Lost

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

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

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

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

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

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

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

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

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

Playing with fire

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Seeing the new doctor

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

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

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

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

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

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

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

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

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

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

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

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

Limbo

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

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

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

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

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

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

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

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

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

I (day)dream of sleep.

One step forward but how many back?

I am not doing so well today.

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

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

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

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

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

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

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

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

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

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

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

Seeking

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

When three out of four IS bad

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Haveil Havalim at YID With LID

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

Musaf as therapy

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

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

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

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

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

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

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

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

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

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

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

Sorry this seat is taken

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No.

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

I don't know how to do that.

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

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.

What if you gave a party and nobody came?

Rabbi Without a Cause has a post up about birthday parties and I have not been able to stop thinking about my experiences with them.

I have already had my birthday for 2007. That narrows it down, doesn't it?

My next birthday is a big one for me. I would love to have a party. A big party. Maybe even a surprise party. But I am really, really scared about that.

Growing up, there was not a single birthday I remember--and I have a very good memory--that wasn't upstaged by a sibling. Usually a male sibling, for whatever that's worth. Extended family would come and ask me about school or whatever was new in my life, and I always had something going on that I was very excited about, and they'd be all ears until any of said siblings walked in the room. You could see all eyes turn to said sibling and I would be forgotten. Not for just a few seconds or minutes. For the whole rest of the evening. And it was my birthday party.

My sixteenth birthday I was certain everyone was planning a suprise party. None of my friends at school said anything and every previous year they had giftwrapped my locker door. This year nothing, so I was sure something was afoot. Some previous years my mom would offer to make me a special breakfast on my birthday. This year she'd stayed up late and slept in. My friends and I usually hung out for a while after school. This year they all had to go home right away.

I went home laughing with joy that I'd figured it out and when I would get home all my friends and family would be there and it would be a dream come true.

I got home and silence. My mom was at the grocery store. Siblings were at their various other commitments. I waited. And waited.

My father came home from work. My mom asked what I wanted for my birthday dinner.

There was no party. The surprise was on me; when I asked my school friends the next day, they had all forgotten it was my birthday.

As an adult I have tried a few times to host a party. Free food, free cake, no gifts expected, a fun time for all. One year I invited everyone I knew at the time, sending out a couple dozen invitations. No one called to RSVP. No one showed up.

So I am wary about having another party, or asking for one. Because with my wacky brain chemistry the way it already is, this is the sort of repeated experience that fuels the belief that no one cares.

To my husband, a birthday party is just a birthday party, no big deal. To me it is much, much more than that.

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.

The rabbi, the gabbai, and sobbing in the bathroom

The last time I wrote about seeing my rabbi, it was October. We met again ten days later. And then again after a week, and when that meeting was unexpectedly cut short, three days after that.

So much happened in those brief 45-minute sessions that I am still not certain I can put words to it all. I think in a lot of ways we both dropped our shields. A bit.

Let me start at the beginning.

In October, I had an agenda when I met with him. I wanted him on my "team," someone to talk to about all those Jewish questions my Christian counselor is intrigued by but can't answer, someone to help me navigate the emotional land mines that come with the interaction and interdependence of community through shul. My plan was to keep to the present, set aside more than a dozen years of shul-related (though not always--or even often--rabbi-related) hurts, and try to rebuild my trust in him.

When we arranged for the second meeting, he told me to come just to "talk about this" some more. It wasn't the time or place for questions, so I began our second meeting by asking, which "this" are we supposed to be talking about?

"This" was re-entry into shul. Why, I asked. Why does there need to be re-entry? Why can't we pick up where we left off? Why can't we pretend the last few months--or in my case, maybe the last year--haven't happened?

Yet I'd answered my own question just the Shabbos before, when I went to help another woman and we got our signals crossed and I thought I'd done something horrible and as much as I tried to stop it, I wound up sobbing in the restroom again, silencing my cries every time a woman came in, so she'd never know.

I did talk to her that Shabbos and we cleared everything up and neither of us had done anything horrible. I related the story to my rabbi at that second meeting, feeling as though I was admitting to some unforgivable sin when I told him about seeking refuge--not for the first time--in the restroom.

In return, he told me that he'd had a run-in with the gabbai at about the same time that day, wanting to get across to the gabbai that those who were coming up for honors during the bar mitzvah needed better cues on what to do when. But wanting brevity over verbiage, what came out was "work with me, here." The gabbai shot something back and it was apparently rather tense for a while until they worked it out after services, and now he says they're best friends again (I don't take that literally).

