Friday, December 27, 2013

10 things I wish I could have told myself when I was diagnosed with depression as a teen

I haven't written in awhile and it's been very busy.
However, with the new year & CBT on my mind, I wanted to send a little hope to others (ie when I read young peoples blogs) and healing for myself.
Mostly these are related directly to my issues but maybe they are relatable to others too....

1. You will get through this. Although you will continue to fight the battle of depression, you will blossom into a great young adult. 
2. The things that seem SO big now, you won't think about in ten years. Do not let your thoughts spiral out of control. 
3. You know the home environment  you are living in is not healthy. Although you have your basic needs met, your family is too caught up in coping with their lives to see your pain. 
4. This is not something that is in your head. It is real and do not let others (parents friends) tell you that this is not a real illness or you are doing this for attention. You are someone special.
5. The guilt you continue to feel is something that has two parts to it (1) it is part of the nature of depression (2) you are a caring person and can be easily guilted. 
6. Depression does not cure itself on it's own. Please, make a better plan when you go to college so that you do not stop taking your medication since you did not plan that far and spiral into coping with alcohol (yes story for another blog post)
7. You know that boy you thought you'd marry and he was your first love and you'd never thought life would go on without him? It will. See #2. Do not let others, like him, spiral your thinking of depression. 
8. Find some leisure activities. Currently you have none besides going on the Internet and self harm. Find creative outlets so when your feelings are overwhelming you will be able to cope. See #2.   
9. Start being in tune with your body and the triggers for your depression. Although your family is little support of this, start keeping a calendar of your mood, eating, hormones etc. it will do wonders for you down the road
10. You will get through this. 

Sunday, November 3, 2013

Where did all my friends who are girls go?... depression or me pushed them away?

I haven't written in awhile. I have been very very busy with work.
However, I have come to the point in my life where I realized I have no girl friends. (And in this article, I am referring to girlfriends in a heterosexual way, ie: my friends who are girls)
Okay- you say- what? You have to have girl friends! You are outgoing, friendly etc.
Well, I guess I have no problems talking to girls, but I cannot sustain a long term friendship unless it is completely connected.

I don't keep in touch with any of my girlfriends. I don't know the last time I called up one of them to talk. Maybe 6 months? Maybe more? I feel utterly and completely alone. I really do. I have completely isolated myself from them.  Honestly, I sometimes feel as though I am incapable and don't know how to have girlfriends. I can talk to people, I can hold conversations but I don't know how to have girl friends. Is it because I have felt betrayed by my friends? Yes. Is it because I feel awkward and I don't like rejection? Yes (isn't that a thing that girls think about guys... no with me, guys are not as scary).
All of my friends are guy friends and lets be honest, it is odd to just have male friends to me because most of them "want to date me" and I know I shouldn't continue to hang out with males who want to date me, while I am using them to fill my void of having no girl friends....
Plus, it is hard for me even to date because if I do become in a relationship, it is not enough because I don't have any other friends outside of the relationship because they are all male friends.

Honestly, this post was more deciphering my feelings. I am starting to think I have more diagnoses then depression. To me, labels are clear and concise and then easier to treat (from an OT point of view-my only OT point of view for today) but sometimes people and things don't fall under labels.... unless I am labeled as " lonely girl who is scared to make girl friends but miraculously has lots of guy friends" .....
until next time. stay healthy.

Tuesday, October 15, 2013

Depression & Transitions-part 2 for OT blog day festival

In honor of world OT blog day festival, I decided to write some more about transitions.
Previous blog post (see below) or go to:

Consumer: Depression can effect transitions. As a date gets closer to a major life changing time (such as starting a level 2 fieldwork or going to my friends wedding) sometimes my depression kicks in and all I want to do is sleep. I am a person with depression who uses an "avoidance" technique. I feel that as if I just ignore it, I will not have to think about the transition and when it comes, it comes. Other times, I get so focused on minimal meaningless aspects of the transition (ie: see my blog post below, when I was moving to a place I had never seen, will I actually be able to park close to my apartment... I didn't think about the moving part or how I would sleep when I was not bringing a bed, I was fixated on this strange aspect of parallel parking). I realized for me: transitions turn on an avoidance technique that I either (1) ignore by sleeping / not talking about it or (2) don't think about the big picture and look at little details. This is either due to the fact that (1) I do not want to be disappointed (2) I feel too overwhelmed and want others to make decisions for me.  Even when people try to talk to me about this, I push them away and just say "Whatever" and I let the passive side of me take over. This is something I have recognize and know I need to work on, however, I am not completely sure how to work on it myself. As you read below, you will read the general advice I give, but I cannot say whether or not it would work for me because no one has ever done this.

