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.

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.

New pdoc?

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

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

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

Not the best thing to say.

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

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

What if?

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

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

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

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

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

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

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

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

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

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

But they're not helping.

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

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

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

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

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

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

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

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

So I'm probably stable . . .

I truly do believe I'm stable. I've made it through the worst of the recent med changes, made it through the rebound depression, and I'm what you would call "stable". I'm not having any major mood swings. Rather than the swings hitting like a tsunami, they're 4-5 foot waves that lap more gently at the shore.

This should be good, right?

In a word: yes.

But also no.

Why? Because the moods I'm feeling now are very stunted. They're subdued. At times, they're almost not there. And this, for me, is bad. I'm used to feeling the extremes of moods. I'm used to the highs (though relatively rare), the hyper irritability, the deep sorrow and depression. I feel that. It's guttural. It's intense. But now my moods are meh. Blah. Whatever. Flat. Apathetic.

Or anger.

Here's my problem: I'm stable, but I'm not happy. I feel more like I'm on the outside of everything, viewing, but not taking part in life. I'm bobbing right along the surface, able to keep my head above water, but still drowning - albeit slowly.

I'm stable, but I feel no real joy in things. My job, that I love, is an annoyance. It's an inconvenience. Everything about it makes me irritable and resentful. Dealing with patients can make my blood boil. I don't enjoy it anymore.

My hubby and son . . . I try feeling joy, happiness, and love with them and I mostly come up short. I don't want to do anything with my son. I don't enjoy him. Him wanting to play a game with me irritates me and makes me snippy and angry and sad. I would prefer not to interact with him. With my hubby I do a little better. But I'm not really happy around him. I try. I try.

I'm stable, but I'm still depressed. Maybe I'm not at the sobbing-constantly-suicidal-depressed phase, but I'm depressed none the less. It's more mild. It's this black cloud that never fucking leaves. It's always there. Always hovering over me, always making everything more difficult. I'm more withdrawn. I avoid people and conversations. I'm almost constantly irritable. I'm down, melancholy. Whatever you want to call it.

I'm stable, but I'm not really alive. Does that make sense? I'm existing. I'm going through the routine of everyday life. I get up merely to make it to bedtime to escape again. During the day at home all I want to do is sleep to escape how I'm feeling - or, rather, what I'm not feeling.

I don't want to exist. I want to live. I felt how it feels to live while on the Brintellix - but I was taken off of that due to side effects. If I can't live, what's the purpose of being alive? Seriously. I want to wink out of existence.

That's not really an option though. So I'm trudging along, going through those motions, praying for a spark. Trying to keep hope alive while I'd truly like to throw in the towel.

Because this shit is hard. Pretending to be okay is fucking hard. Especially when there's no end in sight. Maybe this is as good as it will get for me. That's depressing in and of itself.

My pdoc is happy with my progress. She thinks the seroquel is working wonders. After all, I'm stable, right? That's the whole point. Stability. Who the fuck cares if I enjoy life . . . as long as I'm stable.

And before you go thinking I'm all doom and gloom and dwelling on everything bad - I'm actually not. I'm doing everything I can to stay in the moment. I'm picking out my errors of thinking and countering them. I'm taking it one day at a time. I'm trying to do things that I used to enjoy (though most of the time I have to force myself). I'm doing my best not to catastrophize. I'm eating healthier again, exercising regularly. Listening to good music, keeping busy, not allowing myself to nap too much.

And yet I mostly feel like crap. I'm still depressed. I'm still not happy. The unrelenting black cloud won't break up for anything. I'm stuck.

Increasing my Seroquel

I saw my pdoc yesterday and we're increasing my seroquel. I'll have 4 days at 150mg, 4 days at 200mg, and then be up to the target dose of 300mg (I've only been taking 50mg over the past 2 weeks). I'm hoping it works. We'll see.

When she first gave me the seroquel 2 weeks ago, she said there would be no difference in the level of sedation between 50mg and the higher doses. Yesterday she told me I might notice increased sedation. WTF? I've already noticed that I'm more sleepy throughout the day and have a harder time getting up in the morning and now you're telling me that this will get worse. Thanks. It's also increased my appetite 10 fold and I'm already gaining weight. If this doesn't slow down it'll be a deal breaker for me. (To counter this I'm getting my butt back to the gym and using Sensa - though it's hard to work out when you're sleepy and have no motivation thanks to worsening depression).

