…your sister, your kindred in depression.

Dear Blog,

I am Nigerian, your sister, your kindred in depression.
I too have been there, and I was also suicidal.

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Yes, I am a pediatrician, a veteran, a wife, a mom, a sister, friend, daughter, lover of life-life of the party.
But when I was down, none of these titles came to save me.
I felt my whole entire world crashing on me, and I wanted out.
I have three children, but they did not count
I have parents, and siblings, but they did not count,
I had a great enviable Lt. Col job in the USAF, it did not count,
I have a nice house, fancy cars, cool clothes, badass shoes, they didn’t count
Nothing I owned, counted,
I simply wanted out.
I am at a better place now, because someone heard my cry
She heard my voice, she listened,
She acted,
I survived.
And now am here…
Fighting.
Daily, speaking out, making eye contact, hugging one person at a time.
It will be done.
There will be no more suicides, no more hurt, no more pain.

BB

PS: My website dedicated to fighting teen depression and teen suicide, teenalive.com is LIVE, click the link to check it out!

 

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10th day of September 2018…

Dear Blog,

In this special month dedicated to suicide prevention awareness, and on this day particularly assigned for it’s commemoration, I wanted to take a moment to share a brief insight into teen depression and teen suicide from my perspective.

Let’s face it, teens have stressors just like we adults, sometimes more. I know most of us parents think teenage years are full of fun and games and carefree living–I am here to tell you that it is often not as we think. Not only do they have to deal with issues relating to adolescence, like the hormonal and physical body changes that accompany it, they also have to deal with school work big time. This may include dealing with AP classes, preparing for SATs and other standardized tests, taking college prep courses, as well as picking colleges and interviewing. They also may deal with dating and the drama that comes along with that, nuances of peer pressure from classmates, and pressure from coaches and teammates for those that participate in sports and other extracurricular activities like band, cheer-leading, and orchestra. I won’t even begin to mention how we parents have our own unique requirements for teens to either “be grown” or act grown, or how their siblings and other family members all have different opinions on whether the teens are grown or still children. 

Phew! That can make for tough teen years!!

So, now that we all agree that teens do have it rough, the onus is on us as family members and the community (the entire village it takes to raise them) to be more cognizant of that fact and act accordingly.

Amidst all of these teen issues listed above, it is easy for us to miss true signs of depression and or suicidal thoughts in our teens. I, for one, missed the depressive signs in my son who was then 12-year old son, and  was bullied in middle school. That sadness that has persisted for longer than 2 weeks now, might not be as a result of his or her school workload. It might not be as a result of the recent breakup from a dating partner; it might not be stress from their overscheduled life, nor pressure from their teachers or band director.

It might be depression and your teen might be suicidal as well.

Teens might become gradually withdrawn or lose their appetite, they might start losing interest in their normal daily activities or extracurriculars. Suddenly, they may no longer want to participate in competitive sports or they might simply drop out of the swim team. In some of my patients, I often note the spark is gone from their eyes–their air is of melancholy, with ashen faces and poor or no eye contact. They may begin hanging out with the wrong crowd, experimenting with drugs, or worse still, they may drop out of school altogether. Self-harm usually in the form of cutting themselves may also occur, and they often find creative ways to hide the marks and scars. For instance, be wary of the teen who always wears long sleeved sweatshirts or jogging pants in the (hot) summer. If suicidal, they might start giving away their favorite stuff, asking questions about death or asking about suicide. They often wish they are better off dead, and might mention it in passing. In truth they might be trying to reach out for help, but do not know how, or who to turn to. Regardless of the presence of friends and close family members, they might not want anyone they know, to know.

The average teen who is suffering from depression is most likely not going to tell you–their parent.

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Where do you begin?

A family history of depression is sometimes the best place to start when it comes to honing in on our suspicions about our children and their prolonged moodiness. If you have a family history of mental illness, do not ignore it… it could happen to you or your child. Adolescence is often an easy period for symptoms of depression and other mental health issues to arise. Since the teens are already faced with a myriad of other stressors, depression simply slithers in, takes a seat, and gets comfortable.

When in doubt, ask their siblings, friends, or school mates about the behavior or mood of your teen. You will be surprised at the wealth of knowledge they possess. Afterall, they often spend a lot more time with your children than you do. Furthermore, these friends might not know how to approach the topic and might not know who to go to.

Your teens’ teachers and counselors will be another great resource. They are there to help and are often very willing to assist in any capacity.

Note that your child might not tell anyone at all and might even concoct stories to hide the truth. In fact, a patient’s mom recently recounted an instance when her son had told his curious sibling that the family cat had scratched him, in response to his sibling’s inquiry about the strange cuts on his forearms.

