Depression, the New Reality

Photo by Alan Tang on Unsplash

Depression is something that many are experiencing for the first time for more than just a fleeting moment. People are staying in bed more, and social isolation to keep the coronavirus is a new reality.

Depression is sneaky. You might think those extra hours of sleep is a good thing. Resting is perfect for the system, and a good six to eight hours is good. There is oversleeping, and that is a symptom of depression. I have been monitoring social media, and those that live alone and have to work at home in our new reality are having trouble adjusting. Depression can take over in the best of times, but in this new world, depression is, even more, something to look after. Mental health is essential.

I have talked about social isolation and anxiety, but equally important is depression at these times. I was a victim of this recently. On Tuesday, I overslept for three hours. I habitually wake up at around eight every morning and get to sleep around one in the morning. Since getting my CPAP machine, I have found balance in sleep. I worked a couple of days in bed because of the cold, but it had an effect I was not expecting.

Photo by Alex Iby on Unsplash

With the shelter in place in California, I have lost business with my freelance work because people have more time to work on their stuff. The one major project, the ghostwriting of a book, was put on hold last week and this week as I work on finding the best solution to continue with the interview part of the book. Coupled with finals for graduate school, I was getting overwhelmed, and depression got into my system without me really knowing.

There are things you can do that can curb depression if you are feeling the full force of it right now. The bed should be for sleeping and for that activity only. I am no stranger to watching Netflix in the comfort of my bed, but not leaving your bed can be detrimental. Perhaps watching television on a couch or reading a book. When you associate a bed with all the activities of life, it can give you a sense that everything is okay. Taking a shower is so essential when depressed, and so is going outside for the sun for fifteen minutes can uplift your mood. If you’re in winter and the sun is not out, lightboxes are a fantastic thing to use. I swear by them, and you can find them on Amazon.

One of the more popular things that I am seeing and liking about this time in our lives is that people are connecting with others online since we can’t meet in large groups. Its a fantastic idea and one I am going to be using in the coming weeks as there is no end in sight. I can feel like you are drowning, but if you stay vigilant depression can be reduced effectively.

It took me oversleeping in for me to realize depression had again taken over. It has been a running theme over the last few weeks, and I have been able to limit it for a day or two. I have close to thirteen years of experience, and I can figure out triggers of depression with the best of them. Not all are so lucky. I am always available by email or by phone. Know you are not alone in this fight. For those new to depression, never feel that you don’t have someone. There is an entire community here on WordPress.

One last thing. If you have to go out into the world, make a plan, and limit yourself to exposure. Get items delivered if at all possible and make sure that you sat thank you to those who have to work in this crisis. If you see a nurse, paramedic, grocery store worker, delivery drivers, or anyone who still has to brave the world because they are essential, so be kind. These people are the real heroes of this pandemic. Always stay safe.

Always Keep Fighting

James

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What Happens When I Forget to Use my CPAP Machine?

I got a rare glimpse yesterday of the reality of what it is like when I forget to put my mask on and use my CPAP (Continuous Positive Airway Pressure) machine to treat me sleep apnea.

For those who are not in the know or have not seen the blog posts from late 2019, I found out that I have severe sleep apnea. How bad was it during my first sleep study? My doctor told me I stopped breathing no less than 700 times in a seven-hour period, and I got zero REM sleep, which they say is suitable for brain function. Averaging somewhere around 80-100 times of total stoppage of breathing an hour is terrible, and also very scary. My diagnosis became severe sleep apnea. One of the worst cases my doctor has seen.

One of the worst times I stopped breathing was for 57 seconds. Almost a minute of not breathing.

What feels like since birth, I have struggled with sleep. In 2016, I tried to get on a CPAP regiment, but issues with the dehumidifier and masks made my insurance take my machine away. I decided this time would be different. The CPAP devices now are amazing. One thing I love is that though my pressure level is high at a 15, the machine starts me off at a four, and gradually as I sleep increases to my comfortable air pressure. The dehumidifier is so much more advanced. In my second sleep study, I went down to stop breathing 30 times an hour, a vast improvement.

