2022 was a year that tested me to my core. Week-long bouts of mania - approximately five, but I wasn’t tracking them accurately - would lead to the inevitable crash into the depths of depression where I’d languish for weeks, sometimes months. Depression whispered nasty sentiments to me throughout the day, causing me to forget what I loved about life. Anxiety ripped into me daily causing me to worry about anything and everything, and on top of that my confidence sank. Over the course of the past year I also had several hypomanic episodes, the milder form of mania, which felt good and were harmless, but never lasted. Sadly, the depression was the strongest of my mood states last year, and it unfortunately followed me into 2023.

It’s impossible for me to write when I’m depressed, so I know in this moment as I’m drafting a blog post, it doesn’t have a grip on me, and for this I am grateful. But early in April I was still in the throws of a depressive episode complete with suicidal thoughts, and was left now trying to figure out what helped to bring me out of it. 

There are so many factors to consider. From a recent med change to sleep to therapy to forcing myself to do activities I enjoy - which of these things could have caused the shift? In addition, I’m wondering if hormones play a part in all of this? It led me to search online for a mood chart I could use to track things the way I used to when I was first diagnosed. I found a psychologist in Europe who had a free downloadable (and colorful) chart that I immediately printed to begin using. 

I need to figure out what helps me heal my depression, and so I begin to look back over this past week to analyze what changes could have contributed to the day I felt the depression lift, in an effort to understand and to keep my mood in this stable place. 

My doctor prescribed a new medication the first week of this month. She wanted me to try adding it into the mix of two other meds I’m currently taking in an effort to ease the depression. I was reluctant to add another med to my regimen. If a person is taking more than one medicine, how do you know which is doing which? But the depression wasn’t getting any better on the two I’ve been taking. My doctor reminded me that I’m on low doses of these medicines and many people with bipolar need two or three meds to manage their condition. 

In trying to decide whether to try this third medicine, I remember thinking to myself, if one of my kids were suffering like I was, I’d encourage them to try it. I’d remind them that medicine exists for a reason and sometimes we have to try more than one to find what works. I agreed to go on this new addition to see if it has an impact on lessening the depression and lifting my mood. I began taking it and it’s been over three weeks now since I started this three-pill course of treatment. Four days in I began to feel a shift.

The second week of April I went to lunch with my childhood best friend who has been incredibly supportive through all of my ups and downs in life, especially in regards to my mental health. She listens without judgment and doesn’t try to give me advice unless I ask. I told her how I was feeling and that I was hopeful the medicine would help, and she gently reminded me to try to do the things that bring me joy, like watercolor painting. I promised to pick up my paintbrush as we finished up our lunch.

Thursday brought an unexpected therapy session. Two days before I had canceled my regular therapy appointment feeling as though it wasn’t going to be helpful given that I didn’t feel much relief after my last session. Instead I called a friend who happened to be a psychiatric nurse practitioner and trauma therapist. We got to talking and through my tears she could tell how depressed I was. She offered to do a session with me that morning to see if she could help me have a breakthrough, and felt confident she could do it.  

We met for over two hours and although I didn’t feel much benefit in the immediate moments following therapy, one thing we talked about left a lasting impact. My depression had become like a companion to me, living inside my mind and telling me horrible things that I had started to believe even though I knew they weren’t true. She described this state as my comfort zone because it had become so familiar to me. “What if you were to venture outside your comfort zone, Jenn?” she offered. “What would that look like?” In the moments of discussing this concept I wasn’t fully grasping it, but the next day it began to dawn on me. She was right. It’s difficult to describe how I managed to try to work this approach, but for me it started with talking back to the depressive thoughts swirling around in my head. I would quickly recognize them and tell myself that wasn’t how I wanted to be feeling. This takes a lot of practice, and I’m still working on it. But it does help tremendously and my hope is that I can get back to a comfort zone of joy and fulfillment by using this technique.

Thursday afternoon I picked up my paints and allowed myself to just be present with the colors and shapes I was creating. I used a pretty springtime napkin that was full of bright flowers as inspiration and it led to a heart-shaped floral design that I was really proud of when I finished. I kept with the same design and painted two more pages before wrapping up my art therapy session. It felt good to be creative and definitely helped my mood. 

My sleep hasn’t been perfect lately, but I have been getting about 7 hours a night, which seems to be what my body needs. I can’t get back to sleep once I wake up in the morning which is usually around 4:30/5am. I wish I could get back to my old sleep schedule of going to be around 10-10:30pm and waking around 6:30am, but alas, the kids’ swim schedule wins out. I’m in bed by 8:30pm and asleep by 9pm because our wake-up call as parents is 4:30am to get Owen to the pool by 5am. Even though Ben is the one taking him, I’m awake and can’t get back to sleep. I sometimes wonder if this shift in my sleep schedule had an impact on my mental health. Unfortunately, I can’t change it, as our kids are dedicated to swimming and I want to support them in their sport. So I do my best to monitor the sleep I am getting, making sure I try to get to bed on time to get in those crucial seven hours.

Hormones are an obvious factor that I know affect my mood, but I haven’t had hormone testing to know what’s going on with mine. It’s definitely something I want to look into, and given the call I received yesterday, I may be able to do this in the near future.

My psychiatrist passed away suddenly the first week of April. I was supposed to have an appointment with her that week, but received a call from the practice. They said they needed to cancel my appointment and asked that I call them back as soon as possible. I had been out on a hike with my sister-in-law when the call came in and I ignored it thinking it was just a reminder call. When we got home from the hike a text came in from my doctor’s family sharing the sad news. I don’t know what happened. Maybe she had been ill or maybe it was a heart attack. I’ll miss her and am grateful for the care she provided me. It’s strange to think I’ll never see her again. Reminds me how precious life is.

The practice worked with me to find a provider to take over my care. I’ll start seeing a psychiatric nurse practitioner in a few weeks, and she has a background as a women’s care nurse, so I’m hopeful she’ll be able to help me with my hormone questions. 

So while I’m not able to point to one particular thing that helped lift my depression this month, I’m reminded that taking care of our mental health involves many different approaches. I’m going to keep up with the things that have been helping - painting, hiking, talk therapy with friends and professionals, my new medicine, and protecting my sleep. I’m hopeful I’ll be able to stay outside the comfort zone of depression by remembering how good it feels to focus on the things that make me feel good.