Getting going

I want to talk about motivation.

Again.

Because we can never hear this message too many times. Because understanding motivation might just make you someone’s hero. And it might make people with motivation more thankful and grateful for it, and help them feel empathy for someone in defeat!

Motivation is a BIG, HUGE, MASSIVE, ENORMOUS, GIGANTIC barrier to people suffering from depression.

If you don’t have motivation, the days are more than a huge struggle, a grueling drag, a marathon race, a torture ground, long, hard, awful and just something you don’t want to have to force yourself through again, just because the stupid sun came up!

Sigh, groan, urgh, ahhh, really, why? Do I have to? I don’t think I can. How about later? I just need a bit more sleep. Maybe tomorrow, I’m just not up to it today. Nah I think it’ll wait til tomorrow.

Motivation is what gets us up in the morning. We’re motivated to get to work on time, eat a healthy breakfast, do well at our jobs, keep house, bring up nice, healthy children and because we have this motivation we do what it takes to get these things done. We don’t even think about motivation until we have to make an extra effort, like participate in a sporting event or study for exams. It just comes naturally.

But depression vacuums up every last inch of motivation, unplugs the dirt bag and buries it deep in the middle of a Mexican desert where you will NEVER, EVER find it EVER again.

It’s gone.

Done.

No more.

So instead of going about your business as you normally would, each and every tedious step takes your fullest energy and effort!

Getting up took all my effort, and was delayed to the last possible second or a bit longer. Showering exhausted me: stepping into the tub, standing up for that long, lifting my arms to wash myself. Getting dressed was a Herculean task! So many motions to go through!

Walking to the bus stop took so long since I was wading through thigh deep thick, sticky treacle, figuratively speaking. I slept as much as I could manage on that bus, the train, and the next bus. I grabbed a quick takeaway breakfast of the oily kind and tried to get to the morning handover on time. There were usually some missing minutes before the work day started.

sausage, egg, tomato

Breakfast of the oily kind!

From then on the aim was minimal physical effort, pure survival until morning tea break, until lunchtime, until afternoon tea, until home time. These breaks were my vital link to survival. I got to sit down, and eat. And just be by myself.

Then came the end of the day with the new aim of getting home ASAP and getting into bed and desperately trying to get enough rest for the next day. That never happened, I never felt rested enough the next morning. I started every day in a severe deprivation of rest. I had had exactly the amount of sleep I needed physically but the adrenaline racketting around my body made me feel continually at the limit and exhausted.

But do you know what? I believe that throughout that time I still operated at my usual level in my job. Nobody noticed that I was suffering badly. They didn’t notice that I was suffering at all. All throughout I made a lot of friends and collegues. My peer review rated well. My boss was very pleased with me. I knew I was doing a good job. I was a good pharmacist. My team was tight and I loved the group of pharmacists that I was in. I was keeping up appearances.

That’s what was showing on the outside, and am glad it was cos I loved that job and wanted to do my absolute best. And I feel that I did. Somehow.

All this despite all of this other stuff screaming and shrieking on the inside. Once or twice a week I went to my GP across the road and that was my outlet. There I could cry, sob, not be okay, hate my situation, complain, whinge, feel awful. And he was happy with that. In fact that’s what he wanted, that I could keep going elsewhere, even at home, but have at least that one outlet where there was no hiding, no pretending, no pushing on. Home was my other outlet, no pretence. Or so I thought. My husband says to this day that he had no idea of the extent of my illness. I guess keeping up appearances got to be a habit!

salad

Dinner I made in November 2013…must have gotten up some momentum! It wasn’t all bad news, and no wonder my hubby was fooled! Looking back at this photo, I’m fooled!

This, my friends, all of the above, is why when ANYONE ever suggests that I should “push through the barriers” or “make a bit of an effort” or “just try a bit harder”, my hackles rise, my respect for their understanding and knowledge bungee jumps off a cliff with no rope, and I from then on out try to avoid them as much as possible. Then. These days I try to educate them, but I give up quickly if I’m not making an progress. I don’t have the energy to waste.