I was excited when the first time in two years my events per hour went down, and it only got better when I got my CPAP machine.

The results were instantaneous. Within the first week of constant use, I saw a significant drop in my events per hour to less than one. Before three hours was all I really got, but for the first time, I was sleeping six hours, then seven, and some night I even hit that high number of eight hours of sleep. The upside was I was waking less, and now I sleep through the night. My focus has improved drastically since starting my sleep CPAP regiment. My life has gotten so much better!

So far, I religiously make sure my mask is on before I sleep, but last night I was feeling down about missing my mom. I did not feel like I would sleep, but then I fell asleep without the mask on. I could tell the difference the moment I woke. I doubt my sleep was sound, and remember waking up so many times. One would say, “why not put the mask on when you woke?” The issue is with my Seroquel. It keeps me in a fog, and though I woke up, I was not conscious enough to realize my mask was not on my head.

While I was productive, mostly die to coffee, I felt so lagging in everything. I could feel how bad it was before my CPAP machine. How I functioned without it, I have no idea. My anxiety was a bit over the top but I managed to get it under control. At the same time, it was a great learning experience that sticking to my regiment is for the best. Sleep is so essential to mental health, if you feel like sleep is a significant issue, a sleep study could be a lifesaver. One of the major things about stopping and starting breathing is it can affect your brain, and that is such a vital organ!

One of the best things to come out of 2019 for me was improved sleep. You deserve it was much as I do because mental health is the most important thing you can work on in this life. This is just one side, there are so many parts to better mental health. Stay strong.

Always Keep Fighting!

James

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How Sleep Apnea Changed my Mental Health Outlook

Sleep and I never got along. I am not sure exactly when it started to affect my life, but since my childhood, I have never put much stock into the idea that sleep is possible in my life. Sleep is very important to mental health.

In 2016, my diagnosis became mild sleep apnea, and I was told it was affecting my mental health. My anxiety at the time was at an all-time high, but trouble with the CPAP machine, mainly that it was causing severe dry mouth that was keeping me from using the machine, made my insurance take back the machine before I could get the right mask. It sucked because I needed it, but I decided that it was too much trouble to keep dealing with the insurance and the machine.

Fast forward to 2019, where I began to once again get very little sleep, little did I know that it was worse than I believed. In the first sleep study, I found out some troubling news. One, I was not getting any REM sleep. That is bad for anyone wondering. The worst part? My sleep apnea was now severe to the point that, as an average, I stopped breathing around 87 times an hour. If you do the math, in eight hours, I was not breathing half the time. One of the worst was when I stopped breathing for approximately 57 seconds. That scared me to death. It meant I was waking up so many times a night it was borderline that I could die in my sleep.

In the second sleep study, about a month later, I got sick in-between studies, they added the mask and the CPAP machine this time around. I saw better improvement. It was interesting how advanced the devices had gotten since 2016. I still had sleep apnea events about 32 times an hour, but that was a significant improvement. Things could realistically look up in my life.

In September, I got my CPAP machine. I was hopeful that I could finally start conquering this sleep issue and at the same time, improve my mental health. What amazed me about the machine was that it starts out at a low level of air pressure. As you begin to sleep, it increases to the number that they found during the second sleep study as the best pressure for me to sleep. It starts out at a four, and increases all the way to 15, which is very high but necessary.

Nothing happens overnight, but I could tell in the first week that I was sleeping more through the night and waking up less. The dry mouth was no longer an issue as my new machine had a better dehumidifier. It was gradual, but within a month, I was sleeping around seven hours without waking, which for me, is out of this world. The best part? My sleep apnea events went all the way down to less than one event per hour. I don’t have to tell you how amazing that is, and since I have bought into the idea.

It is not a perfect world. I still have some issues getting to sleep, and the mask is cumbersome. But it works. Slowly the dark circles are disappearing. Its December and I am getting seven hours of sleep. I feel rested. I am more productive and alert. It was something I needed to commit to, and I have more than fulfilled the goals I set this time around. It is amazing what sleep can do for a person.

