How are You?

Hello. How are you?

chronic comic 174

No…really.

I’m asking. I don’t want to hear that you’re ‘fine’ because you’re being polite; because you think I don’t care; because you’re used to most people not caring. So…how are you? You can actually tell me in the comments below because I’m going to tell you how I’m feeling…

I am so sad (yes, I’m depressed and I constantly get angry comments here for referring to it as sadness…but that’s what it is to me – it’s a deep, deep pool of sadness that I cannot swim out from). It seems that, suddenly, the people who I have chosen to surround myself with, no longer care how (or even, if) I answer the ‘How are You?’ question.

And, the worst part is that they don’t have to ask. They all know me well enough to see that there is something very wrong…they are just choosing not to delve further.

My sadness comes from asking myself why – they’re sick of hearing about my woes? they want to have a life beyond the lounge-room? they no longer believe in my worth? they no longer care?

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Pain or No Brain?

Ages and ages ago (except it doesn’t feel that long ago – doesn’t time fly when you’re in a fibro fog!), I (with my doctor’s advice) weaned myself off Lyrica to see if we could find a better way to deal with this condition. If you followed the posts, you’ll remember that I ended up at Step 1 again and back on it…almost immediately.

Basically, it seemed, I was given the choice of being in pain (no Lyrica) or no brain (with Lyrica). I chose no pain.

I am beginning to question my choice…as my brain and everything in it quickly turns to mush.

119. fibro fogLyrica (and Neurontin, by the way) blocks the formation of new brain synapses, drastically reducing the potential for rejuvenating brain plasticity – meaning that these drugs will cause brain decline faster than any substance known to mankind! (This is not me being OTT – this is a quote by some-one else.)

Synaptic plasticity is a key feature of nerve architecture that enables your brain to tolerate stress, recover from trauma, and make changes. That’s how your brain bounces back from intense stress (or not, in our case). Hmmm….and that could be why I just can’t seem to quit smoking. Our brains, on Lyrica, are no longer flexible or “plastic.”

Doctors use them for all manner of nerve issues because they are good at suppressing symptoms. However, can we justify this use now that the actual mechanism of the drugs is finally understood? – they are creating a significant long-term reduction in nerve health.

148. fibro fogTo make matters worse (yes, they can get worse), antidepressants block the action of acetylcholine. What does acetylcholine do, you might ask? It is the primary neurotransmitter involved with memory and learning. And, how many of us take antidepressants? I know that I do. See what I mean by things getting worse?

Can it really be right to force us to make this kind of choice?

scales

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Defeating the Purpose

Alisha - Invisible FI don’t know how many of you think about your PURPOSE. I try not to – it depresses me. In fact, the thought of it depressed me for 3 years so now I avoid it. One of our fabulous FCK bloggers, Alisha Nurse from The Invisible F, has been thinking “a lot of things about it.”

Your Life is Worth More than you Know

As always I am thinking about purpose. A lot of things about it.

I don’t know if the same is true for anyone else who has walked in my shoes, but every time I have seriously considered suicide or acted towards it, I always wondered what the world would be like without me. I say world, but I mean what would it be like for the people in my world to not have me anymore.

I always felt my existence had been meaningless.

And while I still struggle with this to a great degree, I’ve realised something imperative.

I’d always thought without me life would just go on. The people who love me would mourn but eventually life would carry on as it does. I don’t think I’ve made any significant contributions to the world to not be forgotten. Not yet anyway.

Years ago, I visited my home country from which I’d migrated. When it was time to leave, I was surprised at how my little sister wept. She went to school inconsolable. I left and later found that she had cried herself so sick, the school telephoned to ask for a relative to pick her up. I was moved to tears and overwhelmed. This was an important moment for me.

The power of love

When my half-sister was born I was indifferent to her due to no fault of her own. That’s actually putting it mildly. She had been welcomed into the world with loving arms, whereas I’d been told I was an unwanted child. As I grappled with trying to survive a childhood riddled with fear and numerous problems, I showed my sister little love and expected none in return.

But my God, she loved me. And she loved me so much that I couldn’t understand. She loved me even when I didn’t love her back.

I didn’t deserve it. But such is the power of love, it turned my cold heart inside-out, and shook me up. I couldn’t not love her back, my little sweet potato muffin.

Now she loves me and I love her.

When I almost went to my death my sister didn’t know. When she found out again she wept again. And I understood how I had hurt her. I know that had I been successful, it would have hurt many loved ones. But I felt that if I did pass on it would have impacted on my sister’s life in some great way. I am actually convinced it would have altered her life. People close to my sister have before told me of how she dotes on me and is influenced by me. I didn’t know.

