My mom: the scan, part II

My mom sent me an email this evening and said that she looked up her CT scan results on her online patient account. She said it was all highly medical terms, but from what she read, she was pretty sure it said that the cancer had metastasized to her liver and abdominal wall.

Then she said she'd wait to hear the doctor interpret the test results when she sees him on Friday. But until then, she seems to think there is now no hope. And other than say that maybe that's not what the test results said, I'm not sure what I can do for her.

I am bouncing back and forth between being okay and trying to stay positive on the one hand, and suddenly feeling sad when I see or hear about other families sharing, especially when it comes to children and grandparents.

Thanksgiving was very nice but also hard. After dinner, the friends who hosted dinner were sharing photographs with (their) family that was there. I had my camera with me and had just taken photos at my children's school, and I suddenly felt so sad that I didn't have anyone there to share them with. I planned to upload the photos when I got home so my mom could see them, but I could not help but think that this would not last.

Since she sees the doctor on Friday and we don't know what he'll say (immediate surgery to get rid of all the nasty cancer?), we are waiting until his prognosis before we try to find a way to get together.

My mom: the specialist and the scan

Mom had her more detailed scan today. She doesn't know much more than she did before. This CT scan focused entirely on her pancreas so that the specialist will be able to see exactly what is going on and what exactly he can do about it.

I am feeling much more relaxed, though, now that I know who this specialist is. His name is Dr. Jeffrey Norton, and he's the Division Chief of Surgical Oncology at Stanford Cancer Center in Palo Alto, CA (the same place Patrick Swayze is getting treatment).

In fact, I just found out tonight that Dr. Norton was reportedly the surgeon who removed the pancreatic tumor from Steve Jobs (of Apple fame) in 2004. Dr. Norton is one of the foremost experts in the field of pancreatic cancer. Fun fact along the "six degrees" line of thinking: a medical procedure invented by Dr. Norton to treat a rare pancreatic disease was featured in the TV show "House."

So I feel she is really going to be in good hands. She has an appointment to see him on Friday, December 5th.

Tonight she was tired but largely in good spirits. And I was glad to hear her say that she's kind of in information overload and intentionally taking a break from this when she needs to, and doing things that focus her attention elsewhere.

I am doing okay. Still going through periods of shock and denial and feeling like this is all surreal, like I'll call her in a few days and discover this was all a nightmare and she's fine. In the meantime, she's going to her brother's for Thanksgiving and I am going to work hard at focusing on what I do have in my life (including my mom right now).

Happy Thanksgiving.

My mom

I have not written in a long time, and for that I apologize. I have been dealing with my feelings in therapy and talking with friends who live nearby. For some reason, it has been hard to write about it, but I don't feel like I am at the mercy of my memories the way I did even a few months ago.

Besides, I met with my rabbi today and he told me to start writing again regularly. Even if it is hard and even if I do not know what to say and even if no one is listening.

Because I just found out my mom is dying.

She has pancreatic cancer and the doctor said she may have only months to live. I hope the doctor is wrong and a specialist will say something different. I am currently going back and forth between shock and denial.

She found this out this past week. The cancer part was confirmed on Friday. On Wednesday (tomorrow) she will have a very detailed CT scan to determine if the tumor is operable. The doctor said the tumor partially or completely surrounds a major blood vessel in her pancreas and is partially or completely blocking the bile ducts. Her lymph nodes are also involved, but we do not know to what extent exactly.

After she has her CT scan she will see a specialist about treatment options, although from what her current doctor says, it is more a matter of putting off the inevitable than it is actually treating.

My mom lives 2000 miles away. I have a brother who lives near her and is very close to her emotionally. I hope that I and my children (my mom's only grandchildren) will be able to see her once more. Despite all of the challenges in our relationship, my mom and I have reconciled and pretty much figured out how to have an adult friendship without inviting hurt every time we talk to each other. I cannot fathom never getting to give her another hug.

I am scared and sad and hopeful and numb. I want to be able to share this with people I know, but I am unsure if I should post things twice, once here and once somewhere less anonymous. Or if it is time to tell friends that this is my blog, this is a part of me. Some friends already know about my struggles with depression and anxiety. Some might be shocked by what I have written here. I just don't know what to do right now.

My rabbi said I need to check in with him every few days even if it is just a quick note by email. He said this is going to be a difficult journey and one I should not travel alone. In my mind I thought this is especially true as I enter my "dark time" of year.

I will talk with my mom again tomorrow (Wed) night and hear about her scan. We will hopefully also talk about a possible visit and how we can make that happen in terms of time and money.

Right now I just want to curl up somewhere warm, eat something comforting, and not think about this.

Threatening to burst

Tonight I am tense. I am barely able to breathe. I am dizzy. I feel like whatever is going on inside of me cannot be contained by the confines of my body. I feel a little like I am going crazy.

Today I had only three flashbacks. I could actually feel what I felt so many years ago. I had nightmares last night and woke disoriented and panicked. I have been paralyzed by my warring thoughts and emotions. Yes, this all happened/No, this couldn't possibly have happened. My dad did things he should not have done/Not my dad! He loved me! My feelings are normal/I'm just trying to get attention.

I think I should call my counselor tomorrow, or maybe even tonight, but I don't know what to say.

It is too much. I want to curl up into myself and escape. I want to not feel for a while. I crave release.

