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Shmuel Moshe Yonah (Shawn Michael Taub)

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A brief history of my mental illness. [02 Jul 2015|09:01pm]
LiveJournal used to be my platform of choice. Then Facebook happened. But much of my blogging on my mental illness has been here. If you're going to continue looking, then here's the place to be. Much of my posts over the past few years have been about my mental state.

I was always *that* kid, even from grade 1 - the one that stood out like a sore thumb, the one that had very few friends, the one that kept on seeing the school social worker, the one that kept acting up in class and on the playground. The joke remains that my best friend was the school principal, because I saw her several times a day.

An incident in grade 2 led to my being put through every psychological and psychiatric test imaginable for an 8-year-old. IQ tests, rounds of social workers, psychologists, and psychiatrists, and other things that I've pushed so deep down in my memories that I've intentionally forgotten them. The end result: "Shawn is a very bright kid, but he does not achieve his academic potential in school." This statement appeared countless times in countless reviews over the course of my elementary school years. To this day, I reject any compliments because of how much that statement has hurt. If I'm so bright, then why can't I achieve? If I'm such a smart kid/teenager/adult, then why does it continuously take me longer to absorb material and graduate from one stage to the next? It has been 13 years since I started my bachelor's degree, and in that time my friends have started post-doctorates. I started my nursing degree 7 years ago, and in that time some of the most disruptive, offensive, and cheating students finished in four years.

Much of my childhood is a blur. I have intentionally erased large swathes of my childhood memories, so as to not dwell on the ongoing pain I felt as a kid.

In grade 7, I was first given the diagnosis of ADD/ADHD. I was put on Ritalin. This experiment led to me bouncing off the walls, swearing at teachers and classmates, and generally being more of a nuisance than usual. Three weeks later, the principal turned to my parents and said, "Either he goes off Ritalin or he doesn't come back to school."

In grade 8, I was diagnosed with Obsessive-Compulsive disorder, and I started taking Prozac. I had a hard year. I don't even remember why, beyond that I was bullied by some of the other kids in my class.

In grade 9, I went to Yeshivat Or Chaim, a Bnai Akiva high school for boys in Toronto. This was the first year of my depression. There were med changes. Much of it is a blur now. I do remember that the school was unwilling to accommodate for my mental health situation and my learning disabilities. I was effectively kicked out because of it. This was the first time I felt truly rejected by the same Jewish community that had brought me up. In hindsight, it was the start of my religious downfall, something that continues to this day.

The next year I transferred to Thornhill Secondary School, where there happened to be the best learning disabilities program in Ontario. They helped me get through high school. But high school was not a cakewalk. The depression kept on getting worse. At age 16, I was going through more med changes. I spent copious amounts of time in bed, sleeping, unmotivated to do anything. Many times when I went to see my psychiatrist I spent our session sleeping. That summer, I gained 23 Kg (50 lbs), and my knees have never been the same since. I was suicidal. I can't even begin to count the number of times I had a knife against my wrist. I tried to drown myself. I constantly thought of jumping. Everything was distorted. I was always so angry, so upset at the world, building up conspiracy theories about how everyone was out to get me. I lashed out at my family all the time. I saw multiple different psychologists and psychiatrists. This continued for years.

At 18, I entered a psychiatric day program for youth - my first hospitalization. I lost a semester of school to the five months I spent there. Because of it, I did not graduate with my class. But good things came of it. The constant care meant that my psychiatrist was able to monitor every little bit of my med changes, carefully tweaking dosages and drugs until the right combination was found. There I received CBT (Cognitive Behavioural Therapy) for the first time in my life, and to this day I still use techniques I learned there. When I left, I was stable for the first time in my life.

This stability continued for a number of years, the whole time of which I did not stop treatment, neither medications nor sessions with my psychiatrist and psychologist. I finished high school. I went to York University for computer sciences for two years, figured out that I really hate computers, then moved to Israel. I met the woman that would become my wife. I learned one year of Biology at Hebrew University, then transferred to Nursing after Biology proved to be a bust. On February 17, 2009, we welcomed our twin daughters into the world.

Anyone who says that there is no such thing as post-partum depression in fathers is a liar.

Also shortly after the girls were born, I was diagnosed (in a wonderfully half-assed manner) with Celiac Disease. Needless to say, not being allowed to eat bread did not help my mental state. I lasted on the diet for 5 months until I convinced my gastroenterologist that for the greater good of my mental health, I cannot be on this diet.

But things kept getting worse. The depression got worse. The anxiety got worse. More med changes. More psychotherapy. And then, another medical crisis: At age 27, I had a heart attack. At that age, even with my family history, it shouldn't have happened. I survived it thanks to the medical team that treated me. The response I was given when I asked why it happened: Genetics and luck. But a week before the heart attack, I switched medications to Venlafaxine (Viepaxx), an anti-depressant that works on different receptors than most other anti-depressants. A year later, I read a study that said that Venlafaxine has been shown to have a link to heart attacks in young patients.

The honeymoon period of "I survived something that should have killed me" ended quickly. I got angry with God, swearing at God, cursing God out for letting me survive the heart attack only to make me suffer more. The depression kept on getting worse and worse. Everything was horrible for me. My brain was functioning considerably slower than usual, which, for someone like me who relies so heavily on cognitive functioning to feel good about myself, exacerbated the situation. I was tired all the time. I was hungry all the time. My sex drive dropped. I wanted to die. A year or so after the heart attack, I ended up in the ER of Kfar Shaul, one of Jerusalem's main psychiatric hospitals. They referred me to an outpatient hospitalization at Maon Yerushalayim.

I spent two and a half months at Maon Yerushalayim and went through a number of med changes. However, though the referral letter from the ER specifically said that I needed to be receiving CBT, I didn't. They simply didn't have those resources there. None of their psychologists or psychiatrists were trained in it. But at least I left there not wanting to kill myself.

I transferred to a private clinic, where the psychiatrist's theory was that much of my psychiatric problems could be solved if we dealt with the old diagnosis of ADD. This psychiatrist was so dogmatically faithful to his belief that he and his team didn't give a crap to see that the depression got worse instead of better. He milked me and my family of tens of thousands of shekels, letting me crash and burn in the process.

I changed psychiatrists. My new psychiatrist changed my meds again. But it was too little, too late. Purim 2013 I ended up back in the ER at Kfar Shaul, writhing in pain from depression and anxiety. I was hospitalized internally for two and a half months.

Three good things came of this hospitalization: I leveled out to the medications that I am still taking today, I was diagnosed with Borderline Personality Disorder, and I found a job entirely by accident, the same job I'm working at today as a councilor for a social club for people dealing with mental illness. The rest of the hospitalization was torturous. My psychiatrist had an anger problem that made my anger problem look tame, at one point screaming at a patient during a group session. The head psychiatrist of my ward called me, to my face, "a problem child that acts like a baby" - words that to this day are burned into my mind. I spent a night in the lockup ward, and I can't begin to explain the horrific conditions those patients endured.

I left Kfar Shaul feeling almost as broken as when I went in. It took me months to recover from the trauma.

But things got better. I started going to DBT - Dialectical Behavioural Therapy, which worldwide is known as the standard treatment for BPD for twenty years. (Unfortunately, because mental health care in Israel is still nominally stuck in the 1970s, DBT is not available through public healthcare, but must be paid for privately.) I went back to school, and I'm now two weeks away from finishing my final assignment. Up until a month ago, I was the most stable I'd been since I was 19. I'm stabilizing again. The meds are working, the therapy is working, and I'm working on staying stable.

Mental illness is a chronic condition, just like any other chronic condition. But it is unlike every other chronic condition because of the stigma attached to it. The classic example I give is that when I had my heart attack, the entire congregation at the synagogue in which I grew up prayed and recited Psalms for my recovery. This did not happen when I was hospitalized for depression. But stigma goes much deeper than that. Stigma marginalizes the mentally ill patient. Stigma marginalizes the importance of high-quality care for the mentally ill patient. We wouldn't accept this kind of neglect in any other field of medicine. We shouldn't accept it for psychiatry. By opening up and talking about mental illness, we start a dialogue that can shatter the stigma that has forced the mentally ill underground, something to be hidden and ignored. We can break the chain of underfunding, of abusive caregivers, of subhuman conditions in hospitals. We can make the mental health care system more approachable and more friendly to those that so desperately need its help. We can #BreaktheStigma.
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Confessions of an extremely reluctant Likud voter [21 Mar 2015|09:06pm]
Note: This is written in English because it's my mother tongue and even though I've lived in Israel for ten years and am mostly fluent I'm a lazy bastard and I find it easier to express myself in English. If you have a problem with it, feel free to bugger off.

This past Tuesday, Israel held elections. They were quite possibly the stupidest excuse for elections ever, held over the stupidest reason to break up an otherwise functioning coalition that was in the process of doing things, and the entire campaign process was the depth of stupidity. It was vile. More vile than I ever remember it being before. I don't think that there was a single party that didn't engage in fear-mongering, hate-mongering, filthy marketing, and dirty political tactics.

