Ketamine infusion #1

I’m undergoing a series of ketamine infusions for treatment-resistant depression. It’s a series of 6 sessions over the course of several weeks. 1-2 sessions per week.

I had my first infusion on Wednesday for an hour and it was certainly trippy. I listened to soft rock in a completely new way.

I was kind of hoping that effects would begin to take place soon after the infusion. Relief can start to take place within an hour of the first treatment. While I was not depressed or suicidal, I was not happy. In fact, I was irritable. Angry. My doctor and I are on guard to ensure that the ketamine doesn’t trigger mania since I actually have bipolar disorder and not unipolar depression. At this point, I feel like mania would be an improvement.

I’m already pessimistic about the treatment even though my doctor says it can take 3-5 infusions for relief to kick in. My next infusion is Monday. Well, there’s one thing: If I ever wondered whether I’d like doing drugs recreationally, I’ve gotten my answer by getting it legally. (That’d be a no.)

Suicides in Japan have decreased in light of the COVID-19 lockdown. According to The Guardian, “the suicide rate in Japan fell by 20% in April compared with the same time last year, the biggest drop in five years.” The stay-at-home mandates affected about 40% of suicide prevention organizations that shut down or reduced workers’ hours. Also seeming to contribute to this drop includes the lack of commuting vs many people working long hours in the office.

In May, The National Suicide Hotline Designation Act, a bipartisan bill, passed in the US Senate to make the national suicide prevention hotline a 3-digit number. Currently, the hotline is only accessible by the usual 10-digit number 1-800-273-TALK (8255). (If we’re honest, is not that easy to remember.) Should the bill pass in the House and get signed by the president, the number would be 9-8-8, however, the 10-digit number would still be valid.

A study published in General Hospital Psychiatry found that use of antidepressants among patients hospitalized with heart failure (HF) is associated with “minor depression, history of major depression, younger age, unemployment, white race, nonischemic heart failure, polypharmacy, and functional incapacity.” The study, held from 2014-2016, had 400 patients with HF enrolled and found that there was no increase in the patients with major depression taking antidepressants compared with those who did not have depression.

May is Mental Health Month

So what better time to bring back a mental health blog? 2020 demands it.

Baby steps, though.

Loose Screws Mental Health News

An antipsychotic inhalation powder has been approved by the FDA for the treatment of agitation in adults with schizophrenia or bipolar I disorder. While loxapine (brand name: Adasuve) by Alexza Pharmaceuticals acts rapidly, the side effects include “bronchospasm and increased mortality in elderly patients with dementia-related psychosis,” according to Medscape. In case you don’t know, bronchospasm can lead to acute respiratory problems in people with lung disease, asthma, or COPD (chronic obstructive pulmonary disease).

Plans are for the drug to only be accessible through a medical facility with the ability to treat bronchospasms.

In related and somewhat interesting news, the Medscape article also notes that 3.2 million people in the U.S. are being treated for schizophrenia or bipolar I. “Of these, approximately 90% will develop agitation during the course of their illness.”

That’s an incredibly high number of people who develop agitation. Just sayin’.

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According to an article in U.S. News & World Report, patients in a study dealing with depression seemed to have high levels of C-reactive protein (CRP), a marker for increased risk of heart and inflammatory disease. The lead researcher notes that “people with increased CRP have a two- to threefold risk of depression.” It is not clear whether CRP causes depression or is simply a sign of it. Increased levels of CRP tend to be seen in obese patients and those with chronic diseases.

“More than 21 million Americans suffer from depression, a leading cause of disability, according to Mental Health America.”

Note: the 2011 estimate of those residing in the U.S. stands at more than 311 million.

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Depression is increasing among Japan’s public school teachers.

“A report by the Ministry of Education, Sports, Culture, Science and Technology shows that in 2011, around 5,200 public school teachers had to go on sick leave due to various mental illnesses, including severe depression.”

