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.

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.

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?

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.

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.

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.

Reflections on a year

I am still just so amazed and humbled by those of you who have come to read here. I never honestly thought that a blog about coping with anxiety and depression would be all that interesting but I am grateful you all are here and I am grateful that I can be helpful in whatever way.

I wish I could thank all of you by name, to acknowledge how much I appreciate your visits. This blog has been an enormous help to me, just to say things I can't say anywhere else, to express depression in a way I've never been able to express it before, and to get reality checks from all of you. I pray that the new year will be far happier than this one has been though I realize that even in tragedy and sorrow, this year has had its gifts.

May we all find our gifts and look forward to increased happiness. Shanah tovah.

To sleep, perchance to dream

Life is--do I dare say it?--going well.

I had my first counseling appointment without children. They were both in school. It was strange to not be interrupted every few minutes.

My sleep is continuing to be a problem, but it is improving. The psychiatrist's assistant has had me try both Ambien (worked too well) and Rozerem (didn't work at all) and each time I keep going back to Lunesta. It's taken weeks, but now at 2mg of Lunesta a night, I'm finally sleeping through the night without waking for an hour or more in the middle.

I am told this is common with many of the SSRI antidepressants, that they work well on mood but disrupt sleep, causing some people to sleep much lighter. This is exactly what I found. On the higher (for me) dose of 30mg Prozac I've been on since losing my baby in May, my sleep has gotten worse.

But now with the Lunesta, more than the number of hours a night I'm sleeping, the most wonderful, baruch HaShem, thing has happened: I am dreaming again.

Really interesting dreams, intriguing dreams, fascinating dreams. Not nightmares.

It gives me a reason, finally, to look forward to the darkness of night.

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.

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.

My life in lyrics II

It´s been a long road, getting from there to here.
It´s been a long time, but my time is finally near.
And I can feel the change in the wind right now. Nothing´s in my way.
And they´re not gonna hold me down no more, no they´re not gonna hold me down.

Cause I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got faith to believe. I can do anything.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith, I´ve got faith, faith of the heart.

It´s been a long night. Trying to find my way.
Been through the darkness. Now I finally have my day.
And I will see my dream come alive at last. I will touch the sky.
And they´re not gonna hold me down no more, no they´re not gonna change my mind.

Cause I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got faith to believe. I can do anything.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith, faith of the heart.

I´ve known the wind so cold, and seen the darkest days.
But now the winds I feel, are only winds of change.
I´ve been through the fire and I´ve been through the rain.
But I´ll be fine.

Cause I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got faith to believe. I can do anything.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith.

I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith, I´ve got faith, faith of the heart.

It´s been a long road.

***
Enterprise Main Title
Available on the Broken Bow soundtrack
Lyrics by Diane Warren
Vocal by Russell Watson
Source: http://www.startreksoundtracks.com/lyrics/sts-lyrics-wheremyheart.html

It's Adar; reconciling happiness and depression

I never really thought about this until this year, but how do we reconcile the fun and good-natured wish of, be happy--it's Adar! with the fact that some people have really good reasons for being unable to be happy and are not necessarily in control of whether they are happy or not? When I'm in the midst of a depression, I simply cannot just be happy.

It's everywhere now, on signs and emails and web sites and mailings from the shul. I so want to be happy, whether it's Adar or not, but there's only so much I can do. And I dread walking into shul and being met with a cheery smile and a why aren't you happy? It's Adar! Be happy!

I'm not saying we shouldn't encourage the increase of happiness, or that we should ban the signs and the greetings out of some politically correct concession to those who have every reason to be unhappy. Not at all. At the same time, I'm wondering if we're asking everyone to fake it 'til you make it. Just what do we mean by, be happy--it's Adar!

I just wonder how we reconcile it. Or if we do. And if we don't, why not?

My life in lyrics

Sometimes I think that I could make a video of my life with all the high points (marriage, birth of my children) and low points (like this past month) and I think about what music I'd pick to go with the video.

I do actually have a collection of songs that I use to motivate myself and unfortunately they have not worked so far but that might be changing.

One of the movies I lost myself in late last week was The Devil Wears Prada. One of the songs in the movie stuck in my head and even though I couldn't remember any of the words and didn't know who sang it or anything, it seemed important. I tracked it down tonight and the song is Suddenly I See by K.T. Tunstall. It is not, I found out, on the movie soundtrack.

Then I looked up the lyrics and it seemed terribly appropriate especially because the piece that kept playing over and over in my head was, "Suddenly I see (Suddenly I see) This is what I wanna be." That made me think about how a bad depression kind of gives me a chance to rebuild myself as I come out of it. What do I want to be? I know the hospital would ask the same thing. What am I going to do when I get out? If I went in in the first place.

There's more I want to say and one of the commenters that I've already picked on said something that made me realize I am not nearly as free of the destructive messages I learned from my parents as I thought I was. B'li neder, I will write about that more shortly.

My concentration continues to be not so great and I am still terribly tired. I was concerned it was a side effect of the medication but my husband thinks not and doesn't want me to lower the dosage until I'm fully out of the depression. He is afraid it will come back and I don't blame him. Too many things still terrify me, just thinking about them. But I have started to think about things I'd like to do, which I was not doing last week. I don't have the energy or really the motivation yet but at least I am thinking about them.