I have always been a right-wing voter. Ever since I turned 18, whenever I was eligible to vote in Canada I voted Progressive Conservative, and whenever I was eligible to vote in Israel I voted Likud.

This was the first time in my voting life that I didn't want to vote right-wing.

There's a number of factors that go into that. Israel's voting lines are not simply divided by right-left, but by religious, demographic, security, and social lines. When it comes to religious, I do not let that get in the way of my voting patters, as I have sworn to never vote for a party that identifies itself as religious. Demographic also doesn't matter, as I have sworn to not let demographics affect my vote. On social issues, I'm about as far left as they go - increased health care and education funding, increased recognition and support of the elderly and disabled, support for non-religious marriages, pro-choice, decriminalization of cannabis, decreased power to the Rabbinate's hegemony, etc and so forth. However, on security issues, I'm middle-of-the-road right (i.e. not extremist): Two states for two peoples is a great idea in theory, but right now there's absolutely nobody in the entire echelon of Palestinian leadership to make that happen. Severe punishment for terrorists or terrorist acts - Jewish or Muslim. Any negotiations on land will not touch established "settlements" (read: decades-old established towns or small cities). Palestinian self-determination means that they actually take responsibility for their fate, instead of funneling billions of dollars of aid to their leadership's private bank accounts instead of building infrastructure and then blaming the plight of the Palestinians on the so-called "occupation". No territorial withdrawals without iron-clad guarantees that said territory will remain demilitarized. And so forth.

Both camps engaged in fear-mongering, in "us-or-them" threats. The Likud fear-mongered along the lines of security ("vote for us or we'll all die"), engaging in "it's us or the left" threats. The Zionist Union fear-mongered along the lines of domestic social issues ("vote for us or stay impoverished and homeless"), engaging in "it's us or him [Bibi]" threats. And the left-wing media, oh man, the left-wing media. Haaretz and Yediot Acharonot have been waging a campaign of character assassination, personal assaults, and political warfare against Bibi over the past few months. Whereas the right-wing media just kept to the "seriously, Livni?" line and other forms of mass character assassination.

Basically, to both camps, J'accuse. You have both been engaging in the vile tactics that you accuse the other camp of.

But here's the crux of the matter, if the election results are of any indication. Outside of Tel Aviv and the general Merkaz, Israelis are more afraid of having their very lives in danger. For as puerile, sophomoric, and pathetic Bibi's tweets were on "Yes the housing situation is bad, but Iran", the average Israeli is very concerned about security. Because at the end of the day, yes, having an income and a house is nice, but it's not worth anything if rockets are flying, terror attacks are constant, and there's a looming threat of nuclear annihilation.

This would be difficult to swallow for extreme leftists that spew opposite-end vitriol of Apartheid, Occupation, and those poor Palestinians. I get that, and for that, we have Meretz. (Which is why I would never vote Meretz, despite agreeing with their social policies, minus the financial incompetence.) But it would be nice if the Labour party would smarten up to the reality outside of Tel Aviv. I mean, hell, even Ha'aretz published an opinion piece by Eyal Gross (in Hebrew, if you prefer, though it seems like the English version is free but the Hebrew isn't) sorta almost kinda to that effect.

I am very disappointed that I had to vote Bibi. He is bringing nothing new to the social-domestic situation, seems to be determined to let it deteriorate even further, and right now there's talk of Litzman asking for the Health portfolio (to the uninitiated, Yaakov Litzman was hands-down the worst politician that has ever held the Health portfolio, is the reason why the health care system is on the brink of collapse, and is the absolute last thing we need given the state of healthcare in Israel), which is causing me undue amounts of swearing, more than I usually curse and cuss at the world. Yes, that's a side point. But still. Also, I voted Likud before Bibi's obnoxiously racist declaration that the Arabs are voting, most amazingly prophecied by the Joint Arab List. And I voted Likud before Bibi's backtracking on the Two-State Solution.

I would have voted Labour this time around if it wasn't for a) Livni and b) the failure of the left to understand the importance of security concerns for the average Israeli. Or, more to the point, a very accurate poem.
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This war is really starting to wear on me. [03 Aug 2014|05:43pm]
This is my fourth war as an Israeli. Four wars in the nine and a half years since I moved here.
  1. 2006: The so-called "disengagement", in which thousands of Israelis were forcibly removed from their homes in Gaza, leaving Gaza completely without any Israeli presence whatsoever, led to the vacuum of power in which the Hamas terrorist regime took hold of Gaza. The Israeli soldier Gilad Shalit was kidnapped, leading up to Operation Summer Rains, less than a month between the two events. This war was simultaneous with the Second Lebanon War, during which Israeli soldiers Ehud Goldwasser and Eldad Regev were abducted by Hezbollah terrorists in southern Lebanon. In 2008, the bodies of Goldwasser and Regev were then returned in exchange for certain high-ranking terrorists.

  2. 2009: Shalit remained captive throughout the second war, known as The Gaza War or Operation Cast Lead, where the main objective during this operation was to stop rocket attacks from Gaza on Israeli civilians. The number of rockets being shot were reduced, but not stopped. Many Gazans died in the conflict, and from this war came the ill-fated Goldstone Report, which accused both sides of war crimes and explicitly accused Israel of intentionally targeting civilians. Goldstone redacted this stance in 2011, but not without serious damage to Israel's image. Also in 2011, Gilad Shalit was released in return for over 1000 terrorists.

  3. 2012: Relentless rocket fire from Gaza continued to target Israeli civilian centers. In an attempt to stop the rocket fire, Operation Pillar of Defense took place. This too, much like Operation Cast Lead in 2009, failed to stop the rocket attacks entirely, but did manage to slow them down quite a bit. This time, Israel had the Iron Dome system operational, knocking many rockets from Gaza out of the sky before they could land and do damage. This time, Hamas's rockets reached as far north as Tel Aviv and Jerusalem. We had our share of air raid sirens here.

  4. Now: Three Israeli teenagers kidnapped and killed by Hamas terrorists. One Arab Israeli teeanger kidnapped and killed by Jewish terrorists. Rioting in East Jerusalem. Incessant rocket fire from Gaza on Israeli civilian centers. Israel launches Operation Pillar of Defense. It's been a hot mess for over a month now.

It's hard for me to say why I'm taking this war so much worse than the previous ones. Yet again, I have friends in southern Israel that are being bombarded daily with rocket attacks from Gaza. Yet again, I have friends in reserve duty that have been called up for a ground operation. Yet again, I hear the names of soldiers that died to defend our country. Yet again, the ever-mounting death toll from Gaza reaches unknown proportions, since who can really be trusted to properly report what's actually going on?

A major part of what's changed so much this time is social media and smartphones. This time, unlike even the one 2012's Pillar of Defense, I have a smartphone, and I've become obsessed with checking Facebook, various news services, Whatsapp, and getting in a steady stream of news updates from apps as to what's going on. Like with previous wars, Facebook provides a small amount of black humour at first, then just an endless ribbon of propaganda. My PgDn finger is getting tired, man. My scrolling thumb, even more so. And yet, I can't take myself away from the TMI that is this war.

I've said that I've got friends that live in the south, including good friends that live in Be'er Sheva. A certain context changes this: these friends now they have a baby daughter. This kind of parental identification with protecting one's children changes how worried I am about them and others. My girls now have friends whose fathers have been called up for reserve duty. There has already been one young father of two that has been killed in action (possibly more stories similar to this, I can't bring myself to read about the soldiers that died because it's too heartbreaking for me). I have other friends that have gone off to war, and it is absolutely eerie to not even hear from them on social media. The mounting list of young soldiers that have lost their lives, including several "lone soldiers" (soldiers that do not have any immediate family in Israel), and at least one that lived in the same neighborhood as us, and another one that a friend of mine taught high school English just a few short years ago... It's just so much closer to personal.

Yes, there are hundreds of dead in Gaza. Thousands injured. Tens - possibly hundreds - of thousands internally displaced. Entire city infrastructures have been bombed to bits, including water, electricity, and sewage lines. I have no doubt that our military has done their utmost to prevent civilian deaths and suffering, but I also have no doubt that there has been civilian deaths and suffering. Civilian and humanitarian structures in Gaza have been used as terrorist bases. Many civilians have been used as human shields. And yet, that still doesn't justify their deaths. Nothing justifies the deaths of innocents, regardless of whom is to blame for it. And I damn well know where I stand on who is to blame for it.

We haven't had that much in the way of air raid sirens here in Jerusalem, thank God. But one siren still resonates with me, and evidently with the girls. A few weeks ago, on a Saturday (the Jewish Sabbath), I took the girls to a playground. Since it's the Sabbath, there's plenty of other families there with their young children. As we were about to pack up and head home, the siren wailed. It happened to be that there was a public bomb shelter right on the grounds of the playground. I ran with the kids, other parents ran with theirs, it was an orderly mess that was a live rocket drill. Yesterday, I took the girls again to the same playground. They kept talking about how they're happy that there's a bomb shelter we could run to in case there was a siren. As we were heading home, one of them whined, "But there wasn't a siren so we couldn't run to the bomb shelter..."

