New pdoc?

I'm planning on switching pdocs. I was a bit displeased with mine at my last appointment.

(To refresh your memory, she told me that meds won't work on me and that sometimes people have a black cloud over them and are suicidal all the time and you just have to get used to it)

That rubbed me the wrong way. And by "rubbed me the wrong way", I mean pissed me off, had me sobbing, and stole away any hope I still had left of managing my depression. I couldn't believe she told me that. I mean, even if she was thinking that she shouldn't have told me that. Not when I'm depressed, suicidal, and losing hope on my own.

Not the best thing to say.

Hubby and a couple of my friends have told me to find another pdoc. That what she said was unacceptable. That it seems she's throwing in the towel. Meds won't work on you.

I am torn though. I keep thinking, what if this is all me? What if meds won't work for the depression and that I do just need to do more trauma work? What if this is a situational type of depression, that I have to buckle down and plow through and it's all on me?

What if?

What if I'm changing pdocs because I basically didn't like what she had to say? Maybe changing pdocs won't help anything. Maybe the new one will say the same thing. Maybe I'm just chasing meds, looking for the easy way out.

I look back at myself over the last 3 years, trying to see patterns, trying to see what I'm doing right and what I could improve on. I'm trying to be open and bluntly honest with myself. I need to be if I'm going to get stable.

One thing Ive noticed (and I picked up on this about a year and a half ago) is that once I start to get better I'll be better for a couple of months and then relapse. I get depressed again. And a year and a half ago M (therapist) and I discussed this. We talked at length my "not wanting" to get better. We worked through it, we found and worked through a few triggers, and having me identify this flaw within myself had curbed that tendency to self sabotage.

And I look back and I see no self sabotage for my mania (and hospitalization) last November, no self sabotage for my suicidal depression (and hospitalization), last December, and no self sabotage for my suicidal depression (and hospitalization), last May. I find no trigger, no form of self sabotage - it just happened.

July and August this year I was starting to become more stable. In October I started to slide, by November I was down and getting worse, and December has been horrid. I know I had one trigger: a piece of Al-Anon literature I read on forgiveness. It gave me icky feels. I worked through these feels in Al-Anon, in therapy, and with my hubby. I worked through them. I laid them to rest.

Now, knowing that was a trigger, I was doing all the proper things to counter the emotional response. I talked about it, I journaled my feelings and thoughts, I countered my negative thoughts, I didn't catastrophize, I did everything right.

I worked through it. I felt better about it, and felt that I had nothing more to say on the matter.

Several weeks later is when I really started to spiral. I did all of my CBT stuff that I've learned about, I talked to hubby and in therapy. I didn't let myself isolate - I forced interaction. Again, doing everything right.

So what the hell is going on?? Did I have a PTSD trigger that threw me into a bipolar mood episode? Is this just PTSD? Is this just a bipolar shift with no real trigger? Does it really matter?

Because here in lies the rub: I'm doing all my CBT things, I'm trying to stay present, stay in the moment, take it day by day (sometimes moment by moment), counter my errors of thinking, not isolate, trying to "fake it till I make it" . . . all the things I should be doing.

But they're not helping.

They should be helping. If this was all me, all PTSD, all a trigger, then this shit should be working. And it's not. M pointed out that that one Sunday at work where I was crap and laid on the floor for 2 hours because I was suicidal and didn't know what else to do was most definitely not a trauma issue - it was most definitely a chemical imbalance issue.

If all my behavioral therapies are not working that would lead to a chemical problem, right? So meds, right?

But my pdoc won't prescribe me anything else because she believes this depression is all trauma, all in my head. That if I do more trauma work I'll be fine.

I don't even know what to talk about trauma wise anymore. I really don't. We've gone over my abusive relationship and rape. We've gone over my dad's death. We've gone over stuff with my (alcoholic) mom several times. I don't what else to say on these matters. I have no idea. I don't even know what to say in Al-Anon anymore (I've been silent the last three sessions cause I have nothing to add).

