Good morning. Ashton is 27 years old today…in “earth years.” I appreciate those who remember his birthday. I don’t know why that means so much to me…but it does. It touches me to the center of my soul. I think about Ashton every day…EVERY day; it’s nice when others think about him every now and then.

Thanks for being my “tribe,” everyone!

Written by Carter

I thought I’d share some self-care things I am doing. My hope is that taking care of myself will allow me to better serve God and my fellowman. My hope with sharing this is that my readers will also take appropriate care of themselves, get help early and often, and reach out in compassion to others who are struggling with their own mental health.

Yesterday, I met with a psychiatrist who is a medical school classmate of mine. He was also Ashton’s psychiatrist. There has been a recent emphasis in medicine to “de-prescribe,” meaning looking at each medication that our patients are taking to see if they are still indicated and, if not, “de-prescribing” those that are no longer indicated. In about November of 2012 (even before Ashton died), I saw my family doctor because I was feeling persistently and consistently irritable for several weeks or months. I have treated many patients with depression and finally said to myself when looking in the mirror one day, “Buddy, you are depressed!” My family doctor prescribed fluoxetine (Prozac), which has been around for over 40 years. It initially got a “bad rap” from the media; frankly, I think it was treated unfairly. However, I think 40 years is enough patient experience for me to feel comfortable taking it and prescribing it for my patients. I did notice an improvement in my mood over a couple of weeks. I have continued to take it since then because I didn’t want to go back to where I was before I started taking it; that was MISERABLE! However, I have wondered recently, “Do I still need it? How do I know if/when I can stop taking it?” By definition, I cannot be objective about myself, so I sought the advice of a trusted colleague. It has been said that, “Those who are their own doctor have a fool for a patient.” There is something to be said for “common sense” (which may not be all that common), but I think there are times when one should get outside input. I felt like this was one of those times.
Ironically, just two weeks ago, I got very irritated very quickly with Faye over a minor issue. It seemingly came out of nowhere at the end of a very uplifting and positive day. My outburst adversely affected how both of us felt for the next several days. Despite being on the fluoxetine, that happens more frequently than I wish it did…maybe 2-3 times per month. I mentioned this to my psychiatrist and he asked, “I know you. Is this ‘normal’ irritability and you are being overly-perfectionistic about it? Or is this truly something that is abnormal?” I acknowledge that I struggle with perfectionism, but I think these outbursts are “abnormal.” He diagnosed me with “atypical depression” (because I’m not “sad,” per se; just grumpy more often than I think is normal) and recommended increasing my fluoxetine from 20 mg to 40 mg per day. I will see him in follow up in 2 months. He also recommended a psychologist colleague for “talk therapy” if needed in the future: someone who can give me strategies to change how I think about and respond to various situations and challenges.
My psychiatrist also pointed out the following: a) Doctors have a very high-stress job, which can lead to burnout and depression; b) “If/when you do get irritable, apologize to Faye for it and learn from it so you can minimize the chances of it recurring…but also be kind and gentle with yourself! You are a good person, but you are still human!”
In conclusion, I hope that my readers are taking appropriate care of themselves. I hope they encourage others who are struggling with their own mental health to also get the help that they need. Life is sometimes hard! We need each other! 
Happy Easter!Written by Carter