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.

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.

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.

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.

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?

A Chanukah gift from my rabbi

When I met with my rabbi again a week later, he began by asking me what are the obstacles to feeling relaxed and happy in shul.

Three came immediately to mind.

The first was that I am occasionally asked to help in a variety of ways. I love this. It helps me feel connected and valued and a real part of the community. Some things, like helping out in the kitchen, are easy and require no planning on my part. Other things, like being asked to lead a children's service or women's tefillah group, are not.

It isn't that they require planning. I know these things well enough that I could probably do them cold. But I am scared to. Maybe it is the OCD or maybe it's my experience or maybe it's something entirely different, but I get extremely anxious if I haven't practiced and prepared to the point of knowing it backwards and forwards and upside down. And even then I am scared but I do it anyway. And it always works out well and no one has ever suggested I not do this anymore, but I am terrified of making a mistake.

To that, my rabbi told me what he tells his bar and bat mitzvah students. He said in school, to get an A you need to score at least 90%. So however much of whatever they are doing for their bar or bat mitzvah, if they get 90% of it right, they've earned an A. The previous Shabbos, for instance, the bar mitzvah davened about 2/3 of the service and layned all but one of the Torah readings. Figuring the bar mitzvah was leading maybe two hours of the morning, my rabbi said he could have had 12 minutes of mistakes and still earned an A, and to date, no one has ever had that many mistakes.

This helped a little. I still have to find ways to cope with the anxiety, but he said he would do his part to give me advance notice if there was something he wanted me to do.

The second thing I said was silly and I was embarrassed to even bring it up. My rabbi assured me, and in earnest, that it could not be silly. So I told him, still feeling embarrassed, that I was afraid of losing my seat. You see, I almost always sit in the same seat on Shabbos. I chose it years ago and made sure it had been unoccupied before me. It still seems silly to say, but it has great meaning and significance for me.

But one of the times I was absent with a long depression, another woman began sitting there. When I returned one Shabbos and she came in late, she was horribly upset with me that I had taken her seat. She went to other women and complained about me. One mutual friend said yes, it's been your (her) seat for a short while, but before it was your seat, it indeed was Rivka's. I felt, in a word, ashamed. This other woman decided to move and found a seat that was better for her, she said, but it took a very long time before I felt comfortable in my seat again. And to this day, I am anxious until I arrive at shul and see that my seat is available.

I did tell my rabbi that someone--like him--could use this as a reason for me to be in shul every single week, and the earlier the better. He laughed and said, I wasn't going to go there, really. The reality, we both know, is that I have young children and a brain disorder and people get sick on occasion and sometimes I can't make it on time, if at all. He said he would be willing, and saw no problem with, putting a sign on that seat that said, please do not sit here until X hour. I was afraid of that beginning a whole seat reservation system, so I declined, but he seemed seriously willing to do that and it really touched me.

The third and last thing had to do with dinners that take place a few times a year in the shul. On those occasions, I told him, when there is no pre-arranged seating, it is very common for me to wind up virtually alone with my family. Let me explain. Some tables seat 8. Others seat 10. My family is not so large that we'd occupy an entire table (b'ezrat HaShem, it will someday be larger). People tend to gravitate toward their friends and people they know well, and despite the fact that I have been at this shul actively for thirteen years, I am still a newcomer. So other tables fill quickly and I need to sit with my children, so we find a table and there are still enough seats for others to join us but no one does. It is very hard not to take this personally, even though I know it is not intended as such. My solution is that I stopped going, but this still left me feeling sad and excluded.

This Chanukah, the shul hosted a latke dinner on a Sunday evening and there was no pre-arranged seating. My children really wanted to go, so we went. After Ma'ariv, we were one of the last families to find seats, because as many parents know, people without children can move faster than those of us with, and there were few children that evening.

I was near tears, just knowing this was going to happen again, when my rabbi came up beside me and gestured to a particular table with one parent and one child sitting at it. I looked around and saw everyone else was seated. He saw that, too, and as soon as his wife emerged from the kitchen, he wordlessly asked her to sit at our table. And when he was done with the parts of the evening that required him to be standing and mobile, he came and sat with us. It was the first time in at least eight years that I have sat at a table with adults other than my husband to talk to.

I don't know if he realized just how meaningful that gesture was. In a way, I really hope he does, because it meant the world to me, not to have to be left out of the conversation, left out of the community, again. And I got to know his wife a little better, which was very nice. It was a truly wonderful gift.

Being truly SEEN by the rabbi

This, they would say in counseling, is progress.

It is ten minutes since I finished that last post and what I was writing sent me into a new flurry of anxiety. I managed to calm the hair-pulling by forcing both hands on the keyboard, but then those anti-anxiety cleaning instincts took over. I really should clean my keyboard. Not a wipe off the surface cleaning, but a take off all the keys and deep clean with Q-tips and rubbing alcohol. My mouse isn't looking so shiny, either. And there's dust on the monitor and the windows need cleaning and the carpet needs to be vacuumed and the children keep getting out of bed and anything--anything--but sit here and write about how I will not be needy and I'm not worth the rabbi's attention.

I will combat faulty self-talk with logic.

All in all, I met with my rabbi five times over the span of four weeks. This was not at my suggestion. I would have been happy with something more frequent than once every two years. But he saw some necessity in it, and he thought it was worth his time, and he could have had his choice of excuses why we couldn't meet and he didn't take any of them. I know that I cannot always trust my sense of self-worth, but I am certain I can trust his. He thinks I am worth it. I am overruled. Case dismissed.

I wish it were all that easy.

