Posts Tagged 'meds'

No Winter Blues

1sun(Reprinted from Huffington Post)

I am a lucky person: My life is big and good. I am a playwright, actor and activist. I am also well-medicated and my brain has had a good winter.

A decade ago I was diagnosed with clinical depression and anxiety disorder. The shorter days of less sunlight in the winter months terrify me because of the reality that is Seasonal Affective Disorder (SAD). It may exacerbate my depression and plunge me into the dark. I am braced myself and worked on a plan to avoid the hole.

I knew it is necessary because as most people were making New Year’s resolutions, taking inventory of their winter sweater wardrobe and gearing up for skiing or snowboarding last year, I stumbled into the hole after having a good spring, followed by a happy summer.

The invisible hand of depression pushed me down for almost four months. It felt like an eternity. I not only missed the sun and the deep blue sky, but I missed my old self. I slept 11 hours a day and woke up exhausted and ready for a nap. Sadness and despair gnawed at my brain, and because my depression manifests itself physically, I felt like a low-grade flu followed me around like a nagging child.

Prepping for the writing classes that I teach took twice as long and drained me, although I could always rally in the classroom. My classes were always full of talented, generous writers and for a few hours it would take me out of myself.

According to the National Alliance on Mental Illness, SAD is characterized by recurrent and cyclical episodes of depression, usually in late fall and winter. It is estimated that 18.8 million people or 6 percent of the U.S. population suffers from SAD along with another 14 percent who suffer from a milder version we often call the “winter blues.”

By January, predictable symptoms may have existed for two months, as the sun’s rays are weaker and the darkness is longer. Symptoms including extreme fatigue, sadness, emptiness, anxiety, decreased energy, a lack of focus, productivity and pleasure in activities often subside in March or April. Many of us don’t feel fully “back to normal” until early May.

Another symptom that’s common with people who suffer from Seasonal Affective Disorder is an increase in carb cravings. Me? I could not get enough cookie dough, linguine, warm French bread, mashed potatoes, corn chips, chocolate cupcakes, and finally, most embarrassingly, Cheese Whiz. On a cracker or straight from the can.

We don’t know exactly why Seasonal Affective Disorder occurs. The research says there are probably several causes. Scientists have discovered that a neurotransmitter called serotonin may not be functioning well in people with SAD. Also hormones like melatonin play a role. There is the eye’s sensitivity to light and the circadian rhythms, which involve sleep-wake cycles during the changing seasons.

Where you live may also play a factor. Experts contend SAD is influenced not by the cold, but by diminished light and latitude is part of that equation. The Cleveland Clinic estimates that 1 percent of Florida residents, 4 percent of Washington, D.C. residents, and nearly 10 percent of Alaska residents suffer from SAD.

In an attempt to combat this weather phenomena, Rjukan, a small town in Norway recently completed installing three 300 square foot heliosatic mirrors that will redirect the sunlight into the town. Not bad for a community of 3,000 people.

I live in Chicago, where my husband and I have an extended family and our work. I love it here. Chicago has a spectacular skyline, terrific theater and world class restaurants. But unfortunately 79 percent of its winter days are cloudy to partially cloudy. And this winter has been long and mean and relentless.

One gloomy afternoon in early winter as I tried to psych myself getting outside to shovel the sidewalk, I happened to flip onto an article on the website of National Alliance on Mental Illness (NAMI) on the benefits of prophylactic treatment for SAD. In other words, it suggested being proactive before the SAD symptoms sink in.

I am trying. This year I refuse to be bullied by SAD. I did some research, talked about it with my psychiatrist and got an OK.

So every day for 30 minutes I am doing phototherapy by sitting in front of a 12″ by 24″ metal box that contains two long tube lights behind a metal grating that delivers full spectrum 10,000 lux of light. My cat likes to sit in front of it too, so I let her, because who wants a depressed cat? The light board cost $139 and is designed to mimic outdoor light that researchers believe may lift mood and ease other symptoms of SAD.

I am not alone in my efforts.

The Memorial Hospital in South Bend has installed a Light Therapy Feel Better Center and offers complimentary 30-minute sessions.The counseling centers at University of Washington, University of New Hampshire and Macalaster College in St Paul, Minnesota provides light therapy to its students through their counseling centers. And the Lightbar in Portland, Ore. is a bistro that combines food, trendy cocktails and music with light therapy. Genius.

My psychiatrist suggested upping my supplements of Vitamin D and fish oils. We developed a modification plan for my antidepressant regime if I find myself going into the hole. I know from experience that altering your meds may be a complicated hit or miss, but I like knowing that I have a fall back.

He also told me to, “get somewhere sunny if you can. Some people say that they feel better after just a couple of days.”

So instead of going on our traditional summer vacation this year, I split up the time up into two short winter jaunts to visit warm weather friends in January and February. I know that Van Nuys, California and Houston, Texas are not glamorous, but they are hot and full of sunshine.

I am also more vigilant this winter about exercise and yoga and as difficult as it is, I am trying to regulate my sleep patterns.

Finally, most importantly for me, I am booking my calendar weeks and months in advance to get me up and out into the world when all I want to do is stay under the covers and mew. I am planning dinners out, movie night in with fun friends, actually showing up for holiday parties, entertaining weekend visitors, getting theater tickets and faithfully going to writing group, book club and visits with my parents and in-laws. I’ve even decided to throw myself a 1/2-year birthday party.

Seasonal Affective Disorder is real and dark for millions of people, and these measures aren’t for everybody, but for me it is worth a try.

I’ve never been a “just in case” kind of woman. I don’t carry antacids when I go to my favorite Mexican restaurant. I don’t bring an umbrella if it just “looks” like rain and I don’t stash an extra $20 bill into a secret fold of my wallet.