So what more trauma work do I need to do??

There's only one area I see where I need more work: fake it till I make it. I've been faltering in this area. Why? Because it's hard to pretend to be positive, to be okay, to be well, to be not depressed. It takes so much energy and it's so much easier to give into the depression. It's better for me to fake it, it is. But I've been so tired lately, the past few weeks, that it's gotten harder. It's easier to give in. To not fight. See, part of me wants to give up. I'm tired of fighting my moods everyday. I'm tired of the knowledge that I'll do this for the rest of my life. It's too much to handle and so I'm slacking on forcing myself to seem okay (even when - especially when) I'm completely broken on the inside.

What the fuck do I do? Change pdocs I guess, see what the new one has to offer. I don't know. I don't even know. This is all very frustrating as fuck.

Also? I've noticed that since I've been on 600mg of seroquel my cognition is suffering. I forget letters in words or add extra letters, it's taking longer for me to think things through, to respond. Joy.

Bit of a conundrum

Yes. I'm facing a conundrum.

Remember how my hope went *poof*? Well. I decided to try something. See, I'm not all that hopeful that increasing my seroquel is going to do anything for the depression. I'm not hopeful at all, actually.

So I did something.

Last night I skipped taking my seroquel.

Yep. I didn't take it. And I didn't sleep. Maybe 3 hours? Maybe? And this morning I was wide awake and felt deliciously hypomanic. Well, not too high actually - just good. Awake, good, even.

And then I got tremors - like, bad. And some anxiety.

We went to my mom's house this morning to do Christmas there as I work tomorrow (xmas). My brother and his family was there, hubby's mom and brother, and it was okay.

We were there for 2 hours and towards the end my mood was starting to plummet. Probably a combo of lack of sleep and extended family time. Right?

I've been working on my book this afternoon, actually accomplishing something, getting a little more direction with it.

My mood right now is weird. I'm a little anxious and feel . . . weird. Just, weird. I feel a little down, empty, tired, dizzy almost, lightheaded at times, and there's some irritability creeping in. The depression isn't as pressing as it normally is, which is nice, but it's certainly not gone. But I have some of the underlying hypomania.

My conundrum: do I skip the seroquel again and see what happens? See if I get more hypo? Or do I take it as prescribed, like a good girl, and hope that 600mg lifts my depression?

I work tomorrow, so if I skip the seroquel again, and get more hypo . . . well, it could be decidedly not good. But I have klonopin in my purse to knock me down.

I keep thinking that I should be good, I should be compliant and take my meds as prescribed. I mean, Mary told me not to stop the seroquel (or any med on my own). And I know better. I know better than to just to stop taking a med. Especially cold turkey. When I skipped doses of geodon I had rebound depression - bad. Would that happen with missing another dose or 2 of seroquel? Or hypomania? Or mixed?

I want to miss another dose, but I'll admit - I'm scared to.

I was originally put on an antipsychotic for mania - I was hospitalized a year ago November for that. And, I really haven't had mania since then (well, I've had some of the irritable hypomania sporadically, or an hour or two of slightly euphoric mania). But for the most part? Nothing. Depression.

I had a brief 2 month span this past summer where I felt pretty stable. Then boom - horrid depression again.

So what do I do? Stop seroquel on my own against the advice of my psych doc (and therapist)? Or keep taking it and hope against hope that the increased dose helps?

Gaaaaaaahhhhh!!! I hate this! Why can't shit just work?

Fuck me.

Today I should have gone to the hospital

I worked today. I was on the floor, backup for trans. I had easy patients. Nice patients. It should have been a nice day. An easy day.

It wasn't.

I knew this morning when I woke up that today would be difficult. I knew I would struggle. I just didn't know how much . . .

I avoided people. Coworkers, my patients even. Go into a room, do what I needed, and get out. I was irritable. I was angry. I didn't want to be bothered. People asked questions. Questions I'm sick of answering. Have you sold your house? When are you moving? Where are you moving to?

