Friday, January 30, 2015

Update

On Tuesday I saw my new pdoc, Dr. M. First impression: nice, personable, and no nonsense. He read through all of the info I brought him (my med history, illness history, hospitalizations, etc) and asked him why I had come to him.

Well, because the NP I was seeing told me she wasn't going to prescribe anything new, that meds won't help me, and that I'll be depressed and suicidal for the rest of my life and that I need to get used to it. Oh - and have you considered ECT?

His response? "Looking at your med history I can see why she would say that. She could have done so a little more tactfully . . . I think she's stumped. Have you considered ECT?"

"Um, no. It's probably not a good idea because of the short term memory loss, with me being a nurse and all."

He then went on to discuss ECT with me a little more in depth. He's been doing it for 20 years and has seen remarkable results with it. The vast majority of his patients have little to no issues with memory. The talk put me a little more at ease.

But I still really don't want ECT.

One thing he was willing to try was to start me on Lexapro (an antidepressant). Before I was diagnosed with bipolar disorder I had been on Lexapro for depression. Any time we increased the dose, I would get hypomanic for a couple of weeks. The hypomania would slowly wear off and then I would be okay for awhile. But then the depression would creep back in. Dr. M is hoping that since the Lexapro made me hypomanic in the past, that it will lift the depression now.

And that's it. That's all he's willing to try. If the Lexapro doesn't help and I'm still having issues with depression, my next step is ECT. Because I'm doing all the other stuff (CBT, trauma work, DBT, Al-Anon . . .). There's not much left.

Fingers crossed that the Lexapro helps.

Wednesday, January 14, 2015

How I'm Feeling

I'm back at that place of no feelings. Nothing. Flat. I try, but I fail. I keep feeling like I need to cry but I can't. I just . . . can't. There's not enough emotion behind it. There's just nothing.

And that's frustrating.

Honestly, this is just as bad as the raw depressive, suicidal, tidal wave of emotion. It's just bad in a different way.

Have I posted this before?


I might have. I'm not sure. 

But this. Seriously. This is so accurate to how I'm feeling. 

I keep thinking, well, I'm not cycling madly, so am I stable? Is this what stability looks like? This . . . nothing? If this is how I am stable I don't like it. I want to feel things. Other than irritability (I can still feel that). 

Maybe I'm expecting too much. Maybe expecting to have some semblance of "normal" feelings is asking too much. Maybe that's just not in the cards for me.

I hate this. I hate it so much. It's stupid and it's not fair. Existing and living are not the same. All I'm doing is existing right now. At least when I'm an emotional whirlwind there's some sense of living . . . Not now. Not at all. 

Fuck. Everything.

Sunday, January 11, 2015

I wax poetic I guess

So the stupid thing is that I'm at the point where part of me wants to give up again. I'm at the point where I want to throw in the towel. Thanks, life, it's been fun. But I'm done now. You've become too cold and hard and bitter. You've become too much trial and not enough triumph.

I know, I know. By virtue of me still being here that's a triumph, right? At least that's what some people would say. You're strong. You've been through so much and you're still standing.

Yes, I'm standing alright.

Well, more like kneeling. Not on-my-knees praying kneeling, no, not like that. But on my hands and knees, head hung low in despair, my hair sticking to my face thanks to the tears. Sobs racking my body as I wish for a swift end.

That's not what I would call a triumph. No.

Or is it? I'm still alive, I guess. My heart still beats though at times I will it to stop. My lungs still fill with air, even when they burn with exertion from crying.

I still function. I still work and carry on as though everything were okay. I would call that a triumph. Still being able to function.

So there's that, I guess.

I have a hard time finding meaning to things. Life in general, of course, but also of things. Just, everything. I get to where I feel so empty and hollow and lost that I don't know how I can possibly go on. Everything gets so bleak and I get tunnel vision. Except it's not really tunnel vision. No. It's like everything has expanded, blown apart into minute detail but it's all foggy. Foggy and thick and slow and the emptiness is all consuming and I feel myself sinking in the sludge. It feels dark. And cold. And I will my heart to stop - even if for a moment - to give me reprieve. It feels like I'm drowning. And as I try to fight it, to scramble out of the dark and cold and slowness I marvel at how insignificant I really am and how nothing I do truly matters.

But it does matter. I remind myself of this. It does matter. You matter. The depression is talking. It whispers in your ear and tells you lies and you really do matter. Life has meaning.

I force myself to look for meaning. There's the obvious ones: family, friends . . . and more subtle ones. The obvious ones give me grounding, the subtle ones give me hope.

Ahhh, hope. I've been told that as long as I'm breathing, there's hope. I'd like to believe that. It's another thing I remind myself of when depression is whispering softly in my ear.

