after a month of transcranial direct current stimulation therapy

Transcranial direct current stimulation (tDCS) is a non-invasive method of electrical stimulation of the brain using a weak direct current applied to the scalp through electrodes. The aim is to modify cortical excitability and activity in the brain areas under the scalp electrodes. It is thought to work by the depolarisation and hyperpolarisation of cortical neurons.

National Institute for Health and Care Excellence

It has been four weeks since I started transcranial direct current stimulation therapy (tDCS), which is four weeks of going down to the hospital every weekday for a thirty minute session of getting my brain zapped. A shout-out and huge thank you, by the way, t the boyfriend and the mother for sending me there and back.

This post is going to be slightly lengthy. It’s basically going to be about my experience with tDCS thus far, including the effects on my mood and the process. Some background on my history – I was diagnosed with major depressive disorder and generalised anxiety disorder when I was 14, and have been on meds since. My psychiatrist has told me that my condition seems to be rather medication-resistant. Even so, I’m still on several meds that help me function. I recently suffered a major relapse last year, with no identifiable trigger. Ironically, I’d still say that I’m recovering. Relapscovering? Recolapsing?

Highlights from my progress log
A noticeable change in mood was observed by the boyfriend and the sister within the first week, who told me that I seemed happier, particularly after a tDCS session. The second week, my DASS-21 score for depression was at its lowest (9) for the past month. However, my anxiety score was at its highest (18). On the third week, not much change was observed. The fourth week, I got yet another panic attack, but this time I didn’t have any medication with me because I ran out.

As for my own thoughts and feelings, it seems that I have regained some of my capacity to feel joy. As all depressives know, depression isn’t just sadness – it limits the capacity to feel joy greatly. So it is quite refreshing to experience this growth in capacity after six years, although the sadness* is never truly gone. There is the fear, however, of the effects of tDCS being temporary, which prevents me from fully embracing this newfound capacity.

The process

On the first session, I had to go through a whole series of inventories. Some parts, I recognised from the DASS. I also had to go through a pretty long cognitive test. When I asked the doctor whether the tDCS would affect my cognition, he said no, so either he’s lying in an attempt to soothe (or pacify) me, or there’s absolutely no point in going through the cognitive test. Then begins the process that I go through every session:

Electrodue placement for DLPFC tDCS
Electrode placement

My temperature, blood pressure, and heart rate are taken before all else. Then, the nurse measures the dimensions of my head, does some calculations, and marks three X’s on my head – the dorsal-lateral prefrontal cortex (DLPFC; see image), above the eyebrow, and on the crown of my head. An elastic band is attached to my head. Two electrode pads soaked in saline solution are then held in place, on the X’s, by the elastic band.

After I have been hooked up to the tDCS machine, the doctor turns it on, and I can feel the electrical currents. They are rather uncomfortable, but I wouldn’t say that they hurt. I’m sure it would hurt for the slightly more sensitive, though. It’s a stinging sensation that I don’t notice much of after a few minutes. About twenty minutes in, I start to get a headache (or my headache worsens). Ten minutes later, the machine turns itself off and I’m shocked by a sudden jolt of electricity and a flash of light that seems to be coming from the top right (of course, there is no light).

The headache will continue to worsen for a few hours after the session before it gets a little bit better. The headaches increasingly got worse from the first to third week, although they weren’t as bad in the fourth week. From the first to third week, the headache would take the weekend to subside. On Monday, by the time the headache is gone, it’s time for another session. So, it was three weeks of a non-stop headache that made me intolerable of loud noises.

Yup, that’s about it for the tDCS sessions thus far. Hopefully, this post has been somewhat informative and interesting. Note, however, that I am neither recommending nor am I advising anyone against tDCS. You should do more research and talk to a specialised doctor about it before deciding to zap your brain.

*The term “sadness” definitely does not do justice to what depression feels like. It’s just a term I have decided to use instead of attempting to explain the anguish every time I mention depression. Depression is melancholy, emptiness, self-hatred, frustration, a capping of emotions, an involuntary suppression of emotions, and so much more.

gaming: the underused depression rehabilitation resource

The effects of gaming is often seen as negative, and gaming as an escape from issues such as depression and anxiety is deemed unhealthy. However, the tendency of individuals to use gaming as a coping mechanism can be used to rehabilitate instead of harm.

