My Life In Outpatient Treatment: Week 2

This is a continuation, Week 2, of my daily journal while in outpatient treatment for depression, anxiety and avoident personality disorder. Click to read Week 1.

Week 2, Day 9:
Today was a continuation of the feelings from day 8. Even with a weekend between the days, I still feel worthless.
My homework for today was to write a journal post as if I was living 10 years in the future. My doctor told me to describe my life as it was happening, exactly 10 years from today.
We also learned about accountability and victimization. That lesson will be posted at a later date.
Parts of today’s journaling also became it’s own post and can be seen here.

Day 10:
I was informed by my group therapist that I’m getting a secondary gain by being in group therapy. Secondary gain can be defined as benefits received by not overcoming a problem. Secondary gains are problematic because while they make you feel better, they aren’t helping you fix the root problem.
I was also told that I need to have ‘Pinterest thinking’. Pinterest is all about uniqueness, and I need to remember that I am like a pinterest board. I am unique. I need to use “I am” statements, but nothing is really going to help me until I decide to ‘flip the switch’ and do the things I’m being taught.
We also had expressive therapy where we had to draw a picture of ourselves as a kite. It was a fun project, and you can view the picture here.

Day 11:
I’m in a good mood today!! 🙂
I’m feeling better; more like my old self. I have energy, some motivation and ideas. I want to do things! I want to make a difference! I’m thinking about starting an outside support group in my area. A group for people who can relate to each other & want or need outside support.
The Problem: When I have energy, I need to remember not to take on too much. I don’t want to become overwhelmed. I don’t want to crash in the middle of a project. For more information, please view the post on Project Immersion, here.

Day 12:
I had my family session today. I was a little nervous about it. I have had family sessions before, but you never know what someone else is going to say. My parents didn’t say much. It often seems like they don’t want to get involved. We talked about how I need to have a value base and a change in priorities. I need to do things for myself and live like I’m driving.
Living like you’re driving is like this: You have to look in the rearview mirror every once and a while and occasionally, you need to look far in front of you to see where you’re going, but for the most part when you’re driving, you have to pay attention to your surroundings and the environment around you so that you don’t crash.

I was in a pretty good mood until I met with my psychiatrist. He informed me that ‘people need people’, ‘I need to make social connections’, and ‘no one will do it for me’. While I agree with these statements, I’m still struggling with them. My doctors are really pushing me to be social and I just don’t do social. I haven’t been to a social outing since college.
I ended the day wondering why people needed people. My psychiatrist was pushing for me to get outside of my comfort zone and I didn’t like that at all.
He did make me a card though and it says, “Life isn’t fair however you, Talia, can be happy! :)”.
But I also learned that Feelings are not facts and thoughts have no power unless you let them.

Day 13:
I don’t really want to be here right now. I don’t feel like it’s helping. I don’t know how these coping skills are going to help. I feel like they’re not helping now. If all of this isn’t helping, what will? I keep trying and trying. What’s the point, if trying isn’t working?
Why do people need people?

Please stay tuned for Weeks 3, 4, and 5. Please view Week 1 as well.

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More Changes

As I related earlier, I was taking a step to see my doctor and find a new psychiatrist to get on medication to help my depression. I saw my primary care physician for a full physical and blood work to ensure that my depression was not related to thyroidism or a physical issue.

In some ways, I feel lucky because everything came back normal. I’m not suffering from a physical medical issue. At the same time, I feel like treatment would be easier if it had been a thyroid or blood sugar issue. Mental issues are harder to diagnose and medicate. While there are tests to diagnose mental disorders, they are genetic and extremely expensive.

After getting the all clear from my primary care physician, I made an appointment to see a psychiatrist on the recommendation of my therapist.

Less than a week before my first appointment with the new psychiatrist, my therapist decided that the process needed to be expedited. After getting my parents involved with the situation,  they accompanied me to a hospital with an inpatient and outpatient treatment center where I was evaluated for their mental health program for the second time.

This time, I am considered a candidate for the program. I am enrolled in a program (IOP – Intensive Outpatient Therapy) and I start tomorrow.

I’m nervous about it. At this point, I just want change. I want to be happy again. But I’m also afraid that this program won’t work. My depression is telling me that I’m never going to be happy again, that it’s just not possible for me to be happy and healthy. At the same time, I’m hopeful that this program will ‘fix’ me and help me learn to get better.

My Story: The In-Between Years

After a year of trying to deal with my behavior and (I feel) a very minor attempt to understand my illness, my parents kicked me out of their house. They also confiscated my car, which I had been in the process of paying them for, so finding a job, my own apartment, even going to therapy was next to impossible. I crashed at a friend’s house for two months, trying to figure out my next step all while having no idea where to start.

