1. Be myself.

2. Be less fearful.

3. Be more daring.

4. Be more active.

5. Be slow to speak.

6. Be able to say "no."

7. Be willing to not feel guilty.

8. Be more loving.

9. Be less selfish.

10. Be stern but kind.

11. Be a delegator.

12. Be willing to learn from mistakes.

13. Be a leader.

14. Be organized.

* anti-depressants and related medication

* suicide

* self-injury

* treatment

* support

"Jack of all trades, master of none"

"No one can make you feel inferior without your consent" - Eleanor Roosevelt

"Be nice to everyone; you never know how you'll end up seeing them again" - My cousin Peggy

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Monday, July 24

Moved...

I've had a better experience with typepad as I've used their free trial in the past and am ready to make a move.

Visit my blog at the new address: http://deepintro.typepad.com/depression_introspection/

Please update any feeds you may have. I'll only post here to occasionally link to my new blog.

Friday, July 21

Nerves and New Orleans

I promised myself I wouldn't write entries on the past but I'd already had the following typed up and I can't just let it sit and rot:
I haven’t heard much about it but a device called the vagus nerve stimulator was approved by the FDA in 2005 for “chronic or recurrent treatment-resistant depression and bipolar disorder.” It was previously approved for epilepsy treatment only. The VNS generator is implanted under the skin from the chest to the neck, around the vagus nerve that connects the brain with major organs. VNS is only recommended for people who cannot use medications due to side effects or receive no relief from mental illness.
The New York Times has a stunning piece on Katrina’s latest legacy in New Orleans: unprecedented post-traumatic stress disorder (PTSD), depression and suicide in the city. The article is a grim reminder that while the world has moved past Katrina, New Orleans has not. I’m sure the same could be said for Mississippi, which gets considerably less attention.

Prioritizing tasks

Happiness is not having what you want,
but wanting what you have. - Anonymous

Being the perfectionist that I am, I put more time and effort into this blog than I probably should. (Although you may not see it.) Sitting to my right, I have this folder filled with massive documents about anti-depressants and such that I promised myself I'd look at, no matter what. Doesn't even matter if the subject matter is outdated by a few weeks because I think people deserve to know what's going on.

But I've taken on more for this project than I've failed to realize. And that's what my blog is about. Being introspective enough to see that I'm being way too perfectionistic about this.

I think it's better that I update 3 times a week with what little I have to say than sporadically with hefty posts.

So here I go... tossing anything that is too outdated or that I don't want to really read.

It's better for me to write about things that I can relate to, to give a better and more insightful perspective than something that is so generalized a press release says all there needs to be said. I'm also considering a linkage roundup for Fridays. It might help to me get on track with a schedule.

In one of my favorite books, Time Management from the Inside Out, author Julie Morgenstern advises taskers to "delay, diminish, delegate, delete."

Delay: Some tasks don't need to be done immediately or right away. In fact, Morgenstern points out that when people come to you with a task, it doesn't need to be done immediately; it's just that they remembered at that very moment and decided to tell you. I'm still having troubling deciding which tasks should be delayed because I like to get everything done in one day! (which never happens)

Diminish: This is a tough one for my perfectionistic side. Diminishing tasks basically means cutting corners on projects. Morgenstern asserts that things don't always need to be perfect for each task you do. If you're willing to sacrifice perfection on one project for another you deem more important, that's diminishing a task, which in the end, will save you precious time.

Delegate: I'm also bad at this one too because I have a "for it to get done right, I have to do it myself" mentality. (i.e. I abhor when people move my things around because then I don't know where it's been placed when I'm looking for it; usually the person who moved it to begin with doesn't remember either). Delegation, however, is a great time saver - especially for managers. Delegating is giving something to someone else to do. A good way to figure out if you can delegate a task is to ask yourself, "Can someone else do this?" If the answer is yes, find a way to delegate the task. In the end, even if you have to succumb to your perfectionistic side and clean the task up a bit, it'll still save you time than if you'd done the whole thing yourself.

