Wednesday, August 30, 2006

The mean reds

You know those days when you get the mean reds.... The blues are because you're getting fat or maybe it's been raining too long. You're sad, that's all. The mean reds are horrible. Suddenly, you're afraid, and you don't know what you're afraid of. Did you ever get that feeling?.... Well, when I get it, the only thing that does any good is to jump into a cab and go to Tiffany's. Calms me down right away. The quietness and the proud look of it. Nothing very bad could happen to you there.

Holly Golightly in Breakfast at Tiffany's gives a great description of depressed anxiety. And like many people who suffer from depression and/or anxiety, she's come up with a way to cope: she goes to Tiffany's and looks in the window, drinking in the unattainable opulence, elegance, and peace.

When I get the mean reds -- when I'm frustrated about dating, apprehensive about school, miserable about my weight -- I have my own version of Tiffany's. I search online for wedding dresses.

Of course, because I'm orthodox, they have to be modest wedding dresses, and those aren't easy to find. Sleeves on wedding dresses are like teeth on chickens these days. Also, I love silk, which is expensive, but I'm not fabulously wealthy, so I try to find discounted or gently-used gowns; I can't envision spending $500 or more on a dress I'm going to wear once.

I save the dresses I like -- as well as modest bridesmaid gowns, flower girl dresses, veils, freshwater pearl tiaras (which I prefer to faux or glass pearls), discounted silk bridal shoes (there's that preference for natural fibers and bargains again...), inexpensive wedding invitations, bridal bouquets (so that when the time comes, I'll be choosing between specific configurations of calla lilies and roses), and potential locales -- in elaborate powerpoint presentations.

I'm not sure if I consider this a rather pathetic endeavor or an incredible expression of optimism. What I do know is that doing this soothes me. Looking at beautiful things can be a comfort, even if you never buy. And when a friend of mine recently got engaged, I had dozens of pictures of gorgeous engagement rings to send her.
Copyright (c) 2006 "Ayelet Survivor"

Monday, August 28, 2006

37.4% body fat

I got a new trainer at my gym today, post-knee injury, and she decided to assess my overall fitness levels. We did a body fat analysis, with me clutching something that looked a little like a hand-held computer game. Of my 160 pounds (according to the gym's scale -- apparently mine weighs a little heavy), 60 are pure fat. That means my body fat is a whopping 37.4%. "Average" range, for women, is 21-24%; "acceptable" is 25-31%. I am technically obese.

The only good news in this is that apparently I only *have* to lose about 20 pounds to be reasonably healthy -- even 10. And my trainer doesn't think I should lose more than 40. When I weighed 99 pounds I was skin and bones, anemic, and prone to dizzy spells; I am probably healthier now. I need to keep a little of my 37.4% body fat. Also, allegedly my body can "remember" being at a (much) lower weight, which should make it a little easier to lose the weight and get back to that point.

I think I'm going to like this trainer -- she really seems to understand how to work around an injury, and by asking me questions about my last workout, she determined how the last trainer hurt me. I've only got a few sessions left, but she'll help me make the most of them. I might buy another block of training sessions; it's expensive, but if it helps me lose weight, it's worth it. And I can definitely deduct it from my taxes, since it's not vanity but the need to get healthy that is driving me to the gym.

She asked me what kind of exercise I used to do -- what exercises I liked. I had to say I couldn't really think of any; I'd done some yoga and liked it, but at this weight I'm too unwieldy. I forgot to tell her that I like to dance, but that kind of exercise would probably be too hard on my knees anyway. I'm seeing her again tomorrow, and I'm almost looking forward to it.
Copyright (c) 2006 "Ayelet Survivor"

Sunday, August 27, 2006

Margarine is making me depressed

A recent study, published in the Journal of Lipid Research, found that a lack of omega-6 fatty acids -- theorized to contribute to depression -- might be caused in part by a surfeit of omega-3 fatty acids, found in meat, eggs, poultry, cereals, breads, baked goods, vegetable oils, and my favorite, margarine. Apparently consuming too many omega-3's can block your omega-6's.

When I used to take Seroquel, a medication used to treat bipolar disorder and schizophrenia, I had to stop drinking grapefruit juice because the juice interferes with breakdown of the drug, effectively potentiating the medication's effects. Patients taking a class of antidepressants called MAOIs can't consume red wine, aged cheese and a host of other foods.

So I'm used to the idea that having a disorder might limit what I can eat or drink. But margarine, if not exactly wholesome, always seemed so harmless. I know it sometimes has trans fats, which increase bad cholesterol and decrease good cholesterol. But I never thought that margarine could be hazardous to my mental health.

I love to slather Shedd's Spread on a big pile of vegetables -- brussels sprouts, peas, broccoli -- and call it dinner. Now I'm wondering if I have to limit my margarine intake in order to defeat my depression.
Copyright (c) 2006 "Ayelet Survivor"

Saturday, August 26, 2006

More from the media

Recently I received this e-mail:

Dear "Ayelet,"

I'm a reporter for the Justice, the newspaper at Brandeis. I am writing about Sarah Adelman's tragic suicide. She graduated from Brandeis in 2004 and committed suicide last month. I just read your "open letter to the community" on your struggle with depression. I would love to speak with you for my article. I know that you didn't know Sarah, but your perspective on the community would be very useful. I will not print your name in the newspaper. It will be totally anonymous.

I wrote back:

Rachel, I'd be happy to communicate with you, but I'd prefer to do it anonymously. Please e-mail me a list of questions. I'll answer them as best I can, and if you have further questions, I can elaborate.

She sent me a list of questions, and I responded as honestly as I could:

1. What do you think your blog does for people? Judging by some of the comments, it seems like you're not alone in feeling a pressure to obtain a "normal life."

I hope that my blog will be a place where people can find information (through the links on the right) about different mental illnesses, about places like the Albert Ellis Institute where they can get low-cost therapy, about preventing suicide in a loved one, and about support groups they can attend so they won't feel so alone.

I also hope that by posting about my struggles, I'll help them see that these are issues many people struggle with, so that maybe they won't feel so different and damaged. As you noted, I am not alone. A lot of people struggle with mood disorders, and I want to be honest about what I go through.

Finally, I want to educate the "normals" -- a term used by Dr. Fred Frese, an eminent psychologist who has schizophrenia, to describe people without mental illness -- about how hard I work to keep up a stable life.

2. Can you tell me a little about the pressure you've encountered as an orthodox woman to find a mate? Where does that pressure come from? Do you find that it's the same for men?