I don't. Fucking. Know.

And I'm tired of everyone asking.

Wait.

It's a simple thing. It's not a big deal. People are curious, interested, caring. Making conversation.

But it filled me with rage. I couldn't handle the questions so I withdrew a little more. I gave short answers.

In the afternoon I hid.

I stole away to the report room, sat in a chair in the corner behind the door so people wouldn't see me. That only lasted for half an hour before I got a call from a patient. I left my chair, my temporary sanctuary, to bring my patient pain meds.

I had brought my Nook with me so I decided to try reading. Reading should help, right?

Normally it does. Not today though. Not today. Today I couldn't really focus. After a few pages I would have to take a break. Walk, stretch, check my email. I couldn't focus. I couldn't focus why can't I focus what the hell . . .

My mood was worsening. I grade myself on a scale of 1-10. Five is "normal". Below is moving into depression, above into mania. I started the day at a 3.5. Yes. By 4:00, I was a 2, threatening to go lower. Ever lower.

It can't go lower.

It was. I hid. I hid in the report room again. It was dark in there, the sun was already going down and I left the lights off. I wanted the dark, the quiet. I wanted no one.

Leave me alone.

The charge nurse came in. She didn't know I was sitting there, alone, in the dark. I said boo. She jumped and immediately asked if I was okay.

No. I'm not okay. I'm far from okay.

She offered to take my patients and send me home.

I'll be alright. I'm not okay, but I'll be alright. I can last the rest of the shift. It's only 2 hours. I can do it.

She took my face in her hands and told me to let her know if I needed anything.

Wait. I need help.

Wait.

She left and I sat in the dark, alone. I started to shake, to tremble, lip quivering, tears welling up. I wept. Silently. I tried to stop. I can't have someone catching me crying. Sitting alone in the dark is one thing . . . but crying . . . no.

I stopped crying and I sat, drying my tears, blowing my nose as quietly as I could.

I felt worse. So much worse.

I need to lie down.

I laid down on the floor, in the shadows, behind the door. No one could see me if they were just walking by. Perfect.

Wait.

I was worse. I felt worse. I'm lying on the floor alone in the dark at work and no one knows I'm here and they don't know how bad I feel how bad I've gotten again and that I'm lying here and what I really want to do is die but I can't do that not here not at work and maybe not anywhere but I still kinda want to die and why isn't anyone looking for me?

My mind was racing, I was praying. Please, someone, anyone, find me. Find me and HELP ME. I need HELP don't you understand I NEED HELP!! Someone. Please . . .

Stop.

If someone finds me, if they ask me, I need help. I need to go to the hospital. I want to swallow all of my pills and slit my wrists and  want to go to sleep and not wake up and I know that that's not what I really want. What I really want is for the pain to stop. The pain to fucking END ALREADY.

I'm lying on the floor at work in the dark, hidden from everyone, praying, praying, PRAYING and no one comes. No one comes into the report room. I'm on my side, curled in a ball, full of despair and hopelessness and I start to cry again because no one is coming and no one is helping me and please just someone come and help me because I'm afraid I might hurt myself and it might be real bad this time and I'm scared. No, I'm terrified. My mind races with scenarios of my death and how I might be saved if someone would just FUCKING COME INTO THE ROOM.

But no one does.

I'm miserable. I text my husband. I tell him it's bad, I'm having a rough day, I'm hiding. I don't let on how bad it is because I don't want him to worry. I make him worry so much and I don't want him to worry because I'm okay, really, I'll be okay, I'm fine actually. Just fine.

Stop.

You're not fooling anyone. At least, not yourself. You need to get up. You've been on the floor for 2 hours.

Get up.

I can't. I need to stay longer. Someone may find me and I can get help. I need help. Remember?

Get up.

