This is an unsolicited declaration of love to my beloved daughter
On finding meaning in your 40’s
Like millions of women around the globe, I have been defining myself as a mother ever since I was pregnant with my beloved first child.
Being a mother is not only my job, but also my passion, my confort zone and my cherished responsibility. It is a role that I have always loved, a privilege and a blessing.
Having any other role besides it always seemed redundant an infeasible.
I always had an admiration for working mothers, and looked at them with awe; unable to comprehend how they manage to divide their attention and identity to fill more than one shoe.
Years went by and my frustration was building up. I felt that something was missing, especially as my children were becoming more and more independent.
Many unsuccessful trials filled with self-doubt and self-judgement to find a job work, led me to more frustration and shame for wanting me being anything else but a full time mother. Nothing was worth leaving my established identity for. I was convinced that I was only good at what I already knew how to do best. Why look elsewhere? Why make any change?
I was struggling to find the right moment, the right idea, the right motivation and the right remuneration to get back on the employment market. I couldn’t understand that I didn’t need an identity shift or any kind of change. All what I needed is to trust myself and allow myself to expand.
Once I let go of my fears ending with the same suffix (employability, compatibility, feasibility, proximity, etc), I switched to “ action mode”.
I stopped thinking that I my last paycheck is in fact older than my teen. I stopped thinking of all the limitations and chains I had built around myself refraining me from moving forward. I stopped blaming myself or others for my choices and from seeing my destiny limiting. I stopped thinking of how much I should make or I can make per year. I stopped thinking of who would and who wouldn’t employ me. And most importantly I stopped feeling guilty for wanting to expand.
I always tell my children to look at life as an opportunity to gather tools to put in their toolbox and use later when in need. I encourage them to search for as many as possible of these tools and build an immense box. This way, they will always know what to do wherever they are and no matter what situation arises.
Indeed, I found myself doing the same. I had forgotten about my own massive toolbox! I opened it and I was so pleasantly surprised. All these roles and tasks and chores and challenges and opportunities I went through that can’t be written in a CV were priceless when stacked together. I had tools as diverse as breastfeeding to dealing with suicide. Each and everyone of them made me who I am.
When I saw it that way, I stopped wanting to be anyone else and I thus I wasn’t incomplete. Nothing was missing, it was just how I chose to perceive my existence. I had also gotten ridden of any guilt feelings. With this solved, my confidence and creativity were recharged. Instead of jeopardizing all my attempts with ill-conceived ideas about who I should and shouldn’t be, I started doing and enjoying what I do.
One foot in front of the other, I didn’t overthink. I started cooking, packing and distributing meals in front of hospitals. The following week I repeated, and the one after and the one after. Each time I gained a little more knowledge about how to perfect the process. Then I repeated again and learned some more. Word got out and I found people wanting to help. We cooked, packed and distributed more meals, and repeated. Each one of us added a little bit more to the process.
In this repetitive cycle, I found solace. I started acting on ideas that were forming in my mind. And little by little it was more than just cooking, packing and distributing meals. It was about finding meaning. Our small group had and has one mission, making others happy.
In the process of giving to others, you give to yourself. In physical exhaustion working for a greater cause, one forgets to worry about one’s little life. The joy of giving is ecstatic. It fills you up with light and gives you energy to keep going. Nothing beats putting a smile on someone’s face.
Yes I work long shifts and have zero monetary gain. But I wouldn’t change it for anything in the world. Doing volunteer work is therapeutic to me before being of any value to others. It grounds me, gives me purpose and endless satisfaction.
I am still a mother and always will be. It is who I am- I will always want to fill this role. I have simply expanded my identity and decided to give back to my community, and in doing so my existence makes sense.
Perhaps this formula works for you, perhaps it doesn’t. Regardless.
Whatever you do if you feel like I felt for many years, don’t doubt your capacity. Look into your own toolbox and stack all the tools you have gathered along the way and start.
Do anything you enjoy and the rest will follow. Don’t overthink it. One step will lead you to the next. Just keep being in action. Perfect your own process. Ask for help, learn from others, get inspired and inspire. Listen to your heartbeat as you create something for yourself. Enjoy feeling fulfilled and make it contagious. Don’t stop, repeat, perfect, add to it and start all over. You will find solace too 🤍
Few months back I started an initiative called SANED – the closest word in English to it would be “Support”.
