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Ambien makes for strange bedfellow

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By Jack Smith

I got lost at about 3:00 a.m. on Saturday, and I don’t remember any of it.

It wasn’t a relapse or anxiety that prompted me to get out of bed and wander around aimlessly. It was another foggy moment sponsored by Ambien.

We were staying at a friend’s house out of town, and I took an Ambien to help me fall asleep. I’ve taken an Ambien most nights for probably 10 years for insomnia.

Like some football teams, I don’t play well on the road when it comes to sleep. Been that way as long as I can remember.

Apparently, my poor sense of direction didn’t help the matter either. My wife, startled by the empty warm spot in our bed, had to get up, find me and point me toward the bathroom. I’m told I ran into the sofa on the way back, but  I don’t remember one bit of it.

The good news is  I didn’t go in the closet. I actually did that once or twice in college, but I can’t blame those episodes on  Ambien. Anheuser-Busch was likely the culprit. Continue reading

It’s a war on bipolar now, too

By Jack Smith

If someone had just told me about Starburst jellybeans, this whole thing might’ve been avoided.

At some point during my stay at The Menninger Clinic in Houston, my wife bought a sack of the colorful confections. That really isn’t a good idea—not when an addict’s around. I’ve eaten about 327 since lunch.

Other than too many Starbursts and a few sporadic squirelly moments, things have gone swimmingly since I got home Wednesday.

That was the day of my so-called “Diagnostic Conference” at Menninger. It’s sort of like that moment in a trial when the jury foreman stands up and reads out the verdict.

The verdict for me?

Bipolar Disorder (Type I), Generalized Anxiety Disorder and alcohol dependency. None of it was a big s
urprise,as my Menninger team and I worked through most of the issues before the big reveal. The only item the jury was still deliberating the last week was whether the diagnosis was Type I (one percent of the population suffers from it) or Type II.

Continue reading

Depression:Wimp of a word for major illness

By Jack Smith

William Styron called the term “depression” a wimp of a word for such a major illness.

In “Darkness Visible,” Styron says the word “has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.”
Put another way, depression is a hell of a lot worse than the word implies. Many have “felt depressed” at one time or another, usually from a negative event in life. Chronic clinical depression (called Major Depressive Disorder) is another matter, and a surprising number of people suffer from it. Most things I read suggest 1 in 10 battle depression.
Think about what that means. In a town of 50,000, some 5,000 people are suffering from depression.  It breaks my heart to think of those who suffer in silence as I did for too long.
I am one of a fortunate few, though. I am currently seeking treatment at a place called The Menninger Clinic in Houston. It is one of the best places in the world for complicated mental illness cases.
My case is a bit complicated because I’ve had several different diagnoses and I’ve abused alcohol most of my life since high school. Shortly after my recent overdose, one doctor confidently declared that I’ve needlessly suffered for years because I’ve been misdiagnosed all this time. He diagnosed me with Bipolar II disorder (and the depression that goes with it) and put me on lithium.
The frustrating part came a week later when a second doctor declared with equal confidence and assurance that I was most certainly not bipolar. He said I suffer from major depressive disorder and anxiety issues that make it worse.
Already depressed and anxious for answers, I was now confused and frustrated.  That’s what led me to Menninger.
Part of the process here at Menninger is spending many hours a week with my treatment team. We’ve spent a lot of time talking about my tortured history. This exhausting process has given me a chance to read through my journals spread out over a decade. While flipping through it, I found a description of what depression feels like. I hope sharing it helps others who suffer know they are not alone.
It is hard to explain how much depression hurts.  I feel like I have descended into hell. I am mired in a pit of utter despair and hopelessness, and my body aches. My mental illness tortures my mind but it causes physical pain, too. My back aches, my stomach churns with anxiety and my head and face feel lifeless and heavy.
My disease lies to me. I don’t want to believe the lies, but my depression is cunning and ruthless. It waits until my body and spirit are weak because it is one cruel bastard. It tells me I can’t get out of the bed, shouldn’t bother going to work today and I may as well just shut the door and pull the covers over my head. It tells me there is no hope. Depression is misery.
That’s what one of my worst days felt like, but I don’t feel that way today. I awoke early, feeling rested, read from Romans and shed a happy tear after reading a stirring, quite remarkable letter of hope from my daughter. She and her brothers and their mom are my inspiration today.
I miss home but know this is where I need to be right now. God has put me here and I can feel his loving arms holding me up. His arms and the prayers, love and support of many who have reached out since I began sharing publicly for the first time the nature of my illness.
Thank you, family. Thank you, friends. And thank you, strangers who may not know me but do know my story all too well.
Regular access to my blog is not allowed, nor is access to Facebook, but I have conned the staff into letting me write this entry.  Maybe I can share some more as my journey here progresses.
If not, I will share more when I return home.
Grace and peace.

