Month: September 2018

As I write this entry, a lot of children are starting back for a new school year.  Of course, this can bring about a myriad of emotions and thoughts.  Some kids are no doubt super excited about starting a new year, while other kids are not really looking forward to it.  Some love the idea of learning new things, and others do not seem to be interested.  But, no matter what a child feels, if they are in school this time of year can be thought of as a new beginning.  A new grade.  A new set of challenges.  A new set of opportunities.

For people suffering with depression, new school years probably do not mean a whole lot, but the possibilities for new beginnings are still available.  If someone is in recovery from their depression, there is a new beginning based in that recovery.  Even if a person doesn’t get better for a very long time, there are new beginnings in terms of the “new normal” of living with depression.  And, like school, having depression or caring for someone with depression brings with it an education.  Lots of life lessons are learned, and sometimes they are things we don’t want to learn.  However, sometimes there are lessons learned that in hindsight are potentially very helpful to know.

So, as many people begin a new school year, I think it is a great time to reflect on beginnings and on what you may hope to learn in the future, particularly when it comes to depression.  How can new beginnings be established?  Is there a way to recognize new beginnings?  What can we learn from depression, if anything?  What lessons can we share with others?  I think that if possible, learning from depression and sharing it with others can be an important experience.

I work in a job where measurement is everything.  Essentially, if the government decided to stop measuring hospital discharge medication review I would be without a job.  However, healthcare is not the only place where measurement has become a huge part of the conversation, but you see it in education and in many other lines of work.  In fact, there are many out there that believe that if you can’t measure it, you should not be doing it.

When I think about measuring performance, quality, etc., I think the intent for all of it is a good one.  We want to know we are doing better or worse, and we don’t want to just assume all is going well.  However, I have thought for awhile and continue to think that we are have started to go overboard with this measurement thing.

Quality measures in healthcare or measures of any kind cannot be the end-all, be-all of what guides our work and our lives.  It can help, but you cannot measure everything.  Thinking about measurement and depression, how can you truly measure mood and improvement?  There are surveys and scales, but no one can truly measure how someone feels.  How would you measure the pain someone with depression experiences?  How would you measure the relief when someone with depression gets better?  It seems silly to me to think we can measure it all.

How about you?  Do you think our urge to measure everything has gone too far?  Are we forgetting the immeasurable things that are just as important in the human experience?   My hope is that we begin to better balance the role or measurement in our lives.

Here we are again, back from another trip.  This time, instead of seeing mountains and glaciers, we stayed at a beach house by the ocean.  And, although I worked most of my regular hours while there, it was nice to hear and see the ocean while I was working.  Also, at the end of the working day I was able to get out and enjoy it.

Seeing the ocean is a magical experience for me.  Looking at the unending expanse of water, hearing the waves crash to the shore, seeing the tides change, feeling the power of the waves, seeing the shells that are brought in, seeing the grains of sand – to me, it can sometimes overwhelm my senses.  If you ask me, seeing the ocean is one of the most powerful ways I sense God and his or her presence.  Who else could have created something so infinite and beautiful?  But, that is from a personal perspective.

As I looked at the ocean last week, it made me think about how small I feel next to it.  The ocean is immense, and it would be easy for lots of things to be lost in it.  As I thought about it, I began to think that depression could be described as an ocean in some ways.  Like an ocean, depression can loom large and people can be lost in it.  Depression is usually also overwhelming.  However, the ocean is not all bad, and overcoming depression can be like the power of the waves and the beauty that is part of it.

I may not be the best at analogies here, but what do you think?  Would you describe depression as an ocean?  Are there bad parts to this analogy?  Are there good parts?  Whatever your thoughts are here, I hope it gives you another way to think about depression and how it can be treated.

As I write this entry, we are getting ready to go on another, although shorter, trip.  Even though this trip will not be as intense in terms of preparation, my mind is just swimming with all of the things I think I need to get done before we leave.  My list keeps getting longer, and what is worse is that I have gone through the day thinking I can remember it all.  I guess I’m feeling optimistic that my memory is at peak performance today.

Inevitably, though, I will not be able to remember it all.  I really need to take a few minutes and write it down, which I am pretty good at most of the time.  I will even usually write something on my list that I have already done so I can mark it off right away – silly, but true.  However, today I seem to be struggling with even writing it down.

If you are affected by depression in some way, no doubt you have a lot of thoughts or to-dos going on in your mind.  If you think about the positive, helpful thoughts or things that need to be done, do you think it would be helpful to just write it all down?  I truly believe writing it out can be so helpful.  If you get it on paper, then you can get it out of your head.  This in turn frees up your mind for other tasks and for being more present wherever you are.  I know I feel a lot better when I take the time to write things down – in the end I actually save time because I am not spending a lot of time constantly trying to remember it all.

So, with that reminder, I am heading to my list to free up some mind space.  My hope is that you all will consider doing the same.

