Surfacing After Silence

Life. After.

Things That May Be Difficult to Discuss

5340545-Tangled-wires-as-connection-and-network-concept-Stock-Photo-tangled-wire(please remember that this is my own personal experience, and I do not have an MD in either neurology or psychiatry.  Do not take my opinion as fact.  Take my opinion as an opinion.)

It’s not often I’m scrolling through my news feed and up pops an article written by someone who receives ECT, or electroconvulsive therapy, previously known as “shock therapy” or “shock treatment.”

I appreciate how the author points out that she’s not the “typical ECT patient.”  Just because movies and books may feature some middle-aged patient with long, stringy grey hair in a straight jacket in the corner of an empty room, does not mean this is normal.  Also keep in mind that today is 2018; it is not 1923.  When ECT was first used as treatment, it was also used as a punishment for symptomic behaviors, not an effective form of treatment.  It would physically subdue the patient without curing the underlying problem.  That is not how this treatment is used today.

I am not the stereotypical madwoman talking to herself in the corner.  (Although I do talk to myself.  And my cats.)  I am a just-about-40-year-old college professor who receives ECT as a maintenance form of therapy for the Bipolar Disorder I.

When ECT is used in an appropriate and careful manner by knowledgeable doctors with an appropriate candidate, ECT can be the best form of treatment for that individual.  With any form of treatment, you have to consider how the treatment was administered and whether or not the patient is a viable candidate–and, of course, do not  forget that each patient is unique (emotionally and physically), and may or may not have a positive response.  But–I wouldn’t trust my psychiatrist to diagnose and treat my cardiac illness.  I trust my cardiologist who specializes in electrical conditions of the heart and who has done a fair amount of research concerning my particular, rare, illness.  (In other words–ask questions, do research, and talk to an appropriate doctor whom you trust.)

So let’s address a couple of common myths and urban legends.  One: I am anesthetized while receiving said treatment and, therefore do not feel a thing and my body does not go into convulsions.  The ECT itself is extremely brief–a matter of seconds.  Two: I don’t wake up not knowing who I am or where I am.  I am aware before the short-acting anesthetic, and I am aware after I wake up.  While some confusion is normal when first awakening–that’s from the anesthesia and not the treatment–and it disappears quickly.  Three: While I am not allowed to drive that day, I can go about my daily activities and work with only some minor fatigue.  I can still teach and can still officiate, as long as I have transportation to get there–again, typical of restrictions after any course of anesthesia.  The day following the treatment is when I experience a headache or muscle fatigue, but I rest and take what usually is just a single dose of ibuprofen, and the headache is gone.  Four: There is not just a single one-size-fits-all approach to ECT.  There are different forms of ECT, depending on where the doctor chooses to place the nodes and if he uses one or two nodes and the duration of each session.

Memory can be a tricky mistress, however.  When I was in college (for my first bachelor’s), I had a course of ECT over three weeks.  I don’t remember anything from that time period or anything right before and right after those weeks.  This makes me rather uncomfortable, knowing that there is a period of time when the words in my journal entries from that time are unfamiliar.  So when, fifteen years later, a psychiatrist suggested ECT, I balked.  But that psychiatrist also had been treating me for longer than my first bachelor’s degree took, whereas the doctor from my college days only treated me when I happened to be inpatient.  Being the research freak I am, and since I was inpatient and couldn’t get to a library, I asked him to show me some legitimate articles or papers, and then we had an open, honest discussion about predicted results and side effects–both in terms of the immediate future and long term future.

I chose ECT.  After my cardiac diagnosis, I went through a very severe and lengthy depressive episode, and because of my heart, I cannot take a large number of medications.  I was exhausted and my mind was strung out, and I knew I couldn’t be discharged in the state I was in.

By the time I left that particular psychiatrist to move back to the eastern parts of the country, we had figured out that most of my medication was not helping.  My psychiatrist in MO found me a psychiatrist in NY, and the two of them consulted and discussed my treatment–and allowed me in on the discussion.

