Tag / trust

by krubesch

Real Talk

“Write hard and clear about what hurts.”
Ernest Hemingway

Due to the recent celebrity suicides, I have been thinking a lot about what my depression looks like on the outside and how people I am close to would know when I am struggling to keep my footing in this world. I know I have written about my depression and suicidal thoughts before (as this blog is mostly written about these subjects), but each time I put my most vulnerable thoughts on paper and create a permanent record letting everyone know my struggles- it feels like coming out all over again. Let’s be honest, it’s pretty taboo to admit that your brain is fucked up and that is one of the reasons why it’s important to talk about it. A few years ago I had to take a FMLA leave from a job that was very stressful and I was struggling with increased PTSD symptoms along with high blood pressure. I remember being completely distraught when my FMLA paperwork was sent to the wrong fax and a coworker looked through my paperwork and started rumors that I was having a nervous breakdown. I was so ashamed that I had to take a break from work and that my PTSD was a part of the reason why I had to. It felt taboo to show any weakness, especially since I was in management and I was terrified of what people thought of me.

People resort to suicide, or at least I struggle with suicidal thoughts when I am overwhelmed with my feelings and emotions along with the shame and stigma of having these thoughts in the first place. The silence of keeping these thoughts to myself is often deafening and although all of this is embarrassing to admit, we need to talk about it or we will keep losing people we care about. I cannot speak for Anthony Bourdain or Kate Spade, but I can speak for myself.

Today was one of the hardest days I have had in awhile. I had a particularly difficult and draining therapy session last night and being in constant physical pain is starting to wear on me. I feel like I have been hit by a bus, which is how I usually feel the day after I’ve done a lot of work in therapy. I pressed the snooze button for over an hour and fell asleep in the shower. I contemplated staying home from work, but knew that might make things worse. On my drive into work I thought about what my outward signs of depression look like and I came up with this list:

  • I completely stop wearing makeup because I usually end up crying on the days I actually wear mascara and I look like a racoon (it’s harder to hide that I’ve been crying). I also sleep too late in order to have time to put it on.
  • I stop exercising and want to spend most of my time watching tv or laying in bed.
  • I push people away and cancel plans- even though I desperately want to connect.
  • I become forgetful and have a hard time paying attention.
  • My posture is different- it feels like I am moving through my day with a heavy, wet blanket on my shoulders. Every daily task feels difficult.
  • I am way more quiet than normal (crazy, I know!).
  • I have sleepless nights or I sleep for over 10 hours at a time.
  • I avoid eye contact and shut down
  • I use humor in order to avoid serious conversations or in a self deprecating way before anyone else can criticize me

Words I have heard to describe people who have committed or attempted suicide are lazy and selfish. I personally know that this is not true. Suicide may look selfish to the people who are left behind or those who don’t struggle with this particular demon, but as someone who has contemplated suicide, I have convinced myself that it is the least selfish thing I could do. Depression tells me that I am a burden and that people are tired of dealing with me. It convinces me that everyone would be better off without me and that I would really be doing the world a favor. As someone who has worked really hard and spent thousands and thousands of dollars in order to try to combat (or at least alleviate it, since it appears to not be going anywhere) my depression, I would argue that I am the opposite of lazy, even though American society and I tell myself that I am. Sometimes that is the worst part, working so hard to feel better and it never (my wise mind knows that it is occasionally and not always) feeling like it is enough or that I am trying hard enough. Sometimes I get really mad and feel like it is selfish of people to make me promise that I won’t hurt myself, when I know that they just care. I feel like they don’t understand, but I know deep down that this is not necessarily true. I get mad at them because if they cared so much, then why don’t they do more to make me feel better? Don’t they know that if I am contemplating suicide, it feels unbearable to be inside my body and in my mind? But I know, that it’s really not up to them to make me feel better, it’s all on me.

What do you do when a friend is struggling? It helps me when people check in with me, even though I might have stopped reaching out to them. Talking to or just sitting with someone who I know will just hold space for me helps. I clam up if people tell me how I have it better than others (of course I know that, it does not negate that I still feel this way) or if they freak out about hearing that I have had suicidal thoughts. Please do not tell me to do self-affirmations. Please do not tell me that this too shall pass, because in the moment it feels like it won’t. Something as simple as a text can help me when I am in a funk. Asking me to reach out when I am struggling is complicated. That is the last thing I want to do when I am down in it. I recognize that it is my responsibility to get help when I need it, but I tend to only reach out for help when things are pretty bad.