At my third meeting with him, I asked him if he had any idea how hard it was to come see him without an agenda. He gave me a smile that--if interpreted correctly--was somewhere between "It's good for you" and "I don't know, I've never tried it."

He wanted me to talk more about reintegration at shul. How was it going? I told him. Some people did just pick up where we left off. Some had forgotten about my late miscarriage last spring and didn't understand why I felt a pang of hurt when I saw the babies who had been born around the time of my due date. And some asked what I'd been up to, why I'd been gone so long.

How do I answer that?

• Not much, just a little mental breakdown
• None of your beeswax (said politely, of course)
• Well, see it all started with a scarcity of the neurotransmitter seratonin
• Doesn't everyone leave shul for months at a time?
• I overslept
• I gave it up for Lent (a good friend reminds me it's the wrong time of year for that--she finds my ignorance of Christian rituals quite amusing)

I shrugged. I smiled. And then I asked about them. It works almost every time.

One person came up to me during kiddush and said quietly in my ear, I don't mean to out you but I've heard you've been dealing with depression. I've dealt with it too. A lot. Anytime you want to talk, I'm here.

I didn't know how to take that. Did that mean this person wanted to talk? Or was just offering to be on my safe list? What if when I was feeling fragile, they were too? I'm still not sure.

But then as I was talking to my rabbi it all fell apart. I couldn't keep past hurts from intruding on the present and some of them were making me gun-shy. So he encouraged me to tell him what these hurts were. I hesitated.

I don't want to turn this into Let's Bash the Shul or Let's Bash the Rabbi Day, I said. No, no no, he said. This wasn't about him, or the shul. This was about why I felt hurt. So I told him and with it came the tears.

And then he was very quiet and I feared I'd stepped over some invisible line. It was one of those times I wish life had an Undo button. I felt horrible.

Then he said, you take your responsibility to the shul very seriously. I nodded. Yes, of course, the shul means a lot to me. Doesn't everyone feel this way?

He shook his head, inhaled sharply, paused, and said no. And then he said, "you have an overly heightened sense of responsibility. I suspect, from everything I know about you, that you developed it very early as a coping skill, because otherwise there would have been too much pain to endure, and without it you probably wouldn't have survived."

I didn't know what to say. I nodded silently, tears unchecked. This rabbi, this man, didn't just get it. He had Seen me.

There was pain low in my stomach, as if something shifted in the core of my being. He had managed to do what few people in this world have done. He had truly Seen me without judgment or labels or an agenda to "fix" me. We both knew it. And I was grateful.

And then, of course, we were out of time. He asked if I was free to meet again on such-and-such day. I pulled out my PDA and brought up my calendar. Yes.

Doesn't that thing make you more anxious? he asked. Always knowing everything that's coming up?

I was surprised. No, I said. It makes me less anxious because I can look at it and say here's the appointments for tomorrow, I've got notes for this meeting, nothing needed for that one, it's not my turn to bring snack, good, I'm prepared and I can relax.

That's where we differ, he said. Knowing everything that was coming up would make him very anxious. The only way he could relax was having no clue what the next day would bring. Neither one of us saw the need to go into the pros and cons of that approach.

I started to put our next meeting in my calendar, accidentally selected the wrong time, and took a moment to fix it. "Rabbi" he said helpfully.

I laughed and said, cute. Then he told me about this training seminar he'd gone to about conducting hostage negotiations. The part of my brain that censors what I say--especially to my rabbi--had apparently shorted out and I heard myself ask slowly, do you find you need to do a lot of hostage negotiations in your rabbinate? He got up and said, you never know.

We'd meet again in a week and I had no idea what we were going to talk about.

My new anti-anxiety kit

It is amazing that after years of therapy, I am still learning things about myself. What I've learned recently, now that I am recognizing the signs of anxiety and the OCD features, is that I am a very tactile person. Touch is a primary way that I can ease the anxiety.

I learned that when my counselor suggested aromatherapy, to find a scent that would relax me, and all the scents I tried didn't do anything for me other than make me sneeze. But she got me thinking about what I do when I'm sitting and anxious.

I pick at things: skin, hair, scabs, cuticles, fuzz. I pull hair out, which I discovered is a diagnosis all by itself and part of the OCD spectrum called trichotillomania or TTM for short.

I'm attracted by textures. In fact sometimes I wish I could wear a tallit katan just so I could finger the knots in the tzitzit (fringes). A friend suggested worry beads but my first reaction was that it would be mistaken for a rosary!

So I went on a scavenger hunt around home and started collecting things in an old small sewing box:

• satin binding from a childhood blanket
• set of four 1-inch ball bearings, to manipulate in my hand
• palm-sized smooth stone
• pair of strong magnets to play with
• hand-held bathing brush with bristles on one side and pumice stone on the other
• Koosh ball
• Rubik's Cube
• and to top it off, hand lotion in a Eucalyptus/Spearmint scent that I can massage my hands with

Then for Chanuka my husband gave me a home manicure set from Israel, with Dead Sea minerals (or so it says). I tried it on one nail and it's smooth and shiny like I polished it and lately I've been rubbing it instead of picking at hair.

My counselor thinks it is great that my answers to anxiety are things that are self-care. I fear becoming vain or superficial, yet at the same time these things are allowing some of my hair to grow back.

While I don't usually like labels because I think they often are unhelpful, having a diagnosis to help me understand why I do what I do--when I'm not thinking about what I'm doing--has been very helpful. Finally I can stop fearing the manic episode that has never come and work on finding ways to deal with and tame my anxiety before it turns into depression.

