Depression Control

Depression can reoccur.  Does that worry me?  Absolutely.  But I have been given the tools to identify if things are going backwards for me, and what to do if they are. Thankfully, things have not headed in that direction yet, and I guess the real test will come if and when they do.

So how do I identify if my depression is returning.  When I first started getting symptoms many years ago I had no idea what was happening.  My biggest weapon in identifying a relapse is awareness.  I know what it looks like and I know what it feels like, but I also have to be wary of false indications.

In my post titled Finished Up, I touched on this, as after my IVIg treatment I felt awful, but this did pass.  Sometimes you're just going to have a bad day.  What needs to be done is differentiating between a bad day and a relapse.  For me the sighs are:-

1. Having negative emotions (anger, anxiety, sadness) for three days or more.
2. Waking up in a bad mood.
3. Withdrawing myself from social situations.
4. Procrastinating about things I have to do.
5. Not doing things I would normally want to do.

If any of these things are occurring, I have to stop and ask why.  If the reason is isolated I can deal with that and move on.  If it is bigger I can utilise the following tools to help:-

1. Think positive.  What we think effects the way we feel, and the way we feel effects the way we think.  I is very hard to change are emotional state, but we can change the way we think.  This allows us to reverse the trend and put us back in the right direction.
2. Make sure that any issues both now and in the near future are dealt with now.  Waiting, will only allow them to fester and breed negativity.
3. Remind myself of my achievements.  This allows me to feel useful.  This blog for example, allows me to feel productive and useful.
4. Go and see my psychologist.  If I can't figure it out by myself, I know I can always go and get some help.

Well that almost wraps it up now for me and depression.  There will be a couple more posts on the subject, but I will leave the exact nature of those a mystery.  Until next time, stay well:)

If you think you may be suffering from depression, go and see your GP.  They will be able to assess you and point you in the right direction to get help.  If you don't feel ready to see someone yet, type "depression help" into google and that will give you a list of resources you can use for help.  In Australia, Beyond Blue is a great place to start.  There website is:-

www.beyondblue.org.au

Depression Gone

It was a long road, I think in all I was suffering from depression for about eight to ten years, five of those I was just trying to get myself better, something I feel I have only just achieved.  In brief, I did it by following the following steps:

1. Identifying the problem.  For so long I didn't realise I had a problem.  Once it had been identified and diagnosed the depression felt more tangible and solvable.
2. Get help.  In the fine words of Bono, "Sometimes you can't make it on your own." That is so true for people suffering depression.  It's OK to ask for help.  Everyone needs help at some point in their lives.
3. Anti-depressants.  They are not the answer but they do help and assist you in getting to the next step.
4. Validate your feelings.  It's OK to feel the way you feel.  Once you have acknowledged this and validated it you can move on to dealing with it.
5. Rectify past mistakes.  For me certain things I did, or more accurately did not do, were hanging over me like the sword of Damocles.  I was never going to finally conquer my depression until I had sorted them out.

I guess the question is "Am I cured?"  That is an extremely difficult question that can't be answered with a simple yes or no.  Depression is not a switch with an on off button.  It is measured on multiple scales, which makes it extremely hard to evaluate.  So, am I cured?  I am a great deal better than what I was, and if you were after a medical term I think that they would say I was in remission.

Which leads to another question.  Could I relapse?  The answer to this one is much more simple. Yes, absolutely, and it worries me.  Looking back it is somewhere I don't ever want to be again.  But it could happen.  It is not like one day I will just take a wrong turn, I would just simply be there and again I would have this horrendous mountain to climb.  

So what can I do about it?  Well luckily there is a point six.  Tools for identifying a relapse and rectifying it early.  But that is the post for next time.  Until then, stay well:)

If you think you may be suffering from depression, go and see your GP.  They will be able to assess you and point you in the right direction to get help.  If you don't feel ready to see someone yet, type "depression help" into google and that will give you a list of resources you can use for help.  In Australia, Beyond Blue is a great place to start.  There website is:-

www.beyondblue.org.au

Depression Continued.

