Donna Speaks: How is your Cognition?

I thank Jan for her blog post on clinical depression. It was very informative and helpful.  I hope anyone who recognizes the symptoms does value themselves enough to get thee to a therapist.

I have some additional information to share that I also think will be informative and helpful to you.

Clinical Depression (CD) takes a toll on us from at least four different fronts.

The first front, Jan described: Clinical depression caused by situations we find ourselves in that are beyond our control.  A relationship break-up, the loss of a job, or retirement from your life long job, losing possessions and/or your home as a result of a natural disaster can cause depression.

Jan also alluded to the second front: physiological. Depression can adversely affect all bodily systems. 

For example, we know that serotonin, that feel-good chemical healthy bodies produce, is well known as a brain neurotransmitter.  However, it is estimated that 90 percent of the body's serotonin is made in the digestive tract. In fact, altered levels of this peripheral serotonin have been linked to diseases such as irritable bowel syndrome, cardiovascular disease, and osteoporosis. CD and osteoporosis linked?  You betcha.

Your immune system is also compromised by depression.  When depressed, you are more likely to catch that bug everyone else has.  Pain receptors become more sensitive: pain is more painful.  And, your heart really does hurt.

On the third, family and friends front, there is also no doubt that depression makes developing and maintaining relationships much more difficult. Depressed people often isolate, become social hermits.  This is not a conscious choice.  You can rightfully blame that on Big Ole Aunt Anhedonia who usually comes to visit.  When you are depressed, there ain't much you do that gives you pleasure.  So you are pretty much likely to curl up on your couch in a fetal position and suck your thumb.

The fourth front, the cognitive front, is often not discussed as much as it needs to be.  It is way-way-way important when doing therapy with CD folks.

Yes, when afflicted with CD, your mood is way, way down.  And you feel Yuckie-Yuckie-Yuckie.  But, your thoughts are, your thought process is, also really fucked up.  What didn't piss you off last week, does now.  The people you loved yesterday - especially your lover, husband, wife, partner, etc. - you cannot stand today.  Your job was OK; now it isn't.  What changed?  You did.  Your thoughts did. 

Your thinking did. When your body declines to produce enough of the feel-good chemicals, your thinking goes in the toilet.

For a great percentage of the time, the things that upset us do so not because they are by their nature upsetting, but because of the way we think about them.  This is why research has demonstrated that the most effective therapy for CD is Cognitive-Behavioral Therapy (CBT).

Our actions are a result of our feelings.  Feelings are based on the way we think about life, love, people, places, and things. So, in therapy, we examine your Belief System (BS), help you find the flaws in it, the unhealthy beliefs, the stinkin 'thinkin', and assist you in re-thinking your BS, so you do not think BullShit anymore.

The drugs used to treat CD treat mood and cognition.  They will elevate your mood and help correct your toilet-bowl thoughts.  It is essential, in the long run, that you are able to think critically about the way you think, and change your flawed thinking in order to have long term success.

More thoughts about depression in my next blog.

Miss Althea, have a great day.

Anxiety therapy

All of us are anxious at times, some of more than others.  Some of us don't like heights or bridges or snakes or spiders. Others fear large crowds or heaven forbid, public speaking.  Often folks have free floating general anxiety with no apparent cause. Others will not fly in an airplane but must drive or travel by train or bus.  Phobias and anxieties often go hand in hand. Panic attacks can appear with anxiety.

Some of us are just worried all the time. We can worry about if we will get a good night's sleep, if we will past the test in school tomorrow, if boyfriend will like the new hairdo or if mom will get drunk again tonight. Most of the time we have nothing to worry about, but we don't know that, so we do it anyway.

When anxiety starts to get in the way of our lives, we can usually successfully resolve them with therapy.  We find a good therapist like we find any other service. We can ask a friend, a family member, or even just check the internet for who is a Licensed Clinician in our area.

A good therapist will do an intake interview to assess your anxiety levels. Your honest input is the most important part of the interview.  It starts the process of dealing with your anxiety. It may result in a referral for medication depending on your anxiety levels and how much they are impeding your day to day living. If you are not forthcoming with your therapist, you can waste valuable time before you start resolving your anxieties.

No matter how you feel about what you are revealing to the therapist, remember everything you say is completely confidential and never be revealed unless you give consent. Your case record is protected by law. And also remember, your therapist can never be surprised. She has heard much worse than you can possibly tell her, so be honest, be complete and don’t keep secrets from her.

During the coming weeks, you and the therapist determine your treatment plan and begin your therapy.  You will talk about possible causes, the limits your anxieties place on your life and how you can overcome them. You will identify the triggers that start making your feel anxious. 

Anxiety therapy is not easy.  The therapist will not fix you. This is something the two of you do together and you do most of the work with assistance from the therapist.  But between you, perhaps medication, and the competent therapist you can become free of the distress anxiety causes and live more comfortably.

Donna Speaks: The Invisible Ones. What Next

The Invisible Ones: What's Next?

OK.  So I get a diagnosis (diagnoses, to be exact) from my md; I've got antibodies for some of those auto-immune thing-a-ma-jigs.  Like Chronic Fatigue, Fibromyalgia, Scleroderma, Sjogren's, etc.

I think, "Thank goodness... I'm NOT crazy after all." and, "Well, my life need not change so much."  Anyway, only a couple are "active": only the Chronic Fatigue and Fibromyalgia are giving me real problems.  The rest are just hiding in my body, waiting to display their ugliness on some future unknown day.  Those, I am sure, I can totally ignore.

In fact, I decide, I'm gonna ignore all of them.  I've always worked like hell and, by-golly-gosh, I'll continue to do so.  I'm not gonna like this crap get me down.

And, I do just that.

I set up physical therapy threes times a week and earnestly apply myself.  My massage therapist comes twice a week. I continue working at my same pace with my psychotherapy clients.  I do my meetings, my gardening, my weed-eating, my swimming, going on outings with my partner, playing with my dog, etc.   

I concede to take Cymbalta.  I know about antidepressants and this one's "off-label" use for fibromyalgia pain.  The self-administered B-12 shots are also ok to kick my butt outta the fatigue and 12+ hours of sleep. I do some natural remedies when I have a flare-up, e.g., echinacea. 

Then my md has the audacity to prescribe an anti-viral: Acyclovir.  Whoa!  That's what folks with HIV/AIDS and Hep-C take.  That's heavy duty stuff.  I balk at this and take it a while, then quit.

A couple of months into this routine, I am feeling worse. I hurt all over.  

I am so tired and need so much sleep, I have to cancel appointments on occasion. Sometimes my muscles are so weak, I'm not sure if I can, like I hear people say, put one foot in front of the other.

I realize I am trying to make my invisible "conditions", invisible.  I am The Queen of Denial.  Yea, baby, I've got it down pat.  Not to worry about other people not realizing I'm "ill" because I have no crutches, no wheel chair, no scooter, no oxygen tank.  I'm not accepting the facts of my life myself.

That's what comes next: Denial.