I sit up. I feel defeated. I feel empty and hopeless and scared and depressed and I don't want to move but I have to move I have to check on my patients and no one is coming to check on me so I have to get up.

Get up.

I stand. I look into the hallway to make sure no one is around while I make my way to the bathroom to clean myself up. I need to be presentable. People can't know that I was crying. That I was silently breaking down and losing my shit while they were doing their work and being happy and normal and not looking for me or helping me because apparently I still do a good job of hiding my suicidal thoughts and depression and no one seems to be the wiser.

Wait.

I check on my patients. They're fine. I was on the floor for 2 hours and they didn't call me and they didn't need anything and they're fine. I sit in the nurses station staring at my phone, scrolling through facebook, trying not to think about how much I hate life and how much I really want to die and then countering my thinking because I know I really don't want to die, remember? You want the pain to stop. You want to not feel like this anymore.

Please.

My shift ends. I give report. I drive home. I tell my husband if I have another day like today I need to be admitted. I need to go to the hospital.

I don't want to go to the hospital. Not again. Please not again.

Help.

 I feel empty and drained and horrifically sad and hopeless and it's maybe more than I can handle. Is it more than I can handle? I wish I knew. And how will tomorrow be? The same? Worse? Better?

Stop.

I wrote this. Before going to bed because if I didn't write this it would consume me and I wouldn't be able to sleep and my mind would probably race even more and I can't have that, not now. Now I need to sleep. It's the only real escape I have.

And Then My Hope Went *poof*

That's exactly what my hope did.

*poof*

Gone. Lost somewhere in the stratosphere, floating around, uncatchable.

Or it's in the trash. I'm not sure at this point. (Floating around in the stratosphere sounds sexier though).

Why did my hope go *poof*? Well, I saw my psychiatrist, Mary, on Wednesday. And . . .

Wait. Let's back up a minute.

I want to recap what's been going on, in case you haven't read any previous posts. I'm depressed again. It's bad again. I have suicidal ideation on most days. I want to cut and I have. I alternate between wanting to die or wanting to not exist. It feels as though everything is being ripped from me again - I was starting to get stable over the summer and now everything is crashing down around me, hundreds of thousands of tiny shards and there's no way I can possibly pick them all up again. And every time I shatter like this, I miss a few pieces. Or a hundred pieces. Each time I break it's harder to collect those pieces, those shards, and this time they seem to be scattered further.

Okay. Back to Mary.

I sat in the waiting room doing a word search on my phone, feeling irritable and depressed. Surprisingly, I didn't have to wait long to be called back. Mary has a psychiatric nurse working with her who starts the intake - she gets my weight, blood pressure, and starts asking me questions. How are you doing? Bad. I'll go with that - the opposite of good. What's been going on? My depression is continuing to get worse. Five weeks ago Mary increased my seroquel and I haven't noticed any difference. I have suicidal thoughts more days than not. Do you have a plan? Yes. But I have no intent. Can you contract for safety? Sure. When was the last time you cut? This morning (I proceed to roll up my left sleeve). What's been going on the last few weeks? How's home? Work? Nothing has changed. Work is busy, home is fine. No triggers that neither I nor my therapist can identify.  Any hallucinations? No.

She typed everything I was saying, went over my meds, and brought me back to Mary's office. I liked Mary when I saw her 5 weeks ago. I liked her more than Chika (she works with Mary and is who I've been seeing since June).

Mary is reading everything her nurse wrote about me. I sit down. She looks up at me over the rim of her glasses. Cami, right? Yes. Seems like you're not doing to well. Tell me about the suicidal thoughts.  Um, well, I have ideation more days than not. I think mostly right now of slitting my wrists. Before it was always an overdose, but not now. I've had 3 days in the past 5 weeks that I probably should have gone to the hospital. But I'm stubborn and I didn't want to go - I wanted to try and manage it on my own. My therapist was a little mad at me because 1. I didn't go in, 2. I didn't call or email him (but he was in Italy on vacation and I didn't want to bother him), and 3. I didn't call you to let you know.