Delete: There are tasks you want to get to, but you don't NEED to do. Delete those. For example, I have this terrible problem with painful gas buildup in my stomach. I wrote on my "to do" list: Buy Beano. Um, why? It's been on my to-do list for the past 3 weeks to a month. If I haven't bought Beano last month, I probably won't need it this month and therefore, may not need it next month. It needs to go. What I've got (Pepto Bismol) does the trick just fine. There are things you'd like to get to, but you haven't GOTTEN to. Delete the task for now. You can always add it again later.

Small lessons in time managment have helped me with my procrastinating and perfectionistic ways because it helps me prioritize tasks in such a way that staves off panic attacks and mental breakdowns. When you know what you've got to do and you've got a schedule to do it, you don't need to be depressed! (Not about time management anyway.)

Postpartum depression

About 10 to 15 percent of women experience its symptoms after childbirth. For some, it goes away. For others, it gets worse.

Doctors can’t pinpoint an exact cause but they guess it’s

  • stress
  • genetics
  • hormone fluctuations

PPD Stats:

  • Low-income women are at greater risk for PPD
  • Financial stress increases the risk of PPD while decreased access to healthcare lowers the chance of detection
  • PPD is prevalent among Hispanic women on Medicaid Journal of Women’s Health)
  • Half of women who show signs of PPD never seek treatment

While 50-60 percent of new moms get “baby blues” within 2 weeks of a delivery, it can get better on its own. PPD affects 8-15 percent of mothers worldwide and can develop into something serious. It can begin anytime within 6 months after giving birth.

PPD symptoms:

  • loss of interest in hobbies and normal activities
  • frequent crying
  • appetite loss
  • lack of motivation
  • difficulty sleeping
  • potential inability to bond with child
  • possibly harming herself or her child (severe)

PPD treatment:

  • medication
  • counseling
  • both

PPD increased risks:

  • previous PPD
  • depression unrelated to pregnancy
  • severe PMS
  • marriage difficulties
  • lack of support from loved ones
  • stressful events occurring before or after birth
  • women younger than 17
  • single mothers without other adults around
  • divorced women

Thursday, July 20

Bipolar Disorder

I’ve overlooked important pieces of depression. Depression isn’t just what doctors classify as MDD, major depressive disorder. Depression can come in a variety of forms such as seasonal affective disorder (SAD) and bipolar (manic) depression (aka bi-p D).

For many years, especially as a teen, I misclassified myself as bipolar even though I never received an official “bipolar” diagnosis. Here’s what you need to know:

WHAT: “Bipolar disorder, sometimes called manic depression, is characterized by mood swings so severe that a person’s relationships, occupation, and overall ability to function can be severely compromised.”

SYMPTOMS: According to the National Institute of Mental Health, symptoms include: a pendulum swing from euphoria to sadness, depression or anger — but with temperate periods in between. Other signs of bipolar disorder include insomnia or sleeping too much, drastic weight loss or gain, difficulty concentrating, anxiousness, and suicidal thoughts.

TREATMENT
: Bi-p D can be controlled with prescription medications, often lithium, to minimized the emotional swings.

Being a 16-year-old girl in high school, I had emotional swings all the time. It’s a wonder I misdiagnosed myself.

Take a quiz to see if you have bipolar disorder and discuss it with your doctor at your convenience.

Sunday, July 16

SSRIs

Selective Serotonin Reuptake Inhibitors
(from monstersandcritics.com)
  • present fewer side effects than their predecessors
  • less likely to be lethal even in large quantities (important for someone who may be suicidal)
  • the Federal Drug Administration (FDA) wants SSRI dosage minimized to decrease risk of overdosage and close monitoring of younger patients on the drug
  • suicide rates overall have declined since SSRI market introduction
  • side effects ma include insomnia, rashes, headaches, joint and muscle pain, upset stomach, nausea or diarrhea
  • mixed with painkillers, SSRIs can pave the way for stomach or uterine bleeding

In the Hindustan Times, an article ran on a girl who committeed suicide because she had not received the grades she had hoped on a test. One highlight (if you can consider it that) of reading world news is that they'll report local suicides more often than U.S. media. The HT story reminds me that there is no excuse too small or too big for people to commit suicide.

