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perspective

Guest Posts, Mental Health

Letting Go of the Why

January 2, 2022
infusion ketamine

by Tammy Richards

As I leaned back into the soft, adjustable recliner I realized that this was it. The potential of the next 45 minutes would either lead to triumph or defeat and if the result was defeat, I was certain I would die. The last 25 years were a compilation of all my successes and failures, and the results of a lifetime of self-doubt and struggle masked by a wicked sense of humor and relentless drive to be the best. But today the stakes were higher — I was exhausted, hopeless, and the pain was unbearable. I had to decide whether I was ready to give up the control I had so desperately clung to and embrace the willingness to let go of the why. I had to decide I wanted to live more than I wanted to be in control.

“This is just the initial dose, and then we’ll increase it from here throughout the first six infusions. Let us know if you are experiencing any nausea, and we can give you something for that. We can’t predict what you will see or experience, but if it becomes distressing, please let us know, and we can help with that as well. Are you ready to start?” the anesthesiologist looked at my masked face hesitantly, and I wondered to myself what the bottom half of his face looked like.

“Yes,” I replied nervously, “I never thought I’d be getting a “Special K” infusion at the age of 48 to try to manage my chronic, soul-sucking depression, but at this point, I’m willing to try anything because I’ve tried everything else. Let’s do it.” The doctor nodded and pushed the initial injection of ketamine into my arm and then started the IV drip.

“Do you feel anything?” he said.

“My hands and feet and lips feel weird,” I think I said, and then everything changed. My body felt warm, but disconnected and as I closed my eyes, the acoustic guitar music in the room became a touchpoint for my consciousness as what I started to see around me took on different shapes and colors, and my perception of time and space began to shift into a place I had never visited in my mind before. Maybe this was the answer I had been searching for — maybe things could change? Dare I hold out hope one more time?

Major depressive disorder has been an uninvited guest in my life since my late teens. While I wasn’t officially diagnosed until my late 20s, the eventual diagnosis explained so many things about the way I have always perceived the world. An entertainer at heart, my greatest hope was that people would like me. In my mind that meant I had to be exceptional, special, better.

In my childhood mind I remember every failure as a stain upon me until I was covered in darkness, disappointment and sadness. Throughout my quest to measure up, I had always fallen short, was never enough, but was somehow too much.

How I envied my younger sisters. They were prettier than I was, and they didn’t seem to care what other people thought of them. I watched them grow up and become confident, beautiful women with amazing children. They seemed so happy with who they were, and lived their lives authentically, while the shadows of impostor and fraud chased me like so many specters.

My first stay in the hospital was after my psychiatrist found out I had stockpiled enough medication to kill myself.

“You have two choices,” my psychiatrist said as I stared at the worn carpet in her office. Do psychiatrists ever change the decor in their offices, I wondered? I wished the plush pillows behind me would somehow suck me into the couch and port me to a place where I didn’t want to die every day, but I remained in the office.

“You can go into the hospital voluntarily, or I will commit you for your own safety,” she looked at me expecting an answer. I didn’t know what to say. All I could think of was the cost. The financial cost, the emotional cost, and the humiliation.

“I guess I will go voluntarily,” I said grudgingly, knowing that the worst was yet to come. Later that day, my husband of eight years dropped me off at the front entrance to the hospital ER

“See you later. I hope you feel better. I love you. I will visit later,” he signed to me before driving away and leaving me to either flee or go into the hospital on my own. My husband was Deaf, and he knew as well as I did that the hospital wouldn’t make communication with him accessible, and I was in no state to interpret for him, despite interpreting being my chosen profession. Just another kick in the teeth watching him struggle to understand what the actual fuck was going on with his wife.

After entering the ER, I was screened, searched for implements I might use to kill myself, and taken to the fifth floor psychiatric ward — a locked ward with patients whose diagnoses ranged from schizophrenia to mild depression and everything in between.

All around me patients in hospital robes and pajamas wandered talking to themselves, to people the rest of us couldn’t see, or sat looking vacantly at something they wished they could reach. I wondered what alternate realities they inhabited and if any of them were better than actual reality. I entered my room and climbed up on the windowsill looking out the window at the parking lot below. If only I could break the window, forever escape would be mine. Like a deep, pounding heartbeat I began to bang my head against the window, willing it to break and for me to plunge downward to freedom.