At this time, I had fallen into a crowd that smoked marijuana. While not pressured to try it, eventually I decided to see what the appeal was and there was definitely an appeal. I now understand why people use marijuana. The high makes you feel so good. You forget about everything that is wrong in your life and you are just blissed out. It stopped my brain from going a mile a minute, and for me, there was freedom in that. But I also realized that smoking wasn’t going to fix the problems that I had, it was only making me forget them. And while at times, I do still miss that high, I know that smoking marijuana isn’t good for me and it’s not going to help me solve my problems. Only therapy could do that.

Luckily, an opportunity presented itself for me to move out of my toxic, temporary living space.. Through the church where I worked, I met and befriended an older woman, who with her husband, were not very good empty-nesters. After she broke her shoulder, she invited me to live at their house, a farm, in exchange for help with cooking and cleaning. We became very good friends and I lived with them for quite a few months.

While living there, I got back into therapy and managed, for the most part, to mend my relationship with my parents. The lady also turned me onto alternative medication. After previous disappointments with 2 psychiatrists and a variety of medication, I decided to go the alternative route. I began taking St. John’s Wort and Kava Kava. While it seemed like these medications worked for me, it was also summertime and my depression had always worsened in the winter.

A few months after moving to the farm, I met a guy who respected me and my beliefs. We began spending a lot of time together and eventually began dating. I fell in love with him and moved in with him and his family just months later. Unfortunately, the winter months took their toll and my depression returned with a vengeance, coupled this time with the feelings of inadequacy, and worthlessness. My boyfriend was so wrapped up in his work and extracurricular life, that I felt like I wasn’t a priority to him.

After a few months of living with him, I made the courageous decision to move out on my own. This would be my first apartment and while I enjoyed having a place to myself, it quickly became a problem. My boyfriend and I broke up at the beginning of the summer because we made better friends than a couple anyway. But I quickly found myself very much alone. My friendships were few and far between and while I initially attributed this to the amount of work I was doing, I soon realized how alone I really was.

By the end of the year, I realized I needed more help than I was getting so I made an appointment to be evaluated at a local psychiatric center. I was informed that I was on the cusp of needing help but with my work schedule, continued regular therapy should have been enough.

Unfortunately, it wasn’t and less than 3 months later, I was officially admitted into the psychiatric center for outpatient treatment.

Changes

Today was surprisingly, a good day. While life is not perfect, I feel like hopefully, everything is in an upward swing, rather than a downward spiral. It’s nice to have something to look forward to.

I had a job interview yesterday. After filling out tons of applications and not hearing back from anyone, I was really excited to get the call for the interview. I didn’t want to get my hopes up, though, just in case I didn’t get the job. But today, I received a call and was offered the job.

This new job is going to involve a lot of change for me. I will now be working nights and despite being a night owl, it still makes me nervous. I’m having to change my complete routine. On the other hand, it will be so nice to leave a job that wasn’t healthy for me, mentally or emotionally. Hopefully, the shaking that I have been living with constantly, will go away and my hair will stop falling out.

I feel like this could be a step in the right direction. It’s a big change, but I’m hoping that working nights, will allow me to go back to school so I can finish my degree. I’m hoping that this step will allow me to follow my dream.

I am also taking a step by seeing my doctor. I am having a full physical done as well as blood work. It’s been a couple of years and I figured I should rule out some medical issues because I have decided to see a psychiatrist. I feel that after 3 years of attempting to resolve my depression with only my therapist, with little results, it’s time I tried anew. I am hesitant about this step because of my previous misfortunes with psychiatrist, but this time I am hoping to find one that I like.

I will be recounting to you, my current experiences with medication and treatment as they occur. I’m hopeful that this time around, we will find something that works.

My Story: The Initial Treatment

When I was first diagnosed, I did everything I could to get better. I saw my primary care physician, and had him recommend a psychiatrist. I talked to my parent’s pastor and had her recommend a therapist. I took my medications, kept track of my moods, but nothing helped.

The first diagnosis of depression I received was from a nurse practitioner at my college’s health center. She also prescribed my first anti-depressant, Citalopram, an SSRI. (I will be explaining the different types of medication in a later post). While on Citalopram, my depression continued, so when I got home from school, I visited my primary care physician and obtained a recommendation for a psychiatrist.