Try a bit harder? Do you realise that I am constantly at the absolute limit of what I can physically, mentally, spiritually and everything else manage just to be here, out of bed, dressed, among other people, smiling and giving the general impression of being okay? No, of course you don’t. I know it may not look like it, or feel like it. In fact it probably looks the opposite, that I’m not doing very much at all. But to me, right now, I’m doing the very best that I’m capable of. So I smile harder and walk away.

Of course I’m talking mostly about the time before, during and after my diagnosis of generalised anxiety disorder, depression, and bipolar disorder. And the time following each of these when I started medication which was adjusted and added to and removed from and monitored. They were awful days. Not every day, and not all day, but in general they were just hard to get through! And they aren’t gone completely, but I have not had SUCH a bad day in many months now.

These days I’m doing better for motivation, still not back to my old high achieving self with good self care and standards of house keeping. But getting there. It has taken a LONG time to get back, about a year from when I first restarted antidepressants in December 2013 and has been greatly helped by starting lithium in May a year ago, which I still consider to be not only my life raft but the instrument of getting back to my old life. My life takes less thought, less meticulous planning and less energy and effort to conduct. I have reserves of energy that don’t get fully drained, and life is just more enjoyable because of that.

There are tricks and tips that I still have to use against myself. Making things non-negotiable by paying for a course because my inner coin counting self won’t accept waste. RSVPing to organised bike rides so everyone else is expecting me and will be let down if I don’t arrive. Making dates and times to meet people for lunch, coffee etc so that I have to go. Keeping going while I’m going, and doing just one more job, one more chore, tick one more thing off my to-do list before I sit down and don’t get up again.

bed, winter, ginger cat

Getting out of bed is harder. So I make my doctor’s appointment each fortnight at 10 or 11am so that I have to get up on time that day to get there on time, which is also non-negotiable because that GP saved my life more than once and I owe him my best effort. Any other appointments that I have I try to make in the morning also, for the same effect. Lately it has been easier because my miracle working psychiatrist, in one fell swoop, has erased all sedation and daytime drowsiness and sleepiness. So I actually wake up at the time that other adults wake up! Sometimes even earlier like 4 or 5am. And go back to sleep for a bit but often I’m wide awake by 8am or a bit earlier. So that greatly helps!

Showering. This is an issue. I don’t know why, but I just have such a hard time working myself up to getting in the shower! It’s gotten to the point of a serious aversion. My husband has to get the water running (no mean feat with our current plumbing) and frog march me in. Once I’m there its fine, not a problem at all. It’s the getting started that’s the problem. Which, in it’s essence, is what motivation is. The drive and momentum to getting things started. So there’s still a ways to go, but I have come a ways which is comforting.

Launching Place, rail trail, sign

Launching Place: sounds like a good place to start!

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Suicide *warning: the following material may be very disturbing*

Author’s note: I wrote this piece two weeks ago. Then while re-reading it prior to publishing I had some reservations. My personal editor (aka my husband) also had some reservations about how it would affect other people so we decided to wait a while and see if we really wanted to publish this.

I’ve decided that I do want to write publicly about this issue. I apologise if it is disturbing, or frightening, or confrontational, or triggers emotions that are hard to deal with.

I can write about this issue openly now that I am past these horror days and now that I feel reasonably confident that I won’t experience them again, at least nowhere near the depths that I did sink to before. Thanks to an antidepressant and two mood stabilisers, and a team of psychologist, psychiatrist, very accessible and caring GP, fabulous husband and great friends!!

But I do feel that the population of the world fortunate enough never to plunge to these awful depths should have some understanding of the suffering that is out and about in the world, walking around trying to contain their sorrow and hurt. My favourite saying comes to mind:

“Always be kind. Every person you meet is fighting a battle you know nothing about.”

lease PLEASE remember that however impossible it feels, severe depression can be survived. It doesn’t feel like but just ask for help and let someone in! Tell your partner, your friend, your family, your colleague, a local doctor or go to the local emergency department. Tell someone; don’t suffer alone!! You know the numbers:

Lifeline: 13 11 14

Suicide Callback Service: 1300 659 467

Men’s Line Australia: 1300 789 978

Kids Helpline: 1800 55 1800

Employee Assistance Program (employees of public hospitals): 1300 361 008

beyond blue: 1300 22 4636

Suicide Line (Victoria only): 1300 651 251

Suicide Prevention Foundation: 1300 465 366

So here we go!

