Happiness

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In the darkness

A faint light flickered

So faintly as to be questioned.

Yet, I followed it

Hoping to find relief

On the other side of that light.

As I went over the threshold

From darkness into light

Happiness returned.

TTL 8/1/19

On the Other Side of Cancer

7 Rules Of Life, motivational poster print – zingydecor
Credit this to Pinterest

I had my follow up CT scan and visit with the radiation oncologist. The cancer is gone! Follow up will be in October with another scan and that time. I am so glad I changed physicians! If anyone doubts a second opinion is wise, let my case serve as an example. It is always wise.

So, after months of feeling so beat down and depressed, I am beginning to regain my positive attitude and outlook. I will be honest, after 12 or more years of stability on medication for bipolar II disorder, this whole cancer thing threw me for a loop. It has been a roller coaster with my mood swings and changing medications to try to find something that would help. Finally, I feel better.

Among the things I have done the last month or so, I have seen all of the seasons of Stranger Things. My daughter has encouraged me to watch this series for a year and I did not do so until this month. OMG! Love it. Now my husband and are into season II of the Handmaid’s Tale. I read the Margaret Atwood book many years ago and loved it. I just could not imagine a series about it thought. It seems the series is true in nature to the book and the author is a collaborator with the writers of the series. At this point, I could slap Offred…..

I have written more poetry than I have in years during this latest dark time and hope to continue this. I enjoy the challenges because it gives me a direction to go with my writing and creativity. Reading others posts on blogs makes me happy. I love connecting to others through their writing.

Thanks to all of my blogging world friends who have been so supportive and encouraging. I cannot say how much this has meant to me. I feel I can now again enjoy life and that is a superb feeling.

In Response to https://beckiesmentalmess.blog/2019/06/05/june-5-2019-trial-1-working-on-us-mental-health-prompts/

Prompt #1 – Question:

When you first found out that you had a mental illness/disorder, what was your first reaction?  Explain, how this new revelation regarding your health affected you?

From the time I was a teenager in a very bad situation in which I was isolated from any support system, I knew something was not right with my emotional health. I obviously was not allowed to speak to anyone about it because I would have revealed the why of my emotional instability. I made it through high school and went to college where my mother insisted I go because she had a rich coworker who graduated from there and it was an hour from home. She relentlessly hounded me. I began at that point to have more and more symptoms, mostly depression.

As I became older, I would have times I would feel great and do some really stupid, dangerous activities and spend money when I should not. But, the depressions became worse. I went from psychiatrist to psychiatrist and every antidepressant prescribed caused horrible reactions. The last one, Lexapro, caused a severe panic attack while I was driving to a meeting for work.

Finally, a psychiatrist started asking more questions about those times I felt so good and she determined I had bipolar II disorder. It was life-changing and I went through a range of emotions. My husband did not understand the diagnosis and was so upset about the diagnosis, he left. He did return and we are still married.

Treatment has really helped, but it has to be tweaked every now and again. I am presently dealing with a recurrent lung cancer. I cannot even begin to imagine what this would be like without the medication I take for my bipolar II disorder. Still, the stigma of the diagnosis is alive and well and difficult to deal with. That is what I hate most of all.

Changing the Language for Mental Health

In my book,” Things I Think About”, I wrote a chapter about mental health issues, which are close to home for me. I have been considering if the term, “mental illness” was, in and of itself, a disservice to those of us who occasionally struggle with our mental health diagnosis. I believe it is.

A mental health diagnosis is like any other diagnosed condition: Defined by criteria and, when appropriately treated, a state of wellness is achieved with treatment. Mental health issues need not constitute a continuation of a state of “illness”. In the physical, medical world, if one is “ill”, one is actively sick.

Properly treated, persons with mental health diagnoses are no different than persons with an appropriately treated chronic medical illness, like hypothyroidism, or glaucoma, or diabetes, or Crohn’s disease, or rheumatoid arthritis, or…. I could go on. For most of us with a mental health diagnosis, if we did not reveal to you we had a mental health diagnosis, you would never suspect it.

