Psych Patient, MD

Straddling the border of sanity

New Treatment

If anyone is interested in a new treatment for chronic depression that is currently in review by the FDA, check out this website and sign up for the free newsletter.

http://www.vagusnervestimulator.com/

More on Meds: Intro

We have all heard about "chemical imbalances." Medications work to correct these balances. But because the chemicals in the brain are capable of doing so many different things, it is difficult to target specifically a single process to fix. Hence we get the side effects of medications. For example, many antidepressants work on a chemical called serotonin which effects mood. Serotonin also regulates sleep and sex functions among other things. I've been on medications that took away the suicidal thoughts, but screwed up my sleep patterns and/or killed my sex drive. When those side effects were no longer acceptable to me, I worked with my doctor to change my medication regimen.

Why don't' medications "work?" They do, just not perfectly. In future entries I will address issues with medications, how they work, how side effects occur and ways to deal with them, medical issues that may need to be discussed with a doctor. I will also answer questions as best I can. Just need to add the disclaimer that I am not a practicing physician and any decisions you make regarding your treatment need to be discussed with a licensed mental health clinician.

Guest Contribution

Walking The Straight Line

Aaron C. Peavy 

Rust and sandy tan marbled swirl through shale,
The floating foundation of existence.
Limited boundaries of reality
Cloud supported finger of land and trail.

Look back as upon a moment of life.
Sight of blue-gray billowing nothingness.
Not a sight or sound from the world outside
Even though you just stepped from it’s strife.

Squint your pain blurred eyes to the left and right.
Just the same billowed mass of cloud and fog.
In the space occupied by companion
Emptier void than that of the pitched night.

Forward to future only way to gaze.
Follow with teared eyes the course of the rock.
Imagination vexed by depthless view.
No judgements of distance allowed by haze.

Impossible to retreat to haven.
Once left, sanctuaries form triggered snares.
No use trying to scale either blanked side
Cannot rise minus wings of the raven.

Tread onward in search of life in future.
Unsure of frail trail’s continuance.
Narrows to diminished point, fused with clouds
Promised existence no law of nature.

Ambition for movement coming from faith.
Beings dominion over all mankind.
Power of all life encompassed in one,
May it be god, spirit, demon or wraith.

The hiding point of the running torrent.
Moving at speed equal to your approach.
Never glimpse the future, only life of now
Fog shrouds only with your unthought consent.


Close your eyes tight and now witness the view.
The marbled mesa, light hued sky of spring.
Brightness of future, contentment with world
Picture of such power no mortal drew.

Secret of existence, live while awake.
Let the mind not linger on memories.
Nor continue pondering upon hope
For in this gamble, your self is the stake.

Half a glass of water

There is half a glass of water on the table. Is the glass half empty, or half full? Supposedly, "positive" people say the glass is half full whereas "negative" people say that the glass is half empty.

It is still half a glass of water, no matter how you express it. What purpose does it serve to artificially categorize people based on their expression of speech when, in the end, everyone is correct anyway?

Nature or Nurture

My mother was never formally diagnosed with depression during my lifetime, but on looking back at my childhood, I believe that she probably was depressed. I remember her being tired a lot of the time. She often took naps. My younger sister remembers that, after sending me off to school for kindergarten in the morning, she and my mom went back to bed to sleep instead of starting the day. My mother used to watch my sister and I play together, but never really participated with us. My sister and I did a lot of household chores for Mom. I still remember having to lift my sister and practically throw her into the washing machine in order to get all of the laundry out for hanging to dry. Please don't get me wrong. I am smiling as I remember these things. I love my mother, may she rest in peace. She did the best she could with what she had. I am just saying that one thing I think she had was depression.

After my mother's death, the family, of course, talked a lot about her. My older sisters, who are 8 and 11 years older than me, talked about Mom taking them to the park, playing jumprope with them, and reading books to them when they were little. My younger sister and I agree that Mom was definitely different when we were children.

Mood disorders tend to run in families. Much research is being done to determine the genetic component. But genetics doesn't form the entire person. The environment within which one develops also shapes a person. My younger sister and I both have been diagnosed with mood disorders. Neither of us are married nor do we have children. My older sisters do not have psychiatric diagnoses, and both are married with children.

I do NOT blame my mother for my psychiatric problems. I want that to be perfectly clear. I just thought that it was an interesting observation, the different outcomes between the two sets of girls growing up within the same household with the same parents. One difference between them is the childhood memories that the girls have of their mother.

Hug your kids the next time you see them. Call your mom and tell her you love her. And remember that you are doing the best you can with the tools you have.

Story of my life

I used to write poetry in high school. It helped me to sort out my feelings. Let's give it another try. This is a first draft.