Before she asks another question I pull a piece of paper from my purse - the results of my genetic testing - and hand it to her. As far as my current meds go, my dosing is fine (the genetic testing was for medication metabolism - so, for example, if you're a high metabolizer for such and such a class, you'd need a lower dose of that drug).

Mary is looking at the results and to her computer screen. Results. Computer screen. Then she looks at me. You've been on a lot of meds. I know. She sighs. I don't think meds are going to help your depression. Look - you've been on so many and none of them has really helped, at least not more than a few weeks. Meds aren't going to help. I stare at her. The force of what she just said hits me hard and I'm speechless.

Wait. No.

Meds aren't going to work? You're telling me meds aren't going to work? (I think this, rather than say it).

She continues. Have you ever considered ECT? (I'm staring again). It can be very successful in treating depression. I haven't really thought about it for myself. Seriously, at least. It's just . . . the memory loss associated with it. Not such a good thing when you're a nurse. I'd have to be on leave for the entire duration of treatment (3-6 months). That's true. Have you heard about EMDR? Yes. You have a lot of trauma in your past, EMDR would be beneficial. I already do trauma work with my therapist. His specialty happens to be trauma. We're just moving at a snail's pace because it can be so triggering. My session last week was crisis intervention because of my depression. But we've been working on trauma. Okay, good. Have you heard of DBT? Dialectal behavioral therapy? There are group DBT sessions that you may want to look into. You learn coping skills and ways to manage your emotions. Okay . . . You could also look into neurofeedback. What's neurofeedback? You have electrodes placed on your head to measure your brain waves and then you learn how to change your brain wave pattern.  Oh. Okay. Do you give me referral? How does that work?

I'm almost in a trance at this point. My head is reeling. I'm going into shutdown mode. Meds aren't going to help your depression. You don't understand Mary. I need meds to work for me. They have to work for me. I've been doing everything right. I'm trying my hardest. I'm fucking trying and I need a little help here!

She continues. You'll need to research groups nearby and contact your insurance company to see if they cover these treatments. Some companies do, most don't. You do need to work through your trauma. I think that will help. It complicates things. Okay. (I nod. I'm on the verge of tears. I'm trying desperately not to cry). She looks sternly at me. You know, sometimes people have this black cloud around them their whole lives and it never gets better. Maybe they have suicidal thoughts all the time and they're just there. It doesn't go away. 

I'm staring again. I wouldn't doubt that my mouth dropped open a little bit. You're sitting here telling me that this won't get better. Meds won't work. Here are a few therapies you could try that may or may not help and that insurance probably won't cover but I'm trying to give you something to grasp for because let's face - nothing has worked before so probably nothing will work now, either. The same person telling me this told me 5 weeks ago that I didn't have to feel depressed - that we would find something that works and we can manage the depression better and don't give up because I'm hopeful that you'll get better soon.

This is not okay.

She must have read my face, my thoughts, my posture. Look, you should be proud of yourself! Look how far you've come! You're doing every possible thing you can do to get better. You're doing everything right. Okay. How about we try increasing the seroquel to 600mg? Maybe you just need more. Maybe your body needs a higher dose for the antidepressant effects. (I nod. I'm not hopeful. You told me meds won't work, yet we're going to increase a med that you don't think will work. Are you trying to placate me?) Okay. We'll try that for 4 weeks and I can even increase it to 800mg in 4 weeks if we want to try that. But we'll try 600mg for now. Look into DBT group and neurofeedback. And have a Merry Christmas! Okay.

I nod. I'm in disbelief. I make my way to the front desk and make my follow up appointment. The tears are threatening. I make it to my truck before I completely break down. I sat for 10-15 minutes sobbing. Uncontrollable sobbing full of pain and despair and frustration.