The pressure to find a husband for me has been entirely internal. It's something I wanted all my life, even before I became orthodox. I know that others in my community feel pressure from their families, which I've luckily been spared, more or less. My grandmother used to ask me about my dating life, and my nieces are very eager to see me get married -- "I want more cousins!" "Why aren't you married already!"

There's also a near-constant stream of engagements among the lucky ones in the community. Every time I hear about one of these lucky ones, I feel tremendous envy -- why couldn't it happen to me?

It's hard to be orthodox and single, because Judaism is a very family-oriented religion. If you don't have a spouse, you're always scrambling to find a place to have shabbos meals or you're stuck at home alone. If you're married, you can have a cozy tete-a-tete for both meals and feel like nothing's missing. (That is, until you want to add children to the mix.)

Children are another factor. As I get older, I worry that I won't find a husband while I'm still fertile. Friends of mine who married later in life are having trouble conceiving. But it's not impossible, so I try not to focus on it too much.

I think a lot of orthodox men are looking to get married, but I'm not sure I'm the best person to ask about their state of mind. If I understood them, I might be married by now.

3. What, if anything, do you think the orthodox community could have done to prevent Sarah's suicide?

Quite honestly, I don't think there's anything the community could have done to prevent Sarah Adelman's suicide. I don't think that the pressure to get married was the sole factor in her death; if it were, there would be a lot more suicides on the Upper West Side. Sarah had close friends and a terrible disease, and the disease proved more powerful.

When I was depressed, there were times that I had trouble walking over bridges or on subway platforms because the urge to jump was so strong. But my actual suicide attempt, an overdose, was not premeditated; it was impulsive, and that's what probably saved my life. I was found, given a ton of intensive medical treatment, and I survived.

I wasn't that set on dying. If I were, I would have jumped. That's why I say that there's not much the orthodox community could have done to save Sarah's life.

However, I do think that we can make the West Side a more welcoming, inclusive and supportive place, and I'm going to be working with local synagogues on some program ideas. Since we haven't had an initial meeting I can't tell you much more about it, but after Sarah's death, the community rallied, holding "Safe Spaces" discussion groups led by mental health professionals so that people could speak out in a safe environment and generate ideas to strengthen the community. These ideas, and I have one of my own, are the first step. Please check my blog from time to time, since I plan to chart the growth of these developments.

4. Describe the shame associated with seeking psychiatric help in the orthodox community. Is it at all particular to the orthodox community? How should the community address mental health?

There's a general stigma attached to seeking psychiatric help in American society, but I do think it's a little worse in the orthodox world. Of course, it depends which slice of the orthodox world you're considering. The more black-hat/chassidish/yeshivish Jews tend not to be very educated about mental illness, and such a diagnosis is more likely to kill a person's shidduch chances there than in the more modern orthodox world.

But even in the modern orthodox community, a label of mental illness can certainly diminish the number of people interested in marrying a person. I am extremely cautious about whom I tell that I have this disease; only my closest, closest friends know. I don't want this diagnosis to be the first thing people know about me.

Ideally, the community should view mental health as they would any other chronic illness -- diabetes, epilepsy, Crohn's Disease. It's something you take medication to manage, and seek therapy to deal with. It's not any different from any of those.

I wish I could speak openly about my illness and how I manage it. I'm not ashamed of having it, and I'm extremely proud of how I cope. But as I said earlier, I don't want it to be the first thing a prospective husband learns about me.

If I get married, I want to "come out" as a person with bipolar disorder. I've already gotten into graduate school, so I wouldn't have to worry about jeopardizing my chances at that.

5. When and why did you start blogging?

I started my blog on August 2, right after Sarah's death. As I wrote,

I always thought blogging was the ultimate in narcissism unless you really had something to say. I didn't think that my life qualified as unique or interesting enough.

That changed a little over a week ago, when a beautiful, vibrant young woman from our community took her life. I was luckier than she was -- when I overdosed on the medication I take for manic depression, I was in a coma for a week but ultimately survived. That's why I feel I have to share my experience now. Because she didn't need to die.


6. Where are you from? What type of orthodoxy do you practice?

I'm an "out-of-towner" -- i.e., I didn't grow up in NYC or the tri-state area. I identify as modern orthodox. I watch TV and movies, but I dress with a reasonable level of modesty (i.e., no tank tops or short shorts).
Copyright (c) 2006 "Ayelet Survivor"

Friday, August 25, 2006

Hearing from families

My original essay, the first entry on this blog, was recently published on the website of The Blueprint, a non-denominational newspaper for young Jews in Manhattan. I received a very touching e-mail in response:

I just read your open letter to the community, and I am filled with deep respect for you, what you wrote and what you have become. It also filled me with tears as I recall my sister and the exact depression she suffered that you so vividly describe.

Unfortunately, she "successfully" took her own life at age 50; it's been ten years since I gave the eulogy at her funeral. She was a published author and winner of literary awards, a magazine poetry editor, a Ph.D in English literature, fluent in Hebrew, a lifetime student and teacher of Jewish texts... so very accomplished, but always feeling unaccomplished and unworthy.

In the eulogy, I referred to a Chassidic saying that "all descents lead to ascents," and went on to say that my sister's life was filled with descents, and did indeed lead to ascents that would bring peace and joy for many of the rest of us, but didn't for her. I hoped that her final ascent brought her the happiness and joy that so eluded her in this world.

I applaud you for sharing what you did for us to learn about depression and to hopefully be motivated to help others. Kol haKavod and may your life continue to be blessed.

I was so glad to hear from him, although I feel terrible for his loss. It's another tragic example of how badly depression can distort a person's thinking and self-image. Depression is more than just feeling sad. It's a tremendous amount of guilt, and feeling worthless.

When I was depressed, I used to think that all the money that had been expended on my upbringing and education -- trips to Europe, tuition at an expensive private university, braces, piano lessons, and so on -- had been wasted on me, because I was a worthless loafer who'd never amounted to anything. Making Phi Beta Kappa and graduating Magna cum Laude didn't mean anything, because I hadn't accomplished anything after college. Even though I was (usually) employed and self-supporting, I believed I was a complete failure. I hadn't gone to graduate school, as all my family and most of my friends had. I didn't have a career.

But the story of this woman, whose grieving brother wrote me, proves that no amount of achievement can impress a person who is depressed.

