Archive for March, 2011

March 31, 2011

march-ing on (just barely)

I do a double-take at my phone screen as I see what day it is.  March 31. One more day til April. I have no idea how in a world I even got to the end of March, because I certainly haven’t finished all the work I should have by this point in the year. Hadn’t I noticed that all the cherry blossoms are in bloom? Shouldn’t I have felt the nudge to pick up the pace when I started seeing all the Easter merchandise in stores? It’s like everything has moved on around me except for me. A half-written paper, the partly read books…I’m dragging my feet with everything that I do. And not just with these tasks, it’s like my whole body’s going in slow motion. Everything around me is moving so fast, and I can’t grab onto a thing, that is, if there’s anything at all to grab onto. I try to get myself to “just get it done,” but I fall further behind. It’s like I’m watching this whole year slip out of my hands, and I don’t know how to stop it.

I am so disappointed in myself for not having had a productive beginning to this year and for not moving along in a timely manner, like the seasons, for instance.  In fact, I’m angry. The frustration is just mounting because I don’t know if I’m just being lazy or if I need to address the issue with my psychiatrist. Maybe I’m just angry at myself because I’m trying to blame it on the illness when I’m well aware that I just have not performed up to some sort of a standard. Really, I’m mad.

While all this anger is simmering, I do think about how the weather has been during this so-called Spring. I’ve been having to wear a heavy coat every other day, while the rest of the days have been unseasonably warm.  This roller-coaster of a weather has been just that: a roller-coaster ride. I don’t think it would bode well for anyone’s well-being to have such  topsy-turvy weather. So, I guess I need to be a little bit easier on myself, because I shouldn’t expect myself to feel stable when the surrounding itself keeps switching around.

But still, I need to look at the time and realize that the time’s a-ticking, and it’s time to get going.

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March 29, 2011

the suicide gene

There’s a new study out on the journal Molecular Psychiatry that studied thousands of people with bipolar disorder, and found that genetic factors may influence the decision to attempt suicide. Scientists from Johns Hopkins have identified that  a small region on chromosome 2 is associated with increased risk for attempted suicide. Interestingly, the protein associated with this region is also thought to influence the same biological pathway as that of lithium (Read the whole story on Medical News Today).

This is definitely good news for suicide research since this could lead to different and better suicide prevention efforts or take drug development on a new path. But on a personal level, having come from a family tree that does include a suicide attempt makes me wonder if I am still vulnerable to keep making more suicide attempts. I’ve already tried a few times and have certainly done enough thinking about it. Is it ever going to end, or am I genetically bound to the path of completing a suicide one of these days? I realize the scientists are talking only about factors that influence the decision and not a definitive correlation, but I do worry if what I do for treatment, e.g. ECT, therapy, medication, is never really enough to change some series of action that may already be ingrained in my genes. Also, we’ve been told that there’s a genetic link in passing down mental health issues like depression. Because I’ve dealt with depression and also suicidal thoughts, does this mean that, should I choose to have children, I would be making my offspring susceptible not just mental illness, but also to suicidality? I’m not sure I could watch another person(s) suffer through that pain, and also know that I knowingly passed down that particular molecular combination to his/her blood.

Overall, this finding is a really good one, but it’s one that will keep me thinking when my next suicidal thought is coming. This worry never ceases to stop.

 

Side note: in searching stuff for this post, I found a PDF document from the Risk Management Foundation at Harvard of Guidelines for Identification, Assessment, and Treatment Planning for Suicidality.

March 26, 2011

Everything has a story

For the last week or two, I’ve been having trouble writing, whether it is for an assignment or for this journal. This blog post could be about anything, and I’m still having issues getting myself to write something. So, when I was in West Elm this weekend, I saw this big display and thought that I needed to take a picture. As much as I could write something about this giant visual, I thought I’d just leave it be, and enjoy it as a reminder: I have a story, too.

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March 25, 2011

Can books make you more mentally ill?

For my class on social inequality, I got to focus on a certain topic regarding inequality. Naturally, I picked mental health. Since I have two book reviews due, I have been trying to get through reading two particular books, titled “The Protest Psychosis: How Schizophrenia became a black disease” and “Mental Health and Inequality.” In addition to those, I have several books scattered around me that have mental illness in the title (they’re being used for research for my thesis). My mother saw the books and cautioned me to stop reading so many books about mental illness all the time, because they can lead to the reader identifying so closely with the book’s subject that one can think that s/he is more ill than one really is.

