I officially started trauma work

And it kinda sucks. And by "kinda sucks" I mean it's pretty awful and I'm not looking forward to this every week.

But it has to be done.

Today was my first full session of trauma work. It started with a brief recap of my past week and a half (which has been damn crappy with break downs, self harm, and tons of icky feels). Then M said, bluntly, "So let's talk about your childhood". I didn't know where to start. There's so much and it's overwhelming.

I started with my mom's fractured ankle. She fractured her ankle last Friday night falling down her stairs (I can only assume she had been drinking - she's done this before). I took her to the orthopedist yesterday and it turns out she needs surgery and can't drive for 6 weeks. Which means I'll be helping her around. Which means I have to have more interaction with her than I want to. Which raises my anxiety level and icky feels and makes me angry and uncomfortable.

I had a crap day yesterday. I only got one hour of sleep and I was in a foul mood. Then the above happened. I spent most of the afternoon crying uncontrollably. I wan't so badly to self harm. I had decided that anytime I feel like self harming I'd draw a butterfly on my arm instead. I ended up with 9 butterflies yesterday. I shredded 2 lawn chairs and threw them across the yard. I sat outside listening to music while it sprinkled on me (I was hoping for a downpour) trying to calm down, crying off and on.

And then something dawned on me. I started thinking that I was having a PTSD overreaction to something. Namely, having to help my mom out was putting me in the position of caretaker to her - the role I played growing up, taking care of her when she was drunk. Even though the situation for helping her out is different, emotionally I'm going back to when I was little. I'm dealing with childhood feels.

I told M this and he agreed that it was very probable that this is what was going on yesterday. It was a good segway into our discussion. Now, I'm not going to go into detail about what all was said. Not publicly. I'll probably write about it separately as I try to process everything.

One thing that did happen during therapy is that I emotionally shut down. I became guarded. I didn't want icky feels to flood me. This is something that I shouldn't do - I need to feel these things in order to process them, and I shut down. I'll be trying not to do that next week. I think I just had such a crappy week with feels and crying and such a horrible day yesterday with feels and crying that I couldn't take it today. So I shut down.

We spent our last 10-15 minutes talking about horses and horseback riding (I went riding last Saturday). It was a good way to decompress and try to release some of the icky feels.

This is hard, y'all. Trauma work sucks. I know it's necessary and that's fine - we'll muddle through as best we can. And hopefully I won't get thrown into a mood episode in the process.

Annoyances with Creativity

There's something that's been bothering me for a bit now and it's really getting on my nerves: my lack of creativity. It's gone. Just . . . gone.

Some of you reading this may not know that I'm an artist. I draw, paint, and sew. My artwork is a huge part of who I am and is something that brings me joy, helps me escape.

And now it's gone.

My creativity started to suffer shortly after I was started on Geodon. My inspiration started to slip, my muse dried up, and my desire all but left me. For a couple of months I forced myself to paint - Chinese brush style paintings like this one:

(That's my horse Chance, by the way, who we had to put down in December.)

But I couldn't do anything else. Nothing else would come out. 

I haven't painted or drawn anything for a month now. Not because I don't want to - I do - but it's like I can't. I want to be able to sit down and draw and paint and feel good about what I'm doing. But it's not there. I have no inspiration, no muse. I have no desire. I have no vision.

I decided that I would force myself to sketch a little every day - even if it was horrible or lame - I would sketch every day in hopes of getting my inspiration back. I'm struggling with this. I sit down to my sketch pad, pencil in hand, and stare at the blank page. Draw a dragon, I think. Pencil touches paper and nothing happens. Think. I try to flesh out basic shapes but I don't see what I'm trying to draw (in my mind's eye). How about a fox or a horse then. Again, pencil to paper and nothing flows. I try to think of a pose, I try to picture the anatomy, and I'm left with stiff, abstract shapes that suggest they might be something. 

As if this weren't bad enough, I have something else going on - apathy. I want to draw and paint so badly but at the same time I could care less. My desire is gone. Any joy I get out of creating is gone. There's no real motivation because I don't get anything out of it and I struggle with it anyway. 

And I fucking HATE this. You have no idea.

I think my problem is 2-fold. On the one hand we have Geodon, which took away my creativity and my libido (Geodon is an asshole). On the other we have my depression, which I think is very much alive and well in me. The depression brings with it the apathy and the lack of joy. 

No wonder I can't create art.

