Third 3-Month Review

I’m proud to say that I’ve stuck with this blog for 9 months. It’s been a bit of a roller coaster but I’m still hanging on, and so is Fox.

I’ve written 140 posts; you are welcome to read my First and Second 3-Month Reviews. This post will pick up where the second 3-month review left off – in late June.

Fox has written 3 posts (in chronological order):

  1. Masculinity, Tools of Violence, and Embracing Femininity (01/15/13)
  2. From a Supporter’s Point of View (05/22/13)
  3. When Supporting Starts to Hurt (06/29/13)

Most of my posts for the past 3 months have been focused on my efforts to take care of myself – or at least develop a plan for doing so.

Continuous knotwork panel designed by Ziya.

Continuous knotwork panel designed by Ziya.

At first I needed to allow myself some room to breathe. I took a step back and allowed Fox to decide what to keep and what to dispose of when he moved in with me; this made the entire process much easier on both of us. I also gave myself permission to leave projects unfinished and to make my own decisions without feeling like they are unhealthy or morally wrong. This empowered me to take control of my own treatment and recovery.

The first thing I did with my new-found agency was decide to stop seeing my psychiatrist and taking my medications, both of which weren’t helping and were probably making my symptoms worse. (Prescription by Dr. Ziya and my reply to its first comment.) I also learned about how inactive ingredients in generic “equivalents” of brand-name medications can limit the effectiveness of the active ingredient and/or have other adverse effects. I became determined to find a psychiatrist who would take inactive ingredients into account and, most importantly, whose sole concern would be helping me to find the best medication(s) for me.

frustrated woman holding cell phone to ear

why me?

Unfortunately, trying to find help turned out to be more trouble than it was worth. All it really did was make my symptoms worse. I barely had the energy and motivation to take steps to try and make an appointment with a psychiatrist, which required me to overcome my distaste for talking to strangers on the phone. When I finally mustered up the energy to do it, 2 psychiatrists never got back to me and the 3rd played phone tag with me until I got so pissed off at him I doubted our ability to develop a functional therapeutic relationship. I wished someone else could make the appointment for me, but I’m pretty sure health care providers require competent adult patients to make their own appointments. I don’t think anyone involved was ready to have me declared incompetent, even if it would have gotten me the help I needed.
(Stop having Cancer so you can Find a Doctor; Holistic Treatments; Crossroads)

While I was trying to find a psychiatrist, I was also trying to find a way to continue having the health insurance I needed to afford said psychiatrist and the psychotropic medications ze would prescribe. I thought I could continue receiving coverage from my school, but then I learned they no longer offered insurance for part-time students. I was able to find two alternatives. I could switch to the first right away but it cost $400 per month and as far as I could tell did not include prescriptions. The other was $320 per month and included prescriptions but I was confused as to whether and when I’d be able to pick it up. Then I learned that in October I’ll be able to search for affordable health insurance on Healthcare.gov. I made the difficult decision to wait until October to explore my health insurance options, leaving myself without coverage until January. At that time I also decided against continuing my search for a good psychiatrist. (Healthcare Headache; The Healthcare Headache Continues…)

pill bottleFreed from the American headache “healthcare” system, I created my own plan for how to take care of myself: Planning A Head. To be honest, the only part of it I’ve been consistent with is taking 400mg of SAM-e, an Omega 3 supplement, a vitamin B complex, and vitamin D every day. The plan also includes listening to a playlist of songs that help me feel energized and ready to face the day – as well as a variety of activities that involve self-care, enrichment, and/or just having fun. Some of the activities are very easy to do every day, such as spending quality time with Fox and our pets. Others require a bit more organization and forethought; I just don’t have enough structure in my life right now to engage in them regularly.

My scores on the Burns Depression Inventory for the past 4 weeks. Daily scores are marked in blue, while weekly averages are marked in red. Although the severity of my depression symptoms can change drastically from day to day, there has been a steady decline in weekly averages from July 29, 2013 to August 34, 2013.

My scores on the Burns Depression Inventory for the past 4 weeks. Daily scores are marked in blue, while weekly averages are marked in red. Although the severity of my depression symptoms can change drastically from day to day, there has been a steady decline in weekly averages from July 29, 2013 to August 24, 2013.