It's back

This year I had questions I've never had before. I wanted to run from Rosh Hashanah, hide from Yom Kippur. And now the old feelings have crept back into my life and as much as I try to stand strong against them, I have had to increase my meds and I still fight anxiety that several times a day is nearly debilitating.

On New Year's Day the decree is inscribed and on the Day of Atonement it is sealed; how many shall pass away and how many shall be born; who shall live and who shall die...

Is this why my baby daughter died four months ago? Did I not pray hard enough last year?

It's a question my counselor would say is ridiculous. G-d doesn't work that way. Yet here it is. In writing. We daven it. Do we say the words but not mean them? Or do we mean them and if we do, how do I take them? When does prayer move from metaphor to the literal?

I visited my baby's grave site twice during the ten days. Two friends who had wanted to be with me when she was buried, I took them each separately and we paid our respects. I could not cry.

...who shall have rest and who shall go wandering; who shall be tranquil and who shall be disturbed; who shall be at ease and who shall be afflicted...

The question comes naturally, is my depression, my panic attacks, my distorted lens through which I see the world the result of some divine decree? If I were a better Jew, would I get past this? And what would that mean? Whose definition of a better Jew?

How can I do teshuva more than I can do it? How can I give tzedaka more than I can give it? Can I possibly pray harder than I can pray?

There are some who would of course say yes. There are those who claim the Shoah happened because Jews were not religious enough. Without a doubt they would blame my illness on my failings. But theirs is not the voice I want to hear. Extremism is never the answer, no matter what the question.

Would it make any difference if I did my own Vidui?

I have raised my voice to my children; I have raised my voice to the heavens and doubted I would get an answer; I have lost faith in humanity when reading the news; I have lost faith in G-d when my depression tosses me into the depths; I have blamed others for not doing enough to help; I have blamed
G-d for giving me this challenge in the first place; I have berated myself for all the weaknesses my illness makes acute; I have berated myself for not being stronger...

It didn't even wait until October. I saw the first signs nearly a week ago. The red flags, the things that alert me to another onset of anxiety and depression, they started coming quickly and went from nonexistent to frequent in 24 hours. On the third day, I increased my meds from 30mg to 40mg. I see my counselor and the psychiatrist's assitant this week.

I gave my rabbi two weeks worth of available times when we could meet again, but I have not heard from him. I fear he is angry with me or disappointed because I could not face the crowds at shul. I could not stay. That may have been the first red flag and I missed it.

I noticed it when the first signs of hoplessness returned, the sense of being overwhelmed, of fearing attack from every side. Every e-mail, every phone call, every knock at the door I fear is someone unhappy with me. I couldn't possibly confess enough to satisfy the yetser hara's depression inside of me.

This is not how I wanted to start the year. On New Year's Day the decree is inscribed and on the Day of Atonement it is sealed. Have I already been assigned some horrible fate because of my anxiety over the Days of Awe? Has my next baby's death warrant been signed (G-d forbid) because of my depression's timing?

I don't know how to come to terms with the liturgy. I have no answers.

Gathering strength and information: why is contacting the rabbi so scary?

I saw my regular counselor today and I told her of my dream and what my PA said yesterday. I also told her what I posted yesterday and what readers had commented and specifically Rabbi WAC's suggestions. She really liked the team approach.

The team approach is basically this. The biggest responsibility is mine. I have to speak up about what is going on in my head, my heart, my soul. I have to tell appropriate people about when things are good, when I'm concerned, side effects, thought patterns that don't seem right. I have to ask for reality checks and be as accurate as possible in my descriptions of how I'm doing. To not downplay what's going on. I have to be diligent about taking my meds, exercising daily, getting enough sleep, pursuing stress reduction as needed.

The next one in line is my husband. He sees me every day and might notice something I'm missing. He might catch inconsistencies between my words and behavior, or sense that something is just off. He will ask me about it, and using his discretion, may or may not make sure someone else on the team knows about it, too.

My psychiatrist's assistant (PA)/counselor will handle the medication aspect. Do we need to adjust meds, add something, scale it back, try something different, all this is her area of expertise.

My regular counselor will handle most of my other issues: ongoing relationship with my mom, parenting my children, anxieties, negative self-talk, coping with depression, social anxiety, high self-expectations, and so on.

The last ring is the one I'm uncertain of. That's my rabbi. I would like very much for him to be part of the team. I want very much not to be afraid of that, too. I want him to be available to handle my religious and spiritual concerns, issues around and in shul. He sees me most every Shabbat. We have a history together, for over a dozen years. He has played a very important role in my life. I'd like that to continue. I'd like to have someone to take my religious and spiritual concerns to, because right now no one is there to offer Jewish answers.

Many years ago, a psychiatrist told me I needed to focus on both aspects of my life in order to get better: physical and emotional.

Not two, I told him. Not both aspects. There are five: physical, emotional, intellectual, social, spiritual. All five need attention. I was under his care when I began my formal conversion studies. Shortly after my conversion and just before he left the clinic, he began researching and then publishing articles in psychiatric journals on the importance of spirituality to psychiatric healing. It would be nice to think maybe I helped a bit with that, though I'm not sure.

At any rate, only four of the five are getting attention now. I need to follow my own advice and see to that fifth.

One concern my counselor raised was that my rabbi might not be the right person for this. She suggested that I ask him outright, after explaining what I need from him, is this something you can provide? If not, that's okay, just please refer me to someone--perhaps another rabbi--who can.

She is concerned that he might be stretched too thin, too distracted, focused on too many other areas. She was certain that my falling through the cracks is not intentional on his part (I am certain of this, too), but that there is the possibility I am looking for support in the wrong place.

