Surfacing After Silence

Life. After.

electroconvulsive shock therapy

If only our brains looked this cool So my previous entry contained more information about my current depressive episode and what I am doing to help kick its ass.  I mentioned ECT, and have gotten a lot of questions about it–so I decided to devote an entry to ECT.  Maybe dispel a couple of myths and incorrect assumptions.

ECT=Electroconvulsive Shock Therapy.  That’s right.  Shock Therapy.  The stuff of horror movies and psychological thrillers.  You know–where people are strapped down onto the table and then, while they’re awake, they go into massive convulsions, sometimes getting bruises or breaking bones and waking up all disoriented and lost. In the 1940s and 1950s, ECT was given without any type of muscle relaxer or anesthetic.

But guess what?  This is 2012, not 1940.  A lot has changed in terms of ECT and how it is administered and exactly what it entails.

First off, we still don’t know exactly how ECT works.  Doctors discovered way back in the 16th century that seizures helped people with severe depression.  Then, they used insulin shock therapy and  then camphor and metrazol therapy.  And yes, they did have to strap patients down in order to prevent severe injury from the convulsions.

Now they use electrode placement on the forehead to induce a seizure.  Over the previous forty years, scientists have done a lot of research and have made a lot of progress as to where to place the electrodes and how much voltage to use and for how long.  We are still unclear about the exact mechanism that makes ECT effective.  All we know is that it is effective, most usually for people with long term, severe, treatment resistant depression.

That description is perfect for me.  I was first diagnosed while I was in junior high.  It’s been a rocky road since then as I’ve seen different doctors (some not all that good) and tried different medications (some better off not taken by me).  Right now, I am more than happy with my treatment team–my therapist, my psychiatrists, my medical doctor, and my cardiologist all are in communication with each other and working together.  AND AND AND I am included in the decision process every step of the way.

Was I nervous going into ECT?  Of course.  I was scared shitless.  But I asked a lot of questions, and my doctors answered them.  They walked me through ECT step-by-step.  One important thing to note is that they use a muscle relaxer via an IV/heplock so that you do not have a seizure on the medical table.  They also give you an anesthetic so you sleep through the whole thing.  They put electrodes on your head, make sure they have them positioned correctly, and then you fall asleep and then all of a sudden you’re waking up in Recovery.

Sometimes I have a headache afterward, but rarely does it ever get to the point that ibuprofen won’t take care of it.  I’m tired that afternoon and often take a nap.  I can still read, write, watch television, play online, knit, and all that normal day-to-day stuff I do.

We don’t know why, but ECT works better for me than any other medical treatment.  I may be looking at long term maintenance ECT, which is fine with me.  This does not mean that I stop working with the rest of my treatment team.  It really is best when it is a concerted effort, with everyone in communication with each other, asking questions if need be.  I would not feel as comfortable with the future prospect of ECT if I didn’t have a team whom fields any type of question I have.  This is not the 1940s–the patient has the right to know what exactly is going to happen and when, regardless of the type of treatment being used.   Your voice is a powerful ally.

 

Again, if you have any specific questions, please feel free to ask them.  If you want to ask via Formspring, my page is:

http://www.formspring.me/AlexisKatchuk

 

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January 28, 2012 Posted by | bipolar disorder, Communication, depression, ECT, feelings, health, heart, recovery, therapy | , , , , , | 1 Comment

more along the depressed honesty lane . . .

So not much has changed since my last entry.  I wish I could say that things are great and my job is wonderful and life is full of roses.  Actually, I can say that my job is wonderful.  I mean, I knew I liked my job and I enjoy working there and I love teaching (the vast majority of the time)–but I have to admit to being scared shitless a couple of weeks ago when I realized that the depression had continued to grow, and my strength and resilience had both continued to shrink–making my job pretty much impossible for the moment, especially when combined with the fact that we wanted/needed to increase my ECT treatments for a couple of weeks in order to get back on track with them. 

So I went to my boss’s office.  And I sat down across from her and explained the situation–using those dreaded words like “depression” and “crying” and “sleeping all day” and “increase in treatment.”  I was terrified I’d be fired on the spot.  I was terrified I’d lose my job permanently.  And I didn’t want that.  I’ve been through the depression enough times to know when I honestly don’t like something and when the depression is taking away my abilities.  And this, this is the depression.  And most of the time, I honestly don’t feel like it’s ever going to get any better, which is pretty disheartening.  But I’ve been through this enough to know that it will get better.  I don’t know when.  I have a good idea about how it will get better, but even that isn’t 100% sure knowledge–if it were I’d be healed by now. 

Right now, I am doing my best to remember that this does pass.  With time.  With medication.  With ECT.  With my light box.  With treatment.  With my friends standing beside me.  And, with the knowledge that I still have a job (one that I love) to return to when I am ready.  I have to admit that I am proud of myself for going to talk to my boss and tell her exactly what was going on. 

The point of this entry?  I’m not all that sure.  I know I haven’t been writing as much, thanks to the depression, so I guess this is just an “update post.” 