Not only can I not create art (which is the hugest blow to me), I also can't write. And I don't mean blogging - obviously I'm blogging. No, what I can't write is my book or poetry. I've been wanting to write poetry but nothing - and I mean nothing - comes out. I'll get 2-4 lines and I'm dried up. There's nothing more. I'll sit down to work on my book, fingers poised over the keys, and not one word comes out. I just stare at the screen, my mind alternately blank and racing and nothing gets written. 

This is all so very frustrating.

Tonight I'm going to try sketching looking at reference photos. Just animals. Maybe that will help. I won't have to think about poses. I'm going to keep trying to spit out lines of poetry - maybe something will flow eventually. I'll keep trying to work on my book - as daunting and futile that it seems. 

It's all I can do.

Apathy and Anhedonia are my Friends

And I hate these friends. I wish they would go the fuck away.

If you don't know what apathy or anhedonia is, google it.

The week after my hospitalization was filled with depression and despair. Then came Boston where I was warned that my moods might get a little screwy. And they did get screwy - I cycled through depression, irritability, giddiness and feeling okay several times a day. Fucking tiring.

But now . . . for the last week . . . I have been either irritable or nothing. I touched on it in my last post, my icky feels. I just can't shake this numb feeling. I've felt it since last Friday. Almost a full week now. I have the hyper irritability - I've got that emotion down pat - or I have this all encompassing nothingness. This lack of feeling. I try to feel. I force laughter, I force myself to be upbeat (which is all fake - I don't feel any of it). I force myself to talk, to not be as withdrawn as I feel.

And it's not really working. All I want to do is lay on the couch and stare at the ceiling. I want to not exist again.

Tuesday I had no choice but to do something, to interact - I was volunteering at the riding center all day. But I was a hollow husk. Yesterday I forced myself to do things. I had to take my son to therapy, I had acupuncture, I met a friend for pie and coffee. But other than that I just kind of floated around in a numb haze.

Today is looking to be, uh, not good. Today I have more feels and they're of the bad variety. They're of the depressed, self destructive variety. I've spend all morning on the verge of tears but I can't actually cry. Maybe it would help if I could. I want desperately to not exist. I feel like everything is pointless again. I'm always going to have these stupid fucking mood swings to deal with so what the fuck is the point of continuing on?

I want to self harm. I want to burn myself again. I have a string of 4 very noticeable burn marks from Monday on my left inner arm and I want to add to them. I want to feel the searing white flash of pain. I want the momentary adrenaline rush. More importantly, I want the outward expression of the pain I feel inside. I'm hoping my previous burn marks scar. I want the reminder.

It's taking every ounce of self control I have to not burn myself right now. I'm writing this hoping that it will help dissipate the urge. I may try going downstairs to box. I remind myself that self-harm serves no purpose and can even makes things worse. But I may end up burning myself, I don't know. I'm trying not to.

I feel like I don't know what to do with myself or my life. Right now, at this moment, everything seems so bleak. I'll be dealing with these swings my entire life - which is daunting and depressing. I have all this fucking trauma work to go through in therapy which is daunting and depressing. I have no desire/inspiration/get no joy out of my artwork anymore which is depressing. I'm getting no joy out of life right now which is depressing.

All of this is the apathy. All of this is the anhedonia. All of this is part of a possible major depressive episode. I'm hoping not. I'm hoping my brain is just in shut down mode from the whole depression/suicide/hospitalization thing and that soon it will kick into gear again. Who knows, maybe this is my new baseline. Whatever the fuck it is I want it to stop.

Also? All of these thoughts, these words I'm fleshing out here, represent several errors of thinking, or, cognitive distortions. Namely, catastrophizing, fortune telling, all or nothing thinking, overgeneralization, and disqualifying the positive. There are 10 "official" cognitive distortions and I'm practicing 5 of them right now. Intellectually, I know this. Intellectually, I try talking myself out of these, point out the flaws, counter them. But sadly, it's not helping. That's part of the problem with me - I know this shit. I recognize it and work against it. I try. But I still fall prey to it and it makes my mood cycles worse. I've been working on all of this so much in therapy over the past year and still it gets me.

I don't know what else to say. I hate being so negative but that's where I'm at right now. I'm trying not to ruminate, I'm trying to counter my distorted thinking, and I'm trying to not burn myself. I see my new pdoc at 3 today so maybe that will be helpful.

Ugh. I'm tired of having shitty feels or no feels. Fucking brain.

Having some icky feels

Yep. Icky feels. I fucking hate icky feels. There are several things going on, all of which are contributing to my current state of being.

