ECT

Electroconvulsive therapy. ECT. ECT is used to treat depression when medications and other forms of therapy haven't worked. It's not the first form of therapy that's normally tried. It's also used to treat bipolar mania and some other mental illnesses. During an ECT, an electrical energy device sends electric pulses to the brain. This causes a brief seizure, lasting from 30 seconds to two minutes. It's done under general anesthesia. You are not awake and do not feel the treatment. Medication is also used to paralyze the muscles that usually move with seizures. They don't really know how ECT works, just that it does. There are theories. One is an ECT is like rebooting a computer. Turning it off and turning it on again. They also theorize that the seizure makes new pathways for thinking to lessen the detrimental thinking that accompanies severe depression. Suicidality is supposed to lessen a whole lot.

I started ECT on Monday, September 24th 2018. Right now I receive a treatment Monday, Wednesday, and Friday. Right now the seizure inducing nodes are only placed on my right lobe, and the seizure takes place only on that side of my brain. This is less intensive as a whole brain seizure to start out with. We'll see as I go along if they continue that route, or do a whole brain seizure. I've had three treatments as of today, Saturday the 29th of September. Next week will be MWF as well.

I've tolerated it as well as can be expected. I've had extreme muscle stiffness and soreness after the first treatment, from the muscles contracting during the seizure. But that has subsided as the week has gone on. I've been nauseous each time and have taken Zofran to help with that. I don't believe I've had any memory loss yet, but short term memory loss is a side effect from the ECT.

The normal series of ECTs is 8-10. Some people are more, some are less. It just depends on how your progressing and if you're having severe side effects. It's a treatment by treatment kind of thing.

I haven't noticed much of a difference yet. It's still early in my series though. I do feel more hopeful than I have in years, so there is that. I'm entertaining the idea of a future and what that looks like for me. I am willing to let the ECT run its series and see how that helps me. I am hopeful this will continue to work and I'll continue to see improvement. It's pretty draining on the body, but if it helps my depression it will all be more than worth it.

The First ECT

I had my first ECT treatment on Monday, September 24th. I was so scared. But it was fine. The nurse woke me up and took my vitals at 6am. Then the OR people came around 7:10am. I went to pre-op where I put on a hair net and a gown and they prepped my IV and got vitals. The nurses were super nice and helpful. About 8:05am they wheeled me into the OR. I talked to the anesthesiologist and the ECT doctor. The anesthesiologist talked to me about going to sleep and that he'd be monitoring me the whole time. He was really nice. And he let me keep my lip ring in. Hahaha. The nurse prepped me some more and then the anesthesiologist put an oxygen mask on me. That's all I remember of the OR.

The next thing I remember is hearing people around me talking. It was very disorienting. I thought I was still in the OR and that I hadn't fallen asleep yet and I was awake but they didn't know and I would feel the procedure. I was very scared. I couldn't open my eyes or move to tell them I was awake. That lasted what felt like forever, but was probably just a few moments. Then I head someone say my name. I was able to move my head in acknowledgment. My eyes fluttered a bit. I felt very groggy. She asked me if I knew where I was. I said the OR. She said not anymore, I was in recovery. Wow! I said I'm done and she said you're done. I said that was fast. She asked me what hospital I was in and what yeah it was. I knew both questions. My eyes were open by this time but I still couldn't move well. She said everything looked great and I was ready to go back to the unit. I carefully got up and a nurse helped me into a wheelchair and wheeled me back to the unit. I was a little unsteady when I stood up, but was able to walk to the table and eat breakfast. Oh, I wanted to remember that as I was waking up I felt something in my mouth and started gagging. The nurse quickly removed whatever it was.

Anyway. I ate breakfast fine. My neck was really sore and my jaw was sore too. I layed down after breakfast but was unable to sleep. Around 10:30am (I got back to the unit at 9am) I started feeling very nauseous. I had to leave the 11am group at 11:15am and go back downstairs. The nurse gave me some ice chips and I walked the hall for about 20 minutes. She said it was likely a reaction to the anesthesia. She said when they put you to sleep, they also paralyze you so you don't shake during the seizure, and that causes your insides, digestive system etc to slow down so the breakfast was just sitting there not moving through and causing the nausea. SO walking around helped move it around and I started feeling better. Later that day my stomach was still a little upset and I was still sore, but it was manageable. I felt sad when I got back to my room. And a lot of shame. It surproised me to feel this way. It didn't last overly long though. Oh, at breakfast this sweet old man made me coffee and another patient friend wrote a sweet note that was taped to my door.