Today I feel empty

Today I feel empty. Empty and listless. I wouldn’t even use the word frustrated, because being frustrated implies feeling something. I wish I had the energy or the desire to care enough to be frustrated or, heck, even angry. Being angry would be more purposeful than feeling like I just don’t care anymore.


Maybe it’s the new meds. Just a few days ago, I felt ever so slightly more hopeful. The doctor changed my meds again since my last blog. I know the antidepressant hasn’t had time to do its thing, so my guess is a placebo effect made me feel a little better for a brief time.


I am so uninterested in life outside my family right now that it’s extremely difficult to stay focused or be motivated at work.


My therapist and I had a good session yesterday, but that positive energy I felt after leaving her office has all but vanished. It’s been sapped by this dreadful disease once again.


She encouraged me to think about things I’m grateful for each day, especially when I’m reeling at work. She told me to literally write down even the smallest achievements so I feel some sense of accomplishment. It isn’t working so far, maybe because I haven’t done it enough yet.



My anxiety is so severe at times it borders on paranoia. My self-confidence is so shaken that simple tasks seem overwhelming. My fear of mistakes is so paralyzing that I want to just crawl in a foxhole and do nothing. Only that’s not a viable option for a career…at least not for long.


So here goes. I will celebrate one little victory that on the surface seems quite pathetic. I had to craft an email yesterday for an important group of stakeholders. My fear of making a mistake, perhaps a typo, was so great that I put it off all day. Then I finally got the courage to draft it, prayed over it and hit the send button.


How ridiculous is that?


My therapist doesn’t think it’s ridiculous. She said following through and doing it despite my anxiety was actually “courageous.” Only I don’t exactly feel like Braveheart. I feel puny.


That’s what warped negative thinking does to us over time. We are working on my negative thought patterns, but they are so engrained it almost feels like a hopeless effort.


I will keep trying. I will think of a STOP sign every time the negative thoughts start.


What other choice do I have?

Changing Meds Makes for Difficult Days

My patterns of depression are so familiar now, I may as well copy and paste my last blog post into this one.


Major Depression struck again a couple weeks ago. And it was pure hell. I missed one day’s work and struggled like crazy to make myself keep moving for several days afterwards.

My doctor and I decided we needed to be aggressive in trying to stop it, so he changed my meds. I’m now taking Effexor along with Abilify.

The change from Cymbalta to Effexor proved to be a cautionary tale. I had been taking 60 mg of Cymbalta, which I had some success with after a mental health meltdown last summer. To transition to the new drug (Effexor), I was instructed to drop down to 30 mg of Cymbalta for three days before starting out on a small dose of Effexor. 


Only I didn’t do that. My Cymbalta pills weren’t the kind you can split in half, and I never got new 30 mg pills for the three-day transition period. So I just stopped the Cymbalta cold turkey. I won’t do that again.

Wrenching anxiety, stomach aches and feelings of utter hopelessness soon came. 
It was a brutal stretch, probably ranking in my all-time Top 10 list of major depressive episodes.
I’m not exactly copacetic now, but I’m much better. The suicidal ideations that haunted me have subsided. I feel more hopeful than I did even a week ago.

I’ve now ramped up the dosage of Effexor as the doctor prescribed, and I think it’s beginning to pay off.

Those who suffer from depression can relate to the difficulty of changing meds. We often get worse before we get better. And that’s really frustrating.

I haven’t figured this thing out yet, but I’m trying to remain optimistic about the future. It generally takes 2 to 4 weeks for a new antidepressant to really help. My doctor says it takes much longer—maybe six months—to get the full payoff.

So I wait patiently, doing the other things I know help (exercise, eating less junk, etc.)

I only wish Punxsutawney Phil hadn’t seen his shadow. I hate darkness and winter and am ready for it to end.

My guess is many of my fellow depression sufferers feel the same way.

P.S. I hope the few of you who know me understand the difference between the sort of fleeting suicidal ideations I occasionally have and the more serious suicidal thoughts that others experience that involve plans, etc. I’ve never gotten that far before and don’t plan to. I have too much to live for and a burning to desire to defeat depression. I share the brutal realities of depression only so others who feel them like I do don’t feel so alone.