The idea came to me that I would like to cook meals and distribute them to those in need. I started slowly with 10 meals, then 20 then reached 60 meals per day. I was buying the goods, cooking, packing and later distributing in the streets of Cairo.
Eventually I decided to head with the hot meals to pubic hospitals and distribute the them to the families of patients stranded in the streets waiting for their beloved ones to finish a procedure.
Surprised I was that many take the streets for their home during the stay of the patient in the hospital. I found elderly, women with their toddlers and men sitting patiently in front of buildings for hours with no end. Soon I decided to focus on public hospitals and I tried going in front of a few for several weeks.
I noticed the children looking bored and hungry. I decided that the hot adult meals weren’t very suitable for them. So I made them a breakfast or snack meal instead – the same you would give your child when going to school. I asked my children to look for small toys in their rooms to include with the meals. Soon enough with the help of their friends, we had our own SANED happy meal that made hundreds of kids happy.
Eventually, my family, friends and neighbors learned about what I am doing and they wanted to help.
I decided to create SANED with a tag line that roughly translates to “so that no one sleeps hungry” and created a profile for it on social media. Soon enough I started to receive endless phone calls from then strangers who were touched by the initiative and wanted to offer a hand.
In less than a month we became 287 active volunteers who work in transparency and cooperation towards helping patients and their families in public hospitals.
Word of mouth spread fast, and I got connected to the administration of hospitals and they allowed me to distribute inside outpatient clinics. emergency rooms and day clinics equally for children and adults. I reached a public cancer hospital, and I designed a healthy meal and a snack for the patients baring in mind what they can and cannot eat. The feedback was heartwarming.
Our combined efforts in SANED allowed us to cook over 400 meals per day (we distribute once a week till now). We have served 1861 meals in the last month to sick children, cancer patients and their families. We have also managed to buy more than 500 new winter outfits for sick children and their mothers.
On a mental health perspective, I see that SANED has many benefits. For one, it offers a channel to people to think of other problems but their own. In this sense, it is therapeutic to be involved in a greater cause that only brings positive energy.
SANED presents members with a sense of fulfillment due to its altruistic mission. It gives a sense of belonging to a larger community and makes one feel valuable. The experience of getting in contact with the less privileged is very tough especially when they are children as young as 50 days and as chronically sick. Yet, the fact that we bring a smile to their faces makes it tolerable and repeatable.
I was feeling quite down right before I started SANED. I had then decided to reduce my levothyroxine dose that I take for my bipolar disorder. I was left depleted with rapid negative thoughts for 48 hours until I upped the dose again. I was very angry yet I decided to make myself aware of my size in this universe.
Once I broke the barrier, sought out the outer world and decided to see what it is like to be in pain without any means to resolve it, my own problems disappeared. I always knew that the world does not revolve around me, but seeing is believing.
It was an eye opener for me to be able to land a hand to others who are suffering. It was relieving to be able to make a small difference. It was thrilling to see someone smile when offered something with love. It was enlightening that there is always something to offer others even if it is just a smile.
All negativity transformed into finding solutions to challenges I see on weekly basis. I have no time to feel pity for myself or answer existential questions that haunt me since the beginning of dawn. I am busy being part of a larger cause, a cause dear to my heart and harmonious to my values. On a very selfish level, SANED makes me feel productive, useful, positive, connected and alive.
There is this quote that says “when one gives, two get happy “ by Amit Kalantri and he couldn’t have said it better.
I urge everyone to try and transcend this sense of self that is so focused inwards. I urge you to look outside and find others whom you can help. There is always something do no matter how small it is and it will help you reset your perspective and make you evaluate your situation more positively.
Thank you for reading. You can follow SANED on instagram through this link https://www.instagram.com/saned_initiative/
Never forget that you are my hero
Save this for a rainy day
For new readers, hello and thank you for joining.
To put you up to speed, I was diagnosed with bipolar disorder back in 2017. I documented my long and raw journey of fighting this illness here in Happilydepressed.blog. Despite repeated hospitalisations and endless cocktails of psychotropics, I was getting worse. Luckily, in 2019, my husband stumbled across a new approach to treating bipolar, a mix of rTMS sessions (repetitive transcranial magnetic stimulation), and life long high-dose Levothyroxine. If figures, bipolar patients suffer from a lack of Thyroid hormone due to a gene mutation that is compensated by high-dose thyroxine. Slowly but surely, and thanks to this treatment, I was able to regain my life back. For more information on this treatment approach and to better understand the link between thyroid and mood disorders, you can refer to this research article published in 2021 by my treating psychiatrist Dr Andy Zamar.
