The Depression Dialogue

The Reality of What I Hear in My Head

Depression is a master manipulator.  Regardless of what is being said or done around me, my depression has an uncanny knack for twisting and morphing everything into a dark pit of hopelessness and despair.

I talk a mean game.  I’ve been told by some that I am the happiest depressed person they’ve ever met because I am always sweet, friendly and smiling, always reaching out to others to see how they are doing.  What everyone doesn’t realize is that it is all a survival mechanism.  I smile because it is easier than letting others see me cry.  I reassure others that I am peachy because it’s easier than trying to talk about everything that feels wrong, some of which I cannot even pinpoint or put into words.  For me, living with depression means bolting on that cheerful, smiling mask.  Sometimes it’s the only way I can get through the day.

In my head, there is constant turmoil, constant chaos.  No matter how many friends reach out here and there to check on me to see whether I am okay, my depression tells me that there is truly nobody there, no one who cares, nobody I can count on.  Depression convinces me that I am all alone and that the only reason people are even asking is because they feel obligated to or feel guilty that they haven’t spoken to me for a while.

Depression tells me to be suspicious of everyone’s motives for saying they want to be there and never let anyone in too close because it will only make it hurt more when they leave.  According to Depression, everyone is going to leave sooner or later anyway.  It is hard to argue that point because everyone always has.

Depression tells me that I am a burden on everyone, that I have too much baggage, too much drama and that nobody needs that in their life.  So I isolate to spare everyone from that burden and spare myself from eventual abandonment.  It becomes a self-fulfilling prophecy.  I am alone.

Depression tells me that nothing I have done has ever been good enough, that all I ever do is mess everything up.  Depression harps on my flaws, reminding me of every mistake I have made, every time I have let anyone down.  Depression tells me that I am a failure.  It asks me why I should even bother trying to do anything because I just mess everything up anyway.  The constant badgering leaves me petrified of failing again, terrified of even trying.  I find myself paralyzed, afraid that no matter what I do, it will be wrong.

Depression tells me that nothing will ever get better.  No one will ever truly love me.  Nothing I do will ever be good enough.  Depression tells me I have failed everyone in my life – my children, my friends, my partners, even myself.  Depression tells me I’m not smart enough, not pretty enough, not good enough, that everyone deserves better than to have me in their life.  Depression tells me that I’m a waste of space, a waste of breath, that the world would be better off without me in it.  Depression hones in on every single one of my insecurities and uses them as a weapon against me.  Depression spews out a constant barrage of absolute negatives until it is all I can hear.  It drowns out everything else until it is all I hear, all I know.

Though part of me knows deep down knows it is the depression talking and not reality, it is so hard not to listen, not to believe all it says.  After all, depression has been my steady companion for as long as I can remember.  It has been a part of my life longer than any family, any friend, any love interest.  It is hard not to believe that one voice who has been there longer than anyone else.

When I talk about my depression, I describe it as a battle, a struggle, a fight because that is essentially what it is.  Every single day, I am assaulted with a barrage of negativity and hopelessness.  On good days, I am able to fight back, to tell myself that none of it is true and find a way to move forward and be positive.  On bad days, I’m left feeling critically wounded and crippled, unable to even climb out of bed or face the day.  Every single day it is a fight.  Every single day, I wake in this battlefield, never expecting to ever win, just hoping to survive.

People who don’t understand depression assume it is just random bouts of sadness and cannot understand why someone suffering from depression cannot just get over it and move on.  They cannot see this monster I carry with me, this beast that is constantly attacking me, wearing me down, stealing away all hope and dragging me down into the darkness.  They cannot hear the steady barrage of attacks I face every day or see how wounded and broken it leaves me inside.  More than anything, I wish others could see and hear the war that is being waged inside me so that they might understand how weary I am from a lifetime of fighting for my life.

mightylogoRepublished on The Mighty on 03/03/17.

The Meds Crash..

What Happens When Your Insurance Company Won’t Cover the Medications Needed for Your Mental Health

In the last year, I have made so many positive strides in my ongoing fight to get in front of my mental illness and to be in a healthier place.  I not only have begun finally opening up, writing and talking about my struggles with depression, anxiety and p.t.s.d., I have begun therapy at a wonderful facility that uses a multi-pronged treatment plan to combat mental illness, involving not only traditional treatments such as therapy and medication management but also incorporating unconventional tools such as yoga, meditation and art into the mix to help people heal mind, body and soul.  Perhaps the greatest stride forward I have made, however, happened thanks to a genetic test my new doctors gave me that identified a genetic mutation I possessed that has been the linchpin blocking all previous attempts at medication and treatment.  Due to this genetic mutation, my liver is incapable of metabolizing folic acid, a simple b vitamin used by the brain to help transport the chemicals needed to help moderate my moods and depression.  It is a fairly simple fix because there is an already broken-down version of folic acid on the market, a synthetic version that can help my brain to function properly – something it has never been able to do on it’s own, due to my genetic mutation.  However, the simple yet life-changing fix has been completely derailed by my insurance company, CDPHP, that refuses to cover it.

My doctor had been providing me with samples of the broken-down folic acid, also known as l-methylfolate or by the prescription name Deplin, for the last seven months.  While it is in no way a panacea that would make my mental illness disappear, it made a world of a difference.  I had more clarity, was able to focus better and function more.  I was able to fight back tears and move forward, face fears and be productive in ways I previously never imagined possible.  I found myself able to genuinely smile and experience happiness.  Despite the fact that I was going through one of the rockiest times in my life, I had real hope.  It was the beginning of a new life, a new world for me.

Yet despite how much of a breakthrough I had achieved on many levels thanks to this medication, CDPHP continues to refuse to cover it, deeming it unnecessary.  My doctor had a drawer full of samples to keep me going while we began our fight for coverage.  I had been filing appeals, reaching out for help, fighting with every ounce of energy and courage that I could muster, completely due to the Deplin helping my antidepressants and anti-anxiety medications get where they were needed in my brain, something they could never do on their own because I had always been medication resistant due to my genetic mutation.