Indian focus recently has been on eliminating suicide scenes from films to prevent copycat cases. In one incident, a mother dragged her four kids out o the train tracks to die with her. Two of them were able to escape and survive before a train pummeled the rest of the family to death.

Ireland is also tackling suicide - they've set a 20 percent reduction target by the year 2016. A published report notes that suicide rates are rising in males younger than 35 and in females under 25. Wisconsin is battling youth suicide, much like Ireland, and hopes to reduce its current rate of one young adult committing suicide per week by 10 percent. No time frame for the reduction has been set.

An anti-seizure drug, Neurontin, is being blamed for nearly 300 suicides nationwide. It is the best-selling anticonvulsant medicine in the U.S. and Pfizer - Neurontin's maker - posted profits of more than $2.6 billion in 2004. The FDA has not pushed to have Neurontin taken off the market, but in 2005, simply ordered a review. The results have never been made public as of today.

A man who killed himself after bieng turned away from the hospital has drawn worldwide attention to the inadequacies of Australia's mental health system. Although I'm sure similar events have occured in the U.S., it likely does not get widespread coverage.

Can depression be cured?

"There may not be many policies that deliver happiness for all,
but there are some that alleviate misery for many." - The Observer

What seems to be an editorial in the UK Observer asserts that government should step in and care for the mentally ill. Why?

  • 70 percent of men in prison suffer from a psychiatric disorder
  • Homeless people also are "similarly swollen" by legions of untreated mentally ill patients
"There is, more widely, a taboo around mental illness and a common presumption that people should be able to heal their own minds with an effort of will, a stiffening of upper lips and a pulling up of socks. If that attitude were applied to cancer patients, it would quickly be condemned as ignorant and callous."

I couldn't have said that better myself.

Symptoms of depression

How to tell if you may be depressed:
  • persistent sadness
  • anxious or empty mood
  • feelings of hopelessness, pessimism
  • feelings of guilt, worthlessness and helplessness
  • loss of interest or pleasure in hobbies
  • difficulty concentrating, remembering or making decisions
  • insomnia or oversleeping
Take this quiz and see if you might be suffering from depression.

An article from the Financial Times (more of an op-ed piece) tackles the sensitive issue of men and mental illness. The author, Robert Teed, wisely writes:

    “[Men] are traditionally more stoical, preferring to take the course of a stiff upper lip or straightforward denial. Sometimes, it is not until a mental illness has manifested itself as a physical one... that men seek medical help...”

Having had a father who suffered from paranoia and schizophrenia - I never learned his real diagnosis but I think that's accurate - I can wholly understand the context of this statement. My father until he was forced on medication denied that he was mentally ill. My mother helped to cover this up, until he was convinced that he heard voices telling him to do things like drive to an unspecified location or wander in the streets for days at a time without telling anyone.

    “In spite of many barriers broken down over the past few decades, mental illness is still shrouded in ignorance and taboo.”

Teed cites that the World Health Organization (WHO) predicts depression will be the second most costly illness (behind heart problems) by 2020.

    “I know from bitter experience just how hard it is... when you have not been yourself for a long time, to know exactly what 'being yourself' is anymore.”

The most common triggers of male depression, according to Teed: the death of a loved one, redundancy (especially in the workplace) and marital problems.

BBC Stat:
  • One woman in 15 and one man in 30 are affected by depression each year and nearly 44 adults in every 1,000 are estimated to have an anxiety disorder.
(Stat Q: How many men, more so than women, probably go undiagnosed?)

Britain's National Institute for Clinical Excellence (NICE) do not recommend anti-depressants for mild depression but prefer Prozac and Seroxat over other anti-d's because they have a lower risk of discontinuation due to side effects.

BBC Stat:
  • In 1997, 6.5 million prescriptions were written for selective serotonin reuptake inhibitor (SSRI) anti-d's. That figure rose to 13.3 million by 2002.
(Stat Q: Are those figures up because more people are depressed, more people are aware of their depression and are willing to take medication or are doctors flippantly prescribing medication? Such a high jump doesn't seem responsible. I think the drug companies simply have a good ad campaign going.)

