I promised myself just over a week ago that if my head-space did not get better within a week, I would reconsider going on anti-depressants. I made it halfway through Tuesday (even wrote a nice hopeful blog post), and then the depression and anxiety hit me like a load of bricks. I found myself talking aloud, praying (something I don't do), and basically begging God to take mercy on me and to take away the pain. "I can't live like this, I can't live like this," I chanted to the unsympathetic walls. I scared my cats with my tears and outburst but there was a voice in my mind whispering, "It doesn't have to be like this. There is help to be had."
It took all my will power and determination, but I finally emailed my doctor to ask for anti-depressants again (Effexor). I even called the pharmacy. I spent the evening alternately yelling at myself and crying. I promised myself that I would stick by my decision and follow up on getting the meds first thing on Wednesday. I got up, felt lousy and still managed to call and email again. Dragged myself out of the house and to the dentist's office. While I was there I had to decide whether I was going to authorize them to do over $300.00 in dental work and order me a bite guard (for clenching my teeth, huge surprise there). The total bill was $736.00. I don't have that kind of money right now. I was pretty well ready to just lay down and give up, but that's not me, not the real me. So I pulled myself together and said, "Put it on a credit card and a prayer."
I forgot to mention... Tuesday night when I emailed my doctor, I made the decision not to second-guess my choices. I made the decision to be really kind to myself. I made the decision to do whatever I needed to do just to deal with day-to-day life. I decided to put my well-being above all else until I can feel strong, happy and in charge again. I think this was the best decision I have made in a really long time. I also feel proud of myself for making the big decision to help myself by admitting my need for help and not shying away from the dental decision. I think I might have a new, new year's resolution: be decisive and feel good about my choices.
Anyway, back to my story... So when I got out of the dentist's office I still had not heard from my doc. Five minutes later though, I checked my phone again and I had just missed his call. He had prescribed me the med and asked me to call him. I did. He was very kind and reassuring and promised we would talk again in the next few weeks. My neurologist also emailed to check on me.
By the time I had picked up my med, I felt so good about myself for taking this very hard step, that I even drove all the way to Boulder to meet a friend and take a hike. Last night, I felt some of my darkness had lifted. Going on this med is hard. For me the physical adjustment is intense and I know it may take some time, but I am determined to stick with it, to really just live one day at a time because I know beneath the chemical cloud of sadness cast by my depression, I am a strong, tough fighter.
I want to take a really deep breath that fills me completely. I want to follow that breath with another and then another, so that all my breathes are deep and steady. Right now, too many of my breathes are shallow. Not long after being diagnosed with MS, I was also diagnosed with Asthma, but the thing is, I never had asthma before... I only have asthma when I am anxious or depressed. It is more my reaction to stress, but it sucks to not fully breathe. I can tell when my mental state is not exactly as I want it to be, just by the quality of the breaths my body allows me to take. Despite my best resolves to just be, here and now, to be more than ok, I am still struggling.
I want the struggle to just go away. It seems I am taking far more punches than I am throwing, but I also haven't thrown in the towel yet. There have been much harder times. I have my health and my freedom. I am safe and comfortable (even when my mind doesn't believe it). I said it before, and I will say it again, "I am not licked yet."
I ask myself now: "How do I make this easier?" How do I remind myself that good days build on good days, that just a good now is more than enough? In another post, I mentioned breaks in the clouds-- how do I continue to find those breaks and then make them last? I know from experience that I can change my day, my reality, any minute, any second, but how do I do that when I have so many doubts? Lately, this blog has gone from "inspiring" to my own personal attempt to help myself. I guess I want it to be inspiring again.
I have been psyching myself up lately. "Be fierce," I tell myself. I remind myself that I am tough. I remind myself that there are many things that make life good, and then I put my head down and push forward, getting up after each blow to fight again.
I remember writing before about a dark night of the soul. Actually, I remember writing about many such nights. Last night I had what I might term, a light night of the soul.
I went to bed early, planning to try to pick up a morning substitute teaching job, but I couldn't sleep. I took a little klonopin to help with sleep and to keep any anxiety that might pop up at bay. It could just have been the drug that relaxed me, but suddenly things seemed clear, easy. All my doubts and fear melted. Suddenly it was like, "I got this."
The whole job hunt thing didn't seem so hard. I stopped worrying about what ifs. I got excited about the future a bit, and at least last night, I knew what I wanted, and it seemed simple. There were no obstacles in my way. I can work hard. If I teach, I know how to teach. I don't need to be afraid of what I end up with because I can do it, whatever it may be. I realized that while money and security are not the end all be all, they do help me to relax a bit. I spend way too much time worrying that I won't have, or won't get what I really need. When I look at this in the light of a new day, I may have missed the mark a bit, but some of the things I thought about last night were on point.
