I'm really not.
I'm sitting down to write because I've felt like I've needed to all day (I've been out at the therapeutic riding center all day working with both the kids and horses).But now that I'm sitting to write, I find I'm at a loss of words.
I've been struggling again, I think that's a given. I had ECT yesterday and I thought "oh good. I can talk to Dr. M and figure out something to do about these recurring depressive symptoms." I told the nurses as they did my intake and started my IV and they urged me to talk to Dr. M.
So I did.
And he really didn't tell me what I wanted to hear.
One, it can take up to 6 months to get the full benefits of ECT. Two, I need to go easy on myself, be gentle, and give myself time - it took awhile for me to get this sick, it's going to take awhile for me to get better. Three, I need to learn how to better manage/regulate my moods - it appears I'm getting triggered, having an exaggerated, bipolar mood reaction, and that I'm mismanaging that reaction (hence the episodes of despair or sobbing or cutting or intense anger).
I told him I was going back to a DBT group and he got a huge smile on his face. "Good. That will be good for you." The lead nurse, J, agreed that DBT would be wonderful for me.
So the plan stays: my current meds, ECT every other week, and therapy - both my regular and the DBT group.
Here's what's frustrating though: I'd had a couple of fairly good days and I had ECT and group yesterday. And today, today I'm at the riding center all day. Mucked stalls in the morning, work with the kids in the afternoon, spend time with my fave horse and barn buddy there, Thor (who, strangely, happens to be Dr. M's horse). All day I had to keep fighting off despair. It kept washing over me. Random times, no rhyme or reason. I'd be petting Thor and suddenly all I could think about was how nothing really mattered, everything was pointless, and that I'd eventually end up killing myself because nothing gets better. Ever.
I'd throw everything I could into fighting those thoughts and feelings. I do what I'm supposed to do: remain present, acknowledge the feelings, allow them to pass, replace negative thoughts with positive ones. Everything that I practice, that I've been taught to do . . . I do it. Then I finally resort to distraction. I go find something to do or someone to talk to or I immerse myself in grooming. Whatever I can to stay on top.
Today I had that despair wash over me at least 10 times. Even though I would count this a "pretty good" day, I still had to fight so much to stay on top.
Is this how it's always going to be? Always fighting, always struggling, every day? This is what I worry about. Because I don't want to do this every day. I don't want to fight my own mind every day. I'm worried that at some point I'll be too tired. Because what's the point? Why struggle?
I shouldn't think like that. That's not productive, right? I'm just so frustrated.
Well, I have therapy on Thursday, so we'll see what M has to say about all this.
Showing posts with label DBT. Show all posts
Showing posts with label DBT. Show all posts
Tuesday, July 28, 2015
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.
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.
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.
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.
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.
Friday, December 19, 2014
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.
*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.
Subscribe to:
Posts (Atom)