Breakthrough or breakdown? part 2

My counselor took notes on what I was saying and made a copy for me. She says this is what we really need to work on. It is as if the chemical part of the depression and anxiety is more or less stabilized so now the rest of what I keep locked inside can finally come out. (February 22, 2008)

I did not want to deal with this. I have done everything possible to avoid it, and the fantastic reaction I had to the buspirone helped me to keep it away for a bit longer. But even the buspirone cannot keep away what I have kept locked up all these years.

I had to go back through my early posts just to see how much--or how little--I admitted when I started this blog. It wasn't much. In my 'who am I' post, I said I had been diagnosed with PTSD and that The PTSD probably has something to do with being raised in a violent home.

That seems normal, that with all of the raging emotions I had at the time, I could not say any more. But now that medication has stabilized whatever chemical issues my brain has, some wordless intelligence seems to have decided that now is the time to drag out the rest of my issues. I can't even say it now, it is so incredibly hard. But I know that I must. Admitting it is always the first step, is it not?

But I'd rather procrastinate.

Okay, that occupied me for nearly an hour.

The truth is, I am a survivor of child abuse and sexual assault.

My history has been documented going back to my toddler years. Child Protective Services was at my house more than once. My grandmother and a cousin both tried unsuccessfully to gain custody of me when I was about seven, to get me out of that house. There are court and medical records. But until I married and put some distance between my parents and myself, I had little memory of my childhood.
It has been hard for me as welll as for my doctors and psychiatrists and counselors to know what of my depression and anxiety is purely chemical and what is caused by the abuse. I have been reading some studies that show links between child abuse and permanent brain changes, including depression in adulthood.

Both depression and anxiety, as well as repressed memory, dissociation, insomnia, flashbacks, and nightmares (all of which I've had) go hand in hand with post traumatic stress disorder, a common result of trauma. But there is also a history of major depression in my family. My caregivers say it would not be unusual to have both.

Lately I have been having flashbacks and nightmares again, as well as spikes in my anxiety level that aren't controlled by the buspirone. I have been spacey and detached from my body (dissociating). I had to go to an event in public Friday afternoon and I watched myself interact with others, hearing words coming out of my mouth, but I felt I had no control over what I was saying. That was okay. The words coming out of my mouth were far more confident and coherent than anything I could have otherwise thought of.

So I do not know if this is a breakthrough. It feels like a breakdown. Perhaps it is both.

Perfect storm

I see no point in getting out of bed today. I feel depressed, apathetic, and I ache all over. My husband says this is a perfect storm situation.

Could it really be that simple?

I am sorry I haven't been here in such a long time. I didn't intend to take a break from blogging, but apparently I needed one, and by the time I realized it, I needed to stay away enough that I couldn't even come post that I needed to take a break. I apologize for my abrupt departure. And I am not sure if I am back yet or not.

Once again, there is so much to share that it seems overwhelming but really the bottom line is that my PA (psychiatrist's assistant) changed my meds. And it worked. Really really worked.

She was concerned that even with an increase of the Prozac to 70mg/day I still wasn't getting better. In fact I started getting worse, with symptoms of Tardive Dyskinesia.

At one appointment she said, we've been treating this all along as depression with a side of anxiety. But your anxiety always comes first before the depression, so let's try treating this as an anxiety disorder with a side of depression. She has me slowly lowering the Prozac dose by 10mg/month (I'm now down to 40mg/day) which helped relieve the TD. And then she put me on Buspirone.

Buspirone is my new best friend. For the first time since I was about eleven, I can just sit and be, without needing to fix something or do something or even feel guilty about sitting and being. For the first time in a very long time, I feel calm.

I've been taking some time for myself, time to read without guilt, reconnect with friends without pressure, time to do some of the things I want to do and let go of the things I think I should do. (That's where the break from blogging came in.)

This was the first year that Pesach cleaning was not a source of panic and anxiety. I actually enjoyed getting the kitchen clean and into order. I was relaxed and a day ahead of schedule until I got sick (24 hour bug) and even then I was relaxed and catching up. It was amazing.

Life has slowed down a bit for me, though I am still dealing with the same small children and all the same volunteer activities. But now with the new meds, I can go for a walk in the morning with a cup of coffee, enjoy the sights and sounds, and even taking out this 30 minutes just for me, I am actually more productive during the rest of my day. I work a little more slowly, but I get more done. I don't entirely understand that, but I like it.

Meanwhile, I am very aware that I'm coming up on one year since my miscarriage and the delivery and burial of my daughter. I'm a little sad but I feel at peace with it. I am still hoping, baruch Hashem, to have another baby, but I also have come to terms with the possibility that it might not happen.

I am also off the Lunesta, finally. I was very sick with strep throat for a week right after Pesach and couldn't take any medication at all. By the time I was better, I decided I wanted to try sleeping naturally. Sleep is still elusive; last night I slept from 2-3:30 a.m. and 5-7 a.m. That's it. If I need to, I'll go back on the Lunesta, but I'm still hoping to do this one thing med free.

For now, as long as I have my Buspirone I'm happy. Finally.

Breakthrough or breakdown?

I saw my counselor again today and had one of the most intense sessions I think I've ever had. All of the feelings, the seeking, the anxiety, even the depression that usually comes this time of year all came to a head this morning.

My counselor took notes on what I was saying and made a copy for me. She says this is what we really need to work on. It is as if the chemical part of the depression and anxiety is more or less stabilized so now the rest of what I keep locked inside can finally come out.