And then the entire story of Hadar Goldin. A 72-hour ceasefire was announced on Friday morning, and 90 minutes after the ceasefire was called, Hamas terrorists emerged from a tunnel and attacked Goldin's unit, in the process capturing Goldin. Immediately, Israel fell into the deep fear that we would be embarking on another Gilad Shalit campaign. An entire Shabbat was spent in trepidation on the fate of one soldier. His parents, Simha and Hedva, his older sister, Ayelet, his identical twin, Tzur, his brother, Menahem, and his fiancée, Edna, were all in our thoughts throughout a tense and emotional weekend. As of Sunday, the Chief Rabbi of the army has declared him to be considered dead, though I have yet to hear of any mention of a body being retrieved.

All in all, I've been an emotional wreck over this whole thing. Work has become an ongoing drama. I have been laid off from Holy Bagel because no tourists means no business means no kitchen extras. Work at Merkaz Lamah (a social club of sorts for people with various mental illnesses) has become increasingly frustrating because there's been a huge drop in attendance. It could be the war, it could be summer, it could be any number of factors, but when there's less people coming to the club then I feel a whole lot less interested in going to work myself.

School remains ever elusive. It's been a year and a half since I've been in school - two years since I've been in any kind of hospital setting as a student, not as a patient. I know I'm getting rusty. And I know that if and when I get back into school, I'm going to be thrown into the wards without much mercy to my extended and unwanted vacation. I had yet another committee meeting at the school last week, and it went pretty much as I expected it to - I was asked repeatedly what I could offer that would prove that I'm in a better place now than I was when I left, and I repeatedly answered that I can't promise anything. Sure, I fed the committee all the lines about how my treatment has been, how things are at home, what I've done to keep myself as updated as possible, but I somehow feel that it all fell short. If I'm allowed back to school, most of what I have left is clinical work, including one month each of Psychiatry, Pediatrics, and Ob-Gyn - three fields that I have absolutely no professional interest in whatsoever beyond whatever personal interest I would have as a patient, father of a patient, or husband of a patient.

Life goes on, even in the face of this war. Yaffa tries to coach me along, reminding me that the reason why we have soldiers fighting in Gaza is so that we can continue living our lives as normally as possible. She's right in telling me that if I let every single little news bite affect me too much, then I'm effectively playing into the psychological warfare used by the enemies of humankind that are Hamas. I wish I could somehow shake off this heavy feeling of mourning brought on by this war. Sometimes it's easier, sometimes it's not.
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Zombies, RUN! 5k training: Week 1, runs 2, 3; Week 2, run 1 [05 Jun 2014|08:25pm]
A slight delay, but don't worry, I'm actually keeping up with the program.

Week 1, Run 2
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On this run, I went all the way to the end of the bike path behind the train tracks, hoping that the track would continue all the way behind the new train station and onwards to Ein Yael. Well, it didn't. I got up until where you see that little point that's under the stadiums, and then there was a construction site. This run was a little easier than my first, and I did manage to get in a few short jogs during my last ten minutes.

Week 1, Run 3
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For some reason, during this run, I had this nagging pain on my lower right shin that kept on hurting me throughout the run, and it definitely affected my performance. Instead of starting at my usual starting point of Tzomet Oranim, I started closer to home. By the time I hit the 3km mark, I was in a lot of pain and my inability to jog really showed from that point. I walked the rest of it home. The good news from this is that despite the pain, the sets of ten jog/walks were much easier, giving me a lot more confidence in my ability to work up to more extended running.

Week 2, Run 1
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This week, the workout is:
10 minute walk
5 sets of: 30 seconds run, 5 heel lifts, 1 minute walk
10 minute free-form run
I'm a little confused by the heel lifts. As I said on Facebook, it's a little counterintuitive to completely stop the walk/run momentum. As best as I can tell, the heel lifts help stretch the muscles around the ankles, based on what I felt while doing it. Said the physiotherapist in the crowd, it's supposed to stop feet from cramping, but it's the kind of stretch that you would do before running, not during it. I don't think I'm going to continue doing them, just spending the few extra seconds walking. I also seem to have covered a lot less ground on this run, though that could be because I'm missing a bunch of time from the previous week's sets of walk/run exercises. Anyhoo, I didn't feel like I had to put too much effort into the 30 second runs, which could be a good sign that I am indeed progressing well.

Also, this run took place after Shavuot, when my intestines were full of dairy. I am not lactose intolerant, but I also wasn't comfortable. The food was totally worth it.
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Couch to 5k... with Zombies, RUN!: Week 1, Workout 1 [29 May 2014|01:27pm]
First, a quick thing on methods of measurement (because, SCIENCE!): I weigh myself almost every day, first thing after waking up, before I drink or eat anything, after I go to the bathroom, and with as little clothes as possible, to get the most accurate weight that's not affected by things that are not me. My scale measures to 100g. I'll convert this to lbs because for reasons I can't understand still, despite that Canada had been using metric measurements since the 70s I was still raised to read weight in pounds, so this gives me a general idea as to where I am (I believe I was about 190 lbs when I moved to Israel). Immediately afterwards, I check my blood pressure. I have a spreadsheet that's been detailing this on and off since September last year when my blood pressure started to rise to about 150/90, which is Not GoodTM, especially for someone who's already had a heart attack. Basal heart rate means my pulse at resting conditions. The rest of my posts on this matter will follow this given layout.
Weight: 97.1 kg (214.1 lbs)
BMI: 31.70612245
Blood pressure: 149/92
Basal Heart rate: 70

The workout, as dictated by the app:
10 min walking at a quick pace
10 rounds of: 1 min walk, 15 sec slow run
10 min "free-form run" (running and walking, depending on how I feel I can do)

According to Zombies, RUN!, this workout registered:
Distance: 3.95 km
Duration: 36:25
Average Speed: 6.51 km/h
Average Pace: 9:13 min/km
Calories: 403

The route, and my speeds along the route:Read more...Collapse )

My thoughts: Well, apparently I screwed up the first run. I wasn't really supposed to run at all, but rather walk at my own pace. The good news is I got a bit of the back story for the app; the bad news is days of pain and feeling like an idiot afterwards. It took me a while to get back to running because a) my parents were in town, b) motivation low, c) I'm really good at excuses, as is anyone who tries to do something to improve their health. One of the basic models we're taught in Public Health Nursing is Prochaska and DiClemente’s Stages of Change Model, a model that outlines the ups and downs of patients that wish to improve their health. The way we were taught the model was with the steps in an spiral slide - each level was another stage, and there was plenty of opportunity for the patient to slide back down. By this model, I'm currently in the Action phase, which lasts 3-6 months. It takes about this long to cement a new habit as part of one's lifestyle. Most couch to 5k programs take about 3 months to get the runner up to speed, then another three months to keep them on track. Zombies, RUN!'s couch to 5k involves 10 weeks of training to 5k, and the program says to redo runs if you feel it's necessary.

In terms of this workout itself, I liked that it had me starting this slowly. Walking is something that I've always been good at, both in terms of my ability to walk quickly and to walk distances over a long time without stopping. The app coached me along every few minutes, telling me what my progress was (3 mins into first walk, 5 mins into first walk, etc.), then gave me full instructions for the 1 min walk, 15 s run sets. By the time I hit about the fourth set, I was audibly cursing every time I had to start running, but I was able to keep it up well enough for the entire ten sets without needing to break down. After that, I did another ten minutes of combined running and walking as per my pace. You can see in the above graphic about where my runs were and how long they lasted. The initial ten minutes was about from the start to the bridge at Baram, the last ten minutes was a few hundred meters after the bridge at Dov Yosef (where I broke down last time) to Tzomet Pat (the end of the run). Almost the entire run was downhill until about the 3k mark. Notably, the path I took from after the bridge at Dov Yosef until Tzomet Pat was a path I discovered a week or two before my hospitalization a year ago, when I ran out of the house in a severe depressive state. It's somewhat symbolic for me to take that path now in an attempt to get healthy, I suppose.

At Tzomet Pat, I passed the Neeman's bakery, grateful that I didn't have money to buy an ice coffee or some pastries :) I walked to a bus stop because I didn't feel up to walking the rest of the way home, did some stretches, got bored waiting for the bus, then walked home. It took me a while to fall asleep, probably because my body was still sifting through the endorphins from the run, then way overslept this morning. Best news: I didn't wake up in excruciating pain like I did last time! Perhaps running at night isn't the greatest idea, but it's a much better solution than doing it during the heat of the day and getting horribly sunburned.

My one beef with the app at this point is that after closing the app, I can't seem to access the audio clips from the run, nor the bonus story that I got upon finishing the run. I'm still trying to figure out if there's at least a way to access the story without having to redo the run all over again.