William Styron, the acclaimed award-winning author of Sophie's Choice and other novels, has written and spoken openly about coping with depression. Struck for the first time at the age of 60, Styron describes depression thusly:

In depression this faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come -– not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying -– or from discomfort to relative comfort, or from boredom to activity -– but moving from pain to pain. One does not abandon, even briefly, one's bed of nails, but is attached to it wherever one goes.

Styron, of course, is one of many artists struck by the disease. It's tempting to imagine that mental illness mostly targets creative people. However, when I was in the mental hospital, I wasn't sharing space with a bevy of strikingly talented people. Most were middle- to lower-middle-class ordinary folks. One guy owned a dance studio with his wife, but he wasn't a dancer; he handled the books and other management details. Another was a cattle farmer, who suffered from depression and anorexia. One was a mathemetician and composed music. Others were secretaries, housewives, college students.

Depression doesn't discriminate. It's just that artistic types create lasting mementos of their illness in the form of poems, books, paintings, plays, or musical compositions.

Learning about other families' experiences can provide some good perspective. During my last depression, my mother went with me to a Mood Disorder Support Group meeting. They have simultaneous sessions for people with unipolar depression, bipolar disorder, kids in their twenties, and friends and family members.

As we left the building where the groups meet, I asked her how it was.

"I just felt so sorry for all of those people," she said. "There was a young woman with a new baby whose husband is in the hospital with depression, and a woman whose ex-husband has bipolar disorder and is making her life miserable...."

For some reason, that made me feel a little better -- to know that I haven't done the worst possible thing to my mother by overdosing and spending a week in a coma. Other families have it worse.

And I feel lucky. Which is the right perspective to keep, because when you have a mental illness, it's easy to feel unlucky. I have to say, though, that I'm very lucky. Even though my illness is difficult to manage, I don't fall into the category they call "severely and persistently mentally ill." I live independently; I worked full-time and earned a master's degree; I'm in a doctoral program. And my dating life, while frustrating, is no worse than the average single West Sider's; I have dates, and I've had relationships.

As hard as my life is, it's not as bad as it could be. I have to remind myself of that every day. That's what Albert Ellis taught me; it's the REBT (rational-emotive behavior therapy) approach. During one session, when I was kvetching about how hard my life was, he brought up the late Christy Brown, author of My Left Foot. Despite his "gruesome" disability (Al's words, not mine), Brown became a painter, poet, novelist, and husband. In Al's opinion, my disability was nothing I couldn't learn to live with; if Christy could hack it, so could I.
Copyright (c) 2006 "Ayelet Survivor"

Thursday, August 24, 2006

More insurance woes

I just spent $5,076.00 to buy health insurance through my school's insurance program. And that won't cover all of my expenses. I only get $750.00 to spend on mental health care; with my psychiatrist at $160.00 a session, that will evaporate quickly. I also only get $750.00 for prescriptions, which won't cover a full year's worth of my medications. And two of them are branded medications -- not cheap.

I went to an independent insurance agent to see if his plan was any better. It would cost me about $300.00 a month -- and $3,600.00 is less than $5,076.00. It also has a long-term prescription plan that would cover my medication. But here's the catch: there's a $2,000.00 deductible for my out-of-network doctor visits. That means I'd have to spend $2,000.00 before I started seeing any reimbursements for my psychiatrist appointments.

I'm very frustrated. If I had diabetes, I wouldn't have to worry about how I would pay for my insulin. But because my disorder is "mental" -- and let me tell you, in every way depression is very much a PHYSICAL illness -- I don't enjoy the same level of coverage.

There are a lot of people working hard to ensure that mental health care is covered equitably with other kinds of health care needs. I shouldn't be shortchanged when a diabetic is fully covered.
Copyright (c) 2006 "Ayelet Survivor"

Wednesday, August 23, 2006

Getting the word out

I just heard back from the Jewish Week, one of the media to which I submitted the essay that makes up the first post on this blog. They're going to run it soon. I'm thrilled, since they have a tremendous reach. They usually don't allow anonymous submissions, but given the sensitive nature of the topic they're making an exception. (Of course, they also haven't suggested paying me.)

Naturally, the extroverted attention-seeker in me is a little disappointed that I'm doing all this anonymously. I'm craving recognition and acclaim.

This is not an aspect of myself that I'm proud of. At the Albert Ellis Institute I was administered the MCMI, a psychological test that measures personality and psychopathology. It's not supposed to be used as a diagnostic tool, and interestingly, my scores on the depression and mania subscales were unremarkable. Remarkable, however, was my score on the narcissism scale -- I wouldn't say it was off the charts, but it was pretty high.

Since I was a small child, I've always craved attention. I loved performing in plays and singing in concerts. I dreamed about being a Broadway star. I tried, fairly unsuccessfully, to be a class clown, but my sense of humor didn't fully develop until years after college.

Now it's something I'm known for -- and I still love being the center of attention. But like most things you want, the more you chase it, the more it slips away. Desperation isn't an attractive quality. Sometimes I wonder if being the funny girl is going to catch me the man of my dreams, or just drive him away.

A malevolent narcissist is another term for a psychopath. I like to joke that as a benevolent narcissist, I'm going to use my desire to be the center of attention for the betterment of society. I see myself writing articles and books as an expert in my field, and appearing on TV as a talking head.

And maybe someday, if I get married, I can talk and write about my personal experiences. That's what I want to do more than anything. Talk about surviving and struggling with the illness.
Copyright (c) 2006 "Ayelet Survivor"

Monday, August 21, 2006

Is a free dinner too high a price to pay?

Went to a sheva brachot for my ex Yishai and his child bride at a very fancy Manhattan kosher restaurant. Endured hearing "Im yirtze hashem by you!" (Gd willing, you'll get married too) a few times. I really hate hearing that, because most of the time it feels like Gd -- and everyone else -- doesn't care if I never get married.

I was feeling more fragile than usual because earlier that day I had to deal with a very annoying type: the frum guy on the online prowl for a booty call.

One website allows you to post a voice message, and since I did that, I've been getting many more visits to my profile. But I haven't noticed an increase in actual eligibles, and today's viewer was particularly pernicious.

I should have known he wasn't serious when he told me that my picture was sexy and that, while he is shomer shabbat and shomer kashrut, he's not shomer negiah -- i.e., he's sexually active. I told him that while I wasn't shomeret negiah, I preferred to wait a while and get to know someone before entering those waters. He assured me he felt the same way.

We had planned to go to brunch today, but I didn't hear from him. Then he sent me an instant message claiming that he had tried to call me but got a busy signal (unlikely, since -- like most 21st-century phone owners -- I have call waiting). I've given him a pseudonym to protect his anonymity.