But the point he said he wanted to make with this story was that we all get our signals mixed up sometimes. It was the heightened emotional state I was already in, being back in shul after being away so long, that tipped the scales toward my needing the bathroom refuge.

On top of which, he added, my self-censure about even being heard crying in the bathroom only increased the stress and made it that much harder to find relief. Instead, he wanted me to find someone. I told him about my (short) list of safe people, people who know what's going on with me, who know about the depression, the anxiety. He was glad to hear I had such a list, and then he told me to add him to it.

I wanted to cry right there. On the one hand, I was so relieved and grateful that he would say that, and on the other I didn't think I could do it, to come find him when I was moments away from completely losing it and bawling and tearing my hair out in the bathroom. Because I keep coming up against this same wall:

He. Has. More. Important. Things. To. Do.

In my more rational moments, I realize this is a self-esteem issue. I also realize this is a very deep issue because I have pulled out more than a dozen hairs as I am writing this and it started only three paragraphs ago.

My counselor has suggested that I try on a different perspective. What would I tell a friend who was about to go sob in the bathroom? Or what if I was the rabbi--would I want this person to come tell me?

I can argue against my telling faster than I can argue for it:

1. It's not his job
2. I already have a counselor
3. There are at least 1-200 other people here who want his attention
4. They might have bigger problems than I do
5. I cannot--will not--be seen as too needy
6. It's not something he can fix, anyway
7. I'm not always certain I'm worth it

And with that, the bathroom refuge is inevitable.

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.

At least life isn't boring

I don't know why I don't want to write. I am home sick today, my children taken care of, sitting in bed with my computer. For hours my mind has been going over and over the events of the past few months. I want to share but the thought of writing it all down leaves me exhausted.

I think I will have to break this down into different topics. It is overwhelming otherwise. I want to share about

• my several recent meetings with my rabbi
• follow-up to the baby party I helped plan post-miscarriage
• attending a Jewish mental health conference
• treatment update and losing a provider
• my new anti-anxiety kit
• reintegration at shul
• fears about repeating last winter
• the struggle for sleep and what to do about dream interpretation (aka Where is Yosef When You Need Him?)
• safe places, safe people, and using my safety plan for the first time in public
• psychology, introspection and Shabbat Musaf

For now some more tea, a nap, and I hope to be back shortly to begin.

Reaching out to heal

There is much to tell but today I am very tired, so I will only begin.

I saw my rabbi last week, thankfully. I wanted to be strong and in control but even on the way to meet him I was in tears. This recent downturn since the end of September has been hard though the increase in meds helps and I'm sleeping better and I've been through much, much harder. But it has kept me away from shul. Lately it has brought up too much pain, too much remembering of how it feels to be Unseen and not valued.

I know that my perspective is skewed at the moment, that the painful events feel closer and more painful than they do when I'm feeling strong and happy. I even said as much to him.

My rabbi said two things that really stuck with me. One was that he would do everything he could to prevent and help heal such painful experiences related to the shul, short of embarrassing me. I am glad and relieved that he wants to make this about the shul, not about me. I know that I am not the only one in the congregation battling depression and it would be grossly unfair for me to receive validation while others continue to remain Unseen.

The other was that he wants me to help him--and the shul by extension--learn how to help me and others like me. Already I had an idea. It is not unusual to train congregants on the mitzvah of bikkur cholim, visiting the sick. In my area it has been focused on hospital and nursing home visits. But why could we not expand it a bit to include people we see in shul, at work, friends, who are in pain?

The thing I hear most often here on the blog and in person conversations is that people don't know what to say, how to act, so they say and do nothing.

Why can we not teach people a range of things to say and do? The question or offer that helps me might not help another, but if there is a larger range to choose from, adaptable to the situation and the people involved, it would be a starting point. It would open a door that has remained closed for too long.

As if on some divine cue, I received today an invitation to join a committee at shul to study and make recommendations on inclusion. While inclusion is often used in terms of physical, developmental and learning disabilities, there is no reason it should not also include brain disorders such as depression, anxiety, bipolar, and others. Ours is often a hidden illness, but
by nature, these disorders make it hard--even impossible--for people going through an episode to reach out, get involved, or even to come to shul.

Shul should be a place that people can bring their confusion and fear and pain, a place that should be free of stigma for what we know is a biological medical brain illness, a place where those who are able can be there for those who are not, knowing that which end of the need spectrum we're on can change.

I went to another Jewish mental health conference, too. I wrote about last year's conference and I'm relieved that this year's was much, much better. I want to write more about that, too, but today I must take it slow and save my energy.

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.