Here are some statistics on mental health diagnoses:

Key Findings

  • Over 44 million American adults have a mental health condition. Since the release of the first State of Mental Health in America report (2015), there has only been a slight decrease in the number of adults who have a mental health condition (from 18.19% to 18.07%)
  • Rate of youth experiencing a mental health condition continues to rise. Therate of youth with Major Depressive Episode (MDE) increased from 11.93% to 12.63%. There was only a 1.5% decrease in the rate of youth with MDE who did receive treatment. Data showed that 62% of youth with MDE received no treatment.
  • More Americans are insured and accessing care. We can continue to see the effects of healthcare reform on the rate of Adults who are uninsured. This year there was a 2.5% reduction in the number of Adults with a mental health condition who were uninsured.  
  • …But many Americans experiencing a mental health condition still report having an unmet need. 1 in 5, or 9 million adults reported having an unmet need.
  • Mental health workforce shortage remains. Many states saw some improvement in their individual to mental health provider ratio. But in states with the lowest workforce there was almost 4 times the number individuals to only 1 mental health provider. (Mental Health America, 2019)

From this same website, Mental Health America, statistics for my home state, North Carolina, show a rate of 18.98% of adults have some type of mental health issue. Substance abuse affects 7.03% of our population. Those adults in North Carolina who have serious thoughts of suicide are 4.23% and persons in North Carolina who have any mental health issue and do not get treatment constitute 50.7% of the population. (Mental Health America, 2019)

From the National Alliance on Mental Illness, (NAMI), the site states:

“A mental health condition isn’t the result of one event. Research suggests multiple, linking causes. Genetics, environment and lifestyle influence whether someone develops a mental health condition. A stressful job or home life makes some people more susceptible, as do traumatic life events like being the victim of a crime. Biochemical processes and circuits and basic brain structure may play a role, too.” (National Alliance on Mental Illness, 2019, para. 3)

In addition, on the NAMI website it also relays:

“If you have a mental health condition, you’re not alone. One in 5 American adults experiences some form of mental illness in any given year. And across the population, 1 in every 25 adults is living with a serious mental health condition such as schizophrenia, bipolar disorder or long-term recurring major depression.

As with other serious illnesses, mental illness is not your fault or that of the people around you, but widespread misunderstandings about mental illness remain. Many people don’t seek treatment or remain unaware that their symptoms could be connected to a mental health condition. People may expect a person with serious mental illness to look visibly different from others, and they may tell someone who doesn’t “look ill” to “get over it” through willpower. These misperceptions add to the challenges of living with a mental health condition.” (NAMI, 2019, paras. 1-2)

I contacted the NAMI information site to ask the organization to consider changing the language for mental health diagnoses from mental illness to mental health condition or mental health diagnosis. I give my rationale for this request as discussed above. The response I received from Luna was as follows;

“As far as the term “mental illness,” there has been a lot of internal debate about the best terminology to use. And there are discussions coming up this year about how we will move forward in the future, so I will bring this perspective to my team!”

 There have been many public persons who have struggled with mental health conditions. Per Web MD. persons such as, Mariah Carey, Demi Lovato, Brian Wilson, Russel Brand, Kurt Cobain, Jimi Hendrix, Ernest Hemmingway, Mel Gibson, Catherine Zeta-Jones, Vivian Leigh, Frank Sinatra, Jane Pauley, Carrie Fisher, and Winston Churchill all have or had bipolar disorders. (Reviewed by Arefa Cassoobhoy, MD, MPH in October 2017, 2017)

Depression as a diagnosis is, I think, one of the less stigmatized, although that may be an overstatement.  Within our population, beliefs about depression vary. There is the assumption of some that those who are depressed could “will” the depression away if they so choose. Put on a happy face, so to speak. Go do something happy. None of which works to resolve true depression. Then there are those who think the diagnosis of depression means someone will inevitably commit suicide so they avoid persons with a diagnosis of depression. Neither is true, of course.

If one thinks about mental health conditions, many require medications to reset one’s brain chemistry. If mental health conditions were just a state of mind, why would medications resolve the issue? Makes no sense, does it? Yet, that is the way many persons think. Mental health conditions are either horrible or present because one does not have any will power. Silly thinking. Uneducated thinking.

Because mental health conditions are so stigmatized-even by the medical community-many persons just don’t want to know or do not wish to take medications, so they avoid treatment. It would be akin to a diabetic refusing to diet or, if needed, take medication for his/her high blood sugar. Or someone with a thyroid condition refusing to replace his/her thyroid hormone.

If the public would stop considering anyone with a mental health diagnosis as dangerous or weak, it would go a long way to preventing persons with mental health issues using drugs or alcohol to self-treat their symptoms, (Ernest Hemmingway, Carrie Fisher, Demi Lovato, Winston Churchill, and Jimi Hendrix for examples). Without appropriate medical treatment, this is a method to ease symptoms or at least the person recognizing the symptoms exist.

I have bipolar II disorder. There are times I struggle with severe depression and a few times I did not sleep well and participated in some less than safe behaviors. But I am not less than you who have no mental health diagnosis. I can look at my life and say it has been a successful one.

If one in five Americans have some type of mental health issue in their lifetime, chances are you are somehow associated with someone-whether you know it or not-who has a mental health condition. After seeking help over and over again for depression, a psychiatrist asked more in-depth questions than usual and found I was not just depressed, but I had bipolar II depression. I am the same person I was prior to my diagnosis, just better now.