I read her notes on the way home and was sobbing again. I wanted to share them here but I don't have the energy to go through it again. I will try again after Shabbos.

I am exhausted and shaking. Already I feel like I spent that hour in counseling just whining and complaining about "poor me." My husband came with me today because I was in no shape to drive and he thought this might be a good session for his input (it was) and he says I did a lot of very hard emotional work and hopefully this means I can start to heal.

I am still afraid I am being too self-absorbed but I am too tired to argue.

Coping as best I can

I called my counselor today. She only had a moment when she returned my message, another client was waiting, but she created a new appointment for me next Wednesday. By then I should know if the medication is working.

Today I was trembling all day, anxiety trapped in the confines of my body. I can still focus on a task. I remember how much painting helped after my pregnancy loss, so I started to paint my kitchen. It is something I've wanted to do for a long time. I am doing small sections at a time. Today I primed one half of one wall.

This weekend is a big one for my oldest child, with a major school program on Sunday. A smaller program is tomorrow afternoon, part of welcoming Shabbos. He is nervous because he is performing. I am nervous because I need to hold myself together.

You all are right: my perspective is flawed. Even the way I see myself in the mirror is skewed from what it was a couple of weeks ago. I do not like what I see.

My friend D called tonight to see how I was doing but I was too tired to talk long. Another friend came over this afternoon and helped with my kitchen while we talked.

I want to hide from shul but I will not. I need to face this. It doesn't have to be a repeat of last year or the many years prior.

I am still anxious and scared and worried the crash is coming, but I am trying my best to use my coping skills to get through the minute, the hour, the day.

Waiting for what, I do not know. Perhaps it's as simple as peace. I wait and cope, hoping that peace will come soon.

Coping as best I can

I called my counselor today. She only had a moment when she returned my message, another client was waiting, but she created a new appointment for me next Wednesday. By then I should know if the medication is working.

Today I was trembling all day, anxiety trapped in the confines of my body. I can still focus on a task. I remember how much painting helped after my pregnancy loss, so I started to paint my kitchen. It is something I've wanted to do for a long time. I am doing small sections at a time. Today I primed one half of one wall.

This weekend is a big one for my oldest child, with a major school program on Sunday. A smaller program is tomorrow afternoon, part of welcoming Shabbos. He is nervous because he is performing. I am nervous because I need to hold myself together.

You all are right: my perspective is flawed. Even the way I see myself in the mirror is skewed from what it was a couple of weeks ago. I do not like what I see.

My friend D called tonight to see how I was doing but I was too tired to talk long. Another friend came over this afternoon and helped with my kitchen while we talked.

I want to hide from shul but I will not. I need to face this. It doesn't have to be a repeat of last year or the many years prior.

I am still anxious and scared and worried the crash is coming, but I am trying my best to use my coping skills to get through the minute, the hour, the day.

Waiting for what, I do not know. Perhaps it's as simple as peace. I wait and cope, hoping that peace will come soon.

Chaos

There is a battle raging within me. I feel like I am in chaos. It is so hard to focus.

This is what I'd described in the hospital years ago that the doctor thought might be a manic episode. I can tell as I sit here awash in the feelings that it is not. A very good friend stopped by today because she was concerned and I liked her description of mania versus what I am feeling.

Mania, she said, is GO!

What I am feeling is not linear. It spirals, swirls, but trapped, contained. Like vegetables in a pressure cooker and I don't know how to release it without spraying carrots and potatos all over. I feel like I am about to crawl out of my skin. I have felt like this for two days now.

Every sudden sound makes me jump severely. I am so self-conscious that I feel embarrassed to even take up space. I feel that I must apologize for my existence. I am certain that everything I do or say somehow detracts from everyone else.

I want to be distracted, to focus on something other than what I'm feeling. The TV writers' strike is not helping. I am reading but sometimes even focusing on the words and what they are saying is too much. I am constantly figdeting, using my hands, and I scratch and pick and rub without even being aware of it.

Sunday night I took a bath to relax but somehow I zoned out or something and I scratched parts of my shin until they bled. The pain and scabs now remind me that I am, in a way, disconnected from my body. I know this is dangerous. I know this is where the urge to cut can become so strong just so that I feel something on the outside, so that I can show others exactly how much it hurts inside.

Last night I managed to redirect this energy and gave myself a sort of manicure. It got me through an hour and now my nails look neat and shiny. But once I was done, I had to figure out how to get through the next hour. And the next.

Today I spent the day listening to the same six songs over and over again while cleaning my kitchen. I mopped a very dirty part of the floor and then I had to wash the walls and the baseboards in that corner. It is as if the only way to channel this chaotic energy is to focus on smaller and smaller detaisl. First it was the floor. Then the walls. Then the baseboards. Then I was on my knees scraping the tiny cracks where the floor meets the baseboard and the baseboard meets the walls. I was just shy of searching for a used toothbrush and a handful of toothpicks to do an even better job when my friend stopped by.

She asked me to try a yoga pose with her called Mountain. I tried. I managed to get myself to stand up straight but I couldn't relax my shoulders or keep my hands down at my sides. When she asked me to take a deep breath, I couldn't. It physically hurt in my chest. I was so self-conscious I was almost in tears. My hands won't stop shaking. My chin trembles when I try to be still.

Curling up into a ball feels comfortable, wrapping my arms around me and tucking my chin into my chest. My husband calls it 'turtling.' I still cannot tell if I am too hot or too cold. I seem to bounce back and forth between the two.