So. All in all it was a good experience. My anxiety around it has been greatly reduced now that I've been through it once and know what to expect. So go me.

St. Joseph's

Breakfast would come around 7am. I usually mozied out around 7:30am. I went straight from bed to the dining room. The first few days I tried going back to sleep after breakfast, but I soon learned that was nearly impossible. The therapist that morning would come and get your "maps". Your mood, anxiety, pain, and safety. The nurse would bring morning meds. And sometimes the doctor would come in the morning too. Just lots of ins and outs in the first morning hours. Goals group was at 9:30am. I'd set a reasonable goal for the day. Sometimes it was take a shower, fill out my safety plan, go to groups, practice breathing, etc. It was a small group and usually about 30 minutes. At 11am was the first education group of the day. Topics from self compassion, communication, boundaries, to discharge planning and in between. Lunch would come around noon, with another education group at 1:15pm. The same kinds of topics were discussed. That ended at 2pm and there was free time until afternoon goals group at 4pm. Evening shift was on by this time so a new therapist led the group. They'd ask about our morning goal and discuss any issues there may be. Dinner came around 5pm and the last "wrap up" group of the day was at 8pm. We'd talk about our day and usually do a relaxation technique. Night meds were passed and then it was quiet time with lights out at 11pm.

I appreciated my time at St. Joseph's. I appreciated the care and compassion that was shown me. I never dealt with an unpleasant doctor, nurse, therapist, etc. I wouldn't say I learned any new information, but I relearned a lot of the skills and techniques they taught us. Just stuff I once knew but had pushed out of my mind or forgotten its importance. The recreational therapist who led most of the education groups was very no nonsense and to the point, which I thought was great. She definitely didn't appreciate people being late to group, which was almost comical to me. But she was kind and very knowledgeable. There was really nothing I didn't like. My only complaint, which I mentioned on my discharge survey, was being woken up at 5am for vitals when sleep is so hard to come by anyway. Oh well.

I felt some relief when I transferred out. I can tell the new meds and vitamins are starting to kick in and provide some relief from the intense and overwhelming pain I was in.

I am still unsure about the future. I struggle with it a lot. I am willing to try the full length of the ECT treatment. Of course that's another post all on its own. But I am trying. I'm trying to find value and hope in life. I'm trying. One hour at a time.

The Day That Nearly Wasn't

I woke up Monday, Sept 3rd at 4am. I lied in bed until 6am, when I started feeling a huge wave of sadness come on. I started crying. I couldn't stop. I felt utterly and completely hopeless. This was it. I was done. I'd reached my limit. More than any other time in my life, I was finished. I was going to die. I made a plan for my suicide. And I cried and cried. I was sad for myself, not in a selfish sort of way, but I mourned for my own life. A life of struggle and pain. Depression has been prominent in my life for almost 24 years. That's too long. I was exhausted. My plan was not to die that day, but a few weeks out. I had a set date. I obsessed over this. I read up on this type of suicide, I knew exactly what would happen to my body. It was gruesome. But it would end quickly. I was ready. I was sad for Mr. Purrington. I was so sorry I had to leave him. My heart broke into a million pieces. I was sad for my friends. I was sad for Zach. One thing I didn't feel was that I was giving up. I have fought so hard for so long, that this just seemed like the next natural step in the illness. Depression will take my life. I've known that for a very long time. And now was the time. This was it. I cried some more. I did not follow any sort of crisis or safety plan I have made. I didn't care enough to pull myself out of my decision anymore. Like I said, I was done. But I didn't want to be done that day yet. It was as very complicated set of feelings and emotions. I wasn't sure I was going to be able to wait a few weeks. So I used the Crisis Text Line twice when the urges to die were overpowering. It makes little sense, bu I couldn't die just yet. Finally in the early evening I text my dear friend. I told her how rotten I was feeling. Her empathy probably saved my life. Then I wrote. I wrote about dying. About being buried at sea. About taking care of Mr. Purrington. Once again, my heart shattered. I hesitantly posted my blog to Facebook. I think I knew I needed help. Immediately text and messages started coming in. It was almost overwhelming. But suddenly I wasn't alone. I was loved and cherished whether I felt it or not. I decided to go into KMH the next day to hopefully be able to talk to a therapist. I went back to bed and finally by 6am when I wasn't sleeping still took some Seroquel and soon after fell asleep. I woke up at 5pm Tuesday evening. During that time my phone had exploded with texts and messages. I took some time to reply to them. It was too late to go into KMH, so I decided I'd go Wednesday. My good friend brought me dinner and some sleep aids. I was able to go back to sleep that night and fitfully slept until Wednesday morning. A little before 9am this same friend came to take me to KMH. By some grace Callie was available right at 9am. The three of us decided the best path next was to go to urgent care, which we did and the doctor, who was unbelievably kind, sent me to the ER at St. Anthony's. It's the same ER I went to three years ago. At 1pm my friend had to leave, and at 1:30pm the social worker came in to talk to me, It wasn't even an option, I was going to be transferred to a mental health ward. Zach and another dear friend came to give their support while I waited for the social worker to find a room for me. Around 6pm they said they'd found a room at St. Joseph's in Tacoma. At 7:15pm an ambulance came to transport me. I got into my room at 8:15pm and did my intake with my nurse until about 10pm.