There are days when I want to give up.  When I think it will be easier.  But as I said, I know this is not a permanent state.  (You should see my journal.  I remind myself of that on a daily basis.)  And I may not feel like I have a lot going for me right now, but I have a family, I have some kick ass friends, and I have a treatment team that is working together to do whatever they can to help me.  I know that this will pass.  At some point.  With treatment and help.  And I will be back in front of that classroom and making corny jokes that only half the class laughs at.

I know ECT raises some questions for people.  If you have any questions about ECT, depression, treatment, and other related things, please feel free to ask:

http://www.formspring.me/AlexisKatchuk

January 27, 2012 Posted by | Uncategorized | , , , , , , , , , , , , | 1 Comment

*All* You Have To Do Is Smile

I’m finally getting around to posting a new blog.  I can thank the snow plows that went by my house at 5:30 for what is now maybe one centimeter of snow.  My area is in a Winter Weather Advisory until 6 pm for what is expected to be a grand accumulation of 1-2 inches.  Having grown up in New York and then lived in Pennsylvania for ten years, this makes me laugh.

But aside from the trivialities of how they handle snow in the middle of Missouri–why haven’t I been posting?  One of the things I value on my blog is honesty, so I will be upfront in saying that this episode of depression (I have Bipolar Disorder) took one drastic nosedive.  My treatment team and I decided a stay in the hospital was necessary in order to be able to quickly do a complete med change and to get me back on track with the ECT sessions.  Then I came home the next week and was overwhelmed with school and the end of the semester craziness.

It’s now January.  The spring semester has started (I’m an adjunct professor at an area college).  And the depression–still there.  Still rearing it’s ugly head in a ferocious way most of the time.  And I’m bringing this up because depression is often part of an eating disorder–and it’s also often part of the recovery process.

Here are some common ways that people have responded to me telling them I’ve felt depressed lately, both when it was related to the eating disorder and now, after I’ve been in recovery for some time:

“But you look happy.”  “But you’re going to school (or work).”  “But you were just at church last week.”  “You need to get out and have some fun.”  “All you need to do is push through this and it will all get better.”  “I thought you were doing well with the eating disorder?”  “Just keep trying.”  “Keep your chin up.”  “I don’t understand; you were doing so well.”  “You should be happy that your doing better with the eating disorder.”  “Well, at least you aren’t in the hospital.” “Haven’t you been praying?” “Everyone gets sad from time to time.”  “Ugh, I know.  Yesterday was a crappy day for me.”

Some of this is our fault (not the best word choice, I know).  Some of this is society’s fault.  Society in general would like to believe that things are fine and when things aren’t fine, it’s time to change to a new topic of conversation altogether.  Some of these responses are because people who have depression quite often try to hide it from other people, for a wide range of reasons.  For me–I grew up in a family that did not discuss emotions or feelings or moods, and I grew up with the idea that I’m not *supposed* to be depressed.  I was an All Star athlete in all my sports, Salutatorian of my graduation class, drum major, a member of an area youth symphony, and a member of my church choir.  And then I went to college, and the depression got worse and the eating disorder became a very serious issue.  And I still didn’t talk about it.  And with the eating disorder, almost all people who have an eating disorder learn to hide it.  Hiding the depression came with the territory.  And I also felt/feel guilty when I talk to my friends about how I’m feeling because I don’t want to burden them, and I don’t want to worry them.

I guess my point, which I seem to be taking the long way towards getting there, is that just because someone smiles does not automatically mean they are *fine*.  People with mental illness very quickly learn to put up the brave front during the day–which may sound like a good thing.  But the consequences of putting up the brave front are extreme exhaustion, frustration, loneliness, tears, sleeplessness or sleeping too much, isolation, and hopelessness.  We learn that a lot of people brush off our comment that we feel depressed, and then learn not to trust anyone at all.

Depression is not “a bad day.”  It is not the result of not praying hard enough.  And seeing someone smile does not mean things are automatically fine.  Depression is a very serious mental illness that can affect all areas of life from home life to school to work to social relationships to physical health.  Depression is not something that you just “get over.”  It doesn’t just “go away.”  Fighting and pushing through it are two useful skills, but they will not cure depression.

People with depression need support and encouragement and a safe place to let their guards down.  They need to be able to mention the word “depression” without people shutting down, running away, or changing the topic.  They need to be encouraged to seek professional help.  They need to know that people care for them, regardless of whether or not they are depressed.

I fully realize that being a friend or family member of someone with depression is taxing and tiring and frustrating, especially in the case of severe depression or long term depression.  I recommend having your own support person and making sure that you take time for yourself to destress and unwind and relax.

I feel blessed and grateful and lucky for the people who have crossed my path and have been supportive since I began struggling with depression.  I know I wouldn’t be here if it weren’t for my wonderful and downright amazing friends.

 

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And if anyone wants to ask me questions–http://www.formspring.me/AlexisKatchuk

 

January 12, 2012 Posted by | bipolar disorder, coping, depression, Eating Disorders, ECT, recovery, relationships | , , , , , , , , , , , , , , , | 6 Comments