Sunday I increased my Prozac from 50mg/day to 60mg, as the psychiatrist's assistant recommended--when I saw her last she said if I needed to before she saw me again, I shouldn't hesitate to go up to 60. I don't know if I caught it in time. It will take a week or so for me to start feeling a difference, two weeks to really notice it.

In the meantime one of my children has a program at school and I will have to get myself together enough to go out and be in public. That terrifies me.

And I know what is coming next. Something small, insignificant will happen. I will hear something said or see someone look at me and interpret it all wrong and then will come the crash. All this spiraling chaos will turn into a maelstrom, pulling me down until I am submerged and drowning. I can hope that I increased the meds in time to avoid this or that it will be less severe but I am not convinced that hoping will do much good.

My husband wants me to call my counselor but I am so certain that there is nothing anyone can do. All I can do is ride it out, take it hour by hour or minute by minute and focus on what I can do--but not too much focus on too much detail--and keep taking my meds and try to be aware of my body and hold back the urge to scratch or cut. I am so certain of this that I see no point in calling.

It is what it is and I can't see how anyone can help.

Lost

I don't want to jump to conclusions but I am scared.

I have been so tired for so long. The upgrade to 5mg Lunesta has helped me sleep through the night most nights but I still spend a larger percentage of my daytime looking forward to sleep than I do looking forward to anything else.

Erev shabbos I went to bed early, feeling dizzy and unable to stand up any longer. I planned to be at shul in the morning. I woke at 3:37pm Shabbos afternoon. My husband says I am exhausted and needed the sleep. I am not sure what I am doing that is so exhausting.

I dozed on and off until my regular bedtime and then took the Lunesta. I slept through the night again and am sure I dreamed something important, though I cannot remember what it was. I woke this morning feeling a little better. More awake but not more energized.

As today wore on, it was as if my nerve endings were getting increasingly frayed. Being around even just a couple of people felt like I was suffocating in a crowd. Every noise was loud and grating. Every voice too shrill. Every touch painful.

I want to shrink into myself, curl up and hide away somewhere. I can sense tears, though I wouldn't call it sadness. Maybe just lost. There are projects I want to do but no energy to do them. Everything is a strain, a chore. Everything wears me out. My body cannot decide if it is too hot or too cold; it only knows it is not comfortable. Clothing is too scratchy, too warm, too something.

I really thought I felt okay late last week but now my husband says he's seen me headed this way for the past week. I am scared, concerned that this is my bad time of year, this is the treacherous path through the calendar, but this recent feeling seems to have come on too quickly, too sudden and without warning.

Due to scheduling conflicts, I will not see my counselor for three weeks. I will not see the psychiatrist's assistant for another two months. This doesn't seem like something to take to my rabbi. I don't even know if this is something I should do something about or something to wait and see or something not to worry about.

Is it just exhaustion? Or side effects of either of my medications? Or have I already crossed the anxiety bridge, missed the red flags again, and started my stay on Depression Island? I can't tell anymore. I only know I want to be quiet and alone and to sleep.

Playing with fire

It is almost Shabbos and I am feeling anxious and disconnected.

I have finally identified the feeling I was trying so hard to name in my post, Seeking. I don't know if it has a name, but it has a description. It is the feeling of being completely, totally vulnerable and knowing, trusting without reservation, that you are loved. No dark secrets, no white lies, no closet skeletons.

It is a type of intimacy but having nothing to do with sex. It is someone seeing every part of me, every secret I want to keep hidden, every action of which I am ashamed, and that someone still loving me, valuing me, unconditionally.

Perhaps that is part of the very nature of our relationship with G-d.

Once I identified this, I had to call D, who thought that this also ought to be the essence of a parent-child relationship and a marriage, though too often it isn't.

I told D that sometimes I have these intense feelings like what I describe above and then there are other times that it is so very hard to feel connected. I said that it is sometimes like a smoldering--I can't bring myself to think that the light ever goes out--and sometimes like a bonfire. When the light is buried, how can I reignite it? And when it consumes me, how do I tame it?

D suggested I go light a fire and see for myself. A fire, I asked? A real fire? D laughed and said I was the one who started the fire analogy in the first place. So I did (outside) and then I called D back with the results.

Paper burns quickly but not for long. Cardboard takes longer to catch but burns longer and each of the layers pulls away from each other. Wood takes the longest to catch but burns the longest. A smoldering requires paper, not wood. A bonfire is tamed by spreading out the wood so it isn't so concentrated.

D said very nice, now finish the analogy. I said paper is only a single layer, cardboard is a few layers, and wood is many layers, very dense. When I'm feeling the smoldering and I want more ignition, I have to add to my life things with only one or a few layers. I can't expect to take on something very layered and dense and have it reignite that fire. And when I'm feeling overwhelmed, too much feeling, too much fire, I have to spread it out, do fewer things, take it slowly, allow more air (oxygen) to tame the burning.

D liked my answer and then asked, what is the paper in your life? What is the cardboard? What is the wood?

Fixing Shabbos dinner for family plus guests is wood, for me. Going to shul and hoping for intense is wood. But the little things, maybe they are paper. Taking a relaxing bath. Using some nice moisturizer on my hands. The little self-care things that are in my anti-anxiety kit. I'm not sure what else.

Cardboard might be listening to music that I can sing and dance along with. Going for a long walk. Getting together with a friend, or a small group of friends.