…And then the samples ran out.

…And my internal appeal for coverage by CDPHP was denied.

It has been a week since I have had any Deplin in my system.  Where I was previously up before seven in the morning every day, up for breakfast and ready to start my day, I can’t seem to pull myself up out of bed again.  Today, it was almost eleven before I even got out of bed.  Less than twenty minutes later, I was back in bed, wrapped in my blanket, wondering why I was even bothering.  Each day, it becomes increasingly harder to do anything at all.

Even the simplest conflicts feel unbearable again.  I find myself panicking and breaking down into tears over even the smallest bumps in the road.  Where previously I was convinced that I could somehow figure things out and find a way, I don’t feel like I can deal with anything right now.  I’m afraid to go out, to leave my room, because I have no control over my emotions or my tears anymore.  My mind is racing again, I cannot focus, I cannot sleep, I have no desire to eat, no desire to do anything.  I feel like I’m in a constant panic, one word away from breaking down into tears again.

It is like I had entered a Renaissance, a beautiful world full of progress and hope, only to be kicked back into the darkness of the stone age.

I have an external appeal yet to file with the state but I don’t know if I can do it.  I don’t know if I have the strength.  My mind keeps asking me why bother?  Everything feels hopeless.  The battle feels lost.  All I want to do is climb back in bed and cry.  That other world, that one where I was smiling, where I felt hopeful, feels like another world, another life, just a dream.  I’m terrified I’ll never find my way back to that person again.  Sitting out in public, typing this out, I cannot stop the tears from flowing, cannot find my way back to the person I was even a week ago when I believed that things were going to be okay, when I believed in hope.

This story began with Fighting for My Mental Health on 1/13/17.

mightylogoRepublished on The Mighty on 5/11/17.

The Isolation of Depression

Depression speaks in lies.  It utilizes absolute negatives, convincing you that no one else could possibly understand what you are feeling or going through.  No matter how many people are around, you feel completely alone.  It seems easier to become anti-social and push everyone away than to explain your condition, defend yourself or make excuses for your behavior.  Those suffering from depression feel alone so they isolate, turning that lie into a truth.

This feeling of loneliness bleeds into every aspect of your life.  You feel constantly out of place, sticking out like a sore thumb.  It feels as if everyone can tell you do not belong.  No matter where you go, you are self-conscious that you’re so broken and damaged that you have no place there or anywhere.  Your anxiety builds and you constantly want to retreat and flee to avoid awkward and uncomfortable situations.

That insecurity leads to guilt.  You want to be there with others, to belong, but you feel so out of place that you retreat.  You beat yourself up for pulling away, feeling bad that you cannot be the person you assume others wish you could be.  You hate that you cannot fit in.  You isolate yourself out of shame because you feel you failed everyone on a fundamental level. You blame yourself for everything, convincing yourself that you’d be better on your own, away from everyone else.

You feel alone even though there are others there.  You systematically pull away from everyone, one by one, until you are alone in reality.  You withdraw from those that you don’t believe understand what you’re going through because it’s too exhausting to try to explain everything you’re feeling.  You reject those you believe will judge you because it is easier to push them away first than to face their harsh criticism.  You isolate from others because you feel awkward or guilty or ashamed of the person you’ve become.

This isolation goes in cycles, a self-fulfilling prophecy.  You do not feel like you belong so you react to that feeling.  You retreat then beat yourself up from the guilt of your self-imposed isolation.  It all begins with a lie, told by your depression.  It ends with you turning that lie into a sad truth where you’ve walled yourself up, pushing everyone else away, until you find yourself completely alone.

Depression lies because its strength comes from its ability to separate and destroy.  In isolation, it can convince you of other falsehoods you would never believe if surrounded by your support system.  If you had reassurance and compassion from others, depression could not trap you in that web of lies.

The truth is that no one suffering from depression is truly alone.  According to recent studies, one in five people will struggle with mental illness at some point in their life, with depression and anxiety at the top of that list.  That means that, though no one else may have walked directly in your shoes, there are so many others walking along that same path.  So many of us understand exactly how you are feeling.  We can empathize.  You are not alone.

Don’t believe the lies depression tells you.  Don’t isolate or push others away.  People do care.  You do belong.  You do matter.  People care.  Let others in.  Talk.  Do not let depression win.  You do not have to be alone.

Fighting for My Mental Health

Battling my Insurance Company for Coverage

I have struggled with depression my entire life.  Before I even knew what mental illness was, back in a time when it was the gorilla in the room that nobody talked about, I knew something was different within myself.  Off.  Wrong.  Unlike many people suffering from depression that can pinpoint a specific period in their life that marked the onset of their illness, mine seemed to always be present, lingering and lurking in the shadows for as long as I could remember.  Though years of abuse, trauma and dysfunction contributed to its intensity, those demons of depression have always been there, tormenting me.

Throughout my childhood, my mother struggled with often untreated, always under-treated bipolar disorder.  It was a dark shadow that hung over our family.  Mental illness was not something spoken about in our house.  Appearances were everything and it was a dirty little secret, our family legacy, that we all knew was there but no one ever discussed.  When I was a teenager, she shot my father.  When her secret was revealed, I saw firsthand the stigma of mental illness.  Friends and neighbors who once sang her praises ostracized her.  She simultaneously became a punchline to laugh at and a monster to fear.  Back then, I never spoke out openly about my own struggles because I knew all too well how people reacted to mental illness.

In my twenties, the weight of my depression became to heavy to bear.  I began having breakdowns, unable to fully cope with the pressures of life on my own.  On and off throughout my adult life, I have tried reaching out for professional help.  Doctors prescribed a wide variety of antidepressants and anti-anxiety medications in different dosages and combinations with no apparent rhyme or reason, as if they were playing whack-a-mole with my mental health.  Nothing seemed to help.  Time and again, I would become so discouraged with the waves of prescriptions with horrific side effects and no beneficial progress that I would stop treatment, retreating back into the shadows to suffer again in silence.