I can say that the severity of my suicidal thoughts has diminished over the past year and that it does appear my hard work and money spent is helping in that regard. I am too practical to hope that one day I won’t have these thoughts or urges, as they have been a part of my life for a very long time. If you also struggle with suicidal ideation, I can say that is gets better (or maybe more manageable) even as cliché as that sounds.

 

For crisis text line- Text CONNECT to 741741 in the United States.

 National Suicide Prevention Lifeline: tel:1-800-273-8255

 

by krubesch

Honey and Pain

“The days aren’t discarded or collected, they are bees
that burned with sweetness or maddened
the sting: the struggle continues,
the journeys go and come between honey and pain.
No, the net of years doesn’t unweave: there is no net.
They don’t fall drop by drop from a river: there is no river.
Sleep doesn’t divide life into halves,
or action, or silence, or honor:
life is like a stone, a single motion,
a lonesome bonfire reflected on the leaves,
an arrow, only one, slow or swift, a metal
that climbs or descends burning in your bones.”
― Pablo Neruda, Still Another Day

 

I have an impeccable memory when it comes to people, dates, events, and I usually remember these things with how they relate to time. Sometimes this is a blessing and very useful and other times it’s a curse. I am often telling Leah what we were doing a year ago or that 3 years ago today xyz happened. It’s probably normal to start reflecting on the past year during the month of December and I’ve been thinking a lot about all that has happened. It’s hard to believe that a year ago during this time I was making the decision to spend Christmas and New Years in the hospital (and ended up staying there for 3 weeks). It feels like longer than that and also like it was just a few months ago at the same time.

I keep having these eerie dejavu feelings about how this week last year I was completely anxious about going to the hospital and was not sleeping very well at all. In order to quell my anxiety of the unknown, I was obsessed about what I would take with me and finding shoes without laces and clothes that did not require a belt or have any strings. Memories pop up now from my stay when I put on some of the clothes I bought specifically to wear at the hospital and I find myself transported back to that time. Sometimes I wish that I was going back when the tasks of everyday life feel so overwhelming. It was so nice not to worry about anything other than working through my shit. I didn’t have to think about what I was going to cook for dinner or try to figure out how to get everything done (working out, cooking, laundry, grocery shopping, picking up the house, getting up for work when it felt impossible to get out of bed ect.) between work and appointments. It feels like I’ve been taking care of myself for such a long time that I long for being completely taken care of and letting my guard down.

I know now that depression is a liar, at least I know this to be true when I am having good days. On good days when that negative voice sneaks to my head I am able to brush it off and on exceptional days I am able to reason with it. On bad days depression is a fortune teller, the voice of reason, and the decider of all things. I can’t tell the difference between the critical voice in my head and depression, but maybe they are one in the same…or they egg each other on when they are both present. There are days when my critic tells me I am to blame when Leah and I are having marital issues, that I screw up every relationship given the chance, that I’m a failure and lazy. It tells me that things are not going to get better and that my good days never last. That no matter how hard I try it is never enough. There some days where everyday tasks seem to be insurmountable and that scares the shit out of me. I don’t want to go back to that place I was a year ago, I don’t want to have to make a difficult and life saving decision like checking myself back into the hospital. My wise mind tells me that just because I am having a rough patch, does not mean that I will be crushed by the bowling ball of depression. My emotional mind is telling me that it’s only a matter of time before I will need to go back to the hospital.

On bad days depression tells me that I am a burden and an inconvenience. That people don’t want to be around me, that I am a drain. I go from being very excited about making and having plans with my friends to wishing that I hadn’t made those plans. That I won’t know what to talk about or that I won’t have fun anyways. When I listen to depression and cancel, then I’m lonely and sad that I am by myself. I’ve recently had back pain and been unable to do a lot of things for myself. I knew that I was bad at asking for and receiving help, but I didn’t know the extent of it. I thought my difficulty with help had to do more with getting emotional support from others, but it extends to even asking for help with my job duties or tasks around the house that I have deemed as mine.