Scumbag: ok,i tried calling this morning

Scumbag: but it was alkways busy

Ayelet: busy?

Ayelet: busy signal?

Scumbag: yes

Ayelet: that's so weird -- I've got call waiting

Ayelet: at least I'm paying for it

Ayelet: when did u call?

Scumbag: whatever -- do you like lamb?

Ayelet: sure

Scumbag: ever ate at Elijah's a nice rack of lamb?

Scumbag: or lamb chops?

Ayelet: never been to Elijah's

Ayelet: never even heard of it, is it in Brooklyn?

Scumbag: got dinner plans?

Ayelet: yes, I'm going to a sheva brachos

Scumbag: then Elijah is off

Ayelet: forever?

Ayelet: it's tonight or never?

Scumbag: nope

Scumbag: tommorow then?

Ayelet: tomorrow is fine

Scumbag: ok,so tommorow 6pm at elijah's?

Ayelet: sounds fine, where is it?

Scumbag: flatbush

Scumbag: know prison break?

Ayelet: seen commercials for it, never watched

Scumbag: ok,tommorow starts a new season

Scumbag: we can see that after dinner

Scumbag: i cant miss it

Ayelet: where r we goign to see it?

Scumbag: at my place or yours

Ayelet: not a good idea

Ayelet: I told u -- public places ONLY for the first month

Scumbag: i am a man of honor

Ayelet: u can take me to Elijah's on Tuesday when u don't have must-see TV

Scumbag: we can be on a deserted island and nothing wil lhappen

Ayelet: I am a woman of very weak will, and besides, I don't want u to see my apartment until u really like me

Scumbag: so my place then

Ayelet: no, I'm really not comfortable with that

Scumbag: fair enough

Scumbag: it seems to me that we are in different places in life now

Ayelet: ?

Ayelet: so I was right about u all along

Scumbag: i recenly broke up from a long relationship

Scumbag: and i dont really have much time for these things

Ayelet: whatever -- don't waste any more of my time

Ayelet: if you're not in this for tachlis, I don't have time for u

Scumbag: bye

Did he really think I could be bought for the price of a lamb dinner?

I don't know why I'm so disappointed, or even surprised. This isn't the first time a frum guy has made me an indecent proposal. But it was dispiriting to hear this from a guy who contacted me the day after my ex's wedding, a wedding at which I davened so hard. And to hear this right before the month of Elul, when all of us should be on our best behavior, especially toward others.

I guess being a sought-after sex object is better than not being desired by anyone for anything. But not much. I'm feeling so jaded and discouraged. The sheva brachot was lovely, but coming on the heels of this encounter, it made me feel like no one will ever see me as worthy of love and marriage -- just as a sexy body to be used and discarded.
Copyright (c) 2006 "Ayelet Survivor"

Saturday, August 19, 2006

Lonely in a crowd

Today I went to shalosh seudos at a synagogue I don't ordinarily frequent. Two friends of mine were supposed to meet me there but never showed. I ended up sitting by myself, even though I was across from one person and next to another. Neither of them made much of an attempt to chat me up.

It's hard for people who don't know a lot of people to meet new people. The West Side is not a friendly place, despite many official efforts to change that. My first year on the West Side was incredibly lonely and painful; I cried a lot, stuffing a towel in my mouth so that the girl I shared a room with wouldn't hear. Even my four roommates (for a while I lived in one of those multi-person apartment in the "dorms," aka the Key Westmont) weren't really open to welcoming me into their lives. It took me quite a while to make friends, and then when they got married, they'd move away, forcing me to make a whole new circle of friends.

It was exhausting, and at various points I'd give up. One of the reasons so few people know about my disorder is that I don't really have a lot of close friends, especially not on the West Side. When I stayed away from synagogue for months at a time because I was depressed and couldn't stand to be alone in the crowd, few people noticed. I became very isolated, which is very unhealthy for a person who's depressed.

For a while I managed to make a new cluster of friends, all of whom were older singles like me. Then, one after another, they began getting married. I'm lucky that one of them still lives on the West Side, but her husband and children naturally demand a lot of her time. Another is getting married soon and moving to a city far, far away, and I'm really going to miss her.

I don't know what can be done to make the West Side less like high school and more like a warm, welcoming place. After Sarah Adelman's death, YU sponsored a Safe Spaces program: discussion groups led by mental health professionals to help people deal with the issues and emotions the tragedy brought up. Several ideas for future programming were generated:
  1. Monthly discussion groups on various mental health topics
  2. Regular guest speakers on various mental health topics
  3. Mental health referral lists available at all shuls and shul websites (already being implemented)
  4. Regular "orientation to Jewish New York" seminars for newcomers to the West Side
  5. Weekly host families/singles for shabbat meals
  6. Dating support groups and/or hotline
  7. Women group activities/empowerment seminars
  8. Male group activities
  9. UWS mental health professionals meetings/collaboration

Some of these are good ideas, especially hooking people up for Shabbos meals: I for one hate calling people to invite myself over for a meal. Even when I know they don't mind me calling, I don't like doing it, which leaves me at home alone more often than not. I've also got an idea of my own that I want to propose; more on that another time.

At the wedding last Thursday, I was talking with a former West Side resident who now lives in Teaneck with her husband and children. She had an interesting take on the male/female group suggestion. Since part of the "singles problem" could be the natural difficulty men and women have communicating (I'm not a fan of Men are from Mars, Women are from Venus because I'm not into pop psychology, but he makes a number of valid points), maybe it would be better to have coed groups. People could gain a lot of perspective from discussing issues of dating and loneliness with the opposite sex. (I'm also not a fan of "female empowerment." What do they propose we do, go into the Central Park Ramble and bang on drums?)
Copyright (c) 2006 "Ayelet Survivor"

Friday, August 18, 2006

Dealing with rejection

Like many hopeful Jewish singles, I've put myself on a number of dating websites, hoping to find true love.

What I usually find -- or what finds me -- are men 20 or more years my senior checking out my profile. Even though I state clearly that I'm not interested in men more than 10 years older than I am. And they frequently send me messages, hoping against hope that I'll want them.

So on the one hand, I'm dealing out a lot of rejection. On the other, I've often found that my messages to men in my age range are ignored -- unread -- or unanswered. They can't take 2 seconds to hit the "tell so-and-so you're not interested" automatic message.

I see the guys I've contacted who never got back to me online all the time. This could mean one of two things:
  • They're too rude and/or picky to respond to most of the girls who contact them; or
  • The girls they do condescend to contact aren't interested.