Next scheduled run: Saturday night. Skipping today because you're supposed to leave one day between runs, and running on Friday is highly unlikely between the heatwave we're supposed to be having and that I can't run with my phone after sundown. At least it's a start.
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Couch to 5k... with Zombies, RUN! [16 May 2014|02:49pm]
I am in pain. My throat is burning from being incredibly dry due to increased breathing rate. My lungs hurt because they haven't had to process that much gas exchange that rapidly in a long time. My leg muscles are sore. And I don't give a damn, because so help me God, I need to beat the Blerch. More importantly, I desperately need to lose weight and get into shape because a) I had a heart attack at age 27, goddamnit; b) my blood pressure is high; c) it's a damn good way to deal with my plethora of psychiatric problems; d) my family.

Perhaps most importantly, the zombie apocalypse is coming very soon. And I do mean very soon. The US Army recently released a training exercise that outlined a plan the event of the zombie apocalypse. This after the CDC updated on their website guidelines for preparedness in the event of zombie attacks earlier this year - a website that has been urging people to prepare since three years ago. If I've learned anything from Zombieland's rules, Rule Number 1 is definitely the most important: Cardio. Slow people get eaten. Faster people stand a chance at outrunning the hordes.

Most recently, I read Feed, published in 2010. This book dealt with the possibility of weaponizing the Kellis-Amberlee virus - another potential virus origin of the zombie plague. This isn't the first documented case of weaponizing zombies (it is also mentioned in The Walking Dead), but it is the first time I've read about weaponizing otherwise healthy humans by injecting them full of zombifying virii. Living in a country where there is a constant threat of terrorism, and given that we've seen terrorist use of other pathogens such as anthrax, we as Israelis must remain ever-vigilant with this new potential threat - to me, something far worse than being nuked.

A friend reminded me of an app that was published a few years back called "Zombies, Run!". As an avid fan of the genre, and always looking for new ways of fending off the impending undead, I downloaded their couch-to-5K app to my phone in an attempt to train myself to a point where I could run more than half a kilometer. Here's today's attempt:

Park Hamesila

This run is, by rough estimate of Google Maps and a Lat/Long calculator, 2.27km. This is my goal for now. It took me 31 minutes to finish, and I certainly didn't run all of it. I made it about 325m before I needed to slow down and start walking in an attempt to catch my breath. After that, it was a mix of running for a minute or two, breaking at a water fountain, walking, and barely running again. The app was, as best as I could tell, not actually keeping track of my speed or distance. If it was, I would have been eaten by zombies shortly after I needed to end my initial jog. But the story continued, even for the last five minutes or so when I was just sitting at the end of the track, out of breath and out of stamina and out of energy.

I'm still happy with my progress. The journey of a thousand miles, as they say. I just hope that I have time to get myself up to a proper 5k run - and beyond that - before the zombie apocalypse does come.
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Ask me why I'm a Zionist [06 May 2014|10:51am]
Around 10 years ago, I was a student at York University. I wore a number of pins on my backpack, some nonsensical, some political. One of them stated simply, "Ask me why I'm a Zionist". The environment surrounding the Israel/Palestine conflict was toxic then as it is now, and unfortunately I involved myself in the debate more than I should have, and often to the detriment of both my studies and my emotional health.

I was asked, at one point. I was on the bus on my way to campus, and one student, female, possibly Pakistani, asked me. At the time, I already had plans to come to Israel for my two month volunteer mission with Magen David Adom, Israel's ambulance corps. I was not aware that in a half-year's time I would be moving here.

So I tried to answer as best as I could. "It's a combination of religious reasons and that of my strong ties to the history of my people," I said. I talked about the historical connection, both recent (100 years) and ancient (3000 years). I brought up the religious background, dating back to Abraham and Sarah, Isaac and Rebecca, Jacob and Rachel and Leah and sons and daughter. I explained how three times daily, Jews pray facing towards Zion, towards Jerusalem, towards the land of Israel, longing to rebuild our ancestral homeland. The bus ride was over by then, and we both had to rush off to classes.

To this day, I question as to whether I answered her correctly.

About a year or so back, a cousin of mine also challenged me to answer the question again. I emphasized more the connection to our people's history rather than the religious connection. That Jews had always resided in the land of Israel, Palestine, Aelio Palestina, or whatever it has been called over the years. That over the past 150 years, there has been a much renewed interest in returning to the land. That 100 years ago, Theodor Hertzl brought it much more to the forefront of Jewish thought. That 75 years ago, Hitler and his Nazi party - and the rest of the world, through complacency and refusal to accept refugees from genocide - made it blindingly clear how important it was for Jews to have a refuge from anti-semitism. That 68 years ago, the British made it clear that we needed to fight for our right to come home. That 66 years ago, the seven organized invading armies of surrounding Arab countries made it clear that we, as a people, must organize ourselves to fight for our right to live in our country. That 65 years ago, we had to provide refuge for those expelled from Arab countries. That 47 years ago, we had managed to get ourselves to a point where our military could pre-emptively prevent what could have been a slaughter. That 41 years ago, we needed to show some humility despite our military prowess. That for ten years following that, around the world, Jews needed to rally to support our political prisoners in Russia. That 32 years ago, we would be deeply involved in a conflict between our northern neighbors as collateral damage, and that we couldn't afford to let our guard down. That for the past 15 years, we would be subject to a barrage of terrorist attacks, even as we attempted to make peace with said terrorists nine years ago. That even if we gave land for peace while forcibly evacuating Jews from their homes and farms, we would still get a rain of rockets on our cities.

And that throughout all that, we would still be just like any other country, trying to build itself and advance itself. Making advances in industry, technology, medicine, academia, infrastructure, human rights, and so many more fields.

But all of that is a copy and paste response. And I don't think it properly covers why I am a Zionist. Yes, I'm attached to our history. Despite my ongoing personal religious turmoil, yes, I'm attached to our religious roots here.

Every year, Yaffa and I watch the national ceremony that marks the move from Yom Hazikaron to Yom Ha'atzmaut. We watch along as we transition from mourning those that have fallen while we build the State to celebrate what we've built, and to look forward to what can still be done to better our state. We watch the flag-bearers and stand in amazement of Really Old Guy who's been officiating this ceremony for 35 years now. (I don't think he has a name. Or any other job. He's just awesome.) We listen as the Speaker of the Knesset talks about what has happened in this past year and what we need to still work on. We watch as outstanding Israelis light 12 torches (for the 12 tribes of Israel). We'll even occasionally watch the dance troupes and musical routines.

This year, my parents were with us as we watched. While we fumbled to translate in real time for them, my dad talked about how Yuli Edelstein was one of those Refuseniks that he and my mother would protest for them to be released. I know that a generation before, my father's father tried desperately to get into Palestine after surviving the Holocaust, but the British prevented him from doing so. I look at our daughters, and try to understand how they will see Zionism. I don't want them to have to define their Zionism through the hardships we needed to endure while establishing and building our State.

Why am I a Zionist? The historical reasons stand. But so much more important to me than that is that I want to make Israel a better place to live. I want my daughters to grow up with that as well. For all of the history, we need to look to the future. I'm still planning on finishing my nursing degree and going into men's health, but failing that, I want to make an impact on the lives of psychiatric patients. If not country-wide, then at least in Jerusalem. I want to take that little sector and make life more livable for them. I want to lower stigma, and I want to teach them that their diagnosis is a very small part of them - at the end of the day, we're all humans with the regular things that being human comes with.

Right now, that's why I am a Zionist. To improve the country that we have.
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The gluten-free experiment has failed. [03 Apr 2014|05:16pm]
A few months ago, when I initially was given the news that the Celiac diagnosis is indeed confirmed, five years worth of denial and convincing myself that it's just not true were met with a reality that I was not ready to deal with. I took a few months, started to slowly reduce the things that had gluten in them, attempted to prepare myself mentally for what I knew would be an incredibly difficult task, and even set a date.

A month ago, when we got back from Toronto, I started the diet.

Before the diet, I was almost entirely asymptomatic. Now I've spent a week with a horrible stomachache. But the physical symptoms aren't what bother me, because they've never been the issue here.

I am disproportionately angrier now than I was before the diet. I explode at the smallest thing. For all my trolling of websites that validate the anger involved in the diagnosis and the diet, there is no way to validate how much anger I'm feeling in general. Chances are that this is a biased correlation. But there's this added monster gnawing away at me, constantly telling me that I can't eat what I want, that even if I could eat it the food might be contaminated, and a huge proportion of all the food I ever once loved I'll never be able to have again. So everything that would otherwise bother me is turned into a stimulus to get really fucking pissed off.

I could give the excuse that life right now is not very conducive to undergo such a major lifestyle change. (It's not, but I'll always have that excuse.) I could say that I need more time to mentally prepare for this. (I do, but I'll likely never be mentally prepared enough.) But the medicine behind it doesn't care. With very few exceptions, medicine isn't a cost-benefit analysis. You have a disease, you treat it with the appropriate treatment. But I'm having a whole lot of trouble swallowing this pill.

Untreated Celiac disease with chronic villous atrophy triples the chances of developing non-Hodgkin's lymphoma. Treated Celiac disease means I'm viciously angry at everyone.