Over the previous three years, we’ve taped off old medications that proved to be ineffective, figured out which medications are effective, and I now am receiving ECT once every four weeks.  If I start to slip at all in those weeks, I call my psychiatrist and we talk about whether or not I should have an earlier, extra, treatment or if I am coping quite well and should see how things go.

During this time, I have been a college professor, a NYS Track and Field Official, an NCAA Volleyball Judge, a writer, and a friend and family member.  My memory has some glitches–but that could also be from the depression itself or, well, the fact that I’ll be forty in a week.  It’s not enough of a problem to hamper my lifestyle or consider terminating treatment.

I continue to reevaluate everything as new knowledge is produced in the scientific world of research, and I continue to reevaluate my pattern of symptoms, and discuss these with my treatment team.  Given everything–my past, my present, my physical limitations regarding medications, and my response to ECT–the most effective treatment for me is ECT.

 

May 28, 2017 Posted by | addictions, bipolar disorder, Communication, coping, death, depression, Eating Disorders, ECT, health, heart, progress, recovery, relationships, shame, suicide, therapy, treatment | 3 Comments

Sometimes, We’re Just Human

Scrolling through Facebook the other day, I came across this post on how bodies look at different weights.  Yes, there are pictures.  No, they are not posted to feed into the pro-ana craze.  There are all different weights represented and all types of bodies.  The post pairs them up in twos: Two women who weight the same amount and have very different body shapes.

“Eh,” I thought.  “I already know people have different body shapes and sizes. I know weight is just a stupid ass number put on earth to drive us all nuts.”

But I thought I’d take a look at the post anyway.  Here are some things I loved about this post:

  1. The photographs don’t include the person’s  face, and the women aren’t posing in some so-called-sexy-come-hither pose in front of the mirror.  We can’t tell what they are feeling if we can’t read their faces. These photos are more objective than subjective–no special lighting, no special outfits, no special poses.  Just the shape of an unknown person at a given weight.  Because how someone feels shouldn’t be based on their weight.
  2. Also–the women aren’t photographed side by side.  Two different photos of two different women are place side by side.  They weren’t in a position of trying to look “better” or “thinner” or “fitter” or “happier” than  a person standing next to each other.  Because it shouldn’t be a competition.
  3. The post gives us no other information about the women.  Not their age, lifestyle, fitness level, etc.  There are no judgments or subjective comments posted about any photo.  Because you can be fit and strong and healthy regardless of your weight.

I know all of these things.  Most of the time, I even feel these things.  But sometimes, say, at the end a semester of teaching and the end of another very busy track season and after submitting what feels like 500 million thousand job applications in all different types of formats–sometimes I can feel a bit tired and overwhelmed, and my logic isn’t so logical.

And then I try on a pair of shorts that should have fit me but didn’t.  This bothered me.  Even with all my rational statements that are supposed to make me realize my faulty reasoning, I felt crappy.  I wasn’t thinking, “Now I have to lose weight” or “I hate the way I look” or “I’m too big for this world” (a significant phrase from the days I struggled with anorexia).

I just felt wrong somehow.  I was happy with my appearance before I put on those shorts.  I haven’t thought about losing weight in ages.  I know I’m healthy right now–healthier (physically and emotionally) than I’ve been in awhile.  Winters are tough on my body; it’s as if the cold sucks all of the vitamins that contribute to energy levels out of my body and blocks those vitamins from getting into my body.  I thought to myself, “I shouldn’t weigh this much.”

Not because I had stepped on a scale and saw a scary number, but because of the way a pair of shorts fit.

The end of this previous winter and throughout this spring, I have noticed I have more energy and I feel stronger than previous winters.  I was taking care of myself ignorant of all numbers relating to my size–and this led to more emotional and mental strength as well. 

