This really can't be as good as it gets

It's early - 6am - as I write this. I didn't sleep well and I've been up since 5. I've broken down sobbing once already, something I haven't done in probably 3 weeks. I don't know where I'm going with this post, I'm not sure what I'm going to get out.

Maybe some background:

It's been 2 weeks since my last ECT treatment (I go again on the 19th). The first couple of days after I felt pretty good, pretty "normal" (whatever that is). Then on Thursday the 8th I was manic. I started out hypomanic and was very giggly, fidgety, anxious, distractible, in therapy. But Thursday night . . . that's a whole other story. Hubs was very scared and was very close to taking me to the hospital. I was manic, plain and simple. He was texting my 2 best friends, asking what to do. Now, sadly, I don't have any more Xanax or Ativan that I can take to calm me down (I threw it all out 6 or 9 months ago as it was all at least a year past the expiration date). Hubs offered me Benadryl. Unbeknownst to him, I took an extra Seroquel (sorry I didn't tell you - I was kind of ashamed). It knocked me down enough that I could kind of sleep.

I remained hypomanic Friday through Monday, but it moved away from euphoria (I was crazy fucking euphoric that Thursday), and into the irritable kind. What does that look like? Racing thoughts, anxiety, panic attacks, hyper-irritability (I become a raging fucking bitch in seconds flat for no reason), and insomnia. Sounds fun, right?

Then Tuesday morning (this past Tuesday, 4 days ago) I woke up and I just knew. I knew my mood had shifted. The cloud of depression was over me again. I felt the familiar despair and hopelessness, but it was coupled with irritable hypomania. A mixed episode. Oh goody.

Mixed episodes are NOT fun. At all. They're also considered the most dangerous state to be in. Why? You have the depression, despair, and hopelessness coupled with impulsiveness. Not a good combo. Luckily, all I've done is cut.

I had therapy again this past Thursday (2 days ago) and M didn't even have to say a word to me to know something was very wrong. He made it abundantly clear that I need to talk to Dr. M about all of this when I see him for ECT on Monday.

But that terrifies me.

I mean, I know I need to let my psychiatrist know that hey: I spent a week hypomanic with a very scary-but-thankfully-short-lived manic day and now I have feelings of depression again. Of course he needs to know that. But what scares me is what he might say . . .

See, I'm worried that this is my new norm. That this is as good as it gets for me. I'm worried that Dr. M is going to tell me that I need more therapy, I need more DBT to learn how to better manage my moods. That there's nothing more he can do.

That really. Fucking. Terrifies me.

Because here's the thing: I am definitely way better than I was before starting ECT. I feel an improvement. People have pointed out that I seem better. I know it's helping. I don't want him to look at my symptoms and say, "well, it's obvious the ECT isn't helping, so we might as well stop." If it wasn't helping, like I know it is, I would be dead right now. That's the truth. It's a fucking shitty truth, but it's the truth. That's how I know it's helping. I'M FUCKING ALIVE, PEOPLE.

And here's the thing with therapy - I'm really kind of an expert now at using CBT and DBT techniques to help manage my mood. How do I know? I haven't been hospitalized in over a year. I'm functioning better than I was a year ago. Two years ago. Three years ago. And people have commented to this. I feel like I'm better in control. My fucking therapist has told me he sees a huge improvement in me.

I'M DOING EVERYTHING RIGHT.

I really, actually am.

And I'm so scared that I'm going to talk to Dr. M on Monday and he's going to wash his hands of me and I'm going to be left scrambling.

So then I overthink things and I think, wait - what if this is as good as it gets for me. That my stupid fucking bipolar truly is this difficult to manage and I need to work on accepting this so I can move on and learn to even better manage my symptoms. . .

But I don't want to settle. What if I give in and accept this as my lot in life when I could truly be doing so much better? I had a little over a week where I was enjoying myself. Where I felt happy. And I think I deserve to feel happy. I deserve more than just trying to make it through the day.

I really, truly, fucking hate bipolar disorder.