I will have to think about this more, identify the things that help me feel more connected and happier and less anxious, and figure out which ones are paper and cardboard and wood. Because if I am trying to restart a smoldering ember with a piece of wood, that would explain a lot. And if I am expecting paper to keep the fire going for days or weeks or months, that would explain a lot too.

And I cannot help but wonder if this is the right analogy after all, because if it is, what does it mean in real life, then, to get burned?

Seeing the new doctor

I think perhaps G-d is taking care of me.

I saw my new psychiatrist's assistant today and I like her. She is very perky and energetic and talked fast today but she was running late and we had a lot of ground to cover in a short time.

She is leaving me on the Prozac at the current level and concurrs with everyone else's diagnosis of Major Depressive Disorder. I don't think, with my history, anyone can argue with that. She saw that my previous psychiatrist had indicated OCD and with as recent as that diagnosis is, she wants to work with it a little and see if it is true OCD or some other anxiety disorder with obsessive compulsive tendencies.

The thing she said that surprised me the most is that she thinks the fact that I'm not in as good a place as I could be is that we're missing--that is, not treating--something underlying. She said the things I described with my sleep and anxiety sound very much like post-traumatic stress disorder, PTSD.

I was diagnosed with PTSD years ago, but I assumed it resolved when I stopped having flashbacks and excessive hypervigilance. She said if it is PTSD, it might mean a slight alteration in my meds, but mostly she thinks I'm on the right thing.

Except for sleep. It's too hard to say right now, she said, if I've built up a resistance to Lunesta or if I'm just not at a high enough dosage to combat the Prozac or if there's something else going on. So until I see her again in about two months--her earliest appointment, she is very busy--I can increase the Lunesta up to 6mg/night.

I know I am sensitive to medicine so I'll increase 1mg (1/2 tablet) at a time and see what happens. I don't want to take 6mg tonight and wake up on Friday!

Or maybe I do. I have been thinking about how nice it might be to hibernate and avoid this difficult time of year altogether. But then I think of how many things I might miss out on, too.

One thing she said is that she wants me to expand my list of things I do for "fun." She thinks there is too much in each of my days that is about taking care of others and not enough taking care of myself.

Of course in my mind, it is just the opposite. How dare I take a full eight hours for sleep! Think of all the good I could be doing during that time!

I think I have just figured out that my taking care of others around me is related very much to my having high expectations of myself, and others too to some extent. I will have to explore that further.

For tonight, a little more Lunesta and hopefully a full night's sleep.

Limbo

I feel as though I am in limbo. But it makes me wonder, what is limbo anyway? I see now, it's a Catholic origin. The description fits, but I'd rather have a Jewish term.

All I know is that I am not in a bad place, but I am not in a good place either. My meds are keeping the depression and anxiety at bay for now, which is a very good thing. The anxiety has been tolerable and while I have times of higher anxiety and negative self-talk, the majority of the time it is manageable.

My sleep is another issue altogether. I'm still taking 4mg Lunesta a night but it takes 1-2 hours to fall asleep and I wake for the first time after only 3 hours, then nearly hourly after that. My mind isn't racing or busy. I'm calm, relaxed. Just awake. There used to be only dark circles around my eyes; now there are bags under them large enough I think they're going on vacation.

I would call to change this, but I can't. A couple of months ago, my primary psychiatrist, who prescribed this for me in the first place and said I could take up to 4mg/night left the clinic where I'm seen. That was okay, because my regular monthly med checks were with the psychiatrist's assistant. But she left the clinic last month and I'm waiting to get an intake with a different psychiatrist's assistant--supervised by a different psychiatrist--and until I have that intake, there is no one to sign off on any changes to my meds.

This has had me a bit stressed. I liked the women I saw before. I don't know how my relationship will be with these new people. And I have trust issues.

My intake is currently scheduled for next Monday. I'm going to tell her all about the sleep issue. It's only been this way since I increased the Prozac from 40mg/day to 50mg/day so I am hoping I can increase the Lunesta a bit to compensate for the increase in Prozac.

Meanwhile, I go through my days dazed from lack of any quality sleep. Last night, for example, I took my Lunesta at 9:30pm. I finally fell asleep at 11:00pm. I woke at 1:00am and thankfully was back asleep within 15 minutes. I woke again at 3:11am and did not get back to sleep until 4:30am. I woke again at 6:00am, fell back asleep, and woke at 7:37am when I finally got up.

But I am dizzy and forgetful and stumbling and I have a big day today with many things to do before Shabbos and today is a day I am actually glad we do not have company coming over because I simply couldn't handle it.

And so I am on some sort of edge (limbo). The edge of sleep, the edge of sanity, the edge of complete consciousness. I don't know. I only know that while I've been in worse situations and baruch HaShem I'm not there now, I'd kind of like to not be in this one either.

I (day)dream of sleep.

One step forward but how many back?

I am not doing so well today.

I tried to stay with the feeling I wrote about on Monday but it was elusive and by night time I was simply too tired. Yesterday I woke feeling even more tired and by last night my anxiety was really high. I managed to stop pulling hair and got out the brush from my anti-anxiety kit and proceded to work on pulling bristle hairs out. I should add it is not as easy as it sounds.

Then I felt the old familiar icky feeling, criticizing me for pulling bristle hairs out, that I was destroying this perfectly usable brush, commiting myself to destructive actions, and wasting the money spent on this brush just to tear it apart. Hairs at least, the feeling said, would grow back and wouldn't cost me anything.