The sun is shining after days of dark skies

Last week I slipped back into a pretty serious episode of depression and anxiety. And I don’t know why.
I’d been taking my meds and staying fairly active, at least getting on a treadmill for 30 minutes a couple times a week. Not intense exercise, but at least I was doing something.
This week, lo and behold, I feel much better. Could it be the sunshine after days of dreary skies brightened my mood? Or my intentional effort to eat better? Praying for relief more fervently? Going for a sweat-inducing run on an unseasonably warm afternoon yesterday? The long-awaited debut of “American Idol”?
I’m not certain, but it’s probably all of the above. 
One frustrating aspect of depression is it’s easier to deconstruct good days than bad days. Let me explain. I just laid out a bunch of reasons that probably explain why I feel better this week. Only I have no idea how I got to that bad, dark place last week. Did irrational anxiety about things I can’t control start me down the slippery slope to depression? Was it the new drug I was taking as a replacement for Valium, which I usually take as needed when my anxiety gets really bad? Was it those ghastly gray skies, day after day?
I don’t know for sure, and neither does my therapist. She flipped back through her records during our bi-weekly session today and noticed that two weeks ago I reported feeling flat. Walking me through last week, we figured out one difficult and stressful task at work—in which I had no clue what I was doing but was too ashamed to admit I was confused and needed help—may have been the final shove toward despair and depression.
So what did I learn from this experience? My psychiatrist took me off that new drug that just made me miserably drowsy. (I’m back to Valium as needed). My therapist coached me to be more self-aware and to look for “cues” that I’m slipping, because if you know you’re slipping, it’s easier to stop the slide.
A cue might be “all or nothing,” irrational thinking, i.e., “I stink at this project and I’m going to lose my job.” Had I stopped those inevitable racing thoughts, I could have just slowed down and asked for help.
Only that’s not easy for me to do. My sagging self-confidence, which I wrote about in my last blog, sometimes leads me to believe that I can’t make mistakes. My ruminating mind tricks me into believing that if I ask for help, I’ll come across looking like a dope. How messed up is that?
I feel pretty good today. The sun is still shining and I’m able to focus better. And I know winter, the hardest time for me every year, is one day closer to turning into that hopeful time of spring, when the days are longer and less depressing.
Tomorrow, I leave for a three-day spiritual retreat. I won’t get into the details just yet, but it’s 72 hours without cell phones, emails or even watches. I look forward to sharing about that experience when I get back—and hopefully how it changed me for the better.

Depression stole my swagger

There are a lot of miserable symptoms of major depression. Despair. Fatigue. Loss of interest in things we once enjoyed. Stomach-churning anxiety. Real, physical pain. Those are just a few.

Worst of all, this soul-sapping brain disease can steal our self-confidence.

At least that’s what my wife noticed recently.

After a tough six months of on-again, off-again depression, I’ve come to realize she is exactly right. Depression stole my swagger.

I was once brimming with self-confidence. Not arrogance, but confidence in my ability to accomplish anything I set my mind to do. Then I crashed and burned with my first major battle with Major Depression.

Sadly, I can’t remember the last time I felt truly confident.

My current meds and time with my therapist are helping me survive each day, but I’m sick of just hoping to survive. I want to start really living again.

Is that too much to ask? I don’t think so.

So what am I going to do about it?

I’m going to be more intentional about setting modest goals that I can achieve, whether it’s at work or at home. Achieving those goals will surely help build my self-confidence back. I am keenly aware that such cognitive behavioral therapy works, but it is difficult to be diligent about using those tools when you feel depressed and mentally exhausted.

I blogged earlier about the need to “fake it til you make it,” and I still believe that. I just wish it wasn’t so darn hard.

Massage can help relieve depression

Don’t look now, but I’ve had at least three good days in a row. Somebody call Guiness.

I’m not sure who gets the credit. My talk therapist or my massage therapist?


I went into the spa a few days ago with heavy shoulders and a sore back. As those who suffer from depression know, it’s not just an in-your-head problem. Depression hurts. Physically.


As I always do, I emerged from the spa feeling like a bear that just awoke from hibernation—rested, rejuvenated and hungry…hungrier for life too.


While massage may not be a cure for depression or anxiety, it sure does help manage the symptoms. It’s expensive, yes. But can we put a price tag on our mental health?

While the science doesn’t suggest massage is a miracle cure for depression, there are studies like this one that show it sure helps. I always go in with heavy shoulders but come out feeling like a champ.


They say our thoughts control our feelings, but that’s easier said than done for many of us. I’ve found that when my body feels better, say from depression or exercise, it’s easier to tame the torturous negative thoughts that sometimes push me to the edge of sanity and bring on bouts of depression.


I’d love to hear from you if you’ve found massage to be helpful. If you’ve tried it and it didn’t help, I’d suggest a new massage therapist.


So give it a shot. Massage away that nagging anxiety—even if only for a little while.