Last week, I tried reducing for the second time this year my dose of levothyroxine (from 700 to 650). My idea was that I might be able to function as well, now that I have been stable for a long time.
It started fine, I was ok. All of a sudden, hell broke loose without any warnings. I was bed-ridden, crying, not eating, and suffering tremendously. My negative thoughts were spiralling. Nothing seemed right. I even doubted my previous stability and all what I had achieved fighting bipolar for 5 long years.
I was aggressive, repulsive, talking in monologues and saying hurtful things. Three days in, I agreed to shower and listened to my dear husband, who was trying to convince me to increase my dose to the initial 700.
Soon enough, the dark cloud began to disappear and I found myself regaining the confidence I had lost.
I made a list of what I learned and what I should remember if I ever have another relapse. I try to give meaning to my suffering, and perhaps if I do, I will manage to avoid it in the future. So here you go, you might want to save this for a rainy day:
- NEVER UNDERESTIMATE BIOLOGY: As much as bipolar disorder is defined as a psychiatric disorder, it is really a genetic illness with psychiatric symptoms. There is so much one can do in face of a biological deficit. Ask yourself, am I fighting the right battle?
- HEALING IS RARELY LINEAR: Growth, development and healing are not linear phenomena. You do need sometimes to regress to move forward. I am not telling you anything new. Look at the big picture, not just at an arbitrary snapshot.
- REMEMBER YOUR PAST TO APPRECIATE YOUR PRESENT: Never forget where you are coming from. Be humble and grateful. Have you been worse? If your answer is yes, then try to get up.
- MENTAL WELL-BEING IS NOT A FAD DIET: Fast results fade fast. With perseverance you will reach your goals. When has it been any different? So hang in there and get back on track.
- LOVE YOURSELF WHEN YOU ARE LOW AND PLEASE DON’T CRINGE: Be kind to yourself. Being harsh, unrealistic, and idealistic won’t help you one bit now and you know it. Don’t make it harder than it already is.
- REMISSION IS NOT A RACE: Why compare to others? When was this a reason to move forward? Did it ever make you a better person? No? So, give yourself a pat on the back and praise what you know how to do best. There must be something you do well. Now, go do it.
- BE GRATEFUL (DON’T GRINGE): Count your blessings, and recount them. You should count them again, especially if you are feeling low. Imagine if the little (or plenty) you had disappeared? Believe me, it can always get worse. So be grateful and get up.
- BE HOPEFUL: As long as we are alive, as long as there is a place for hope. If you have been to the other side (no need for me to be more explicit to avoid any triggers), then you know that today is better than many other days you have managed to live. No one is telling you this, you know it in your bones. So get up.
- NOW GO COMPARE YOURSELF TO THOSE SUFFERING FOR “REAL”: If you think you suffering has reached its peak, and that you are in intolerable pain, get up and go see some real suffering. Visit a hospital, hospice, an orphanage, special needs school, or just walk in the streets of the less privileged parts of your town. Get up and go help others.
- YOU ARE A SURVIVOR: Ultimately, you are a hero. My hero. Waking up for some of us is already a huge achievement. So for my sake, get up. You have done it so many times before. I love you too much to see you not doing what you do best: When you fall, you get up again.
Happy and no longer depressed …
Many days have passed since I have written.
Today is a happy day. I come with message of hope. I want to tell you that there is a possibility of getting better.
I have been well for over 8 months now and this is the longest symptom free stretch I live so far since I got ill.
It might not seem much. But my Dr. told me that after 6 months without bipolar symptoms I should start feeling less worried. It means I could start relaxing.
I want to tell you my medical regimen – I take 750 levothyroxine daily and supplement with omega 3. No more antidepressants, no more anxiolytics.
Bipolar is not treatable with those.
I do rTMS now as maintenance, at least twice a year.
My treatment has been life changing but it would have never been possible without the help and daily support of my family. My amazing father and my husband nursed me like a newborn. They believed in me; they knew I would get better. I am blessed to have a very solid support system with my immediate family. My mother in law took me in like her own daughter.
