Whatever it Takes: Ketamine for Depression

For the last 4 days I have been in Denver, Colorado, dealing with an important medical issue.  I had a relapse of depression, brought on by the stressors I spoke of in previous entries.  The last straw was when I stopped taking Vyvanse, a trendy new stimulant for ADHD, and I was left spiralling into an endless pit of fear, despair, and hopelessness.

It was a crippling blow from depression.  All my hard work and insight overshadowed by a chemical imbalance, my brain going haywire, and reverting to deeply engrained unhealthy patterns. Once this happens, depression becomes much more than my shadow or negative beliefs, it actually becomes a medical issue.  I wake up with no spark, and a sense of dread.  Each episode feels heavier as if this cloak of stagnation has grown stronger through subsequent episodes.  I felt powerless, alone and afraid.

 I needed medical help, so I checked myself into the hospital.  Realizing they had nothing for me but uncomfortable hospital beds and an increase in prozac, I checked myself out.  I waited in the ER for 2 days, and stayed in the psych unit for 2 days.  I cannot fucking believe they leave patients in the ER for 2-3 days in Canada, seems abit cruel.

As my roommate Carol drove me home I was pretty sad, because there was nothing medically that could prevent me from having another 3 month bout of depression that the hospital could offer.
I asked the psychiatrist at the hospital about ketamine, and he earnestly  replied "why would we give you something potentially toxic when we have so many great drugs at our disposal?"  I was so discouraged, because antidepressants have not been super successful for me and the onset of action is 4-6 weeks minimum and I've tried almost all the classes of medications.

When I got home I was pretty despondent, but I said fuck it, I'm going to do ketamine infusions in the US for treatment resistant depression.  There are treatment centres in almost every large US city, because ketamine has a 75% success rate at treating depression in a matter of hours to a couple of days.  Its a powerful tool that got me out of the depths of despair, and gave me a higher perspective on my situation.  It was somewhat spiritual in nature, and frightening and magical at the same time.

 I have 10 years of sobriety from drugs and alcohol, and I didn't love it when I realized ketamine was a powerful narcotic.  I realize that some people in recovery community may think I'm a hypocrite for taking this treatment.  The founder of Alcoholics Anonymous, Bill Wilson did LSD to deal with his treatment resistant depression.  I can't deny I got a certain high off ketamine infusions, but that was a side effect of a powerful medicine that may save lives.  I will write more about the actual trips and self realizations I had in the posts to follow.

I want to end my saying a sincere thank you to everyone who reads my blog.  I was to deeply honoured to see that my blog has 4255 page hits since its inception.  Thank you all for reading and relating to my online journal, my thoughts and perceptions on the human condition as I have experienced thus far.  I don't know how or when I might write a book, but this blog will serve as the unedited manuscripts for whatever I create.

Optimism in the Face of Mental Illness

I try to be optimistic about my recovery from mental illness.  That's easy on good days, I think its clear sailing, and I feel like I have some mastery over my inner landscape.  I take pride in doing what I need to do to take care of myself and deal with the daily nuances of my mind and guide myself in the right direction.

Recovery is a lifelong journey, and there are days when I'm actually scared for my life and everything I've fought so hard for, because I still have alot of vulnerability to clinical depression.  Days like today I'm acutely aware that I don't have full control over scary thoughts and feelings that have in the past spiralled to the point of changing my brain chemistry leaving me lost and alone, disconnected from my soul, my life force and other people.  Just writing this makes me want to cry, because I don't think that anyone should ever have to feel this way.  I don't know why some of us are so delicately wired and have to overcome patterns in our brains that are so detrimental.

Yesterday, I was with a friend and I started feeling disconnected in a scary way so I curled up on his couch and started crying.  I reached a point of deep compassion for myself, I realized how overwhelmed I was with all the pressures I put on myself, trying to figure out my career, dealing with adhd thats makes focus so hard, and being confused about relationships.  I grieved that lack of control and held my wounded, disappointed heart.  I realized in that moment, I'd done everything I could and being mad at myself for letting myself get to this state wasn't going to help.  I connected to that inner love for myself, I'm only human, I didn't ask for this burden.  I didn't ask to have to reach such scary places dealing with everyday challenges.

I guess at the end of the day, everything I achieve means that much more, because I fight like hell to do what other people take to granted.  Years of therapy, trying to understand my triggers, taking more and more responsibility for my choices, learning to relate to my mind in a different way, and still sitting here crying because living well with mental illness is the hardest thing I will ever have to do.