Or both! It's amazing the number of men who describe themselves as menshes, sensitive, kind, caring, and/or considerate (or all of the above) and don't respond to first contacts.

This isn't a gender issue, though: there are plenty of people on both sides of the dating coin who are rude and inconsiderate. Sometimes I almost feel like giving up on online dating -- but to paraphrase Winston Churchill, online dating is the worst way to find your soulmate, except for all the others.

Dating is an activity full of opportunities for rejection. And for vulnerable people, that's difficult to deal with. It also seems that I'm only presented with opportunities that I'm not at all interested in -- just this week one shadchanit I know got a call from a Lubavitcher 12 years my senior, begging her to ask me to go out with him.

Meanwhile, the men I want are aloof to me. I don't think it's a case of Groucho Marxitis -- "I refuse to join any club that would have me as a member." And when I contacted that same shadchanit about a guy my age, she told me that he only dates women five years younger than he is.

That's even more frustrating than the weight issue. I can always lose weight, if I really put my mind to it, but I can't erase 10 years from my age. And it infuriates me that so many men are so locked into this ageist mindset. Including the decrepit geezers who keep e-mailing me. Especially those geezers. Why can't they date women their own age -- and leave me alone?
Copyright (c) 2006 "Ayelet Survivor"

Thursday, August 17, 2006

Weddings are mixed blessings

Just got home from a wedding. Someone else's wedding, obviously. The chatan is a good friend of mine, actually an ex-boyfriend, Yishai; the kallah is ten years younger than I am.

I don't begrudge him happiness; I truly wish him well. But it hurts to go to another woman's wedding, especially such a young one. I feel like it's never going to be my turn.

It's a good thing they serve mixed drinks at these mixed blessings.

The wedding was in Queens, so I got a ride in with friends of mine -- Eric and Ahuva. Both of them used to be "older singles"; they've been married for many years now and have kids, but they remember what it was like to go to weddings and feel like stale bread left up on the shelf. It was great to be able to say, "I'm happy for the happy couple, but I'm sad for me." They didn't judge; they just advised me to daven for my single friends, and I did. I just sent this IM to my friend Dvora, who lives in Israel and communicates with me primarily via IM and email:

I davened for you tonight -- I went to a wedding and was feeling a little sorry for myself; the people who gave me a ride told me to daven for my single friends, so I davened for you. I want you to know, I gave Gd a very stern talking-to. "Dvora's waited long enough for someone to appreciate how wonderful she is and make her happy," I told Him. "So I want her to find the right guy SOON." We'll see if He was listening...

Indeed.

One of the other guests at the wedding was on duty at the emergency room when I was brought in after my overdose. A few years ago, she introduced herself to me at a kiddush after davening at one of the UWS synagogues, and just told me how happy she was to see me healthy and functioning well. (Or appearing to.)

It's great to talk to somebody who knows how far I've come and how hard I've worked to get here. Sometimes I can hardly believe it. There are days, when I'm depressed, that I only get out of bed to go to the bathroom. During my last depressive episode I didn't bathe for weeks, and only left the apartment to get food or to see my psychiatrist. But usually I'm more capable than that.

The thing is, I think people should be impressed by the fact that I have this illness, yet I'm capable of holding a job, going to grad school, babysitting, writing.... I have to work twice as hard to cope with my life, but I'm coping.

It annoys me that I do this juggling act all day, every day, and no one gives me props for being such an awesome juggler. It was easier when I was in therapy; then I heard every week how terrific I was doing, and since I was in group therapy for a while as well, I got positive feedback from a bunch of people.

These days, I get praise from my psychiatrist and my closest friends, who know what I have to contend with. But I feel like I've developed this amazing skill I can't brag about. If I studied another language or learned how to throw pots, I could show off a little. I can't expect people to be impressed that I can shower regularly now. They assume everyone can do that.

But they don't know how hard taking a shower or trying to carry out any kind of purposeful activity is for a depressed person. You can't concentrate even on the simple steps that it takes to accomplish something small like brushing your teeth. Your neurotransmitters aren't functioning well; the electrical impulses that carry thoughts through the brain are being interrupted. So I develop gum disease during my depressive episodes. Somehow I can't even go through the motions -- putting toothpaste on the brush, brushing, rinsing. It's all too complicated and overwhelming.

I wish I could explain this better. I'm not at the top of my game these days. I really hope that starting school will pick my mood up a little.

And I wish I could speak out openly about coping with mental illness and trying to live a more or less normal life. If I were married, I know I would. I love public speaking, and I'm good at it. But I don't want the illness to be the first thing men know about me. I can't risk that. My mother thinks even this blog is too risky; my psychiatrist and friends disagree.
Copyright (c) 2006 "Ayelet Survivor"

Wednesday, August 16, 2006

I knew it!

Research has just demonstrated that marriage has excellent antidepressant qualities.

Of course, it's no substitute for therapy and medication. But apparently everyone who's been telling me that marriage isn't all it's cracked up to be is WRONG. (Of course, one of those people is now divorced, and another is cheating.)

Maybe I should tell the shadchanim I know that it's imperative that I get married as soon as possible -- it could save my life. Pikuach nefesh. That oughta light a fire under them.
Copyright (c) 2006 "Ayelet Survivor"

Getting started is the hardest part

One of the more annoying symptoms of depression, at least in my case, is a difficulty in getting started and a tendency to be easily frustrated by minor setbacks. This has proven abundantly true in trying to lose weight, which is an undertaking rife with minor setbacks.

After gaining a ton of weight during my last depressive episode nearly a year ago, I finally started trying to lose it and joined a gym -- only to injure my knees during a personal training session. They've been healing, and I've been cleared to return to the gym, but it's proving impossible to get myself there.

Part of the problem is the low-level anxiety I feel whenever leaving my apartment, which is characteristic of my mood -- slightly depressed -- at this point. I just feel more comfortable being home alone, not having to deal with people or to be looked at. But isolating myself is not healthy, and sitting at home is not going to help me lose any weight.

It's hard to explain how depression feels. Even mild depression makes every mood worse. I'm irritable, anxious, and very down on myself. I waver between considering myself the laziest person on earth and trying to cut myself too much slack. I get so angry over minor things -- I want to shove people on the subway who block me from leaving the car, I snap at my family at the slightest provocation, I resent friends of mine who seem to be having an easier time of things.