Doctors consider SSRIs safer than older tricyclic drugs which have a high overdose risk. Nevertheless, any patient on anti-d's must either gradually taper off of anti-d's or brace for possible side effects.

According to the Medicines and Healthcare products Regulatory Authority (MHRA), analysis of data by the Committee on Safety of Medicines (CSM) experts showed "a modest increase in the risk of suicide from SSRIs compared to placebos" in adults. But (!) compared to other anti-depressants, SSRIs posed no additional risk. (As if a modest risk isn't work enough.) The MHRA also recommends closer monitoring of adults ages 18-30 on SSRIs.

Kent Woods, chief executive of the MHRA, insists, "The benefits of SSRIs in adults are still considered to outweigh the risk of adverse drug reactions."

People - especially those with mild depression - need to know that SSRIs aren't a cure and in most cases, aren't even needed. Proper counseling and therapy will aid people with mild to moderate depression.

At the American Diabetes Association conference in Washington, scientists presented findings that people at risk for diabetes may want to stay away from antidepressants. Overweight patients with a high risk for developing diabetes were more likely to develop the disease with anti-d's. While those with type 2 diabetes are more prone to depression after being diagnosed, Dr. Lawrence Fisher of the University of California in San Francisco says that about one in every five or six patients with type 2 diabetes reported symptoms of depression.

And in already reported news, I wanted to reiterate that the anti-d fluoxetine will not help patients with anorexia nervosa maintain their restored body weight or reduce their risk of relapse. Apologies to Nicole Richie and Lindsay Lohan.

Tuesday, July 11

External shakeup

“Fall seven times, stand up eight.” – Japanese proverb

I had my first networking event on Friday and it didn’t go so well. I’m trying to organize a chapter of a national media networking group and the first event (for my chapter) was movies then mingling at a bar about a mile away.

A girl e-mailed me at the last minute to tell me that she wanted to come to the event and bring five people. Sure, I said. “See you then!” Another guy, who lived two hours away, said he couldn’t make the movie but would try to meet at the bar. Sure, I said. He wasn’t definitive in his commitment, but I was worried that he’d drive all that way only to not find me. I called my husband, told him he didn’t have to make an emergency appearance because a girl was bringing five other people with her. Another girl — RSVP girl — had e-mailed me a while ago to tell me she was coming and never wavered from her commitment.

I arrived at the movie theater early and waited. Despite the large amount of people swarming outside, RSVP girl showed up on time and found me. Last-minute girl with five people never showed up. RSVP girl couldn’t go to the bar afterward, which was fine since she'd told me that beforehand. I figured the guy out in the boondocks might show up.

I went to the bar, called my husband to pick me up and sat there all alone for one hour until he showed up.

I’d never felt like such a complete idiot or total fool since I got made fun of in high school. But this time, no one was pointing fingers and laughing at me but myself. I immersed myself in Glamour magazine and an Amaretto Sour. Considering that I’m not much for the bar scene, I felt terrible. Add in the fact that I was tired, came to the event straight from work and was having a bad hair day, everything was that much worse.

All weekend I tried to cheer myself up with pleasant thoughts about the situation: “There can be no success without failure” and “If at first you don’t succeed, try, try again!”

By Sunday night, my cheery demeanor was at its max. I got depressed while working on other projects and finally broke down, sobbing.

I revealed to my husband that despite my positive thinking, I’d felt like an idiot all weekend and all I could do was obsess about how pathetic I looked with one person showing up to the movie and no one else showing up to anything at all.

I’d prepped myself previously by asking other city coordinators if low turnout at the first few events is normal. Most replied with a resounding “yes” and told me to not give up.

But I evaluated the situation and noticed a few mistakes:
  • Identification: I didn’t identify who I was, how people would find me or where I’d be located
  • Contact information: I failed to re-e-mail my cell number to those attending
But I’ve learned from my mistakes and despite my social phobias, I’m planning another event for the end of the month. I don’t consider myself resilient, but after not completely hiding in my bed after something like this, I’m beginning to think otherwise. I’m not accustomed to this positive thinking thing.