This past year, an angel appeared to help me battle my demons.  I was blessed to find a new doctor who actually listened to my past struggles instead of going through the motions of standard mental health treatment by continuing with the painful game of whack-a-mole that had been my previous experience.  He thought outside the box, wanting to run tests to better understand why I had been so resistant to medications and to help pinpoint which drugs might be a better choice for me.

He arranged for me to take a genesight test.  A cheek swab and a few vials of blood later, the lab had my complete genetic makeup on file.  Based on my genetic markers, this test could determine which medications my body could and could not metabolize and which were likely to cause moderate to severe interactions.  I had never heard of such a test before, but my insurance covered it and I was at the end of my rope, with very little hope, willing to try anything.

The results of this test were mind-blowing.  Not only did the test identify that many of the prescriptions my previous doctors had prescribed would cause moderate to severe interactions and should never be given to me, the test also revealed something completely unexpected.  I have a rare genetic abnormality.  Due to this genetic mutation, my liver is unable to break down folic acid.  The broken down version of folic acid, l-methylfolate, is used by the brain as a conduit to help the brain transfer the chemicals needed to regulate and moderate moods.

Finally, my lifelong struggle with depression made perfect sense.  Because my body could never break down folic acid into l-methylfolate, my brain was never able to properly regulate my moods.  No matter what my body could make on its own or what doctors had prescribed, it was unable to get to the part of my brain that needed it because the l-methylfolate was never present to transport it where it was needed.  Because my liver genetically was unable to break down this vitamin, my brain had literally been starving for a basic b vitamin my entire life.  It was an easy solution, though.  There is a prescription form of the broken down version of folic acid, l-methylfolate, on the market.  It is called Deplin.

This discovery was a life-changer for me.  I finally had hope where previously there was none.  With Deplin, my brain would finally be able to regulate and moderate my moods.  Prescriptions that previously were unable to get where they needed in my brain would finally have a chance to work.  I was given a ray of hope for a semblance of a normal life where I was not struggling to battle the demons of my depression every moment of every single day.  My doctor, my angel of hope, began me on samples of Deplin, six to a box, as we applied for coverage from my insurance company, CDPHP.

It seemed a clear cut and dry request.  CDPHP had fully covered my genesight lab work.  The lab work identified that, due to a genetic abnormality, my liver was incapable of metabolizing and breaking down folic acid into l-methylfolate, a substance needed by my brain to combat my depression and regulate my moods.  A pharmaceutical company manufactured a pill form of the broken down version of folic acid that I needed.  It wasn’t an experimental or new substance.  It had been thoroughly tested, approved and was readily available on the market to be prescribed for those who needed it.  It was even less expensive than many of the previous antidepressants and anti-anxiety medications that I had tried without success, though still more than I could afford to pay out of pocket.

However, much to my doctor’s and my surprise, CDPHP refused to cover my Deplin.  The first time it was rejected, we were told that they had determined there was a cheaper alternative available.  Their “cheaper alternative” was folic acid tablets.  Folic acid that my liver was incapable of breaking down on its own.  I called up CDPHP’s 800 number provided on my denial letter and pleaded my case, explaining the lab results, why I so desperately needed the Deplin covered and why the cheaper alternative would not work for me.  They suggested we resubmit the claim, assuring me that, based on my explanation, it should indeed be covered.

Yet again, the next claim was denied.  I was told that CDPHP does not recognize the results of the genesight test so they could not cover any medication determined necessary based on the results of the test.  My mind was blown.  CDPHP fully covered this lab work being done, yet refused to acknowledge the results of the very test they had paid for.  Because of this, Deplin was considered not medically necessary.  Furthermore, they refused to acknowledge the list of prescriptions to avoid determined by the genesight test as likely to cause moderate to severe interactions.  CDPHP refused to cover the antidepressants deemed safe for me based on my genetics because “other anti-depressants were available”, regardless of the fact that the prescriptions they were referring to were all either on my genesight list of prescriptions to avoid or they had been previously tried with adverse effects.

Meanwhile, I am living off of sample boxes of both my Deplin and my antidepressant.  There is a noticeable difference in the last few months.  My depression is by no means cured but I have an easier time coping, I find myself genuinely smiling sometimes, I have real hope where previously there was none.  Yet, there looms anxiety and stress over my ongoing battle to get my prescriptions covered.  I am currently drafting both an internal and external appeal to get my prescriptions covered, though my doctor, my guardian angel, has informed me there’s little hope for a positive outcome.  He has dealt with this system for years, explaining that the insurance companies and the government work hand in hand and never want to pay for anything more than they absolutely have to pay for, regardless of whether or not it is needed.

I’m honestly at a loss.  I want to hold onto hope because I desperately want to get better.  I want to fight this depression, to heal and have a chance at a semblance of a normal life.  Yet I find myself anxiety-ridden every time my doctor opens his sample drawer, fearful of the day when his sample supply runs out.  I’ve been living off of those sample boxes, six pills, six days to a box, for months now.  I know his supply won’t last forever.  I dread the day when he runs out and I have to go back to that life without hope, drowning in a depression that nothing could touch, all because my insurance company refuses to cover the medication that a test they covered says I need.  I’m battling for my life here.  I’m fighting for my mental health.

 

Status Update 2/2/17:

I was informed this week by my doctor that his supply of samples of Deplin has come to an end.  The news was bittersweet.  As he handed me the last of his supply of the medication I desperately need to treat my mental illness, I calculated that I barely have enough to last another week and a half.  He suggested I try to stretch out the last pills by taking the remainders on alternate days to keep some in my system as long as possible before they run out.  Yesterday was my first day without one and I could honestly feel a distinct difference – less energy and pep, less motivation to even do basic tasks.  I found myself crying more easily and my mind drifting back down into that darkness more easily than it had in months.  I’m genuinely scared.