During my depression I made a lot of mistakes.  It was not so much with the things I did, but with what I failed to do.  In a way, dealing with the medical problems was easier.  I had little control over the problems that I was confronted with medically, but the other problems I had created by my failure to do what was necessary.

Since 2002 I had been running my own business.  With that comes certain responsibilities.  Responsibilities that I had to fulfil.  To run a successful business you have to work hard and be proactive. To run a business there is a bare minimum that you have to do.  I was doing less than that.

It could have been viewed as me being greedy or selfish.  The truth was that in reality nobody was hurting more than me.  If you told me in 2002 that I would be in this situation, I would have laughed at you.  But in that moment where work had to be done and decisions had to be made, I would pick up the edge of the carpet, shovel everything under there, walk outside and bury my head in the sand.  For five minutes I would feel better.  Inside my head my problems would disappear, but hen they returned they would be worse and harder to deal with.

It was not a good space to be in.  I felt tremendous amounts of anxiety and guilt, and I had felt like I had let a lot of people down.  But it came time to deal with it all.  I realised at the time that I could not deal with my medical problems and run a business.  My medical problems weren't going to step aside, so I had to take a leave of absence from my business.

I order to do that I had to let a couple of people in on the problems I had created.  This was extremely hard.  I was embarrassed and guilty and the people I confided in were really great.  I couldn't have blamed them if slowly but surely they left, but they didn't.  Instead they helped me deal with it.  I was really surprised, but also extremely grateful.

As it stands now, I have a very solid business.  The problems I faced although tough have been dealt with, and although I am still not involved with the business on an operational level, I am still very proud.  I started it, I created it, I moulded it into the company it is today, and although it was others who took it that final step, I set the foundation.  I am also no longer guilty about where we are positioned.  We are strong, healthy and moving forward.

Next time I will talk about where I am at now and what tools I have to stop me falling backwards.  Until then, stay well:)

If you think you may be suffering from depression, go and see your GP.  They will be able to assess you and point you in the right direction to get help.  If you don't feel ready to see someone yet, type "depression help" into google and that will give you a list of resources you can use for help.  In Australia, Beyond Blue is a great place to start.  There website is:-

www.beyondblue.org.au

Depression Smack Down!

When I last posted to you, I had just felt like I had really made some headway tackling my depression.  I had taken myself to a point where things actually started to feel possible.  I had issues that needed addressing, and now I was in a space where that was possible.  If I had tried to skip straight to this point I would have failed and probably ended up in a worse spot.

Every step I made I did in consultation with my psychologist.  We discussed each step, what I needed to do, how I was going to do it, when I was going to do it by, what my expectations were, and most importantly, what I would do and feel if it didn't go as planned.

The first things I needed to address were my medical issues.  Be proactive not reactive.  I had three major issues that I needed to counter. Kidney stones, CIDP and tremor.  In terms of my battle with cystinuria and kidney stones I had been losing the battle for a long time.  Throughout my 20's I hadn't really been very good at looking for a medical solution.  If I wasn't symptomatic, I would pretend I didn't have a problem and carry on living my life normally.  If I was symptomatic I would get my stones dealt with surgically.

Truth be know, in my late teens and early 20's this actually worked quite well.  When I was not symptomatic I could go about my business as a regular uni student, and when I was symptomatic I had the time to go and have surgery and my young fit and healthy body would recover well and quickly.

However, when I got older, time was more precious and the surgery took more of a toll on me until I finally had my mega hospital stay in 2006.  Something had to change.  I organised to see a different nephrologist, who I liked and respected a whole lot more, and instructions I was much more likely to follow.  I also went and got hypnotised to help me drink more water.

With a metabolic disorder like cystinuria, you are never going to get rid of the stones completely, but I went 3 years after then without one stone!  Something I hadn't done since my first stone in 1994.  Next, I set my sights on CIDP.

I was extremely focused on getting better, but I had tried nearly every known treatment there was already, so where to from here?  My answer was to hit the disease with multiple treatments all at the same time.  I had in the past been treated by IVIG, plasmapherisis and mycophenalate, but never all at the same time.  So that is where we headed.  