I recommend you find a nice neutral place to sit and talk, or a simple walk around the neighborhood, or a nice long drive, or even a picnic. A good ambience might help facilitate the communication on a face-to-face basis with your child. This might be a fruitful exercise if your child will cooperate, unfortunately, most teens really do not want to confide in, nor discuss these issues with their parents, however, it is still worth a try.

A short visit to the health professional, like the family pediatrician, family doctor, counselor or therapist is always a very good decision. They will ask you the proper questions and point you in the right direction to get your teen the appropriate kind of help they need. There are multiple places you can get help for your teen as well as their siblings (because there is often a need for siblings to participate in the treatment sessions in order to adequately understand exactly what is going on) and for yourself as well (especially if there is a family history of depression). These can either be online virtually, as telemedicine, or at your regular doctor’s office.

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#endteendepression

#endteensuicide

#askdoctorlulu

1-800-273-TALK

BB

PS: My website dedicated to fighting teen depression and teen suicide, teenalive.com is LIVE, click the link to check it out!

Physicians, never forget your WHY…

 

Dear Blog,

Last Friday, as I sat finishing up notes on the last of my almost 30 physicals (this number is never any surprise for us Pediatricians this time of the year, it’s back to school week, so every Thomason, Dickinson and Harrison is lining up for sports physicals and regular physicals and all sorts of clearance and medication forms that need to be filled out and turned in “yesterday”) I took a deep breath and exhaled, my mind filled with the events of the day. As is customary, my beloved patients often postpone their physicals all summer, in search of sandy beaches and clear blue vacation skies, so it’s usually a mad rush the first week of school.

I found myself reflecting on the patients I had seen that day as I often do at the end of my day. Most of them were mundane well baby and well child checkups, nothing really of note, a few of them had minor issues to clear up before returning to play…but one of them stood out clearly like a lily in a field of carnations…a 16year old we shall call “Maya”. I have met Maya only a couple of times in the past and I have known her to be a troubled teen, plagued with depression and anguish, never really smiling, not much eye contact, not much of an affect…just sad. I have tried to manage her depression the best I can with counseling in the office, a referral for proper psychotherapy. My good friend, and child psychiatrist sees her regularly and has placed her on an appropriate dose of antidepressants, and she reportedly goes to counseling regularly, all with little or no change in her mood(s)

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She came in that day in the company of her mother and her older 17yr old sister. I sensed something wrong right away, but I continued my usual intros and salutations and other little talk. Her mom could not stop fidgeting, with the characteristic continuous knee shaking. Her sister’s face was buried in her mobile device for pretty much the duration of the visit, except when I inquired about her. It turned out her sister was also to be seen that day. Both mother and child proceeded to explain to me that her sister needed to be seen for “stomach problems” that only happen at her high school, stemming from her “unique eating habits”, and her lunch time not being fixed at a particular time of the school day. This apparently never happens at home or during the holidays or vacation, when she reportedly “has her own eating schedule”. She wanted a note from me to the school nurse authorizing her to eat her lunch at the exact time she wanted, or she would develop abdominal cramps, nausea and headaches and “get so sick” she would end up being sent home from school. This story line and request stuck me as bizarre, I recognized a familiar thread of possible anxiety in her sister, and maybe some co-dependency in her mom, but I digress…

Maya on the other hand, wore a thick black sweat shirt and jogging pants…mind you, it is 105F outdoors in San Antonio Texas in July! As I indicated in my first two Kevinmd articles https://www.kevinmd.com/blog/2018/07/a-pediatricians-healing-spirit-treating-depressed-anxious-and-suicidal-teens.html, and https://www.kevinmd.com/blog/2018/08/why-this-physician-quit-her-job.html

I somehow am a magnet for depressed and suicidal teens, and Maya, was no different. She made absolutely no attempt to engage with me, no eye contact, shoulders drooped over, melancholic and flat affected. She appeared pale, ashen and sullen, with dark circles around her eyes, she simply looked like she could use a looooong-warm-heart-filled-hug. During the physical exam, she hesitated to take off her sweat shirt, but I insisted, eventually, her mother ordered her to do so. She did so veeerrry-reluctantly, and immediately pronated both forearms…I gently supinated them, and to my horror, revealed numerous, clearly visible, freshly carved cuts all over her forearms, extending from her wrists all the way to her elbows, on her left and right forearms respectively. I said nothing, gently turned them back to her preferred position, completed her examination, and walked back to my seat. I then calmly asked her mom about Maya’s depression and how her cutting behavior was fairing. She hurriedly replied “oh, a lot better, she is receiving counseling, and has not cut in 2years. 2yrears?? I thought to myself, more like 2days!!… Her response immediately made me stop typing on my laptop EMR,  I looked up at her, made sure my words came out clearly and as gently as my rapidly beating heart could muster, as I said, “No ma’am, I am afraid but I have to tell you that Maya has fresh cuts on her forearms and wrists, that are probably not more than 2 days old…”Self-inflicted lacerations on arm of man : Stock Photo

The rest of the visit was a bit awkward. Her mom asked to see the cuts, Maya vehemently refused, and an uneasy silence set in after I explained to mom that, she would probably do better waiting until they got home to approach her alone in her bedroom. Meanwhile, we should probably revisit her counseling sessions, and explore the possibility of an in-house facility if possible, especially since her self-completed PHQ-9 score that day was a total of zero.