I understand what my mom’s trying to say, in that I could so come to identify with characters like Esther in “The Bell Jar” or Suzanna in “Girl, Interrupted” that I might think that my life is more like what they portray them to be. But is it such an activity detriment to my well being to be reading books that are about mental illness, most of which are filled with a bunch of stats and research?

Well, Mom can give me advice about what to read, but the reality is that I have no choice but to read a bunch of these ‘crazy’ books.

March 22, 2011

digging ditches

My mom brought over some cake from Japan to be taken to my psychiatrist, Dr. A., so yesterday morning, I figured I’d just head on over to her office to drop it off, even though I didn’t have a scheduled appointment with her. I was planning to hand it to her receptionist to give to Dr. A. later, but I happened to catch her in between appointments. She quickly ushered me to her office just to check in with me, telling me that she was planning to call me to see if I was doing okay. After all, I hadn’t seen her since November. I smiled, told her I was fine, and that I’ll come see for an appointment in two weeks.

It’s true that I do have an appointment lined up with her, but I’m not sure if it’s really true that I feel fine. It’s not like things are falling apart, but I just feel like something is off kilter. I’ve been feeling this way before the ECT, and not much has changed even after the ECT. Today, I met with my therapist, to whom I briefly mentioned that I’m not feeling right. I passed it off as probably stemming from my inconsistent med schedule as of late, but honestly, I don’t know what’s causing this rut.  Maybe it’s from the stress of having Mom around. Maybe I’m just having a bad week and it shouldn’t concern me this much. But having depression/bipolar disorder scares you into thinking that maybe you’re once again stuck in a hole that you might not be able to dig out of easily. Regardless of what’s causing this dip, I really just need to get to feeling better. I’m already behind on turning in a midterm exam for my stats class; I can’t get far behind on other tasks at hand……..and I also need to get back to writing something of substance for this journal.

March 20, 2011

I get it. I’m fat.

There are several things I expect will come out of my mother’s mouth when she’s staying with me here at my place. One, she will most certainly tell me that cleanliness of the home leads to better management of my illness. And two, she will make sure to tell me that I need to lose weight. Mom brought up how my place needed to be cleaned better within a day of her staying, but for some reason, my weight wasn’t the first thing she commented on when she saw me. After a day or two without any mention of my figure, I almost, almost wondered if she’s decided to stop making those remarks. Then, it came. She said ever so bluntly, “You’re too fat.”

I know she means well, and that she says it for my own well being. It is very true that in order to avoid illnesses like metabolic syndrome or diabetes, I need to trim down a bit. But really, shouldn’t I have realized this truth by now, and don’t necessarily need someone else to point it out, repeatedly? Part of me does agree that I need to be nudged to get into some sort of a routine to shed some pounds, but I think it’s almost odd (or perhaps inappropriate) to say to me that I haven’t been listening to what I’ve been told to do, as if I’m five years old.

Yes, I’ve gained 20 pounds in the last two years, and there are a lot of clothes in my closet that needs me to go back to my old weight so that I can wear them again. I could burst out in tears over getting told over and over again how fat I am, but at this point, all I can say to my mother right now is “thanks for your concern.”

March 19, 2011

Using texting 2 care 4 ur depression

There’s a study that’s been e-published in the Journal of General Internal Medicine that looked at a trial of using text messaging to provide aftercare to mental-health patients. After five months, compared to the half of the patients randomly assigned to receive usual care, the half who had three online care management contacts with a trained psychiatric nurse were significantly more likely to feel less depressed, take their antidepressant medication as prescribed, and be “very satisfied” with their treatment for depression. (Read the entire article on Medical News Today).

I think it makes a lot of sense to use text messaging to keep in contact with patients who really could use any sort of human contact, like a text message. As the lead author mentions in the new article, texting doesn’t have a hassle of having to play phone tag when a call is being placed to the patient.

March 18, 2011

a good time to stop?