The next thing I remember is waking up rather groggy and feeling hungry. What had they given me? Images of nurses pulling me from the windowsill and a sharp prick of pain flashed through my mind as I pieced together that they must have tranquilized me like some kind of psychotic racehorse when I wouldn’t/couldn’t stop banging my head against the window.

What now?

It has been 22 years since that hospitalization. Since that time, I have divorced, re-married and now have two teen sons. Through all the medication changes, additional hospitalizations and ever so many treatments of electroshock therapy the depression has been lurking, ready to pounce at the sign of the tiniest crack or the most minor divot in my mental armor.

In 2017, that crack began to appear. Something visceral shifted and I could feel the descent into despair. How could this be happening to me again? What had I done wrong that had sent me back into the place where every day I woke up wishing I hadn’t?

By January 2020 I was back in the hospital. A week there and I felt that all I had done was reaffirmed that I couldn’t live this way anymore. I couldn’t stop thinking about my poor children. The day I checked myself into the hospital my 13-year-old-son was crying and hugging me,

“Honey, it’s ok. I will come back soon. I just need some help right now,” I tried to reassure him and hold back my own tears.

“Mom, I’m not crying about you leaving, I just don’t want to end up like you,” he replied, sobbing.

My heart cracked and broke into sharp shards of glass, too small to piece back together.

“You won’t, honey. You will be fine,” I replied, the guilt and shame overpowering now.

By June 2020, after months of the pandemic and barely being able to crawl out of bed each day, I knew it was only a matter of time before depression would kill me and reduce my family by one.

“I have done everything I can, Ryan. I don’t know what else to do at this point. I’ve been on too many medications to count, shocked my ever-aging brain dozens of times, and done so much therapy I’m surprised you haven’t sent me packing yet!” I complained to my long-time therapist and staunch supporter.

“Tammy, there is one thing that is somewhat new, but you could consider trying. It will take an extraordinary amount of willingness and bravery to try it, but I think you should consider it. There have been a number of very successful trials and studies, and they have shown this treatment can be effective in up to 70% of patients struggling with depression,” Ryan explained.

“What is this magical unicorn treatment that I haven’t yet tried?” I said, sarcastically.

“It’s called ketamine infusion therapy,” he explained.

“Wait, you want me to take Special K — like the party drug??” I was skeptical. Was my therapist seriously telling me I should consider taking a psychedelic drug to alleviate my depression? I was absolutely terrified by this prospect. I have serious control issues. I cannot stand to feel like I am out of control. The idea of taking a party drug, via IV infusion no less, sounded instinctively like a bad idea to me. Here I was at 48 years old, and I had never even been drunk or smoked a joint before! I hadn’t even partaken in THC-laced edibles, though all these things had been legal for years in Oregon.

What if I became so altered that I started doing or saying things I couldn’t remember? Visions of crazy, naked, trippin’ hippies running down the street came to mind. And dare I even have the slightest bit of hope that this treatment would help when so many others had failed in the past?

“What do you think?” Ryan asked as he stared at me through the video monitor as we continued our online session. It seemed like it had been an eternity since I had seen him in person. I secretly wondered if he still existed or if I was just talking to a therapist avatar of some sort that happened to look like Ryan.

“I am terrified. I don’t know if I can take the disappointment and feelings of failure if it doesn’t work for me. My capacity for hope is gone. I just can’t be disappointed again,” I explained.

“You don’t have to hope for anything,” Ryan reassured me, “I’ll hold that hope for you, but I need you to be on your own team, ok?”

Somehow having Ryan be my “hope proxy” was comforting. If this didn’t work, I wouldn’t have to have my own hope crushed, he could just hold it for me. I had to make a critical decision at this point: would my need for control outweigh my desire to live? Would I be able to choose willingness?

I decided that I would try the ketamine therapy. I had nothing left to lose by trying it, and everything to lose if I didn’t.

Ketamine infusion therapy is done in a six-infusion series over the course of two to three weeks. The dose is titrated up over the course of that time until the patient starts to experience clear dissociation which is the effect that the doctor is trying to achieve. All treatments are overseen by a nurse monitoring vital signs and a board-certified anesthesiologist who administers the infusion.

By the second infusion, I could feel a small shift in mood. I felt the boulder on my chest had decreased in size just a bit, and while I could still hear her, that horrible internal voice that railed against me, telling me that I was worthless, stupid, and vile, was more of a whisper instead of a shriek. And then, during the fourth infusion, things broke wide open.

A tiny crack appeared. It was slight but real, and with each failure, it grew until I poured out of it leaving myself empty and hollow.