I decided to use the Burns Depression Checklist to keep track of the severity of my depression symptoms from day to day and week to week. I took a look at overall daily scores and weekly averages in Measuring Recovery: Part 1, and analyzed my daily scores on the subcategories of the checklist in Part 2.

I’ve been less consistent in using the checklist in September, but from what I can tell the oscillations in daily scores have continued. The weekly average score actually went up in the first week; it’s hard to say anything useful about the second week because I only tracked on Friday and Saturday, which both had scores in the teens. I’ve been visiting with Banji and her parents, which has been a pleasant break from the norm.

I also joined SparkPeople in hopes that it will help motivate me to take better care of myself, including exercise and better nutrition. To be honest I lost interest in that pretty quickly; I’ll log in every so often and occasionally track, but I’m nowhere near as active with it as I’d intended. But it’s sitting there, waiting for me to sign in, ready to reward me with points for any efforts I do make toward living a healthier lifestyle.

The Dark Side
(trigger warning)

There has been a darker thread running through my posts in the last 3 months; I wouldn’t be upholding the purpose of this blog if I didn’t at least try to write about it in this review.

In More Celtic Design Knotwork I wrote about how I often lack the passion and energy to express my emotions, and use coping mechanisms to suppress them so I’ll come across as calm (often for the benefit of others). “I just want a day off” more often than I care to admit; you can almost say there are times when I don’t want to be bothered with my whole life! Then I retreat into video games, which give me a space where I feel in control and can vicariously experience the benefits of getting out of the house and doing things in a fantasy world with no real consequences. Most importantly, in those games I can accomplish my goals with minimal interference by other people; if the characters in the game get annoying enough I can kill them; if that causes the game to become very difficult to play I can go back to a recent save. (Invasion)

Fingers with strings tied to them, controlling a puppet.I simply cannot do that in real life and it’s very annoying. I have to compromise with somebody in order to accomplish anything. It’s driving me nuts! My mother especially has been making things very difficult by trying to control me. She undermines my confidence by criticizing my appearance (Mother-of-the-Bride Zilla) and causing me to question my decision to marry Fox, never mind all the decisions we’ve made regarding the wedding. When I wrote No Space for Me I felt like Mom, Fox, his mother, and his sister were all against me, completely disregarding my boundaries and right to have and state my own opinion. That was the first time I recognized the Warden (though I didn’t write about that persona in the post) – the voice in my head thought process that says I’m not allowed to do anything of my own will, to dissent, to assert my needs and rights. It’s positively devastating; it leads me to suicidal thoughts.

I mentioned that “the images of knives cutting into me are coming back again” on August 12th, when I wrote about my undergraduate mentor’s Death. That imagery has not been coming up with much frequency, but there have been a couple times (other than those I wrote about) when I’ve scratched myself as a kind of punishment / refocusing. Thanks to Fox, I was able to channel the immense energy of suicidal ideation into making music on August 14th (Spring Cleaning). I’m pretty sure my crisis on August 19th (No Space for Me, link above) was the most recent, but it’s still rather terrifying.

tomboy holding up prom dress and looking at self in mirror

Contrasting Views on Norman Rockwell’s America

Similarly terrifying is the difficulty I’m having thinking of myself as an employable person, someone capable of holding down any (preferably meaningful) job. It started in Career Person? when I realized that striving for a meaningful career outside the home was no longer a crucial part of my identity. Then I allowed anxiety to completely undermine my chances of being offered the job I’d applied for, using every doubt and insecurity hidden in my mind. It finally won by preying on my insecurities around weight and fashion, particularly in the context of being female in this society. I don’t have any confidence in my ability to make myself look attractive – and therefore employable – to the mainstream; I’d much rather wear sweat pants and avoid it. (Oh No! Interview?!)

If I can’t pull off a career … that thought is too devastating. I could be a stay-at-home parent but that feels just as if not even more empty than having a career but no kids. I need to feel like I’m having a meaningful impact on society; having some kind of income would be wonderful. (It will also be necessary if Fox and I ever want to move out of my mother’s house.) I’m trying to be hopeful but mostly I’m afraid. And sad. It’s not even that I can’t see any open doors, I don’t see any doors at all. Only windows.