I say all of that to say no matter how insignificant we think we are and our existences may be, to someone we are so special, that a world without us would break them.

We struggle, yes we do. But if ever we venture down to the path of death we must know it’s not only our lives we take. We are likely taking someone else’s.

Be encouraged.

If you feel suicidal, please know that you are not alone and you do not have to walk that road alone. Reach out. There are some numbers below that you can ring to get help.

Need help?

In Australia, call 13 11 14 Lifeline Australia
In the USA, call 1 800 SUICIDE or 1 800 273 TALK
In the UK, call 0800 068 4141
In New Zealand, call 0800 543 354

Related Posts

 

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I Couldn’t Be Happier!

smile-happy-yellow-faceWhen was the last time you said, “I couldn’t be happier…”? Happiness can be elusive. It can be fleeting. Too often, it can be lost in our modern world’s swirl of stress, multitasking, and 24/7 news. Today you are already thinking about tomorrow.

Positive Psychology, a Special Health Report from Harvard Medical School, is a “how to” guide to greater personal happiness. It will show you how you can surmount the obstacles that disrupt and diminish your ability to enjoy life to its fullest, with awareness and connection.

We all know money can’t buy happiness. So, how do we get it? Current research is confirming what many of us heard from our elders and spiritual leaders: satisfaction comes with being engaged, doing good, and focusing on the present.

In this report, you’ll see how positive psychology is helping men and women use their psychological strengths to increase attentiveness and concern, and draw greater fulfillment from each day’s experiences.

Positive Psychology will help you identify your unique strong points. You’ll gain an important understanding of the role of gratitude and how it can be successfully cultivated and employed. You’ll learn the keys to “going with the flow” — becoming more at one with whatever you are doing. The report will also give you practical strategies for maximizing concentration and eliminating distractions.

girl-happyYou’ll read about the key role of mindfulness, the ability to “live in the moment” fully and without judgment. You’ll be introduced to techniques for savoring life’s pleasures, large and small, with equal enthusiasm and enjoyment.

The report offers helpful guidance on using positive psychology techniques to develop the resilience to handle difficulties more easily. Plus, you’ll read about the significant effect positive emotions have on health and longevity, how positive psychology’s principles can enhance personal relationships, and much more.

Order your copy of Positive Psychology now. You’ll be happy you did!

To your good health,

Anthony Komaroff, M.D.
Professor of Medicine, Harvard Medical School
Senior Physician, Brigham and Women’s Hospital
Editor in Chief, Harvard Health Publications

Lyrica(l) Depression

Pregabalin (Lyrica®) can significantly improve FM pain in people who also are being treated for depression, according to research presented at the American College of Rheumatology (ACR) Annual Meeting in San Diego. And my recent slow tapering off of Lyrica, and then returning to it (after way too much pain) confirmed this to me.

chronic comic 189I also suffer from depression. In fact, 50 to 70 per cent of people with FM report a lifetime history of depression, and approximately 25 per cent have a history of taking antidepressants.

Pregabalin is approved for the treatment of FM in the United States, Japan, Australia and other countries. But, because prior studies excluded the use of antidepressants in treatment, information about the effectiveness and safety of pregabalin for the treatment of pain in people with FM who are also being treated with antidepressants for their depression is lacking.

“Depression is common in patients with fibromyalgia,” explains Lesley M. Arnold, MD; professor of psychiatry and behavioral neuroscience; University of Cincinnati College of Medicine, Cincinnati, Ohio; and lead investigator in the study. “Many patients present to their doctor for treatment of fibromyalgia pain already taking antidepressants for their depression. This is the first study to evaluate the efficacy and safety of pregabalin for treatment of fibromyalgia pain in patients who are also taking antidepressants for depression.”

288. rate your painWith this in mind, researchers completed a study to determine if pregabalin would affect pain levels in people with FM who were also being treated for depression. The study included 197 patients who were, on average, 50 years of age and overwhelmingly white females. To join the study, patients had to meet the 1990 ACR Criteria (including manual tender point exam), have an average pain level of at least four out of 10 on the Numeric Rating Scale, (0 = no pain and 10 = worst possible pain), have a documented diagnosis of depression and be taking a stable dose of an antidepressant medication — either a selective serotonin reuptake inhibitor (such as Celexa®, Lexapro®, Prozac®, Paxil® or Zoloft®) or a serotonin-norepinephrine reuptake inhibitor (such as Cymbalta®, Effexor®, or Pristiq®). The antidepressant treatment was continued throughout the study.