Suicide. Death by one’s self.

We don’t talk about it enough.

It’s taboo. It’s avoided, ignored, swept out of sight.

There can be sense of shame about it. Some consider it selfish.

In some places and in some era’s it is and has been illegal.

Some insurance companies won’t pay out life insurance policies if a death is determined to be a suicide.

Yet, along the death spectrum a ways, people campaign for euthanasia, the right to kill oneself if life becomes physically unbearable.

What about when life becomes emotionally unbearable? Mentally unbearable? Somehow people never consider the rights of a person suffering in this way.

But this is a dreadful, terrible, awful way to suffer.

Why are we sympathetic to cancer patients with terminal illness suffering physical agony but don’t give the same thought to mentally ill people suffering emotional agony without relief?

And to some people there seems to be or is no end in sight; treatments that don’t work or take too much time to work, emotional turmoil with no relief, desperation. What then?

Personally, I don’t believe suicide is right. Morally, that is. I believe what the Bible says: thou shall not kill, including oneself.

But it was a whole different story when I found myself in the grips of severe depression and assailed with suicidal thoughts.

Suicidal wasn’t about self-harm and ending my life. Initially.

It was about feeling terribly awful in the midst of my perfect life, so awful that I didn’t know if I could survive, if I would ever feel good or well again and I just wanted a break!

It was about dragging myself through the motions every day and wondering if I would ever feel like every physical step wasn’t a tiresome chore. It was about emotionally forcing myself through the duties of the day, pasting a smile on my face and coping when I felt like crawling into bed and never coming out.

I wanted an escape, to step into a time warp that would take me out of my life for as long as it took for the depression to go away. Then I could just step back into my life and take off where I’d left off, minus the awful distress.

I wanted the escape, but didn’t know how to get it. I was on two antidepressants, an unusual combination and a bit risky. But that was what it took to get me feeling better and sleeping. To start with, but then I started having odd thoughts as my mood took a steep dive downwards, the first time I experienced what I would later find out was a mood swing.

What would happen if I just stepped out in front of the bus? If I just took one step out…

Would it hurt? Would I just die or would I be injured and gain nothing but more pain?

I’ve always been against the idea of committing suicide by using another person driving a vehicle. I’ve called it selfish. I’ve called it unfair and sympathised with train, bus, truck and car drivers used in this awful way.

Is this karma? To be wondering whether I would actually take that step? To be thinking not about the awfulness that the driver would experience, but to be wondering if I could be that person? Wondering if it would solve my problems? If it would just take everything away so I didn’t have to try to deal with it day by day by day.

I’ve always been nervous about people standing close to the edge at train stations. I’ve always been half-prepared to see something so awful that it would damage me for life.

But then nothing happened and this mental disease arrived, bit by bit. Maybe it was the anxiety in me the whole time, all these years worrying and thinking about such things.

This was my thought process, back then, before I went to hospital.

I could never jump in front of a train. I’ve read ‘Dear Miffy’ by John Marsden. I know what happens when a jump in front of a train is misjudged! I don’t want to be in a wheelchair or completely dependant on someone else.

I don’t think I would jump in front of a car; too small, more likely to end up alive and well with a couple of broken bones. So that’s out.

So that leaves a bus.

Or an overdose. But I know that the medications that I’m taking are relatively safe in overdose. They won’t kill me. I’ll maybe sleep for a while then wake up back where I started. With the added stigma of having tried to kill myself!

I don’t want that for me, but mostly I don’t want that for my husband. I don’t want to leave him with the bill, so to speak. He doesn’t deserve a life of questioning what went wrong, where could he have done something or done it differently, of blame. He doesn’t deserve any of that. No one deserves that. So I came to this: I can’t do any of those things. I have to keep on going, to keep trying, to keep fighting. Because I can’t do that to him. But it’s so hard!