Unfortunately, that didn't work, and in the past it would have wrecked me, but with my counselling I had prepared myself for that eventuality.  I was disappointed, but I could carry on.  But there is hope, as I have been researching the possibility of an autologous stem cell transplant.  But that is another story for another time.

Lastly, I had to combat my tremor, and since I was hitting it hard, it was time for the deep brain stimulation surgery.  There was an element of fear, but I realised that it was something I had to do.  I was done with my diseases dictating my life, I was in charge and I was going to have the surgery.  I have blogged about this surgery extensively, but if you haven't read it before, it went great.  In contrast to the CIDP, where I didn't let the bad news set me back, I certainly let the good news from this surgery carry me forward.  For the first time in a long time I had experienced the joy that came with success and triumph.  Positive emotions rock!


If you think you may be suffering from depression, go and see your GP.  They will be able to assess you and point you in the right direction to get help.  If you don't feel ready to see someone yet, type "depression help" into google and that will give you a list of resources you can use for help.  In Australia, Beyond Blue is a great place to start.  There website is:-

www.beyondblue.org.au

Next time, I will talk about all the other issue that I had to confront and face as part of my depression recovery.  Until then, stay well:)

I'm Back!

I was going to call this post 'Back to Normal'.  But what is normal?  For a while my normal was feeling depressed and all the baggage that came with that, so I've just gone with 'I'm back!'  Back from that nasty place from which I don't ever want to return.  Also in terms of our emotional constant, our normal is forever changing.  My normal from ten years ago (the last time I could be sure I wasn't suffering from depression) is different today.  So I'll simply say I'm Back! Back experiencing positive emotions, back feeling useful and productive.

But the question remains how did I get here?  In my post titled "Not so Silent, Not so Deadly", I commented on how I had made baby steps to solve my problem.  But they weren't really baby steps as much as one big step.  And that was creating a foundation for myself to tackle my depression.  I had talked to my doctors and was receiving professional help.  I was on anti-depressants which although weren't the answer, stopped me from reaching the punishing lows I had once experienced, and I had made mistakes which allowed me to see which direction not to go in.

So, where to from here?  I realised that I still needed help, so it was back to the GP.  This time he referred me to a different psychologist, but I realised that I had to make the change.  I had to be completely honest with my new psychologist, and not leave anything out.  That was a really tough thing to do.  I have always found it hard to open up to even the people closest to me, let alone a complete stranger, so I kicked off my first consult by letting her know this little conundrum I faced.  As insignificant as that seems, I had started to let my guard down, which lead to open honesty and a path to correcting my problem.

That first consult also marked a huge point in my treatment.  We talked about how I felt about all my medical problems.  I felt ripped off, like I'd been robbed, and inside I was upset and angry.  I had never shared this with anyone because I didn't want to be branded a whinger, or burden my problems with people who clearly would prioritise their own issues and would not want to hear mine.

So there I was, laying it all out on the table.  For me it was not the talking about it that really helped.  It was the unexpected response I got.  I was expecting a response like "Suck it up! Its the lot you were given you just have to deal with it." Or, "It's not so bad, think about all the people in the world worse off than you."

Instead, what I got was complete validation of how I felt.  Total and unconditional validation.  For the first time I felt justified in the way I felt and all of a sudden it didn't feel so bad anymore.  Instead I felt strangely calm.  The relief was the first real positive emotion I had felt in a long time.  It proved to me that I could get back.  I felt like I did not just have to fight the fight, but I wanted to.  What is more, I wanted to win.

Next time, I will talk about the battles I had to fight and how it all unravelled.  It was still a long road, but personally, a rich and fulfilling journey.  Until then, stay well:)

If you think you may be suffering from depression, go and see your GP.  They will be able to assess you and point you in the right direction to get help.  If you don't feel ready to see someone yet, type "depression help" into google and that will give you a list of resources you can use for help.  In Australia, Beyond Blue is a great place to start.  There website is:-

www.beyondblue.org.au

Karma doesn't like me :(

So in the last couple of posts I have been saying how things can be surprisingly easy when you only have one thing to worry about, and I have to say that mentally, I feel as prepared as I possibly could be for my surgery, and this still remains, except for one unexpected stressful situation that reared its ugly head this afternoon. Yes, I had to have a car accident.

