Heart of Darkness

When I recently wrote my extended family to tell them I was too fatigued to celebrate our 50th Wedding Anniversary, many assumed I was fatigued because cancer had returned.

This is not so.

The fatigue is from almost overwhelming depression and anxiety.

The surgery and radiation treatment I had for cancer in 2018 was easier to bear. Recovery was smooth and linear. Support from family was heart-warming and helpful.  The pain was manageable.

My struggles with a recurrent major depression have been ongoing now for six months, with no improvement. (I am under the care of a good psychiatrist and recently started another new antidepressant.) The symptoms are more severe than I have experienced in thirty years.

Anxiety compounds the picture as it amplifies all my senses. My skin is super-sensitive to touch, sounds are all noisy (even running water from a faucet), reflections from mirrors and windows are distracting, and little pains convert to bigger pain.

What helps? We are attempting to solve the puzzle.

Quietness, completing little tasks, coloring, and listening to Jim reading to me (a 50 year tradition!), and sometimes reading on my own.

A quiet companion holding my hand is very soothing. Conversation and questions are agonizing.

Hope springs eternal? By God, let it be true.

Lies your depression tells you when you are suicidal

He was middle aged and in the prime of life when he killed himself. He had family and children. A prestigious appointment at a respected University – and he had received several awards for his research. Wholesome looking and in good shape, he seemed to have had everything to live for. Do you know what? That’s right; he did have many things to live for, including a promising future.

Yet he went out of town for the weekend, quietly rented a motel room and died there by his own hand.

We all ask why. It seemed like the man had the world by a string. Why does anyone commit suicide?

It doesn’t make sense, does it? No it doesn’t and yet people take their lives every day. WHY?

Nearly always there is an intractable depression pushing the person into despair. Depression lies, and its false thoughts and lies are utterly convincing. Yet to the depressed person these thoughts feel completely real and desperately true. In my experience they are intense, persistent, and severely painful.  The person becomes overwhelmed by their depression’s lies.

I’d like to share insights from Amanda Redhead, Mother, Nurse, Writer, and Warrior from her Huffington Post blog entry of Sept 9, 2016:  Five Lies Your Depression Tells You When You Are Suicidal.

Here are five lies that depression imbeds in the head of a sufferer:

  • YOUR LIFE IS ALREADY OVER. YOU HAVE SCREWED UP BEYOND REPAIR!
  • YOUR LOVED ONES ARE BETTER OFF WITHOUT YOU.
  • THE PAIN WILL NEVER END, NEVER END.
  • YOU ARE NOT WORTHY OF LOVE OR LIFE.
  • … THEREFORE, YOU MUST KEEP YOUR THOUGHTS ABOUT HARMING
    YOURSELF QUIET!

One: Your life is already over. You have screwed up beyond repair.

Wonderfully, there is no such thing as a life ‘beyond repair.’  Amanda writes “You may have messed up so royally that you believe that no one will ever forgive you. But there is life beyond this pain and there is life beyond whatever mistakes you have made.”

Two: Your loved ones are better off without you.

This empty lie is probably the biggest of them all.  Far from removing their pain, suicide only creates an emptiness in your loved one’s hearts. That hole remains. Your loved ones find only sadness and the pain of losing you. “You may be feeling like a failure right now but I cannot imagine a greater mistake than having your last act on earth be one that causes intense pain for each and every person you love.”

Three: The pain will never end.

It feels like a pain that will never end.  I remember looking for just a brief reprieve.  Silently I bargained for relief in minute increments. The pain of depression felt very catastrophic and chaotic to me. I couldn’t believe that the rest of the world would or could go on functioning with my pain in it.  A moment in this pain feels like a year.

But there IS an end to the pain, unlikely as it seems now. As Amanda said, “I cannot tell you when that end will happen, but I can tell you that the end is somewhere.” You may have to work for it, your may have to get help or take medication or reach out when you want to stay silent, but the end of the pain is out there on the  horizon.