I consider it bittersweet for two reasons.  The first being the obvious fact that I have finally found something that genuinely helps with my depression.  While it is far from a panacea, the difference is clear and vast.  The end to his supply of samples also means that instead of filing a long, drawn out appeal to have this medication covered, I can file for an expedited appeal, which is decided within 72 hours.

I began the process today.  My first call was to CDPHP itself, to begin the expedited appeal process.  My next call was to Assurex Health, the company that conducted my Genesight test that identified my gene mutation that determined I needed Deplin.  I spent a good hour on the phone with different departments as they suggested everything from reports and information packets to clinical data from their genetic studies to submit for my appeal.  My next call was to Pam Labs, the pharmaceutical company that makes Deplin, who offered to send me whatever information I needed to help fight for drug coverage.

After speaking to both companies, I received a call back from CDPHP’s appeals department to inform me that they received my expedited appeals request and that I will receive a decision by tomorrow afternoon.  The woman I spoke to also claimed that CDPHP never approved nor covered my Genesight test, a claim I found very fishy.  Every single other time CDPHP has denied coverage for anything, not only did my doctor receive a packet explaining their decision to deny coverage, but I was notified, as well, with a decision number in case we decided to dispute it.  Six months after the test was completed, I have received no notification that it was supposedly not covered, nor has my doctor ever mentioned such a thing to me.  I spent over an hour on the phone today with the company that did the testing themselves, as well, and though I spoke directly with the billing department who needed my order number to pull up my test before the lab technicians could speak to me, not a single person at Assurex Health even offhandedly mentioned anything about not being reimbursed for the labwork, nor in the last six months has that lab ever attempted to contact me regarding payment.  I have never been one for conspiracy theories but I cannot help but question the validity of CDPHP’s appeals department claim that they never approved nor paid for the test.

I am thoroughly prepared to fight for my medication to be covered through whatever channels I must in order to get it covered.  It has been recommended, as well, that I contact a local reporter who specializes in stories about health coverage since I already have a relationship with that station after doing a story with them this past fall.  My flight response has always been high but this is one fight I cannot allow myself to run from because my mental health is too important – I must continue my fight for coverage through every and any avenue available until I get the medication I need.

Status Update 2/7/17:

My expedited internal appeal was denied, despite sending CDPHP almost one hundred pages of paperwork, between clinical study data provided by Assurex Labs and multiple articles both about my specific gene mutation and the use of l-methylfolate to treat it when a patient is treatment and medication-resistant.  My next step is to file an expedited external appeal with the state who oversees the healthcare plans.  I am down to five more days of Deplin and have begun trying to space them out, alternating days, in order to keep some in my system for as long as I can.

selfgrowth

Republished on SelfGrowth on 1/13/17.


EmpowHER Health Blogger - BLAcker
Republished on EmpowHER on 1/13/17.

Holding Onto My Past

I recently had someone close to me criticize me for “holding my past in front of me” and bringing it up as a reminder of all that has happened.  They lectured about how unhealthy it was to dwell on the past and let it consume me.  In truth, though both of our words and actions in the past had tarnished and diminished our relationship over the years until it was a bare shell of the friendship it had previously been, I still sincerely valued their opinion so I took their words to heart and gave them serious contemplation.

In my ongoing journey to improve my mental health, I’ve spent a great deal of time in self-reflection, weighing my own actions and experiences along with the opinions of others.  While I can understand where their criticism was coming from in some ways, I also know what’s best for myself and what I need to do in order to heal and hold myself together.  I admittedly do hold onto the past in a few ways, some as an old habit and some fairly new.  While others may not agree with or understand my reasons why, I believe I hold onto the past for a multitude of good reasons.

I spent much of my life running from the majority of my distant past.  My demons and monsters lived in that portion of my past.  All my traumas and abuses lurked back there.  I avoided going to certain areas and talking to many people, not because they were bad places or people that had done me any harm themselves, but rather just because they had a proximate link to rougher times in my life.  My flight response has always been very high so when things became overwhelming, I had a tendency to flee.  I’ve spent my life hoping to outrun the scarier aspects of my past.

Holding onto that segment of my past is a fairly recent thing for me, an effort to stop running away and get healthier.  I came to the realization that I could never get beyond the traumas of my past until I turned and faced them.  Instead of fleeing from everything, I began to grasp them firmly, attempting to demystify it all and make it less terrifying, to find some sense in it, decipher what there was to learn from each thing, make peace with it and move on.

I am surrounded right now by that segment of my past because I have spent a lifetime running from it and it has finally caught up.  There are so many things in life right now I need to process and come to terms with in order to move on from them.  I have a backlog that goes back decades.  It isn’t that I’m choosing to live in that portion of my past because I refuse to let go of it.  I am surrounded by the past because it has all caught up to me and I must deal with it before I can move forward.  I write often and fervently about this period in my life because I want so desperately to heal from it and take away the power it has over me.

There are other aspects of my past that I cling to tightly, such as cherished memories.  I’m very nostalgic in that way.  I remind myself of the good times to help myself pull through the bad.  Love, especially, is very dear to me.  Even heartache and pain are tempered by the realization that relationships and situations were not always all bad.  Being able to see everything in shades of gray helps to soften my heart so that I do not become bitter and resentful by clinging only to the bad.

Others find it acceptable to hold onto the good memories but expect me to immediately forget the bad, especially if it puts them in a bad light or brings attention to their prior bad deeds.  They would prefer for me to forget their past transgressions rather than hold them accountable.  While I do not cling tightly to the bad in the same way that I cherish the good, I will no longer blindly disregard it, either. If I refuse to acknowledge the past, I cannot prevent history from repeating itself.  Calling attention to repeating patterns is not living in the past.  It is an attempt to avoid living through the same pain repeatedly in the future.