I tried the self-talk I've been working on in therapy against the feeling: everyone else would rather see me pull bristles out of a brush than pull my own hair out; this is what I bought the brush for; better I hurt the brush than hurt myself.

And the feeling returned with images of my torturing this poor brush when I was the one who deserved the pain.

I told my husband I wasn't doing so well, about my anxiety. He thought it was due to exhaustion and he had a point. I had slept maybe 12 hours in the past 4 days. So I took my Lunesta and went to bed and fell asleep quickly.

While sleeping, I dreamed. I dreamed that I had a conversation with one of the Rabbis quoted in the Talmud. He expressed great concern over my urge to hurt myself, even to harm a single hair.

And then somehow in the dream I knew that he was quoted in the Jerusalem Talmud but not much if at all in the Babylonian Talmud and how the BT is generally considered more complete and consequently more authoritative than the JT and I wondered in the dream what it meant that I was visited by someone less prominent and if that was a reflection on me. And before he left he said something about how this was concerning that even in my sleep I was looking for ways to put myself down.

I woke groggy and still very tired and with a tremendous headache that encompasses the entire left side of my head. It is hard to concentrate. I think I should not be driving. I fear I am wasting time by not accomplishing anything productive today.

I was certain I was doing better, improving. Using my brush instead of myself. And on Shabbos I used my plan again. I was feeling a bit fragile and rather than invite opportunities to feel marginalized, I went up to a woman I know well, who knows what's going on with me, and said, I'm feeling a little fragile right now; can I hang out with you for a little bit? She said of course and included me in her conversations with others and about 20 minutes later I felt much better and was able to stand on my own again.

If I am doing better, making better choices, managing better, then why do I feel this way? Why do I search for a negative in what would otherwise have been a very intriguing dream? Does this increase in anxiety have anything to do with the overwelming feeling I had Monday? Am I expecting too much too soon? Why am I still convinced I have wasted today because I didn't get anything "done"?

And why does the thought of tomorrow bring with it more fear than hope?

Seeking

Now I must address the feeling I have been trying to avoid since the last post.

My mind wants to find easy origins: not enough sleep, going without Lunesta for one night, hormone changes, no view of the sun in the sky today. But none of these seem right because this is a pervasive, encompassing feeling. It led me to select certain books over others from the library this morning. It determined which articles and blogs I've read today. It has kept me from wanting to answer the phone when it rings, even when the caller is a friend.

I feel it in my shoulders and upper arms, like a physical longing for a hug or the need to cradle a baby. I feel it in my chest, tight and compressed like I know something is looming on the horizon but I can't see it yet. I feel it in my stomach, a sort of dread as if I know the truth is going to be dragged out of me one way or another but it will ultimately be a relief. I feel it in my legs, wanting to run from this but knowing there is nowhere to go.

It isn't a sadness, exactly, but I can feel tears nearby. It reminds me of the way I feel sometimes when I see a TV ad like this Hallmark commercial.

It isn't depression. There is definitely hope there, not hopelessness.

It isn't loss, I don't think. I haven't lost anything recently, big or small, but it does feel like I sometimes do when I remember someone close who is no longer living.

It isn't gratitude, but there is an element of thankfulness. I read today something my rabbi wrote recently (not to me specifically) about accepting each other's humanity--rabbis and congregants--and all that entails, and I was so overcome with this feeling that I momentarily felt weak.

It isn't fear, but there's definitely something there that I'm afraid of.

It is a feeling that flares up when I think about friendship and the sacrifices we make willingly--even eagerly--for those close to us. It is similar to how I feel when I hear about a police officer losing his life while protecting someone else.

It is how I sometimes feel--if I am lucky--in shul, davening and suddenly overcome with a need to convey through my prayers, Thank you, and I'm so sorry, and I miss you when I'm not paying attention.

I hear others around me, the whisper of silent prayers, and I know there are others here in pain and in mourning, those experiencing gratitude and relief and the realization of long-held dreams. And everyone has brought these parts of themselves to this one place on this one day to share, however privately or publicly, with G-d.

And I see glimpses of this humanity in action: one man trusting enough--or hurting enough--to weep openly and consoled by the man next to him. One woman surrounded by others, some of whom are offering comfort and others who are supporting her simply by being present. One exhausted mother relieved temporarily of her active children by a few teens who offered to help. One elder repsectfully helped to a seat. One rabbi passing by a congregant on his way to somewhere else, then stopping, returning to the congregant, and asking, are you okay?

I see this and I am humbled and moved beyond words. It occurs to me that this is what it's all about. Whatever it is, it is present here, now.

My husband called me as I was writing this post and I answered the phone and the display said CONNECTING before I put it to my ear.

What I am feeling has something to do with connection. Something deeper than community, more complex than love. It is seeing that connection, knowing that connection, having experienced that connection and also the loss of it when I needed it. It is wanting a constancy of that connection. It is recognizing that I need this connection in my life and knowing all too well what it's like to not feel it. It is hoping, struggling, craving, longing, physically and spiritually yearning.

I still don't know exactly what I'm feeling. But apparently it has something to do with seeking G-d.

Competition, blogging, self-esteem and a bit of procrastination

I have been in the midst of a very intense emotion all day today and I can't identify it. Whatever it is, I'm afraid to go near it but I am drawn to things that touch on it, that resonate with it. I called my friend D while I was running errands this morning and D suggested I blog about it, that maybe by writing about it, whatever it is, I could identify it.