And I know that exercising will help my mood immensely. There are no medication changes that would be prudent at this point. It's all exercise. And I just have so much trouble pushing myself out the door.

I'm hoping that after school starts, I'll be more energized by the excitement of learning new things and having a new focus, and will start wanting to go to the gym more regularly.
Copyright (c) 2006 "Ayelet Survivor"

Monday, August 14, 2006

COBRA: A poisonous way to get health care

According to the Department of Labor,

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.

It's the worst kind of health care, except for no health care. I've been "between jobs" a number of times, and COBRA can really eat a hole in your savings. Between COBRA and rent alone, I'm spending more than I get in unemployment benefits. Of course, NYC is an expensive place to live, but COBRA premiums are outrageous. I'm not comforted by the knowledge that I can deduct them from my taxes.

Also ironic is the poor coverage that my graduate program provides for mental health care. We're supposed to be learning how to treat mental illnesses, and they provide much less coverage than for pregnancy or a host of other "normal" conditions. It infuriates me. When studying for your doctorate in clinical psych, students are often advised to enter therapy. It would help if the school provided decent support for us to do that!
Copyright (c) 2006 "Ayelet Survivor"

Thursday, August 10, 2006

Weighty matters

Depression is an interesting illness, with a whole bunch of symptoms to choose from. Sometimes it makes you overeat, sometimes it makes you undereat. As a result, my weight has ranged between 99 and 165 pounds.

Right now I'm at 165 and not happy about it. I had a bad depression last August/September, when my insurance decided that I should start taking a generic version of Lithobid. My body disagreed; I started feeling dizzy, shaky, and out of it. After I stopped taking the generic and the lithium left my system, my mood crashed abruptly. I was wretchedly anxious (anxiety and depression are closely linked). I started the brand-name medication again, but until it reached a therapeutic level, I dealt with the anxiety by eating Entenmann's cakes and donuts. Almost a year later, and the weight's sticking.

It's hard to look in the mirror and see a face you don't recognize. To outgrow your shoes as well as your clothes. And to be rejected by men as unattractive. The spike in my cholesterol and triglycerides has my doctor worried, too.

Of course, during my first depression, my weight sank to 99 pounds, and that didn't make me happy either. I was so bony that when I tried on a silk knit turtleneck sweater, my collarbones were clearly visible beneath the fabric. Only time in my life that I've been a size 2, and I wasn't proud of it. Because even seeing double digits on the scale couldn't shake the misery gripping me.

And when my Lithium dose was raised from 600 to 900 milligrams, I lost 30 pounds in less than two months. I needed to lose it; I had gained 30 pounds the year before I started graduate school, because I hated my job and felt rudderless, like I'd never find the career I was meant to pursue. Once I started grad school, and once I started a higher dose of lithium, the weight came off effortlessly. Later my doctor raised my lithium dose even higher, and I felt sick. Dizzy, nauseated, couldn't eat. And I lost even more weight.

Then I got a new doctor, the one I revere, Dr. Jan Roda. The only psychiatrist in NYC whom I'd recommend. It's been a struggle for us to find the right medications, though, because bipolar is an illness of instability. At one point I was taking Risperdal, an atypical antipsychotic that's often prescribed for bipolar. It made me hungry all the time. Even when I could feel my belly was distended with food I'd scarfed down, I'd keep scarfing. And I gained back a lot of the weight I lost. On top of that, the pounds from last year's depression weigh heavily on me.

I've even considered increasing my lithium dose. Temporarily. Just to kick-start a weight loss. But the risk of liver or kidney damage scares me. Even though my overdose didn't damage any of my major organs, I'm afraid to push my luck. Also, the weight you lose by stopping eating clearly comes back to haunt you; I'm living proof.
Copyright (c) 2006 "Ayelet Survivor"

Tuesday, August 08, 2006

Danny Bonaduce: World's funniest former mental patient

I rely on my sense of humor to defuse anger and anxiety. It was something I reached for as soon as I woke up from the coma: "That's what you get when you overdose," I told myself (I couldn't talk because I was on a ventilator). "They tie you to the bed. It's not a gesture that inspires trust."

I wanted to call myself the world's funniest former mental patient, but I think that title rightly belongs to Danny Bonaduce, former child star, dj, actor, and reality TV force of nature. I was thinking about him tonight because I remember a great line from his reality show, "Breaking Bonaduce": "I'm bipolar. I take enough pills to get full."

I thought about Danny tonight as I swallowed my handful of pills. They include:
  1. three pink 300-mg tablets of Lithobid, a time-release form of lithium, which is used to treat bipolar disorder
  2. one white 45-mg caplet of Remeron, an antidepressant, the maximum dose; and
  3. one yellowish-green/teal blue 60-mg capsule of Cymbalta, another antidepressant, the maximum dose.
On top of that I take:
  1. a multivitamin;
  2. a calcium supplement -- supposed to help me sleep; calcium helps relax your muscles (this is probably why people recommend a glass of warm milk at bedtime);
  3. chromium picolinate -- supposed to boost my metabolism, since I'm trying to lose the weight I gained while taking Risperdal, which helped me for a bit and then stopped working, and during my last depressive episode; and
  4. two softgels containing fish oil. Fish is brain food, as the old saying goes; omega-3 fatty acids are supposed to be a natural antidepressant. I have to be careful with these -- when I took a higher dose, I developed a low-grade fever and lassitude.
At least I only have to take pills once a day, at bedtime. When I was put on Neurontin, an anticonvulsant thought to have mood stabilizing properties (it's no longer used for that purpose; no studies have shown it to have any effect on mood), I had to take it three times a day because it's metabolized so quickly. If I were taking an SSRI like Prozac or Celexa, I'd have to take them in the morning because they're energizing, so I'd be popping pills twice a day. Instead I take everything at night.

Also, I'm down to three medications, whereas only a few months ago I was taking five. Part of me wonders if it was smart to discontinue the other two, since I've been feeling down lately, but that could be due to other factors. Moreover, when I start school my health insurance is going to be more limited in scope than the insurance I get through my current employer, so the less I spend out of pocket, the better.
Copyright (c) 2006 "Ayelet Survivor"

Monday, August 07, 2006

Reaching out

A few people have commented on the essay I posted on bangitout, and tonight I got my first email asking for help. I'm going to share most of that email and my response, redacting any information that could be used to identify the person.

Dear "Ayelet",

I was diagnosed with bipolar illness when I was 20. It was really nice reading your open letter.

I have been to countless therapists and psychiatrists since I was a child. I have been on lots of different meds. My current psychiatrist has really helped me a lot, but I feel like we're not really getting anywhere right now.