As an OT: If someone you are with does not want to talk about transitions, sometimes the best thing to do is just educate them and let them know about the choices. Moving to a new place or from community to home living can be very mentally taxing. Sometimes it is best, if the person is taking a passive role to really help to increase their independence and self esteem by empowering them and using therapeutic use of self to feel as though they are making decisions and learning new skills for the transitions. Even if you, as the therapist, are the one who is really suggesting and giving ideas, by helping clients to feel secure in how they are transitioning (even if it is discussing minor details at first such as parking) and then slowly working on bigger issues, this can help a client to not feel overwhelmed. As OTs we task analyse and break down ADLs/occupational tasks, but never forget the environmental factor of time and breaking down the anxiety/depression that comes with  transitions. By analyzing the transition and coping skills used to avoid the transition or be anxious by the transition, we can help the client to focus on individual aspects so they do not feel overwhelming. That's my two cents and I wish I had an OT to help me out with this ;)

That's all for now folks! Hope you enjoyed.

Previous blog post:
Transitions-discontinuity in routines
Transitions are hard for everyone. Transitions can be even harder for people with mental illness or disabilities.
OT perspective: Supporting clients through transitions are an important part of  OT. Transitions can be defined as a “discontinuity” or “interruption” in habits and everyday activities (Blair, 2000). Transitions can be as simple as having to  wrap a leg for lymph edema everyday to moving to a new city or starting a career. By understanding the environmental impact and time management of transitions we can fully help our clients.
Consumer: I have been anxious for the past few months about moving. So much so that depression has really kicked in. So many regrets & feeling alone & isolated. I am bad at saying goodbye. As my therapist tells me, everyone feels anxious about moving, it's big changes. However, as with depression, I continued to ruminate on how I am feeling & how I am scared of moving somewhere might trigger an episode of depression. These feelings felt so deteriorating that it was making me not functional. I couldn't pack, I couldn't do work. I reached put for social support & got help. I made lists, I used positive coping skills. Thank you family. 

What are your thoughts on transitions? How do you deal with client transitions? What coping skills do you use? 

Wednesday, September 11, 2013

What would my life be like without medication?

Sometimes I wonder what my life would be like without the medication I take. Since I've been on medication for about 15 years now it seems to me that it's a part of my personality. After all the medicine does change my brain chemistry so what am I really like without it? I sometimes wonder how different my personality would be without medication. I know everyone is seeing me as happy-go-lucky girl and sometimes I feel just very numb on the medication. If I get off of medication will I be a happy person or will I be more depressed? 

Since I haven't been off medication for that long I'm thinking of possibly trying to get off medication. I have many fears like people do that the medication could be causing changes that they possibly might not know about until the future. I'm also hoping to have children in a few years and there has been some articles linking antidepressants to various genetic disorders. I don't know how valid this research is or have really looked into any of the studies it's just  things that go through my mind. Honestly, it's very weird to take pills to get through your day. However a mental illness is just like a physical illness and I know other people who have physical illnesses feel same way. 

I wish I knew the correct answers to questions about the medication. However my psychiatrist told me & what I've heard from many mental health professionals is a lot of medication for depression is a trial and error. Although I am tolerating my mom right now I feel I could do more or take less medication. 

Occupational therapy view:.
Always discuss with your doctor if concerns and possible side effects of your medication 
Never stop your medication without talking to your doctor first
Sometimes it's good to keep a log of how you're feeling on your medication if you change doses or If you think you're noticing a pattern with your medication
Do not give up hope medication and therapy have helped many people Live functional lives with mental illnesses 

Tuesday, August 20, 2013

How is stigma subtle in words and actions?