The Japan Daily Press article also notes:

“The study also highlights the fact that the main reason for the increasing depression is a school environment that puts too much workload and pressure on the teachers that they cannot have a healthy work-life balance anymore, much less deal with students, their guardians and the paper work that comes with all of these. (emphasis mine)”

I recently finished a book by actor Tony Danza called I’d Like to Apologize to Every Teacher I Ever Had in which he chronicles his yearlong stint in Philadelphia’s inner city public school system. He echoes some of these sentiments as well. After trying to teach his students, he notes that it is difficult not to get involved in their personal lives as well. In the Epilogue, Danza writes:

“…I can only do so much. Where does teaching stop, and start? Where should it? I don’t really know. To engage my students, I found that I had to become engaged in their lives, their problems, and their futures. That connection was what made the job the most rewarding. Yet it was also the intensity of that involvement that, by the end of the year, had made the job of teaching so much tougher than I’d ever expected.”

It seems that Japan’s public school teachers are no different from American public school teachers.

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Although 38 states require mental health background checks, only a quarter of states actually report their statistics to the federal NICS (National Instant Criminal Background Check System).

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And surprise, according to a recent study, pot could lead to psychosis in teens or teens who smoke pot can later develop psychosis. I find it interesting that teens were actually evaluated after smoking pot.

Loose Screws Mental Health News

In the wake of the Newtown, CT shooting, NRA chief executive Wayne LaPierre called for a national registry of those who are mentally ill. According to the Washington Post, the federal government does not possess the constitutional authority “to require state agencies to report data.” All the federal government can do is either offer or withhold funding, as it did in the wake of the 2007 Virginia Tech Shooting when it provided additional funding for state governments that shared 90 percent of their mental health records. But it seems that 38 states already maintain an active database that “require or authorize the use of” mental health records during gun background checks. And the Gun Control Act of 1968 does not allow sales of firearms to people who have been institutionalized or considered to be mentally “defective.”

For the purpose of firearms sales, I support the idea of maintaining a database of people who have been institutionalized. This could prevent a person from being a harm to himself or to others. I speak as a person who has been institutionalized for being a harm to herself more than once. If I’d had access to a firearm, I wouldn’t be here right now. There may be many others who are in the same boat.

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The New York Times reported on mental health coverage through insurance. In any given year, 26 percent of adults have a mental disorder, and 6 percent of adults have a mental illness that prevents them from functioning, according to the NIMH. In addition, 21 percent of teenagers between the ages of 13 and 18 undergo a “severe emotional disturbance.” But it seems as though 85 percent of employers offer some kind of mental health coverage through insurance, and 84 percent of employers with more than 500 employees allowed access to in-network and out-of-network mental health treatment. Beginning in 2014, insurance plans will be required to cover mental health disorders as part of President Obama’s Affordable Care Act.

The New York Times notes that many psychiatrists, however, don’t accept insurance:

Plenty of psychiatrists in private practice accept no insurance at all, though it is not clear how many; their professional organizations claim to have no recent or decent data on the percentage of people in private practice who take cash on the barrelhead, write people a receipt and send them off to their insurance company to request out-of-network reimbursement if they have any at all.

My psychiatrist does not accept insurance. He writes me a receipt, and I am to seek out-of-network reimbursement, a claim that has been repeatedly rejected by my insurance. The NYT is right on the money in this instance. But I am happy with my psychiatrist and would rather pay out of pocket for him without reimbursement than to find another psychiatrist who is in network.

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According to the San Francisco Chronicle, California is ahead of every other state in covering mental health services with public money. But as always, there are critics who say California does not go far enough, even though in 2004, California voters approved Proposition 63 that funnels $1 billion annually for mental health services by taxing the state’s highest earners. But funding is being cut, not just in California but also nationally, according to NAMI.

Overall, California cut $768 million from its state mental health services outlay during the past three fiscal years, according to a November 2011 report from the National Alliance on Mental Illness. California’s 21 percent reduction in mental health funding over that period is the seventh-highest among all states.

Nationally, states cut more than $1.6 billion in general funds from their state mental health agency budgets for mental health services since 2009, according to the 2011 report by the National Alliance on Mental Illness.