First, the Denver Comic Con was this past weekend. Hubby and I dress up, we kinda go all out. And in Cons past I've enjoyed this and have had a good time. Not the case this weekend. I spent pretty much the entire time emotionally numb. Just . . . numb. I was just kinda there. I didn't feel anything. Except when I was hyper irritable. I did have that. How fun. I was worried I was going to have issues with anxiety, but, save for one panic attack, I was okay on that front. Little things I guess . . .

Second, I'm kind of a shitty wife. And by "kind of", I mean I've been a shitty wife. Why? Well, I have had lots of shit going on mentally/emotionally the past several months and I've let it overtake me. I've become a bit self-centered. I've been very difficult to be around. And to top things off, I forgot that yesterday was father's day. Which hurt my hubby. We typically don't do gifts, but I failed to even say Happy Father's Day until I heard something on the radio about it. Oops. I feel terrible about this. I was going to write something up last night that explained things, that let him know how much I appreciate him.

But nothing came out. Not because I couldn't think of things, but because I couldn't put it into words. I felt horrible. I hurt his feelings. After everything he does for me, I couldn't even make one small acknowledgement of how amazing he is. Which made me realize that I have, indeed, been self-centered and have put my family and everything else on the back burner. Which compounded my feeling horrible but also brought up anger. Anger at what I've been doing, and anger at hubby because he's making me aware of my shortcomings.

Now, don't get me wrong, none of that is his fault, but it's what I felt and was why I couldn't write anything. So instead, I tried in vain to verbalize my appreciation and apology, tearing up and trying desperately not to. (which, hubs, I love you more than anything and I still don't know how you put up with my crazy ass).

This whole situation led to something else - me trying not to catastrophize the situation. Something I'm an expert at and something that is exceedingly detrimental to my emotional well being. So I rationalized, told myself focusing on my shortcomings would do me no good and that I needed to focus on not doing this again. Crisis averted.

Or so I thought.

This morning my icky feels were worse and I felt very self destructive. So much so that I burnt myself with a lighter. Part in punishment, part out of anger/frustration/confusion/fear. I'm not entirely sure why I did it, just that I did it and it helped very briefly. I actually wanted to be more destructive, but I at least stopped myself from doing more.

Third, I had therapy this morning. M and I went over my report from Boston (it came in and Dr. Schulman change my diagnosis back to Bipolar 2 - make up your mind!). So we talked about that and discussed my weekend, lack of emotion, the hubby situation, and my burning myself (M said he'd smack me if I did it again - I wouldn't put it past him). It was all very tense for me and not the easiest to talk about.

And then . . . and then we spent the last 20 minutes or so discussing how we were going to go about all of the trauma work that needs to be done. This is very treacherous, complicated terrain, and we have to be very careful lest we send me into another major mood episode. We agreed that the most troublesome area is my ACOA/alcoholic upbringing/mommy issues - especially since my mom is alive and I have a very strained relationship with her (and she wants desperately to be a part of my life). He asked when I last spoke with her (which was last Tuesday, after Boston) and just talking about that phone call made me tense, apprehensive, and brought up lots of nasty feels. M actually specializes in trauma (works very closely with the military and local law enforcement here) and redirected and "reset" me before I left. It was very clever, actually.

I still have all these icky feels though. From everything mentioned above. I'm trying not to dwell, not catastrophize, not ruminate, not fortune tell - all of the things that I automatically do. Which is hard and puts a lot of strain on me. I'm trying to redirect myself like M did in therapy. I'm going to read today so that I can escape my own mind for a bit. I'm not allowed to do any ACOA/codependency related stuff on my own - only during actual therapy (M doesn't think I'll be able to handle it right now and I tend to agree with him). So reading. And probably sketching. I'm forcing myself to sketch every day in hopes that I'll get my muse/inspiration/creativity back (since the Geodon stole it away).

Stupid fucking icky feels.  

Back from Boston

And can I just say "wow". It was a whirlwind of a trip - we were only in Boston for around 24 hours. But I learned quite a bit - and can hopefully move forward in my recovery.

I'm still processing everything I was told, and probably will be for some time. A bomb of knowledge was dropped on me and, while some of it is just speculation, it's a lot for me to think about.

Let's start with this: I saw Dr. Brian Schulman at the Bipolar Clinic and Research Program at Mass General. I was sent to see him as a "second opinion". Basically, my psych doc (pdoc) has no idea what to do with me so he wanted me to see the big dogs - the guys who work only with bipolar patients. The appointment was 2 hours long and started with a thorough health and mental history (hubby was not in the office for most of the visit - only for about 30 min). He had me explain things about my past (my upbringing in an alcoholic home, my abusive ex, my father's death) in way more detail than anyone other than my therapist. He had me explain what my mania and depression were like, going over the big episodes and as many of the little ones as seemed relevant.