If at first I don’t succeed, I must try, try again.

Monday, July 10

Celebrity depression and suicide

First, the suicide because that's pretty straightforward.

According to People, soap star of As The World Turns Benjamin Hendrickson killed himself at his Long Island home during the fourth of July weekend. The Associated Press reports that police found him in his bed with a gunshot to the head. According to People, Hendrickson’s friends told the New York Post that he’d suffered from depression since his mother died of cancer three years ago. Apparently, no one knew just how deep Hendrickson’s depression became. While people are lamenting the loss of a talented actor, I sit here and lament at how no one saw any warning signs. Although I’ve attempted suicide multiple times, it’s not something I take particularly lightly when I attempt it. My fear is that after attempting suicide multiple times, people start to view me as the “boy who cried wolf.” My husband has assured me that he takes me seriously each and every single time — which is a comfort when I’m not depressed. But when that fog of depression hits, I’d do anything to get people to leave me alone in the hopes that I can carry out the task of taking my own life away. Some people call it a “cry for help.” Others have told me that I’m simply seeking “attention.” But things are not always what they appear to be from other people’s perspectives. It’s a shame that Hendrickson was such a good actor that he had to act both on and off screen.

Ashley Judd has recently said that she suffered from severe depression as well. Judd, considered a Hollywood golden girl, shocked many people with her revelation. But like Hendrickson, she too, is a good actress — both on and off the screen. She entered a rehabilitation facility for 47 days to deal with her issues of depression, isolation, co-dependency, and signs of obsessive-compulsive disorder. She explains that her life was constantly in a state of transition as a child (she attended 13 schools in 12 years) and exhibited perfectionistic characteristics to please everyone in her life: grandparents and parents.

"They said, 'No one ever does an intervention on people like you. You look too good. You're too smart and together. But you (and Wynonna) come from the same family, so you come from the same wound.' No one had validated my pain before."
As for her OCD and perfectionistic habits, Judd is using her lessons from therapy to control herself. People reports:
Of curbing her compulsive habit of wiping down plastic surfaces on planes and at hotels, Judd says: "Now I try to remind myself that if I engage in perfectionism, I am abusing myself."

Heart problems to gubernatorial races

The Baltimore Examiner highlights the increasing awareness doctors have about heart patients.

Vital stats:

  • Older white men are most at-risk for suicide
  • Three main factors lead to suicide: health, income and social support
  • Older people who have recently lost a spouse or feel financially unstable are also at increased risk for suicide
  • People over 65 who have health problems and cannot be as active as they once were are at a high risk for suicide
  • People who have had heart surgery are at a higher risk for depression

The Washington Times ran a story on gubernatorial candidate Doug Duncan, who dropped out of the Maryland race due to depression. Duncan cites a family history of fighting the disease. This serves as a prime example for me — to cut back when doing too much. To be honest, I can’t say I would have done the same thing. I probably would have run myself ragged before bowing out gracefully. I should know: I do it much too often. This article just reminds me that I need to learn my limits — external and self-imposed.

I found this
college piece from Brigham Young University quite interesting. Writer Elizabeth Adkins cites depression.com’s statistic that “6 percent of adults encounter depression in any given year.”

“This is a mind-body-spirit plan. You can’t get better without working on all three.” – Brant Slade, bishop of the NYU 117th Ward

This is where I’d butt heads with atheists — I believe that taking care of the spirit nurtures the physical and mental health of a person. Pick your spiritual remedy: being “one” with nature, worshipping a higher power or getting in touch with your inner self — it all adds up to equal a better well-being.

“Some people think holistic is quackery. It depends on your beliefs. ” – Dr. Lorraine Davis, psychiatrist at the BYU Health Center

This final quote is certainly worth a mention:

“Just because something is natural does not mean it is safe.” – Depression.com

I do prefer herbal and supplemental treatments but natural treatments do have the potential to conflict with prescription medication. Tell a doctor if you are taking natural supplements in conjunction with prescription medication or before beginning prescription medication. If something is working, let your doctor know as well — it’s possible it might work for someone else.

