Depression vs Unhappiness

I've been pretty shitty the past several days. Very shitty. Depressed, sobbing, struggling. I've been trying to figure things out. I like having shit figured out.

My first two weeks of ECT I went 3 times a week - Monday, Wednesday, and Friday. I started feeling better quickly. I was the poster child for how ECT should work. Then we switched to weekly. I had ECT on Monday. By Friday my mood was starting to slip, starting to drop. So I saw Dr. M the next Monday and told him about that. He doesn't want to increase the frequency of ECT treatments (the goal, after all, is to eventually space them out to monthly). He told me to call his office and make an appointment so we could adjust my meds.

That appointment was last Wednesday. We're increasing my lithium from 600mg to 900mg. I'm not optimistic that this will help at all - I've been as high as 1200mg without any added benefit. But we'll see I guess. He also told me that he doesn't believe I'll ever not need ECT. Meds historically haven't worked well for me and he thinks I'll always need to have ECT. Again, the goal is to get me to monthly treatments but he sees me staying weekly for the foreseeable future.

Then last Thursday night, as I was getting ready for bed, I realized I couldn't remember if I had taken my meds. See, I normally take my night meds around 8:30, and here it was 9:30 and I couldn't remember if I had taken them. Well, I couldn't take a dose at that time because I can't double up on my Seroquel. That's a bad idea for me.

Thursday night I didn't sleep. Maybe 3 hours? Which means I probably hadn't taken my meds (Seroquel knocks me out). So now here I am, having missed meds and not slept. And Friday was horrible. I spent the majority of it sobbing uncontrollably. I cut. And I cut deep. Deep enough it needed stitches (which I did not go get).

Saturday I worked and my mood was equally as bad. I hid. I didn't want to interact. I tried though. I forced myself to. My coworkers knew I was struggling and they rallied around me. Gave me hugs, words of encouragement, and checked on my patients for me when I was unable to do so (I spent a good hour hiding in the break room sobbing). I wanted to cut so bad, but I didn't. I folded paper cranes instead. On of the labor nurses cleaned my cut and put steri strips over it for me (kind of like stitches but it's really sticky tape).

Sunday I was still crap. J and I went to the gym (I really didn't want to, but I really fucking need to). His brother wanted to go bowling with us. I didn't go. I couldn't. I desperately didn't want to. It didn't sound fun and I didn't want to interact.

Today I had ECT and I talked about all of this with Dr. M. Asked him what more I could do. His response was classic: "Well you could stop cutting yourself for starters!" He said the cutting is probably related to trauma or unhappiness. I asked him, "So I have to be like Billy Crystal in City Slickers and find my happiness?" (I've mentioned that to M as well).

It got me thinking: how am I unhappy? What's making me unhappy? I did an inventory of symptoms:

- difficulty waking in the mornings
- increased appetite
- consistent weight gain
- no motivation to workout
- no motivation to clean the house
- not wanting to do things
- not caring about my appearance (I've been wearing hardly any makeup, haven't been doing my hair, wearing gym clothes)
- not wanting to interact with people
- feeling worthless
- feeling like things are pointless (why should I bother? nothing matters)
- feeling like life is too difficult, people would be better off without me (suicidal thoughts, can't do this anymore)
- not finding joy in things (doing things, my artwork, working with the kids at the riding center - I like spending time with the horses, but working with the kids isn't feeling rewarding like it used to)

All of that stuff right there? That's depression. Those are symptoms of depression. Now, last few days aside, overall my depressive symptoms have been better. Overall I feel a hell of a lot better than I have (because, to be perfectly honest, had I not started ECT when I did, I would have killed myself - I was planning it). So I'm better. I am.

I've been trying to figure out the last few days. Did I become exponentially worse because I missed a dose of Seroquel and didn't sleep? Can that really fuck me up that much?? Am I that sensitive?

And so then the cutting. And the uncontrollable sobbing. Is that unhappiness? Trauma? Depression? All of it?

Like, if I had taken my meds Thursday night like normal and slept, would I have been fine this past weekend?

And how fucking frustrating is that?? I don't sleep one night and I completely lose my shit.

The past few weeks have made me realize how much I truly need to take things a day at a time. How much I truly need to stay in the moment. I'm not going to have the answers for everything and I have to be okay with that.  I also do have to remember that I have bipolar disorder - a chronic, progressive illness - and that I will have days that are worse than others. That I will have times where I will lose my shit for seemingly no reason. And that sucks. But that's reality. I think another problem is I was secretly under the impression that I would have ECT, start feeling better, and then miraculously not need it anymore and be essentially "cured" of my symptoms. Bitch, you're bipolar. For life. Fucking accept and deal with it.

It also doesn't help that I think personality wise I tend to lean towards more melancholy. Always have. I need to focus on little joys. Keep forcing myself to interact and be upbeat - even when I don't feel it.

And I need to not cut.

I don't know how to NOT be depressed . . .

No seriously though. Is that maybe what's going on? I don't know how to not be depressed?

It's Wednesday. I had ECT on Monday and I don't have my next treatment until next Monday. Dr. M wants to try once a week. He's worried that 3 times a week might be a bit too much for me - what could be throwing me into a mixed episode. I don't know. We'll see.

Today I feel a little depressed. More than a little, I guess. I want to cut. Yesterday and today both. I don't really know why. I know it won't help anything . . . but I still want to.

I don't know what that's about.

But it's annoying.

I don't know how to qualify or quantify how I'm feeling. Because I'm better. Overall, I'm better. I'm not suicidal. I don't want to die - and that's huge.