"But how could you do that to your wife and kids?" It's not like I couldn't drop dead at any moment. I've already had one heart attack, the next one can't be too far away. My liver is under attack twice daily from a pharmacopeia of drugs. My psychiatric issues are more-or-less under control, but I'd rather not be caught off-guard. And besides, how could I impose my seething anger upon them? Yes, I just said that medicine isn't a cost-benefit analysis, but this treatment isn't the only one I'm on, and Celiac disease isn't the only problem that I have.

I don't need to see a dietician; I could teach most dieticians things about Celiac disease that they never knew were even applicable. I don't need to see my gastroenterologist; chances are I'm more current on the research than he is. I don't need to see a therapist... scratch that, I'm seeing a therapist, and for all the work we did on getting myself ready for this, it didn't work. I really don't need your fucking recipes. Oh sweet God, I don't need your fucking recipes. I don't need your show of support for me being on the diet, because it ain't gonna make a difference in the outcome. I will fucking stab the next person that says anything remotely close to "you can live a good and fulfilling life gluten-free", because my relationship with food seriously doesn't allow that.

It's not healthy for me, it's against medical orders, it makes me a stinkin' hypocrite, it triples my chances of cancer, but for the good of my sanity and everyone around me, I really don't think that I should continue on this diet.
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Three weeks on the celiac diet and I'm fucking losing it. [27 Mar 2014|05:32pm]
Some ignoramus asked me recently if I'm feeling better now that I'm on the diet.

I can't express this in simpler terms: I feel a whole lot fucking worse on the diet. Like, really, incredibly, disgustingly worse.

I am not an idiot when it comes to celiac disease. I probably know more than your average gastroenterologist about the pathophysiology, the health hazards, the current research, and diagnostic tools.

I went from being nearly completely asymptomatic before the diet to being in a state of debilitating rage every time I eat or see or shop for or talk about or think about food - which is pretty much all the fucking time because I even fucking dream about food. My stomach is constantly hurting me because I'm always fucking hungry and what I can eat is not remotely satiating. My so-called pre-diet "GI problems" have not gone away. I feel weaker now than I did before I was on the diet. And I'm sure as hell more prone to depression than I was before.

This is pretty much what happened the last time when my gastroenterologist decided that it would be better for me to be off the diet to save what's left of my fractured sanity.

Jewish law explicitly states that one should not do anything to harm one's body. I've done more than my fair share of ranting using this exact same logic when it comes to religious people who smoke or drive recklessly or drink excessively or ignore doctor's orders. Regardless of my current religious state (update: God's still an asshole and I really don't know how much I give a shit anymore), it would make me a massive fucking hypocrite if I didn't follow the obviously necessary guidelines for someone with a clear-cut case of Celiac Disease. Cancer and all.

And yet I'm back to that point where I'm thinking that non-Hodgkin's Lymphoma sounds pretty peachy keen if it means that I can have bread again. And if an August 2013 Swedish study is right, then I'll totally take that 0.7% chance of cancer if it means I can eat what I want.
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Because the celiac diet is nominally better than cancer [11 Mar 2014|03:57pm]
If you've missed the drama up until this point, a quick recap from Facebook:

6 January at 15:39
6 January at 21:08
7 January at 10:45
7 January at 14:55
9 January at 13:29
10 January at 13:50
26 January at 18:45

I'm gonna come out and admit it: I was a bit of an asshole. I was also incredibly pissed off. Really fucking pissed off. And I'm still pissed off. I'm gonna apologise in advance because I'm probably going to continue being an asshole. And so help you God if you try and offer me any fucking recipes, I will torture you in the most painful manner possible until you beg for me to mercifully end your life. And if you tell me it's gonna be ok, I will hunt down and destroy every last thing you ever cared about.

I don't want your fucking recipes. I really don't want any bullshit of how I can still live and eat normally.

My heart and my head have already declared war on me, my liver isn't faring much better, and now my intestines and immune system have gone full-on kamikaze batshit. I swear, if I reach 50, it'll be a fucking miracle.

Yes, I'm angry. I'm not likely to exit that phase of grieving for a long time to come.

But here's the thing.

Celiac disease is linked with intestinal cancer. Cancer is a bitch to cure, regardless of which type and how early it's detected. The only way to truly cure cancer is to never get it in the first place. Celiac's link with cancer is inherently built into the pathology of both diseases.

Four weeks ago, someone I know had a biopsy performed on a mole they had on their arm. The biopsy returned that it was a Lentigo maligna melanoma - basically, skin cancer. Luckily, the cancer was detected early enough that it was operable. So the surgeon took out a large chunk of skin, and left this 4cm bunched-up bit of skin in stitches. And for the past three weeks, all I heard from this person was non-stop bitching about how ugly the scar would be, how it probably wouldn't heal properly, how much of a bother it was to treat the wound, how the wound kept on oozing, how they couldn't even exercise until it properly healed.

I looked at them and said, "You know what? It's better than cancer."

For two weeks, every time this person would even so much as start to whine about it, I shot back, "Better than cancer."

At some point, they started saying it before I could get snarky.

It's become something of a catch-phrase now.
"Nicotine withdrawal? Better than cancer."
"BRCA positive and having your ovaries out/breasts off? Better than cancer."
"Doctor's shoving their finger up your ass to palpate your prostate? Better than cancer."
It's morbid as fuck, and it's true.

Which is why I would be a huge fucking hypocrite if I didn't grow a pair and start the diet. And why no matter how pissed off I get, I need to start saying to myself: Better than cancer. no matter how much I want that slice of pizza, cake, or bread: Better than cancer. Any time I whine about how much I hate this diet: Better than cancer. I feel so goddamned restricted in what I eat and I can't walk into a supermarket or down a street without being knifed in the stomach by this disease: Better than cancer. And oh hell, much like that person wanted to kick the shit out of me every time I said it, I'm gonna hate myself for saying it. But I would hate myself more if I didn't. I don't have much self-respect to begin with, but I have enough to do my best to not be a complete hypocrite.

I've survived a massive heart attack and many countless bouts of suicidal depression. I should be dead by now. I'm not about to give God another way to take me off this earth. I owe it to my family, I owe it to my friends, and I owe it to myself. And yeah, there's gonna be a lot of bitching here and there, and the diet's gonna suck, and still being asymptomatic with all the proof necessary that the disease is real is a real kick to the 'nads.

But at least it's better than cancer.
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On the great misery of Hadassah's patients and employees [10 Feb 2014|10:08am]
It's hard for me as someone who is so close, but not yet there, to being a nurse, to read an article like this. I'm still in that ideological state of mind that as health care practitioners, we have an absolute ethical responsibility to our patients, because otherwise this kind of thing will inevitably happen.

However, it's equally as hard to read the stories going through my feed of nurses and doctors struggling to make ends meet month-to-month because Hadassah has failed to give them their full paycheck. Hadassah Hospital's management has failed to own up to how badly they fucked up, and in the process, fucked over their employees and their patients. Hadassah-WIZO has failed to take responsibility for its flagship project. The State of Israel, its Finance Ministry, and its Health Ministry has claimed that we "earn too much", that "there are too many employees", when we, who work on the floor and earn paltry paychecks for the hours and overtime we work, see the exact opposite. Health care economists condemn the new tower built at Ein Karem, yet they fail to see that the standard of care offered by this tower is how we, as young professionals, were taught as to what health care should be, and not five patients per room, exponentially increasing the potential cross-contamination hazard, as it was in the old building.

I don't have an answer as to how the everloving fuck Hadassah ended up in over 1 billion shekels in debt. I also have no answer as to who the fuck should cover that debt, as much as I would like to see the government cover as much of it as possible. All I know is that the patients are suffering. That is the bottom line. Patients are suffering and dying, the employees of Hadassah aren't getting paid properly, and everyone above us is flinging accusations of incompetence at each other while failing miserably to solve this goddamned problem. Fuck your accusations of incompetence. Solve the goddamned problem. And make it really fucking quick, so that patients can stop suffering and dying, and so that the employees of Hadassah will have a reason to go back to work beyond their personal ethical concerns vis-a-vis the patients.
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הסיפור שלי - לפרויקט דו-שיח [04 Feb 2014|04:24pm]
So I'm doing this thing where I'm going to speak to various different groups of people about my story as a psychiatric patient. I need a little help with my Hebrew, which I know is atrocious. Any help appreciated.

הסיפור שלי

הרקע למשבר
שלום, אני שמואל, נולדתי בטורונטו, קנדה, בן 31, אבא לתאומות בנות 5. עליתי ארצה לפני כ-9 שנים. אני בן בכור, יש לי אח שמסרב להיות בקשר איתי, ויש לי אחות שעלתה ארצה לפני כחודש. אני (ברמת העיקרון) סטודנט לסיעוד שנה ד', כרגע לא בלימודים בגלל המשבר המתמשך. אני עובד חצי שנה כמדריך חברתי במרכז למ"ה, מועדון למתמודדי נפש, שהוקם לפני כ-5 שנים ע"י מתמודדי נפש, ותמיד מנוהל ע"י מתמודדי נפש.