Yesterday I was mostly okay. Kind of.

I tend to overthink things, and not just big things - everything.  I overthink all the things. Sometimes this is good. Mostly, it's bad.

Yesterday I was overthinking things. About my mood swings. You know what? It would probably be helpful to tell you about my day to lend context to what I was overthinking. Maybe.

But that's what I'm going to do, so you'll just have to deal with it.

I worked yesterday, in trans (meaning in the transition nursery, where I attend deliveries and care for the newborns). I woke up feeling mostly okay. Not great, but okay. My jaw locked first thing in the morning - like at 7am (I have lock jaw from an old karate injury from high school and it's been flaring up bad lately I think from ECT - bite block and tense, tight muscles during seizures probably not good for my jaw). Luckily I was able to relax the muscles and get my jaw to open before my first delivery (at 9:30). Not that I needed to to do a delivery, but it's much comfortable when you're able to actually open your mouth to talk.

So mom smokes pot (legal in Colorado for adults over 21 - not legal for an infant to be exposed. DHS gets involved, baby gets drug tested through the umbilical cord and urine). Pot crosses into breast milk and we encourage these moms to either quit smoking pot, or to not breastfeed. But we can't stop them from breastfeeding. We give them the education and they make their own choice. I was informing mom of this when grandma starts going off on me. Yelling, rude, obnoxious. I managed to stay professional. Now, she wasn't going off because her daughter smoked pot - she was going off because how dare I imply that smoking pot could be bad and maybe I should smoke a bowl because I'm way too fucking uptight.

I did my teaching and left. Vented in the nurses station. But I noticed something: an exaggerated emotional response brewing. I had gotten angry and frustrated, I vented (and cussed), and that should have been the end. But oh no, not for my brain. No. I felt completely overwhelmed, anxious, angry, and as if I was going to completely lose my shit and break down sobbing uncontrollably. I felt despair taking over. I wanted to curl in a ball and hide away from everything. This is not okay. I argued with my mind, with my thoughts, reoriented and centered myself, used all my little CBT and DBT tricks that I know, did everything in my power to be okay. And after about an hour of wrestling with my thoughts and my feelings I was approaching mostly okay again.

I ate my breakfast with B (charge nurse), talked, tried to joke. And it was okay. I was okay again.

Until I wasn't.

My next episode came out of nowhere for no reason. I was chatting with the L&D nurses (trying to be normal over here . . .) and then WHAM! Despair, hopelessness, on the verge of breaking down sobbing. I have no idea why. I got up and went to the locker room to be alone. I fought my thoughts, countered them, constantly, over and over. No, you don't want to die. You aren't going to cut - no, not even a little. You're not stupid or fat - you've lost weight! NO! You're not taking all of your pills tonight - you want to LIVE. Everyone isn't out to get you. They care about you. Stop this ridiculous thinking. You can get past this. You have before, you will again. Over and over and over. Reorient myself (you're at work in the locker room. You're sitting on the bench. Take some deep breaths. That's it. In . . . out. You're wearing your new shoes and fun new socks - taco dinosaurs for fucks sake! You want to live and your going to live. Just breathe . . .).

After about 30 minutes I felt okay enough to leave the locker room. I didn't feel mostly okay yet - but I felt like I didn't have to hide. I chatted with our CNAs, trying to interact, not withdraw, appear/be normal, joke, everything's fine here people. And it was again, for a little bit.

Until it wasn't.

A little before lunch (like 1pm or so) I was blindsided by overwhelming despair. I felt exhausted, like I couldn't possibly keep going. It was bad. I needed 2 things - a hug and a nap. But I'm at work. I can't nap. I can get a hug though. From B (we're friends). I start walking over to post partum to awkwardly ask for a hug but I never made it. No, I had to pop into an empty patient room to sob uncontrollably for 10 or more minutes. And then I stayed hiding in there for awhile - I'm not even sure how long. I calmed myself, reoriented, centered, wrestled with my thoughts and emotions. When I left that room I wasn't mostly okay. I'm not sure I was even slightly okay. But I was functional and I could put on my mask.