I'm not ready to say that, yet. I haven't ever before asked him for regular, ongoing support. I want to give him that chance.

She said I should have a full year of regular support from him before I bring up past issues. My relationship with my rabbi is not broken but it is wounded. It needs time to heal, she said. I can do that.

She also said that she is concerned that the sometimes lack of follow-through issue is sort of like intermittent positive reinforcement. That is, sometimes I get the reward of a meeting with him. It is the type of reinforcement of slot machines and it is dangerous for me because it keeps me hanging onto a relationship that may or may not be healthy for me.

But she is optimistic that it might work. I did, at any rate, promise her I would contact my rabbi and ask to schedule a meeting with him. I would do my part to see this happen. Then it is up to him.

Good news better news best news

I am so tired tonight but I wanted to write about the good things that have happened or are happening here. It is a wonderful feeling to know that good things are going on, even as there are pockets of sadness and grief around me.

My neighbor's 16-year-old Akita, one of the gentlest dogs I've ever met, died today. We are sad for their family and ours--we'll miss him too--yet for the first time, I don't feel my own happiness over recent good tidings diminished.

The first bit of very good news is that we did receive the financial aid we asked for. This is an incredible relief. We try to make ends meet on one salary and my husband is certainly not a highly paid doctor or lawyer or similar professional. But I am so pleased that we can still provide a Jewish education for our children. It is so important to me that they have this strong start, this confident identity as they begin their school careers.

The second bit of good news is that I am gaining some perspective on the rabbi issue. I have not seen him in weeks and this is okay with me. I think that perhaps I need to be very, very, very direct with him. I think perhaps I was expecting him to have a greater sensitivity or a more perceptive sense of people than perhaps he really has.

I think I need to decide if I'm going to continue to fall through the cracks or not, and if not, then I have to make myself visible and heard. If he offers to give me a referral list of Jewish counselors, then I need to ask him exactly when he might have that for me. I think I need to pin him down, metaphorically speaking. I think I need to think in terms of tasks and deadlines with him.

I also think I need to figure out exactly what I need from him, from shul, from my shul community. October is coming fast and I need to prepare for the inevitable downturn that will accompany it. There is the possibility that it won't be so bad this year, but in 22 years it has been hard, so I expect the worst and hope for the best.

Meanwhile my painting art therapy is going well and almost complete. I will have a whole new room within a week or two. I love to go out there now and just enjoy the colors and looking out the windows. I think when it is finished, it would be a nice place to daven.

So this is maybe my homework. My rabbi often invites people to come see him before he is too overwhelmed preparing for the High Holy Days, to talk about the past year or what they envision for the coming one. If I can figure out exactly what I need from him and from the shul, what do I need when I walk into the building on Shabbat or a holiday or whenever, then I can meet with him and tell him. I might even take relevant parts of What would I want my rabbi to know Part I and bring them with me.

I see my counselor this week. Maybe this is a good thing to work on. And yes, my high expectations. Those aren't going away any time soon I don't think, so they will be there to talk about. Ayelet is right that those often come from not being or feeling good enough. I know that feeling well. I grew up with it.

B'ezrat Hashem, I will have more good news on my other anxieties soon.

Anxious

Anxiety takes a lot of energy. I should be fixing lunch for my children right now, then getting challah started so it will be ready in time for dinner tonight. Instead I am sitting here feeling exhausted and anxious and wishing only for sleep and an end to my anxiety.

This time I think my anxiety is really caused by real things happening in my life. I don't think it's all chemical but I acknowledge my brain chemistry might make it less tolerable than it would be for others.

We are awaiting a decision on financial aid for our children to attend the only Jewish day school around. If we do not get it, they will have to go to public school.

We have to refinance our house because our current mortgage is an adjustable-rate one and it adjusts big time next month.

We are facing an unlikely but still possible 10% wage cut.

So I am anxious. And Shabbat is nearly here again and the rabbi is back and I just have so many conflicting feelings about going back.

I had a dream the other night about having a meeting with my counselor and my rabbi and my husband and me. Sort of like a team approach to helping me cope when things are bad, and even when things are okay, or dare I say, good. But then I am back to what is appropriate to ask for. Maybe all I can regularly expect is for him to announce page numbers.

Just thinking about this I feel tears coming. It hurts so much and I've been so disappointed though there have been good times as well, and leaving just isn't an option. There aren't really any alternatives that are better.

I'm just so tired thinking about all of this. So I will go make my children and me some lunch and maybe that will energize me so I can make challah. (There is no place to go buy challah here today.)

I will be in shul tomorrow. Wish me strength--I may need it. Gut shabbos.

Rasslin with the rabbi issue

I went to shul last Shabbat. I was horribly anxious but I knew I needed to go for me. As it turned out, the (shul) rabbi was not there and another rabbi who is usually a fellow congregant (and whom I like very much) was leading services. This helped a lot.

While I was there, I talked with another woman who knows the rabbi better than I do. While I did not go into detail about how I felt or my recent struggles, I did ask in a very roundabout way about the prominent member's comments regarding the rabbi's commitment to the individual's Jewish life.

She rolled her eyes at that and said something unrepeatable about shul politics. But the bottom line is that I should take what that member had to say with an entire jar of kosher salt. She then said that the (shul) rabbi is very understated in how he supports people. To him, a great deal is communicated through a handshake or a hand on one's shoulder or greeting someone with a smile rather than a scowl. He is not overt in his support, but that does not mean he is not supportive.