And I don’t know how to talk about it. I spent a whole week not knowing how to talk about it, before I wrote Update. As much as I wish I could take care of myself the truth is I can’t; I need help, and I need that help to include some kind of vocational guidance, training, and employment.

The Flashlight

This weekend has given me some hope (even though I chose to end it by staying up too late writing about my most painful thoughts and experiences for the past 3 months). It started with Banji’s parents showing me respect on our way to visit with her (Creating a Space for Me). I’ve spent the weekend making a conscious effort to assert myself more, with satisfying results. It hasn’t exactly been my ideal weekend – I’ve been cold, awake when they’re sleeping and sleeping when they’re awake, and going online while Banji finishes unpacking. Dad kicked my ass at the same board game twice. But it has been a good weekend, what one could call a corrective family experience. As much as I might be tempted to isolate myself, I’m part of this group. My views are respected, my needs taken into consideration, my self valued. All I have to do is speak up – and more importantly, I know it’s safe to do so!

Fenix-RC15-Flashlight-Beam

I know I can assert myself around other loved ones, too. I’ve seen positive results from doing so in the past. I needed this opportunity to practice in a different setting, a group with a (generally) much calmer and slower dynamic. I needed to see and feel their respect for me; sometimes I have a lot of trouble doing that in other groups. Maybe now that I’ve had this experience, I’ll be able to request the help I really need – and deserve.

Spring – er, Late Summer – Cleaning

Today was positively gorgeous. A tad chilly, with a very invigorating wind, just a handful of clouds in the sky. I couldn’t have asked for a better day.

I wanted to get outside; while I was out I took the opportunity to clean up the plants in our garden. Most of the leaves on the basil have turned white, so I cut them away. This allows more resources to go to the healthy green leaves near the tops of the plants, and allows more sunlight to reach the newer, healthier-looking sprouts that have emerged. When I was done with the basil, I similarly cleaned excess, dead-looking stuff off the cucumber plant.

Once I was done pruning away the dead or sickly stuff, all that was left were (mostly) healthy plants, full of life. I thought, I wish I could do that for myself. Get rid of all the dead stuff, the clutter, and just keep what fills me with vitality.

So I went back in the house, opened all the windows so it would be full of fresh air and sunlight from this beautiful day, and proceeded to clean. I started with the bathroom and cried as I scrubbed the bathtub. I fought the mean voices that told me I was either in my rightful place as a woman (on my knees cleaning) or that I was demeaning myself by doing housework. I reorganized items so the sink looks presentable and the contents of the medicine cabinet are useful, not past their expiration date. I got that picture I don’t like off my wall, and cleaned up the stains it was covering (using white vinegar diluted in water, a paper towel, and some elbow grease).

When I was done, I moved to the kitchen. I started by reorganizing all the plastic containers we keep for storing leftovers, so they’re mostly on one shelf, sorted by shape and size with lids readily available. They look neat and there’s most of a cabinet free for storage of additional items – which is good, because the house as a whole is still intolerably cluttered. Soon after Fox got home he took care of the dishes, while I sorted through trash and recycling, found homes for items we wanted to keep, and cleaned surfaces. Before long we were sitting together in a very pleasant, relatively clutter-free kitchen, sharing a simple but delicious dinner. It felt so good to finally be at peace with my environment while in that room.

I did a lot of good work – quite the accomplishment, especially considering I didn’t see much point to getting out of bed this morning. But I’ll admit, I’m a bit disappointed that the only cleaning I got to in the living room and bedroom was trying to remove the dirt from the windowsills. (Seriously, how does dirt get on windowsills? It’s not dust, it’s dirt, like the stuff on the ground with grass growing in it outside! And it’s thick and hard to pick up. Gross!) I really wanted to change this space, make all of it more liveable. But I guess I just need to be patient with myself. Patient, and persistent.

It drives me nuts that unless we make a constant, conscious effort to maintain this, it’s just going to get intolerably gross again.

