Depression Was a Living Hell

Since I was an eighteen-year-old college student, I have lived with mental illness. My 18th year was a living hell. That’s how I’d describe the severe suicidal depression that overwhelmed me.

What I Learned at 18

1) I want to live, even when the pain of depression is so severe that I think that the only way to end it is to die.

2) I can and will ask for help when I need it.

3) I’m not alone. My friends, my dorm resident assistant, and a cognitive psychologist at UCLA all supported me when I sought help.

4) Therapy works. The cognitive therapy I received helped me to rewrite negative depressive thoughts. I believed my parents, my sister, the whole world would be better off without me alive. That thought was irrational. I learned the skill of stopping negative thoughts, questioning if they were rational, and replacing them with more rational positive thoughts. The world would NOT have been a better place without me. My family and friends would have been devastated by my loss.

Mismanaged Medications Can Trigger Episodes

At thirty, I experienced a deep depression. I turned to medication for the first time. The psychiatrist I saw at the time told me that I was in the adolescent stage of development — an insult. I was a thirty-year-old psychotherapist who worked in nonprofits for low pay, yet I managed to put myself through graduate school and years of internship while supporting myself in the San Francisco Bay Area, an expensive place to live. The psychiatrist mismanaged my medication so that over the course of a few months I went from depression to a week of full-blown psychotic mania. At that point, I had been unable to sleep for a week due to three simultaneous racing streams of thought about mystic saints, chaos theory, and binary code (ones and zeroes).

What I learned at 30

1) Again, I’m not alone. A dear friend of mine called my father and my priest, telling them that I needed help. My father immediately flew up from Los Angeles. My priest rushed over with a seminarian (someone studying to become a priest) who lived with bipolar disorder. They asked me if I had told my psychiatrist about my symptoms. I called my psychiatrist and described my psychotic thought process. Over the phone, the psychiatrist prescribed three antipsychotic medications, which stopped my thoughts in their tracks, allowing me to sleep.

2) Doctors make mistakes. That psychiatrist warned me to never disclose that I had ever been prescribed those antipsychotics. Whether his warning was to prevent a malpractice suit or due to stigma, as I was a licensed psychotherapist, I don’t know. Clearly, I needed a new psychiatrist. My second lesson learned: doctors are not always right. The psychiatrist I later saw helped me to find a medication that kept me stable for years.

3) Family support is important. My parents went out of their way to help me through this mental health crisis. I learned the importance of family support. I had been taught in my psychodynamic graduate program and in psychodynamic therapy that my depression was the result of abuse. Clearly, my parents loved me. Yes, my parents were not perfect. But, as a psychotherapist of severely emotionally disturbed children, I had worked with families who clearly loved their children. Many of those parents struggled with mental illness, substance abuse, physical and emotional abuse, even incest, but I could see that they still loved their kids. The dysfunctional family dynamics were learned. They came to therapy to unlearn those dysfunctional dynamics. If I could feel compassion for my clients’ parents, I could feel compassion and have forgiveness for my own parents. I ended up moving back in with my parents until I was stable enough to move back out on my own.

4) If at first, you don’t succeed, try, try again. Just because I had a horrible reaction to the first trial of antidepressants, didn’t mean that antidepressants wouldn’t help me. The second psychiatrist I saw listened carefully to my story. Rather than tell me that I was an adolescent developmentally, he assessed if I had bipolar disorder or a severe reaction to an antidepressant. Back then bipolar disorder type II was not in the Diagnostic and Statistical Manual of Mental Disorders. He carefully titrated my dose of an antidepressant. When my thoughts raced, I’d call him and he’d lessen the dose, increasing it more slowly.

Diagnosing Bipolar Can Take Time

At thirty-nine, I was diagnosed with bipolar type II. Since receiving that diagnosis, I’ve been hospitalized and participated in months of partial hospitalization. After trial and error, I’m “stable” on medication.

Living Purposefully with Bipolar

Twice I attended seminary where I wrote a mental health ministry workbook. I have found purpose as a mental health advocate. I volunteer for the National Alliance on Mental Health as a Provider Educator. I am active online promoting mental health. I write about living with bipolar disorder both on my website kittomalley.com and in my upcoming memoir, Balancing Act: Writing Through a Bipolar Life, to be published September 19th.

My Response to Natasha Tracy’s post, Bipolar Disorder and Pregnancy: Bipolar Taking Away Choice

I didn’t know I had bipolar disorder when I chose to become a mother. I was diagnosed with dysthymia [chronic depression]; although, I knew I likely had, at the very least, cyclothymia [mild form of bipolar disorder]. Once I got the diagnosis of bipolar type II [characterized by hypomania, rather than mania], my son was 27 months old and still nursing (he loved it and I was a pushover). I had to abruptly wean him, as Depakote is not safe for nursing infants or, in his case, toddler. I proceeded to put my son in daycare and reenter the workforce due to my fear of parenting my son now that I had the diagnosis of bipolar. I believed that I was all of a sudden a dangerous mother whose son was better off in the care of someone else. I was wrong. In spite of the challenges of bipolar disorder, and those challenges are real, I’m a good mother. I work hard to be a good mother.

But, motherhood is challenging, especially if you are struggling with a serious mental illness. Not only is motherhood challenging, but the hormonal changes of pregnancy and childbirth can trigger and worsen bipolar disorder [perinatal onset — see also Birth of a New Brain]. I respect your choice. If I had known my diagnosis before I chose pregnancy, I may have made another choice. My husband and I created a wonderful, gorgeous, brilliant son who suffers from migraines, anxiety, and depression. He’s had a tough neuro-atypical life with challenging high-strung neuro-atypical parents. We do love one another, though, deeply. It’s been worth it.

Originally published at kittomalley.com on March 8, 2016.

Recently my mother slammed the door on her speech therapist. She refused nursing care for herself and blocked nurses from seeing my father. Her behavior has caused both of them to be discharged as patients from home health services. No more home nursing visits, physical therapy or speech therapy.

My parents reside in a board and care near my home where they are fed and cared for by caregivers. They still are seen by an internist with expertise in treating seniors. They take their medications. And, I have requested that a psychiatrist see my mother.

Back to the story about my mom… When I visited, my mom restrained me and blocked me from leaving their room. My husband felt compassion for my parents and questioned whether they received adequate care (they do). (He supports me now and tries not to offer opinions or “fixes.”) I ended up feeling so out of control and overwhelmed that I posted this to Facebook:

I really need a friend right now. Feeling alone, isolated, misunderstood, on my own, unsupported, inadequate.

I received just what I needed — love and support. Here are responses I posted:

Today I heard that my mom’s home health care providers were discharging her as a patient because she refuses service and slammed the door in their faces. I’m working so hard to help and feel so helpless. Hard to just let it be.

I’m stressed out caring for my parents and for my son. Got to me. Just broke down. Feeling better but the weight of my responsibilities remains. Must let go.

Thank you, friends! Greatly appreciate all the support. My feeling isolated passed. You all helped. Spoke to my dear neighbor. In the midst of family crisis. Will be ongoing for a while. Stress can weigh too much and wear me down at times. Sometimes I throw up my arms and cry for help. Thanks for answering my cry.

All the love is loud and clear. The mood has passed. The stressors and triggers remain. Have to let go of what I cannot control.

Originally published at kittomalley.com on February 16, 2016.