’t think that’s to much to ask.

blue boat getting away?

letter to the family

this is an email that i sent to my family letting them know of my new diagnosis.


title: Good New!

body:

I’m bipolar.

I bet your reaction was similar to a good friend of mine. His wife has struggled with depression much of her adult life only to be diagnosed bipolar. He initially replied to my diagnosis , “I’m sorry.”
You see, even he, who deals with this disorder every day, still fits into societal stereotypes. Society has preconceived, misconceived, and ill–conceived notions of Bipolar disorder, bpd as I’ll refer to it.
Bpd, or its equally other maligned name, manic depressive disorder, for to long has had stigma of wild and nearly uncontrollable moods swings from depression to manic.  Along with that, comes with someone unable to deal with society and best be locked away. If that’s the case, better get ready to throw away the key, because I’d be headed to the loony bin.
¿Fortunately?, my manic swings are nearly non–existent. That lead me and me docs to believe that I only had struggles with episodic depression. Because of that, my real problem had gone undiagnosed for years.
An additional “side effect” of the treatment of my depression with SSRI’s potentially shortened the times between my episodes of depression.   Oh what joy!
With a proper diagnosis, there are some “mood stabilizers” that will help restore some balance to my life. With that, comes a good prognosis.
With my new found discovery, I would like to pass along some advice. If you or someone you know has been struggling with on and off depression, it might make sense to schedule a trip to a  psychiatrist to review if there might be a misdiagnosis, similar to what happened to me.
It would also behove you to add this to your medical history; there is a genetic component with this disorder. Studies with identical twins show that if one twin has bpd, there is a one in three chance that the other twin of suffering with the disorder at some level, also.
My psychiatrist has given me a pretty extensive package of information on bpd and its treatments. If you would like to see them, just let me know and I can forward them on to you.
It has been a long a rocky road. There is a new found hope that perhaps, with a little bit of roadwork, I’ll finally have a smoother ride. Let’s hope so. I’ve already worn out one too many sets of shocks!

a little bird sitting on a branch

charts tables & graphs

i am a scientist at heart. one thing that differentiates science from art is measuring. put another way artist observe but scientist observe and then make notes and measurements and keep track of things.

that is what i have been doing for at least the last five years. we got a  wii fit in 2007. i initially used it to track my weight. i would weigh in every morning.

somewhere, early on, I decided to also track my daily mood. i would track my mood on a scale of one to ten, ten being awesome and one being horrible. so, i have a nearly daily mood record going back to 2008. my only missed days occurred when i was away from home.

below is a chart of my moods. i start actually keeping records in a spreadsheet starting in 2009. these are the averaged the results on a weekly basis.

mood history going back to 2009

this is a historical record of my moods going back to 2008.

this is a historical record of my moods going back to 2008.

the first bits of information that can be pulled from this graph is my episodes of depression and the length of time:

history of depressive episodes

history of depressions since 2009

history of depressions since 2009

so, i have had 4 episodes since 2009 lasting from 3 to 5 months in length.

oh, i forgot to tell you i have a degree in mathematics so if geeky statistics make your eye glaze over, you have permission to skip the next paragraph.

with all this data, one can pull out such geeky things as my average mood is 6.21. one standard deviation is 1.48. that means about 68% of my moods range from about 5.5 to 6.95. these are geeky statistics numbers. if you don’t know what they mean, don’t lose sleep of them.

This is a bar graph of the occurrences of my moods.

mood bar graph. number of occurrences on the y axis and weekly average on mood on the x axis

mood bar graph. number of occurrences on the y axis and weekly average on mood on the x axis

with this graph, the number of occurrences on of the y axis and the average mood in on the x axis. for example, I had 1 week where i have an average mood of 2 (ugh!) and 14 weeks were I had an average mode of 8 and 3 occurrences where i had an average mood of 5.4 . also one can see i have a cluster of moods, small ones around 4, 5 and 6 and a big one around 7.

so, what does this really mean? to the general population, not much. to me it means i have empirical and historical data that points to my depressive cyclels and their lengths of time.

I’m sure there are research psychiatrists out there that would love it if every one would keep such a log. they could then pull from a wealth of information to aid in their research on moods and mood disorders.

bipolar sojourner