Depression doesn't whisper softly though. Not usually. It's firm and direct and demanding. That's the problem with it. I can tell myself all of the positive things in the world and the depression throws its head back and laughs. It counters every positive with a negative as I scramble and climb and try to keep my head above the darkness. It bares its teeth and grins at me, a beastly, ghastly thing. It holds me fast.

But then my resolve strengthens and I find a new way to fight, a new way to counter.

And I'm trying yet another new way. I don't know if it will work. I don't know if it will help. I don't know if depression will release its stronghold on me. Its grip is tight and fierce and convincing.

I am, however, still breathing.

Wednesday, January 7, 2015

Procrastinating . . .

That's what I'm doing right now. Procrastinating. Writing this post. I've been looking up random shit on the internet instead of writing. For a couple reasons, really. One, I'm depressed, and sometimes I want retail therapy when I'm depressed (hence looking up shit to buy on the internet), and two, I'm depressed and emotionally drained and writing is sometimes difficult when I'm like this.

Wait.

Let's go further back.

To Sunday. Sunday was a bad day for my depression. Very bad. The highlight of the day was seeing Big Hero 6 - a funny movie that was pretty epic.

Monday. Monday wasn't great. Had some suicidal ideation (it would be so easy to take all of my seroquel and just go to sleep . . . just sleep and not wake up . . .). There was that, and that's bad enough. But around 3 my tummy wasn't terribly happy with me. Around 5 it was kinda angry. And then after dinner my ENTIRE INSIDES waged war on me.

That's right. Food poisoning.

I was stationed on the toilet with the trash can in front of me for almost 2 hours. The stomach cramps left me moaning in pain, hyperventilating and both cursing God while begging him for mercy (you son of a BITCH PLEASE make this stop . . .). I stripped down to nothing because I was sweating so much from my misery. Hubby tried to help, which involved getting me some water and watching helplessly as my gut tried to kill me.

What made my shenanigans worse was that I couldn't take my meds. Nope. Even water was making my intestines angry again.

So I couldn't sleep. See, my body is now wholly dependent on seroquel for sleep. Stupid, right? And my stomach was churning and gurgling and angry and nauseous . . .

But by 12:30am I couldn't take it anymore. I got up, had a slice of bread, and took one seroquel (I usually take 2). I figured, hopefully one won't upset my stomach as much as two, and it should be enough to go to sleep.

Nope.

Too little too late I guess. Or my tummy issues were enough that I wouldn't sleep no matter what. I finally fell asleep around 3:30 and promptly woke up at 5. Yay! So much sleep!

I had therapy at 8:30 yesterday morning. I'm depressed, my stomach is still all wonky, I haven't had coffee thanks to stomach wonkiness, I'm tired, and now I have therapy. It was a long session. And exhausting (it would have been exhausting even if I had gotten sleep).

We're trying to figure out the depression thing and M has a way of challenging me and my thinking. Which is good. That's what he's supposed to do. So I'm telling him how I have an appointment with a new psychiatrist on the 27th, that I'm no longer going to see Mary. "And so you'll make sure to tell this new psychiatrist that if he says something you don't like, he'll be fired too," M quipped. I glared at him. "No. That's not what I'm doing", I growled. "Chika has always been very business and short and cold. Mary, the first time I saw her, said that I didn't have to be depressed all the time. That we should be able to manage the depression so that I could actually feel good. And NOW she tells me that meds won't help and that I need to figure out how to deal with feeling suicidal every day. That is NOT OKAY in my book!" I almost spit at him. "Even if that's what you believe, you don't tell your depressed, suicidal patient that."

I lean back against the couch. I didn't realize I had crouched forward, wringing my hands. "I've been seeing them since June. I've given them a fair shot. They took 2 months to get my med prescriptions straight and their secretaries are horrible. And good luck getting seen if you have an emergency - they already double book appointments." M nods. "I just want to make sure you have realistic expectations," he says.

Yeah, well, I probably don't.

"I don't know what to do med wise," I say. "See, I've been doing 'research'", I make air quotes, "on what was going on this past summer when I was the most stable. I was stable when on geodon and brintellix. But we had to stop the brintellix because of the anxiety and then switched from geodon to seroquel to try and help the depression. Well, there's no difference in my mood between being on 50mg of seroquel vs 600mg - except for more pronounced side effects. So what's the point of that? There's no point!" I stop a moment, rubbing my temples. Everything is so muddled. "My thinking is slow. I'm sorry." I wait a minute. My thinking is slow, but my thoughts are racing. So many things I want to say but they're not coming out. "Okay, so Mary had mentioned that I need to do trauma work, right? And so did the doc in Boston. Okay. Trauma work. We've been doing trauma work almost every week since the middle of June. We've done that. We went over my past relationship and rape almost 2 years ago and I'm comfortable with that. We've been going over the ACOA stuff for a while now. I'm going to Al-Anon. I'm doing stuff in workbooks on my own. And honestly? If you were to say, right now, what do yo need to say about your mom, I would have no idea what to say. I have no idea what more to talk about. We went to her house Christmas Eve morning and it was good. I've been texting her here and there and it's been good. I'm not feeling triggered by that like I used to be. I've invited her and her boyfriend over for dinner. She's respecting my boundaries and I feel good about it. Is there more stuff to work through? Yeah, there probably is. But I don't know what it is until it punches me in the face, I guess. Point is, I don't know what more to say, I'm comfortable with her, I'm not getting triggered like I was . . . so what then? What do we do when this happens? She says trauma work but I don't know what more to do with trauma work." Big sigh. I don't know how much of that makes sense.