תמיד הייתי הילד החריג. כבר בכיתה א' החברה הכי טוב שלי הייתה מנהלת בית הספר; ביקרתי אצלה כמה פעמים ביום. או לפחות היום ככה מתבדחים. לאורך כל לימודיי עד כיתה ט' הייתי במסגרת של המערכת החינוכית היהודית בטורונטו, שבו אם לא מתייצבים בתוך התבנית הנוקשה שלה, אתה בחוץ, ילד חריג, עם בעיות משמעתיות, וכו'. סביב גיל 11 "אובחנתי" כ-ADHD (הפרעת קשב וריכוז), התחלתי טיפול בריטלין, ואחרי שלוש שבועות של טיפוס קירות (כלומר, התגובה הלא רצויה של הטרופה), הפסקתי טיפול. נשלל אבחנה של טוראט'ס.

בכיתה ט', כשהייתי בישיבת בני עקיבה בטורונטו, קיבלתי אבחנה של OCD (הפרעת תורדני-כפייתי), והתחלתי טיפול בפרוזאק. כמו שאומרים באנגלית, "", ובחרתי לפרוש ממערכת בתי הספר היהודית, והלכתי לבי"ס ממשלתי לכיתה י'. למזלי, בביה"ס הממשלתי באיזור שלי היה תוכנית לסטודנטים עם הפרעות בלמידה מהטובים בטורונטו בזמנו. למרות ה"בושה" שהיה כרוך בילד יהודי אורתודוקסי שלא לומד בישיבה, מצאתי את מקומי שם, וגם אצל ארגון נוער יהודי אורתודוקסי.

בגיל 16, חליתי בדיכאון קשה מאוד. ניסיון להחליף תרופות רק גרם לי לישנוניות יתר, והשמנתי כ-22ק"ג בקיץ אחת. (שתדעו, Risperidal היא סוג של הורמון, ויכולה להיות מאוד מסוכנת ומחייבת פיקוח הדוק.) שנתיים הייתי בדיכאון עמוק, עם מחשבות מרובות של אובדנות. התאשפזתי באשפוז יום לנוער לאורך חמישה חודשים. שם קיבלתי טיפול הדוק עם תרופות ופסיכותרפיה, ולפעם הראשון, תיפול ב-CBT (תרפיה מחשבתי-התנהגותי). ב"ה, מצאנו את שילוב התרופות הנכון, וביחד עם הטיפול של ה-CBT, חזרתי לסיים תיכון בהצלחה.

עברה כמה שנים מאז האשפוז הזה, למדתי שנתיים באוניברסיטה בטורונטו מדעי המחשב, פרשתי מזה, עליתי ארצה, התחתנתי עם בחורה מדהימה, יפיפייה ומהממת, למדתי שנה של ביולוגיה בגבעת רם שלא היתה מוצלחת, עברתי לסיעוד, נולדו לנו תאומות מדהימות, יפיפייות, ומקסימות. זמן קצר עבר עד שהתחיל את הדיכאון מחדש. לכל מי שאומר אין דבר כזה דיכאון לאחר לידה אצל אבות, הם בורים, מיושנים, ושקרנים.

פה מתחיל המשבר הנוכחי שלי. לפני כ-4 שנים, קיבלתי אבחנה של מחלת צליאק. האבחון נעשה באופן מחופף יחסית המשאיר מקום לפרשנות. אני, כבנאדם שמאוד מחובר למזון שלי, שהתחתן עם אופה ושפית, ובנוסף עם נטייה לדיכאון, קיבלתי את האבחנה כמה שיותר קשה. עם הדיכאון שכבר חשתי לאחר לידת הבנות, הסיפור הסתבך. שינויי תרופות, המון טיפול פסיכולוגי, ואז שוב משבר גופני: עברתי התקף לב בגיל 27. (לענות לשאלותיכם, יש רקע משפחתי ברור, אף פעם לא עישנתי, BMI אז הייתה כ-30, הייתי בטיפול לכולסטרול, הכול היה מאוזן. עד היום אין תשובה מעבר לגנטיקה ומזל.) מצב הנפשי שלי היה בסדר לכמה חודשים, והידרדר במהירות לאחר מכך. הייתי ישנוני, היו ימים שלא יצאתי מהמיטה, היו לי לא מעט מחשבות אובדניות. קיללתי את ה' שלא נפטרתי מההתקף לב, כאילו שהוא רצה שאסבול כל כך.

התאשפזתי באשפוז יום שנקרא "מעון ירושלים" לאורך חודשיים וחצי. שם קיבלתי טיפול תרופתי ופסיכולוגי. למרות ההוראות ממיון כפר שאול לפני האשפוז, לא קיבלתי שם CBT. השתחררתי, לא היו לי מחשבות אובדניות, אבל לא התפטרתי מהדיכאון. הלכתי למרפאה פרטית שהיה מטפל ב-ADHD אצל מבוגרים, שם קיבלתי CBT שלא רק לא הצליח, אבל תחת פיקוח של הרופא הזה היה לי הידרדרות נפשית שוב. התיאוריה שלו הייתה שאם מתפלים ב-ADHD, אז כל הבעיות הנפשיות ייעלמו. הוא דחף עלי ריטלין וקונצרטה, אמר לי שכל עוד שהטרופה עוזר לי עם ה-ADHD, אהיה בסדר. חבר'ה, יש רופאים מרושעים ורשלנים שימכור למטופל תקוות שווא. שנה המשכתי איתו עד שהבנתי שהוא סוחב אותי. לפני שנה וחצי, פיטרתי אותו. המצב היה בלתי נסבל. הדיכאון חזר חזק יותר, עם יותר מחשבות של אובדנות, עם פחות רצון לחיות. עברתי לעוד פסיכיאטר פרטי שהפסיק לי את כל הטיפול בריטלין, התחיל אותי בליתיום, אבל זה היה מאוחר מידי. לפני שנה, נכנסתי למיון כפר שאול שוב, הפעם התאשפזתי במחלקה הפתוחה.

אין לי דרך קלה להגיד את זה: היחס למטופלים היה מרושעת ומשפילה. אכן, היו אחות או שתיים שהיו בסדר, אבל לרוב צוות הרפואי היו חסרי כל הבנה, אמפתיה, ותקשורת ביחס למטופלים. אכן, קיבלתי את הטיפול הנדרש במיעוטו. החליפו לי טרופות כדי לאזן את המשבר הנפשי. קיבלתי פסיכותרפיה. היה שעות לריפוי בעיסוק. אבל כשנתנו לי אבחנה חדשה של Borderline Personality Disorder (הפרעה אישיות גבולית), לא קיבלתי את הטיפול הסטנדרתי עולמי שלו, טיפול בשם Dialectical Behavioural Therapy. ערב אחד איימתי לגנוב את נשק השומר לירות בעצמי, זרקו אותי לתוך המחלקה הסגורה, ואינני יכול לתאר את הזוועה שהייתה שם. לאחר ששוחררתי בחזרה למחלקה הפתוחה, ראש המחלה אמרה לי שאני "ילד מופרע שמתנהג כמו תינוק" – בדיוק המילים שלה. המילים האלו נשרפות לי בזיכרון.

תהליך ההחלמה :
בשעה טובה, יצאתי מהאשפוז. המשכתי לחפש טיפול ב-DBT, ומצאתי מרפאה פרטית באבן יהודה, קרוב לנתניה. הרופאה הפסיכיאטרית שם הפנה אותי לטחנה לבריאות הנפש המקומי שלי, שהיו אז מתחילים להתחיל לתת את הטיפול, תחת השגחה של אותו מרפאה פרטית. היה גם סיפור בטחנה, שהרופאה פסיכיאטרית הראשית שם לא הסכימה לקבל אותי מתירוצים מרובים כמו "אין מקום", "אנחנו רק מתחילים לרשום אנשים", "אולי יותר כדאי שתהיה במסגרת יומית". חלף כמה חודשים עד שהפסיכיאטרית מאבן יהודה מצאה לי פסיכולוגית פרטנית שתעשה DBT איתי. חלף עוד זמן עד שהתקבלתי לקבוצה בטחנה, גם חלק מהטיפול. כיום אני הרבה יותר מאוזן מזה שהייתי לפני שנה. אני מקבל דמי נכות מביטוח לאומי וגם עובד. עוד לא התקבלתי בחזרה ללימודים בסיעוד, אבל יש תקווה לזה. אני פעיל בקהילה הירושלמית לשיקום נפשי, ולומד כל יום עוד על מערכת הפסיכיאטרית בארץ וגם על טיפול במטופלים נפשיים.