I’m not sure what can be done to stop funding cuts of mental health services when state budgets are slashing services across the board.

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And finally, according to NY1 News, New York City Mayor Bloomberg has announced an initiative to get mentally ill people out of jail and into treatment facilities. The mayor’s office estimates that 36 percent of inmates suffer from some kind of mental disorder. The city initiative will attempt to “reduce incarceration rates, improve jail safety, and lower crime.”

Adam Lanza, Violence, and Mental Illness

Much has been made of the Newtown shooting. After many inaccuracies by the media, the truth finally emerged that 20-year-old Adam Lanza shot and killed his mother then proceeded to his old school to murder 20 children and 6 adults before killing himself. Then another detail emerged that he may have struggled with Asperger’s syndrome. Thinking the Unthinkable (also now known as the infamous “I Am Adam Lanza’s mother” post) at the Anarchist Soccer Mom’s blog has gone viral about violent people who struggle with mental illness. (Or rather, a mentally ill person who struggles with being violent.)

I want you to know that you don’t need to be mentally ill to do what Adam Lanza did. His plan to kill was not merely cold but also very calculated. That is not the rash act of a mentally ill person; that is the meticulous act of a mastermind. He destroyed his hard drive beforehand so people would not be able to figure out why he did what he did, and according to the Daily Telegraph, rigged “his semi-automatic rifle… to fire with maximum efficiency.”

Now, autism groups and moms who have children with Asperger’s are scrambling to defend autistic people from the stigma that already comes with mental illness. The truth is while mentally ill people have moments of violence—I have kicked and punched my own mother in the throes of bipolar disorder—they are never planned acts of violence. Psych Central addressed the issue of mental illness and violence back in 1998:

Unless drugs or alcohol are involved, people with mental disorders do not pose any more threat to the community than anyone else.

It’s high time that people stop blaming cold, calculated acts of murder on mental illness.

(From a Christian perspective, sin, or an evil heart, is the real reason why things turned out the way they did.)

Anxiety. Depression. Suicidal Thoughts.

Anxiety. Depression. Suicidal thoughts. They are all rolled up in one.

I am anxious about a lot of things these days. From something as mundane as sitting here typing on the computer to driving to cold calling a prospective client (which may never pan out because I’m too anxious to call right now). My anxiety has been debilitating in the past where I didn’t want to leave my home, and I fear it’s getting to the point of debilitation again on some days.

My anxiety depresses me. It keeps me from doing things that no one would think twice about. But here I sit, a prisoner in my own body, freaking out about nearly everything. To escape this, combined with my severe lethargy, I crawl into bed and sleep, hoping that when I wake up, things will be better. But they usually are not.

Please don’t get me wrong. I have a life many people would envy: a loving husband, a supportive family, and a steady job. I am thankful for the good things in my life. But this attitude of thankfulness and gratefulness doesn’t take away the depression inside of me.

I do not want to go back to the hospital. If I fear anything worse than death, it may be going back to a psych hospital. I have passing suicidal thoughts about hanging myself, but I haven’t been able to act upon it. I can’t determine whether I am a harm to myself in which case I would need to go to the hospital. The point of the hospital (for me) is to get me away from things that would cause immediate harm to myself. But I can’t be locked up in a hospital forever. (I guess I could in a state institution but that would be a nightmare.)

Somehow, existing in this jumbled mix is me. Somewhere inside, I am bubbly, wonderfully wacky, and beautifully strange. The depression and anxiety fuzz all of that. I am only some of what I used to be. I go to sleep, hoping for some kind of reprieve from this dark cloud that hangs over me.

Celebrity Sensitivity: Catherine Zeta-Jones & Demi Lovato

Image from people.com

Catherine Zeta-Jones has bravely put her face on the cover People magazine—and on the face of bipolar disorder. And in a less publicized interview, 18-year-old Demi Lovato of teen Disney fame admitted last month to People that she too also suffers from bipolar disorder.