My point is that in this mental illness life, find things that will help you. I feel as if my anxiety is something I can work on, and my panic attacks will become less of an issue the more rested I am to start the day. I can finally start immersion therapy for my panic disorder. On occasion, I oversleep something I never did before, and it feels good! I will continue to stay committed and who knows where I will come in December 2020.

If you have any questions about sleep studies, sleep apnea, and CPAP machines please leave a comment and I will share my wisdom further.

Always Keep Fighting

James

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Is Sleep the Answer

I have been putting off talking about my sleep apnea and getting my machine that helps with the apnea until I am a few weeks into the new adventure. Sleep has always been a significant issue in my life. While there are so many positive benefits to having a CPAP machine, I wanted to see if after a few weeks in if there were some real changes to my sleep habits. I have to say, this time around, I am having a much easier time adjusting to the CPAP machine. My past experience two years ago was not great, and I was skeptical that things could change. I am happy to say that I was wrong.

Continuous Positive Airway Pressure or (CPAP) is a type of sleep therapy to treat sleep apnea. As I stated in my previous blog posts, my sleep apnea is considered very severe to a point that was stopping breathing at 30 minutes to every hour, and sometimes more. This was resulting in me getting zero rem cycle sleep. That is all bad.

So, I got my CPAP machine, and officially I have been using it for a month. While it is not an overnight fix, I still struggle a bit staying asleep, but it has been beneficial in me getting real sleep, which is everything to me.

The dark circles that have been a staple part of who I am are fading away, which makes me believe that my sleep is improving. There is an app for my machine. The app focuses on how many hours I use the sleep therapy, how much air leaks per night, how many times I take the mask off, and the most important, how many times I stop breathing per hour. The amazing thing is in my second sleep study, they found the right air pressure that gives me the best chance to get to rim sleep. Even better, the machines now are really advanced with better dehumidifiers, and it starts me out on low pressure. As I gradually fall asleep, it ramps up the pressure. This very important because my air pressure peak is very high (it starts out at a four and ramps up to 15).

I see my sleep doctor early November, and I will find out just how effective it has been, but I have less than one episode an hour of stoppage of breathing, and I am waking up feeling better than when I was not on the sleep therapy. It, like anything in this life, is a process. I hope that more sleep will lead to fewer depressive episodes and less anxiety. My anxiety is my biggest issue next to sleep.

So, I am hopeful. I am staying on it and not giving up this time on sleep therapy. I still have some mask issues, but it is not so bad this time around. I hope that things get better by the end of the year. I will be writing a post about my doctor’s visit and just how effective sleep therapy really has been when they look at the chip in my machine.

If you have sleep apnea please share your stories below.

Always Keep Fighting

James

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Sleep Studies, Sleep Apnea, and Sleep Apnea Machines Pt. One

Working on the Sleep Part of my Mental Health

Image by Jess Foami from Pixabay

The First Step

Over the past three months, I have been working on my sleep issues. Those that are new and old to this mental illness life know that sleep is paramount to mental health.

The first step in the process was getting back into my sleep doctor to get the process moving. It was slow going because my sleep doctor is only in town three days out of the month, so it takes time just to get into to see the doctor. I knew already that I had sleep apnea, but because I went through this process three years ago but had issues with the machine. Anyway, I met with my doctor, and through his office, I set up two different sleep studies.

The First Sleep Study

The first sleep study is where they determine if you have sleeping issues. The process is long as it takes about an hour while they hook up wires all over from your head to your legs to they can analyze you through the night. It is tough because sleep is rough with all the wires, and you really have to stay sleeping on your back position. I slept roughly seven hours that night but it is the results that show I was not sleeping.

The results of the first sleep study were terrible all around for me. I stopped breathing (or my breathing was obstructed) in those seven hours no less than 872 times for about an average of approximately 80 times an hour or more an hour. Some were less than a second, and my longest was at 56 seconds. An okay level of not breathing an hour is around 32 times an hour, and that is bad, and so I was diagnosed with severe sleep apnea. The worst part is during the first sleep study, I got 0% rim sleep, which is also bad as rim sleep is the most critical part of your sleeping.