Another day I got to thinking again: what if I just jumped off these rocks into the crash of waves breaking? Would it hurt? How long would it take? Would someone rescue me? Would it just be easy and instant?

What about sharps? One of my horrors is paper cuts to my eyelids, no idea why! But I’m always super careful around knives and I hate blades, which is why I now wax instead of shave; I’ve cut myself enough times as a total accident to give away shaving! And our knife set is new and super sharp, but I don’t think I could ever do that.

I don’t have a gun and I wouldn’t know what to do with it.

What about painkillers? I don’t have any above supermarket strength and I know they don’t work in overdose, it’s just long slow painful illness of liver failure that can take forever and is a terrible idea. Or bleeding, also slow and awful, not at all a solution.

I’m not great with heights, I just know I could never make myself jump.

So, all out of ideas.

And that’s how I came to be in my doctor’s office at midday on a Monday, bawling my eyes out.

The doctor asked me, have you had any suicidal thoughts? Yes, I sobbed.

Do you have a plan to harm yourself? No, because I can’t think of a way that would work! Sobbing harder and harder.

If I let you go, can you promise me that you won’t hurt yourself? I don’t know, I think so but I’m not sure, I feel so terrible! Sobbing, and sobbing, and sobbing!

A terrible, awful point for me in such despair and not even able to come up with a good way out. Still believing that it’s wrong, but needing so badly some relief! Just a few hours off, just a day of rest from the hurt and chaos in my mind!

Which I did get, later. I took a Valium on the way to the hospital, they gave me another one in the emergency department a few hours later. I slept then, for a few hours. That was just what I needed. But then I woke up and they wouldn’t keep me. As desperate and at the end of my rope as I was, they sent me home.

With 2 temazepam, double the usual dose of this sleeping pill. Which gave me another 8 hours of absence until I could come to terms with going on, dealing with a new day, another battle, keeping on keeping on. Until they could send members from the outpatient psychiatry team to visit and help me.

And then they started the long path to bring me back to today.

Starting new medications, changing doses, scrapping that one, starting another one, altering, fiddling, trying and failing and trying again in the long haul to now, a better day.

Today it is 77 days since I was in the emergency department of my local hospital (author’s note: written two weeks ago). Not the hospital I work at, another one near home. I could never have gone in that state to work and shown any of my colleagues the face under my usual coping face.

77 days. None of them spent working. All of them spent here at home. Making tiny steps of progress, going backward, coming forward, a couple steps one way, another few the other way, teetering backward and forward on the scale from deep depression to hypomania and somehow, at long last, feeling like I’ve settled in the middle around a place that I could call home, somewhere around about “normal”.

My husband in fact thinks maybe I’m better than “normal”. He sees now that maybe I’ve never been as good as I am now.

Sure I still get tired, and have the odd afternoon nap. But I’m more productive, I’m more energetic, I’m more engaged, I’m enjoying life, I’m driving a bit, I’m shopping a bit, I’m doing the dishes occasionally, the laundry sometimes, making the bed some days, hosting visitors rarely, doing day trips every now and then, actually living my life 🙂

We know there will still be days that are further toward one end of the scale or the other. The aim of all the treatment is to not go so far toward either end. My personal goal is to never ever in my whole entire life get anywhere near as deeply depressed as I have been. I don’t ever want to see the shape or colour of that place ever again!!

But we’re living life, and enjoying life! That’s something to be deeply grateful for every day. We’re alive, and relatively well, and life is good! Well, better anyway. That’s something.

I want to live life to the fullest. It’s a cliche, but that’s what I want. My aim is to enjoy every day that I can enjoy because depression is not ruling my life with it’s inability to enjoy pleasure, or it’s sadness, and hopelessness, and pointlessness.

Now ruling my life is just…life. Just life. Getting less complicated, more predictable, more fun! Yes, it takes an solid dose of antidepressant and a good going dose of two mood stabilisers/anti-psychotics. It takes weekly visits with my GP and psychologist, and fortnightly visit to my psychiatrist. It takes good doses of friends and hobbies and enjoyable activities. Who cares? What works, works and I have no argument against that!

Link: how to talk about suicide