Now I might sound like I'm whinging here (and I probably am) but the accident was not my fault, but unless I prove otherwise, I still get the blame. Anyway, the details are irrelevant for this blog, what is important is how I cope with it two days out from surgery. Time is not on my side, and I have to work through it quickly. All insurance details have been taken care of, and seeing as I can't drive for a month from tomorrow my wife will have to take care of the repairs. This means that the only problems left were all in my head.

So how did I feel? At the time I felt suddenly angry, but this dissipated quickly and I was left with annoyance. After I got home and had time to have a vent and a grumble to my wife I just felt stressed and worried. Still these are not good emotions to take into surgery and needed to be dealt with. So I talked it through with my wife. The rational steps to the conversation went something like this:-

1. Nobody was hurt.
2. We all did the right things post accident.
3. Insurance company was notified.
4. There is nothing more for me to do.
5. It is just a car.

And she is right, after that I felt better. Right now I am simply looking forward to dinner with friends. I think I am over my little mishap this afternoon. Until next time, stay well:)

Last Weekend Before Surgery

First, I must apologise. A couple of posts ago, I said I was done with my medical obligations until the day of my surgery. Oops. Friday I was back in the hospital for my routine intragam treatment (that I confess I forgot about completely) and I also have to see my GP as my surgeon informed me last week that my referral had run out. It was kind of opportunistic anyway as I can get him to update my drug regiment chart and medical history report. This makes life easier as when I am filling out those damn forms I can just write see attached in the relevant sections and attach a copy to the back.

Anyway, I promise that barring any unforeseen circumstances I will have then had my last medical obligations. So where am I know? I have officially finished up at work, and here in Australia we are currently in the middle of a long weekend for ANZAC Day. The extra time is great, and although there are many positives, there are also negatives. I have almost eliminated all stressful elements from my life now, which is great, but we still have that one massive commitment to deal with. Yes, my surgery. So I have really busied myself playing with the family, having fun with friends and working on this blog. It is a wonderful distraction too. However, when I stop, my mind always drifts back to the surgery. However, being just one stress to focus on it does feel easier. Right now I feel as though I have boarded up the windows, reinforced the structure to my house, and now I am just sitting on the porch waiting for the hurricane to hit.

I know I am prepared, it is a question of simply filling in the time between now and the surgery. Rest assured, I will let you know how it goes. Until next time, stay well:)

The Final Stretch

One week out and the testing is all but complete. The next time I see the inside of a medical facility will be in a weeks time when I front up for my surgery. But in this blog I will write about my final two obligations I had to fulfil before my surgery.

First, I had to see my neurologist, Dr Richard Peppard one last time. I have to say that this must have been one of the most beneficial doctors appointments I have ever had. When I got there his nurse Mary ran through everything. My long list of questions were answered and for the last fifteen minutes Richard joined us to add just a touch more clarity to the process. At the end they got me to do some tests so I would have a baseline comparison for my tremor. I had to do some fine motor skills, and they observed my tremor on video as well. They also had me do some reading as voice can be effected by the procedure, and if it is, they like to know by how much (as would I).

However, the main benefit came from having my questions answered and the assurances that I didn't even know I was looking for. Two of my main concerns were having the procedure not work and freaking out on the table. Richard shot these two concerns down in a smoking ball of flames whilst being extremely professional and compassionate too. For the procedure not working he basically made me feel like I was the ideal candidate for DBS and it would be extremely rare for it not to work. I have decided not to question the validity of this new belief as research in this area might only stand to worsen my anxiety. Sometimes, ignorance really is bliss. As for the freaking out on the table, he told me that he has never had a problem with any patient before, even Parkinson's patients, where anxiety is commonplace. He also talked up the compassionate nature of the staff and the effective nature of the drugs that they use, and if it really did hit the fan, they could always put me under with the general.

I am lucky that I have a great team working for me on April 30th, and although my anxieties have been somewhat relieved I have decided that it is still probably best to focus on the outcome and not the surgery. Next time I will talk about my MRI experience. Until then, Stay well:)

OK, I'm officially psyched out.