I knew this feeling well. The innumerable fissures that I had carefully patched and spackled so as not to reveal the damage and breakage to anyone because I couldn’t let them see the imperfections and so much damage.

Sometimes the voices were so loud they overtook me in waves as rough and surly as any hurricane; screaming to me of my worthlessness and failure until all I heard was death and wished so hard it would take me. I cried as I believed the mind that tricked me, telling me lies so convincing that I couldn’t hear anything else because I KNEW it was right.

For years, I awoke, bitterly disappointed that I woke up at all. Wanting so desperately to end the screaming and hate and loathing that consumed me. But even when I tried to help it along, death wouldn’t come and teased me by saying I couldn’t even get that right.

But one day, I was so deep in the ocean that I couldn’t hear the screaming anymore and I floated upward seeing the light at the surface. I didn’t dare hope because hope was for suckers, and I had been fooled so many times before, but I pushed toward the surface as hard as I could until I broke through and was engulfed by the sun. I smiled, with genuine joy because the voices stayed quiet, and my mind didn’t tell me how stupid and worthless I was, and I could finally breathe, at least for now because something inside had popped.

The fissures and cracks had been made watertight again, and I felt myself inside myself again, not leaking out onto the floor and into the despair I usually occupied. There was finally space again.

It was after this fourth infusion that I began to allow in hope, and I made the choice to be willing to accept that I may never know why I experience such profound depression. I just do, and that explanation must be enough.

As Ryan has said to me many times, everyone struggles sometimes, it is learning how to struggle without suffering that is what we all need.

Tammy Richards lives in Portland, Oregon (a proud, life-long Oregonian) with her husband of 18 years and her two sons. She has served as a certified American Sign Language Interpreter for the past 31 years. When she is not writing or interpreting, she enjoys volunteering for access-related social justice causes (such as interpreting for inaccessible YouTube or Livestream content) and participating in endurance cycling events with her AIDS/LifeCycle team: Team Portland. She is an avid reader and is also a thriving child-taxi, driving her kids around to their various sporting activities (when we are not in lockdown). She has three mini-pigs: Zena, Zorro, and Zoey, who she adores. Tammy has trained Zena as a therapy pig, so she makes appearances in special needs classrooms and nursing homes where she visits, does tricks, teaches people about pet pigs, and gets lots of treats and belly rubs. Tammy’s memoir, “Toward Not Away: A Journey Through Depression to a Values-Driven Life” is currently in the works. You can follow her on Instagram @towardnotaway and on Facebook at @towardnotaway. 

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Guest Posts, Relationships, Starting Over

Turning Around

July 19, 2021
year

by Monica Garry

The other day I was driving down a road by the river that all of a sudden came to a dead end. There was no warning for the road closure until it happened, which was totally fucking inconvenient given that this particular road was one that stretched no wider than 20 feet. I muttered through what must’ve been an entire library of curse words while making an 8 point turn-around, only to find myself facing one of the most stunning views.

The sun, which we don’t get much of in February in Minnesota, was blaring through the trees, just about to set; leaving all of the snow and the big silver buildings that sat just by the waters edge blindingly glistening in its reflection – the sky bluer than I’d seen her in months – and amongst all of the snow and ice, on my right, sat one small patch of rock that the sun had warmed just enough to let water pour down its edge. As I began driving, following the sun blindly, a smile stretched across my face, I realized that this is exactly what life had been doing for the last year. That today wasn’t the first time it had stopped me in my tracks.

I thought about how my three-year relationship had ended, how the pandemic hadn’t allowed me to see my family, how my mom’s relapse had landed her at rock bottom, how I felt burnt out at work. But I thought, really, about how my break up gave me the space, freedom and, frankly, fear, that I needed in order to find myself again. I thought about how even though I couldn’t see my family physically, I’ve spoken to them more in the last year than I had the previous two years combined. How my mom‘s relapse had brought about incredible healing and strength, how I’m closer with her now than I have been in a long time.

I thought about how my burn out at work stemmed from a lack of connection, and how this had allowed me to see how truly accessible connection is, how I just needed to actively seek it; to actively participate in it. I thought about how many new places I had found and felt profound amounts of love.  I thought about how all of these challenges were really just life forcing me to change course. Because left to our own devices, we humans tend to miss out on the really good parts of life – the parts that come from the unknown, the unpredictable, the uncontrollable.