One of the signs of bipolar II depression versus unipolar depression is the person’s reaction to antidepressants. Over the years I had tried many and had severe problems with all of them-the old ones and the new ones. Another sign of the diagnosis of bipolar is the age of onset of depression. If one experiences depression that begins in adolescence or early adulthood, this is a symptom of bipolar depression. Unipolar depression begins later in life. I had finally come to a point I was willing to take medication long-term for my issue, despite my fear of the diagnosis and of medications. It was a difficult diagnosis to accept. I knew how the public viewed mental health conditions. I felt shame and the need to hide my diagnosis from everyone, even my doctors. But, medication made me feel so much more stable.

Some of the medical professionals still seem to think because one has a mental health diagnosis one is liable to do all types of unusual things-verbally and physically. I think some are waiting for the patient’s head to spin around like in” The Exorcist”.

Winston Churchill was an amazing statesman,( although he did drink a bit). Look at those persons above noted in the article by Web MD. Did they not and, the ones living, still, make significant contributions to our society. Of course, they did.

Wake up, grow up America. Recognize we are not to be feared or shunned or stigmatized just because you have not taken the time to educate yourselves on mental health issues. Come into the 21rst century. If you can spend time learning technology, you can take the time to educate yourselves on this subject. One in five, people, one in five.

Works Cited

Mental Health America. (2019). Mental Health America. Retrieved April 10, 2019, from The State of Mental Health in America: http://www.mentalhealthamerica.net/issues/state-mental-health-america

NAMI. (2019, paras. 1-2). Living With A Mental Health Condition. Retrieved from National Alliance on Mental Illness: https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition

National Alliance on Mental Illness. (2019, para. 3). Mental Health Conditions. Retrieved from National Alliance on Mental Illness: https://www.nami.org/Learn-More/Mental-Health-Conditions

Reviewed by Arefa Cassoobhoy, MD, MPH in October 2017. (2017, October). Celebrities With Bipolar Disorder. Retrieved from Web MD: https://www.webmd.com/bipolar-disorder/ss/slideshow-celebrities-bipolar-disorder

Come On Surgery!

Testing out the new robotic surgery equipment

This is the machine that will actually perform my surgery. The doctor controls it from a panel away from me.

It is amazing how creative I can be when I am depressed. Poetry comes easily-though it might be dark, it is normally fairly substantive. The other end is slightly hypomanic and I normally get a lot done in that state also. At least there is some small bright spot with both abnormal states.

Within the last twelve years I have had minor mood swings. No changes in medication. Then this last year and a half, multiple health crisis hit me and my husband. I hung tough until the last episode, with more yet to come after six months of asking doctor after doctor, “What is this lump on my side?”  After experiencing multiple doctors, some more than one visit, telling me it was a side effect of my surgery, (about which I was not told prior to the surgery), that could not be fixes and with which I would have to live with it, I became severely depressed.

My husband had a lung nodule show on a CT scan. After a PET scan, he had lymph nodes and his thyroid light up. We waited for testing to progress. We waited for appointments. Finally, the testing began and fortunately, he has nothing that is to be addressed immediately. He will have to have testing routinely, but for now, nothing about which we need to be concerned. That helped some with the depression, but not enough to stop the additional medication.

So, in addition to my old medication, Lamictal, I was placed on Mirapex. I tried, I really, really tried, but could not tolerate it. Then my psychiatric FNP suggested Vraylar and I began on that medication. I gradually increased it to 3 mg a night, which is supposed to be the dosage for depression. At 3 mg a night, I began to become increasingly irritable and had to back off to 1.5 mg. All throughout these months, I could not sleep-well, around four to five hours tops. Then, I could not slow down to nap either.

Meanwhile, I had my yearly physical. My medical doctor looked at my last abdominal CT scan and thought it appeared abnormal. Now, keep in mind two different radiologists had read two different CT scans throughout a six-month period and stated there were no hernias, (plus a surgeon and an oncologist and a gastroenterologist). My doctor called the radiologist reading CTs that day and ask him to please look at my last CT scan again. Low and behold, I have a rare, fairly large hernia. Most likely this is from the lung surgery, although a doctor will always try and cover for the doctor and radiologists that missed the diagnosis completely and looked at me like I was crazy when I asked about the second head I have growing out of my side. I had several doctors tell me it was something I would just have to live with and insinuated I should just be happy to be alive.