She also said that he shows his satisfaction or delight in what someone has learned or accomplished by asking them to do more of it or to take on a responsibility that would use their new knowledge. The fact that he has, on quite a few occasions, asked me to teach a class or lead a minyan or write something for the shul to distribute should be, she said, interpreted to mean he is quite pleased.

This helped me feel a lot better.

I talked to another friend about being visibly Jewish versus not, meaning something like when I wear my Magen David necklace versus when I don't. She laughed and said that I was always visibly Jewish and that even she (a non-Jew) could recognize Jewish values and ethics and my commitment to Jewish law in the words I chose and how I dress and how I raise my children and even the friends I choose. I didn't think it was that obvious. She thinks it is glaring but in a good way. When I told her about feeling like maybe I wasn't Jewish enough yet, she said that just wasn't possible.

My friend D called me after Shabbat and we talked for a while, too. D asked me how I was doing and how the medication was helping and about my anxiety, because that always shows up before the depression does. I told D about my anxiety around shul, around the rabbi, and D asked if any of the things I was afraid of had ever happened.

Once, I said. There is this woman at shul who, years ago, angrily told me that I'd never be truly Jewish because I'd converted. I was horrified then and a friend stepped in and defended me. But I never forgot it and that woman still glares at me when she sees me.

After saying this was clearly this woman's issues and not mine, D said if anyone at shul suggested something like that again, I should simply ask if they trust the rabbi, because if they do, accusing me is tantamount to questioning his judgment, since the rabbi is the one I learned with and he brought me before the beit din for my formal conversion. I felt not quite so alone then. I liked the idea of the rabbi's status backing up my claim to Jewishness.

D also suggested gently that much of my anxiety seemed to be as if others had very high expectations of me and I wasn't measuring up. When asked, I really couldn't point to anyone who has high expectations of me. Except me.

Might I be projecting my high expectations onto others, believing that's what they expect of me? Could this be a part of my anxiety? D knows this is certainly part of my history, my childhood. It is maybe a good topic to pick apart in therapy.

And then before I went to bed Saturday night, I picked up my book of Tehillim--Psalms--again. I thumbed through, skimming, and then stopped short. The words seemed to almost leap off the page at me.

Chapter 91:

4. With His wings He will cover you, and under His wings you will take refuge; His truth is an encompassing shield.
5. You will not fear the fright of night, the arrow that flies by day;
9. For you [said], "The Lord is my refuge"; the Most High you made your dwelling.
10. No harm will befall you, nor will a plague draw near to your tent.
11. For He will command His angels on your behalf to guard you in all your ways.
12. On [their] hands they will bear you, lest your foot stumble on a stone.

I hold onto this, the words of my friends, and the support for this blog. And I hold tight to my belief and trust in G-d, because that is my center and my foundation.

What would I want my rabbi to know? Part II

I wrote about this first six months ago in I cried at shul and then in Shul, and of course I wrote about it in What would I want my rabbi to know? Part 1.

I'm still dealing with it. And I still have no answers.

I'm not even sure I have questions and maybe that's part of the problem. Back in Part 1, I wrote

I wish I could just schedule an appointment and tell him all this. Tell him what I need. But I don't trust that what I want, what I think I need, what I wrote at the top of this post, is appropriate.

I know that I have to ask. I know that I need to voice what I need. I know that the more specific I can be, the better. But I'm stuck on the appropriateness.

Is what I want from my rabbi something that would fall in his job description, so to speak, or am I looking for what I need in the wrong place?

I want to trust him. I want to trust that when he says he'll do something, he does. Right now that doesn't exist. Sometimes he follows through and sometimes he doesn't, and I never know which it will be. Last winter, he offered to give me some referrals to Jewish counselors for the religious piece of my depression and I said yes that would be very nice, but then nothing happened. And I got worse before I got better and it seemed pointless to ask later.

Besides, I was afraid that asking again, or bringing up that he'd offered, would be taken as a criticism of him. I can see that happening all too well. I think it's realistic. And I know for a fact that he hates criticism.

I want to understand how to reconcile being Jewish and living with depression. I talked with a friend today who remarked how the Scandinavian trait of holding one's emotions in was so foreign to Jewish culture. Yet it's not okay to be open about depression in Jewish culture either. So which is it? How open can I be? Should I be? Can I be any more honest with other Jews than I can with everyone else?

I don't know if these are questions a rabbi can help me answer. I only know that I don't have the answer and am not qualified to answer them.

I want to feel like I matter to the shul, like I help make a difference, like I contribute in some way to the congregation.

I want to feel like he'd notice if I stopped coming to shul. I want to feel like he'd care whether I disappeared off the face of the earth or not. The last time I saw him was when I said Kaddish the first Shabbat after my baby daughter's burial at the end of May. I haven't been able to get up my courage to go to shul since. I miss it horribly but it is too hard to go. It is the one place where I am forced to confront myself, my pain, my anxieties, my resentments, my hopes, my fears.

When I talked with him after shul at the end of January (in I cried at shul), I told him that having this illness somehow makes me feel less Jewish. He rolled his eyes, clearly dismissing that as an absurd idea. I've also written in that same post that my depression makes me just feel less.

I want to feel like I've learned enough about Judaism in the past twelve years of off-and-on formal learning and twenty-three-plus years of informal learning to be considered--by him--as reasonably knowledgeable for a lay person. Like I finally qualify to really be called Jewish. Like I earned the trust he placed in me when he brought me before the beit din at my conversion.

I want to feel like I really belong, that I'm not still an outsider looking in. I want to feel like I can and should stop questioning my authenticity as a Jew. I want to feel like I'm good enough.