I don’t know how to assess my depression. Fox thinks the SAM-e is making me more irritable and anxious; I think he has a point. Last night I almost cried myself to sleep because I saw no point in living, no reason to care about sleep, waking, no point to even trying to do anything … and I felt trapped. I can’t end it, there are too many people who would be hurt. The thought of just going on, suffering horribly, my whole life pointless, just so my loved ones would be protected from the pain my death would cause … it was too much to bear. I couldn’t help crying.

Fox heard me, of course, and asked what was wrong. I started telling him all this stuff and somehow the conversation turned to composing music. I said, “I really like exploring different sounds. That could be a good reason to live.” Next thing I knew, I had a melody in my head that wanted out. I got up and started writing; a few hours later I had the melody written down, a list of instruments with timbres appropriate to the mood I want, some ideas for harmony and counterpoint, and the beginnings of a composition in Notion. It felt so good to be intentional in making choices that created the effects I was looking for, while also allowing for spontaneous creativity (e.g. a second melody that practically wrote itself).

So I have severe symptoms of depression and anxiety – including some suicidal ideation – alternating with incredible energy that I can consciously direct: last night into a new piece of music; today into improving my environment.

It doesn’t make any sense. It seems horribly contradictory. … or is it?

Unpleasant as they may be, those intense emotions are overflowing with energy. At their core is an intense desire for (possibly mixed with a fear of) change. “I can’t live like this anymore!” really amounts to “I want all these things – maybe even everything – to change!” And what greater change is there, than death?

We have to admit, looking our fear in the face and accepting it, taking direct action to cause such a huge change – THE huge change we are wired to do everything in our power to avoid – that is an incredibly powerful act. Not a good or desirable or advisable act, mind. But a powerful one, nonetheless. Like Voldemort.

I’ve been incredibly fortunate. I’ve had the support and force of will to take that power, that immense energy, and channel it into something less self-destructive than suicide. Even something creative. Last night, for better or worse, a new musical being entered the world. In the past I’ve sculpted and drawn and improvised music. Today I removed a lot of gross dead stuff that was standing between me and the life-giving sun.

If the price of such power is suffering, well, I guess I’m willing to pay it – as long as I can still have my moments of joy, which I do. I’ll take this power and put it toward making the world a better place. For myself by cleaning my house, and beyond by doing Spock knows what. I have the power – the raw energy – to do it. I just need to get better at using it instead of feeling overwhelmed.

The Healthcare Headache Continues …

I thought I had the answer: I would take a 3-credit course, in part out of interest and in part because it would make me eligible for my school’s “voluntary” part-time student insurance. But today I learned that there are no longer any part-time student plans available – whether that’s because my school dropped them, or the insurance company stopped offering them, I don’t know. I just know that I was very confused and frustrated when one part of the site still said I could opt-in to the voluntary insurance, but when I clicked the link it said no plans were available.

I’ve reluctantly accepted that they’re not offering insurance to part-time students, based on the mail-in forms having last year’s dates. They just didn’t bother to update the whole website. Lazy bums. (Acceptance doesn’t make me any less angry. It just saves me the trouble of trying the same thing over and over again just to be repeatedly disappointed by the results.)

I’m disinclined to trust the $400/month short-term insurance plan offered by an affiliate of my school’s insurance company. The very nice representative I’d talked to called back, reminding me to apply in time for coverage to start on the date I’d requested. She also re-sent the information she’d initially sent me. I’m tempted to call her back and thank her for her help. But the attached PDF clearly stated that prescriptions weren’t covered; when I tried to see if other plans were available, the one she’d recommended disappeared, so there were no plans available at all! I know I can call her back and ask questions, but I don’t want to risk wasting money (that I don’t really have) if the information she gives me turns out to be wrong.

In light of all this, paying nearly $2,000 to take a class purely out of interest became a lot less appealing – especially since a similar one might be offered for free on Coursera. I started listening to the lectures for one of my Coursera courses last night and found them to be positively fascinating. It felt so good to just soak in the information. No deciding what to wear, traveling, finding parking, potentially being late, awkward social situations, and consequences for not doing assignments required. So, I’ve decided to drop the 3-credit course I’d registered for at my school, and go the continuous matriculation route. A relatively small fee means I’m still a graduate student, really!