That was not what I was expecting from that appointment. Well, increasing the seroquel I expected. But not to be told that meds probably aren't going to work, aren't going to help, and we're kinda at the end of the line so maybe you should look into ECT because there really isn't much more out there for you. I was looking for hope, and I didn't get that. The thin strand of hope I'm desperately holding on to is unraveling.

And it fucking sucks.

I'm looking into DBT and neurofeedback. I'm going to discuss them with my therapist (I don't see a huge difference between DBT and what I've learned doing CBT with my therapist).

All I want is for something to work. I don't think that's too much to ask.

I've two docs tell me I need to sort through my trauma stuff and I have been. And even though I have been, I still can't identify triggers (I know some, and I can counter them so I don't have such a large emotional response, but I don't know most).

So I went up to 600mg of seroquel Wednesday night. Yesterday morning and this morning were hard to wake up to - for many weeks now I've been having a progressively harder time waking up simply because I don't want to be awake - but jumping from 400mg to 600mg seems to have made me more drowsy in the morning (hopefully that will go away).

The only thing I can do is to keep trying. At least my stubbornness comes in handy with this. My therapist had told me that as long as I'm breathing, there's hope.

I'd like to believe him.

So I want to kill myself . . .

I really do. . . at times.

Like yesterday. Yesterday was bad. Yesterday I wanted to slit my wrists and watch the blood flow. Watch the blood flow and feel myself weakening as I slip into darkness.

But I didn't. You know why?

Because deep down I know that I don't truly want to die. What I want is for the pain to stop. For my constant up and down (mostly down) to stop.

Here's a story:

Friday night I forgot to take my meds. I usually take them around 8-8:30. Well, I didn't. But when I went to bed at 10, I didn't realize I hadn't taken them because I'm so used to taking them at that time. I've been late taking my seroquel before and I typically have insomnia, tremors, nausea, night sweats, and racing thoughts until I take it (even if I'm 2 hours late taking it I have these symptoms). Friday night I had insomnia - I only got around 3-4 hours of sleep. But I had no other symptoms until 6am - I didn't figure out until then that I had forgot my meds (after having the other symptoms, I counted my seroquel and yep - forgot it).

Of course I worked Saturday. All morning I rapid cycled. I'd have depression with racing thoughts, poor concentration, and irritability. Then my mood would lift and I'd feel okay, I'd giggle a little, and become very talkative. Then my mood would plummet and be mixed again.

This happened until around 3. At 3 I became hypomanic. Euphoric hypomanic. I felt amazing. I laughed so much. I laughed at everything and nothing. I talked rapidly and became highly excitable. I had racing thoughts. I said inappropriate things. I was loud, and at times obnoxious. I cussed. A lot. In my hailstorm of activity and loudness and giddiness, I told numerous people that I was bipolar and didn't take my meds (people didn't need to know that).

But I felt amazing. Like I could conquer the world.

When I got home from work I was still giggling and talkative, but my lack of sleep was starting to catch up to me (in retrospect, this was probably good - if I had gone higher, or if it lasted longer, I may have needed to be hospitalized).

I had a great day. A wonderful, amazing, and happy day. Because I didn't take my meds. So I rationalized that maybe I should stop my meds. At least the seroquel. Now, seeing how my judgement was probably clouded, I asked my hubby and my best friend if I should take my meds. They both said yes, take your damn meds. Don't be a noncompliant idiot (my friend's words).

So Saturday night I took my meds like a good girl. I went to bed around 10. Hubby came to bed around midnight to find me unable to sleep, plagued by racing thoughts. My whole body hurt because I was so tired and my mind was going so fast. He had me take a benadryl to try and help me fall asleep, and an hour after I was able to sleep. I slept until 9am (I'm usually up by 7).

I woke up knowing something was wrong. Knowing something was off. Knowing that it was going to be a bad day.

I awoke depressed. I tried to hide and ignore it. I tried all day to hide and ignore it. How could I possibly feel so bad after having a day where I felt so good??