מילה אחרונה:
הדבר הכי חשוב לי שתלמדו על אנשים עם הפרע או מחלה נפשית כלשהו זה שאנחנו לא שונים מכל חולה אחר. אין הבדל בין חולה סכרת, סרטן, לב, או אפילפסיה לחולה נפש, חוץ מהפרטים של המחלה. אין הבדל בין נכות של כריתה, פיגור שכלי, עיוור, או חירש לנכה נפשי, חוץ מהפרטים של הנכות. אין הבדל בין בן-אדם שלוקח תרופות ללחץ-דם, כולסטרול, או כאבים לבן-אדם שלוקח תרופות פסיכיאטריות, חוץ מהפרטים של התרופה ותפקידה. בסך הכל, כל שמתמודד עם קשיים נפשיים הם לא שונים מכל בן-אדם שמתמודד עם מחלות שונות. להפסיק את הסטיגמה, את דעות הקדומות, את הלחישות של "פסיכי", "חחחולה נפששש", "משוגע". גם אנחנו בני אדם, גם לנו יש את הבעיות שלנו שאיתם אנחנו מתמודדים, גם לנו יש רגשות. בזה אנחנו לא שונים מכל בן-אדם אחר.

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Running commentary on BSG S01E03-10 and Farscape S01E03-08 [25 Jan 2014|09:42pm]
So as to not experience too much burnout from a single show, I've been alternating between BSG and Farscape episodes. This after learning that I did burnout a little from watching so much damn Doctor Who episode after episode.

BSG S01E03 - Bastille Day: I can't hear the words "Bastille Day" without belting out the Rush song at the same time. Also, I'm really starting to dig Gaius Baltar's character. This was an excellent plot episode, with no traces of Star Drek. I'm a sucker for a good prison riot.

BSG S01E04 - Act of Contrition and S01E05 - You Can't Go Home Again: I fucking loved these episodes. While at first I found Kara "Starbuck" Thrace to be incredibly one-dimensional, the backstory with her and Zak Adama gave her, Lee "Apollo" Adama, and Cmdr. William Adama the necessary depth needed for central characters. I very much so look forward to seeing this family dynamic in action in future episodes. Also, the Caprica side of things hasn't disappointed at all.

BSG S01E06 - Litmus: And now Chief Galen Tyrol is given depth. And it works well. Piss-poor acting, but what's not to like about a court scene?

BSG S01E07 - Six Degrees of Separation: More Gaius Baltar! More! This was an excellent use of the Cylon clones, both in the fleet and on Caprica. I love that we're still stuck on four Cylon clones, with eight more still to be discovered, and the dramatic irony is really well-played out with the viewer knowing more about the Cylon clones than the characters themselves. It's actually written well, giving a certain depth to the characters while allowing for many future plot twists. If only the acting could keep up with the writing...

BSG S01E08 - Flesh and Bone: A brutal episode of sorts, touching on the issue of torture. Too much half-baked philosophy (theology?), but gives an interesting view into the Cylon mindset.

BSG S01E09 - Tigh Me Up, Tigh Me Down: You'd think than an episode about Col. Saul Tigh would actually reveal another dimension to his character. Nope, just more alcoholism.

BSG S01E10 - The Hand of God: I'm rather bothered by the half-assed theological discussion in this series. Also, Lee Adama vs. Luke Skywalker, debate amongst yourselves.

There is no question, by the way, as to which I prefer between BSG and Farscape. I'm such a hopeless Henson fanboy with more SQUEE than can be contained with every self-reference made in Farscape. A certain Mr. Sterman told me that Farscape is less about the space opera/science fiction than it is about the people. And he's so right. (Wikipedia doesn't have full episode links, so here for synopses of the episodes.)

Farscape S01E03 - Exodus From Genesis: A beautiful look into the species of the Peacekeepers. This is a great set-up episode which will certainly be of use to future plots involving the Peacekeepers.

Farscape S01E04 - Throne For A Loss: Despite her playing a relatively small role in the episode, Zhaan's character is the strongest in this one, giving us some great insight into her species. Also a great showing as to what humanity should be: Tolerant and loving of all things, but with the ability to defend themselves only when attacked directly.

Farscape S01E05 - Back and Back and Back to the Future: The "time travel" in this episode could have been used much better, but either way it played out quite well. Crichton's self-referencing to things on Earth is great, and the insight into D'Argo's past and his species makes for some fun viewing.

Farscape - S01E06 - Thank God It's Friday, Again: I do love a good dystopian story.

Farscape - S01E07 - PK Tech Girl: Aww, romantic foreshadowing. Ok, this episode was pretty much without substance.

Farscape - S01E08 - That Old Black Magic: This was an incredibly fun episode. Zhaan's strength as a character continues to be one of the highlights of the show.
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Lies, damned lies, and reality [14 Jan 2014|12:34pm]
Anyone who ever says that it'll be ok, they LIE.
Anyone who ever says that it'll get better, they LIE.
Anyone who claims to be able to help, they LIE.
Optimists are LIARS.
Because things don't get better. They only get worse.
Hope is a LIE.
Every day I wake up with the FALSE hope that things will improve.
The TRUTH is that every day I wake up is another day closer to my merciful death.
I was born to SUFFER, I will die in suffering.
Any "happiness" is quickly replaced with the truth. The real TRUTH.
Yes, my daughters are a source of "happiness". They are also one of my greatest sources of SELF-DOUBT and SELF-HATRED. It's not their fault, it's mine; I am a horrible father.
Yes, I love my wife, but she is much better without me. This too is my fault; I am a failure of a husband.
I want a career that is completely unobtainable to me because I'm too fucked up.
The future as I hoped it is impossible.
Take your BULLSHIT optimism and shove it up your ass.
Take your power of positive thinking and shove it too.
I am not meant to be happy. I am not supposed to be happy. I am not allowed to be happy. I shouldn't be happy. I have no right to be happy.
Fuck you and your accusations of negativity.
Fuck you and your accusations of self-fulfilling prophecy.
Fuck you and your sickening inability to even so much as try to understand that it WON'T get better, that it DOESN'T get better, that I'm not going to get better.
I'm not just thinking that I'm condemned to live a life of HELL. 31 fucking years of trial and error continue to prove that my life is shit and it will continue to return to that same shit within a very short span of time of the extremely few and impossibly far between fleeting moments of things not being shit.
Life is pain. And I don't even have the capacity to end it.
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On my form(s?) of self-harm [10 Aug 2013|05:58pm]
Given my obnoxiously strong survival instinct, time and time again I have proven to myself that suicide is not only not an answer, but also not an option. Also, given my obnoxious inability to tolerate pain, I have found that any physical self-harming activity is also not an option. Sadly, given the above, that still allows for a great deal of social self-destruction, and this is a path I take time and time again, willingly or unwillingly, consciously or subconsciously, and spanning the full spectrum of how much control I have over my actions.

My laundry-list of diagnoses complicate this social self-destruction even more. Through my Narcissistic Personality Disorder (NPD) (though I still question the validity of that diagnosis), I push people away because I make everything about myself. And let's face it, who likes being around someone who makes it all about themselves? Any conversation, social situation, or even lecture I'm in, I make it personal. This could range from ignoring others' input to actively forcing a change of subject to be about my issues. The more I pay attention to it, the more I see it. Hell, one could say I'm even doing it right now by indulging in my exhibitionism, publishing details of my otherwise personal life to the entire fucking world just because I can. (Thank you, Internet! I've been blogging since April 2003!) I usually justify it as me just using a blank page to type in my thoughts, then seeing if anyone catches on to give me some feedback. Truth is, I crave the feedback just as much, if not more than, the ability to think out loud. Facebook has complicated this exponentially with their "like" feature, as I pathologically check back to see if what I wrote got positive feedback based on the number of "likes" I get and who "likes" it. It's bad. I know. And yet I do it. And I can't help but wonder how many other people do the same thing. And it is so good that I don't get involved too much on sites such as reddit to see how many upvotes I can whore for myself.

Then there's the other recent diagnosis of Borderline Personality Disorder (BPD), to which the first criterion in the DSM-IV-TR rings so true with me that it's scary: frantic efforts to avoid real or imagined abandonment. I will do anything to avoid abandonment. Literally anything. Well, except for change the behaviour that will likely cause abandonment, despite the knowledge that I desperately need to change my behaviour in order to avoid abandonment. Because while I cognitively know in the most blindingly obvious way possible that continuing said behaviour will result in abandonment, I can't seem to make the behavioural switch to stop it. Why? I have no fucking clue. I just can't seem to make the switch between cognitive and behavioural. A recent attempt at cognitive-behavioural therapy (CBT) failed miserably to help me make that switch, in part because the therapist was a complete joke, but largely because I just. couldn't. do it. Hence where dialectical behavioural therapy (DBT) comes in, assuming I can ever find it through the only clinic in Israel that specializes in it.

Major Depressive Disorder is my go-to diagnosis. This is the only diagnosis that has remained constant since I was first diagnosed with it at age 13. Well, okay, my recent hospitalization deleted this diagnosis, instead saying it's "depressive decompensation on the basis of BPD and NPD", but to me that simply means that the depression is, was, and will be there. And depression's effect on sociability is well-documented. More to the point, my depression causes much avoiding of social situations, whether directly (avoiding situations because I feel unworthy of being sociable with certain individuals or groups) or indirectly (spending days on end in bed because I can't bring myself to get out of bed). My legendarily low self-esteem, whether a part of the depression or a separate disorder unto itself, severely complicates all of this.