I just don't know exactly what to do? I don't know. I don't. Know.

I want to feel content. Happy. I don't want to have to struggle for my feelings.



. . . . ugh. I feel like I have so much more to write, but I have nothing coming out.

I guess I'll just have to see how I do over the next week. I'm going back to work on Saturday.

Frustrated

Well. I have 6 ECT treatments under my belt. And overall, I'm feeling better. Hubbs has noticed a positive change. Yaaaaaay.

But I'm fucking frustrated. Why? I seem to have slipped into a mixed state. Meaning? I'm hyperirritable. I'm a cranky-ass bitch. And I feel like I may snap - either go off or break down, I'm not sure which. This is a shitty feeling to have - especially after starting to feel better.

I'm trying to keep things in perspective.  First and foremost - you were close to killing yourself. ANY reprieve from feeling that shitty is to be cherished. Secondly, the majority of your days over the past 2 weeks were an improvement over where you had been.

I don't know what it is, really . . . .

I've been feeling better. I want to go do things. I want to start working out again, get in shape, eat healthier. I want to do more things with my family, participate in life again, go back to work. I'm excited to do this stuff . . .

And then this weekend hits. And my mood is crap. I'm irritable, bitchy. And today . . . ugh. The depression is trying to weasel its way back in. The despair. Everything is trying to come back. I'm on pinterest and see a post about cutting . . . I feel the draw, it's a trigger. Why? Why is it such a trigger? I'm feeling better . . .

I'm scared. I realize, I must be scared. I've struggled for so long, I don't know how to not struggle. I don't know how to not be depressed. And I realize, I don't want to struggle anymore - I don't want to have bad days. I think I equate bad days with failure. (God forbid I fail).

Again I have to remind myself that I have a chronic, lifelong, illness and that I get to battle my brain and emotions every. Single. Day.

And I don't fucking want to. I want the ECT to work and be done with it. I don't want to have to struggle every day. I just want to be fine. Yeah, I know: whoa is me, life is unfair. Stop with the pity party, right?

Well fuck you.

Thank  God I have therapy on Thursday.. Fuck.

My First ECT Treatment

I arrived at PVBH at 6:45am, the time they told me to be there. Hubby and son were with me and they planned on staying and waiting. I didn't wait long before Chris came and brought me back. Chris is a portly, young fellow, jovial most of the time in my dealings with him (from being hospitalized).

I followed him through the familiar hallways to the pre-ECT room - the room where I had done my initial intake. I sat in a leather recliner, tried to make myself comfortable. Another girl had come in with me (Samantha? who cares . . .). A female nurse whose name escapes me and a male nurse I knew, Johnny, came in to start IVs, while Jim (the RN who heads the ECT program), went through my paperwork, had me sign consents, and asked me orientation questions.

A third woman was brought back, an inpatient, and she sat in the far chair, wrapped in a blanket. She was the first to go back. Chris put the Princess Bride in the DVD player to keep us occupied while we waited.

I went back second - Dr. Chu came and got me and leaded me to the ECT treatment room. She made small talk and joked, seemed genuinely concerned about my wellbeing - the opposite of how she seemed for my intake. A pleasant surprise. She had me place my purse and glasses under my bed, and remove my shoes and socks.

Since this was my first ECT session, she explained, they do things a little differently. She has to experiment a little to find what my seizure threshold is - how much electricity to cause a 30 second seizure. She would start with a dosage and measure the seizure activity - and adjust the electricity dose accordingly (meaning I might have 2 or 3 seizures). She laid me back and began hooking electrodes to my ankles and wrists while Jim attached them to my forehead and temples. The anesthesiologist was applying a blood pressure cuff, a finger probe, and chest leads. A cuff went over my left ankle and one on my right. (The cuff on my left ankle cause my toes to spasm - the intent. When they stopped spasming the docs knew the paralytic was working. The cuff on my right ankle kept the paralytic from reaching my right foot so that they would see it spasm from the seizure).

Dr. Chu and Jim are explaining everything as they're doing it and the room seems in utter chaos. Jim remarks on my new cuts. Dr. Chu asks how bad I was getting - bad enough I almost admitted myself on Friday. "These probes are going across your forehead" "Jim, do you see the mark here?" I feel wetness on the tip of my head and what feels like a marker tip "You just have to move her hair a little - I marked your head so Jim knows where to place the probe" "Can I get another lead? This one isn't sticking" "I'm going to put this mask over your face, just breathe deeply" "If you need to be admitted, come in - it's what we're here for" "You said your cut could have used stitches?" "Just breathe. You're going to drift off to sleep now . . ."

I had felt panic welling up in me. The mask made me feel claustrophobic and the talking and questions and noise were overwhelming. And the burn of the anesthetic through my veins . . .

"Would you like some juice?"

"What? Yeah, cranberry." I'm sitting up in bed. My vision is blurred - but that has more to do with the fact that I'm not wearing my glasses rather than the anesthesia. The nurse, the one who started my IV, hands me cranberry juice and I drink it greedily. "What time is it?" I ask.

"8:30"

I was brought back shortly before 8. She asks me my orientation questions and leads me out to the lobby, where hubby and son are waiting.

We went home and I ate and had coffee, and then napped for 2 hours. I had a wicked headache for about half of the day. Around bedtime my neck and shoulders were starting to get sore and this morning my whole body is sore. Like I spent hours in the gym and ran a marathon.

Without the health benefits.

But no memory issues. So far. Hopefully that will be the norm.

Treatments are Monday, Wednesday, Friday for 4 weeks.

Cheers, y'all.