Two years ago I came up with an interpretation of the Four Children in the Passover haggadah that really excited me. I told my rabbi about it, explaining my interpretation. He said he'd never heard anything like it before, but he liked it a lot. He asked me to write up what I'd just explained to him and the shul would include it in the Pesach handouts they make available each year. But I didn't trust it would actually happen and I didn't want to deal with the letdown of submitting it only to have it left out, so I didn't send it in.

I want to hear these things from him and yet I am not sure I can always believe him. I know he means well but the many times there has been a lack of follow-through just hurts too much.

A prominent member of our congregation recently lost his mother, aleha hashalom. He wrote an article distributed to the congregation that read in part

what I have learned is how deeply [our rabbi] is committed to our congregants, particularly to their individual Jewish lives. [His] attention and consolation and advice was precious to me and my family.

I do not feel that I received much of anything in the way of attention and consolation and advice from my rabbi--the same man praised by this other congregant--when my father, alav hashalom, died three years ago. Or when my daughter died in May. Once my conversion was over and I had no reason to meet every two weeks with my rabbi, I am not at all sure that there is much of any commitment on his part to my individual Jewish life. If there is, how do I find it? How do I see it? Feel it?

All I can think of is, what does this prominent member have that I don't? Why does he get what I felt I needed, both when my father died and just recently when my baby died?

He is able to donate a generous amount of money to the shul.
He is born Jewish.
His brain chemistry is normal, not wacky.

I have none of these things, since the whole thing with my maternal great-grandmother still meant I needed a conversion. Is that why? Is that why I don't count as much? Does my individual Jewish life not matter as much?

I never say these things out loud, never tell anyone especially the rabbi for fear I would be labeled too needy. But these things are in my head anyway. I don't know if it's the depression talking or my history or reality.

And it's why I don't know what's appropriate for me to ask for. Or if the rabbi is even who I should be asking.

I had thought there were no words

I have not been on the blogs lately. I guess you can tell. I was inconsolable for many days after losing my baby, almost a week. I feel I did eventually make peace with it. I think maybe she left me with gifts, changes in both my attitude and my body. Changes for the better.

The universe was kind to me, overall. I had an appointment with my new psychiatrist and my counselor two days after I was discharged from the hospital. The psychiatrist immediately increased my meds. We talked longer than our alotted time and she was, I think, very supportive.

It turned out I had two side effects from the increase--a higher dose than I've ever been on, though it is considered a starting point for most people. My side effects were a loss of appetite and dry mouth. So I was eating less and drinking more water. So sad.

Seriously, if I could have picked any side effects those would be the ones I wanted.

I made a memory book of photographs we took at the delivery. I included our ultrasound photos and photos of the burial. Since her death, I am seeing (living) dragonflies everywhere. They fly to me and around my head. I wonder if they are a message from her. I picked an album with dragonflies and butterflies on the cover.

I thought I had done a quick recovery and was playing "it would have been worse if..." games with myself. it would have been worse if she'd been full term. It would have been worse if she'd been born and lived only a few days or weeks or months. It would have been worse if she'd been my first child. I'm quite good at those games, but they serve no purpose other than to keep me from feeling my grief.

So I turned to another better method. I am painting a (large) room in my house. It had been unusable before but I have fixed and repaired and sealed and am now painting. It will be a cheery yellow with white trim.

It occurred to me today after emailing a friend that painting this room is kind of like Jewish prayer. It is something for my body to do, moving and concentrating on something known and familiar. Just as reciting prayers is almost like a mantra, painting is something like a kata, repeating movements as in a martial art. Both free my creative and spiritual mind to contemplate Something Else.

I have thought of my daughter a great deal while painting. I almost feel as if this room will be one she and I will share. It is comforting.

I am still hopeful that we will have another baby. Meanwhile I work on getting healthy again.

Having mentioned healthy, I did have another depression, as my psychiatrist expected. It was much more mild and the worst lasted only one day. She increased my meds again a little bit to try and keep my depression cycles to a tolerable level. I have usually four a year: January, April, July, and October. The worst are always October and January and the psychiatrist thinks it may be related to SAD, Seasonal Affective Disorder. I am sure that the fact that there are many, many holidays in both months might play a part, too.

I am exercising, briskly walking two miles a day. My sleep is not so great. I wake at 4am and can't get back to sleep for a couple of hours. My psychiatrist prescribed Lunesta but both times when I took it I woke with panic attacks and acute anxiety that lasted for a couple of hours, so no more Lunesta for me. I have lost 18 pounds in the past five weeks, which makes me happy. My blood sugar remains normal.

I am slowly unraveling my issues with my shul. I will save it for another post because it's so involved.

It is still so hard to reach out, so hard not to isolate, so hard to feel. Thank G-d for medication. And good doctors. And good friends. And a place to share. And the words to begin to heal.

I don't even know where to start (good post)

I would never in a million years have guessed what has happened over the past two months.

Yes, I am still pregnant, baruch Hashem! Four and a half months and counting. Baby seems to be doing well and I should start feeling movements any time now. I have developed gestational diabetes for the third time in as many pregnancies, and while I have to inject insulin twice a day so far, and test my blood sugar four times a day, I'm doing okay with that. I don't enjoy the needle pricks, but I do like knowing that I'm taking care of myself and my baby by doing so.

That isn't the zinger though. The event that blew my mind is this:

Apparently, I am not bipolar and have been living with the wrong diagnosis for 13 years.

