Today I had another guest observer. This guy was visiting from a university in Texas, and was both a neurologist AND a psychiatrist. Lots of free time or ambition or both.
Visitors provide a good opportunity for me to learn more about the treatment, as the treating doctor always tells them about stuff I wouldn't even think to ask. I learned today some of the ways the Cervel device (the one being used on me) differs from other rTMS devices. A big difference, apparently, is that the Cervel is water-cooled, while others are air-cooled. I'm not sure yet what benefit that provides, but it was a big talking point. Cooling is a big issue because the high current would make it crazy hot without a good system in place (my layman interpretation). While talk was muffled with my earplugs in, I think I heard that the device operates at 3,000 volts. Considering 120V is standard in US households, that sounds high enough to sautee my brains.
I took out my earplugs for a few seconds to try to better eavesdrop. All I heard really was the tapping, which was my first time hearing it without earplugs. It was louder than I realized, similar to the sound those annoying wooden clackers make that small kids sometimes play with.
Dr. George pointed out my twitching face to the Texas doctor. Apparently it's as visible on the outside as it feels on the inside. Dr. George asked me about any discomfort, and I told him that it didn't bother me except when I tried to talk during active tapping, because then I was trying to talk with chattering teeth.
Dr. George is very personable, and chatted with me about my progress in a way that included Dr. Texas. I told him that I was feeling on average a six or seven on a scale of 1-10, a nice improvement. We discussed that I had still not reached remission. Dr. George bragged to Dr. Texas about my having gotten a job in Charleston and that I walked to treatment, symptoms that indicated improvement to him. Indication that he doesn't know me well, to me.
When Dr. George conducted my intake interview, he seemed surprised at my accomplishments. He even asked how I had managed to graduate high school on time. I didn't even mention to him that it was with honors or that I had received multiple scholarship offers. Graduating high school on time, finishing college, walking to treatment, finding a job... these to me were minimal accomplishments, but Dr. George's response helped put them in perspective.
If you've never experienced true depression, it's hard to explain. Small accomplishments do feel impossible. There have been many days in my life where thinking about getting out of bed felt overwhelming. Taking a shower has sometimes taken a monumental effort. But I've never really quit trying, not for any length of time, anyway. This is what I most wish I could have other people understand. I don't expect anyone to understand that taking my medicine every day or responding to phone calls is hard. It doesn't make sense, even to me. I just wish that everyone who knew of my struggles also knew that I am almost constantly fighting to win. It looks like I'm lazy or hopeless or helpless, but simple things like showering or answering the phone are often challenges for me - challenges that I usually accept.
When a person has lost a limb, we are often amazed at all they accomplish despite that lost leg or arm. We marvel when they learn to accommodate their situations and can still drive or run. My depression isn't as obvious as a missing limb, so no one notices how much accommodating I do in a day, despite my condition. Dr. George is one of the first people in my life to really understand what an accomplishment I have achieved by choosing to walk to treatment or get a part-time gig. He just doesn't realize that it isn't from treatment, but from my own stubborn will to make it. I chose to walk to treatment from day one, knowing that I wouldn't want to but that it would be better for me. I looked for the catering gig because I learned that idle hands are incredibly dangerous for me a long time ago.
This is the first entry I've written that has made me cry. I cry because this is the first time I've put into words the weight I carry every day. As I've said, I'm good at putting on a pretend face and seeming like all is well. It seems so pathetic to try to tell someone that brushing my teeth felt impossible today. There are no automatic habits in my life other than lying in bed. Everything I do requires a conscious decision. My only instinct has been to wait for death to come and, at times, to try to force that action.
I don't want to end this on that sad note, though. What I'm really most trying to express is that it feels like a load lifted to have someone really understand the million challenges I face in a day. Even writing this, I feel like I sound like a whiny wretch, trying to get credit for showering and other things most people do everyday. But I know that everyone can't understand, any more than I can understand what life is really like for those missing a limb.
One of my biggest issues is absurdly low self-esteem. I'm always trying to be a super achiever so someone will pat me on the back and make me feel worthwhile for a moment. Dr. George has helped me see how many little things I should be patting my own back for. I know that the treatment alone won't "fix" me, but I hope that I pay attention to all the little lessons like these I learn on the journey. Before, I was too unwell to hear the messages, but I think my mind is clearing in multiple ways.
I like this Dr. George. And he is right to marvel at your will to accomplish big and little things- he just can't take credit for this with the treatment... Well, maybe if brushing your teeth suddenly becomes a joy. But YOU made yourself be a good student. YOU went to college. You have big important jobs. And YOU have remodeled your house from the floor up. If he knew all this, he would truly marvel-- like the rest of us do. These are huge things! So, you're good at the big stuff. Hopefully, this treatment will make the day-to-day things less monumental. :)
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