And here I am today. This is now. Tomorrow will be a week in the hospital. I have worked closely with many nurses, social workers, counselors, and the psychiatrist. They've been exceptionally wonderful.

But how do I feel? I still want to die. I'm still sad. My eyes are still glassy. I'm still very anxious. I still have my plan. Today I feel like the fog in my brain is lifting. I haven't been quite so tired today. The intense suicidal urges are not quite as strong. But as they subside, the self harm thoughts increase. I plan on talking to the therapist about that tonight. Also I want to talk to her about my plan and how no it's problematic it's for a later day because I still plan to do it. It's not like I was going to kill myself that day.

What's going on with my treatment? My vitamin B12 and D levels were really low, so now I'm on a high dose of those vitamins. The Zoloft has been increased to 150mg. And I've been put on 10mg of Abilify. I've been on Abilify before, but am willing to try it again. The doctor wants me to start ECT. I gave the ok and now he and the social worker are advocating for me to start. Unfortunately it's a process and will take a day or two for the other hospital's team to accept my case. I'm extremely anxious that I'll be denied. I can't be. This is my last hope. My last chance. Something I haven't tried before that is very effective in a lot of people with major and resistant depression. So I wait.

And that's today. This is my life. I don't know if I'll be ok. I honestly can't say if there's a tomorrow. I feel hopeless. I feel helpless. I am sad.

It is what it is.

Should I Die

Should I die tonight. Bury me in the ocean. Cremate my body and scatter my ashes at sea. This is what I want. I don't belong to this earth. I never have. Let me rest in the water, the only place I've ever felt at peace. Please don't have a funeral. I see no need for any type of sermon. Let the life I lived be enough. Get together still, it's ok to cry. It's also ok to laugh. I want to be remembered for being a real person. I want people to share stories of times we shared together. I cried a lot. I laughed a lot. We have a lot of memories and I want them to be shared. So get together and remember who I was. Then leave and get on with your lives. Don't forget me, but move on. I'm at peace now.

Remember that mental health was my passion. I tried so hard to help and to share what it is like to live compassionately with a mental illness. I hope I have succeeded in some small way. I hope I can be seen as someone who fought off and won their demons, until I couldn't anymore. There is no shame in death. I'm not ashamed. I did my best. In the end depression will take my life. I hope I have helped someone along the way so depression won't take theirs. I understand the fight. I get it. I know.

I trust you will take care of Mr. Purrington. My angel baby. Be patient with him. Learn his quirks. Don't try to handle him much, he doesn't like it. He'll let you know when he wants to be cuddled. Just love him like I did. It's urgent. Be grateful for the years we had and the help he gave me. My boy.

Mostly though, bury me at sea. That's all I wanted to say. It's been a long, long fight. In the end though I just couldn't save myself.