I'm a perfectionist, and having hard days can feel like a failure.  I'm never going to be perfect.  I will struggle with a mind that is  distracted and scares easily.  In times like these I need to remember I've found peace in this life through yoga, meditation, connection and recovery.  I'm not alone.

All my problems need to be surrendered at a certain point.  Yes, these low points are signs I may need to change something in my life, maybe a perception, maybe a behaviour, but I'm not going to figure it all out at once, and fix my life overnight. I've done my humanly best and I accept my suffering, that I'm not a loser because I am feeling somewhat powerless.  Accepting where I am and committing to small changes can be empowering, reminding me I do have some control over my life, and I'm stronger than the dark feelings that haunt me from time to time.

I think having deep compassion for myself, realizing how stressful its been being un employed and making art, and putting pressure on myself to be positive even though I'm not making any money has been tough.  Realizing if I want to have a landscape business again, its alot of work and I need faith in myself that I can make it work, I need to surrender my fears, because they are keeping me sick.

Believing that I can make something  meaningful out of my life helps. Goals of advancing my art practice,  getting ready for markets and believing that I can either have my own landscape company or work for someone else keep my moving forward.  Closing my eyes and remembering the joy I've experienced having felt mastery and visualizing getting there again feels amazing.

I am responsible for making the most of the cards I've been dealt.   I'm not a victim, just a person that has another layer of frustration and challenge to learn to accept and overcome. I only have one life, and I believe that the power of my soul, my connection to my higher power and the beauty of my vision of myself healthy, happy, and contributing to society will pull me through.

The Struggle is Real! 10 years sober and still not out of the woods

Ten years ago my Mom chaperoned me to the Nanaimo Ferry terminal, where a militant woman with razor sharp bangs and a nononsense attitude drove me to rehab.  It was pretty epic, like summer camp for bad kids.  Where else can you safety interact with such a broad range of disturbed adults, from multimillionaire crack addicts, to members of the Hells Angels, to moms who do meth in front of their kids, and cops who can't stop taking sexual favours from criminals.  There were doctors and dentists there too, because it was a pretty classy place.

Anyways, I defied the odds, and I took it all in, and decided fuck it, I may not be as far progressed in my addictions as my fellow campers, but this wasn't a joke. So I did it, and I'm clean and serene for 2017.

I'm still not out of the woods.  Not only do I struggle with addictions, I have been through the wringer with mental illness.  I did what society recommends and trusted my doctors and all their lovely medications that they give out like candy in different flavors, depending on your diagnosis.  The shitty part is that psychiatrists, far from being well rounded, or having an in-depth knowledge of psychology, are pretty well versed in the DSM 5 or whatever version they're onto now and use a simple set of criteria to pick out scary drugs to prescribe in abundance.

When I went to rehab, I had to fill out a drug and alcohol history, which I had hoped proved I was ok to go home.  The counsellors weren't having it, I'd already disclosed to many life or death situations I'd willingly subjected myself to, high and drunk out of my tree.  I really was powerless over my addictions and my life had become unmanageable.

The crazy thing about all of this is that I'm in a similar predicament with substances, 10 years after rehab, but these were all prescribed to me by a series of GP's and Pychiatrist's, who were well meaning and thought their drugs were an integral part in me living well with mental illness.

It took 9 years before I walked through the doors of the Cochrane Counselling centre, and spoke to the first psychologist that actually got through all of the questions necessary to understand what was really going on.  She figured out that I had ADHD, and depression from trauma, from growing up getting bullied, seeing my parents train wreck marriage, witnessing verbal and mental abuse at home, and causing myself more trauma in active addiction, including being sexually victimized by predatory men when I would get loser drunk.

I'm actually happy to know I have ADHD, that my depression is treatable, and that I can retrain my brain with DBT and other modalities.  Before that, I was wrongly diagnosed as bipolar 2, and thought medication and acceptance were my best solution.  I felt victimized my the label, not empowered, because it wasn't accurate.  The pyschiatrist who diagnosed me had just finished reading Kay Jameson,  famous bipolar psychiatrists,  book on Exuberance.  He asked me if I'd ever felt exuberant, and I said yes, I've been high on rave drugs starting at 15.  That was that, I was bipolar for 5 years, and got more and more drugs shoved my way.  I'm kinda disappointed in pychiatrists, none of them reviewed his diagnosis and I really wanted answers from the doctor that gave me that label, not drugs.  I told him my whole life story thinking he was going to see that is made perfect sense I had the issues I did given my experiences, but that's simply not his training which is disappointing to say the least.