Well, after two psychologists appointments in two days, I think that it is safe to say that I am officially psyched out. Last time I talked to you about the clinical psychologist, and today it was the turn of the neuro psychologist, and as yesterday, I had a list of questions that I wanted to know:-

1. What were all the purposes of this appointment?
2. What exactly are all the tests that you will run?
3. What are the disqualifying factors?

As this procedure was not invasive I wasn't really concerned accept for one thing. Could this appointment exclude me as a candidate for surgery? The short answer was yes, but as it happened I had nothing to worry about.

So, what happened? First, we started with the general chit chat. I asked her my questions and she gave me a brief explanation of what we would do. From then on it was all testing. There were tests for my memory (both long and short), cognitive reasoning, IQ, problem solving, mental stability, and mental health. I was a little bit annoyed by this last section. She asked some very strong questions, such as "What do you think the worst thing that could happen is?" and "What will you do if the procedure doesn't work?" and then we explored these further in quite a lot of probing detail. She also didn't like my answer to the former, when I didn't acknowledge death as the worst thing that could happen. The fact is, the way I see it is I could have a stroke and live 40 years as a vegetable. She also didn't understand when I said I did not fear death. Don't get me wrong, I love life and I am not looking to hasten my demise or take ridiculous risks, but death doesn't scare me and I don't think she quite understood this. I also felt that this was covered by the clinical psychologist and I didn't really want to cover it again.

Anyway, at the end of it, I got the seal of approval to go ahead, and a full set of psychological benchmarks to compare against, God forbid something does go wrong with the surgery (which is the main reason why we did this). Now we are just a month out from my surgery I will take you through my checklist for getting ready in my next post. Until then, stay well:)

The Games Begin!

Well, today felt like the first official day in the lead up to my brain surgery. Being quite a major operation, I have a few tests and consultations to attend in the next few days. They are:-

1. Consultation with a clinical psychologist
2. Consultation with a neuro psychologist
3. Consultation with neurologist
4. Sedated MRI
5. CT scan

So today I trotted off to the clinical psychologist. I was sort of crabby before I got there as I already see a clinical psychologist, and I couldn't see the point in consulting another one. I would have thought that a report from my psychologist would have been enough, but the surgeon insisted I saw theirs, so off I trudged. After 15 minutes looking for a parking space (then giving up and going to the secure parking) followed by 45 minute wait for the psychologist, I was a little cranky.

But finally I got in to see Victoria Miller, a smartly dressed, professional looking lady, but at the same time a very friendly, comforting and disarming demeanour. My first impression was that she was very good at her job, and she didn't prove me wrong. Seeing as though I had struggled to see the relevance of this consultation, my list of questions that I had prepared was relatively short. They were:-

1. What do you wish to achieve from this session?
2. Is it really necessary?

I asked the second question first. I wanted to get it out of the way, but I did not want to appear cynical. So I asked if this was something that my current psychologist could do and did I really need to be here? Her answer was that she probably could, but Precision Neurosurgery like to get their own assessment. So what was the purpose of the session?:-

1. Make sure I have no underlying undiagnosed mental disorders like Bi-polar or depression. Since I had already been diagnosed with depression, this really was not much of an issue. They needed to know I was being treated, and as I was there was no need for concern.
2. Make sure I had a strong support network of family and friends and offer an extra avenue of psychological support if needed. I have a very supportive wife and a close family, and if that failed I still had a good network of friends I could rely on, so not as issue for me.
3. Make sure my expectations from the surgery were realistic and what if it failed to work or went wrong. Well I will focus on my fears from the surgery another time, but I fairly sure she was happy with my answers.

So the big question is was the session necessary? I would have to say yes, it was, but probably not for me. The doctors need to find out these answers, and if I gained anything from the session, it was the comfort that the doctors were being thorough, and they cared about my general health (both mental and physical) as well as simply trying to cure my tremor. I guess that in itself was simply enough to make the consultation worth while.

Well, tomorrow it is off to the neuro psychologist. Rest assured I will let you know how it goes. Until then, stay well:)