No matter what I actually end up doing, I do want more security. I thought I really wanted to own and operate my moving arts business, but I think I might rather focus more on being a student. Sometimes I would rather just show up to learn and play. Right now I am imagining just working during the day, and then having most evenings to do with as I please. I realize that in my mind I have sort of glamorized this stuff, glossed over all the things that were really awful before. I am glad I am taking the time now to write about last night. It was beautiful, that temporary certainty that obliterated all the doubts that have been stalking my mind. When I look at some of last night's logic now, some of it seems rather flawed, but I took something from it too. I need that kind of certainty and confidence in myself all the time. When I believe in myself and allow myself to trust that things can and will work out, I feel good and any failures are just tiny set backs.
Sometimes I doubt myself to the point where I am almost afraid to leave home or to take on any challenges. The truth is, most of the things I fear, I do just fine with. Last night I felt for a bit like everything was "solved." It's not, but somehow I still feel more hopeful and more confident today than I have in a while. I think I needed that short stretch of pure illumination.
By the time Sunday night rolled around, I was fed up, ready to give up, and ready to email my doctor for anti-depressants, but then I was again faced with the idea that I really have no reason to be unhappy. Well this realization can only take me two ways: my struggles are either purely chemical, or I just have a hard time remembering how to allow myself to be happy. At that point, I decided to fight my hardest to be in charge of this thing. Is it possible to just continually decide to be happy? I suspect it might be. I decided I just have to give it my best try. Yesterday was a pretty great success. Today through trial and error, I am at a minimum ok, maybe a bit better, but I can feel the crazy lurking underneath.
I got myself out of the house not long after awakening today. This kept me from devolving in ways that I do not wish to devolve, but did not save me from indulging in some acts of crazy. My latest, and largest obsession, is job hunting for next year. It doesn't seem to matter how much I remind and reassure myself that I have time, it's early and I will find something, I still think about this problem every day almost the minute I open my eyes. I keep thinking that if I can just get this figured out, everything else will fall into place. I wish that were really the case. I just can't seem to relax about this issue for long, no matter how much time I spend reassuring myself. I made a deal with myself that on my free days I would send out two cover letters. Of course today, despite my generally better state of mind, I sent out four, and I feel an itch to do more. I have been getting replies from a few of my letters, but each of them has been to tell me that the position I am seeking has already been filled. I suspect I am spinning my wheels in many cases, applying for phantom posts... And even though I know this deep down, I can't seem to stop myself in the same futile process every day.
The thing is that I know myself. I know my own compulsions. It is super-difficult to coax myself into down time. I kept telling myself yesterday that laying around with a novel is hardly wasting my life or ruining my chances of finding a job for August, but I must have done a poor job of convincing myself because when I considered such an option this morning, I felt that bubble of contentment I spent yesterday creating, starting to slip a bit, and I knew that if I didn't leave the house, I would slide down that sharp abyss of mind into a place of darkness.
I believe that I may have the ability to control my state of mind, to be in charge of how I feel, but I wish it didn't feel like "work." Until Sunday night, I found myself fighting so hard against impending anxiety and depression that my head ached. The last couple days I am not fighting nearly as hard, but it is still there, closer to the surface than I want it to be. That is why anti-depressants remain a bit of a lure to me. I promised myself a week to try a commitment to happiness, so I am really trying...
I suppose the fact that I can take the time to sit in a coffee shop and update my blog is a form of self-indulgence. At the moment, I don't have internet at home and I keep feeling this need to update my blog. Sometimes I think the best way to fight the darkness that keeps trying to engulf my brain is to write. I am not sure if it really helps, but I have already realized the hard way that I can't just hole up in the house and hide from dealing with my life. Sometimes I find the hiding gives me temporary relief but ultimately, I think it makes me feel worse.
Sometimes I just want to bury myself in bed, under the covers with my beautiful kitty beside me and just try to forget, forget the imperative to do, and worse the imperative to find something to worry about every day. It seems the moment that I have managed to put one worry to bed, another one finds a way to crop its ugly head. I try to fight them, but every day, something seems to emerge. I feel like these things will strangle me. I just want to go back to bed, but I know that if I do, in the end, I will feel worse. Each day I find that by somewhere between noon and five I feel good again and I can hardly remember what was plaguing me. The whole thing then just looks like a giant self-indulgence, but when I am in it, I am in it. I find my breath is shallow, I am filled with a nameless fear and I am not sure how to find relief. Later, I seem to start dragging out free, deep breath, after free deep breath, until I feel fine again and no one who sees me can even suspect that my day started so wrong.
I keep trying to figure it out... How can I get my day to begin without sadness or fear? Why can't I feel as good at 7am as I usually do at 7pm? Every day I tell myself, "Tomorrow will be different" but then the next day arrives, and the cycle repeats itself. I am confused. Why is it that no matter how much I tell myself not to even let the ugly thoughts start, they just creep in and then settle down to quietly strangle me? And then, like right now, they are just gone and I am fine but almost afraid to go home, afraid they are waiting for me there...