Four: You are not worthy of life or love.

Another big lie. This lie and others like it are invasive and seem so accurate. Everyone is worthy of love, no matter the mistakes they have committed. Everyone is worth living! You are only seeing the negative things about yourself right now. Remember depression colors your thoughts. You are a valuable human being and deserve to be alive and loved.

Five:   …You must keep your thoughts about harming yourself quiet.

#5 is the ultimate lie: Yes, your depression wants you to stay silent. Depression wants you to take your life. There is great shame around depression, anxiety and suicidality.  When we talk about the depression, we erase some of that shame and stigma.

Please believe me: There is no need to suffer in silence.

Pick up the phone and call one person and tell them what you’re struggling with. This may be the hardest thing you will ever do, but it gives life – your life – another chance.

Here I must add a word of hope:

Yes, depression distorts the depressed person’s thoughts. And depression’s thoughts can be deadly.  The five lies illustrate various cognitive distortions.  And forms of cognitive therapy can assist depression suffers to learn to recognize and combat false and irrational thought patterns – depression’s lies. Today recognizing and analyzing distorted thoughts that feed depression is called cognitive behavior therapy (CBT). There is a promise of hope for recovery.

Psychiatrist Dr Aaron T. Beck laid the groundwork for the study of these distortions. His student, David D Burns, MD, continued research on the topic. Dr Burns’ book, Feeling Good: The New Mood Therapy, was first given to me in the mid-eighties by my psychiatrist. I glanced at it and rejected it, thinking that my doctor was telling me I should learn ‘positive thinking.’ I knew depression was a disease more serious than superficially thinking right. But in the 1990’s I was able to accept the book and its premises. Soon I underwent a group therapy session during which some of the basics of CBT were taught. I was able to learn those basic principles and asked for a therapist to do CBT regularly with me.  The short of the story is that I did find a therapist, who had a PhD in psychology and had done significant graduate work specifically with CBT. He was willing to take me on weekly for several months.  Cognitive Behavioral Therapy became one of the essential pillars undergirding my recovery from suicidal depression.

Depression now sometimes gets a grip on me. But with medication that works for me, with the practice of cognitive behavioral therapy, with a supportive family, and with a doctor’s ongoing psychiatric care I no longer develop full-blown depressions. Depression occasionally gets a start, but CBT’s corrective is powerful, and negative thinking doesn’t get a hold on me for long.

Thanks for reading,
Gail Louise

Communities in Action to Prevent Suicide, part III

A core value, again taken from The Way Forward, that Ursula Whiteside highlighted during her keynote:

Preserve dignity and counter negative stereotypes, shame, and discrimination

“The negative perceptions of behavioral health issues and subsequent discrimination pose major barriers to help-seeking.” …. “Stigma, negative stereotypes, and discrimination (covert or subtle) are particularly damaging when we already suffer from depression, hopelessness, damaged self-image, trauma, self-doubt, and shame – thoughts and feelings common during a suicidal crisis. In contrast, when we are treated with dignity and compassion, it reaffirms our sense of worth and value.”

My second psychiatrist (and each of those who followed) treated me with the dignity and compassion I needed to progress. It made a HUGE difference. One appointment I’ll never forget is the day I thanked him for NOT telling me ‘my difficulties’ were that I was ‘too sensitive’ (as I had been told by my first psychiatrist) . My doctor got very still, sat up straight, looked me in the eye, and said, “Gail, it’s not that you are too sensitive. You have major depression. It is an illness for which we will pursue and persist in finding the right treatment combination for you.”

He treated me with full dignity by clearing up any chance that I would misunderstand ‘sensitivity’ for major depression. Or think that ‘my difficulties’ were only that, ‘difficulties,’ and that they were something I caused. I felt affirmed and clear about the real lesson I was learning.

I particularly like this core value because it is so active…….counter stigma.