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.

Release

In the interests of being completely honest on this blog about what I'm going through, I have to admit that I sort of gave in to the overwhelming urge to cut last night. I'm not proud of my weakness. I thought I could fight it off.

I tried to tell people yesterday about how much I hurt. By late last night I was having panic attacks. Horrible, reality-distorting panic attacks when I thought about the near future. I tried to tell my husband, but admittedly it was 1:00 in the morning and he was tired. I had no one to call.

I deliberately chose something that was sharp enough to hurt but neither sharp enough nor big enough to draw blood. I pressed and dragged it slowly over sensitive skin until the pain made me nauseous. This was not about suicidal ideations. I do not want to die. I simply needed a physical release for the pain ready to burst out of me. That's why I was careful in my choice. It's not ideal. Ideal would be never to have had to do it in the first place. But not doing it would have meant being driven to take handfuls of pills or drive my head through a wall.

I scratched up my arm to save my life, really. I know that is twisted and warped but that is what depression does to me. It was the lesser of two or more evils. Even as I did it I thought about b'tselem Elokim, being created in the image of G-d. I thought about that and felt badly, but I didn't know what else to do. Prayer was not helping last night.

Today it hurts. It's red but there's still no blood. It didn't cut deep enough to even ooze. The pain remains a release today. I don't have to do it again. G-d willing, not ever.

To the hospital???

I didn't want to bore anyone with continuing tales of woe, but the fact is, despite the various things that have happened over the past two weeks or so, the depression that made its severity known here has not gone away. It's questionable whether or not it's gotten worse.

I just saw my counselor today and my husband went with me. Between the two of them, they think this is serious enough that they are of the opinion that I should be hospitalized. I managed to talk them into 48 hours until we make that decision, so I have until Sunday. I really don't want to go. It's been fifteen years since I was last hospitalized for this.

In the past hour I've managed to gather most of my emotions and seal them away. It may not be particularly healthy but it allows me to function for now. Otherwise I'd be terrified of going to the hospital and equally terrified of not getting any help.

I think I will maybe be meeting with my rabbi tomorrow, though I have no idea what I would say. I'm not even sure what I need.

Update (evening): I kept busy this afternoon by cleaning and reading and was able to keep the depression at bay but it keeps all my feelings at bay as a result. It's also tiring; six hours of this and I'm dizzy and stumbling around from exhaustion. I don't really know what that will get me except buy me some time. Please G-d, may tomorrow be better.

Existing

I'm so tired and emotionally numb. My motivation for getting through the day is that Mandy is on tonight. It's silly, my little infatuation. It's not even so much that he's quite handsome, though he is. It's that there's something about his eyes, that I can almost believe he would understand how I feel. I crave that.

My husband has been very tired lately. He's working hard, picking up the slack I leave because I can only do so much right now. I feel guilty that I can't do more. I feel guilty for adding to his burden. I feel guilty for not spending as much time with my children as I could. At the same time, I feel like I have nothing left to give.

I want to sleep all the time. Everything takes such effort. I did get up, get dressed, fed myself and my child. My hair is uncombed and I don't care. I'm wearing the same shirt I did yesterday and I don't care. And then I feel guilty for not caring.

The pharmacy called yesterday. My refill for my medication hasn't been approved yet because they can't get a hold of my doctor. I placed the refill order late last week. Now I'm out. Two nights of missing my meds and this could spiral out of control. My husband called and they said they can give out a few since I'm out, until they can get the refill approval from my doctor.

I don't know why this is so hard. The last time I saw my doctor, I told her how the meds were working and about sometimes needing to go from every other day to every day. She supported that. She didn't need to see me until late 2007 unless something changed. I don't know why my prescription wouldn't extend until then. It's overwhelming to me.

I feel like I'm whining, like just stating how I feel is complaining. I don't want to whine, complain, wallow in negativity. I just want to feel better, get my energy back, get my enjoyment from life back.

I have to be at shul this week. No option. I don't know if I have enough energy to put on my public face, but I'm still scared to cry at shul again. Too much. I just want to go to sleep.

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.

Four more hours

I'm shaking. My hands are trembling and my legs feel weak and it's hard to think. Facing the day seems so huge, so difficult. I've barely slept the past few nights, a few hours here and there, and the anxiety that comes with my depression sometimes reaches the point of being unbearable.

Yesterday my husband worked from home while I somehow made it through the day. I read a lot and thought a lot about my Depression as adversary post, if that would work as well in practice as it seemed to in theory. I still like the theory, but it seems I still need tools to fight the adversary. The perspective itself is not enough.

Today my husband is back at work and offered to come home early to run some errands so I don't have to leave home. I am grateful to him for that. I just need to breathe and calm myself through the next four hours.

I sent email to four friends yesterday. It was a big step. I summarized what was going on. I said this particular depressive episode was probably the worst one in three years, which my husband originally observed. I said I was slowly climbing out but not ready to be social yet. I didn't talk about my diagnosis or get into any more detail other than going through a depression. I didn't ask them for anything. I'm not sure what I would ask for.

One friend who knows me very well replied and was sympathetic. I haven't yet heard from the other three.