"A mark of shame associated with something"
Stigma can be something that is outright: "Did you see that (any mental illness ie:) "schizo" on the street?" (using slang terms is also a form of stigma, along with using the illness before the person, it should be "person with schizophrenia")

I have one personal story to share about stigma. Although this is not "outright" that was "outrageous" stigma, however, this comment stuck with me in a weird kind of stigma way.
I had one day in graduate school where I did a brief lecture on research in mental illness to  students. After the lecture, the professor thank me and said "it was great that I was such an advocate". I briefly told her that I had depression and she said "Wow! You are so high functioning for having depression"....

Okay, is it stigma? Yes I believe so, this is implying that everyone with depression must have an outward appearance of not functioning. ( to be diagnosed with clinical depression it includes an aspect of lower functioning in various aspects of your life.) However, depression is a mental illness that you recover from, you can be "high functioning" when you are on medication/therapy/in treatment and have an outward appearance to world of being "high functioning" but honestly, inside, I still feel as though I have a long ways to go. At this time, I was sleeping, 12-14 hours a day that included naps/actual night sleeping due to my depression and only going to the grocery store 1x a month. In my head when she made this comment, I felt a few things, I felt gratitude that she thought my depression was under control, although it felt not very in control to me, and then again I felt stigma because this implied that everyone with depression must have an outward appearance of not functioning. Although I suffer from depression, I am high functioning, and I do not think that "high functioning" is a proper word to use. Many others suffer from depression and a comment like this shows lack of awareness of how widespread mental illness is and how it can effect so many people that we like to think are "high functioning"

Okay-off my soapbox. This may be an awkward article to some, and might not make the most of sense but it's just something that hit a chord with me.

Any stories anyone would like to share would be appreciated.

Monday, August 19, 2013

Isolation and depression, as a friend or family member, how does depression effect you?

As I have talked to people with various addictions, one thing I heard that rings true is "Isolating myself from others so they don't know how bad it really is". I guess the it could be many things, "it" could be a substance such as substances or "it" could be taken a different way, such as the symptoms of depression.

I feel that sometimes I am isolating myself because I don't want to discuss "it": how I am doing in general with my everyday activities. I sometimes feel very silly because things are going "so right" in my life and I still tend to feel down. But once again, this is due to depression, and the few people I discuss it with, mostly do not understand. They may say things like "Why don't you come out?" or "You have so much to be happy for! How could you feel down?" I have had friends even get mad at me  and lost many friendships over isolating myself. The only true friends I have are ones who are able to keep coming back to me. It is almost as if I have the "All of nothing" complex. If I want to be with my friends, they are my world. When I am in my "depression" world, my friends are "out of site out of mind". Obviously, I am not being a very good friend. Although it is not an excuse, active clinical depression, in research, is linked to worse relationships in regards to all types of relationships. It makes me even sadder writing this, but it's something that I feel everyday.

OT Thoughts:
If someone you know is suffering from depression, you may feel effected too & this is entirely normal. 
You should always understand that your safety and your mental health is important, even if you don't have a mental illness. Sometimes it is easier to blame ourselves for how someone acts with a mental illness then recognize that it is the illness and not you or the person with the illness who is pushing you away. Different things can be helpful for different people. I don't have all the answers and I don't claim too, but here are some good ideas/resources...

These 15 ideas are taken directly from: "15 ways to support a loved one with a mental illness."by: By MARGARITA TARTAKOVSKY, M.S. Read more indepth here:

1. Educate yourself about the illness
2. Seek out resources
3. Have realistic expectations
4. Reach out for support
5. Work with your loved ones treatment team
6. Let your loved one have control
7.Encourage them to talk to their mental health professionals
8. Set appropriate limits
9. Establish equality
10. Realize feelings of guilt and shame are normal
11. Recognize your loved ones courage
12. Help yourself
13. Be calm
14. Convey hope
15. Get political

Here are a list of websites for support for families/friends of someone with a mental illness: - All about mental illness and impact on families. This section is specifically for depression:
Mental health support groups for people with illness & families:
15 ways to support a loved one with a mental illness

Monday, August 12, 2013

My experience with my IEP for depression as a child & OT: How do we help children combat stigma of IEP/mental illness?

Although my blog is typically about depression, today I am going to discuss a little bit about my experiences with IEPs.