A seemingly illogical part of me of me keeps thinking, "If only x,y and z fall into place, I will just stop worrying and everything will be perfect," but that is the real crazy because I am looking at external things to solve some very internal issues. For years I have continued to try writing all this out, always hopeful that if I am just self-aware enough, I will resolve all things that bother me.
Women and the MS Experience: Different from Men?
It’s no secret: women develop Multiple Sclerosis two to three times as often as men. In addition, Harvard Medical School and Healthline agree that women’s MS symptoms are similar to those of men in both frequency and severity. Both men and women seem to respond to cooling therapy and experience depressive symptoms, perceived health, and exercise barriers the same way. So what’s the difference in “the MS experience” between men and women?
The well-documented reduction in MS relapses during pregnancy is at least one opportunity for a break in the MS symptom parade—one that men don’t have the option to experience. Despite this brief chance to swap some MS symptoms for the nausea and exhaustion of pregnancy, treatments (in animal studies) based on altering sex hormones still only show limited promise for relieving women’s MS symptoms. In addition, the risk of MS relapse increases again a few months after the baby is born. Women can at least be grateful that having kids does not seem to negatively impact their MS disease progression in the long run.
Despite the similarity between men and women in symptoms and disease progression, women don’t have quite the same disease indicators or related disease outcomes. For instance, MSRV, a retrovirus believed to be related to MS, is present at significantly higher levels in the blood of women with MS than in men with MS. This retrovirus is also present at much higher rates in women without MS than in men without the condition, suggesting a potential reason behind the higher rates of MS among women.
Even more troubling, women with MS have to worry about the cardiovascular comorbidities associated with their primary illness. Unfortunately, women with MS are more likely than the general population and men with MS to experience cardiovascular problems. These problems include heart failure and stroke, which only adds to the chances that women (and men) with MS will fall prey to the number one killer in the U.S.: heart disease.
Is There Any Good News for Women with MS?
Although some of the news above doesn’t bode well for the health of women with MS, there is at least a silver lining. One of the best ways to prevent cardiovascular disease is also one of the most successful ways to relieve certain MS symptoms: exercise. An added bonus? Exercise can release hormones and chemicals that also boost mood and energy levels, combatting fatigue and providing some extra oomph in the fight against depression—which is common among both men and women with MS. In addition, regular exercise can improve mobility, endurance, and quality of life for women with MS.
Thankfully, exercise can be slowly incorporated into the daily life of women with MS; “all or nothing” and “no pain, no gain” mottos do not apply here. Even if you are currently inactive, incorporating exercise (with your doctor’s knowledge and go-ahead!) may offer you relief from MS symptoms and its life-threatening comorbidities.
The ultimate exercise goal for adult women is pretty manageable: 2.5 hours of moderate activity each week (like a half-hour brisk walk five days each week) plus strength or resistance training at least twice each week. Swimming, yoga, cycling, and other gentle exercise programs combine some muscle training with coordination and a bit of aerobic work. Many inactive people with MS are able to begin with stretching exercises and build up to longer, more difficult routines over several weeks. Women who use wheelchairs are no exception to this! Ask your doctor for advice on the best exercise options for you.
Opt for a time of day when you have the most energy. If your worst fatigue hits you in the afternoon, try exercising in the morning. Use bottles of water as light weights for simple strength training while you watch TV, and incorporate more work into trips to the grocery store (park further away, carry a basket instead of using a cart, etc.). Work on your weakest muscle groups first; improve balance by working the core and the legs, or increase motor skills by combining stretching exercises with grasping, clutching, and wrist exercises.
Your goal should be a combination of cardio and strength exercises each week. This will help protect your heart and fight the progressive nature of MS by restoring some muscle, energy, and balance. All in all, you’ll be fighting MS, depression, cardiovascular disease, diabetes, and many other problems with one prevention technique—and that kind of effective multi-tasking is certainly good news for all women with MS.
Sometimes I just want to lay down and never get back up. I just want to succumb to the darkness obliterating my light, my reason but I am not ready to stop struggling. I am not ready to just give up. I might if I had never felt like this before... But I have known darker times, tougher days and still gone on to know happiness. I wrote the other day about a break in the clouds. I have more of those these days now than I ever have had before in times of anxiety and depression.
I am watching myself, trying to decide how many days of anxiety and depression, days where I feel powerless and unmotivated that I can take before I just give in and email my doctor for an antidepressant. So I count the days, good versus bad, and I cling onto the little things that give me hope, the little things that bring relief and sometimes even happiness.
Today I am winning the battle. I won it Thursday, fought a skirmish yesterday, and survived, and now I look forward to a good day today and tomorrow. I am not licked yet...