I write this story today to remind myself of my why. To urge each one of us doctors to remember our why(s) Never lose sight of the reason you went into medicine, no matter what. We are a special breed, a unique set of like-minded individuals who choose service to humanity above all. We choose to make a difference in our patients’ lives regardless of all the administrative, legislative, personal and sometimes insurmountable difficulties we face daily in the field. I was reminded that day of my reason for leaving my beloved 9-5 job to follow a passion of fighting to end teen depression and teen suicide. I was reminded to follow my heart and believe in my dream. I was reminded to stay the course, because, for every Maya in my office, there are a hundred or even a thousand more out there, so, I must go forth. “The harvest is plenty, the laborers, few…”, Luke 10:2

rear view of a boy sitting on grassland

#endteendepression

#endteensuicide

#askdocotorlulu

BB

PS: My website dedicated to fighting teen depression and teen suicide, teenalive.com is LIVE, click the link to check it out!

He has been intentionally deliberate.

Dear Blog,

This week was fairly emotional and trying for me at work. I am nearing the end of my 2mo notice and the emotions are getting real and raw. I have had lots of patients find out both from me and from the nursing staff and they are not taking it lightly. I have had patients’ moms crying, I have joined my tears with theirs, and the s*** is getting real. But just like Julius Caesar, I must go forth. Isn’t that the definition of faith?… going forth in trust and belief?

I still struggle with the unknown future, and the uncertainty of not having an immediately apparent source of income, and still marvel at the guts it has taken for me to do this…

The first time I did something this gutsy was in 1999 when I started my own private practice only months after finishing residency. That. was. Trying! I had only one son, Papa. Luckily, I was breast feeding, so at least the poor kid had a somewhat steady source of nutrition. I, on the other hand would eat an apple for breakfast, some noodles for dinner and barely have enough for lunch in those early days before my private practice truly took off. I was terrified, unsure, flat broke, and diffident, but committed and determined, for so many reasons, top of which was my J-1 visa that was about to expire…“whaatt?? girl, you better get it together and get that practice started in that rural area of South Kakalaki that is a qualified HPSA (health professional shortage area) before you find yourself on the wrong side of 45’s great big wall…” my id said to my ego.

Even more gutsy was when I filed for divorce from my now ex-husband. Nervous, afraid, unsure, but determined to divorce a strong-willed “Africa-man” (broken English accent) to the pure amazement and shock and (probably pity) of my onlookers. Many of whom I know, not only thought, but also believed I had lost my mind…what?, you? Naija woman, filing for divorce??? whatever will your people say?? But he is such a quiet man, a good man, what did you do to him? have you done lost yar mind? you dey crase? who do you know ever did that in your family? what have you children become these days? no one wants to stay in their husband’s house anymore, what about your children, how will they manage? blah blah blah. To which I would reply something in the realm of “darling, I don’t expect you to understand…but, he is now single, so please introduce him to any of your available single sisters, cousins, nieces, etc…since he is such a good man…(swinging my hips and whipping my neck and walking away as I roll my eyes…)

Another time I did something very gutsy in recent memory was when I joined the United States Air Force at the age of 42…! Now, at this time, ma guys had probably decided I was a crazy kid that needed prayers…they all probably shook their heads in wonder, said a prayer for me, and commended me into the hands of God (thankfully) as they walked away in disbelief…but if they thought that was bad, then the news that I was getting married to a woman, or that I had gotten married to a woman, finally “broke” the proverbial internet and sent them all in a frenzy…! I guess with those instances in mind, it should not come to my “followers” as a surprise that I quit my day job with not so much as a replacement in its place, to pursue a passion (that potentially is non paying) while I have two sons in college. And bearing in mind that their completely absentee father is absolutely NO help, financially or otherwise… But, if by so doing, I am able to stop one single teenager from committing suicide or spiraling into the dark space of depression, then it was ALL WORTH IT!

I guess that is where my vision leaves their ordinary sight to set off, plotting its own path.

Bringing me back to the topic of today…

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In the past few weeks, I must say I have felt the hands of God more in my life than I can honestly say I have in recent memory.

Since deciding to take up this new journey of re-branding myself. It has been one revelation and one learning experience after another. I have now decided to trust that I have a guiding hand from above and let it do its work in my life.