That still leaves the matter of health insurance.

I’ve decided against going to see a psychiatrist for the time being. The SAM-e (along with other factors) seems to be helping quite a bit, especially on days when I remember to take 2 doses of it (400 mg 2x/day, total 800 mg per day). It’s not perfect, but it’s at least as good as the antidepressants I’ve tried so far, with less adverse side effects (maybe because it doesn’t contain weird, unnatural chemicals?). It’s not exactly cheap, but I think I’m saving money over seeing a psychiatrist and paying for medication, especially if I need brand-name instead of generic. I can buy the SAM-e in 3 clicks and have it shipped to my front door – no phone tag, traveling, disclosing personal information to a stranger, and waiting at the pharmacy required. It might not be the best, but it works better for me right now. I can’t help wishing I’d found out about it years ago.

Health insurance suddenly seems a lot less important if it’s not the only way I can afford to treat my depression. Wakana doesn’t take insurance; I’ve been paying her at a discounted rate out-of-pocket. Insurance wouldn’t cover the SAM-e anyway. Hospitals are required to give life-saving care regardless of whether you have insurance. The only thing left is preventative care, which I’m hoping I can find a clinic for nearby. To my knowledge my state isn’t among the insane ones trying to shut down Planned Parenthood, so I intend to begin my search there.

(In case it’s not blatantly obvious, I hate going to see doctors. So, for most things, I wouldn’t bother seeing a doctor. If I’m miserable with a cold or something, I’d rather be miserable at home where I have access to things that help – like tea and soup – instead of at the doctor’s office.)

And in October I should be able to shop for an insurance plan on Healthcare.gov, so hopefully I’ll only lack health insurance until January. Hopefully.

Let’s be honest, I hate making these decisions. But this is the hand I’ve been dealt, and I need to do (or choose not to do) whatever it takes to protect my mental health. I’ve been burned by conventional medicine and the insurance required to make it remotely affordable, so I’m finding alternative ways to take care of myself.

Planning A Head

I have had enough. Enough feeling horrible. Enough choosing not to go out because I don’t want anyone to see me. Enough living in clutter because I feel completely unmotivated to do anything about it. On Monday I didn’t even want to eat, that never happens (if anything, I usually overeat).

Saturday night was a lot of fun; Fox and I went out with some friends to a game store, where we could play board and card games to our hearts’ content and socialize with other people. It got a bit loud and overwhelming, but I was able to enjoy the social interaction and have fun playing the games. I even won Ticket to Ride: Europe and a hand of Magic: The Gathering. That felt really good!

A map of Europe with colorful train tracks connecting major cities.

The outcome of a 5-player game of Ticket to Ride: Europe. I played as blue – and won!

Unfortunately, it went a bit on the late side, and when we got home we were too excited to go to bed. We ended up pulling an all-nighter (sorting through Magic cards) and were a mess for two days. Our sleep cycles have been completely thrown off, our diets far from balanced (meals? what are they?), with barely any energy or motivation to do anything useful. We both seem to have some kind of cold or something. Yuck.

(Potential) Psychiatrist C-1 called while I was in my session with Wakana on Friday and I didn’t have a chance to call him back until Monday. No answer. I left a message. No return call. Now it’s late in the day on Tuesday. Nada. It’s been two business days, he might not even be in. But I’m sick of this nonsense. I know it’s unreasonable to blame him and I really don’t but I need to do something. Psychiatrist C-2 hasn’t called at all.

It’s time – past time – to take the matter into my own hands. I’ve had enough – more than enough – of this nonsense. I’ve written about treatment plans before but did I act on them? No. Well, not this time.

I really really hope, not this time!

Wake Up on the Right Side of the Bed

On Monday I made a 25-minute playlist of 5 songs to help me feel energized – or at least less dead – in the morning. I listened to them soon after waking up today (Tuesday) and wow, what a difference they made!

MP3 player next to a quarter.

This tiny little mp3 player is awesome.

The first two songs are from Barefoot and Flying by the Ebony Hillbillies, who play Black string music. They’re fun and active without being overly energetic or hectic, and I’m madly in love with the bass. The vocals are quite enjoyable, too. One song has a violin part that outright tickles me, and I enjoy the unique rhythms and timbres from the washboard and other percussion in both.