I had an IEP since I was in middle school due to being hospitalized due to depression and missing approximately 100 days due to depression in 1 year. At 12, I was unable to "attend" my first IEP meeting. However, in the future, as a student, it felt very awkward. When I didn't go to class due to an IEP meeting or having resource, I felt as though I had to make up excuses. Most people did not know I had resource or was in "special ed". Being in high school, I felt I had to lie to my friends about my schedule having resource on it or missing class to go to the social worker. Since outwardly I came across as a "typical" student, the stigma of a mental illness was too much for me to discuss with peers.

(OT perspective)
I know now that the only way to combat the stigma of a mental illness is to discuss it and educate people. However, when you are a teenager, how do you take on this responsibility? Middle school, high school, those are very hard times. Students already feel different and awkward and it's even harder when we feel as though we have to hide from other students and carry a deep dark secret. This dark secret is due to the fact that the stigma of having a mental illness still exists, especially around children, because mental illness is something hard to understand.  The stigma of all illnesses must be extinguished. We, as professionals, aim to educate all children about disabilities. This means all disabilities, including disabilities that are visible and those that are not visible.  

Some ideas:

  • Discuss with a student on your caseload, if appropriate, about feelings about special education.
  • Aim to do an inservice for teachers on incorporating barriers to breaking stigma into teaching
  • Work with other professionals to develop skill groups/after school/extra curricular groups promoting mental health and healthy living
  • Ask your students what would be most helpful
  • Arrange with local organizations/speakers come in who have a mental illness to talk about their experiences and life (Some local organizations do this to combat stigma)
  • Please comment and write your thoughts. I would love to hear anything you have done.

Sunday, August 11, 2013

Depression: coming to terms with myself & the elephant in the room

Being diagnosed with depression at the age of 11 is something that is mind baffling to me... I am sure it was to my family as well, however, I can only speak from the view I had when I was diagnosed.

Depression was something that was a secret in our house. We never talked about "it" (depression = silence in my world), everyday life was normal: going to a therapist, being hospitalized, taking medication every morning, checking for cuts...

Somehow "it" became so normal that "it" was something that was abstract and broad in my mind. I am diagnosed with depression, I had an IEP from being depressed, however, it was never discussed in my family. I am not sure why. That is why when I used to look in the mirror growing up, I would see a girl who I didn't know. I didn't really understand my depression and I never really understood how it came about.
I never thought that my depression was real. Somehow in my mind it was a phase I was going through. It was something that was normal, since my parents treated my depression as if it was nothing. I wanted to believe it was something I could control. I really thought that everyone was overreacting and it was something everyoe experienced.

Not going to school because you're too depressed is not healthy. Wanting to hurt yourself is also not healthy. However, in my mind I validated these things as things that were "everyday experiences"

Although I am slowly coming to terms with my depression, to this day, 14 years later, it is still a secret in my family. Every once in awhile my parents will ask me "Do you need that medication? you should get off it" And that is about the extent of our conversation about my depression.

This post-I don't really know what I am trying to say. It is just that to me depression is something that is hard to comprehend to all- from a child to an adult. I can't say I am at terms with my depression now. But I know it is a life long challenge.

OT Perspective:
Client education is tremendously important. Education on what it means to have depression and how it effects ADLs/everyday routines/life and also family education on what depression is.
This type of treatment is important to be a part of the team with therapists/psychiatrists to really make sure that everyone is getting the help that they need to understand this diagnosis.

Monday, July 29, 2013

What's the tune of your depression?

Sometimes music makes me feel great. Other times, I listen to music that makes me feel down to listen to. Music: does it make you feel better or does it make you feel worse?
This song makes me think my battle with depression. (Although I believe this song could easily apply to having bipolar or an addiction-it's all about our experiences and perception)

Sometimes in the morning I am petrified and can't move
Awake but cannot open my eyes

Depression sometimes make me feel like I cannot wake up in the morning, that I do not want to get up out of bed. The fatigue.

Then you hang up the phone and feel badly for upsetting things
You'll be a better daughter
This is the guilt I feel with depression. I feel guilty all the time for not being good enough. I feel guilty about how I treat others, about how my depression makes me not want to go to the store to get food, how it makes me feel bad for having low energy around my family and friends. How being quiet means they think I am mad at them. how my guilt makes me paralyzed. 