While I'm glad I got this last piece of the puzzle, and the right diagnosis, I'm now facing a situation where I've been over prescribed medications, and feel powerless once again.  I was given a stimulant for ADHD, and I've been struggling because it doesn't work that great with all the drugs I was given for depression and bipolar.  I'm now over stimulated, feeling wired, edgy, like my skin is crawling, having to much adrenalin etc almost everyday.

My last pyschiatrist told me I was doing well, that I had this all under control and would be fine if I stopped letting assholes sleep in my bed, which I thought was great, but now I have to get my psych meds under control with my GP.

Its been pretty humbling, Im no longer Queen Sh#$ of Recovery with 10 years of sobriety, I need recovery as much today as I did then, but now its due to my powerlessness with stimulants.  I have had to quit smoking, and probably caffiene is next.  I have had to reduce antidepressants.
All of this because my GP and last psychiatrist are convinced that Vyvanse really helps ADHD.
All I know is that as I sit here shaking and writing, I feel alot of compassion for everyone in recovery, no matter what page you find yourself on.  Struggle reminds me that life really is JUST FOR TODAY,  to Trust the Universe,  reach out to others, and to believe in myself, and that I really do have the tools I need to OVERCOME my challenges.

Patience

I've been working on recovery from depression and addictions for 8 years.  It was obvious to me that alcohol was a depressant, and that drinking was a no win situation, so I quit, it was easy, because I have a strong will to be well and live a good life.

I only quit drinking because I wanted to get a handle on my depression, which has been way harder than quitting drinking.  I have been able to put together months of feeling well. Once, 2 years.
 Still, this depression persists for as much as 1/4 of my life.

It makes me sad, because I've done so much to fight for my life and grow as a human being, and yet when I'm down, it's so hard to see that maybe one day all the pieces will click.

Having adhd doesn't really help either.  Its easy for me to forget entire pieces of my recovery program until I start to slide.  Also, I'm pretty sure the constant state of excitement at the start of things is hard on my brain.  Almost like I have to much neutral activity, so its only a matter of time before I shut down.

As I sit here, missing myself, wanting to analyze this situation, but knowing my brain basically isn't functioning well enough to figure out anything.  A depressed brain can't be objective.  I can almost sense that part of my brain is functioning very minimally.  That this is a physical issue.

I'm just trying to accept that once again, in my wanting to be ok, like everyone else, I ignored the signs I needed to back off from the drama of my life, and take better care of myself, to accept that I have to do less work and do more recovery to stay functional.

I've made it back to shore when depression strikes tons of times, but unfortunately this hasn't been one of them. I can see some of the situations that started my erosion, but I don't know what more I could have done to change things.

I know I did my best up until this depression struck, and there's not a whole lot more I could have done.  I've finally gotten to a place of acceptance, that I don't have control over this illness yet, and that I don't need to be so upset about it, so dramatic about how sad and unfair it is.
I do sometimes feel that it's sad and unfair, but mostly I find a way to accept that sometimes my life is colourless, emotionless, and empty.  Other times its vibrant, meaningful and full of connection.

So today, for another 8 hrs, I just need to accept the cards I've been dealt, and do small things to keep myself moving forward.

Frustration and Adult ADHD

During my last depression, I reached out to a new psychologist, because inspite of my best efforts I was back down the rabbit hole.  I told her about my history, how I was apparently "bipolar 2" and how I wasn't getting better.  She paused and said, I worry about people like you, who've tried everything, and are slipping through the cracks.  There's something missing from this picture, that hasn't been picked up on yet."

I sat in her office, and it wasn't interpersonal therapy.  She actually asked me 100-200 questions to screen me for more than "depression" or "bipolar" which were the easiest and trendiest conclusions for her peers to jump to in 45 minutes.  I left with an answer and a glimmer of hope.  I had adult attention deficit (hyperactive) disorder.  I am still amazed and so grateful that even though most of my symptoms were masked by depression, she still extracted the truth.

I started doing her DBT (dialectical behavioural therapy) class, and after a few months, and medication changes, snapped out of my low grade mood.

She than gave me another insight which I have alluded to in this blog.  Perhaps my depression wasn't simply a "chemical" imbalance, or an unlucky spin on the genetic wheel of fortune.