Two more songs are from Dance of the Celts: the first starts kind of mellow and picks up speed and energy as it goes along, while the second includes didgeridoo. The low drone and unique timber of the didgeridoo do amazing things for my mood; listening to it (for me) is like eating the most decadent chocolate while having absolutely fantastic sex. If that can’t perk me up in the morning, nothing will.

Finally, I ended the playlist with The Chieftains Reunion, an 11:22 monstrosity with a variety of changing instruments, very fun energetic rhythms, and a unique female solo vocal part around 8:30 that I can’t resist singing and sometimes even dancing to.

By the time I finished listening to the list, I felt calm, alert, ready to face the day, and even happy. I noticed that my mood started worsening pretty soon afterward, though, and the high energy to … well, nothing – because I wasn’t listening to music anymore – seemed to be the key contributing factor. I think adding a mellow, soothing song or two to bring my energy down more gradually would probably help quite a bit.

Break Your Fast

I’m usually pretty good about eating something very soon after I get up, even if it’s just a handful or two of raw nuts. Add some water, and I’m pretty much good to go – or at least less grouchy. My ideal would be to have eggs and whole wheat toast for breakfast every morning; it’s the most satisfying and energizing breakfast I’ve ever had.

A field of flax flowers, whose seeds will provide me with Omega-3. image from informedfarmers.com

A field of flax flowers, whose seeds will provide me with Omega-3.
image from informedfarmers.com

The harder thing for me to do is take pills. If I’m going to take them at all, around breakfast is the best time. I’ve decided to resume taking an Omega-3 supplement (1200mg flaxseed oil, which includes Omega-6 and Omega-9 as well but at lower doses) and a complex that has multiple forms of Vitamin B and includes Vitamin C for some reason. I’m thinking I should see if I can find a similar complex by a different manufacturer, though, because the one I currently have includes “inactive” ingredients I expressed concern about in my post, Ingredients.

I ran out of the Vitamin D supplement I’d once been taking, in part because I thought I’d be okay if I didn’t take it in the summer. Unfortunately, I just don’t seem to get enough sun for my body to produce what it needs. So maybe I need a lower dose of the supplement in the summer than I do in the winter, but I still need to supplement whatever my body is able to make naturally. I plan to resume doing so as soon as I’m able.

Finally, I’ve decided to go ahead and self-medicate with SAM-e. It’s a supplement that is supposed to help one’s brain produce the neurotransmitters it needs to run, well, considerably better than mine has been. Unlike Protazen (see previous post) – which explicitly has not been subjected to efficacy research “in order to avoid raising the cost to consumers” (according to their customer service representatives) – SAM-e has multiple empirical studies backing it up. It’s probably not any more – possibly less! – expensive than taking a brand-name drug, even with a prescription (insurance) plan. And I can get it in about 3 clicks, no phone tag required. I took my first dose today.

After shopping around a bit, I’ve decided to buy my SAM-e (and possibly other supplements) from Now Foods. They (say that they) use “natural” ingredients – things you could find in nature or synthetic chemicals that are essentially identical – and explicitly avoid the strange substances I expressed concerns about in my post on inactive ingredients (link). I’m hoping the stuff they use will be a bit nicer to my body and possibly even help (or at least not hinder) the active ingredient.

Spock Helps Those Who Help Themselves

So after I wake up to the sound of music, pop a bunch of pills “natural” supplements, and eat breakfast, I get to focus most of my energy on trying to feel good – or at least less like dying. (That’s not an exaggeration.)

a rat on a girl's shoulder

furry little companions make everything better!

The rats are wonderful. They’re cute and fuzzy and happy to see me – especially in the morning when they’re hungry. It’s really hard to interact with them without a smile breaking out across my face, whether I think I feel like smiling or not. The more I can spend quality time with them, the better.