Throughout the day I felt increasingly more depressed. My thoughts became darker. I wanted to cut. I needed to cut - but I didn't. I tried to keep my anger in check, even as it swelled and threatened to consume me. I didn't want to be around anyone - including hubby and son. I didn't want to interact with anyone - including texting friends.

I thought more about slitting my wrists.

After putting my son to bed I broke down sobbing. I couldn't take it anymore. It was the ugly cry where your snot gets everywhere and was filled with utter despair and hopelessness.

I can't go on like this.

I told hubby that. I can't. I can't do this anymore. It's too hard. It's not fair. How can anyone possibly think that I can keep this up??

Over the past 3.5 weeks I've had suicidal ideation on more days than not. There have been 3 instances where I probably should have gone to the hospital (last night, honestly, was one of them - I really wanted to slit my wrists and I was feeling impulsive). I'm doing everything right. My therapist pointed that out as well - I'm doing everything I'm supposed to be doing. All the CBT stuff I've learned in therapy - I'm applying it. I want to isolate - I'm forcing myself to interact. I'm staying busy rather than just staring at the ceiling or sleeping (which is what I want to do).

And yet I continue to get worse.

I see my psychiatrist on Wednesday. I'm guessing she'll increase my seroquel again. To either 500 or 600mg. Then probably another month of "let's wait and see if this helps at all". I'll be curious to see what she has to say about the suicidal ideation (my therapist was a little annoyed that I didn't call her office to let her know about the suicidal thoughts - well, I don't know her well and I didn't want to be told to go to the hospital; I thought I could handle it on my own).

Something has to change. It has to because I truly can't keep doing this. I'm tired. I'm not hopeful (why should I be? Nothing has worked so far).

I don't understand why I have to exist. Can't I just disappear until something manages my depression? Until I feel better? Why can't I do that?

SSDD

Same shit, different day.

My mood is still shit. I'm still depressed, still having suicidal ideation, and have been cutting. That is most certainly not a good combo. I have had 2 days in the last 3 weeks where going to the hospital might have been a good idea - except I don't think it would help much (I have been able to keep myself safe . . . well, except for the cutting).

I had a talk with hubby about everything a couple of nights ago to let him know what goes on in my fucked up brain. Maybe I scared him a little, I don't know. He thinks I need to add something else to my cocktail again. Maybe I do. But I don't know what. I don't have a good track record with antidepressants. He gave me homework though - to look back through my mood journal and see if there was something that I was on in the past that helped, even if I had to stop it for some reason.

Here's what I found:

I've always been on lithium and lamictal  - l&l - (both are mood stabilizers). For awhile I was on those with an antidepressant (most of the time, wellbutrin). This combo had me in a constant mixed state. I had mostly irritable hypomania mixed with depression, with a few short stints of euphoria. Reading through my journal, seeing how much irritability, distorted thinking, and depression was there makes it obvious that this is not a good combo.

I've also been on l&l with cymbalta. This combo lifted the depression a little but still kept me in a mixed state. L&l by itself renders me with deep depression.

I was on l&l with wellbutrin when I was hospitalized last November - wellbutrin was stopped while I was in the hospital and I was started on zyprexa. That knocked out the mania, but depression was still there and I was hospitalized in December after Latuda pushed me over the edge.

While on l&l and geodon, I had depression, sometimes a little more mild, often times more moderate and I lost my creativity. Mania/mixed symptoms are gone. Then, geodon was stopped and I started on seroquel. Still no mania/mixed symptoms. Well, irritability, but I'm not sure if that's mixed or more the depression. And I've been on wellbutrin and brintellix with these combos with no real benefit.

So, l&l with antidepressant alone = mixed episodes. L&l with antipsychotic = no mania/mixed, but depression. L&l with antipsychotic and antidepressant = no mania/mixed, but depression.

I'm not sure what to do. I'm sure my pdoc, whom I see next Wednesday, will suggest maybe upping the seroquel again. But I don't know what else would be helpful. I need something. Something has to change because I can't keep feeling like this.