And this is how the rest of my day went. Over and over I had to struggle against my mind, bring myself back to reality, fight against my thoughts and emotions. And this got me thinking - what if these types of mood swings aren't related to bipolar disorder? What if something else is going on?

What popped into my head was borderline personality disorder - which is characterized by intense mood swing lasting hours to days. So I started reading about it, comparing what I read to my life, overanalyzing/overthinking. I certainly match some of the diagnostic criteria. But other stuff? Not so much. But still I kept thinking about it and thinking about it. I had J read the diagnostic criteria when I got home to see what he thought. He said no. And what would it matter anyway? The only real treatment is therapy, which I've already been doing for 4 years.

But why then? Why were my moods so labile? Why did I get so bad so fast? And why was I (mostly) able to get a little better?

Well, in a word I think, I'm bipolar. And regardless of what the DSM would have you believe, people with bipolar disorder can and do have mood swings that occur this rapidly. It can happen the other way too, with mania, and it has with me.

As to why I was able to mostly be okay? I'm trying insanely fucking hard to counter my errors of thinking. I'm trying insanely fucking hard to be okay. I'm actively using everything I've learned in 4 years of therapy - both CBT and DBT. I'm doing everything I fucking can to battle this illness and take back my life.

You know what? I'm not entirely sure I made any sort of point with this post. And I don't really care.

Mike was right to be worried . . . . and that worries me.























Fuck.

Fuck Things

I'm having a hard time getting things down on paper. I want to write. I fucking yearn to write and every time I sit down to write, my brain becomes a jumbled mess. I know it's the ECT, which sucks.

Today is weird. Today has been kinda rough. Not bad, I guess, but just rough. It's Tuesday, and Tuesdays I'm at the riding center all day. In the morning, from 9-10:30, I do EFP with kids in a special school program. From 10:30-12:15 I clean up, play with my horse, Thor, and eat lunch. Then I have therapeutic riding with 2 kids from 12:15-1:45.

Well, this morning I was pretty much checked out during EFP. Then I go to get Thor to work with him and the whole time I feel like I'm on the verge of losing it. But the weird thing is that the emotions aren't there. Like, it feels like they're going to be, and then they're not. But I still feel like I'm going to lose it.

As it was getting closer to afternoon class time I was feeling more and more like I couldn't cope. Like I couldn't handle being in class. And during my first class with Gabe, that feeling intensified. So much so that I had to leave before my second class - I couldn't stay, I couldn't handle it. Couldn't handle the interaction, faking it, I just couldn't. The whole way home I felt empty and hollow and on the verge of breaking down - but with no real emotion behind it.

And I wanted to cut.

It was my plan to pick up A from school and come home and work out. I have not worked out. I'm not going to either. I don't care. I don't care at all. Fuck it. I don't know what to do with myself.

I'm apathetic. I just want to go to sleep. Go to sleep and not wake up until I feel better. But I don't have that luxury. No. I have to battle my stupid fucking brain every day. Fuck it.

fuck

There's a good chance that I should be in the hospital right now. And if I'm thinking that . . . well . . .

It's just that I'm struggling - really struggling right now. I can't keep my moods managed. I'm irrationally angry or I'm sobbing and full of despair. Maybe it's my new med, Prestiq, causing this. Or not. Maybe it's something entirely different. I have no fucking clue but I'm not doing well.

I feel like I can't cope with anything. I want to curl in a little ball and block out all stimulation. I want to cut. I want to scream and throw things. These are the only ways I can see myself coping.

This morning I drove to my mother-in-law's house to pick up my son. I had to pull over because I was crying so hard I couldn't see. Pulled myself together, got him and went to work with my horses. Felt a little better. Okay. Good. See? You'll be fine. You're fine.

As I drove home, my anger was building. We went grocery shopping, my anger was building. Putting away groceries I yelled at my son and I could feel the anger spiraling out of control. So I went to my bedroom and sat down. Figured I'd give myself a little "time out", do some deep breathing, gain my composure and control.