I live with my parents. I want to get my own apartment but honestly I'm scared that I won't be able to handle it, and then I'm afraid I'll fall into a depression. So I feel pretty confused about what to do.

The thing that I want to talk to you about is as follows: I take 5 different meds every single day and I try to be happy but I'm scared. I'm afraid that I am never going to get married. I'm not even asking for kids, kids would be great but I just want a special person to be with, to spend time with, to do fun things with, and most importantly to share love with.

The bottom line is that I pray for death each and every night, because I want to go to Olam Habah, I want the pain to end, I want peace and happiness. I know it's assur to kill yourself and I would never do it because I know that's not what Hashem wants. I'm not a danger to myself or to others. I just want to be happy, but I don't know how to find happiness.

I would really love it if you could write back to me with some words of wisdom, encouragement, or just write me some bullshit to pretend that you care about me and my letter.


I wrote back:

Thanks so much for writing to me. I'm so sorry you're in so much pain; I hate to think you're praying to die. I don't have too much wisdom to share so far, but here goes.

I know an exceptional psychiatrist -- mine -- who specializes in mood disorders. He is very respectful, very kind, and very thorough. He's originally from Czechoslovakia, and I really feel like he knows what he is doing. His name is Jan Roda, and his phone number is (212) 752-8919. He would be an excellent person to see to manage your medications. I used to take 5, now I'm down to 3. I definitely think you should get your medications under control before trying to get your own apartment.

I also think you could benefit from some therapy that actually works. I would recommend you contact the Albert Ellis Institute. I was in therapy there for about four years, and it helped me immensely.

Have you ever been to a support group? The Mood Disorders Support Group has regular meetings for people who are going through similar tough times as you are, and also has a friends and family group. My mother went to one of their meetings and got a lot out of it.

I don't have any easy answers for you concerning your future in terms of marriage and children. But I think that getting into a better medication regimen and better therapy would be a big step to take.

Please don't give up hope. I'm working hard at my life, but good things are happening. And please keep in touch.


If for no other reason than to try to help this one individual, I'm so glad I've reached out.
Copyright (c) 2006 "Ayelet Survivor" target=_

Sunday, August 06, 2006

Being single

Like many young orthodox Jews on the Upper West Side, I'm single and not particularly happy about it.

Quite honestly, I don't know what to do. I'm on a number of online dating sites, I go to shul and social events, and frankly I'm sick to death of looking. I know that being unmarried (and feeling hopeless about ever getting married) was a factor in my suicide attempt, but while I've had quite a bit of therapy to help me accept the less preferable possibility that I'll never get married, I still want to.

I really wish that the married couples I know would make more of an effort to introduce me to eligible singles. Unfortunately, few of them seem to have any inclination in that direction. And it's not because I haven't asked.

I also wish that more married couples would make more of an effort to invite singles over for Shabbos, because one thing I've never gotten used to is calling someone up and asking them to invite me. I do it, because otherwise I'd spend every Shabbos by myself, but I hate it. I've been to many couples for a Shabbos meal, but I'm always reluctant to call upon them again for another go. And if I wait for them to call... they won't.

If I ever do get married, I hope that my husband and I will take some time out of our busy busy lives to reach out to singles, hosting them for shabbos and trying to match them up with each other. I've tried to set up a few of my friends, but I feel like no one reciprocates the effort.

I wish I could end this post with something inspirational, witty, or insightful, but I can't. Right now I'm just sad and frustrated. I guess the good thing about a blog is that I can get these feelings out, alongside more useful or interesting material.
Copyright (c) 2006 "Ayelet Survivor"

Thursday, August 03, 2006

Fasting and psychiatric medication: a dangerous mix

Today was Tisha b'Av, and I had a very difficult fast. Since I've been taking one particular medication, the antidepressant Cymbalta, I get very shaky when I don't eat. (That's the only unpleasant side effect of this medication, and because it works extremely well for me, I'm not about to stop taking it.)

I've been taking Cymbalta since my last depressive episode, which began in August 2005 and lasted about a month. I spent last Yom Kippur in bed because I was afraid to go to shul, I didn't know how I would feel. And today I felt truly awful--exhausted, dizzy, very listless. I tried to write this blog entry and couldn't focus, had to wait until I ate something. I was able to stay at home in the air conditioning (New York City is in the grip of a pretty bad heat wave), and spent most of my time either sluggishly surfing the web or lying down and watching television.

I'm going to have to talk to my rabbi about Yom Kippur, and whether it's better for me to go to shul and eat a little, or fast and stay at home. (Come to think of it, I should probably ask my psychiatrist what he thinks, too.)

The worst fast I ever had was the first Yom Kippur after my overdose. I was taking the antidepressant Wellbutrin, among other medications. I didn't know that it was associated with an increased risk of seizure, and I didn't know that low blood sugar could also induce a seizure. And my psychiatrist didn't tell me.

That Yom Kippur started as one of the best of my life. I truly felt that I was reconciling with Gd after my horrible depression, overdose, and the long climb back to health. I really felt a connection, a breakthrough.

Then a friend asked if I wanted to walk across the park to visit patients at Mount Sinai Hospital. Bikur cholim, visiting the sick, is a very important mitzvah. I used to do it frequently on Shabbos, but I hadn't participated in a long time. I thought, what better day to do a mitzvah than YK?

So I hiked across the park, walked all over the hospital visiting with patients, and returned to synagogue feeling pretty good about myself. And standing in front of the synagogue, I had a seizure. First I felt dizzy, and it seemed like time slowed down for a bit; the next thing I remember was being bundled into the Hatzolah ambulance and having my blood pressure taken. And having to answer all sorts of embarrassing personal questions in front of the guys I daven with:

"We have to ask you this, Ayelet. Are you pregnant?"

"NO," I wailed.

"Are you having your period?"

(It was a long time before I could go to shul and look these guys in the eye again.)

"What medications are you taking?" It took me a while to remember the name and dosage of each; between my overdose, only four months prior to Yom Kippur, and my seizure, I'd gone through a number of medication changes. In fact, since my initial diagnosis with depression and then manic depression, I've taken about 12 different antidepressants, five different mood stabilizers, and two atypical antipsychotics that psychiatrists use off-label for people with bipolar. Usually in varying combinations--a mix 'n' match that mental health professionals call a "cocktail." (Trust me, it's not as fun as it sounds.)