Patients were on study treatment for a total of 14 weeks. There were two six-week treatment periods when patients received either pregabalin or placebo, with a two-week break in between these periods. Each patient was randomly assigned to receive either pregabalin in the first six weeks, then placebo in the last six weeks, or to receive placebo first, then pregabalin. None of the patients knew which treatment they were receiving at any point in the study. Pregabalin was started at a dose of 150mg per day, and increased to 300-450mg per day, based on each patient’s response; this dose was continued for the rest of the treatment period.

Chronic Comic 157At the beginning of the study, the average pain score amongst participants was 6.7. The average pain score dropped to 4.84 after treatment with pregabalin and to 5.45 after treatment with placebo. Pregabalin treatment significantly improved patients’ pain compared to placebo.

Side effects were reported in 77.3 per cent of those on pregabalin and 59.9 per cent of those on placebo. For pregabalin treatment the most common events were dizziness (28.2 per cent) and drowsiness (19.9 per cent). A total of four serious adverse events were reported; however, the researchers concluded these events were not related to the treatment.

“The results of this study demonstrate that pregabalin is safe and effective in reducing fibromyalgia pain in patients who are also taking an antidepressant to treat their depression,” says Dr Arnold.

Optimism: the Opium of the People

lemonadeWe’ve all heard the positive sayings: some pursue happiness, others create it; and when life gives you lemons, make lemonade. Transforming negative thoughts into positive ones increases your chances of success! Yes, it can be hard to do.

If your inner sceptic is saying, “Bah… humbug!” and you’re still not convinced here are a few findings that prove the power of positivity:

  • Optimism can lead to longevity. Several studies have confirmed that those with a positive attitude often live longer than their gloomier counterparts. A study performed at Wagening University in the Netherlands examined nearly a thousand men and women. The predicting factor of their longevity was their agreement with the statement – “I still have goals to strive for.” When subjects were tested nine years after the original survey, the death rates of the optimistic men were 63 per cent lower than those who had not agreed with the optimistic statement. Women were 35 per cent lower. Optimists who have more to live for often make more positive lifestyle choices that may help prolong their life.
  • Optimism nurtures healthy relationships. According to author and Harvard medical professor Dr George E. Vaillant, our greatest source of resilience comes from our internal capacity for optimism. In his book The Wisdom of Ego, Vaillant writes that the healthiest, most resilient people possess “both the capacity to be bent without breaking and the capacity, once bent, to spring back.”
  • Optimism is contagious. A physician and social scientist at Harvard Medical School studied nearly five thousand people and their connections with family, friends, neighbours, and co-workers over the course of twenty years. According to the study, which was published in the British Medical Journal last year, our level of happiness impacts not only those in our immediate circle, but also people two and three degrees removed from us.

pieOptimism allows us to successfully navigate life’s greatest challenges. Optimism truly is a powerful force. So, forget lemonade! Let’s make Lemon Meringue Pie!

QUESTION: Starting today, which area(s) of your life can you infuse with more optimism? 

A NORMAL LIFE

I remember when life was normal…

When I wasn’t sick
When I had a future so bright
When I loved my job
When I didn’t cry to sleep each night

When I didn’t wake up to a handful of pills
And go to sleep with another
When I had friends who cared
When I was still loved by my father

When going out was fun
When I chose who, when and where
When my highs were high
And I just remained there

When I wasn’t trying to kill myself
By drowning in this self-pity

drowning

Somedays by Lisa Fulham

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Somedays it’s easier

To believe the bad stuff

The cruel words

The harsh tones

 

Somedays the darkness is all I see

Light is but a distant memory

Hope only comes

In the form of hopelessness

 

Somedays my loudest screams

Are torn from me in silence

Words loose meaning

So I crawl into myself

 

Somedays my only option is to hide

Hide all the hurt I’m feeling inside

How can I expect others to understand

When I don’t understand myself

 

Somedays my inner turmoil

Brings me to my edge

The gravity of depression

Pulls me into a downward spiral

 

But somedays

The pain feels lessened

The voice of sorrow seems quieter

The darkness isn’t such a void

And my words begin to have meaning once more

 

Somedays I see a glimmer

Of who I used to be

I hear the echo of laughter

From times gone by

My smile tries to curl

The edge of my mouth

 

Somedays I know I need to talk

Find the root

Of where the darkness came from

Find the path

That leads to the light

 

Somedays I hold out my hand

And say the word that fears me most

Help

 

Those days I feel i’m at my weakest

 

These days I feel I’m the strongest I have ever been

Social Isolation…or Hibernation?

hibernationI’m hibernating…yes, it’s Winter in Australia. I don’t want to leave the house (not even to step outside to get the mail) and I just want to sit quietly, alone, on my couch.