There are a couple sayings that go together wonderfully.  “Hindsight is 20/20” is one.  “Fool me once, shame on you. Fool me twice, shame on me” is the other.  By looking back and learning from my past, I can stop myself from repeatedly being played for a fool.  I spent over a decade playing that part because I refused to learn from the past or listen to my intuition.  I cannot allow myself to fall into that same trap again.  Though I do not blindly mistrust without reason, I am more vigilant today and more willing to learn from my past when situations repeat themselves.

One such example is my ex-fiance, who was a serial cheater.  We argued time and again because the same patterns kept revealing themselves.  He would pull away and become distant, more secretive and sneaky about his online and phone usage.  He would begin withholding intimacy and attention.  His time away from the house would increase, with increasingly outlandish explanations for his tardiness.  I kept wanting to trust him or at least give him the benefit of the doubt.  Yet each time these patterns emerged, it was later revealed he had once again been unfaithful.  Had I learned from my past, I could have saved myself years of heartache.

When I bring up many events from my shared past with others, it is because those issues have not been resolved and I am struggling to understand how they fit all together.  When situations are up in the air and varied emotions are thrown into the mix, I need to put everything out there like pieces of a puzzle and derive their meaning so that a resolution can be achieved, especially if the words and actions of others are contradictory.  I bring up the past because I need to understand the inconsistencies in order to learn from them, make informed decisions and move forward beyond all the confusion.  I do not wish to live in the past nor do I wish to repeat it.  I just need clarity so I can best determine how to proceed.

I truly want to move forward in my life, to be healthier and happier.  Much of my past has haunted me for years and must be dealt with before I can heal from it.  I will continue to cherish the good times in my past because nostalgia softens my heart and makes me a better person.  Other aspects of my past must not be forgotten so that I can learn from them and avoid history from repeating itself.   I do not intend to live my life in my past or to let it consume me, but I refuse to blindly disregard it anymore, either.  I bring up portions of my past with others in order to better understand contradictory situations so that I can make an informed decision about how to best move forward.  While I can appreciate the concern of others that I may be living in the past or letting it consume me, I truly believe that I need to acknowledge and align my past with my present so I can better understand how to live on a healthier path in the future.

If I Were Gone…

When Suicidal Ideation Takes You to Dark Places

Suicidal ideation differs from being actively suicidal in that there are not any active plans to kill yourself.  You are not intending to take your own life, but rather your mind finds itself contemplating how tired you are of living a life that feels hopeless.  You are exhausted, drained and just want to stop hurting.  You find yourself thinking about death in abstract terms, almost as a sweet release and ponder how the world would be without you.

When I am overwhelmed with anxiety and stress and my depression has spiked, my mind will travel to dark, scary, morbid places.  I find myself pondering how everyone’s lives would be better without me.  I dwell on the fact that if I was to give up tomorrow, I don’t even have family that could make arrangements because all I have in my life is my children who are not old enough to take on such a responsibility or burden.  I have no intention of taking my life, yet there are days that these thoughts consume me.

Today, in the depths of my despair, I began to think about what my obituary might read if I were gone.  In my mind, it would read something like this:

Today, we lost Beth W-.  She was 40 years old.  She had a kind and compassionate heart, always trying to reach out to help others even when she was struggling to stay afloat herself.  She had a great love of animals, nature, children’s cartoons, bad movies, good chocolate and life in general.  She was quick to smile, laugh and give out hugs even though she was always crying inside.  Over the course of her lifetime, she filled many roles including fiance, wife, friend, student, teacher, caregiver and author, though there was no role she cherished more than motherhood.

She passed today after losing her battle with a lifelong invisible illness, complicated by the apathy of others.  She bravely battled both her demons  and a system who saw her as a number instead of a person, doubting what they could not see.  Though she fought long and hard to get help, she met roadblocks at too many turns, eventually being consumed by the fiery wreck of her own life.  She truly wanted to live but was not sure how, or whether life itself truly wanted her in it.

She is survived by amazing children with beautiful hearts and sharp minds who deserved so much better than the mother they received.  She is also survived by a handful of friends, some distant because though they cared, she was too overwhelming to be around for long periods of time and some estranged because she pushed them away so they would not see how broken she truly was.  She is also survived by a best friend who had too much on his own plate to see how her life was crumbling beneath her.  She was preceded in death by both of her parents, who passed to her the legacy of dysfunction and abuse.

There will be no services because she has no family to arrange them.  In lieu of flowers or donations, it is requested that parents hold their children tightly to ensure they know they are loved, that friends make a genuine attempt to listen to one another and that society in general begins to openly talk about mental illness and depression because deaths like these are both tragic and needless.  The world would be such a different place if everyone walked it with compassion and empathy.

As I sat here morbidly imagining what I would wish my obituary would say if I were gone tomorrow, I realized there was neither anyone to write it, nor anyone I was sure would care enough to read it.  My passing would likely go largely unnoticed, my death another number added to the statistics of the mentally ill.

Such is the case with so many people struggling with mental illness today.  We are struggling, stumbling, floundering through life.  We are trying so desperately to live and not give up hope yet we feel all alone in the world.  All too often, we find ourselves drowning in depression, just wanting the pain to end.  Whether or not our situation is truly hopeless, all we can feel inside is despair.

More often than not, even when we reach out for help or assistance, we’re met by roadblocks and red tape.  There are so many hoops to jump through, unknown roads to navigate on our own that it quickly becomes overwhelming, complicated and unbearable.  We are met with doubt and suspicion along the way as if we are fabricating our struggles or looking for attention.  We are treated coldly, without compassion or care, like we are numbers and not people.  We are made to feel like we are inconsequential and somehow less than human by the same groups and agencies we have turned to for help.

We watch as one by one friends and family distance themselves from our “drama” but we don’t fight it because we already feel like a burden.  We begin pushing away those who are left because we come to believe it is only a matter of time before they would leave us, as well, and it seems easier to cut the ties ourselves.  We feel completely alone.  On some level, we feel we deserve it because we are such a mess.  We honestly believe that everyone would be better off without us in their lives.