Instead, I lost my shit and cried for 30+ minutes. I kept thinking, I wish hubs and the boy didn't care so much, that way I could just go, just be done with it. I was staring at my wrists through my tears, visually tracing the cuts I would make.

No.

I kept telling myself, "I don't want to die. I'm going to live." My new mantra. Over and over. I know the constant thoughts about death and suicide are because of the depression. Depression lies. I know this. Think of all the good. There's so much good. So many people love me and care about me.

I know this. I know all of this. But I sit and sob and stare at my wrists.

I'm so fucking sick of this.

My Brain is Stupid

*Disclaimer: this post might be a rambling, jumble of nonsense. There is, I think, a high probability of that happening. You've been warned.*

I have now, officially, had 14 ECT treatments. The first 2 weeks were 3 times a week (my first treatment was June 1), then I went to weekly for several weeks, and now I'm every other week. If I was following Dr. M's trajectory, I'd be every 3 or every 4 weeks by now.

But I'm not following his trajectory. My depression is stubborn. My depression is a fucking asshole. My brain, Clancy, is being a huge fucking dick and is making things difficult.

Let me start by saying this: my depression is a lot better than what it was before ECT. If the ECT wasn't helping, I would be dead. I had it planned. So let's get this important piece of information clear: the ECT is helping.

But here's the rub: it's not holding me.

What do I mean by that? Well, I'll be floating along, doing pretty well for about a week to a week and a half after a treatment. And then my mood starts to slip, my mood starts to falter, starts to sink. Depression starts to sneak its way in. This lasts several days until I have my next treatment and then the process starts again. I've noticed the pattern, the nurses at the hospital have noticed the pattern, and Dr. M has noticed the pattern.

Now, this wouldn't be a big deal, I guess, if it were only a day or two. But it's not. It's 4 days or 5 days or 7 days. Each time it's more, longer. Over the past 4 or 5 weeks I've spent more time depressed than not - and that's NOT okay with me. That's NOT how this is supposed to fucking work.

I had ECT last Monday and then saw Dr. M in his office in the afternoon for a regular appointment, where we discussed all of this. He said we need to figure something out medication wise to help hold me over between ECT treatments, as we need to at least get those spaced to once a month (the ultimate goal is once every 6 weeks). We discussed options and decided to stop my Lexapro and switch me over to Prestiq. Now, as with any med change, it will take several weeks at least to see any changes.

Which fucking sucks because I feel like shit.

I'm floating around with this low grade depression. I call it low grade because I'm not actively suicidal. Notice I said not "actively" suicidal - I still think about killing myself. Every day.

So anyway, I'm floating around in this low grade depression. I'm not sobbing every day, breaking down, anything dramatic like that. I just don't care about much of anything. It's like I can't really muster up any emotion except for anger. I feel like I need to cry; I just can't. I don't have the emotion to make it happen. I don't want to do anything. I don't want to go to work or clean the house or draw or paint or play with my son or have sex or cook or exercise or talk to people. I force myself to do stuff - I don't allow myself to just stare into space - but it's difficult and I just don't care.

The only strong emotion I can muster is anger. And I'm fucking angry at everything. That's not an exaggeration. Every little fucking thing makes me angry. The littlest things set me off. Simple things, like misspelling a word while I'm typing, or needing to go to the bathroom. People talking to me or me dropping something. Every. Little. Fucking. Thing. And the anger is very volatile. It goes from nothing to full on rage in no time. I hate it.

Oh hey - remember how at the beginning I said jumbled mess of a post? Everything prior to this I wrote Sunday morning. Then I got cranky and went downstairs to workout. I got on my spin bike and then broke down sobbing. J came downstairs and held me, stayed with me. I kinda wanted to die. And by "kinda wanted" I mean I wanted to die. Sunday ended up pretty shitty mood wise.