The first psychiatrist I saw diagnosed me with dysthymia. She switched my medication to a combination of sertraline, an SSRI and Wellbutrin, an NDRI. Neither medication did anything to fix my mood. Instead, I started shaking in my hands and my legs. Whether this was a side effect of my medication or a worsening of my depression, is still unknown. I was also seeing a therapist, weekly. The talk therapy was helping more than the medication, but not enough. I ended up having to drop out of school because of a loss of motivation and disinterest.

I stopped seeing my psychiatrist, mostly because I didn’t like her. I felt like she wasn’t helping me, that she wasn’t listening to me. I felt like another number to her, an experiment. But I did continue to see my therapist. I also stopped taking my medication. Not something the doctors recommend but I didn’t feel any different when I was on it. The medication didn’t feel like it was making any difference. About a year later, my therapist again suggested that I needed to be on medication. She recommended a psychiatrist and I went, hoping that this time the doctor would listen. He put me on Cymbalta, an SNRI, starting low but quickly increasing the dosage with each visit.

I did feel better, initially, but after a while, it was like I relapsed into a more depressed state. I stopped remembering to take my medication and then I stopped caring about attending my appointments. Again, I felt like the doctor didn’t really care about me. I was just another patient with a problem. How could he understand what I was going through and which medication to treat me with, if I only saw him fifteen minutes, once a month.

I stopped caring about anything and my parents, fed up with my behavior, kicked me out. While at the time, this almost devastated me, it ended up being one of the best things to ever happen to me.

Depression: A Personal Definition

While the clinical definition helps us understand what depression is, it is a totally different experience when you live with it. Depression is not some vague term that other people have to deal with. I used to view those commercials for antidepressants with casual disregard. Now, those commercials apply to me and often describe my very life.

I have my good days and my bad. It is worth noting that I am not on medication at the moment, but I am in therapy and have been since I was first diagnosed. Honestly, I probably should be on medication, but I will get into that more on a later post.

Lately, I have been having mostly bad days. Things in my life have not been going well. I used to have a plan, but unfortunately, my depression derailed that. For those of you without depression, this may be hard for you to understand, but depression seeps into every part of your life and turns it upside down.

It is not a matter of just “getting over it” or “thinking positively”. Telling me that “there are other people worse off than you” or “you don’t look depressed”, is not helpful either. Honestly, I mostly want you to listen and show me that you care.

Often, it is a struggle just to get out of bed and many days, I feel like I am fighting just to survive. One of the biggest issues I find with suffering from depression, is not the the disease itself, although that is a struggle. But the biggest issue from my point of view, is the lack of understand that the general public has towards mental illness. The stigmas attached to mental illness, are oftentimes more difficult to live with, than the illness itself.

I want everyone to understand that depression can get the better of us. It can be fatal, but it does not have to be. With more understanding, and tolerance towards mental health, we can ensure that more people survive. I want you to understand mental illness, and if you have any questions, please do not hesitate to ask. Depression is not the same for everyone, but with a general understanding we can make the world a better place.

The Beginning

To understand how depression affected me, you need to know who I was before I was diagnosed.

During high school, I was the go-getter. I was very involved in choir, musicals and my studies. I had no problem getting good grades with minimal effort. I wasn’t popular and sometimes I felt like I didn’t fit in, but I had my friends to hang out with.

I was always told that I would thrive in college, that it would be the perfect place for me. That couldn’t have been further from the truth. I struggled, not with my courses, but with me classmates. A series of issues with various roommates left me feeling lonely and forgotten. The feelings that I didn’t fit in and wasn’t wanted became extremely prevalent.

My sophomore year, I was introduced to a guy by a group of friends from home. My first relationship, albeit a long-distance one, began. He was the one I could talk to when things weren’t going well. I fell in love, but like first loves, it wasn’t meant to be.

After another string of roommate failures, I had gotten special permission to live off-campus my junior year. A work opportunity kept me at college the summer before, 6 hours away from my boyfriend. The distance took its toll and 10 months after we started dating, we called it quits.

I was devastated. It had been my first real relationship, the first guy I had fallen in love with, and the guy who had taken my virginity. For weeks, my health deteriorated; loss of appetite, nausea, loss of motivation, tiredness, I wasn’t attending my classes and I could barely get out of bed. At first, I thought I was pregnant, but a pregnancy test quickly negated that. Finally I went to the health clinic on campus. Finding nothing physically wrong with me, I was diagnosed with depression and was put on my first antidepressant.

And so began my battle; a fight that has lasted over three years, thus far.

I would like for you to follow along my journey, as I recount it.  I feel as though sharing my thoughts and feelings through major moments of my illness would help those unfamiliar with depression gain an understanding, albeit small, of what it’s like to live with depression.