Meanwhile, we’re drowning.  We’re drowning in hopelessness, helplessness, depression and despair.  We’re struggling harder and harder to find reasons to pull ourselves out of bed, reasons to keep living.  It’s not so much that we want to die that we are just so very tired of living this way.  We already feel dead inside.  Our minds take us to dark places, dwelling on morbid situations that we know are unhealthy yet give us a strange sense of peace.

Deep down, I know I would be missed, at least by my children and by the few friends who have stood by me through my struggles.  It is a fact I cling to on my hardest days, when I feel like I am spiraling down into that hopeless abyss.  No matter how hard I try to fight it, that darkness sometimes seeps into my consciousness and beckons me.  Though I am not actively planning to take my own life, there are days I cannot help but ponder what it would be like if I were gone.

Cutting Free

Today, I cut all ties with someone who once meant a great deal to me.  It isn’t that I didn’t love him as a person.  He claimed even to love me back.

It is that how he treated me was wrong.  It was unacceptable.  He made me repeatedly feel like I was nothing, worthless, like I didn’t matter.

Ironically his last message to me had numerous lines that echoed almost verbatim from the abuses of my childhood, words that still haunted me decades later.

He broke my heart repeatedly and tried to blame me for it because I chose to put my heart out there in the first place.  He felt he bore no responsibility because I kept choosing to care.

I used to believe that love could overcome everything.  What can I say? I’m a hopeless romantic at heart.  But I know now that sometimes all the love in the world can’t fix some things.

I don’t claim to be perfect in all of this.  I know I’ve made mistakes, too, and I’ve hurt him over the years, as well. He’s been quick to remind me of it all so I’ll never forget.

But I’ve never point blank told him that he meant nothing or just wasn’t worth the effort.

Once a relationship has gotten so bad, so toxic, that I find myself crying and wanting to just give up, give in, it is time to say enough, let go and cut the ties.

No friendship, no love, NOTHING is worth holding onto once it begins hurting me so badly that I begin thinking, even for a moment, about giving up.

Love should never feel that way.  You don’t intentionally try to hurt those you love.  You don’t try to break the people that love you.

Love is supposed to be gentle, kind, compassionate and understanding. Love doesn’t belittle, talk down to you like you’re stupid or damaged or worthless.

Whatever that was, it was not love.  It was not healthy.  It had to go. Before it killed me.  Before I became consumed with thoughts of escaping that pain.

Everything deleted. Everything blocked. Everything done.

No one is worth giving up on life over.

Nobody has the right to come into my life and inflict that much damage and hurt.

Anyone who makes me feel that worthless, that hopeless, that unlovable, that lost, that I find myself longing for the pain to stop for even for a single moment does not deserve a place in my life or in my heart.

When he tore into me tonight, that edge clearly came into view.  It beckoned, whispering those sweet lies about a peaceful release.  Much like he said to me tonight, I, in turn told that edge “Fuck you”.

It cannot have me.

And neither can he.

I’ve cut all ties.

It hurts like hell.

But I’ll survive and I’ll eventually be okay.

Because I’ll still be alive.

Why I Prefer My Thanksgiving Alone

Thanksgiving, for many, marks the start of the holiday season.  It’s also a day, for better or worse, that many spend surrounded by family, friends and loved ones, contemplating and giving thanks for all their blessings in life.

It is a day I prefer to spend alone.

It isn’t that I hate holidays or am bah humbugging my way through life.  I’m not intentionally avoiding Thanksgiving to honor my Native American roots or in some silent “meat is murder” type protest.  I am not morally opposed to the concept of being thankful nor do I believe I have nothing to be thankful for in life.  Quite the opposite.  I thoroughly enjoy most holidays, including Thanksgiving, at least in theory.

The day is just hard for me.

My children are with their father on Thanksgiving.  When we split up and began dividing up the calendar, I knew that my ex’s mother, their paternal grandmother, had lavish spreads every year on Thanksgiving and never wanted my children to feel torn about where to spend the holiday.  I kept their best interest instead of my own desires at heart, and willingly gave up Thanksgiving day.  I celebrate it each year on the Friday after Thanksgiving so I can have them with me and they never miss out on festivities with the other side of their family.

A holiday is not a holiday without my children.

Six years ago, I got a call that my mother had passed away.  On Thanksgiving.  We had been estranged for a few years at that point, which made her death feel even more tragic and jarring, because I had never made peace, never received closure.  Some of the worst trauma of my life had been a result of her actions.  I have since come to terms with the fact that it was due to her mental illness that went untreated and undertreated for years, but acknowledging such things does not make her loss any easier.  Though I normally do not say anything, I feel her loss the greatest now every Thanksgiving day.

My mental illness, sadly much like many workers these days, doesn’t get the day off.

Holidays are extremely hard for most people struggling with mental illness.  My depression and anxiety are always on high alert, but even moreso on holidays that revolve around togetherness.  And I am not alone.  In every single one of over a dozen online support groups I belong to, page after page, post after post, about people struggling to cope with the holidays have begun to appear.  I’m drained by my own feelings today.  The bombardment of emotions from others on top of that is downright overwhelming.  On any average day, we feel lost and alone.  During holidays that emphasize togetherness, that chasm of loneliness and hopelessness spreads farther out into an endless wasteland.  It isn’t that we’re just not trying hard enough to be happy or that we are ungrateful at heart.  Depression drags us to a place of absolute negativity against our will.  We are trying, are fighting, harder than anyone even realizes just to avoid succumbing to that utter hopelessness that is trying to consume us.

Thanksgiving is supposed to be a time for togetherness and a time to give thanks for all your blessings in life.  Though many, often with tongue in cheek, will complain about spending mandatory time with family, it is for the most part a happy, albeit somewhat stressful, day.  I refuse to mar it for anyone by dredging up my own issues throughout the day.