The Second Sleep Study

The doctor ordered a second sleep study, and the process was the same with one exception. The sleep technicians would be adding a sleep apnea machine with a full face mask. What this machine does is allow constant air keeping the airwave open so that you don’t stop breathing. Throughout the night, the technician watches over you and changes the air pressure until they find the right air pressure that gives you the best sleep possible.

The results were a lot better with the machine. I still stopped breathing throughout the night, but I got it down to about 36 times an hour, still bad and severe, but an improvement considering the setting and the conditions. I also reached rim sleep about 30% of the time, which means that was the best sleep I probably got in my life.

The Next Step

After the second sleep study i had to wait two months to see my doctor and I suffered the entire time with not sleeping well. I will be chronicling my experiences in getting my sleep apnea machine and how the first week went in the next blog post later this week.

Always Keep Fighting

James

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Sleep, Is it the Cause of it All?

Last week I saw my sleep doctor where we talked about my sleep apnea. It was not good. The results I will keep to myself, but basically, it means that my sleep apnea, which I knew was terrible got worse over the last few years. I never got to the rim sleep that night, and it is most likely the cause of my increased depression, panic disorder, and social anxiety.

Sleep has always been an issue in my life since I was a young kid. I can’t remember a time when I truly got a good nights sleep. Sure I get so tired that occasionally I will sleep okay for a few hours a night, but I wake up regularly, and it sucks because there is a chance that the root of all my mental health issues is sleep. Sleep apnea is no joke as I have found out over the last week.

So tonight I go for my second sleep study this time they will connect me to a sleep apnea machine. For those who have never gone through a sleep study, the nurse hooks you up with a ton of wires all over your head, neck, and legs. It’s a very long process, and it makes it harder to sleep.

This is not the first time that I have done these tests and got a sleep apnea machine. I had issues with the mask, and eventually, my insurance decided that they would not pay for something that I was not using. Since the masks have improved and I am hopeful that tonight’s sleep study that things will work out better and I will finally be able to conquer this insomnia thing.

Part of this process will lead to my therapist helping work on my panic disorder, and I think overall, it will really help me get better. Depression, panic disorder and social anxiety along with insomnia have been kicking my butt lately, and I want the next five months to be the catalyst to finally finding myself and be in a better place with my mental health.

Always Keep Fighting

James

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I Sleep Four Hours or 14 Hours

Sleep feels like an irrational beast. It’s rare that I get a full night’s sleep. If I do, I sleep more than needed and still feel tired. The number of hours I sleep usually don’t matter. It might be eight hours but broken into segments. Broken by nightmare or waking several times for no reason. This all depends on if I fall asleep to begin with. Some nights I don’t sleep. My body always feels restless like I haven’t done enough work in the day. More often than not, I sleep less than six hours every night.

For a while I took vitamins to help encourage energy and sleep. I took one vitamin pill a day for weeks. I discovered a pattern. I started writing down when I had a nightmare. I only wrote down certain kinds of nightmares. When they involve me running from something or escaping something. Sometimes I would know what was chasing me, other times it was only a feeling of danger. I had these nightmare every two weeks, sometimes every week. I stopped taking the vitamins (magnesium, calcium, and zinc). Then I stopped seeing or remembering the nightmares. I imagine I still have them but never recall.

When I lay in bed, regardless of the time of day, my whole body vibrates from my heart pumping. Sometimes it feels like my chest is pounding when I’ve laid still for hours. This makes it difficult to rest and fall asleep. Along with these physical symptoms, my mind races with negativity. I’ve worked hard to limit this, but I still struggle. The anxiety and depression only add to the restlessness. The more nights I get poor sleep, the more negative I become. This is still nowhere near as negative as I used to be.

I plan to get more vitamins to help me sleep. Part of me doesn’t want to have the nightmares again. It’s a catch 22. Poor sleep without nightmares or better sleep riddled with constant nightmares. My chest is often pounding when I wake from my nightmares. It’s not much different from lying in bed before sleeping. I have fewer negative thoughts when I have the nightmares. It’s likely the better of two evils. My mind wants to work through the trauma but never has the means or an outlet. This must be why I write horror fiction in my spare time.