You can see from the photographs that Dr. Whiteside – Ursula – is younger than I. Her experience and youth were very helpful as I gained insight on how to reach to a younger public than I am used to addressing. She does social media very well; I need to go there too. The mid-part of her keynote presented her vision developing www.NowMattersNow.org into an online public resource focusing on strategies for managing suicidal thoughts and intense emotions. Ursula introduced us to her colleagues: Team Now Matters Now. I smiled with pleasure as one of the team members mentioned was Marsha Linehan, PhD, clinical psychologist. Nothing more was said about team member Marsha … But it’s worth noting that Dr. Linehan is the creator of Dialectical Behavior Therapy, the psychotherapy that has helped so many people with borderline personality disorder. She is well known and admired for her work.

DrUrsulaWhiteside    DrMarshaLinehan

Ursula summarized what she and Team Now Matters Now had learned from suicidal people working through a crisis. Here are some of these points (underline emphasis is Ms. Whiteside’s):
Be fully present with me
• Help me hold my pain ( so I feel less alone in my pain)
• I feel helpless, broken and scared
• Discuss with me my diagnosis, as it is in the charts and go thru the DSM criteria with me
When including family and friends, tell me and let me decide who and how
Help me empower myself
• Gently examine my paranoid thoughts with me
• First I need empathy, a witness (rather than fixing)
Know that I am telling you about my suicide ideation/plans because I want to live, I want help and I want to work together

About Partnerships … thinking about enhancing care and support within them

46 years. That’s how long my husband and I have been married.  And it was 50 years ago when we first dated, a sweet memory today.  Jim has always been the very kindest, most fun and interesting man I know.  Our kindness toward one another is a key to our relationship, especially when the water wasn’t so smooth due to effects of mental illness on my thoughts, feelings and behaviors.

My partnership is our marriage.   It is the most supportive aspect of our lives together.  It is, it turns out, quite a bit stronger than mental illness.  Yours may be another partnership – marriage is not the required word, but supportive is.  How do we support our partner without being overwhelmed?  How can we be supported without having to feel we’re a burden?  I don’t have all the answers, but we do have some suggestions here based on our experience.

From Shame – Moving Toward Healing

During the recent half decade I have been so fortunate, as Brene Brown* describes, to have completed the journey from the “not being good enough” shame struggle to believing and knowing “who I am is enough.” Shame from having mental illness has left me. Shame from being related to other people with mental illness has left me also. I have been graced.

I only recently realized I had made this journey. I understand now how much shame – and my growing resilience in the face of shame – had influenced the course and depth of my mental illness through the years.

It didn’t happen, this journey to being shame-free, automatically. I happened to want to do what is recommended for building shame resilience for other reasons; I wanted to help others cope with mental illness. Often, as part of my work, I told my story of family and personal mental illness. I didn’t realize then, twenty five years ago, how much nurturance I would receive from assisting others.  My story of the power of shame and how I arrived at healing from shame follows …. [Read the Full Article]

 

*   Brene Brown, PhD, LMSW   Audio lecture, 2012: Men, Women & Worthiness, The experience of Shame and the Power of Being Enough.  Available on CD at Soundstrue.com  PO Box 8010/Boulder CO  80306.

Real Depression; Real Men: “Because you have to deal with it. It doesn’t just go away.”

This post’s title is taken from a video clip “Real Men, Real Depression” featuring Patrick McCathern, 1st Sergeant, US Air Force, Retired, and available here on The National Institute of Mental Health’s website.

Depression in Men often manifests itself differently. What ails men may not be recognized by them or their family or friends as depression. It may be mistaken as a sleeping problem or a digestive problem … or a character flaw. When a man has depression he has trouble with everyday life and loses interest in anything for weeks at a time.) He may be irritable, feel very tired, and lose interest in his work, family, or hobbies.