As a pharmacist in the United States, my training was definitely heavily steeped in Western medicine.  As a result, one core idea I received is that we don’t typically recommend supplements or any product that has not been approved by the Food and Drug Administration (FDA).  Although I am sure it was not explained in this way, my reasoning was that the drugs that are approved by the FDA can have issues, so anything not approved by the FDA could potentially be even worse.  I have spent a lot of my pharmacy career thus far recommending that people not just grab something off of the shelf without checking with their provider first.  Although a conservative and cautious answer from me, I am starting to realize that maybe there is more to supplements than to “just don’t take them”.

As the years have gone by, I question more and more how we treat and prevent disease, and I understand there is not a one size fits all for everyone.  Also, my education wasn’t perfect, nor is the FDA.  The more I learn the more I understand there is a lot I don’t know.  So today, I wouldn’t tell someone to not take a supplement, but I would still encourage them to check with a trusted provider first.  Of course, a lot of providers may not know much about supplements, so it is important to check with someone who does and can discuss how it may work for you and your situation.

Looking at depression specifically, I think there are some possible supplements out there that may be helpful.  I wouldn’t take them right away, but again I think that is a discussion with someone who is knowledgeable about treating depression with the supplements in question.  There is a lot of promise out there, and I wouldn’t want someone to miss an opportunity to treat their depression because of an outdated idea about the potential evils of supplements.

For the last week I have been listening to recordings from an online conference on the mind and body.  There are around 60 speakers, and of course each one of them has different thoughts and concepts that they are presenting.  While I enjoy learning new things and being exposed to new ideas, it is starting to get overwhelming because of the volume of information being presented.  Now, I could choose to break these talks up more and listen to fewer of them during one sitting.  I could also spread them out over a longer period of time.  But, I have the feeling that no matter what, I would still be overwhelmed with all of the different viewpoints on healing and prevention.

A lot of these talks touch on mental health and depression.  While it is exciting to see all of the ideas that are out there about what causes depression and how it can be treated, again it can be a lot of information.  A lot of the ideas sound reasonable to me and worth a try, but where would you start?  I mean, you can’t do it all, nor would you want to.

If I or someone I cared about was faced with depression again, I would look at the options that make the most sense to me.  I would also consider the ease of getting that care.  If there are simple things that could be done and don’t require a lot of time, money, or other resources, I would start with or recommend that first.  If those things didn’t work, I would move on to things that might be a little more complex and require more resources.  Although maybe not ideal and hopefully something that we can improve, essentially treatment involves a lot of trial and error.  All of this is easier said than done, but the important thing is to start, and start somewhere that makes sense to you.

When it comes to depression, this is an exciting time for research and the development of new ideas and treatments.  Today I want to touch on one treatment that I have been hearing more about – ketamine.

Perhaps you have heard of ketamine.  It is a legal drug in the United States, and it has been around for awhile.  It is typically used in surgeries for its anesthetic properties, however, it is sometimes used for pain not related to surgery.  Unfortunately, these uses make it a popular drug of misuse and abuse.  You may find ketamine being illegally used on the streets.  Needless to say, ketamine is a powerful drug that requires careful use and monitoring.

While I am not sure of the history behind it, lately I have heard about ketamine clinics that are being used to help people with depression.  There is some evidence that ketamine may help treat depression, and patients go to these clinics to get infusions of the drug under medical supervision.  My assumption is that the number of sessions attended can vary, but some people have dramatic improvements, and this option is probably not going to go away anytime soon.

I think there are still some questions about how ketamine works in depression, but it is exciting to consider the possibilities.  However, at this point, a lot of the health care industry does not recognize ketamine for depression, so getting insurance to pay for it is difficult at this time, and multiple infusions of the drug can get expensive.  So, even if this might be an attractive option for people to consider, cost can definitely be a factor for these infusions.

What do you think about ketamine?  Is this something you would consider for someone who has depression?  I encourage you to do some more research and see if this might be a consideration for someone you know who is struggling.

As I write this entry, it has been 6 years since my dad became a suicide victim. 6 years.  In some ways it seems like a lifetime.  In other ways, it seems like it just happened yesterday.  I still have days where I figure that I will see him that upcoming weekend, but of course it doesn’t happen.  I feel him still with us, yet he also seems so far away.

The grief never, ever goes away.  He was and is my dad, and I was, in his words, “one of the best things that ever happened to him”.  How do you let go of that?  Truth is that you don’t.  Life for me has been divided in two – life before Dad died and life after.  Life after has actually had many great events for me, but there is still a touch of sadness knowing that my dad is not here on earth to share those moments with us.  Even more poignantly, now when I look at my son, it reminds me of baby pictures I’ve seen of my dad as a little boy, and it both haunts and delights me at the same time.

And, in a way, a mixture of haunt and delight is a good way to sum up how I feel 6 years after my dad’s suicide.  Nothing is truly delightful, but nothing is truly haunting either.  It isn’t even something in between.  It is something both light and dark together.  Perhaps that is the way life has always been, but it took me 36 years to realize it.  I certainly don’t have all the answers, but the great news there is that it gives me the freedom to continue living and doing what I think is right.  And, ultimately, I hope that what I’m doing in part is doing right by my dad and the hell he went through.