“This is a disorder that affects millions of people and I am one of them,” the [Zeta-Jones], 41, tells PEOPLE in an exclusive statement in this week’s cover story. “If my revelation of having bipolar II has encouraged one person to seek help, then it is worth it. There is no need to suffer silently and there is no shame in seeking help.”

Last month, Lovato said:

“I never found out until I went into treatment that I was bipolar. Looking back it makes sense,” she says of her diagnosis. “There were times when I was so manic, I was writing seven songs in one night and I’d be up until 5:30 in the morning.”

I’ve said before that I’m not a fan of mental illness fads, but bipolar disorder has such a stigma attached to it that celebrities who seriously suffer from the disorder have a chance to put a face on and say “There’s no shame in getting help.” And while psychotropic drugs certainly aren’t a cure-all in conjunction with talk and behavioral therapy, bipolar disorder can be managed—not just for these celebs but also for anyone who suffers from the disorder.

Celebrity Sensitivity: Catherine Zeta-Jones

Image from people.com

Of all the celebrities I would have pegged with some kind of mental health disorder, Ms. Zeta-Jones would have never made the list. After supporting her husband Michael Douglas through his cancer treatment, she remained quiet about herself only outspoken on issues pertaining to how upbeat and positive the couple was on Douglas’s treatment.

But clearly, being a bedrock for her husband has taken its toll on her. Last week, she checked into a mental health facility seeking treatment for her bipolar II disorder. Bipolar II is characterized by frequent depressive episodes rather than a constant swing of manic-depressive ones. While only Ms. Zeta-Jones knows what’s been going on inside her mind and her heart, I can only imagine that she’s been suffering with some depression for a while but quietly put it aside as her husband struggled to become healthy again.

In the past, I’ve used the Celebrity Sensitivity feature of this blog to mock celebrities who seem to be diagnosed with nearly any mental illness fad that goes around (normally, depression), but this time my heart goes out to Ms. Zeta-Jones who decided to seek treatment for herself instead of putting on a face like everything’s okay and toughing it out.

Trying to conceive with mental illness

I’m now in a new phase of my life. Last August, I came off of my bipolar disorder medication and have tried to regulate my mood through natural remedies such as taking 1000 mg of fish oil and multivitamins and by exercising regularly.

I’m also trying to get pregnant.

I haven’t wanted to discuss this particular phase of my life as I think it’s a very personal and private time. However, the emotional and mental toll that TTC (trying to conceive) brings upon someone who struggles with mental illness, I think, is worth discussion.

I wrongly assumed that when I decided that I wanted to have a child, I’d automatically be able to get pregnant. (Bristol Palin had no problem, right?) Several cycles later, I find myself still childless and even more desperately yearning for a child than the month before.

The mental anguish of TTC month after month is tough for any normal woman. During this phase of life, women may experience the following feelings:

• Anger
• Depression
• Anxiety
• Low self-esteem
• Social isolation
• Sexual dysfunction
• Marital problems

In a woman who suffers from depression, bipolar disorder, or any other mental illness, those feelings can become so intensely extreme that they can be debilitating.

I can’t even begin to explain the psychology behind the agony a women endures when she desperately hopes for a child, only to be disappointed by a negative pregnancy test or the monthly visitation from a visitor commonly known as Aunt Flo. Month after month and year after year, the pendulum of emotions range from anger to despair. How is it possible to want and love someone so much whom you’ve never met?

For me, I’ve found that I am relatively sane and able to go on with life for about a week after trying. When I am a day or two away from my expected period, I am thrown into such emotional turmoil that I am nearly inconsolable. Part of it has to do with the sadness that accompanies my body preparing itself for the beginning of a new cycle; the other part of it is the emotional roller coaster that comes along with PMS (premenstrual syndrome). Throw in a dash of bipolar disorder and there’s no limit to how despondent I can be. I can only imagine the same would be true for women who suffer from other mental illnesses.