Avoiding social contact is a common pattern you might notice when falling into depression. Some people skip activities they normally enjoy and isolate themselves from the world. Others turn to alcohol or junk food to mask their pain and unhappiness. I do both.

I’m doing it all at the moment…BUT I don’t feel depressed (I think!) I just want to stop for a little bit – I don’t want to fight at the moment, I don’t want to search for answers at the moment.

So, maybe I am depressed? I just can’t tell anymore.

Depression traps vary from person to person, but what they have in common is that they can serve to worsen your mood:

Trap #1: Social Withdrawal

isolationSocial withdrawal is the most common tell-tale sign of depression.

“When we’re clinically depressed, there’s a very strong urge to pull away from others and to shut down,” says Stephen Ilardi, PhD, author of books including The Depression Cure and associate professor of psychology at the University of Kansas. “It turns out to be the exact opposite of what we need.”

“In depression, social isolation typically serves to worsen the illness and how we feel,” Ilardi says. “Social withdrawal amplifies the brain’s stress response. Social contact helps put the brakes on it.”

The Fix: Gradually counter-act social withdrawal by reaching out to your friends and family. Make a list of the people in your life you want to reconnect with and start by scheduling an activity.

Trap #2: Rumination

A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.

Rumination is a toxic process that leads to negative self-talk such as, “It’s my own fault. Who would ever want me a friend?”

“There’s a saying, ‘When you’re in your own mind, you’re in enemy territory,'” says Mark Goulston, MD, psychiatrist and author of Get Out of Your Own Way. “You leave yourself open to those thoughts and the danger is believing them.”

“When people are clinically depressed, they will typically spend a lot of time and energy rehearsing negative thoughts, often for long stretches of time,” Ilardi says.

The Fix: Redirect your attention to a more absorbing activity, like a social engagement or reading a book.

Trap #3: Self-Medicating With Alcohol

cocktailsTurning to alcohol or drugs to escape your woes is a pattern that can accompany depression, and it usually causes your depression to get worse.

Alcohol can sometimes relieve a little anxiety, especially social anxiety, but it has a depressing effect on the central nervous system, Goulston says. Plus, it can screw up your sleep.

“It’s like a lot of things that we do to cope with feeling bad,” he says. “They often make us feel better momentary, but in the long run, they hurt us.”

The Fix: Talk to your doctor if you notice that your drinking habits are making you feel worse. Alcohol can interfere with antidepressants and anxiety medications.

Trap #4: Skipping Exercise

If you’re the type of person who likes to go the gym regularly, dropping a series of workouts could signal that something’s amiss in your life. The same goes for passing on activities – such as swimming, yoga, or hydrotherapy – that you once enjoyed.

When you’re depressed, it’s unlikely that you’ll keep up with a regular exercise program, even though that may be just what the doctor ordered.

Exercise can be enormously therapeutic and beneficial, Ilardi says. Exercise has a powerful antidepressant effect because it boosts levels of serotonin and dopamine, two brain chemicals that often ebb when you’re depressed.

“It’s a paradoxical situation,” Ilardi says. “Your body is capable of physical activity. The problem is your brain is not capable of initiating and getting you to do it.”

The Fix: Ilardi recommends finding someone you can trust to help you initiate exercise — a personal trainer, coach, or even a loved one. “It has to be someone who gets it, who is not going to nag you, but actually give you that prompting and encouragement and accountability,” Ilardi says.

Trap #5: Seeking Sugar Highs

When you’re feeling down, you may find yourself craving sweets or junk food high in carbs and sugar.

Sugar does have mild mood-elevating properties, says Ilardi, but it’s only temporary. Within two hours, blood glucose levels crash, which has a mood-depressing effect.

The Fix: Avoid sugar highs and the inevitable post-sugar crash. It’s always wise to eat healthfully, but now more than ever, your mood can’t afford to take the hit.

Trap #6: Negative Thinking

NTWhen you’re depressed, you’re prone to negative thinking and talking yourself out of trying new things.

You might say to yourself, “Well, even if I did A, B, and C, it probably wouldn’t make me feel any better and it would be a real hassle, so why bother trying at all?”

“That’s a huge trap,” says Goulston. “If you race ahead and anticipate a negative result, which then causes you to stop trying at all, that is something that will rapidly accelerate your depression and deepen it.”

The Fix: Don’t get too attached to grim expectations. “You have more control over doing and not doing, than you have over what the result of actions will be,” Goulston says. “But there is a much greater chance that if you do, then those results will be positive.”