But in this post I want to thank one person specifically- for without him, I wouldn’t have been able to make it.
Hassan – you are a saint. Your patience and love were and are unconditional.
If I am alive today it is because you trusted my judgement despite my illness that the medial system as it is today is wrong yet still fought for a solution.
Night and day, with the children around us you would make me laugh, juggling work and trying to find a way out of this endless night.
Today, I would like to say that I am simply happy and no longer depressed.
Thank you for your endless love and unconditional love.
You were my sanity when my thoughts were gone.
You taught me that impossible does not exist.
I would like to take this opportunity to thank everyone who reached out during these difficult times and wrote to me or called me. Each and every single message brightened my day and made a difference; you wouldn’t believe how much.
And now… let me end my post by a quote from Rumi “ whenever we manage to find love without expectations, calculations, negotiations, we are indeed in heaven”
You must know
Know that I love you since before I was born
Know that I loved you since before you were born
Know that you are my every reason for being
Know that I want to leave to set you free
I try and I fail and I try again and I fail and fall harder
Maybe this time it will work
Getting out of the closet
Getting out of the closet would make you think of sexual orientation. But many others have gotten out. Today, I will write about why I decided to link my blog to Instagram and Facebook.
I have been writing for a while now. I am documenting my journey fighting mental illness as a person, a woman, and as a mother. It has been rough mostly, but it taught me a lot. You might be surprised by some of the topics or posts that will be shared. The main purpose of this blog is to promote awareness of mental illness. I want to also tackle a broken system, where mentally ill people are seen as helpless beings with no choice of treatment or quality of life.
Although I am supposedly a clinical psychologist, please do not take this blog as as a place for “medical” advise. It is just a safe heaven for broken hearts. I hope that in our unity we will be able to free ourselves from the burden of depression, bipolarity, eating disorders, addiction, or else.
Thank you for respecting other points of views, and thank you for trying to understand what the other is saying. We shall not blame each other or use inappropriate words. We are builders – it is enough to fight our inner battle; we do not need a wall to fight on to.
On waiting for remission…
Waiting sucks. Whether waiting for a bus; your turn in a public restroom; your birthday present; your dessert in a restaurant; or even waiting for yourself to finally fall sleep. Waiting sucks when you did well, when you didn’t do well, or when you didn’t do anything at all.
Waiting is seen essentially as a waste of time. It is the place between two radically different states. Waiting is ambiguous, monotone, and yet interesting,..
The interesting stuff lies between where you were before needing to wait and where you will be after waiting is over. It is like a twilight zone, where we discover things we didn’t know before…
How can waiting be active ?
If waiting were passive, life would be so dull. We wait all life long for things to happen: some of them we want and some we are very keen to avoid. We learn to wait as soon as we are born. We wait to be fed, cleaned and cuddled. We even wait to die…
Waiting changes as we grow. We discover sooner or later that our needs and wants are not instantly met by the world.
Frustration builds up as we face negative experiences where waiting was not just long, but led to an undesirable outcome. We resort to prayer, to superstition, to therapy and sometimes we end up in depression; waiting.
Waiting and expectation go hand in hand. The higher the stakes, the higher is the expectation associated with waiting. Waiting for a bus is unlike waiting for remission. The first is bound to happen (the bus will eventually come no matter how late). Yet, some other waiting is tricky. What happens when you wait for remission? For better health? For a better future? For a full life?
What to do while waiting other than waiting? What can be done before waiting to make waiting more bearable? What can be done to make waiting matter, so that it makes sense?
How can we wait for remission?
I have learned so far that waiting for remission boils down to two main factors. The first, is wanting to get better. (For the sake of simplifying things, we will assume that we actually and truly want to get better). Interestingly, the second factor is accepting not getting better.
It was so confusing to me. The more I wanted to get better, the more frustrated I became. After being frustrated waiting, I gave up hope, which definitely didn’t make waiting any easier or quicker.
Waiting is a skill that sooner or later we better learn to master, especially if we are waiting for something of such great value such as remission.
We could complain or wait in silence, while we are shattered internally with each second bringing us closer to the end of a bottomless void. We can swim in the darkness and sink deeper as the pain never lessens. This would not mean that we are accepting this reality, but rather that we give up. We give up hope, we can’t see any other possible scenario. This is it. And if this is the case, remission will never happen.