I still am having difficulty with my body image and managing impulsive behavior, although it is much better. Depression tells me to eat crap. That chocolate or baked goods will make me feel better. And it does, momentarily. It does until I catch my reflection in the mirror and see this fat person staring back at me. I tell myself that I don’t have any discipline, that I’m disgusting, and that I have to go on a diet. I can’t remember a time when I felt good about my weight (I started my first diet in second grade). When my pants are getting tighter around my waist as I try to button them I berate myself for making bad decisions, for not taking care of myself. I know in my wise mind that I would feel better if I ate healthier and went to the gym more often, but it’s a vicious cycle where I am so tired I can’t fathom adding one more thing to my day. I get mad at myself for succumbing to my exhaustion and then bully myself into eating healthy for a day or two until I give in again. And it starts all over.

Depression tells me to buy things. It tells me that a little treat will make me feel better, I get a rush from looking around stores and feel better about my appearance if i can make myself more presentable with something new. It does not have to be something big, I can be something as simple as a t-shirt, but that stuff adds up. I then get mad at myself for spending unnecessary money, especially on myself. I like picking up treats for Leah and have an easier time justifying spending money on her. There is something about spending money on myself that gives me a lot of guilt or maybe it’s shame.

Depression or is it my critic? (sometimes I can’t tell the difference) tells me that I am a failure and that I will never be financially (career wise) successful. It tells me that I buckle under pressure and that I am destined to stay in jobs where I don’t make a lot of money because they are low in stress and pressure. My mind recalls all of my memories in which I feel like I have failed when I am lying in bed trying to fall asleep. It ridicules me for having to drop chemistry and convinces me that I am not cut out for grad school. I feel like I have not pulled my financial weight in my marriage for years now. We used to trade on and off organically as to who is the breadwinner, but Leah has been left holding the bag for awhile. I look at how much money I have cost us since July in doctor’s appointments and the therapy that is out of network with our insurance and I feel guilty and like a drain. My body hurts all the time, but I cannot justify acupuncture visits and massages because we have more important items and appointments that we need to pay for.

I know that a lot has changed this year and that I will be ending 2017 in a better place than it began. It’s hard to remember how much has changed when I am am in the thick of a flashback, a body memory, or letting myself feel emotions that are foreign and difficult. I have to remind myself that a year ago it was rare for me to go through a day without some kind of suicidal thought and that I had come extremely close to giving in. I think about all that I put my wife through and how we are in a much better place today (thanks to a lot of hard work on both our parts). I know that I am better equipped to handle a rough day and that I have started reaching out and talking more when I need extra support. There is a part of me though that thinks that none of this is enough and is impatiently waiting to move past this, to be able to get off my meds completely, to be able to be present in my body without wanting to disappear, to not have depression ever present and looming in the background and to not feel like we are spending so much money on maintaining my mental health.

 

 

by krubesch

Re-entry Part Two

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I’ve started feeling melancholy on Thursday, the first time since I’ve been home.  I have to stop myself from thinking that the “honeymoon” is over and re-frame it as this is a feeling that will come and go.  The only thing is that in my experience it’s the good feelings that fluctuate and the hard ones stick around a lot longer.  I knew that while I was in the hospital I was in a safe bubble, but I think that I expected that once I got home things would be easier than they feel at the moment.  They are a little bit easier (things, life in general), but I’m still really anxious, jumpy, and some of those feelings I don’t like are returning.

 

Today is the one year anniversary of Patrick’s death and the weather is gloomy outside and I feel gloomy inside myself.  As usual with death, my heart does not hurt quite as much as it did when he died, but I do miss him so much.  I think he was one of the safest people I have met: I could trust him without great repercussions.  If he hurt my feelings I could blame it on the Lewy Body Dementia instead of myself, I could tell that he was kind right from the beginning, and I knew that he would not reject me in the way I fear that others might.  Because of this I think I trusted him in a way I have never trusted anyone else.  We were content to spend time together in silence and it did not feel awkward, at least not for me.  I did not anxiously feel like I had to say something, anything to fill the silence, which I often feel in the company of others.  