It was the result of trauma, of being bullied as a child for 6+ years, and not processing the information correctly.  I decided that I was weird, not really accepted by the tribe, an outsider. She told me "sadness" that never gets resolved results in recurrent depression.  This may not be the whole story, but at least there's a narrative of how I came to suffer and therefore a pathway out of my suffering.

Anyways, my point is that getting a psychologist to actually confirm what I knew deep down has been a lifesaver, but I'm still trying to navigate my mental health situation.

I can really relate to the theory that people with ADHD suffer with low dopamine levels.  Dopamine is the brain chemical that spikes when we do something rewarding or exciting.  Its necessary to have enough dopamine in the brain to stay focused on every day activities for long enough to complete them because we know there is satisfaction in having a clean house, getting an assignment done etc. With ADHD, my brain is starving for dopamine, so I jump from task to task, thought to thought, seeking that satisfaction.  I do well in situations that I enjoy, like bringing together a landscape project, because I'm getting the dopamine I need.  I also enjoy being silly and talking about ideas with people because it feeds my brain.

I tried stimulants, and they were awesome, I actually understood what it feels like to be content
with staying on task and getting projects done.  I also found my mind didn't jump from topic to topic and I was less prone to depressive rumination.  Because I'm taking 2 antidepressants, the first stimulant I tried stopped being helpful once I went back to work.  The extra nor-adredrenalin pushed me towards pathological anxiety and the inability to get grounded and comfortable in my own skin.

I've been wanting to be ok without stimulants, but as I write this I can really see how the ADHD goes hand in hand with my depression, because it affects my self esteem not being able to do things that other people take for granted.  Its hard having an unfocused mind, that needs constant re directing and its exhausting.

This whole journey of self discovery definitely has its highs and lows.  I quit writing for awhile because I was just so glad to feel normal.  Now I'm in bit of a rut and I think its been brought on by feelings of inadequacy about my ADHD.  I want to get this thing right, either accept how hard it is to live with this or change my antidepressants to a medication that helps regulate dopamine. All I know is that feeling better and getting my recovery on track takes time, and it probably involves periods of feeling shitty when I look ahead and all I see is an upward climb.  Being ok with where I'm at and taking on step at a time is all I can do right now.

Why So Sad?

For me depression is deeply rooted in my subconscious and the wiring of my brain.  Its painful because as soon as I start thinking I've got a handle on the situation and I'm feeling better, I want to take on the world and forgo some of my self care rituals, forgetting how real the struggle is for me, and that managing this illness requires, diligence, patience and self awareness.

Days like today I just feel little haywire mentally, emotionally and spiritually.  Not clinically depressed, just off.  It's like I've forgotten to keep the guards posted at the door that keep the gremlins at bay, and now they're running loose inside my head.  They're pretty small but they cast long shadows.  The trick for me at this point is not to activate the fight or flight response, because those yucky chemicals that is releases just make things wo
rse.  I need to remember, whatever they're saying to me is BS, a sick part of my brain that doesn't need to be given anymore attention than it deserves.

Self analysis, without an outlet like writing doesn't help to much either.  When I'm in a fragile, scared position, and I mentally feel like shit, my ability to see the whole picture is really compromised. Like the people in Plato's "Allegory of the Cave,"I just see the shadows of things, and my point of view is compromised by my mood.

Work has taken it's toll on me.  Before going back to work as a landscape company owner, I was surrounded by light and love, doing a yoga leadership course.  I wasn't trying to be a yoga teacher, but I really liked what I saw in the course leaders Jess and Sara.

I was doing yoga daily, and feeling pretty ok with my inner and outer landscape.  SHit has been getting real lately, and the pressure has been rising quickly.  I'm doing ok, but there are some cracks in my foundation.  The interpersonal stressors at work and at home from running a successful business with my partner are triggers for stress, which not handled properly can cause the return of depressive symptoms for me.

The truth is, the triggers that set off the bad wiring and depressive tendencies  in my brain are probably just unhealed sadnesses from the past.  Little Jeanne was sad an awful lot.  Yes there were magical childhood moments filled with light and love which have sustained me throughout adult life, but there were also alot of sad, uncomforted, lonely and isolated tears shed in my formative years.