I'm not going to go into my other two throw-away diagnoses, Obsessive-Compulsive Disorder (OCD) and Attention Deficit Disorder (ADD). As the years have gone by, my various psychiatrists (with one notable recent failure) have all moved away from these diagnoses. Sure, these two diagnoses offer their own quirks that screw with my ability to be social, but I really question their validity and how much they actually take part in my social life.

But what really matters to me, beyond these various tags that I've been tagged with, is that I still, continuing the trend from my early childhood all the way throughout high school and then some more, tend to suck at being social. I'm abrasive, I'm honest to a fault, I swear a whole fucking lot, I'm needy, and I really don't care much for other human beings nearly as much as I care for myself. I've all but stopped short of actively destroying my entire social status by revealing every last skeleton in my closet to the entire searchable internet. I'm a bit of an asshole, really. Not that I try to be one, but it just happens that way a hell of a lot more than I care to admit. And I hurt those around me, intentionally or not. Then I go through the same frantic efforts to avoid losing those I care about after slashing at them with my abrasive, overly-honest, assholishness, only to slash at them again with my abrasive, overly-honest, assholishness.

I want to break this cycle of pitiless cruelty. But saying that I'm going to stop and knowing that I must stop doesn't let me stop it. So I cycle again. And every single success where I break the circle slightly only comes around to bite everyone in the ass again. And so I go into that frantic mode to try and stop the circle again, but it only tightens again, making it worse.
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I need a way to preserve this link for all humanity. [12 Jul 2013|03:16pm]
Never in my life have I ever seen such wonderful trolling done so right.
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I'm gonna try and explain why this is offensive to psychiatric patients. [12 Jun 2013|01:58pm]
While browsing my friends feed on Facebook, I found this meme twice.

A little laugh...

You are in a mental hospital. Use the first seven people on your chat list
Your roommate:
Person helping you escape:
Your doctor:
Person running around naked:
Person yelling nonsense about clowns:
Person you went crazy with:
Person who disappears without a trace:

I mean, it really should be self-explanatory, but I was actually surprised by the two people who posted it. So let's try the usual clubbing you over the head method first:


Now that we have that unpleasantry out of the way, let's take a little time to nitpick.

A little laugh...
You are in a mental hospital.

See above where I said that MENTAL ILLNESS IS NEVER FUNNY.

Next, we have, on separate lines:
Person helping you escape:
Person running around naked:
Person yelling nonsense about clowns:
Person you went crazy with:
Person who disappears without a trace:


Actually, I think I'm done now.
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Yet again, I was right; or, how to completely drop the ball in psychiatry. [20 Apr 2013|01:30pm]
For the most part, this hospitalization has been a nightmare. With the exception of one week where I actually felt good and functioned properly, it's been a string of therapists and doctors telling me to snap out of it (in one form or another), blaming me for all my problems (in one form or another), and failing to meet my expectations (in many forms).

Now I actually have proof of it.

See, a while back, I had a severe reaction to a very small dose of an anxiolytic/amnesic/sedative/hypnotic/anticonvulsant/antiemetic/muscle relaxant known as lorazepam, here in Israel known as Lorivan and in the States/Canada as Ativan. It was after an anxiety attack brought on by the incredible stupidity of both my peers and my teacher (who has since graciously retired) in a class on depression an suicide. As per protocol, I took my "as needed" dose of lorazepam, and within a few minutes, I was unable to move my limbs, my speech slurred, and I was taken from the nursing school to the ER until the drug left my system, a little over five hours later. Notably, this was about five months after my heart attack, so nobody was taking chances.

That was then. This is now.

I've been hospitalized at Kfar Shaul Mental Health Center for two months now. I've actually had a similar reaction under the same type of drug - clonazepam (aka Klonopin/Rivotril/Clonex) while here, where my limbs went completely numb and I couldn't stand up. The head of the department accused me of grandstanding.

Wednesday evening, brought on by a bad mix of rage, depression, hopelessness, and suicidal thoughts, I went down to the nurses' station and ranted about how I'm not getting the proper treatment, that I'm not getting better, that they're releasing me within a week without actually doing anything to better my situation, that I'm ready to steal the guard's gun to put a bullet through my head to end the incredible pain that I'm in. This landed me in the closed ward, whether I was going to agree with it or not.

In the closed ward, I showed all of the nurses the bag that contained my past file, which included the full report on the aforementioned ER visit. My valuables were taken from me for safekeeping (I did get them back later), my suitcase locked in a small storeroom, and I was allowed to keep my backpack, for which I was given a locker.

Later that evening, one of the nurses came up to me after drug distribution with a syringe, telling me that he was going to inject me with 4mg lorazepam. That's eight times the dose that landed me in the ER three years ago. I flipped out, and told him that if the hospital wants to kill me, I'd rather do it myself. Several minutes later, after a heated argument over whether or not the idiot doctor that prescribed such a potentially lethal injection read my file, he returned with a different needle, this time with promethazine 50mg (aka Phenergan): a high dose, but something I could probably handle, having had half that dose on a previous unrelated ER visit.

Boy, did it knock me out. I was a zombie well into Friday evening. I barely remember the round-table discussion with the head of the department, my personal psychiatrist, another senior psychiatrist, and the head nurse, when they extended my stay by a week and brought me back to my old ward.

Saturday morning, once I finally found the energy and courage to get out of bed, I went through my stuff, and I found the file that contained that ER report. It was in my suitcase that was locked in the storeroom. Nobody ever looked inside the file, as it was locked away before any doctor would have seen it. So that potentially lethal dose of lorazepam was considered an option, because nobody knew otherwise - despite it being clearly laid out in that ER report.

Laughably, now that I reread the post mentioned above, I said then, "Sadly, Israel is still in the stone age as far as psychiatry is concerned." I guess it still is.
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"It gets better"? Try being a psychiatric patient. [08 Mar 2013|09:56am]
Here's the problem that I had with the whole "It gets better" thing for LGBT youth from a few years back. Yeah, it might get better. But right now, I can't see past the fact that I haven't seen my daughers in two weeks, that my career in nursing is yet again in serious jeopardy, that I had to drop out of Hairspray (why haven't you seen it yet?!), that I'm not in the comfort of my own home with the comforts found in my own home, that I'm plagued by unpredictable, indescribable, immeasurable, illogical, incessant, unrelenting pain that comes from absolutely nowhere, that every single little stimulus turns into an amplified screeching forcing me to switch to the worst possible "fight" survival mode, that there is no cure for all this hell I'm going through, and that I don't want to live another minute if it means suffering like this.

So thank you for your "it gets better" message of hope and happiness and unicorn farts and Care Bear ejaculate. But I can't see past that right now I'm dying inside, and whatever energy I'm not wasting trying to ward off how shitty I feel, I'm using it to make sure that I don't actually die.

You want to help? Volunteer at psychiatric hospitals. Get to know patients like me who are in so much pain that they don't want to live anymore. Start to understand that just because you can't see it, and the patient looks outwardly normal and can even act outwardly normal at times, does not mean that everything's A-OK. Learn a little about psychiatry, about how our brain communicates with itself and how it can go horribly, terribly wrong. If you can afford it, donate to psychiatric research, because we're really fucking drowning here.

Speak to the families of these patients and offer them comfort, because they suffer the external signs of the daily crap that their loved ones go through. I love my wife and kids inversely exponentially to how much I hate my disease, but that still doesn't protect them from my outbursts.

And for fuck's sake, I'm bored out of my mind here. Come visit me. I need to see my friends, at the very least to know they care enough about me to recognize that my illness is no less severe than the heart attack I had two and a half years ago. Kfar Shaul Psychiatric Hospital, Machleket Bet. Get yourself to the Har Nof bus terminal (bus lines 8a, 33, 52, 55, 60, 64, 67, 74, 75) and you can get here. Weekdays between 4-9pm, Fridays and Shabbat 8am-10pm. Call me before you show up. Bring food or games, or just yourselves.

Just don't load me with the bullshit of "it gets better". I'm not nearly close to the point where I can believe in that load of shit. That goes double for any mention of God, who is so high on my shit list right now.
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Another mass shooting by another psycho [16 Dec 2012|01:28pm]
"In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness."

Mental illness is the elephant in the room that nobody wants to talk about. I hate every single time that these massacres are perpetrated by someone with mental illness because it feeds even more into the stigmatization. And yet, if we don't start talking about mental illness, and if we don't stop the mercilessly cruel stigmatization of it, then we will be doomed to repeat these massacres, time and time again.

I do not identify with the massacre committed, but quite unfortunately, yet again, I am forced to identify with the perpetrator - much like I did with Eric Harris and Dylan Klebold of the Columbine massacre, when, at the time, I myself was a lost teenager in high school, depressed, picked on, and into violent video games. So too the mother who wrote the post linked above, but in her case, it is her son that resembles these perpetrators.

Enable access to proper mental health care, and you break the random outbursts of violence. But then, that would require having a functioning health care system in the first place...
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