I wrote a one page article about it, which you can view in PDF, in the format it was supposed to be in (and with an image about rehab vs treatment), here.

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I had once blogged about my willingness to give my phone number to readers who feel like they need a listening ear.

However, I now feel that it’s too intrusive to do so. I no longer log onto Facebook either. You may still email me or message me on Twitter (@dino_claire) or kik (erisian), but I shall not promise prompt replies (if at all, at the moment). Feel free to rant, though.

I will not be meeting any readers or social networking followers whom I do not know in person.

I am learning to put my own health and well-being first, and while I apologise if I have disappointed those who want to text or meet me in person, I do not apologise for putting myself first.

i’m relapsing but i’m the happiest i’ve ever been

Does that statement even make sense? Perhaps not. Then again, a lot of things in life don’t make sense.

I am going through a relapse. In late 2015, anxiety plunged. Anxiety left me very drained, and I was tired all the time. I realised that, for my own good, I had to cut some people out of my life because, in the long run, they would be causing a lot of damage. I was learning to put myself first, but that is besides the point. A few months ago, depression started going down, too. I’ve stopped talking to a lot of people, and I rarely leave the house without my boyfriend (certified caregiver, btw) or family. My psychiatrist recommended transcranial magnetic stimulation because I haven’t been responding well to medication and psychotherapy.

At the same time, I’m the happiest I’ve ever been. The light at the end of the tunnel sometimes can’t be seen (if there’s even an end to this metaphorical tunnel of doom). It’s demoralising and it makes my resolve waver. But I have something I never had before. I’m not sure what it is. Insight? Reason? I don’t know. What I do know, is that I see how I am loved; I understand the lengths that those who love me would go through just to care for me; I’ve learned to tell who would make a genuine effort to be there with me, rather than for me. Most importantly, I no longer feel lonely.

I have always known that I was not alone, but I felt absolutely lonely. The sense of loneliness that haunted me for years started going away as I realised that what was missing wasn’t just people who were there to listen to me and make me laugh, only for me to go back to a state of anguish after the laughter had ceased. What was missing was somebody to hold my hand, walk with me, and push me forwards even if it upset me tremendously, because it’s for my own good.

What was missing was somebody to show me that I don’t need a full recovery to be happy.

So, I am relapsing, but I am the happiest I have ever been.

reconsidering the right to die

For the past decade, I have believed in the right to die – if you want to die, you have the right to do so and nobody else has the right to make you live. Committing suicide is your choice, and nobody has the right to make that decision for you. I quote Rebecca Wait, author of one of my favourite books, The View on The Way Down:

Because he wanted to die. Because he was ill and didn’t believe he’d ever get better. Because it was his choice. Not mine. Not my parents’. We’d have chosen to keep him with us. Of course we would. But it wasn’t up to us.

But then, I see this post on Pinterest:

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I look back at my suicide attempts. The first time I was hospitalised, I’ll admit that I doubt I would’ve gone through with it. But the second time, I was going to. I was prepared with a plan, packets of pills in my bag, lies to tell, and blades in my wallet. My last suicide attempt landed me in A&E to get my stomach pumped. I was rather close to death. I was furious that the people around me didn’t let me die. I got angry every time somebody told me that suicide was selfish. Which is more selfish – leaving the world behind, or making somebody stay in a world whereby every waking moment is agony?

People often say that those who attempt suicide don’t want to die; they want the pain to stop. While I did want the pain to stop, I also wanted to die. Even if it would get better, I didn’t care. I wanted to die.