This lasted the first hour.

We spent only around 10-15 minutes going over meds - what I'm on currently (which he said is a good combo and he wouldn't change it) and what I've previously taken. My reaction to 2 meds (Latuda and Depakote) is highly unusual.

But we all knew that I was unusual.

And then the meat. Then he got to work. He pointed out that the most recent 2 diagnoses that I have been given (rapid cycling bipolar 2 and rapid cycling bipolar 1 with psychotic features) sent up a red flag. See, rapid cycling - true rapid cycling - is rare. (Rapid cycling is defined as having at least 4 distinct mood episodes in a year - each episode lasting at least 2 weeks). He said I didn't actually fit this criteria (while I've been told by my current pdoc, my new pdoc, my second opinion pdoc in Pueblo, and the docs at the hospital that I am rapid cycling). He said that since my hypomanic and mixed states (except for one in October/November 2013) don't typically last for more than a few days, they can't be considered a major mood episode. Hence, I'm not truly rapid cycling.

He told me that 9/10 times when someone comes to him with a "rapid cycling" diagnosis, something else is going on too.

My something else?

Chronic PTSD.

From my childhood. From being raised in an unpredictable, often unstable home with my mom. From my dad, who was my safety net, my confidant, and my strength, dying so young (he was 43 and died from lung cancer). From being in an abusive relationship. From being an RN (yeah - RNs actually build up chronic PTSD - we see some fucked up shit, y'all).

Dr. Schulman said that people with chronic PTSD react differently than say a war veteran with PTSD or a one time rape victim with PTSD. With the acute PTSD, you think of flashbacks, nightmares, all of that stuff. Not so with chronic. We don't adhere to the typical fight or flight - instead, we freeze. We either become numb, or we overreact emotionally.

Now, think about this. I have bipolar disorder. A mood disorder. Characterized by exaggerated moods. And chronic PTSD, in which I overreact emotionally. Let that sink in. I did.

Dr. Schulman explained that the 2 almost feed off each other and it's hard to tell which is which - which mood change that I have is from the bipolar and which is from the PTSD. He said that in the brief time he'd talked to me he saw only 2 "true" manic episodes (meaning they lasted 2 weeks or longer) - one in college and my one in October/November 2013 (this alone earns me a Bipolar 1 diagnosis). My hypomanic episodes (which can last hours to a day or two) could be bipolar mood shifts or PTSD overreactions. Or both - acting off one another.

So, in other words, it's complicated.

My medications, he explained, do an amazing job at warding off the big bipolar mood swings - the true mania and sometimes major depression - but do nothing for the little swings. Which is why changing medications all the time trying to manage these swings is ineffective (and mimics the unpredictable environment I was raised in, he pointed out, which can trigger more cycling).

We've been doing everything ass backwards it would seem.

So what helps these little swings? Psychotherapy. He said I had a lot of work to do in that area, in going over my past. Which, I know. We've spent so much time in therapy doing damage control and crisis intervention that we haven't spent much time delving into my past. I wouldn't even know where to start.

Now, there's the depressive side to this too, we can't forget that (especially since that's what I struggle with). I've had depression for as long as I can remember - 4th or 5th grade at least. And I always seem to have this underling depression, this black void in me that never goes away. Dr. Schulman believes that I also have Major Depressive Disorder - and that it's difficult to tell which depression is bipolar related, and which is depressive disorder related. So the depression is harder to treat. Most likely the constant underlying depression is depressive disorder and my more acute, suicidal depressions are bipolar related. But there's no way to know for sure.

Listening to all of this just kinda . . . clicked. It made sense to me. It seems very plausible. Dr. Schulman pointed out that some of this was speculation, based on the short amount of time we had to meet and talk, but that that was his professional opinion. Does that mean that this is a set-in-stone diagnosis/treatment plan? No. It most definitely isn't. This is another set of eyes taking a fresh look at my situation. This set of eyes just happens to be from a bipolar specialist. And what he said did make sense to me.

So I'm left with this - my diagnoses:
1. Bipolar 1
2. Major Depressive Disorder
3. Chronic PTSD

And work. I have a lot of work to do now. If Dr. Schulman is correct about my smaller swings, then it's all on me to manage them. And I've been doing a piss poor job at that because it's fucking hard, y'all. My mood swings, whether bipolar, PTSD related, or both, are unpredictable and difficult for me to manage - if it were easy, why the hell would I be going through everything I've been going through?