And crawl back into bed to dream of a time
When your heart was open wide and you loved things just because

This reminds me of the the activities that I lose interest in

But you'll fight and you'll make it through
You'll fake it if you have to

And you'll show up for work with a smile
And you'll be be better you'll be smarter
More grown up and a better daughter
And you'll be awake and you'll be alert
You'll be positive though it hurts

You'll be happy 
The coping to make it through everyday

Your ship may be coming in
You're weak but not giving in
And you'll fight it you'll go out fighting all of them

And finally, knowing that you are fighting your demons everyday, and you will make it through.

Song: A better son/daughter by Rilo Kiley

Monday, July 22, 2013

Is it sunlight or my occupations in the sun that help my depression?

Consumer: Ok so this post is a little late. It's summer, I love the sun, I love the sunlight. I feel a million times better soaking up the sun! As discussed (will put up the study links later), sunlight-even artificial sunlight can help people who have certain forms of depression (seasonal affective disorder) Although I am not diagnosed with this, overall the sun always makes me feel happy. This leads me to.... Is it the sun or the occupations?
When I think of sunlight I think of: swimming, beach, pool, putting my toes in the soft green grass, watching pretty blue clouds,  smelling spring flowers, going to the park, vacations, eating watermelon, reading a book, camping with friends...
All these things I love are made up of occupations I enjoy  :) So is it the sunlight or is it the occupations or maybe a combo of both :) 
OT thoughts :
Make a list of things you love to do everyday, keep it somewhere you can see it!
        -Order them most to least helpful             and use as needed to cope
         -Order them by time (ie: I can do this in 5 min to watch clouds or take ms 3 hours for the zoo) 
        -Order them by numbers and randomly pick a number to go do when you're feeling blue

PS: Use sunscreen & be safe, happy summer :) 

Saturday, June 29, 2013

Low energy: is it normal or am I depressed?

Low energy. Something I rarely understand and others don't understand with me!

Consumer point: Sometimes it hard to tell if my low energy is due to depression or due to normal day to day every activities. Whenever I start something new, say for instance a new job or something in my routine that changes my schedule and I come home exhausted and all I want to do is sit on the couch. Uh oh, rings a bell in my head, here comes my depression again. I have thought so much about things that show me I am depressed that sometimes I can overreact and think that being normal tired (ie: something that would make anyone tired) is my depression. I do do a lot. Understanding that I can't do everything is important.
However, on the other end of the spectrum, sometimes I need time to recharge my mental health and people do not understand this. They think that I am blowing them off or don't understand how sometimes I do just need to be on the couch for awhile. I get very very frustrated trying to explain to people that I am not blowing them off, but sometimes I just need time to relax.

OT tips:

  • Time management:
    • Planning out the week, to make sure that there is an occupational balance
    • Helping clients to understand when this is low energy vs. symptom of depression
  • Energy conservation
    • Helping clients to plan emotionally and/or physically draining activities throughout the week and not overdue it in one day
  • Acknowledgement
    • Acknowledging that living with a mental illness is hard and sometimes you do just need to recharge
    • Acknowledging when there seems to be low energy that is not typical and a sign of worsening depression
  • Exercise
    • Exercise can help to combat some of that low energy
    • Eating healthy 

Saturday, June 22, 2013

ADHD: Your own attention barriers to accessing your medication

Consumer perspective: I had the biggest issue arise when I was dealing with fieldwork. As I decided to go somewhere very far away from my family and psychiatrist, my psychiatrist informed me that she would not be able to prescribe my adderall if I was out of the state. I could get the prescriptions for my other medications but I could not use my adderall perspective in any If you don't know about controlled substances, read about it here: 
You cannot have refills on your medication and you must have a hard copy. 
For someone who has legitimate ADD or ADHD, a few times I have completely lost my written prescriptions. The whole issue with ADD/ADHD is attention. I have the attention to put the prescriptions into my purse but the time I get home, I may have my attention completely elsewhere. This is the thing with ADD, why I lose my keys, because I am not paying attention because my thoughts tend to run. So having to have a paper prescription can cause nightmares. 