I firmly bolt on that mask I’ve become accustomed to wearing over the years, reassure people that I’m “just peachy”, I grit my teeth and I smile. I send warm wishes on and off throughout the day and encourage others to enjoy and make the most of their day.  I prepare food for tomorrow, my Turkey Day, throughout Thanksgiving day.  But I keep mostly to myself.  I will talk to others about how their day is going, though I remain vague and distant about my own.  Because today is not an easy day for me.  Not a good day.  And I do not want my own issues to tarnish anyone else’s holiday.

There are many days that I can embrace a saying an old friend used to love throwing at me:

“Get off the cross Beth.. We need the wood..”

I know I do not have to carry the weight of the world on my shoulders.  I understand that it is okay to lean on others and that I do not have to deal with everything by myself.  But holidays for me, even though some may be rough to get through, are a beautiful and sacred thing.  This time of year I will willingly make that sacrifice and carry my burden on my own.  I will use that wood I have hoisted on my shoulders today to make a yule log later for my fire.

My Thanksgiving holiday is my own burden and some burdens I choose to face alone.

—————

I truly hope that everyone had a wonderful, or at least bearable holiday today.  I intentionally waited until the early morning hours to share this because I wanted no one’s holiday to be marred by my own.

If any of you who are reading this are struggling yourselves this holiday season, please stay safe, stay strong and know that, no matter how hopeless and alone you feel during this time of year, depression deals in lies.  You are not walking this path alone.  Don’t give up.  Don’t give in.  Reach out if you need.  Talk.  There are people who truly care.  Please stay strong.  We can make it through this holiday season.  Never lose hope.

I have begun a resources tab above if anyone is struggling and feels they have no one to talk to and nowhere else to turn.  There are suicide hotline numbers in it, not only for those within the United States, but many other countries, as well.  There are also links to various mental health groups to help built a support system so you do not fall between the cracks.  There is no shame in reaching out if you are on that ledge and need someone to talk you back off of it.

Even I Don’t Understand My Anxiety

It’s 4:30 am and I’m wide awake.  An hour and a half ago, I bolted awake feeling anxious.  There wasn’t even a specific thing weighing on my mind, just this broad, generalized sense of urgency, a feeling that things just weren’t right and I needed to wake up.

I know there will be no more sleep tonight because my mind is already racing, my thoughts bouncing around from one topic to the next.  My leg bounces a mile a minute.  I try to focus my thoughts but my brain won’t stay on anything long enough to process it.

There’s many times when my anxiety locks tightly to something and wont let go.  The thoughts become repetitive and increasingly louder and more urgent.  There is no way to focus on anything else.  It beats down on me like a hailstorm, cold, wet and jarring.  There is no ignoring it because its voice is booming, drowning out anything else going on.

There’s other times, though, that I cannot even pinpoint why I am anxious.  The urgency is still there, though it is surrounded by a dull fog.  I know that something is eating at me because  I cannot focus on anything else.  For the life of me, though, I cannot put my finger on it.  Yet my anxiety is in full force just the same.

I’m jittery, uncomfortable, unable to focus.  My chest is tight.  I have trouble catching my breath.  I try to calm myself with breathing exercises but I cannot center myself.  I have this strange burst of energy but no will to use it.  My brain has grabbed that energy to fuel its racing.  I’m wide awake.  My thoughts, like my sentences, are choppy.  Nothing quite seems to flow.  I cannot focus.  I cannot rest.  I cannot get comfortable.  My anxiety is jarring, like percussion being banged on haphazardly without any rhyme or reason.  It is loud and bracing, impossible to ignore.

I feel itchy, shaky, edgy and uncomfortable.  I am annoyed and agitated though I cannot even explain why.  Some days, my anxiety wraps its head around a thought or concept and will not let go, holding it in a stranglehold, allowing me to focus on nothing else.  It will often link itself to other things I am struggling with, making it even harder to cope.

When my anxiety attaches to my depression, it becomes that parrot that repeats all the bad in my life on an endless loop.  It asks me what else I could have expected and makes me question how much is ultimately my fault.  It is unyielding, unwavering and unforgiving.  It eats at me, making me feel inherently and hopelessly a mess.  My depression feeds it a steady dose of fuel, so my racing thoughts never seem to slow or falter.  My anxiety pushes for me to beat myself up for everything, whether it was my fault or not.

When my anxiety combines with my PTSD, I am bombarded by a steady barrage of emotions that threaten to push me into a bad place.  One of the most common themes my anxiety clings to that triggers my PTSD is safety.  Once my anxiety has grabbed onto that fear, my brain reminds me repeatedly that I am not safe, not safe, NOT SAFE!, I can no longer concentrate on anything else.  Though I try to reassure myself that everything is okay, doors are locked, everyone is safe, it is to no avail.  My brain won’t listen to reason.  It becomes a battle to fight off an anxiety attack or worse, yet, to be yanked back to those times when I truly was not safe.

One of the most frustrating parts about struggling with anxiety is that nobody truly seems to understand or sympathize.  People suggest to just breathe, not realizing that it feels like there is a weight on my chest and I can barely catch my own breath.  I’m told I should just try to calm down and try to focus.  I would love to do that, but I feel like I have no control over my mind at this point.  I swear I’ve yelled at my mind a million times Stop! Enough! but it never listens.  It has gone on a hundred mile an hour joyride along a dangerously winding cliff-side road and I’m just along for the ride.

The worst, though, is when I am asked what exactly I am anxious about or when someone tries to use logic and reason to convince me that there is nothing to stress about.  Often, I honestly don’t have an answer about why I am feeling this way.  I don’t understand it myself.  As I try to explain it, my hand shakes and my mind just cannot form the words.  I know I’m anxious, I’m restless, that something is definitely wrong, even if I cannot always put a finger on exactly what it is.  I know they mean well, want to understand what I’m feeling and try to talk me down, calm me down. But how can I explain my anxiety to anyone else when I don’t even fully understand it myself?

mightylogoRepublished on The Mighty on 11/21/16.