"That was really nice," M remarks. "That shows how much progress you really have made. You've kind of come full circle and you're recognizing it. You have done a lot of work. You've made a ton of progress. You really are exceptional."

I blush. "I wouldn't say that . . ." Truthfully? I have done the work. I've been in therapy for 3 years. Weekly sessions almost the entire time. And I have learned a lot. I recognize me errors of thinking and then stop and replace them with positive things. I'm doing much better at mindfulness - being present (I'm not great, not perfect most of the time, but I try all the time). I'm truly taking things one day at a time. I'm recognizing triggers and either avoiding or minimizing them. I'm trying not to isolate. I do positive readings, track my moods via chart and mood diary, take my meds, go to therapy, keep a regular sleep routine, am cleaning up my diet, trying to get back into exercise . . . I'm not exceptional, no, but I'm doing the fucking work, that's for sure.

"No, Cami, you are. And with all of this, maybe this depression is a bipolar chemical thing."

I nod. I'm hoping it's a bipolar chemical thing. It has to be a bipolar chemical thing. Why? Because look at all the shit I've done. All the shit I'm constantly doing. If this isn't chemical? Then what the fuck else am I supposed to DO??? Seriously. There's not much more I can do. I'm trying a DBT group. I met with the therapist who runs the group yesterday and my first session is next Monday. It meets every other Monday. So there's that. I guess I can always try neurofeedback (but there aren't any good studies on it, it's expensive, and insurance doesn't cover it). Then there's good 'ol ECT. Which is not even choice for me.

Truth is, I'm doing everything I can. So if this new psychiatrist tells me that changing my meds, in what ever way, is not going to help . . . I have no idea what to do. Because I'm doing everything I can already.

M wanted me to describe an acceptable level of functioning for me. Here it is: I would like to be able to enjoy my husband and son. I would like to enjoy their company and doing things with them. I would like do enjoy doing things. I would like to not have suicidal ideation every day. I would like to not hate my job.  I think that's pretty reasonable. I think that's pretty realistic. M thinks so too.

And I know that that's not a destination. I know it's a journey, something M always points out. I know that I'll always have to manage my moods and triggers and meds. I get that, I really do. I hate it, but I get it. It's a lifelong journey. I just don't think I should have to spend so much of it so depressed that I want to die. Is that so much to ask?



I know I've had a lot of posts about this lately. It's been bugging me. Trying to figure out what is going on and how to best handle it. I don't know what is bipolar or PTSD or situational or environmental . . . I don't know. I just want to feel better.

Thursday, January 1, 2015

New Years . . . ?

I should write a new years post, right? Isn't that what most people do? Reminisce the previous year, state their new resolutions . . . I should do that, right?

No.

I'm not going to. For a few reasons I guess. One, I typically don't make new years resolutions, and two, this past year has been pretty crappy.

And my heart just isn't in it.

I couldn't care less about new year's resolutions and all that crap*

                          *all that crap = life in general   

My mind has been in a tizzy as of late. It's either slow as molasses or racing around throwing stupid ideas and thoughts in my face because my mind is an asshole. So now, just to try and make sense of shit, I'm throwing this all out on (figurative) paper. Maybe it will help. Maybe I'll still be confused and racing sludge and annoyed with my asshole brain. Who knows.

Hopefully we all remember what my pdoc told me about what she thought my "treatment" should be. And we remember how I was thinking of looking for a new pdoc.

I decided a couple of things: I made an appointment with a new pdoc (whose specialty happens to be bipolar disorder), and I'm going to start group DBT sessions. I see my new pdoc on the 27th and I'm meeting with the therapist for the DBT group next Tuesday (and then sessions are every other Monday, starting on the 12th for me).

These are both good things.

But my mind is still in a tizzy.

Why? Because I keep second guessing myself  and what is truly right for me to do.

I'll elaborate, of course.

I keep thinking back to what Mary said. That I may be depressed and suicidal and I should just get used to it. That meds won't help. That I need to do more trauma work, DBT, neurofeedback, ECT . . . that, basically, I'm failing at doing what I can to feel better. In everything she told me, she's insinuating that if I just did this thing correctly, did this thing more, I'd be okay. Life wouldn't suck. I wouldn't be depressed.