 

Sometimes I found myself speaking with him in ways I was not able to speak to my therapist- we had this ease with each other.  I always looked forward to going to work and often had things I wanted to tell him or food I wanted him to try.  He always asked about the score of my soccer games from the night before and seemed proud when we won.  I know that Leah and Susan sometimes worry that taking care of him and seeing it through until his death made my depression worse, but I feel like my relationship with him helped facilitate more meaningful relationships with others.  As I was in a really bad place before I started working with Susan and being around them was the right medicine at that time.

 

Reintegrating back into my life at home has been a little hard and exhausting.  I forgot how much the daily things like making dinner, packing a lunch, making sure bills are paid, and taking care of our animals and basic things around the house seem to wear me down.  My mind is also less clear from the medications I’m on, so it feels more draining to think logistically and make sure I’m not forgetting anything.  Leah and I are working together on this by trying to build rest time into our daily or weekly schedule.  I’m finding that I really need that time.  Although sometimes slowing down makes me more aware of my feelings, which is arduous as well.

 

I’m pretty much giving up on the idea of going back to school for the near to distant future. I just don’t think it’s the best or smartest decision, which makes me want to criticize myself.  I know that by 2020 all the courses that I have taken in undergrad will no longer be valid as prerequisites because of the 15 year rule. That makes me want to just give up altogether.  Maybe i just have to realize that not everyone is cut out for higher ed and accept that.  I don’t know how women with families and jobs go back to school with all of that going on. They definitely have my respect.

 

My therapist told me on Friday that I need to stop worrying and trying to predict the future. That thinking is causing me a lot of strife right now.  It’s really hard to stop doing that when you’ve been doing it your entire life.  I am working on staying in the here and now even if that’s painful or difficult because I know that my old ways of coping saved my life at one point, but are not longer working or useful.  I am also hoping that writing this down makes me want to do it more than I really do!  

by krubesch

Triggers

“Ongoing experience convinces me that some children respond to pervasive emotional neglect and abandonment by over-identifying or even merging their identity with the inner critic and adopting an intense form of perfectionism that triggers them into painful abandonment flashbacks every time they are less than perfect or perfectly pleasing.”

Pete Walker

The only time I am in touch with my anger/rage is when I’m driving.  It always shocks me when I venomously yell out curse words or hurl insults at crazy drivers around me.  I don’t recognize my own voice. I have to stop myself from flipping people off.   It’s interesting to me that this is the one situation where I express anger. I guess it’s safe? Because I am in my car and it’s socially acceptable to have some road rage.  No one can hear me and I am in my own space.  Quiet  and calm Katie disappears when I buckle my seatbelt and put my car in drive. I’m becoming more aware of my habits, traits, and actions.

I mentioned in the my last post that I have started EMDR with my therapist and it’s been pretty intense.  I have also been attending DBT (Dialectical Behavior Therapy) class every other week.  Since I’ve begun processing events of my childhood I’ve gone from one regular therapy session and one DBT session to as many as three therapy sessions and one DBT session a week.  I’ve been gauging how I am doing by how many sessions I’ve had to go to in a week.  A four session week means that I am  not doing well and having to take each day an hour at a time.  The good thing is that I’ve been reaching out and asking for more appointments when I need them instead of “toughing” it out.

Since we started doing EMDR I am more aware of my anger and a greater presence of PTSD symptoms.  I’ve been extremely jumpy in my everyday life.  The other day Leah was driving and I literally jumped out of my seat because of brake lights ahead of us. I scared the crap out of both of us!   Today I’ve jumped when the office phone rings, when I hear a loud noise from the restaurant above our office, and when the bank teller surprised me.  I had forgotten what this feels like- always being on edge. I’m also not paying as close attention to tasks and everyday things as I normally do. I went flying over a speed bump that I did not see and took my car and myself by surprise.  Laundry, grocery shopping, and meal planning have been incomplete to my wife’s alarm.  She’s used to me being the one who gets most of this done. Sorry honey!   My therapist says that this is normal and that things are going to get worse before they can get better.  I’m just afraid of what worse means.  I’ve also been way more emotional and triggered by things that I would normally just let roll off my back.

I’ve found myself unable to cry when I feel like I need to.  I don’t know if this is because of the anti depressants or because I’m somehow not in tune enough with myself to let the tears fall.  I’ve recently started getting sad books from the library because when I really get into a book I am able to let the tears flow. I was not sure if this was going to work because I had not tried it with this round of drugs, but last night it did still work. Is this self-care? I’m not sure.   I am able to identify more with a book than with my own life. I’m not quite sure what this says about me.