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The Unfettered Insanity of Unmedicated Bipolar Disorder

My wife says she can always tell when I go off my medication. She says I stop making sense, speak gibberish, and do and say things that are utterly irrational. I say she can tell because when I’m off my meds, I feel nonsensical, disconnected and irrational. I’m perfectly aware of the inane babble that comes out of me when I’m unmedicated – and yet I allow it to happen anyway.

I’m on four different antipsychotics and antidepressants to treat my disorder. I’ve been diagnosed with Bipolar Type 2, which is where you have very mild manic episodes alternating with extremely severe depression. The medications help to keep me on an even keel, even if I do still swing toward the depressive end of the spectrum more often than not, and when I’m consistently medicated I can function, hold normal conversations, feel motivation, and generally get through the day.

So why on earth would I trade that for what is, essentially, bouts of total insanity? I’ll give you an example: the other night we were preparing dinner, and I couldn’t wash and recycle a plastic container. I just … couldn’t. To an outside observer (i.e. to my family), it must have looked like I was batshit crazy – I babbled about how I couldn’t wash it, that the most I could do was throw it away, and then I started pacing the kitchen, turning around every two steps. I probably tore at my hair a little, and eventually ended up on the couch in the dark while my wife screamed at how lazy I was being.

Believe me, it wasn’t laziness.

There are a whole slew of reasons why I do this to myself. Ironically, none of them are because I think I’m better when I am medicated – even though that’s a commonly cited reason for patients to stop. The most common reason – and perhaps the least sensible – is that I’m afraid to run out.

That’s right – I stop taking my meds so that I don’t run out of my meds.

This is the kind of train of thought that probably makes perfect sense to a lot of you – and absolutely no sense to anyone whose never had to take psychiatric medications before. I mean, you wouldn’t stop taking your heart medicine for the same reason, would you? But for some reason it seems, in the moment, perfectly reasonable to skip a day or a week so that I don’t run out.

Sometimes there are more valid reasons to stop. Most recently, I stopped taking them for about two weeks because I couldn’t afford to renew the prescription. Now that’s kind of a shitty position to be in, but the truth is that I didn’t have the money to pay for the medications – partly because my most recent paycheck got screwed up, but also because I do sometimes spend money on things I don’t need (mostly coffee).

But wow – the difference between medication and going au naturel is itself insane. As in, within a few days in either direction I notice a huge difference. When I go off them, I start to feel anxious, unsettled, and completely disconnected from reality. Then the depression sinks in, and the despair … or sometimes the anger and rage. Sometimes I sit in a corner and cry; other times I rush around madly between tasks, unable to start or complete any of them. More often, I sleep, because it’s the only way I can escape the madness.

After a few days, I feel generally unsettled and disconnected; after a few weeks, I feel totally insane. After a month or more, I start to become suicidal.

And the difference when I go back on them … within a few days I feel stable, in control, and able to do most anything. I might still not want to do anything, but at least I can make myself do it.

I know that this constant cycle of going on and off my meds is really, really bad for me, but I just can’t seem to help it. I don’t ever mean to stop taking my meds; it just happens. And when it does, I feel so out of control that it’s hard to find the willpower to go back on them. Sometimes even the effort of taking the top off the pill bottle is just too much.

I hate feeling out of control, but I do it anyway. It’s damaging my brain, but I do it anyway. It’s a vicious cycle, and I honestly don’t know if it’s one I’ll ever get out of.

For now, I’ll just have to go and take my pills.

Living Well With Bipolar Disorder

1 in 4 Americans suffer from a mental disorder, and out of those millions of Americans, 5.7 million Americans suffer from bipolar disorder, characterized by erratic moods consisting of mania (an elated state of being) and the more familiar depressive episodes. I am one of those 5.7 million Americans.

Bipolar disorder is often considered the “artist’s disease,” from Sylvia Plath to Vincent van Gogh exemplifying the creative bursts of energy, severe depressions, and unstable highs and lows that come with the disorder. There is a range of creative treatments that safeguard mood stability, including traditional medications and therapies that are universally recommended to treat bipolar disorder. Often, mood stabilizers, antipsychotics, and psychotherapy are the first lines of defense, alongside a good support system, to prevent mania and depression. However, three simple life changes can safeguard against serious bipolar episodes and help those who suffer from bipolar disorder maintain a stable, healthy lifestyle.