I immediately worried if I was overreacting and if this was a sign that the eating disorder was sneaking into my thoughts and and and.  But this post is a good reminder, that not everything relating to my body comes from the old history of anorexia.  Sometimes, it’s just me having a crappy day, combined with being surrounded by media that tells everyone they need to lose weight or gain muscles or lose inches.

These thoughts can be persistent and stronger in people struggling with an eating disorder, but this is not just an eating disorder issue.  It’s a cultural one that affects all sexes, all ages, all weights, all lifestyles–and, as a whole, we need more posts such as this one to open up communication.  A scary monster in the closet can’t remain a monster if we are willing to bring it into the light of day.

May 21, 2017 Posted by | bipolar disorder, Body Image, Communication, coping, depression, diversity, Eating Disorders, exercise, feelings, guilt, health, identity, images, progress, publicity, recovery, responses, shame, treatment, weight | Leave a comment

How Much Do We Share?

how-much-is-too-much-coffee-for-health-benefits_0A couple of weeks ago, I spent an hour and a half speaking with one of my colleague’s course sections.  It’s a course that speaks openly on death and dying, and I shared my experiences as someone who woke up and lived after attempting suicide.  I’ve spoken to her classes before and I speak to health classes about my recovery from anorexia.  It always brings up one significant question, one that I think about even after my guest speaking:  Did I share  enough or did I share the right amount or  did I share too much?

When owning our stories and sharing them, how much do we tell?  Of course, this is different for each individual, and it depends on the context and the recipient.  When an eight-year-old asks me why I have so many scars, I’m extremely careful about how I word things.  Think, “Sometimes I get very sad for long periods of time, and when I was younger, I didn’t know how to handle all those painful feelings, so I didn’t cope with them in the best way.  Now I have people to talk to and I have a bunch of different things to do when I start feeling bad.”

I am not ashamed of my past, of having attempted suicide, of beginning self-harm so young, of needing multiple hospitalizations for anorexia, of needing ECT as maintenance therapy for the bipolar disorder.  But it did take time to go from hiding everything from everyone to admitting things to myself to honestly answering questions.

But there are things, especially concerning the eating disorder, that I don’t share, that I knowingly withhold from anyone who isn’t one of my doctors.  I don’t want to have someone use my story to “get sicker.”  I read all the eating disorder memoirs and blogs I could, and I watched certain movies over and over.  I didn’t care how the author/subject got better.  All I cared about was how she got sick in the first place.

When I talk to groups of people, I say I was hospitalized.  I don’t say how many times or for how many months.  I may discuss refeeding, talking about the pain of refeeding and how scary it was emotionally.  Depending on the context, I may address tube feeding and explain it.  I don’t tell people what my mealplan was or how much weight I gained at what stage.  I don’t tell people how much I lost.  I don’t discuss the ways I used to purge, just that I did.  I don’t want to be “that girl”–the one someone compares herself to and then thinks, “I’m not as sick as she was, so I must not be all that sick at all.  I’m fine.”

Many sufferers grew up on competition, via sports or clubs or school.  Many of us used the illness as competition.  And many of us walked away thinking, “I’m not doing it right” or “I’m not good enough.”

It’s so easy to walk into Target and compare yourself to everyone else there.  It’s easy to take sneaky, sideways glances at other people and judge them.  It’s easy to judge ourselves and come up short.

I still compare myself to other people; in some ways, we all do.  “I wish I could speak French.”  “I wish I could knit that fast.”  “He’s a really good singer.”  “I really like the way she handles a classroom.”  But these things no longer determine my worth.  Yes, I have a horrible past, but I’ve chosen to keep moving forward.  I may strive to be better is some areas of my life, but my happiness does not depend on these things.

My happiness is here.  Now.

 

 

May 14, 2017 Posted by | addictions, bipolar disorder, Body Image, Communication, coping, death, depression, Eating Disorders, ECT, exercise, feelings, guilt, health, identity, mindfulness, progress, publicity, recovery, responses, self harm, shame, suicide, treatment | Leave a comment