We are social beings and not feeling welcomed and loved by your tribe in grade school can cause deep psychic wounds in a person that they may unconsciously carry into adult life.   I bought into the lie that there was something fundamentally wrong with me starting at 5 years old.  All this unprocessed, unacknowledged pain and the thoughts, feelings and sensations that went along for the ride, need to be brought into the sunshine, honoured and healed.

Just a Crack of light

I haven't been able to write for awhile, but something's shifting inside me.  I see a small ray of light and that's very powerful.  Even a tiny fracture of self awareness is a miracle in the face of the self doubt and confusion that depression casts on everything.

I actually got up this morning at 6:45 with no alarm.  For me this is well, sort of amazing.
For the last 7 weeks I've been unable to get up before 10, waking up earlier, but anxiously trying to prolong that state of being semi unconscious, knowing I'm up against one of "those days."
Days where before I open my eyes, I know it's going to an agonizing battle to put on foot in front of the other and try to justify to myself why I keep going at all.  For me it's like being in a long, slow purgatory of souless boredom, self condemnation and meaningless existentialism.
I read a quote that says, "If you're in Hell, don't stop, keep going."  I think that's true, because the one day I did stay home alone all day sitting on the couch, I found myself reading about people jumping off the golden gate bridge to escape their current predicament.


Anyways, back to the ray of light part....This morning I felt like something was a little different.
Some of the heaviness and mental fog had lifted.  I could almost hear my little spirit birds chirping.
I started thinking about my life, and my thoughts had some nuance, some hope.
I could see more than one way to look at a situation, and the a realistic, positive outlook didn't feel so foreign to my conscious mind.

I've been desperately looking for some answers for this cycle of low moods, and periods of joyful dis-organized living.  Drugs and therapy for bipolar haven't really arrested these cycles, and I was pretty sure it was getting worse and I was really in for a tough ride through life.

Than finally, a meaningful second opinion, first from a highly trained therapist and than a psychiatrist.  They picked up something that I thought was pretty trivial or maybe even funny.
It's a diagnosis that's almost always overlooked in women presenting with depression.
Since I've beed a teenager I've been battling with ADD.  Just because I've hid it well and learned to be "functional" doesn't negate the struggle I've failed to recognize for all these years.

I still have along ways to go.  Even as I sit here writing, I can feel the pain of what I've gone through haunting me.  I want to take all of it and weave it into something meaningful, but I can only do that if I'm well enough to feel a sense of self amidst the suffering.  My ultimate goal is to take all the colours of my sorrow and make an art installation on a white gallery wall, that I can reflect on periodically but ultimately detach from and move on with my life.  Perhaps other people can look at what I've experienced and see if anything resonates with their journey.

I still haven't been able to start taking medications for ADD, but I think I'm going to talk another therapist at the private clinic about this option and pursue counselling related to managing the this condition effectively.   I was instructed to get off a medication first, because I'm on a whole shwack of medications and two mood-stabilizers is overkill.  I begged the doctor to go back on an SNRI and I'm on day four of that, so that may be helping.  I also did something I'm kind of embarrassed about, but may account for some of my positive spirit today.  I "gulp" "sigh" "erg" got botox.  There are some preliminary studies saying that having a relaxed facial expression helps the feedback loop in the brain that controls mood.  I believe this to a degree, because my depression feels like I'm on a circus ride through a haunted house, over and over again.  I can see how even one system reporting a different impulse, i.e. neutral facial expression, could be a shift.

That's the thing I find about depression.  I have to keep going, and trying new things, because it really comes down to interrupting that negative feedback loop, which can take a lot of effort. It feels like the train of thought is speeding around on the depressive track, and the switch to a normal mindset is broken.  So here I am a tiny person, trying to get a train to stop by throwing cans at it. It feels pretty futile.  That's what recovery from depression feels like, I'm a tiny being trying to derail a massive train.  It feels like I'm not getting anywhere, because each gesture of recovery in singularity is ineffective.  It takes a lot of continual effort and new strategizing to stop this monster.

I'm really hoping I am on the right track again, but I know my neutral or positive train of thought gets derailed to easily.  I'm hoping that by working with a therapist that knows ADD in adults I can work out some of the kinks that I fearfully thought of as being hypomanic.  If the disorganization and frustration I feel when I try to start my art business or contribute in a substantial way to my landscape business are resolved by addressing the ADD that might make all the difference.  I want to feel like a competent, capable adult, not a teenager staring out the window, doodling in her notebook, unable to follow what is going on in class, or take control of her life.