Sorry if this is TMI, but my entire blog is pretty much “too much information.” I was diagnosed with a urinary tract infection yesterday and boy has this been the biggest trigger so far.  It’s all I can do to stay awake and present with the pain from my lady parts. I’d love to just retreat by going to bed and pop a trazadone to fall asleep until the pain goes away.   I’m really glad my therapist and I did not do EMDR last night during our session because I don’t think I could have handled having flashbacks along with this intense pressure in my pelvic area. It was nice to be able to go home and be with Leah and lose myself in a book after therapy last night.  I think reading has always been a welcome escape for me even as a child. I remember loving how reading could take me away from the present moment and into the lives of other people.  I felt like I had a relationship with others through stepping into their lives.  I’m still learning which of my coping skills are “effective and kosher” and which are not.  I know that in a way reading lets me dissociate from the present, but it also serves as a great distraction.  It’s a lot better than drinking, self-harming, or eating.

More info about DBT http://behavioraltech.org/resources/whatisdbt.cfm

by krubesch

Walls Falling Down

The best way to find yourself, is to lose yourself in the service of others.

-Ghandi

For those of you who don’t know, there seems to be an unwritten rule in healthcare (maybe it’s written somewhere) to keep patients at a distance.  You are supposed to follow OSHA guidelines, assist the patient to the best of your ability, to have empathy, but not let that empathy have a profound effect on your personal/ mental health.  Basically to not let emotions and feelings play into the relationship you have with your patient.  I’ve worked in the health care industry for the past seven years and I’ve been really good at this unwritten code.  That is until now.  I am currently a caregiver for a man who has Lewy Body Dementia and he’s completely undone the armour I thought I had in place at the beginning of this job.

I knew I would be great at this job because I have (at this point HAD is a better word) a great poker face and the ability to push my feelings, thoughts, and emotions away.  I’ve been told that people often think I don’t like them because of my cool, collected demeanor.  I just don’t show a lot of emotion one way or another.  When I began caregiving for Patrick in September I thought that I could handle watching him decline into the shadow of LBD.  I didn’t know him before he was in the midst of his battle so I didn’t have the memories of “old Patrick” to tug on my heart-strings.  What I didn’t count on was how I would develop a friendship with Patrick and I would/do feel my heart-break little by little as this disease takes him further away from himself and his loved ones.

I spend more time with Patrick in a week than I do with my wife, so it’s funny that it’s surprising to me of how well I feel like I know him.  I can anticipate his needs and can tell how our day is going to go simply by how our morning starts.  I know that we will be able to communicate and joke around more according to how long he stays in bed.  If I get to the house and he’s pulled out all his shirts, socks, and underwear I know we are both in for one hell of a day.  If he naps throughout the day, I know he’s going to be less restless and comprehend more of what is happening around him.

For instance, today has been a challenge.  Patrick tried to get up and dressed several times throughout the night and I can definitely tell he did not have a restful night.  There are no jokes, words I can’t understand and body movements have been difficult for him.  A big indicator that we were in for a challenging day was that I had to bend his knees for him to sit down and pants were extremely difficult to get onto his body.  He usually spends these kind of days watching hours of cowboys on the tv and is not interested in leaving the house or doing other things around the house.  He’s taught me that I need to go with the flow instead of having our days together planned.  He’s teaching me to be less rigid and more in the moment.  Days like today make my heart ache for him. I know that if I had these kinds of days I would be in the throes of a deep depression.  This ease and openness I have with him is only going to make me hurt more when he’s gone, but it would also make me feel less alive while he’s still in my life.

I think the face of healthcare could change if providers, managers, and staff weren’t as concerned about volume as they were quality.  Every practice I’ve worked with has had their goal be to maximize the amount of patients that they see.  I wonder what our health as a society would look at if we were more concerned about maximizing the quality of our care and establishing an actual relationship with our patients. I know that I am able to take better care of Patrick through establishing a relationship with him instead of treating him like a stranger or looking at this situation simply as a source of income.

For more info about Lewy Body Dementia www.lbda.org