But hearing this, that all these little swings are most likely up to me to figure out and will probably never go away . . . that's fucking daunting. You kinda hold out hope that the right med combo will make it all better - and that's just not going to happen. He warned me that the weight of this would hit me - and might hit me hard. He even wanted to make sure I was seeing my therapist this week because of this. He told me to warn my hubby about it.

As I write this, I feel mostly numb. Mostly. Given the right trigger, I'd break down sobbing. I am so grateful that I had the opportunity to see Dr. Schulman. His opinion is by far the most different from any that I've received, but also the most comprehensive - it seems to take in the whole picture, whereas others are just about the meds.

At any rate, I have more of something that I've been lacking for awhile now. . .

Hope.

So some shit happened

And by shit, I mean SHIT. Serious shit, y'all. And I'm going to write about it, and I'm going to be blunt and visceral and personal.

Because I'm lucky to be alive to be writing this.

Last week I came the closest I ever have to killing myself. And had I attempted, I probably would have completed. I had a plan and a backup plan. I had a backup plan to my backup plan.

If you know me, you wouldn't have known any of this. I hid it. I hid it as well as I could from everyone. Even my hubby and best friend. Why? Because if they knew then I couldn't carry it out. Now let me tell you something that may not make any sense - I don't want to die. I flat out don't want to die.

So why suicide . . . ?

I was put on a medication called Depakote. It's a mood stabilizer that was going to replace my lithium. I was started on a low dose - 1000mg. After 2 weeks I was more depressed. I was having some thoughts of death. And I knew it was the Depakote. I saw my psych doc and told him this. His response? No, it's not the Depakote, you need to go up on the dose. We're going to double it. I stared at him a minute. Seriously? I just told you I've had worsening depression since starting it! No, go up to 2000mg.

So I did. He knows what he's talking about, right? Wrong.

During the first week at 2000mg, I became obsessed with death and dying. I purposefully read books that centered around suicide - it was on my mind all the time. The thoughts were intrusive - I didn't want them there - I really didn't. They were disturbing. They were scary. I had my hubby lock up all of my meds.

My second week at 2000mg was the most horrific week of my life. I spent hours sobbing, curled in a ball on the floor, wishing I could just die. The pain was so bad I just . . . I needed to die.

If you've never been at this place, this place of utter terror and pain and despair, you'll never quite understand this. The pain is guttural, animalistic. It reaches into every fiber of your being. It hurts emotionally, mentally, and physically. While I cried, while I sobbed and wailed and screamed and pounded my fists, all I wanted was the pain to end. The torture to end. I hit my head against the wall. I burned myself with a cigarette lighter. I would have cut myself but the blades had all been locked up. There was no way I could go on like this. No way I could possibly continue to live like this. How could anyone? How could anyone be expected to live with this much pain?? Death was the only way out.

Last Wednesday night I told my hubby that it was a matter of when, not if, I would kill myself. I know I scared him. I was sobbing, laying on him, hurting and scared and tired. I was so tired. Tired of pretending. Tired of hurting. Tired of trying and having nothing work. I was tired. I told him that I wanted to die and that it was a good thing my pills were locked up. I knew I needed to go to the hospital then, but I didn't. He knew, but didn't press it.

Thursday morning was bad. I felt worse. But I had to press on, right? I had to take my son to his therapy session. And his therapist, upon seeing me, told me to call my therapist. I trembled. I knew I needed to be admitted but I needed someone to tell me that. I needed validation that it was okay. That I needed to be safe. I went into the bathroom and called my therapist, sobbing so hard I was almost incoherent. He told me what I needed to hear: go to the damn hospital.

And I did. I admitted myself on Thursday afternoon. Had I not, I would have overdosed on Geodon. One medication that isn't locked up because I take it every day. I have way more than enough to do the job. And had I not gone to the hospital, well . . . well those pills would have been down my throat.

I was discharged today, Tuesday. I'm still depressed. Damn depressed, actually. But I'm no longer suicidal. Depakote was the culprit in this - my first day off of it and the suicidal thoughts went away.

Last week I felt the worse that I ever have in my life. I never want to feel that way again. Ever. I can't. I came scarily close to killing myself. Closer than I ever need to come because I have wonderful friends and family.

I can't put into words the amount of pain I was in. I wish I could. I wish I could make you understand. But until you've been there, you can't possibly.

I'm alive. I'm going to Boston on Sunday to see the bipolar specialists and maybe get a new perspective. I'm trying to stay positive.

But I'm still so tired.