When I lost my prescription, not only could I not get the drugs, my psychiatrist was worried I was abusing the pills.This made me laugh because honestly, I would never risk my license or job over drugs. However, this was straightened out when she talked to my therapist who reassured her that my issues are with organization. However, this had come at a bad time as I was doing many projects in school. 

OT perspective: Our clients are on many medications. Understanding how medications are accessed and can be accessed are important to understand medication management. Although adderall is just one simple example, many other drugs are similar to these restrictions. For someone who has a controlled substance medication, you not only need to put into place how/when they take the medication but also WHERE they put prescriptions if they get multiple prescriptions (the pharmacy will not hold onto the prescriptions, the person who has the prescriptions must). For someone who is taking the drug for organization, this needs to be in a clear spot. What I ended up doing was creating a little bag that was only for my prescriptions and other small important cards (ie: CPR card, etc). This bag was never moved and remained in the same place. This system helped me. Other people may need something different such as a caregivers help. 

Saturday, June 8, 2013

Transitions-discontinuity in routines

Transitions are hard for everyone. Transitions can be even harder for people with mental illness or disabilities.
OT perspective: Supporting clients through transitions are an important part of  OT. Transitions can be defined as a “discontinuity” or “interruption” in habits and everyday activities (Blair, 2000). Transitions can be as simple as having to  wrap a leg for lymph edema everyday to moving to a new city or starting a career. By understanding the environmental impact and time management of transitions we can fully help our clients.
Consumer: I have been anxious for the past few months about moving. So much so that depression has really kicked in. So many regrets & feeling alone & isolated. I am bad at saying goodbye. As my therapist tells me, everyone feels anxious about moving, it's big changes. However, as with depression, I continued to ruminate on how I am feeling & how I am scared of moving somewhere might trigger an episode of depression. These feelings felt so deteriorating that it was making me not functional. I couldn't pack, I couldn't do work. I reached put for social support & got help. I made lists, I used positive coping skills. Thank you family. 

What are your thoughts on transitions? How do you deal with client transitions? What coping skills do you use? 

Friday, June 7, 2013

Coping mechanism: from collages to polyvore

Artwork I have made from Polyvore. I do this alot as a coping mechanism. I used to like to make collages, but now I just use Polyvore. 

My reason behind this blog: OT and consumer views

Depression is very common and one the leading causes of disability in the US.
I am an occupational therapist and I have been diagnosed with depression since the age of 11 when I had my first suicide attempt. (Since 14, I have not had any more suicide attempts). I have an IEP and have been in the special education system since the age of 12.
 I hope to give insight into depression & special education not only from a consumer perspective but from an occupational therapist's perspective. I am also diagnosed with ADHD and may blog about this later, since depression & ADHD make life very interesting.

OT thought of the day: OTs continually say "we do not treat depression", this sentence needs to be changed from "we do not treat symptoms of sadness but we treat symptoms of depression". Depression has many symptoms that OTs treat. Looking at the DSM-IV: (I haven't seen DSM-V but I from what I have read, depression has only changed in regard to grief component) decreased interest or pleasure in activities, weight loss or weight gain, difficulty in concentration, fatigue, insomnia or hypersomnia. These symptoms are such a vital part of treatment from an OT perspective.

Consumer thought of the day: I continually talk to my therapist about organization. I am a very messy person. I have a system for academics that have taken me 10 years of resource to implement, but I am unable to organize my daily routines and clothes. How may you ask can I be an OT if I cannot do this for myself?  I can easily task analysis people's routines and break them down and help. I am able to regurgitate what I know from OT : organizational system put into your daily routines, use a planner, make goals, categorize etc But no one has been able to help me implement this. When I come home I have zero motivation. I like to stay on my couch from 5-10 pm and watch Netflix. Is this a symptom of depression? Is my disorganization heighten due to ADHD? I have no idea. I just understand how hard it is to implement ideas and suggestions when people are not in the environment. One of  my thoughts about this is related back to home health/ Assertive Community treatment. (Please see link if you don't know what it is) ACT is only for serious mental illness and it is proven to work. However, it combines key components of OT, helping people in the environment! Getting off track, I wish OTs could help people who function, but not functioning fully in their environment. I kept thinking in OT school... Perfect fit for OT. Although high functioning, I have serious disorganization and motivation problems that keep me from even having people over. Rambled on but I think others will relate to this.