Early to Bed, Early to Rise – Healthy and Wise

Sleep is perhaps the most important preventer of manic relapses and a strong source of mood stability. Bipolar disorder is directly related to insomnia. The fewer people with bipolar disorder sleep, the more likely they are to become manic. The Center for Disease Control recommends seven hours of sleep daily for adults. Having a healthy sleep routine, such as an established bed time and avoidance of caffeine after 2:00 PM can help people with bipolar disorder achieve a good night’s rest. As someone who is diagnosed with bipolar disorder and has worked for years to combat insomnia, I have found that turning off screens (from televisions, phones, computers, tablets, etc.) an hour before bedtime and having a strong sleep routine where I turn in around the same time each night works wonders. If insomnia persists, one can talk to a doctor about sleep aids available by prescription and consider using Melatonin or a Circadian rhythm stabilizer (available over-the-counter).

Healthy Body, Healthy Mind

Exercise is another great mood booster, especially during depressive episodes and to combat the side effects of bipolar medications that often cause weight gain. The NIH recommends 150 minutes of moderate exercise a week. When you are active, dopamine floods your brain and gives you feelings of happiness similar to a runner’s high. This is especially important for bipolar disorder sufferers, whose serotonin levels are often imbalanced. However, staying active can be a challenge during depressive lows. I like to hike or cycle, which leaves me feeling satisfied and helps keep the pounds off from medicine. Find an activity you enjoy, whether it is biking or running, and watch as your mood improves.

Nourishing Your Brain, Nourishing Your Soul

Finally, good nutrition is directly linked to mental health, especially for those with bipolar disorder. Nourishing one’s body with healthy foods like whole grains, veggies, and lean meats, while reducing intake of fatty and sugary foods, and using probiotic supplements can improve mental health, buffering mood swings. I rediscovered my love of cooking healthy meals and have seen vast mood improvements since choosing a diet that works for me, specifically the low carb diet. Perhaps the Mediterranean or vegetarian diets will suit you? Experiment with food groups you like and remember to take probiotic supplements for a happy gut and brain.

Your brain, body, and emotions are all linked, bipolar or not, and with these healthy lifestyle changes, supplemented by the proper medication and therapy, bipolar disorder patients can not only survive but thrive.

My Worst Anxiety/Panic Attack Day

ryan-whitlow-535703-unsplashYesterday sucked, it was the hardest and longest panic attack that I have had in a long while. Since the moment I woke I had this feeling of dread, that it would take all that I could to get through this day– and I was right.

It has been relatively quiet when it comes to the panic attack department this summer. I have had a couple since July, but while my anxiety is high, lately it has not gone into full panic attack mode. I am guessing that it was inevitable that I would hit that place again, it has been all too familiar in the past two years.

In the first few hours of my day, it was spent trying to get my anxiety out of panic attack mode. much-needed I tried all the old tricks. I sat in the sun and tried to relax, that lasted about two minutes.

rob-bye-250270-unsplash

I was a mess by the time I came down from the panic attack about two hours later. One o the worst things with panic attacks is that your whole body feels like you ran a marathon after without actually running a marathon. What is worse is that even though the panic attack is over, you still have to deal with the anxiety.

The only way I came down was with Ativan, as I have not learned how to deal with anxiety/social anxiety without medications (I am a work in progress.) It sucked. The rest of my day consisted of anxiety and Ativan. I found a way to keep going. I ended up getting a much needed haircut and got pizza after. It was something postive.

Then I entered into no sleep which was worse, but that is for another blog post.

With that said it has been a tough week and I am only a few days (October 1st) from starting my master’s program. I worried. I always somehow find a way to pull it out of nowhere and figure this out. I am going to take a day off and then hopefully get back on track. I need a mental health day.

Always Keep Fighting (AKF)

James

Photo Credit:

Luke Palmer

Ryan Whitlow

Rob Bye