So, here’s my advice: if life turns you around, let it. It’s going to feel like it’s being a bitch, and truthfully, it’s probably going to hurt like one. But once you get there, you’ll realize it’s doing just what it did for me that day, what it did for me that entire year, and what it’ll do for all of us hundreds of more times to come – making sure we don’t miss out on the really good stuff.

Monica is a community mental health worker, currently living and working in Minneapolis. Aside from this work, she has a passion for writing. This past year and a half, with all of it’s tragedies and hopes, have inspired this piece.

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Although each of Jenny Offill’s books is great, this is the one we come back to, both to reread and to gift. Funny and thoughtful and true, this little gem moves through the feelings of a betrayed woman in a series of observations. The writing is beautiful, and the structure is intelligent and moving, and well worth a read.

Order the book from Amazon or Bookshop.org

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Anti-racist resources, because silence is not an option

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Gratitude, Guest Posts

Perspective

November 13, 2020
think

By Erica Hoffmeister

Don’t think about how much you hate parenting. Not being a mother, not mothering, not your children—you love those, you do, really, you do—you just hate parenthood. The menial, daily, repetitive tasks that send you into a spiral. So, tell yourself it’s natural to hate sweeping the floors six times a day. Tell yourself no one enjoys doing other people’s dishes for zero wages or applause. Tell yourself hating these things does not make you a bad mother, does not make you love your children less. Don’t think about how much you often hate breastfeeding, the constant tug and pull and smothering of your skin and parts. Don’t think about how much you’ve actually always hated the company of children, even as a child, how you find them overall insufferable and annoying. Tell yourself your own children are excluded from this blanket opinion. Tell yourself you will do crafts with them tomorrow, like your mother did with you, like your husband’s mother does with them. Tell yourself you’ll build a fort with them, play dress up, teach them their letters and numbers by singing to them, banging on a ukulele. Remind yourself these things are supposed to be fun, not annoying. Not a chore. Look on Pinterest for ideas, plan a social media post to keep yourself accountable. Don’t check that friend of yours that became an “affirmation coach” and don’t think about how stupid you think all of that garbage is. Don’t think about lighting a candle and doing it yourself. Tell yourself you don’t need positive thinking. Tell yourself you’re a realist.

Don’t think about how much you miss not having children. Not being someone’s wife or mother. Not belonging to anything but the earth. Not being anyone’s every or any need. Don’t separate those feelings by dividing memory by before and after so you miss yourself before. Don’t think about how wonderful it would be to see a movie alone, whatever movie you want at whatever time of day. Don’t think about all the times you’ve cried cathartic in the back row of a movie theater because you didn’t have to share the popcorn or the drink or wave little toys around a child’s face or walk a toddler back and forth from the bathroom twenty-seven times, distracted through every important scene. Don’t think about how much you want to get in your car like you did when you were twenty-three and drive down the highway until your gas bleeds half dry, then drive back just for the hell of it. Don’t think about the fact you no longer own a car, how you traded your first in for your husband’s city bike and drive a family car now that only gets 10mpg so you can’t afford spontaneous highway drives, anyway. Don’t think about the hours you’d spend as a teenager locked in your bedroom staring at the ceiling, how much you loved silence, no one touching you, or speaking to you, even before you understood the value of boredom. Don’t think about the unread stack of books in your nightstand. About your chewed finger-beds that bleed into rounded stubs, years from your last manicure.

Don’t think about the guilt imbedded in all these fantasies. Tell yourself this guilt is proof you love your children. Don’t try to pinpoint the guilt’s genesis, when it starts in your life along the timeline of regret. Don’t think about regret. Don’t think about the hundreds of thousands of dollars in debt you are. Don’t think about your useless degrees, your nonexistent career. Tell yourself you’re taking this time to raise your children. Tell yourself this is your choice, that you chose this. You chose this. You chose this. You chose this. Don’t think about countries that have paid maternity leave or affordable childcare. Don’t think about your credit card debt you lived off of because you are not a citizen of one of those countries. Don’t think about how it’s really not the country’s fault you drank and snorted your way out of grad school and then didn’t write a single thing for six years. Don’t think about the karma you earned in that fruitless interim. Tell yourself it wasn’t fruitless, that no experience means nothing as a writer. That it was all for the greater good. Don’t think about how you made all the same mistakes the second time around. Don’t consider choosing your husband over everything else a mistake, think about how you should have prioritized yourself and your career and your future over him when you met instead of falling in love instantly, and rearranged everything to be with him. Don’t remind yourself how many times you’ve done that in your lifetime. Don’t think about how you aren’t published yet. Or at least not enough. How much you hate yourself for wasting your kid-free years not banging out fourteen novels, or something, because now you write in the lost corners of some morning hours,  lucky to get even ten uninterrupted minutes and you really think that whole story about how Stephenie Meyer wrote the Twilight series by the pool while watching her kids swim is a goddamn lie. Remind yourself that you have, in fact, published a lot, and that not it’s not profit, but the act writing that makes you a writer. Don’t think about how you are going to stretch fifty-four dollars for a week’s worth of groceries because being a low-level technically-published writer means still working in a bar. Don’t think about the men that hit on you while you serve tables. Don’t think about how you are still, after seventeen years, still serving tables. Don’t think about why. Tell yourself it’s nice to get out of the house. Tell yourself it’s nice to talk to adults. Tell yourself anything while you do it so no one can see the pain and regret and annoyance and hatred on your face so that you still make at least 20% in tips a night.