Hey, you know, Fox is pretty wonderful, too. When he’s not being grumpy pants … and sometimes even when he is. 🙂

Our herb and vegetable garden is doing pretty well, all things considered. Sure, the parsley is a lost cause and the basil has seen better days (literally) and I’m not sure we’re ever going to get cucumbers from the strange prickly vine that’s waiting to ambush us from its pot. But the weed chocolate mint is thriving (seriously, looking for a delicious ground cover? get this stuff and hope your neighbors can appreciate it, too), our peppers are getting fat and starting to turn orange, and on Monday I harvested the first of our beautiful red Roma tomatoes! Just thinking about it makes me very happy. It would do me a lot of good to at least check on the garden every day, even if it doesn’t need weeding, pruning, or watering.

I’m enrolled in several free online courses on Coursera as well. To be honest I haven’t been paying much attention to the one that’s already started, but that’s okay because it won’t affect my GPA, I didn’t pay for it, and I’m taking it entirely out of interest. This gives me something to do and an opportunity to learn about diverse topics I’m interested in, for the fun of it, no need to stress. Win-win.

I’m still seeing Wakana twice a week, though we’ll have some breaks because she’s traveling in August. I stopped being consistent with massages but they’re still on the radar as something to help relieve stress. Aromatherapy can be added to the massage; maybe I’ll even get around to trying it at home, too. For starters, I can use the extra lotion I took home from past aromatherapy-enhanced massages. And I’ve been increasingly tempted to go see a chiropractor as my back, shoulders, and hips become increasingly painful.

Yes, I know, 30 minutes of exercise per day has been shown to help fight depression. It would probably do wonders for my chronic pain, too. I’m just not quite there yet. Nor am I ready to get out, join social groups, try new things, etc. – at least not without a lot of support, poking, and prodding by people I trust enough to share a bed with them. Let me practice on the foothills until I can climb halfway up one without struggling to breathe, before you ask me to climb Mt. Everest.

But speaking of climbing Mt. Everest, I have no idea where the Out of the Darkness Overnight is going to be in 2014. Wherever it is, I want to do it next year; whether I can attend the event or not, I want to start training for it ASAP. The more time I can give myself to get in shape, the better.

book cover: Codependent No More by Melody BeattieFinally, I’ve got some self-help books I’ve been meaning to read and do the exercises in. They have to do with time management, unlearning the lessons of an abusive childhood, and cognitive therapy for depression. One of them isn’t a self-help book per se, but might provide useful information for selecting music based on its potential therapeutic effects. (Just to clarify: that’s not music therapy, because I’m doing it for myself. However, it is one thing music therapists often do as part of their work with clients.)

I took another look at the chapter on Detachment in Codependent No More by Melody Beattie. I’m not entirely sure I’m done with it, nor whether I want to write another post about it, but I do plan to continue on through the rest of the book from there.

And How Will You Know If All This Stuff Is Working?

The Burns Depression Checklist is a very valuable tool for measuring severity of symptoms and tracking changes in said severity over time. It’s a self-report measure that’s been tested and found to be quite accurate and reliable. It’s used by many mental health professionals. The link above is only one of several that can be found via Google search; I selected it because it includes the scoring scale and will calculate your score for you.

I filled in the checklist Monday evening and my score was 60, indicating severe depression. It’s easier for me to focus in on one day at a time, but the severity of my symptoms can fluctuate pretty drastically from day to day or even over the course of a given day, depending on a multitude of factors. There were times Monday when I felt like I was perfectly fine, and yet also enough shitty moments that my responses earned me a 60. So, I think it’s probably best if I complete the checklist multiple times per week, focusing on a single day each time, and then take the average score for each week. Over time a pattern will emerge, and that pattern will help me see how my depression is doing.

It might also be helpful to make note of anything that might be having a particularly strong impact on my symptoms. “So-in-so visited for a few days and I was very happy to spend time with zir. It was great while ze was here, but a bit of a letdown when ze left.” “I had a very fun high-energy social evening, but didn’t get enough sleep afterward. Sleep deprivation made my symptoms a lot worse until I managed to fix my sleep cycle.” … I think you get the idea. Then instead of throwing up my hands when there are too many variables to have any clue which ones are having an effect, or whether the positive effects of my treatment are just being utterly thwarted by the shit life’s throwing at me, I can actually look at all (well, most?) of the variables and get a better feel for what’s going on.