So that is what I will try to do. But not now. Because it's still too scary right now. Maybe when I'm done with this post?

Instead I will write about something else that has come up that has left me with mixed feelings. When I started this blog, I didn't really know what I was doing (I still don't, really). I looked at a lot of other blogs and here and there I picked up references to various aggregators and the whole feed thing that I still don't understand.

But I submitted my blog because I knew that if no one knew I was here, no one would read anything, and I knew--I just knew--that eventually I would use that as a weapon against myself, a way to prove that my depression was right all along and no one cared and I was just babbling away to no one and it wasn't going to make a difference so why bother?

I am moved beyond expression that the blogosphere in general and the Jewish blogosphere in specific has proved that train of thought very, very wrong. That potential weapon has been neutralized. And now with mixed feelings I have become aware of another.

I didn't realize that one of the aggregators encourages readers to rate posts, or that it automatically rates the post as soon as it becomes aware of it. The aggregator appears to rate the post based on the number of words; short posts, even if they speak of something important, are rated lower than long posts even if they are about nothing. One of my readers pointed me toward this aggregator (JBlogCentral) and explained to me about the ratings and how readers can rate posts and what it meant that I had an overal rating of 4+ stars with only a couple hundred points. And then I found out about the JBlogAwards.

It took me a while, clicking on things around the site, to figure out how it worked, and then I felt uneasy when the site itself encouraged bloggers to rate their own posts.

Because when I write something, it isn't here to compete with everyone else's posts or earn me international attention or win a Pulitzer prize. I'm not qualified to offer psychiatric advice or rabbinic advice or medical advice. It's just me, trying to muddle through life the best I can while dealing with depression and anxiety, and relying very much on the strength I have found in being Jewish.

I know that competition is a good thing, generally. Competition is what allows me to afford my prescriptions. Competition is what drives my need to give my children the Jewish education I never had. Competition keeps a paycheck coming into our family.

But how do I take it when some people rate a post that to me is raw and vulnerable and just lays my reality out there for everyone to see, a five and others rate it a three? Or a one? Was I just not angst-ridden enough? Not compelling enough? Not provacative enough? Not political enough? Perhaps I didn't provide enough gossip or badmouth people in shul or threaten to out my rabbi? Or perhaps I was too much out there, too emotional, too honest. I don't know.

I remind myself that I am writing this blog primarily for me because I have never successfully maintained a written offline journal. As a bonus, the feedback I've received is tremendously helpful. And a result I never expected was that it's apparently helping others, those who are experiencing similar issues, those who are caring for those experiencing similar issues, and those who want to help via their profession or vocation or simply because it's important to them.

At the same time I'm reminding myself of this, I'm noting that some of the blogs I enjoy visiting, like Rabbi Without a Cause and A Mother in Israel, are at least today on the Top 50 blogs list. Yid With Lid, who hosted the most recent Haveil Havalim, is today number three.

What do I feel? Disappointment? A touch of benign envy? Happy with the overall ratings despite individual votes? Does it affect my ego? Should it? Why does it even make a difference? Who relies on those ratings anyway? Is that last question at all a sour-grapes sentiment?

I want to be Seen and noticed and valued, and the ratings and awards seem like a good way to accomplish that, but there is dark territory in there for me.

My feelings are very mixed. The only way I know that my blog is anything positive in the world is from comments and email that people have left, and the occasional mention on another blog. I can't at this time trust ratings and awards. There is too much potential for me to criticize myself or stomp on an already wavering self-esteem if I allow ratings and awards to define the worth of what I write, which on this blog, is most certainly tied to the worth of me.

When three out of four IS bad

My doctors and counselor have emphasized that there are four necessary components to my success in coping with depression and anxiety:

1. Consistent medication
2. Proper nutrition
3. Regular exercise
4. Adequate sleep

I suppose I could add that a positive attitude helps, but that's just not always possible, and I don't want to sabotage myself by requiring a positive attitude when depressed because that will just set me up for failure.

I'm consistent with the medication. I'm still taking generic Prozac, still at 50mg/day. I know that my ability to cope with each day is due in part to my staying on the medication; forgetting or missing a dose for whatever reason will impair my near future, and I'm the one who has to live with me.

I'm doing better with proper nutrition, in part because my husband is taking better care of himself and is therefore better able to help me with grocery shopping, meal planning, fixing healthy meals and so forth. If it were not for his contribution, there are many times I'm not sure I'd eat at all, much less eating healthy. Keeping kosher usually makes it easier to eat healthy. Sometimes it makes it harder, or at least demands more creativity. It is possible to make a fleishig (non-dairy) chicken pot pie from a treif (non-kosher) recipe, and have it taste good.

I noticed today, in fact, that I have lost some weight and the only major change I've made is eating better. Plus, I like how it feels and that buoys my mood too.

I am not a couch potato but I could do better about getting aerobic exercise. Cleaning house and chasing after children helps but is not quite the same as a workout. If only I had the room and the money to blog on a treadmill. Our health insurance now offers us a reduced membership at the local Jewish Community Center if I exercise some number of days each month. Time will tell if it is incentive enough for me.

And then there is sleep. Or no sleep. Like last night when I finally fell asleep at 5am and woke at 7am.