Don’t think about the guilt or the shame or regret. Don’t tell anyone. Don’t make new friends and don’t maintain old friendships so you won’t risk spilling it all out over coffee, or a more likely, few drinks.

Don’t think about how the world is ending anyway—stop reminding people of this in person in general. They know. We all know. Stop feeling guilty for having children and helping the world end faster. Stop trying to de-age in general. Stop thinking about all the things other people your age have done in comparison. Don’t think about your empty passport pages, your children’s hand-me-downs, your WIC card. Don’t think about your mom, and how she’ll never retire, or how she takes out credit cards to pay for Christmas presents. Don’t think about how poverty is a cycle, is insidious. Don’t think about how you may have escaped it, but now how everything tastes like Shit on a Shingle.

Think about this instead:

Wrap yourself in the memory of how the sun felt pouring through an open window while driving down Highway 1, feel this sensation when your baby snuggles beside you, her big eyes swallowing the sky whole. Or, the first time you witnessed your toddler perform on stage, exuding more confidence than you’ve had in your entire lifetime, how she unabashedly shares her mind, and how you think of her when you’re scared to tell the truth in public spaces.

Think fondly of before:

The lowlight of city sidewalks on an October afternoon as you hazily held the hand of a new lover and made him your whole life. How you repave entire cities and worlds to find your own path, how unapologetically courageous it is to head into things straight-on, even in the hard times, when you crave stillness. Seek for stillness in the long nights, the tufts of the baby’s hair between your fingertips, your husband’s toes between the arches of your feet to keep them warm. Imagine how your spaghetti sauce tastes only to your daughter, how she’ll spend the better part of her college years missing it with such fierceness, she’ll visit you twice as often—don’t tell her your secret, that it’s canned tomatoes and jarred garlic—so that she’ll keep coming home to ask for it.

Think about your smallness, your bigness, of the impossibility it is to have known it all before, just to have it all then.

Think about Paris in wintertime, the streets slack with moisture, the sound of your heels clicking across cobblestone the night you turned thirty. Think about how that memory will never fade, never disappear into the disintegrated soapy sponge, worn from overuse, how your sense of self has not really been suckled dry by breastfeeding your children, how your abs are still there, below the torn muscle from giving life. That your skin still glows between stress wrinkles, and by God, that your talent for cooking dinner is unmatched, and how no one does that for their families every night anymore but you.

Think of your own mother, the way she looked so tired and faraway, and yet, still held your hand in a gentle squeeze, still rubbed the back of your hand when you were sick, still loved you before and after all her past lives gelled together into yours.

Think of the universe, and stardust, and blackholes, all the shades of green that grass blades can be, how Montana’s horizon looks like a curved earth when it swallows sunset at 10p.m., or the skin of a ripe plum off your childhood tree. How nothing, and everything is just as hard as it always was—how nothing and everything is still inside you, no matter how many times you’ve swept or neglected to sweep the kitchen floors on any given day.

Erica Hoffmeister teaches college writing across the Denver Metro area and holds an MFA in Creative Writing and an MA in English from Chapman University. She is the author of two poetry collections: Lived in Bars (Stubborn Mule Press, 2019), and the prize-winning chapbook, Roots Grew Wild (Kingdoms in the Wild Press, 2019), but considers herself a cross-genre writer. She has had a variety of short fiction, creative nonfiction, poetry, and essays published in several journals and magazines, earning several accolades. She’s obsessed with pop culture, horror films, cross country road trips, and her two daughters, Scout and Lux. You can learn more about her at: https://www.ericahoffmeister.com/

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