When Dr. F. mentioned yesterday about the eventual end to my having ECT, I was a little surprised. I had become resigned to going through the treatment for a long time to come, so it was a bit of a shock to me to hear that he doesn’t foresee this to be a long-term thing. Sure, I’m glad to hear that comment, but to be honest, I’m a little scared to stop it all together. I still remember when I started becoming depressed again within a few months after my first go-around with ECT. I personally would rather keep having ECT every few months or so rather than stop it and then deal with having to start it up again. That would probably require another thorough physical, a psychiatric evaluation and maybe even several ECTs all within a few weeks’ time before getting back on a maintenance schedule of once-a-month or later.

I just can’t tell exactly what’s working for me—is it the drugs, the therapy, or the ECT? Can any of the above be cut without compromising my health?

March 17, 2011

ECT #37 (my 22nd maintenance treatment)

This morning was another day for ECT. Since my mother is in town, she took me to the hospital. I really can’t recall much of what went on today except that the staff all came up to ask me if my family was okay from the earthquake and tsunami in Japan. When Dr. F, my ECT psychiatrist, came by, I think he did mention something about the eventual end to having ECT. Of course, it’s not quite over that soon, but at least he said something about it. He did kind of get on me about my not having seen my regular psychiatrist in months, because I had told him that I hadn’t been feeling all that up in the last week or so. He was reluctant to schedule the next one for eight weeks later instead of six weeks, but I told him I really didn’t want it any earlier. Otherwise, the anesthesiologist injected me with some anesthesia, and then I was awake and done. Not too much to recount today.

March 14, 2011

the resolve of the Japanese people

My friend had texted me asking if my family was okay. I hadn’t checked the news that morning yet, so I immediately turned on the television. I stood frozen. Despite my little knowledge of Japanese geography, I did realize almost immediately that the area that was hit was not close to where my parents live. But I hadn’t heard from them, so I called. The busy signal rang for next several calls I placed. My parents finally got through, what was probably a barrage of calls trying to get through to/from Japan, a few hours later. While they are not anywhere near the epicenter, they still felt the aftershock for minutes.

My parents love the United States, even though they’ve moved back to Japan. And I love America, too. I mean, I grew up most of my life in this country. But yesterday, I saw that my father posted something on his blog about the earthquake. In the words that he used, it was clear how much love he had for Japan, and I realized, too, the love I hold for the land where I hold my citizenship. Here, we use the phrase, “the resolve of the American people” as if it is unique to this country, but my father talked about “the resolve of the Japanese people.” I sensed a feeling of call for solidarity in my father’s words that reminded me of the words I heard after our 9/11. And I thought about how patriotism is not simply an American concept. Japanese people may not be wearing their country’s colors to show their patriotism, but as I sit and watch the news of the faces of my countrymen, I think that their quiet expressions capture their immense resolve.

 

 

March 10, 2011

The Psycho-meter: is it offensive?

Huffington Post has an article titled “This Week in Crazy,” featuring a “psycho-meter.” What do you think? Is this just funny, or is it offensive?

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March 10, 2011

poetry in motion

I was sorting through some stuff in a box when I came across a piece of paper with a quote written on it. It read:

Ring the bells that still can ring
Forget your perfect offering
There is a crack in everything
That’s how the light gets in.

It’s actually part of a song lyric from “Anthem,” by Leonard Cohen. I don’t really know the song or the singer, but I just really like this quote. I think the quote captures whatever it is that I want to say right now, so I’ll let it be.

March 8, 2011

taking care of self, starting with the lashes

I was cleaning out my closet today when I came across a little Kiehl’s bag tucked way behind a a pair of some shoes. And lo and behold, there’s product in the bag! I found a totally unused yummy, black-raspberry lip gloss and a stick of  black mascara. They must have sat in my closet for a long time since I really don’t remember having bought those items in the last few months. Looking at this new stick of mascara, it dawned on me that I hadn’t worn any mascara this year. Have I not gone out to any place that warrants putting a little mascara on?