And how, exactly, am I feeling?

Let's take a "good" day (good being a relative term). Today is a "good" day. I start the day not wanting to be awake because being awake is pointless and stupid. I spend the day going through the motions, feeling empty, and vacant, and detached. I don't really feel anything. I'm flat, apathetic. Why should I bother cleaning/drawing/etc when everything is so pointless and hopeless? It doesn't make sense. Sleeping to escape makes sense. Cutting makes sense. If I cut at least I can feel something physically - pain. That's almost like a feeling. My urge to cut is strong, sometimes overwhelming. I float along, feeling nothing, doing nothing. Well, that's not entirely true - I feel irritability. Easily. It's the only thing I do feel. I get snippy and bitchy. And in trying not to be snippy and bitchy, I tend to withdraw more.

Now, a bad day. Again, I awake not wanting to be awake because everything is pointless and stupid. Only now, I feel despair. Overwhelming despair and depression and darkness. Not only is being awake pointless, living is pointless. I want to die. I don't know how I can possibly make it through the day. The emotional pain is so great that all I want to do is curl in a ball. Curl in a ball and not exist anymore. Sometimes I do this - even at work - because I don't know what else to do. I get overwhelmed easily, I feel like giving up, and my irritability can get out of control. I tear up easily and often break down sobbing. I want to cut - this time not to feel physical pain, but rather to numb the emotional pain. I want to cut deep enough that I need stitches. My mind fixates on death - my death. Suicidal ideation. I hurt so bad that I don't know how I can go on living. I can't live like this - this is torture, not life. I know that if it does continue to go on like this, I'll kill myself. It's a certainty I'm terrified of.

I struggle whether it's a good day or a bad day, just in different ways. Neither of these days are really okay with me. I have to feel something other than this. I'm so fucking tired of dealing with this. No one should have to - especially for as long as I've had to. I'd really love to throw in the towel.

But I can't.

So there's where I am. Stuck between shit days and shit days. We'll see what my therapist says this week and what my pdoc says next week. What else can I do . . .

3 weeks later . . .

It's been around 3 weeks since my last post. Why so long? Because I don't want to post negative post after negative post. I've written some, I've just never published them.

I saw my pdoc, oh, I don't know, 2.5 - 3 weeks ago? Something like that. She said that we should be able to manage my depression better. So she upped my seroquel from 300mg to 400mg. She said that on doses up to 300mg seroquel works on mania and as a sleep aid. At doses over 300mg, it works on mania and as an antidepressant. She's confidant that this will work. I see her again on the 17th.

Long story short, it's not helping much. My depression is still bad. Most days I battle with suicidal ideation. This past Saturday was particularly bad as I was actively suicidal and wanted to slit my wrists. Luckily hubby was with me all day. I didn't quite let on how bad I was though (I don't want to go back to the hospital).

I want to spend all my time sleeping. That way I don't have to deal with how I'm feeling. I've been reading a lot to escape too. And art. I've been drawing.

I'm really getting tired of this. This stupid depression. I'm trying so hard to stay positive and yet it beats me down. I tell myself over and over that life is worth living, but the majority of the time I don't feel that way. I do have good moments, sometimes even a pretty good day, but they're few and far between. It's mostly me trudging through, faking it, forcing myself to talk and interact. I had started pulling away from hubby and son and I talked to him about it - I can't let myself pull away.

I still feel distant though. I feel like a lie.

I'm trying not to talk about this much, to anyone really, because 1. I don't want to be a burden, 2. I don't want to seem selfish and self absorbed, 3. I don't want people to think I've brought this on myself, and 4. I'm hoping minimizing/ignoring/denying how I feel will help (I'm aware that this is not the best tactic and usually doesn't work - and yet I try it anyway).

I'm done for now. Maybe I'll write more later, maybe not. I'm trying not to go to in depth as I don't want to break down right now.

Ugh.