The tricky part of depression in men: They may not want to recognize, talk about, or acknowledge “it” or how they are feeling. (Please see my entry on Male Depression under These Illnesses in the menu section of my website for life experiences with my father’s depression.)

The quiet truth about depression is that it is very, very painful, and unending. And although women with depression more often attempt suicide, men are more likely to die by suicide.

HOW CAN I HELP A MAN WHO IS DEPRESSED? (Recommendations from The National Institute of Mental Health):

  • Offer him support, understanding and encouragement. Be patient.
  • Talk to him, but be sure to listen carefully.
  • Never ignore comments about suicide, and report them to his therapist or doctor.
  • Invite him out for walks, outings and other activities. If he says no, keep trying, but don’t push.
  • Encourage him to report any concerns about medications to his health care provider.
  • Ensure that he get to his doctor’s appointments.
  • Remind him that with time and treatment, the depression will lift.

MEN WITH DEPRESSION ARE AT RISK FOR SUICIDE. IF YOU, OR SOMEONE YOU KNOW IS IN CRISIS GET HELP QUICKLY.

Call your doctor or 911 for emergency services.

Call the toll-free, 24-hour lifeline, National Suicide Prevention Lifeline

1-800-273-TALK (1-800-273-8255)                  TTY: 1-800-799-4TTY (1-800-799-4889

Oh So Real: Pregnancy and Suicidal Depression

“Oh baby,” I said, as he/she came down the birth canal, “You are born!”. It was 1979. We didn’t know the sex of the child before birth. The birthing experience was wonderful, a balm for the difficult pregnancy caused by the onset of major depression in the fourth month of pregnancy.

I was alone.

Don’t get me wrong, my husband was with me very much during the pregnancy. But I was alone with being pregnant and being ill. I knew no other woman who was or had been pregnant and seriously depressed to talk to, to compare notes, to help me express my feelings or to hug. I hope this summary of my story of the difficult pregnancy will help other mothers who find themselves struggling with similar experiences today.

If you are pregnant and depressed, you are Not alone.

People with mental illness want to succeed as parents

Parenting. I know that when my son was born, and I had serious depression, I was overwhelmed by the thought of taking care of a newborn, the rest of the family, the home, meals, …..the whole shebang. No one in my health care team thought of arranging for assistance for me or even meeting with me. My extended family assumed once the baby was born the depression would correct itself and, with the joy of the new baby, I would manage fine.

Actually the terror of my anxiety level worsened. I was sure I would do things wrong. The depression worsened.

My children are now ages 35 and 40. They are well and we are doing well with each other. I couldn’t be more blessed as a parent. In fact, now I am a Grandparent to two children, a boy and girl who are 5 and 9. Their birthdays are coming up and celebrating grandchildren’s birthdays  is an awful lot of fun!

I’ll discuss some things I would have done differently when my children were born in a second post.

Parenting, continued….

Raising children, for me, while taking care of my own mental illness, was a double challenge. I was a parent before major depression, and later Bipolar Disorder II, evolved. My article on parenting (in the menus above under “Real Life, Real Challenges”) was written several years ago but this post gives me the opportunity to add to my observations.
Support should be given to them every step of the way, as needed, per individual. We love our children and want to do the best for them. Support during pregnancy check-ups; assistance at hand, if wanted, when the baby is about to be born; coordinated discharge planning when mother and baby are leaving for home; weekly in-home visits, etc.

With that in mind, here are some things I would do differently if I had the opportunity:

  • I would be less critical of family members. In fact, I think that some parenting classes can be suggested to parents with mental illness ( we’d learn the program and we’d all learn from each other) Stress techniques that would teach how to do positive reinforcement so the parent with depression/mental illness has some tools to use.
  • I would teach my children at an earlier age, in simple terms, that I had an illness and that sometimes I needed the house to be extra quiet and I had to nap because I wasn’t feeling well.
  • I/we would teach that the illness and bad feelings that I had were not the children’s fault, nor anyone’s fault.