This little bit I'm writing Monday. I don't know how I'm feeling today. Okay, I guess. I started the day VERY angry. Then I talked with a friend and went and worked with horses and that helped. Now I just feel . . . empty. I'm sitting here drinking some hot mint tea and I start thinking, ooooo, I can't wait until it's colder outside and I can wear sweaters and sip hot tea! And then my mind immediately reminds me that everything is pointless and hopeless and I would truly be better off dead.

It's like I can't just have a nice fucking thought. My brain has to go and fuck it up. This is very frustrating and I'm so sick of it. I'm tired of struggling.

Showing Some Improvement

These past few weeks, overall, have been the best weeks I've had in a long while. My mood, overall, has been less depressed, less full of hopelessness and despair, and less full of bitter rage. That's not to say I'm not having these feelings - because I am - but they're not as intense and aren't lasting for as long.

So what's changed? What's different? In a word: I don't know.

I really don't know. I have some ideas, sure, but they're just ideas I have happened to pull out of my ass. Me acting like a psychiatrist, tossing theories around.

First off, have you heard of the Spoon Theory?  If not, go read it. Seriously. Please. Taking the 2-3 minutes it takes to read it will be so much more beneficial to you than having me try to explain it. So please - go read it. Here's the link again, just for fun: HOLY FUCK I'M A LINK!

Alright. You back? Good. How was it? Pretty fucking awesome, right?

So. One thing I've decided to do is to apply the spoon theory to my life. Because bipolar disorder? Chronic fucking illness. It's a chronic fucking illness that takes a lot out of me. Every day. Some days worse than others. And I've discovered that I really can't do it all, and that the more that I try to, the more miserable I am.

But there's more than that. See, I grew up in an alcoholic home and a bi-product of that is this pesky sense of perfectionism I have. Everything has to be perfect. Has to be. This makes me miserable because nothing is ever good enough. There are too many shoulds. So what to do about that? Accept that I am not, nor will I ever be perfect. I can fuck up and that's okay.

My therapist has been telling me this for, well, almost four fucking years. Yeah. Four fucking YEARS. I'm stubborn. And maybe a bit stupid :P Listen, you dumb bitch! (I call myself "dumb bitch" lovingly).

Then about 3 weeks ago, at not my most recent ECT treatment (3 days ago), but the one before that, Dr. M kinda went off on me. And by "kinda went off" I mean he yelled at me. He told me to relax, calm down, and trust the process. That this wasn't perfect, I wasn't perfect, and that it takes time. And to also "stop cutting my fucking arm". Yes, he cussed. One reason I like him.

So I decided to try just that - relaxing. Giving in. Not being perfect (or trying desperately to be). In order to do this I had to do something big. I had to accept - really, truly accept - that I have a chronic illness that needs to be monitored/maintained daily, every day, and that sometimes I need help.

This is not easy for my stubborn, prideful self, but I'm working on it.

See, monitoring my illness isn't that much different as someone with diabetes monitoring theirs. Whereas they count carbs, watch their diet, check their blood sugar levels and take insulin, I have my own things I need to monitor:

I monitor my mood, sleep, surroundings (is it crowded, noisy, close exits, bright or flashing lights . . .), temperature (too hot = instant bitch), sounds, who is around me . . . and countless other things.

I'm slowly learning to recognize some of my triggers. And in recognizing my triggers I can better manage them, so they don't have as huge (or catastrophic) effect on me. Sometimes this means simply resetting myself. Other times, it means removing myself from a situation (nurses station getting too loud? I get up and leave. Go on a walk, go to the break room, whatever, just get away from the voices). Maybe it means not going out (I skipped a bike ride with my hubby and son because I simply didn't have it in me to go - I had no spoons left that day).

And in doing all of this (along with the ECT working) I'm feeling better. Finally feeling better. But this is hard, y'all. Doing all of this is fucking hard. It's tiring and it takes focus. It is, however, worth it.

I'm hoping that over time I won't have to work so hard, that things will get easier. Right now, I'm calling this a victory. And I finally have hope.