This is my thought regarding that-and I told this to the surgeon who will have to fix this mess the other surgeon left-I was not completely sold on this lung surgery anyway. I had considered radiation treatment, which my first oncologists, (who was the wife of the lung surgeon), stated would have also been effective against my cancer. But, my lung doctor recommended this lung surgeon and  the surgeon was so confident that this surgery would be a breeze and cure me, that I signed up for the surgery and asked few questions. BIG MISTAKE. Dr. “We will take good care of you”, did not. I am all about quality of life, not life at any costs. I was lulled into thinking this surgery would cure me and be so much easier than my dad’s lung cancer surgery. I did well with the surgery as far as breathing and stopped pain medication the third day after surgery, but then I got an infection and the hernia that no one acknowledged for six months.

Lung cancer is one of the most difficult cancers to cure. It has a way into the blood stream pretty much anywhere it should crop up. Microscopic cells cannot be detected so it can spread and be undetectable for a while. My cancer was staged as an early stage squamous cell lung cancer. I know that is the best I could have hoped for with lung cancer, but I also know I am not out of the woods. There is a term for cancer patients who fear the results of their every three-month, six-month or yearly CT scans. It is “scanxiety”. Hell, I don’t even have that right now. I am pretty much miserable and would like to be happy enough about my life to dread the scan results. Sad but true. But I digress. Anyway, now I am waiting to see if the depression will return since backing down on the Vraylar. I actually slept last night. That was fantastic. But, when I woke this morning, I had a brief episode of severe depression. It did not last long but I have come to dread that feeling more than physical pain.

I am so angry, but grateful my medical doctor persevered. I am happy that my present surgeon actually read my CT scan for herself, (although the hernia is much larger than when I had the last CT scan in January 2019), and saw this weird hernia. I am so relieved she can fix this. She said my sides should be very close to the same after the surgery and she will not need to make a huge incision to fix it. I am angry that I have suffered so long before someone cared enough to press further. I mean, the lump is the size of a grapefruit sticking out of my side and firm to examination. And, I do have nerve damage in the area per the neurologist that is trying to minimize that damage, so there is that. Thank God my pain tolerance is high so I don’t need pain medications for any of this.

The hernia easily could have cut off the blood circulation to my colon. If that had occurred, it would have been very serious. I am relieved that did not happen, although, being a nurse, I knew what to do when I had symptoms. Maybe that is why the hernia did not progress to something more serious, or maybe it would have not progressed regardless. Perhaps God or fate or whatever you wish to call it came into play.

So, here I sit awaiting surgery, which is still a month away because of the special equipment needed to perform the surgery, fighting depression, adjusting medications with side effects I hate, 15 lbs. overweight from depression and inactivity since the lung surgery and the appearance of the hernia three days after the lung surgery, feeling like shit.  I am trying to be more positive, I am, but this just sucks.

We have canceled three vacations now. We are lucky our dog sitter/boarder is a friend. Vacation one was canceled for lung surgery. Vacation two was canceled due to costly treatment needed for our dogs. Vacation three was canceled because I had to wait a month to have this surgery. I just want to run away and be myself again.

I have begun to do some of the active things I did prior to surgery and that helps me feel a little more normal. But, due to the size of the hernia and weight gain, I am wearing these loose, flowing tops I hate and continually looking for a pair of jeans that fit. As the hernia gets bigger, the more effort it takes to hide it. It is hideous and I feel hideous.

If I talk about my feelings about all of this to some of my friends, I get the “put on a happy face” talk. Well, damn it, I don’t feel happy and I will be damned if I will lie to my friends to let them off the hook of the need for them to be a friend and listen to me. It seems if they take my feelings seriously, they have to fix it for me. That, of course, is not the case. I just need someone to commiserate with me.

There is nothing happy about this shit I am experiencing. After this surgery, I promise, if all goes well, I will be happier than I am presently. It is suspiciously like the doctors who had no idea what to do so they turned it back into my problem only. If I would just be happier, I would be happy. Well, yeah, but I cannot wish myself into that happy place right now. Sorry my depression is inconvenient for you. Thank God for my husband who has been my support throughout all of this.

After my surgery, my poor sister was with me constantly for three days. She would leave at night to go back to my brother’s-who also came every day for hours to stay with me after he got off work from his grueling job. Good to have a supportive family. Both my parents are deceased so we are all we have left.

The FDA just approved ketamine nasal spray for depression, but it is not available around here. Only certain approved centers can carry the spray or administer it. After the spray is inhaled, one must stay under a doctor’s care for two hours. This is the miracle cure for resistant depression. It has few side effects, but you must fail on two medications to be eligible. I would be eligible, but just live in the wrong area. I think ketamine is given during anesthesia. The surgery may mean I get some relief from the depression as a incidental effect of the ketamine used in the anesthesia cocktail. Finally. Come on surgery!