They took me to the emergency room--the same place I was taken after my overdose. (Of course, I don't remember my first visit there since I was already unconscious when they brought me in.) A friend came to pick me up after the fast was over, bringing me some honey cake. But I missed Neilah, the final prayer service of the day, and usually my favorite; the focus switches from mortified atonement to joyful reconciliation with Gd. At the risk of stating the obvious, having a seizure totally ruined my Yom Kippur.

And I also felt betrayed by Gd. I felt like I was being punished for trying to do a mitzvah. Sometimes I still feel a little resentful, especially since the injuries I sustained when I crashed to the pavement contributed to a long struggle with lower back pain. And I haven't had a really good Yom Kippur since that day.
Copyright (c) 2006 "Ayelet Survivor"

Wednesday, August 02, 2006

Surviving despite depression

I always thought blogging was the ultimate in narcissism unless you really had something to say. I didn't think that my life qualified as unique or interesting enough.

That changed a little over a week ago, when a beautiful, vibrant young woman from our community took her life. I was luckier than she was -- when I overdosed on the medication I take for manic depression, I was in a coma for a week but ultimately survived. That's why I feel I have to share my experience now. Because she didn't need to die.

For more than 10 years, I've been struggling with this illness. My symptoms have included profound sadness and despair; drastic weight loss and gain; inability to concentrate; impulsive and erratic behavior; irritability; and an inability to read people and situations.

At its most severe, the disease has prevented me from keeping a job, interacting with others in a positive way, and enjoying a decent quality of life. I've lost friends who couldn't understand that my bizarre behavior was a symptom of manic depression, something beyond my control.

A month before I turned 30, my illness almost killed me.

For months, I'd been plummeting into a depression ever more profound. I hated my job and feared I would never find my true calling. I was exhausted of dating, became convinced I would never meet someone to love and respect. I stopped eating. I slept 18 hours a day. I didn't go to work.

I needed help desperately, but my psychologist had convinced my mother not to hospitalize me: If I spent time on the psych ward, said this psychologist, I'd never get another job. I'd never get married. My life would be ruined.

The night I overdosed, I couldn't fall asleep. Schizophrenia is hearing voices that don't exist. Depression is hearing your own voice in a relentless wave of criticism -- "I'm a failure. I'm lazy. I'm almost 30 and still not married. I'll never get married. I'll never have children. I'll never have a normal life. I haven't achieved anything worthwhile.

"I don't deserve to be alive."

That last sentence was implicit in everything I was telling myself. I didn't express it directly, but it underlay my whole miserable outlook.

I was sick to death of listening to my wretched thoughts, but I couldn't turn them off. Reading usually helped, but I was in too frantic a mental state to concentrate. I decided to take a tranquilizer. Anxiety and depression are closely linked, and while I was on a daily course of antidepressants and mood stabilizers, my psychiatrist had also prescribed Ativan for me to take as needed. I had just refilled my prescription.

I picked up the bottle and shook a handful of tiny white pills into my hand. They were scored so that the dose could be easily halved, but I didn't even consider splitting one. I debated how many to take. One might not be enough. Two would help me sleep, but slowly. Three would make me fall asleep quickly-it was the highest dose I'd ever taken.

I looked at the pills in my hand and then shook the rest out of the bottle. I swallowed them with one gulp of water.

I'd also just refilled my prescription for the mood stabilizer Depakote. They were medium-sized orange caplets. I took five a day; there were about 150 in the bottle. I swallowed that bottle in two handfuls.

I was taking 60 milligrams of Prozac every day. There were close to 60 green-and-yellow capsules in that bottle. I swallowed them too.

Then I lay down and waited to fall asleep.

I woke up a week later, tied to a hospital bed, breathing through a ventilator, but happy. I knew that I would finally get the help I needed. My depression had rendered me unable to ask for it. As clich├ęd as it sounds, the overdose was a cry for help, and it was heard and answered.

During months of recovery, both physical and mental, I lost my job but I gained self-respect, stability and hope. After I woke up and my physical condition was stabilized, I signed myself into an inpatient psychiatric treatment unit.

It was one of the best experiences of my life: I learned to say "I have manic depression," rather than "I'm a manic-depressive"; I commiserated with dozens of other people who were grappling with illnesses like mine and getting better; and I learned new ways of thinking about my illness and my life.

Going to the hospital didn't ruin my life. It saved my life. Today, thanks to a competent psychologist and psychiatrist, I'm thriving. I got another job, earned a master's degree while working full-time, and got on with my life. Soon I'll start a doctoral program in clinical psychology; I want to use what I've suffered through and learned to help others.

I'm still single, and still hope to marry and have children-but even if I never do, I will always have the love of my family and friends, especially my siblings' children, to whom I am a very devoted aunt. Even though I struggle with my moods every day, and I'm reminded of my illness each night when I swallow my medication, I am very much happy to be alive. I feel incredibly lucky.

And I feel tremendously sad when I read about others who weren't as lucky as I was, who didn't get the help they needed, and whose lives were needlessly lost.

Sometimes good can come out of tragedy. It can bring awareness to an unspoken problem, or bring a community closer together. I hope that this recent loss will motivate us all to take greater care of each other. If you have a friend who seems depressed, please urge them to seek help. If you are depressed, don't hesitate to contact a therapist yourself.

It is hard to know where the tipping point is for someone who is just suffering through normal emotional swings and someone who is severely depressed and at risk. San Francisco Suicide Prevention has put together an excellent list of warning signs.

I am blessed with good friends who go the extra mile when they worry about me. People who are depressed tend to isolate themselves; when I say I want to be alone because I'm feeling depressed, my friends won't let me. They gently coerce me to open up or spend time with them, because they know that ultimately it will make me feel better, or they urge me to tell my psychiatrist about the downturn in my mood.

If you have a friend about whom you are concerned, please don't wait for them to say they want to see you. Call, visit, reach out, encourage them to seek professional help.

There should be no more shame in going to a psychiatrist for depression than in visiting an internist when you have bronchitis; illnesses are not character flaws. And if one psychiatrist or therapist doesn't help, seek another -- in New York City, they're not exactly in short supply. I've gone through five psychiatrists and numerous therapists, but now I'm confident that my doctor and I are managing my illness as best as it can be handled.

I wish I could speak openly about my illness, but unfortunately psychiatric disorders carry a huge stigma, especially for a person still on the shidduch market. However, I can be reached at helpfordepression@gmail.com. Please don't hesitate to contact me if you need help, for yourself or for a friend or loved one.
Copyright (c) 2006 "Ayelet Survivor"