Depression Kills

I began this day like most others, pulling my laptop into bed with me, scrolling through emails and social media as I slowly wake up and try to gather enough motivation to start the day.  One of the tweets that crossed my path was a chart about suicide awareness, listing many of the contributing factors.  As I looked through them, though only one was labeled directly with mental illness, the majority of the others could be linked to depression, as well.  Half-awake, I hit the button to share, and added in my own two cents:

We need to stop treating mental illness as a dirty secret that we can’t talk about. Depression is killing people. Silence is killing people.

I continued my scrolling, continued waking up.  Grabbed a leftover piece of texas toast to take my pill with and continued on with my day.  I changed out the cage set for my sugar gliders, cleaned their cage, continued on with my regular routine.  Yet that post about suicide risk factors lingered in the back of my head, drumming along, refusing to be silent or to fade away.  My mind kept going back to it and my sleepy response to it.  Sometimes those thoughts that form when my mind is still muddled with sleep are clearer than anything I think about when wide awake.

Depression kills.

I think back to when I was a young teenager.  The son of one of my father’s friends killed himself.  He was in his late teens, a popular kid who played sports and had a long-term girlfriend that everyone assumed he would one day marry.  He was a few years older than me, around my brother’s age, so I didn’t know him well beyond the fact that our fathers were friends and we both were involved with sports at school.  He seemed happy enough.  Nobody saw it coming.  It blind-sided everyone, especially his father.  I always remembered his father as being this sweet, goofy guy who was always joking with my dad.  The last time I saw him, his eyes had a hollow, empty look to them, like part of him had died and would never fully recover.  It was my first exposure to suicide.

Depression kills.

I’ve known many people who have walked that ledge and attempted to take their own lives, myself included.  I remember my mother taking too many pills and my father frantically pleading with the emergency room to let her come home, that it was an absent-minded mistake, not an attempt, as my mother kept repeating “Jim, you can’t leave me here.. you can’t let them keep me,” and I sat quietly in a row of chairs they assumed was out of earshot.  Pills would be my choice, as well, the first time I tried.  Nobody wants to talk about struggling.  We make excuses and minimize situations.  We don’t address the gorilla in the room because it’s a hard conversation that nobody wants to make.

Depression kills.

Someone very dear to my heart almost lost his mother to a suicide attempt.  He was the one that found her, had to call the ambulance, pull her out of the tub, try to revive her and wait, praying someone came in time.  It scarred him for life and damaged their relationship beyond repair.  She had been struggling but, like many of us parents, always put on a brave face and pretended things were okay because no parent wants to appear weak in front of their children, but that is no excuse.  No child should ever have to see their parent like that, to fear not only for their parent’s life, but theirs, as well.  Every time now that I walk that ledge myself and consider giving up, I think of him and how that experience still haunts him years later and it snaps me right back.  I could never put my children through that.

Depression kills.

Not too long ago, I found out someone who had been a close, dear friend and much more years ago had lost his battle.  He was an incredible man with so much passion, so much to give the world.  He was the type of person who lit up a room just by being in it and made my life brighter just for knowing him.  He will forever be my one that got away.  He was struggling hard and couldn’t take the weight of his life pressing down on him.  He felt lost and alone, like he had no one, even though he had a brood of children who loved him to death and friends who adored him.  Everyone knew he had been struggling here and there, but figured that everyone struggles sometimes so nobody gave it a second thought.  Nobody really saw it coming.

Depression kills.

I receive letters and emails here and there from people who have read things I’ve written and related enough that they wanted to reach out and say something.  I always try to respond because I never want anyone to feel they have to struggle alone, that they reached out but were unheard.  I never spend as much time, though, as I do with anyone who messages talking about being affected by suicide.  I’ve spent entire days messaging back and forth with complete strangers because they lost a loved one, a spouse, a sibling, a friend, and just can’t seem to get past it.  I find myself going back and forth, trying to help explain everything from both sides, as the one who wants to die and as the one left behind, because I have been on both sides of that fence. It destroys people on both sides of that fence because, whether or not an attempt is successful, nobody on either side will ever be the same. Walking that ledge and wanting to die kills a piece of you, whether you actually die or not.  Having someone you love give up on life, feeling like your love wasn’t enough reason for them to keep going, kills a part of your heart just as much as if you had been the one to die.  I know how it feels on both sides.  But some things aren’t able to be explained.  Even if you know how it feels because you’ve been there, some things will never make sense.

Depression kills.

Every now and then you see stories in the news about celebrities killing themselves.  Whether it was a direct act or labelled as an “accidental overdose”, it is always followed by some vague statement about a “history of mental illness”.  Memorials are set up, posts are made.  The world seems momentarily heartbroken because someone in the spotlight has died.  Everyone remembers fondly their lives and mourns their death, yet everyone avoids focusing too much on what snuffed out so bright a light.  Mental illness is uncomfortable to talk about, even when viewed from a distance, because it forces us to consider how it may be affecting our lives, as well.  It sits there, the gorilla in the room that we all know is there but are afraid to address.

Depression kills.

The fact is that people are dying every single day because of mental illness.  Whether their depression is caused by the loss of a loved one, the end of a relationship or job, bullying, struggles with physical illness or whatever other reason, it is there, it is agonizing and it is unbearable.  People are struggling through life, feeling completely lost and alone, feeling like they have nobody to turn to, no one that understands.  People are suffering in silence because we’ve made them too afraid to speak up.  They’re afraid of being labeled, seen as weak, a danger to themselves or others, or a joke.  We’ve told them too often to suck it up and reminded them that others have it worse rather than acknowledging and addressing their pain.  These are people who are loved, cherished and adored, even if they themselves cannot see it.  They are our parents, our siblings, our partners, our children, our friends and our co-workers.  They are faces we see every day and names we carry imprinted on our hearts.  They are people who should never have had to die but they’re too afraid to speak out and we’re too uncomfortable to have that hard conversation.  So nothing is being said and the body count keeps growing.

Silence kills.

mightylogoRepublished on The Mighty on 11/14/16.