Yet, if we surrender, maybe things could change. We surrender to and accept the pain, the guilt, the remorse, the shame, the pity, the ugliness of it all. We accept the status quo while knowing that nothing stays the same forever. We need to know this in on our bones. Like seriously know that nothing ever stays the same forever. It is not over, until it is over. Repeat it, feel it, believe it, know it.
We should never give up hoping to get better. I always say, if I feel better for a minute now, next time I will feel better for two minutes, then three, then an hour and so on. Yes I will get worse, but then I will get better again. Hope cannot be taken out of a person unless they decide to give up. One single minute lived without pain, means more minutes will come. Just wait.
Wait actively. Listen to your soul and body. Don’t undermine your thoughts. You are still creative even if life is putting you down. You still have a mind, even if you are drugged down by the doctors. You know what it is that is really wrong with you. Better still, you surely know what is really good with you. Yes, there is plenty. You are just looking the other way.
Wait while searching. Dig deep, and take it step by step. Work on everything you know how to solve, and leave the rest to time. Work it like a puzzle. Your life is a giant Lego. Do the easy parts first. No one will fix you. You need to fix yourself. There is no perfect scenario. Life is not black or white. Accept being in the grey zone.
Make your bed, shower and eat real food. You can do that. Do your laundry and get a hair cut. Get back to this thing you used to like before. Was it writing , painting, composing, gardening? Pick up something you never had the chance to do before, but always wanted to learn or do. Make waiting count.
Don’t be the same person once waiting is over. You would have lost double the time. Either way you have nothing to lose.
The goal is to rediscover yourself beyond your illness. There is an “I” behind the illness. You are not the illness. Who is it who is waiting for remission? What will s/he do if they were not sick this very second? What would have happened if they hadn’t fallen sick? What is this bloody and agonising state trying to tell me?
Don’t wait for an answer. You already know it.
Forgiveness and recovery
The blog has shifted gears. My writings were sometimes exercises of introspection – reflecting my state of mind during my struggle with depression, anxiety, and bipolar disorder. Other times, I would write about what I thought was wrong with the medical system as it stands today; not seeing the person as a whole or just silencing and over drugging the mentally ill till they slowly lose themselves in an array of side effects and endless adjustments of dosages. I also wrote about misdiagnosis and malpractice, and how our lives could change just by being given one very wrong label or another.
In my last few posts I started sharing with you the lessons taken home. There is no pretentiousness or ‘I know better’ in my words. I try to repeat this one way or another because it is so important!
So here goes…
Today I want to talk to you about a pivotal moment in my recovery.
You know getting better is not linear. If anyone tells you so, then they either don’t know what they are talking about, or they are simply really very optimistic, or just they were super lucky and are the 0.01%.
Recovery has so many elements. Naive, I used to think about it like a finish line. It was actually more of a destination, and to get there you have to take a bumpy ride.
To recover, I of course needed be on the right medication. I was supposed to find stability. Yes little by little I didn’t have anymore mood swings. A small relapse here, a little adjustment there…
I relate to this as trivial compared to what I went through. I didn’t feel depressed or have this huge void eating me up; true. Yet, I felt surprisingly guilty. Probably not surprisingly.
I was not able to feel relief. Why aren’t you happy now? Good question! I was faced with two major problems.
One: the aftermath of what ‘I have done’ to my family witnessing all this suffering. Two: the immense fear of this ordeal happening again. Three: I know I said two but I also had memory issues, self-confidence issues, brain fog, and 20 plus kilograms to lose to fit in my old socks because of all the meds I was taking before finding the right treatment, tapper off a few others, and of course I had to reintegrate into society.
After spending time feeling stagnant in these negative thoughts, I talked to my psychiatrist who suggested that these signs are very well similar to those of Post Traumatic Stress Disorder (PTSD). In brief: the experience of illness is so intense that in itself it becomes traumatic and creates guilt, fear and flashbacks. Are you familiar?
He suggested I undergo a few sessions of EMDR – Eye Movement Desensitisation and Reprocessing therapy. It is non invasive, simple and fast method of psychotherapy. I was skeptical at first but I tried and It worked really well on my trauma. Highly recommend it if you find a qualified therapist.
Relief was not immediate. But at the time I decided that I needed to open a new chapter in my life if I am to recover. Again this does not happen over night. It is a process. You plant the seed.