During those times, I’ve tried turning my eyes toward God and attempting to put my faith in His wisdom for my life, but I feel so isolated and so alone that I wonder if even God could comfort me. The pain of hoping for a child each month then discovering that it is not to be brings a sense of abandonment (for some reason). Negative thoughts creep into your mind at a furtive pace:

• I’m not meant to be a mother because I’m already suffering from a mental illness and God is doing any kids I’d have a favor by not bringing them into this world through me.
• I’d be a terrible mother anyway.
• What is wrong with my body? Why can’t I conceive?
• There’s no point in me living if I can’t have a child. I want a child of my own so desperately that I just don’t want to live anymore if I can’t have one.

Each month, a woman trying to conceive goes through the five stages of grief:

1. Denial (The pregnancy test must be wrong; I’m pregnant for sure. Maybe my hormones haven’t been detected yet.)
2. Anger (Why is this happening to me? What’s wrong with me?)
3. Bargaining (I’ll do anything be pregnant. Please, just give me a baby.)
4. Depression (I’ll never get pregnant. What’s the point? I’ll be a terrible mother anyway.)
5. Acceptance (I’m not pregnant. [Some women can also say: But at least we can try again in the next cycle.])

I usually go through all that in the course of, oh, about 2 days.

I haven’t been trying for an extremely long period of time so I’m not classified as infertile but the internal and external pressure of trying to conceive can be stressful nonetheless:

• Family members ask when a little one will arrive in your family
• Friends and family members will have conceived (and even given birth) to a child within the time you’ve been attempting to conceive
• Well-meaning people offer advice to simply “relax” and go on vacation to get pregnant
• Pregnant women you know will complain about all the awful symptoms of pregnancy
• Mothers you know will complain about all the downsides of parenting and rarely offer the upsides

I haven’t fully figured out how to deal with the uncomfortable situations I find myself in with others or the drained energy that comes from learning of a barren womb. This site provides coping techniques for normal women dealing with infertility, but I want to go a step farther in specifically addressing women TTC who suffer with some kind of mental issue:

• Talk to a trusted doctor or counselor. Determine this is the path that you want to be on and discuss how to develop strategies in the face of another disappointing month.
• Determine whether you need to take medication (if you’re not already on it). I tapered off of my mood stabilizer in the hopes of being able to have a natural birth and breastfeed. I’m altering those dreams. It’s not the end of the world if I have to have a baby in the hospital and a child won’t die if I feed it formula. (Although I’ll probably catch flak in the Christian community because what self-respecting mother doesn’t breastfeed?! [sarcasm])
• Determine whether you need an adjustment in medication if you are taking something. Is the medication you are on relatively safe for pregnancy? Will you need to switch? Is the medication you’re currently on affecting your ability to adequately deal with the emotional pendulum that accompanies TTC?
• Consider using natural mood-boosting remedies to bolster your mood. I know it’s cliche to mention this, but for some women suffering from mental illness, natural remedies actually do help. (For some women, natural remedies have little to no effect.) Here are a few to try:

• • Take at least 1000 mg of Omega-3 fatty acids daily. BEWARE: 1200 mg of fish oil does not equal 1200 mg of Omega-3s! I take 900 mg capsules of fish oil that only contain 450 mg of Omega-3s each. I need to take at least 3 capsules to get more than 1000 mg of Omega-3s. You can also get the weekly required amount of Omega-3s by eating fish twice a week. (Science Daily)
  • Take daily multivitamins with at least 400 mcg of folic acid. Folic acid helps lower the risk of birth defects in a baby. For me, I need the iron supplement to help me fight fatigue as I don’t eat many foods rich in iron.
  • Exercise regularly. I’ve been exercising about 3-4 times a week for about 30 minutes. Exercising temporarily boosts my mood although that’s only been a recent occurrence (within the past year).
  • Try to steer clear of mood-altering substances. The depression that accompanies not having a child can drive a woman to smoke, drink too much alcohol, or engage in the use of illegal drugs. (I’m guilty of having a bit too much wine.) Although we all know to avoid this stuff when TTC, it’s sometimes hard to resist. But try.

I hope this post can be of some help to women who are trying to conceive but also suffer from mental illness. We may be a small minority but we’re not alone. Feel to offer feedback on this post by leaving a comment.