The Prozac, even when taken in the morning, will disrupt my sleep. It makes my already light sleep practically non-existent. My doctor tried me out with Lunesta, Ambien CR, and Rozerem, and only the Lunesta had positive results. Over the past few months, I've very gradually needed to increase my dose of Lunesta from 1mg/night to 4mg/night. Until recently, it has helped me get to sleep within less than an hour and sleep through the night, waking if I need to without feeling drugged or drowsy. It has brought dreams back into my nighttime, something that has been missing for over a year.

But within the past few weeks it has not been working as well. It's taken me longer to get to sleep and then I wake at 3am or some other middle of the night time and cannot get back to sleep. So I thought last night I would try going without it. Unfortunately, that meant going without sleep, too.

I know that Lunesta, like many sleep aids, does have a risk of dependency so that going without it may cause a few nights of interrupted sleep before the body's own sleep cycle takes over again. That appears to be the case with me. I don't see my doctor for another week, so I'm not quite sure what to do. What I know for certain is that I need my sleep. I need that REM sleep. I need more than 2 hours a night.

I'm doing pretty well on the 50mg/day of Prozac and there's no indication at this time that last year will repeat itself, despite my worries to the contrary. But staying out of the depression by using medication is resulting in less sleep, which increases my risk of depression, which might cause another meds increase, which will result in less sleep, which increases the risk....

It is enough of a challenge to live with the depression and anxiety/OCD, knowing there is no cure, only management. Why does treatment have to be so challenging too?

It maks me really wonder what G-d wants me to learn from this.

Haveil Havalim at YID With LID

Thank you to Yid With Lid for posting this week's Haveil Havalim and including my blog.

Musaf as therapy

I think there is a lot to be said for sacrifice.

Let me explain that. I'm not saying it's time to fire up the altar, and I don't want to go anywhere near the political ramifications of rebuilding the Temple. I'm not even saying that sacrifice has to involve death. Not like it used to.

Rabbinic Judaism has replaced the Temple offerings with our tefillot, our prayers, which require an investment of time and effort, and if you count synagogue membership and other annual contributions, also money. Musaf is the additional prayer service that represents the additional Temple offering on Shabbat and holidays.

I think about this and I am not certain it is enough. Because nearly everything in life today requires an investment of time and effort and money. What makes our offering to G-d any different than our offering to a political cause or a social cause or a few hours of Internet shopping?

To me, it should be different. It should be special. And so when I reach Musaf and I'm contemplating the role of the Temple in our collective history, I take a moment to reflect on a different sort of sacrifice, my own "addition."

What do I personally need to sacrifice that is standing in the way of my connection with G-d?

What obsolete defenses, inaccurate fears, faulty assumptions have cluttered my life and made it harder to reach my potential? Which of those need to "die" and make room for new life?

Lately I've worked on my fear of loss, my tenuous trust in the universe, my fear of not belonging, not deserving, not having the right to be.

It isn't easy. It isn't painless. Sometimes this blog is part of that sacrifice because there's safety, it seems, in silence, in never bringing these things to light.

Speaking up means I have to think about it, put words to it, talk about it. Hear others' opinions and ideas. Learn from it. Change it. Allow myself to be changed for the better.

It seems to me that is at the heart of Judaism itself.

Sorry this seat is taken

I started blogging 50 weeks ago. Almost a year. Due to the depression, I have only hazy memories of last January, so I went to see what I'd blogged about then.

Much to my surprise, very early on there's a post about being told, sorry this seat is taken, again and again at a shul-sponsored brunch.

Interesting. How much has stayed the same and yet how much has changed.

You don't need OCD to need a fixed place in shul

I hadn't spoken with my friend D in a while, until yesterday, when D called with new year's wishes and to check in. D reads this blog regularly and occasionally calls to talk with me about something I've written. (D was the one who got me to start this blog in the first place, since I was horrible about keeping a written diary.)

My last post about being embarrassed to admit that I was afraid of losing my seat in shul caught D's attention.

Why are you embarrassed to say you want to sit in the same seat at shul?

Because in comparison to everything else, it seems so mundane. So insignificant.

And yet you write--without embarrassment I presume--that having a seat at a table with others for a meal at shul is quite significant. How are they different?

(I hate it when D points out my inconsistencies.)

They are. Let me see if I can explain. Knowing that you have a place to sit, to daven, to be in shul without worrying about taking someone else's seat or breaking some protocol is something I consider important. So important, that I'm always thinking of people who come in after me, and what if they don't have a seat? I find myself wanting to make myself smaller or sometimes even to disappear so they can have my seat and won't have to go through the discomfort I've felt. But at meals, which are far less frequent than once a week to begin with, usually everyone else is already seated, so I'm not as worried about people coming in after me.

Rivka, I've lost count of the number of assumptions you've made in that explanation. It sounds to me like you value having a regular, fixed place to daven, a makom kavua, and you value having a place to sit at a meal where you're valued as a person and not just a mother. Yet you seem to be saying that you don't deserve the first and you do deserve the second. I'm curious why you don't feel you deserve a place in shul?

I don't know. It just seems like others are more deserving.

Based on what? Do you think G-d wants you to disappear so someone else can have your seat? Do you think the congregation wants that? The rabbi?

No.

I don't think so either. In fact, I think they all want you to take your seat and inspire others to sit with you.

I don't know how to do that.

I know my feelings of "deservedness" are related to my history and my depression, not to mention my self-esteem. But even when my head understands that it's okay to need a fixed place, my heart doesn't accept that I'm worthy enough.