How can I ask those around me to forget what happened if I am constantly thinking about it? How can I be ‘normal’ if I am living every moment waiting for another attack? How can I expect to be ‘forgiven’ if I cannot forgive myself?
Forgiveness was the magic word. And trust me it is everything but cliché.
I had no choice. I internalized this and repeated it to myself for the millionth time. Mental illness could happen to anyone at anytime. Mental illness is not a choice. Mental illness teaches you how to be human and humane. This experience showed us all how we are connected and how we love one another and how blessed I am to have my family and loved ones. They also used to tell me the same, but you know guilt…
Before all this, I had to forgive myself for the pain I went through. I decided that I will allow myself the suffering that passed and say it is ok. I don’t judge you. You were hurting and you are fine now. Again, you water the seed.
I gave myself a pat on the back and a big hug for the long road travelled and I said it is ok. I looked at all the things I have learned. How strong I have become. How loved and cared for I was and how things could have turned much much worse.
I looked at my family hoping day in day out that what dwells inside my soul will reflect into my behavior. Little by little, things began to change, and a new normal appeared.
The seed grows into a plant.
My dear reader I decided to be kind to myself because I had suffered enough and I invite you to do the same even if you are not in recovery, or even if you are not mentally ill. We have all suffered one way or another. We deserve to live guilt-free.
Allow yourself the gains you have achieved though little they may seem; for today is a good day and we only hope we replenish the well a little more tomorrow.
What does self-care actually mean?
I talked in my last post about self-care and its importance to mental health and well-being:
Today I would like to elaborate a little bit and dig deeper and try to tell you what I really mean by this concept.
Superficially, self-care is really simple to understand. It entails taking care of yourself. If you google the term you will find diagrams and articles giving examples of self-care including eating well, good sleeping habits, going for a walk, listening to music, and so on… Basically, it is about any action you do to take care of yourself.
I of course agree with all of the above. Who wouldn’t? But I like to stretch the concept a little bit more to include some other essential elements to our well-being that we tend to overlook.
Self-care is also essentially about self-acceptance, self-forgiveness, and self-love.
If we don’t accept, forgive and love ourselves we will not be able to truly care and mend our wounds, and ultimately start unfolding to meet our true self.
My new year’s resolutions, my goals, were almost never achievable not just because I lacked the will and the motivation to reach them. I discovered it was because I was rarely true and honestly accepting where I was at; I was not forgiving myself for my “mistakes” and I was judging myself for “lagging behind”. I didn’t love myself wholeheartedly and doubted that I could ever achieve anything.
We also get dragged and pulled by negativity right and left. We are consumed by toxins and more importantly by toxic relationships. We spend hours tending to these tasks while we could be using this vital life energy on our beings.
Self-care is about using our intelligence and intellect; our senses and sensibilities. We know down deep inside what we need to develop; what capacities we lack in order to become stronger and more complete.
I discovered along the way that my anxiety would reduce exponentially when I would “work” on myself away from the attacks. I had to accept me and forgive me and love me.
Another attack was bound to happen. Anxiolytics had to be stopped – they were threatening my life; I was becoming “addicted”. At the time, pain equaled pill: it was unbearable.
Putting thoughts into compartments helped me a lot. I blocked the negative energy coming from outside. I protected myself. I set boundaries. This is very important in self-care and it is not selfishness.
Along with compartmentalization, prioritizing, labeling my emotions, and repeating that I want to be happy and that I can be happy were all part of the package.
I repeat that I am under treatment and that I am very lucky that I found a good one that works for me. The final result would not have been possible without it.
But for months during my illness I suffered from severe brain fog. I was not able to think clearly. It was the residue of all the bad chemicals in my system – yes even after I quit them. It was the strangest feeling. Still deep under the person was still there; the process was in place.
The real you is always there. Your beautiful self is there, whispering and waiting to be heard.
I am telling you this because no matter where you are at now in your journey it is never too late or too early. Despite the heavy meds you are taking, despite the pain and the rejection you are feeling towards yourself: you can stop, assess and reconsider.
The same goes if you just feel that you are not in-synch with yourself. If you feel you are unhappy, starting a mild depression. Stop. Assess and reconsider.
I invite you not to wait till it bubbles up into something that becomes more organic and more difficult to manage.