I think that, in general, I’ve been kind of bad at taking care of my physical self, especially as of recent. My nails are all chewed up and stubby, and I’ve really put on a lot of weight. My hair’s been needing a haircut for a while, and I’ve been wearing the same jeans all the time as if I didn’t own anything else.  I’m not saying all of this for vanity sake, but I really think there is some value in taking care of your physical self—–because it, too, makes up part of the whole being. Giving yourself time to put on some nail polish isn’t a waste of time, but it just means I actually spent time on myself, me. And if taking a few minutes to apply a coat of paint gives me a little boost, why not do it?  Sure, my putting on some mascara isn’t going to make me feel oh, so much better, but it signals that I did spend some time taking care of me (and my lashes).

Well, now that it seems I own some mascara (and nice mineral mascara from Kiehl’s, for that matter), maybe I will put some of that on, along with pants not made out of denim, and face the rest of the world tomorrow……even if that really just means “Go to Home Depot and exchange the shower set.”

Oh, and Happy International Women’s Day!

March 7, 2011

bursting the bubble

It’s technically spring break for me, but that distinction doesn’t really matter once you’ve been out of school and have other things going on in life aside from school. Even if that’s the case, it is still nice to get a little breather. So, what have I done with my day today?  Nothing. I had grand plans to get a whole bunch of things done this week, but thus far, the plan isn’t working out too well. I guess I still have the rest of the week to achieve my goals.

I’m once again sitting in one of the single leather couches at a Starbucks nearby my house. What I should be doing instead is be at home and cleaning every inch of my house.  My mother is coming in from Japan next week and is planning to stay for several weeks, and my place is currently not suited for habitation. I’m glad to have her come over but I’m a little nervous about having her around. One thing I meant to take care of by the end of last week was my periodical appointment to have ECT. I was supposed to get ECT last Thursday, but due to my sister’s schedule, I had to move it to next Thursday, which means my mother will be around to have to take me to the hospital that day. Why am I so nervous about having my mom take me to this appointment? I mean, she’s the one that took me to all 15 of my initial treatments.If anything, I should be most comforted by having her around on those days. But I’m not.

Currently, I have ECT only once every six weeks or so. When I do have them, I don’t really make a mention about it to my parents. So, when my mother comes next week and have to take me to get this procedure, it’s kind of like my fantasy bubble of being normal is broken. I once again go back to be seen in their eyes as a sick person…at least, that seems to be how I see myself. I don’t actually know what my parents think about my still having ECT, but in my world, not having to discuss the ECT with them somehow protects me from having to deal with the fact that I don’t really feel comfortable with myself when having this treatment. And it’s not just the ECT I don’t discuss. I hide all my pills when my parents are around and take them in hiding, as if I’m taking illicit drugs. It’s not like they don’t know that I take medication for bipolar disorder, but maybe a part of me wishes I wasn’t dealing with any of this—not just the treatments, but the illness itself.

It was in the news today that the United States has the highest percentage of diagnosed bipolars in the eleven nations that it studied.  According to this study by the NIMH, Japan has a surprisingly low bipolar rate. Reading this study did make me wonder, had I stayed in Japan, would I have been diagnosed as bipolar, even given showing the exact symptomatology?

March 5, 2011

Are psychiatrists becoming like ‘candy’ dispensers?

There’s a really interesting article in the New York Times today, titled: “Talk doesn’t pay, so psychiatry turns to drug therapy,” written by Gardiner Harris. It’s basically about how the low insurance reimbursement rate for talk therapy has led to many psychiatrists opting simply to treat each patient by prescribing them pills. Here’s an excerpt:

Medicine is rapidly changing in the United States from a cottage industry to one dominated by large hospital groups and corporations, but the new efficiencies can be accompanied by a telling loss of intimacy between doctors and patients. And no specialty has suffered this loss more profoundly than psychiatry.

Trained as a traditional psychiatrist at Michael Reese Hospital, a sprawling Chicago medical center that has since closed, Dr. Levin, 68, first established a private practice in 1972, when talk therapy was in its heyday.

Then, like many psychiatrists, he treated 50 to 60 patients in once- or twice-weekly talk-therapy sessions of 45 minutes each. Now, like many of his peers, he treats 1,200 people in mostly 15-minute visits for prescription adjustments that are sometimes months apart. Then, he knew his patients’ inner lives better than he knew his wife’s; now, he often cannot remember their names. Then, his goal was to help his patients become happy and fulfilled; now, it is just to keep them functional.

The whole article really shines a  light on a quandary that the psychiatric discipline is in.

 

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