My Life

Running from the past
Avoiding the future
Screaming in a sound-proof cell
No one can hear me

Watching the world go by
from behind a glass wall
Only way to participate
is to punch through and bleed

Denied my wants
Others have more need
Feeling undeserving,
waiting silently, forgotten

"Your turn is coming."
"Work hard, you will achieve."
Delayed gratification
Justice denied

My Apologies

To those of you that are following the thread under Response to diamondsharp, I apologize if my remarks about only one person picking up on my possible suicidality hurt you. I did not mean to imply that nobody cares. I understand that writing anything personal on the Internet, especially anything of this nature, is something most people are not chomping at the bit to do. I wrote that remark to point out how I minimize and cover my symptoms. I am sorry that the remark was not interpreted that way.

I never intended for this blog to become so personal. I had intended to comment on mental health issues in general for the most part. I thought that was a risky enough venture to undertake. I never expected the positive response that I received with my first entry. I was touched by the number of personal stories that were generated by that entry. How could I not reciprocate? But I knew that opening up was going to cost me. I just didn't know how much.

I asked for input, and I got it. I even got what I expected. And I responded exactly as I knew I would, irrationally. I knew that I would be upset, even angry. But I did not expect to completely lose my inner peace. I've had a really rough time these past few days, and that is nobody's fault but my own. I wish that I could respond to stressors in the same way most people do, but I can't. My world is black and white. I don't know what gray is. There is no happy medium with my emotions. I go full out at either extreme.

Maybe I am depressed. Maybe I have a personality disorder. Maybe I am a sociopath and expect everything to be handed to me for nothing. I don't know the answer. My therapist isn't telling me if he knows. I can't expect people who don't know me to know what is wrong with me. I never should have asked the question. It wasn't a fair one. I am very sorry.

Father's Day

A Happy Father's Day to all those who mentor and nurture someone.

My father has had the biggest influence on my life. I didn't realize how big until the following happened.

I was living in Philadelphia working on my Masters degree (yeah, I got one of those, too). One day I was talking about my parents with a med student who I had been dating for about a year or so when he gave me the weirdest look.

"I thought your mother was dead," he said (this was years before my mother's death).

"What gave you THAT idea?" I asked.

"You've never mentioned your mother before. You always talk about your father."

I still can't believe that I dated a guy for a year and never mentioned my mother. But, yeah, I guess there is more of my father in me than there is of my mother.

My father is VERY traditional Chinese. I know that it is a huge disappointment to him that he has no biological son, even though he won't admit it. But his disappointment worked out to my advantage. Despite his traditional upbringing, he was able to raise his daughters to be independent people. He fought for the recognition of women in our formal family clan association. He insisted that each of us girls go to college. He encouraged all of us to take our educations as far as possible. He even let me move out-of-state to continue my education; daughters aren't supposed to leave the household until they get married. (I say "he" let me move out because he had to talk my mother into letting me go.) My parents' peers are not that progressive. My mother once told me of her friends asking about me, wondering why I wasn't married yet and why the heck was I still in school (I was 25 and in medical school at the time). To my parents' peers, education is wasted on a woman. Daughters leave their birth family to marry into other families. Why educate a daughter for someone else's benefit? But my parents have always been behind me in my goals, especially my dad.

We still run into conflict over traditional values. He expects his little girl to come home and visit him, but he always gets this strong-willed, outspoken woman instead whenever I show up. He loves me just the same, though. I may not be his little girl anymore, but he will always be Daddy to me.

Response to diamondsharp

RE: YOU diagnose me

Maybe it wasn't fair of me to ask for opinions on my mental state. All readers know about me is what I publish in this blog. This blog is a public forum. I have learned to behave appropriately in public. It is not appropriate to express depressive thoughts in public.

I cover my feelings with humor. I learned early on that people would rather laugh than listen to me whine. Maybe that's how my love for sarcasm was born. Sarcasm seems to be the only socially acceptable way for me to express myself and still be true to my feelings.

I personally struggle with the question of whether I am diagnosed properly. I voluntarily sought treatment for depression in 1994 and withdrew myself from it shortly thereafter. I went back on medication and was diagnosed with adult ADHD as well as depression in 1996 as part of the academic probation process in medical school. I started psychotherapy in 2000 at the not-too-subtle urging of my residency program. I can argue that I was forced into treatment. On the other hand, I have stayed in treatment since 1996. I cannot focus myself without a stimulant on board. Without antidepressant medication, I cannot push thoughts of suicide out of my head. I feel abandoned whenever my therapist takes vacation, which is rarely by the way. Minor disappointments are the end of the world to me. Any mistake I make proves to me that I do not deserve to live. Layer all that on top of my mother's death in 2002, losing my residency position (and quite possibly my chosen career path as well), and having to once again depend on my father for financial support. Am I clinically depressed or simply reacting to severe life stressors?

More comments to follow. Stay tuned.

Health or Illness?

Check out this article at MayoClinic.com

Mental health: What's normal, what's not
http://www.mayoclinic.com/invoke.cfm?objectid=0D9E914C-486D-425E-A823B1FC0A2EB794

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