I don’t live in Florida or Rjuka, and I have not the time or inclination to erect giant mirrors on Willis Tower.  But I am going continue to be proactive. I have made do right here staring into the light and it has worked.

NOTE:  I start touring the solo show-“A Little Bit Not Normal”  A serious comedy about depression-  Fall 2014.  This Blog, the show, talk back sessions, community writing workshops, articles in publications & the book- is part of my iniative to become part of the national conversation around mental  Illness.  Kickstarter will be launched later this year.  I hope you’ll join me- because its 1 in 4 of us suffer sometime in our lives- and much of that time it is in silence.

Into The Blue

Blue

Into The Blue
I flip the car visor to apply a slicker of raspberry. I’m so exhausted that I look like phlegm. But phlegm who’s wearing lipstick because everybody knows that lipstick can disguise anything. You never see any of those actors who play sick characters wearing it, not even if they are Angelina Jolie. It’s early and slippery outside, one of those days in Chicago when the fog feels like a permanent guest on the road. I move at a glacial pace. Sometimes one depression hour feels like a dog year.

Me, in another psychiatrists’s office. I keep my eyes to the floor like the guilty one on Law and Order. I am shamed. This is my Roswell 54. I’ve always prided myself on being a “happy, optimistic and motivated person.” I’ve even bragged about it but out of nowhere Depression just crept in through a basement window and I found him sitting there with his feet up on my nice, new mushroom colored couch and he decided to stay.

I took my first 2 pills. They were melon colored and shaped like kites and I felt like a teenaged girl waiting for her boyfriend to change his Facebook status to “In A relationship” because I wanted those meds to work and work fast. They didn’t. I tell no one about the black sinkhole except for Dan, my good and kind husband who guards the secret like it’s a magician’s trick. We both know that crazy and unstable does not get hired, does not get invited to fabulous parties. We both know that all crazy and unstable gets is judged.

Meds are added, taken away, tweaked and tweaked again. There are pretty little yellow pills, rainbow capsules and ones that look like teensy hotdogs. Another one make me feel l’m on a tilt a whirl and I throw up for 24 hours straight. Some work a little, some not. I don’t know. My brain skates the edge of winter-gray and presses at my brain.

1

INTO THE BLUE Arlene Malinowski

And then I just stop. Mail and magazines are left unread. Clothes with zippers and buttons and proper fit sit in the closet. The TV flickers like ghosts in the night. Phone calls roll into voicemail. The bed becomes both my shroud and sanctuary. I look into the mirror of the medicine cabinet. I’ve become invisible-even to myself. I wonder when is it time to find a new doctor? Until one day she says kindly; “I think we should wait to see if this lifts. Your body’s been through a lot. I don’t know what else we should try right now.” Six weeks later she moves away to a city that’s warm and sunny.

How are you? the question comes automatically from the mouths of others. “Fine, I’m just fine” I reply smiling, pink bubbly. A dozen years of acting classes, money well spent. In my soul, I dream about Sylvia Plath and Bell Jarring. I curse my electric oven. And then Dan does the unthinkable and betrays me. I hear him in the other room on the phone, “She’s clinically depressed. It’s bad. We need to get her into see someone now.” I panic, “What are you doing? I was just having a bad moment.” He holds me, “I had to tell someone. I’m scared for you”

My head is spinning lurid purple. “Don’t you understand they’re going to tell everyone!” He doesn’t listen. There are phone calls to brothers and friends and colleagues and I’m in, right away with a guy who is not taking new patients. They say he’s a rockstar but I don’t care. Now the whole family knows. Screw them.

I look around the waiting room. I feel like I’m sitting in the middle of a pharmaceutical Burning Man. The patients rock and mutter and sweat and tremble and stare glassy eyed and get up for cups and cups and cups of water. These are the last chance people and I am one of them. There is a place in your mind that is so far down you don’t see color. That’s where I am.

We wait for 2 hours and when we finally get into his office it looks like a bomb hit it. There is stuff everywhere, it feels like the inside of my brain. He looks nice, like the kind of guy that you should have gone out with in college instead of chasing the bad boys who would make out with you at a party and then dump you for a girl named April- at the same party. I hand him the history that Dan so meticulously kept and I tell him the dark side of calm. “The gnawing at my brain is relentless. I can’t do it anymore. I want go to sleep and never wake up again.”
Dr Last Chance leans in, connects with me my eyes and says in a low quiet voice;

“I know you’re in pain but you need to know that we have lots of options to try.” and then starts naming off lists of drugs and drug combinations. When we are leaving I throw my arms around him and hug him hard and he hugs me back.

Hope is a great gift- maybe the best of all gifts and that’s what he gave me. I slowly start to come out of it. Depression like mine doesn’t just go away, it leaves quietly and surreptitiously like the honey colored light at dusk but word about my break down spreads quickly and at full tilt. I am humiliated beet red but the most unexpected things happen. A funny card shows up in the mailbox. A hand reaches out. The kind opportunity to teach a class if I felt up to it is offered. And people whisper to me “Me too! I have it too” and I wonder “why didn’t I know this about you? Why didn’t we know this about each other? It would have made everything so much easier.” But these timid, tentative and big-hearted acts of care surround me. I swallow my fear and I recognize that loosening the shame and releasing the secret into the blue- saves me.

NOTE: My one-woman show  “A Little Bit Not Normal”  A serious comedy about depression-  Spring 2014.  This Blog, the show, talkback sessions, community writing workshops, articles in Huff Po, publications & the book- is part of my initiative to become part of the national conversation around mental  Illness.  Kickstarter will be launched later this year.  I hope you’ll join me- because its 1 in 4 of us suffer sometime in our lives- and much of that time it is in silence.