Here is the background. Remember when I was really depressed in January? I was referred to a psychiatrist and a psychiatric physician's assistant back then, but didn't get an appointment until April. I guess a lot of people need psychiatric help. I had an in-depth intake and several long appointments. They reviewed my psychiatric history over the past 17 years and had one question: how did I get the bipolar diagnosis?

I remember that part well. It was 1994. I was hospitalized for the second time in six months and my doctors convinced me to begin medication. To determine what meds I should be on, I had to answer a ton of questions about my moods.

Did my depression last for more than two weeks? Yes.
Did it interfere with my ability to live life? Yes.
Did I ever feel like I had a lot of energy? Yes.
What did I do with that energy? Clean, organize, shop.
Did I find it hard to sleep when I had this extra energy? Yes.
Did this extra energy alternate with the depression? Sort of. I never had the extra energy during my deepest depressions.
And so on.

There was no question about episodic depression, and one doctor suspected bipolar. So I was put on an anti-psychotic, a mood stabilizer. I was told that if this stabilized my moods, I was bipolar. If I didn't react to it, then I wasn't.

It stabilized my moods. Sort of. I wasn't sad but I wasn't happy either. I was just mildly depressed all the time. I lived life like a zombie. I did this for two years and finally couldn't stand feeling like I was just taking up space. I weaned off the meds and found that exercise, avoiding sugar, and a strong spiritual/religious life kept me pretty grounded most of the time. My depressive episodes slowed to two bad times per year--October and January--and two more mild episodes in April and July. My psychiatrist at the time told me to keep doing what I was doing, and eventually ended treatment.

Fast forward to April 2007. I was asked more detailed questions about these energy surges.

Did I ever feel invincible? No.
Did I ever take risks that put me or others in harm's way? No.
Was this excess energy goal-directed or generalized to everything? It was always goal-directed. That's why I couldn't sleep. I was so excited about my grand plans for whatever I was about to do (as in finding that perfect clock radio), that I couldn't wait until morning.

Then they asked other things:

Do I ever feel anxious in social situations? Yes. Always.
Do I ever worry about something that may or may not happen in the future? Constantly.
Do I ever have physical symptoms from my worrying? Yes--lack of sleep, headaches, stomachaches, sore muscles.
What do I do when I feel anxious? Clean, organize, shop.

Aha.

There is nothing here, the psychiatrist said while patting my very fat psychiatric file, to indicate mania. Episodic depression, yes. Anxiety, yes. And a high likelihood of Seasonal Affective Disorder. Even indications of Obsessive Compulsive Disorder--a type of anxiety disorder. But not mania. Every episode I had where I had to clean my kitchen until it sparkled, or shop for the perfect clock radio, or reorganize all the bookshelves? Anxiety attacks.

After a month of appointments, they are about to toss the bipolar diagnosis. My new diagnosis is Major Depression, General Anxiety Disorder with Obsessive Compulsive Features, and Seasonal Affective Disorder. And the reason for the recurring depressive episodes--roughly every three months? Most likely a hormonal imbalance.

As it turns out, the Prozac I'm on is what they'd first recommend for the depression and anxiety. And I don't have to worry about triggering a manic episode. Come September, we will develop a plan for when the baby is born, since I have a documented track record for severe postpartum depression. After that, probably after the baby weans, we'll look at other options, and both have said that I will be a full participant in deciding which option to try in what order. But medication may be some combination of an antidepressant and hormones.

This has completely changed my identity. Here I have worried, sometimes excessively, about triggering a manic episode, and the worry itself is part of what's wrong.

And yet it's a relief. It feels more right than the "atypical bipolar II" ever felt. I don't have to explain how my manic episodes aren't like everyone else's manic episodes. Now when I get the urge to clean (and it's not just prior to Pesach), I ask myself if I'm anxious about anything. So far, I always am. I try to deal with what I'm anxious about instead and that helps a lot.

The best part is, I feel like I can finally get the help I need for what's really going on with me, and that, I believe, will better my life not only for me but also my entire family.

Improvement

Today I am still very tired and have a difficult time with concentration but it has been three days since I cried last. I also have found that almost precisely five hours after I take my meds, I get terribly sleepy, so I am now taking them at dinner so I can get to sleep at a reasonable time.

I still have a great deal of anxiety and little things still overwhelm me, but it is not the hopeless state it was a week ago. With time and G-d's help, I believe I can take on more and more and get back to what I consider my more normal life.

I am still thinking about some of the comments to my experiences last Shabbos, but I cannot right now come up with a coherent response so I will leave it until next week. My apologies for taking so long to answer.

A good Shabbos to all; Shabbat shalom.

How to respectfully ignore someone?

In a previous post, I talked a little bit in the comments about a handful of not so nice people at shul. I got an e-mail from one of those people today. She was angry because when I saw her last at shul, she was verbally bashing another group of people and even though everyone else who was listening to her were just nodding silently, I couldn't stand it anymore.

I probably shouldn't have said anything, but all I could think of was how horrible these people would feel if it got back to them. This woman is one of those who thinks she's right and everyone else is wrong and she'll only be nice to you if you agree with her. I was just so overcome with emotion, and I thought very carefully about what I was going to say because I didn't want want to make it worse but I wanted it to stop.

I told her, this is what I hear you saying, and I summarized it as, you don't like ... because they ... That was all I said. My summary was exactly what she'd been saying, and the others around later confirmed that. But when I summarized it, the irrationality of her dislike and subsequent verbal attack on these people was evident. She took it to mean I was calling her a racist.

She's very involved in shul, socially and politically. I want to just ignore her, but I don't know how. We aren't a huge congregation, and I'm sure to run into her now and then. I'm also apprehensive about retaliation from her.