“There is no higher or lower goal. There is only one goal, Self-Realization”Meher BABA [The Answer 26]
The importance holistic of self-care
Tear and wear as we approach our mid-thirties and forties not only gets to our bodies but also to our minds.
Life has such a demanding rapid pace. It leaves us a few moments for reflection and decluttering. We rarely put ourselves first; we say, later, just let me finish one more thing first. We silence the rising alarm saying “I am tired” until we become unhappy and eventually psychically and psychologically unwell.
Small droplets form oceans.
These oceans form because of events that are out of our control. Life is not easy. Yet, we are at fault too. We rarelystop, assess, and reconsider our strategies before it is too late. We ignore our intuition and end up caught in vicious circles leading to more physical and mental pain.
I learned throughout my journey that in order to break free from negativity, it is imperative to decide to be self-critical and assume responsibility. One has to want to be genuinely happy, or at least try to. Being passive brings us no good.
The wish is the beginning of the realization of the dream.
Quite often, in conversations with people, I see how they are absorbed by hopelessness. They simply cannot see any different outcome. Circumstances seem like a life sentence. They don’t put themselves first and gradually become someone else.
We carry too much on our shoulders, and we either give up or wait for things to miraculously change.
We forget that our mental health affects our physical health and vice versa.
When we become emotionally unbalanced, we develop all sorts of illnesses. Our immunity weakens. Look around you. Chronic back pain, migraines, indigestion, weight problems, fertility issues… Dig deeper. You will probablyfind a lot of emotional turmoil too like sadness, remorse, fear, anger, and guilt. Later these develop into anxiety, depression, PTSD, and eating disorders.
We might not be able to avoid everything. But there is always something we could work on: caring for ourselves.
We cannot take care of others if we don’t take care of ourselves.
Remember that a bad day will always end. Small real changes go a long way. Recognize the importance of yourmental well-being and know that some choices though hard to make are for your best. It is never too late to be your first priority.
Our mental and physical well-being are closely related. When we feel overwhelmed by physical pains, we should stop and think: is my body trying to tell me something? Is there a psychological reason for my physical suffering? Often, when we dig deeper, we discover that many illnesses are due to feelings of guilt, fear, and anxiety. Take a breath and reconsider. As Jalāl al-Dīn Rūmī said, “What you seek is seeking you.”
“What you seek is seeking you.” Jalāl al-Dīn Rūmī
The importance psychiatric empathy and engagement in patient /doctor relationship
Today I had a routine FaceTime appointment with my psychiatrist. I wasn’t expecting much. We were just going to discuss the usual.
Yet, the first thing he told me
was “I read your blog”.
I was taken back for so many reasons. I had no idea he would have such interest in his patients, or have the time really.
What is interesting is that I had written my last entry on how I am suffering from the side effects of the meds I am taking, especially how I have lost hope, and how I feel disabled mostly because of the antipsychotic quetiapine of which I take a significant dose. Although I had shared this with him before, reading my words seemed to have had a different impact on him I would discover.
Yes. My doctor told me something I would have never ever have imagined any medical practitioner to ever say. He told me I have failed to treat you.
I could not believe what I just heard. First of all we are far from being done. I am still being treated. And I am a thousand times better my dear doctor than the first time I saw you. I cannot even find words to describe the state I was in when I first talked to you and you said yes I will take you as my patient. I could barely speak, yet you were able to translate my pain and understood me.
Today my doctor showed me how he truly listens to his patients. I had talked to him over and over again about reducing the dose of my antipsychotic. He had refused categorically on many different occasions and told me if I did I would relapse. He told me I had to bare the side effects and be patient. He was extremely worried about me.
Today however, he told me that he thought long and hard about my blog piece and decided to change the treatment plan.
He decided to change it to accommodate to my needs and because he had already increased during the past weeks my levothyroxine. [My treatment is based on three pillars: levothyroxine, quetiapine, and rTMS]. I had also a few sessions of rTMS as a back up before this new treatment plan. He also told me that if I don’t respond well to reducing the quetiapine, he would shift me to another antipsychotic. This was all I needed to hear. Hope is the most powerful medicine of all.
I am sharing this story today because it is really a breakthrough on so many levels. I rarely hear of anyone admitting or alluding that they are wrong or even questioning themselves really- especially if they have any kind of authority over you. Two, who has the time to read or listen or care about their patient outside of the 15 minute appointment slot they have? Who cares what they feel, like or dislike? I have seen my share of psychiatrists and usually when I start slightly feeling uncomfortable it means that the relationship is going south and the end is near my friend.