And this has hit me hard, actually. Not as in, depressing me more (not really), but as in making me second guess everything. Much of this is stated in my last post - and much of it will be restated here because I need to vent people and it's my blog so I do what I want.

The past few days have been . . . not as shitty? I'm not sure how to define it. Here's the prevailing thoughts/feelings: don't want to wake up (being awake is stupid), withdrawn, quiet, not wanting to interact (too difficult, takes too much energy, don't care), depressed (but not the sobbing despair kind), flat, angry, irritable, don't care about things, periods of not wanting to exist, feeling "tired", wanting to nap to escape or constantly reading to escape, over eating, and feeling empty and nothing. That's still kinda shitty, right? Not how I want to feel. Not at all. But I keep thinking, I haven't been the sobbing, suicidal depressed for what, almost a week? So I'm not depressed. I can't be depressed if I'm not suicidal, right???

Wrong.

We all know this. I'm depressed. Just a different kind of depressed.

But the kind of depressed I'm in now doesn't garner the same attention as me being suicidal. I'm seen as being stable. I'm seen as getting better. When, in reality, I'm still fucking depressed. I'm still terribly withdrawn from my family and everything else. And it sucks. Feeling like this sucks.

And then I get confused. Is this how I'm supposed to be feeling? Is this normal? Do I still feel this way because I'm not trying hard enough? I mean, Mary said I needed to do trauma work, do trauma work, it's the only way. Maybe I haven't done enough . . . maybe I need to hunker down and really do trauma work and I'll be fine. This will pass.

Wait.

I've been doing trauma work. M and I have worked through a metric fuck ton of trauma shit. I'm at the point now, in talking about my alcoholic upbringing, I'm not sure what more to say. I'm slowly building a relationship with my mom and I'm okay with that. She isn't nearly as big f a trigger for me . . . So that's good, right? That means I've been doing something right . . .

But if you're still depressed, obviously you haven't done something right.

What is that something?

Are my expectations too high? Let's be honest, if I could choose, I'd be mildly hypomanic all. The. Time. Who the hell wouldn't want to feel like that? Here's the thing though - I know that's unrealistic. I know that's not how I'll feel. What I really want? To enjoy life. To feel joy and happiness and contentment. To feel connected. To feel love. To feel emotions other than hate, anger, resentment and irritability. I want to not constantly feel like I don't want to exist or that I'd be better off dead. I want to feel emotions - all emotions - without feeling like I'm drowning in them.

And I don't feel like that's too much to ask.

So I've been doing trauma work, my expectations really aren't that high . . . so what else? What am I not doing right? Self sabotage? No, I've been actively countering all my errors in thinking and I'm forcing myself to try and stay connected, interactive, all that shit. If this isn't chemical, like Mary said it wasn't, what the fuck else?

SAD.

Could this be seasonal affective disorder overlapping the bipolar? Is that what this is? Do I just need to wait it out and I'll feel better? Is that my problem? I'm not strong enough to wait a few months? Suck it up, buttercup. You're life is going to be fucking suicidal shit for 3-6 months, but you can handle it. Try and stay positive. Muddle through. You'll make it. Meds won't help. Just deal with being suicidal.

Stop.

I get on that line of thinking and I get stuck. My brain goes faster. I'm not strong enough to wait it out. I should be able to wait this out. I should be able to do this.

Wait. Stop.

That's an error of thinking. No "shoulds". Counter that. Replace that thought. Better.

Let's try this. If it is SAD, then yes, it's cyclical. Right? So it should end, right? But when? I can't spend 3-6 months struggling every day, trying not to kill myself, and ostracizing my family and friends. Honestly, that's no way to live. And it's not how I want to live. So what then? What do I do?

Should I try going the med route? Is that the answer? Something to help me through this time period (assuming this is the problem)? More therapy? I mean come on - I do CBT, trauma work, Al-Anon, and I'll be starting DBT. What the hell more can I do? Do I truly just suck it up and deal with it? I don't want to accept that as the answer. Surly I can feel better than this.

I don't know. I can't even remember how I used to be. How I was before my "break" 3 years ago. I know I was depressed after having my son, and that that got progressively worse and worse until I lost it 3 years ago. I know I've had depression all of my life. But I don't remember how it was. My hubby says that I was upbeat, easy going, go with the flow, didn't get upset much (although at times I was "go, go, GO" with things, projects, ideas). But I don't really remember it. All I seem to remember is the chaos that the past 3 years have been. My friends say I'm not the same. I'm not who I should be.

I'm rambling anymore. My mind is going too fast right now for me to keep up with it. I can't separate thoughts anymore. I can't continue to be like this, though. I see my new pdoc the 27th. We'll go from there I guess.