The American Journal of Psychiatry reports that omega-3 fatty acids can help kids with depression. Pediatric depression is something I have little knowledge about. How is a child determined to be clinically depressed? How young is too young? (Reuters)

Sunday, July 9

Contentment

"I'm alive, so I should be content. Then tell me why the hell my whole world is bent?"
Atmosphere: "A Girl Named Hope"

Sometimes, the best ideas are stolen ideas. But used ideas nevertheless.

Friday, July 7

Faith in God's Secret Purpose

I receive a daily devotional from Elisabeth Elliot, a famous missionary whose husband, Jim, died while trying to minister to a tribe in South America. Sometimes, I receive nuggets of wisdom too good to glance over and must share. Here's one.

God's Secret Purpose
Whatever the enemy of our souls can do to instill doubt about the real purpose of the Father of our souls, he will certainly try to do. "Hath God said?" was his question to Eve, and she trusted him, the enemy, and doubted God. Each time the suspicion arises that God is really "out to get us," that He is bent on making us miserable or thwarting any good we might seek, we are calling Him a liar. His secret purpose has been revealed to us, and it is to bring us finally, not to ruin, but to glory. That is precisely what the Bible tells us: "His secret purpose framed from the very beginning [is] to bring us to our full glory" (1 Cor 2:7 NEB).

In my mind, I'm always wondering whether what I'm doing is right for me, but thoughts like the one above remind me that I often need to "let go and let God" take care of my anxieties and worries. Burdening myself with so much only exacerbates my depression.

Thursday, July 6

Sitting on the dock of the bay

My depression has been at bay. A new job with no stress, a marriage to a wonderful man and time to myself have kept me content for the most part. My obsession with New York is still an issue, but mainly for the the magazine industry that I'd like to get into rather than the place itself. I've been thinking about my "big picture goals" as Julie Morgenstern puts it and one of them is to begin my own Christian magazine for single and career women. Therefore, in looking at ways to achieve my goal, really, I don't need to work at a major magazine in NY (although, I'd love to). There are three major magazines in the Philadelphia area that I can work with and I'd like to do whatever I can to pursue one of them. I'm learning to modify my goals to make them work for my location and my marriage. Living in New York is no longer realistic and I need to let go of that dream - mainly because my husband hates New York and all things mass transit. But it is realistic for me to consider living in a suburban area with access to New York City: my husband will be content in the suburbs and I'd be more than happy to work in my favorite city in the world. Modifying my goals is something I will consistently need to do, especially when I have kids. (!!!)

We have found a new apartment about two minutes from the train station and 10 minutes from the hubby's job. It's quite convenient. The location saves both of us gas, parking fees, sleep and all sorts of other assorted things. It's a bit pricey but well worth it when we think of why we made this move. We spend a lot of time together now - just enough to satisfy the both of us - are able to do the things that we want to do and have a life we enjoy. I can honestly say that I enjoy my life now. Things don't always work out the way I want and sure I get sad about things, but I haven't been depressed in some time. But external circumstances are working in my favor and I tend to perk up when external circumstances are status quo.

I'm also attempting to overcome fear. I'm trying to take risks - as small as picking up the phone and calling for an appointment with a doctor I've never seen. I'm trying to organize a group in the Philadelphia area of young media professionals. The main chapter is in NY (of course) but there are small chapters around the country and I'm spearheading Philly's! I've prepared myself for major turnover since I'm so close to NY but I'll never know if it will work if I don't try. (My lame attempt at social networking.)

I'm hoping to revamp my blog's layout. I don't know many blogspot pages with three-column layouts but that's what I'll shoot for. In the meantime, I've updated the "Resources" links.
Commentary on depression-related news to come soon...

P.S. The Madonna concert at Madison Square Garden last week was simply excellent. I enjoyed myself despite walking through torrential downpours to get there.