Do I just avoid looking at her? Do I look at her and feel sad that she's carrying around so much anger? Do I keep a wide physical space between us? I have a bad poker face and when I'm feeling low it's very hard not to take things so personally.

I don't know how to avoid her and retain my self-worth. She's very angry at me and even though I think I handled it as best I could, I can't help but feel like I'm in the wrong. Am I? Do I just talk to my rabbi about all of this? I don't want to feel scared or unwelcome in my own shul.

What would I want my congregation to know? Part II

If there's a book called The Care and Feeding of Your Depressed Friend, this should be a chapter. The following are taken directly from my experience. Unfortunately.

What not to say to someone who is depressed or bipolar:

1. Snap out of it / get over it
   Believe me, if I could, I would. In a heartbeat. Or less.
   
2. You're too sensitive
   Maybe, but that doesn't change the fact that I'm struggling with an emotional disorder.
   
3. Everyone gets depressed
   Everyone can have situational depressions; far fewer have chemical depressions when nothing is wrong in their lives.
   
4. What's wrong? What do you have to be depressed about?
   Nothing, and that's the point. I endure terribly low depressions even when life is quite good.
   
5. Stop whining. Nobody likes to be around someone who is sad/cries/complains all the time
   Which is exactly why I don't want to tell my friends or ask for support. And then it's even harder to get better.
   
6. Lighten up / you need to toughen up
   Thicker skin will not change how I feel inside.
   
7. Get over yourself already / Why is it always about you? / You're just trying to get attention
   There are far less painful ways to get attention, if that's what I wanted. I withdraw and isolate because I don't want attention. And it's about me because this is what's going on with me. This is my reality. Comments like this also contribute to my not wanting to ask for support.
   
8. This again? Didn't we go through this a month/year/whenever ago? / I'm not your therapist
   That's the problem with episodic, cycling depression, the problem with bipolar: it always comes back, no matter what I do. I can find tools to cope, control the worst of it with medication, but it will always be there. Many people are happy to help--once. But for those of us with cycling depression or bipolar once usually isn't enough. I know that I may need extra support as often as 2-4 times a year. And when people ask, this again? it further reduces my willingness to ask for the support I need.
   
9. It's not Jewish to be depressed / It's a mitzvah to be happy
   Believe me, if I could, I would. I'd much rather be happy. But being happy is not one of the 613 mitzvot, and calling on G-d for help from the depths of despair seems to me to be exceptionally Jewish. Besides, where or when--ever--in our history were Jews always happy?
   
10. You owe it to your family/husband/children to ignore this; they need you more than you need to be depressed / You could feel better if you only tried hard enough
    Again, it's not a choice. It's not something I can ignore or put behind me. It's not something I can control any more than someone can ignore their asthma or diabetes or irritable bowel syndrome. It is my reality and I have to work within it. And sometimes that means I have to take care of myself before I can take care of my family.
    
11. I know what you mean / I've been depressed, too
    I don't know how to take this. Lots of people have had situational depression, feeling down because of a trauma, unemployment, death, financial problems, divorce, infertility, terminal diagnosis, war, etc. Far fewer really know what it's like to have a chemical imbalance: major depressive disorder, bipolar disorder. How do I know you really know what I mean? Until I do, I'm more likely to see this as patroizing, even if it's entirely well-intentioned.
    
12. This too, shall pass
    Yes, that's true. And I remind myself that in a few days or weeks or months, provided I don't harm myself, it will eventually get better. But eventually doesn't help me now. And now is when I need help.
    
13. What can I do to help? ** See comments, please. I will be writing more about this.
    This may be the most-asked question and the hardest to answer. If I'm already in a depression, I won't know what you can do. I simply can't think. It's better to find a time when I'm stable and create a written plan for the next depression: this is what you can do, this is how you can help, this is what I need. Maybe it's child care for a few hours or going to the grocery store for me or making some telephone calls or helping me to clean my kitchen or maybe it's just sitting with me while I bawl my eyes out.
    
    I know people who have done training in bikkur cholim, visiting the sick. One of the things they learned is not to ask, what can I do to help? because quite often the sick person doesn't know.
    Instead, offer something you know you can do: run errands, babysit, cook a meal (beware of kashrut issues), help clean, visit, make phone calls, enlist other support, walk the dog, check out books from the library. Think about things you would want help with when you're sick.
    
    Finally, please be understanding. I may be too embarrassed for you to see my house after a week or more of depression where I can't clean. I may not want to impose. When you offer to do something, I often see it as a trade, even if you don't. You'll do this for me and then when you need something, you'll call in the favor. Of course, I would do everything I can for my friends, if I'm able. But I can't guarantee when I'll be able, and I dislike feeling that I owe someone something. So I may say no because I want to avoid the debt. If you offer, and if you mean it, make sure you offer with no strings attached.
    
14. I know your plate is full, but can you help us with this / We could really use your help / I helped you when you were depressed, now it's your turn
    When I'm depressed, I can't. I simply can not. And guilt trips will breed resentment. Besides, I self-guilt myself better than anyone else can. When I'm hypomanic, I will absolutely help, but at a cost, because I tend to overcommit when I'm hypomanic. And my emotional cycles work such that at the height of my hypomania, something insignificant will happen and trigger a crash. Within literally minutes, I can go from laughing extrovert to sobbing negative self-worth. I do my best to hide it. If I'm in public, I find a restroom and ride out the initial crash there. If you know I have a lot going on, please consider not asking me to do something more. Or ask me to do it when I'm in a better emotional state.