From my chance encounters to my scheduled meetings, to my patients, to their parents, to my kids, to my extended and nuclear family, to my co-workers to my adversaries, it has all been one message of positivity after another. I have felt nothing but God’s hands on this chess board called my life. Through the transition thus far, He has been intentionally deliberate. I have seen him move Pawns, Queens, Knights, Bishops and Kings in my way, all to propel me to a new level of self-understanding and self appreciation. He has deliberately put the right people in my path, and what I do with them is entirely up to me. But put them in my path, He has. I can only liken the situation to the old days of Long Playing records (LPs), when we would select the record, place it on the gramophone, pick up the pin, and carefully place it on the desired track to play to our delight.

He has literally placed all kinds of helpers, advisers, new acquaintances, collaborators, teachers, mentors, and future team mates etc on the road with me. I shall give you the full details of each encounter at a later blog. Just know that, henceforth, I am a firm believer in the deliberateness of His actions in mine and everyone else’s lives. We all simply need to have our eyes open to these encounters and know that  He IS ever present and ever working. Whether good or bad, it is designed as He wants it. He might not give you fish, if He knows you already know how to fish, but He will supply you with the fishing rod, the hook and the worms, you will however have to find the river, and then cast your rod.

Has it all been good news along the way? absolutely not. Has it all been smooth sailing?, not at all. But through it all, through the disappointments and the good times, there has always been a hint of positivity in the air, and I deliberately choose that energy, no matter how tiny… I am still nervous about my decision, but no longer as much. I am still anxious that things will not be easy, but nothing good comes easy they say, so I must be doing something right. For I know deep inside that, indeed, it is well, and it is rated AG (all good)…

Cheers to the future!!

PS: My website dedicated to fighting teen depression and teen suicide, teenalive.com is LIVE, click the link to check it out!

      “when writing the story of your life, don’t let anyone else hold the pen”

“what you think of yourself is much more important than what people think of you”         ~anonymous

                                                                                             

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Welcome to my Blog !

My name is Uchenna Umeh (oochaynnah oomay).

Welcome to my blog, affectionately called “wordsbyblackbutterfly”.

I chose this name because I have always seen myself as a butterfly. I will touch many  lives as I go about my business and pollinate them, and hopefully positively influence their lives in time…only staying long enough, to make my mark as I flutter along…;0)

I am a pediatrician, a wife, a mom, a disabled veteran, a “docpreneur” in the making, and an exercise enthusiast!

I have been a pediatrician for almost 30yrs. This is my reason for living…I absolutely LOVE what I do! My passion of late has however been focusing on At-Risk Teens: with depression, anxiety and suicide. My first experience with my patient that completed suicide was on July 04 2008. Since then, I have noticed a steady increase in the number of patients with depression, anxiety and suicidal behavior in my practice. This is why I quit my job to pursue my passion for public speaking, essentially educating the world about depression. Check out my weekly Facebook Live series every Sunday at 2pm CST on my Facebook page called “Ask Doctor Lulu”, where I discuss topics about teen life and teen (mental) health. Please Like my page, and feel free to share it on your social media platforms. You may follow me on IG, @askdoctorlulu, I am also on Twitter as Uchenna Umeh, as well as LinkedIn. I also have a YouTube channel.

This is my second attempt at marriage, and while I have not mastered it, I believe I am doing a much better job this time around. I recently celebrated my 5th anniversary with my “wifener” who has also been my lifesaver, my business partner and adviser (thanks baby)

Of all the hats I wear, I must say that my mom hat is most definitely the best fit. It is the most comfortable, and also the most challenging. I am blessed with tres hijos (three sons), and they are simply put, my heartbeats, my lifelines, my Paches…

As a disabled Veteran, I am now beginning to see life through the eyes of the less physically able, and it is humbling. The VA has been instrumental in my current re-education (I am getting an Executive MBA) and for that I am grateful. To show my gratitude, I am currently doing a year-long #22BurpeesforVets challenge to raise awareness for Veteran depression and suicide (22 Veterans commit suicide every day) so join me!

I LOVE to exercise! In spite of my bad knee, my bad back, bad neck, and a diagnosis of Fibromyalgia, I refuse to see my body as physically unable, so I continue to push myself to the max, and beyond… That is why I am SO proud to announce that I am currently working on getting my “Strong Zumba” coach certification.

Life, for the most part, is good, but as I approach the 50th anniversary of my birth, I am on a re-branding quest. I am trying to empower myself and change my outlook on life as I work on the many business ideas that I have. #moretocome.

In ending, thank you for visiting my blog site, I hope you enjoy my stories and my insights. Feel free to comment and reach out to me with any questions you might have.

QUICK UPDATE!! My Website teenalive.com is LIVE, click the link to check it out!

Thank you, and again, welcome!

BB