I have all the respect and admiration to you Dr Andy Zamar, a great man, extremely bright and sensitive.
Mind you this is just the top to the iceberg. My admiration for this great doctor has no limit.
I only hope that he has the opportunity to train other fellow psychiatrists.
Thank you for your humanity.
Bipolar, Quetiapine & side effects
Like many days, I was thinking today long and hard about mental illness. How it infiltrates the body and gets deep into it before you even know what hits you.
You wake up one day and you don’t feel fine. You probably ignore it. How long does it take to develop a mental illness? A few months? A few years? Extenuating circumstances? What do you think?
I was obsessed, trying hard to search in my memory looking for the one moment where I became bipolar. Was it a moment to start with?
I recall anxiety, difficulty coping with everyday demands, depression, but I don’t recall mood swings. I also don’t recall a moment or an incident.
Mental illness is not a common cold. It creeped on me a little by little until I was totally submerged and couldn’t breathe. Only then did I know I was ill. I did not have the tools to detect it earlier. How about you?
This is why recovery is difficult. The longer the illness before detection and treatment (whatever the sort- especially if they screw you up) the longer the road to wellness.
Now am better. At least I know what is wrong with me. I am taking meds that work, albeit the fact that they do have side effects. There is no drug in this world that has no side effect.
My thyroid is inactive. So I take a lot and I mean A LOT of levothyroxine without much trouble. My main problem is Quetiapine of which I take 700 mg. I have gained so much weight on it and can’t lose it. It makes me lethargic, slow, drowsy, and I could sleep on it 14 hours plus naps minimum.
Yes I don’t have mood swings. Yes I am not anxious. Yes I am not depressed. Yes I am not hypomanic. But I have no initiative, my IQ is probably half what it was before, I am just plain yoghurt.
Yes I know all them drugs alienate you. But this one is so subtle. Or maybe it is the high dose that is making me unaware of how different I have become.
You know I just want to be me. I haven’t been me since 2016 when I was 36 and now am 39 and am still this other person I don’t know.
Do you feel the same? Are you on Quetiapine? Are you suffering from its side effects like me? Are you thinking of tapering off? Are you scared? Did you do it? Is the grass greener on the other side? Your experience is highly appreciated here from a fellow survivor to another
Bipolar – my disability
My illness is flagrant. It is clear as sunshine. Bright as a star. Big as a 10 cart diamond ring. Obvious to the naked eye…
Yes it is when I have an episode.
But when I don’t…
It is dormant. Blends with the background. Goes unnoticed. Quiet common. Just like the flue. It is a John Doe..
I tend to forget, for am human. And we humans tend to do so. A lovely quality we have. Makes us able to live, to turn the page.
When my illness strikes back, am always surprised. It takes me a few days to adjust. As if it is the very first time am experiencing the symptoms. All fresh.
The pain is new, yet the depth of the scar is familiar. I remember the fear of falling into the abyss of mental illness with all what it means – more meds, more symptoms, more side effects, hospitalization, days in bed, fear of losing my mind, fear of losing control, fear of finally giving in to suicide…
Yet I know I can’t. Something tells me this cannot be the end. I recall the conversations I had, the notes I wrote, specifically for these moments to remind myself not to give in.
I try to summon my strength, the strength I have and the one I don’t, and pretend to stand up. I rise in my dream above myself, above my tears, above my hospital bed and tell my doctors to let me live some more.
But if you are ill like me, you will soon learn that living isn’t the point really. So what is the point of having a life with such an illness that makes hell a walk in the park? On average I get two good weeks a month and if am lucky we can stretch them to three.
I am heavily medicated, but at least the meds I take do work.
I got PTSD. I am being treated for it, but I feel mostly guilty all the time for how my illness affects my loved ones.
That’s where am at now with my bipolar. I cannot always embrace it. I don’t rise above it. I wish I could say it differently, bipolar is my disability…
The New Business Model in Psychiatry
I checked myself yet again at the hospital. It became my full time job really.
Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?
Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!
My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.
When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.
Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.
I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.
While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.
That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.
My business teachers at university always said a good product or service starts by answering a customer pain.
Very well, mental illness is filled with customer pain; be it the patient herself or her family members.
I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.
Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.
Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…