Since 2012, things have gotten better for me. Yes, I’m currently going through what is my worst relapse thus far. But at the same time, I’m the happiest I have ever been (perhaps I shall explain in my next post). And, at the same time, I am able to distinguish between myself and depression. I still get the thought “I want to die”, but I know that I don’t mean it. I know that that’s depression talking. However, the line blurs at times, and I want to cut. I haven’t cut in a little over half a year, by the way. *cue praises*

What if, just maybe, it was depression telling me I wanted to die all along? Not everybody who wants to die has depression, but I wonder – what if the ones who want to kill themselves are being controlled by something else that has overpowered and overwhelmed them so much, that they cannot resist?

forcing myself to write / acknowledgements

It’s been awhile since I’ve blogged. It’s been awhile since I’ve written anything, in fact (assignments don’t count). No more poems, no more stories… Sometimes I feel like writing, but then I’d open up a document or start a blog post, and then nothing. A few minutes later, I’d get frustrated and give up.  Sometimes I have a topic in mind, and I know what I want to write about, but I cannot find the motivation to do it.

Now I’m thinking, perhaps it’s time to force myself to write.  So, that’s what I’m going to do now. I’m setting myself a minimum of one post per month.

Here’s to hoping that my writing has not deteriorated and that perhaps, soon, I won’t have to force myself to write anymore. It was, after all, one of my favourite things to do.

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unreplied messages: i’m not sorry

For the past two months or so, I have not been messaging people much. I have a list of people in what I call my Care List – people that I check on every once in awhile. This is probably the longest I have gone without checking on any person at all. I also have not been checking or replying messages and, if I do, my replies are short and rarely encourage conversation.

The conversations that I do hold are usually only with family (more specifically, my parents, sister, and boyfriend).

I don’t owe anybody an explanation for this, but I suppose it would put some of you at ease if you knew what was going on. This is nothing personal. This is about me. I am undoubtedly relapsing, and I am not sorry for being unwell. Usually, even if I don’t feel like talking, I make it a point to reply messages, especially when people are looking for a listening ear (reading eye?). However, I feel that I would, if anything, only cause said people even more distress.

With the relapse, the schoolwork, and starting work, I am not in the position to support other people right now. I will prioritise my own well-being for once.

i’ve had a rough month: a blogging sabbatical

Hey readers!

I’ll be taking a break from blogging for the next one to two months. Maybe even more. I had a lot of plans to write during my two week holiday between my schooling semesters, but the universe seems to have other plans for me.

*groan*
This month has been going pretty rough, and it doesn’t seem like it’s going to get better just yet. So I’m going to put blogging aside for now. I may also be replying to emails from readers slower now, if at all.

Dinoclaire is not dead, so do stay subscribed.

When I return, I will be writing about the following:
– what people don’t tell sick people
– what illness has taught me
– starting work with caregivers alliance limited (cal)

It gets really frustrating when you have two (or more) illnesses.

Just when one of them seems to be getting better, the other will get worse. Just when depression starts to become under control, anxiety gets out of control, and vice versa.

It’s tiring.

cbt isn’t for me: my first psychotherapy session

Earlier this week, I had my first psychotherapy session that I felt was fruitful. It was the first session I had that the therapist recommended something which actually fits my needs.

When it comes to depression, self-harm, and anxiety, the most widely used therapy is cognitive behavioural therapy (CBT). CBT includes the tackling of cognitive distortions – that is, erroneous thinking and thought patterns [read more here]. It also pays little attention to the past, and instead focuses on current anxieties rather than the root of said anxieties.

I have seen several therapists, all of which chose to use CBT. I left those sessions feeling equally shitty about myself, if not even worse. As a result, I gave up trying to attend psychotherapy sessions. They did me no good, and they were a waste of time and money.

As it turns out, the issue wasn’t with me (okay, the issue is me), but the issue is with the choice of treatment. CBT just isn’t for me.

My new psychotherapist – Karen – has recommended a more experiential approach. Instead of desperately trying to reason with myself and berating myself for my distorted thinking, I need to learn to let myself feel the emotions, irrational or not, and deal with them emotionally rather than logically.

I embark on this series of psychotherapy sessions with hope, for once. Granted, a part of me is still skeptical that I am fixable. But this is the first time I have walked out of a session thinking, “Yes, the therapist is right. This is what I need.”

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