I had decided that I would give this med change 8 weeks to fully take effect. I think that's more than reasonable. Which means I still have 6 weeks to go. I'll be honest - I'm not optimistic. One might argue that I wasn't optimistic with the Brintellix and that worked. And that would be true. I'm hoping that seroquel will prove me wrong. I don't know if I'll wait the full 8 weeks. I might decide at 6 weeks whether or not it's working for me. If not, I want back on the Brintellix. If the anxiety comes back then we treat it. I'm tired of feeling like crap.

The last 2 weeks have been rough. I've cried almost every day and I'm back to not wanting to exist. I'm back to thinking that everything is hopeless and pointless and why should I bother trying. Sadly, what comes next is not wanting to live. And that quickly spirals into suicidal ideation. I don't want to go there. I don't want to be there. I want to feel good. I want to feel happy. I want to be stable. I'm tired of this fucking unrelenting depression.

It's frustrating to have felt so good and to now feel so bad. And no, it's not fair. It's like I'm not supposed to be happy. I'm not supposed to be well. And that's a bunch of bullshit.

Weird day so far . . .

I woke up this morning with the feeling that it was pointless to get out of bed. I was wide awake, which is unusual (the past few weeks I've been horrifically groggy in the mornings), but it just seemed stupid to get out of bed. I mean really, what was the point? My son is at his grandma's, I'm home alone, I have nothing to do until I see my pdoc at 5, so what's the point? Nothing really matters anyway.

But we have a guy coming to clean our ducts, furnace and air conditioner today so I needed to be up and showered. So I got up. And I showered. And I had breakfast and coffee. All I could think about was cutting or burning so I decided to make myself do something. I tidied up, folded laundry, dusted, and cleaned my office. I got my son's sheets in the wash and our comforter in the dryer.

It's 10:45 and I again have nothing to do. The duct guy is here. I can read, but I don't really feel like it (and I've got 6 hours to kill). I could try drawing but that just seems too daunting a task. Nothing I draw comes out right anyway and I get frustrated to the point of wanting to destroy something.

I want to get rid of stuff. Like, a lot of stuff. Trash it, give it away, sell it, whatever. Everything feels cluttered and we're going to need to downsize anyway.

I'm still apathetic but I'm restless. I didn't sleep well and I'm tired but I have this nervous energy. I hate it when I feel like this. Like life is meaningless and I'd be better off not participating in it. I'm not suicidal, I just want to disappear. Not exist for awhile. Obviously, I can't do that. So I'm just kinda stuck. Feeling like crap but not really feeling.

I hate not feeling. Well, the past few weeks I either have icky feels or no feels. Both are bad. I keep thinking that I'll even out, that Dr. Schulman will be right and I'll be okay and everything will even out. He said to give it at least 3-4 months. But then I think, feeling like this? For another 3-4 months? Can I get any fucking reprieve? Trauma work fills me with the icky feels. Triggers fill me with the icky feels. And when I'm not feeling icky I feel empty and dead inside. This is no way to be. And I keep thinking about how I get to deal with this for the rest of my life. Maybe my pdoc was right - maybe I do need to be on something for depression. The Brintellix like she recommended. But I'm scared to try something new - I have a bad track record with medications.

Oh well. What can I do? Keep plugging along and hope for the best I guess. Every day is a new day, and just because today is crappy it doesn't mean tomorrow will be crappy too.

Torn . . .

After having several days of full blown depressive symptoms, I made an appointment with my psychiatrist. My hubby agreed (and almost insisted) that this was the right thing to do. My appointment is next Wednesday - that was the soonest I could get in.

Four days of full blown depression in a row, followed by an okay day, then back to depression. I even considered taking pills to escape the pain.

And now I'm conflicted. Yesterday I had a pretty good day. I was a little down, sure, I was drained as usual, but I was okay. I laughed during therapy. I hung out with my best friend and had a good time. I was exhausted after, but it was a good day.

Today I'm at work. I'm drained (as usual) and I'm withdrawn, though not as withdrawn as I have been. I'm irritable and annoyed and don't want to interact with patients. However, I've been able to joke a little and laugh.

Am I wrong to see my psychiatrist? Despite my shitty days, I have a couple good ones and immediately question my course of action. I suddenly think I'm stupid and overreacting. That I should give it more time because I'm jumping the gun. I was trying to be proactive in not letting my depression worsen, but now . . . should I be waiting?

I hate when I feel like this, when I question myself and my decisions. It's probably good that I see him. I can bounce my thoughts and fears off him. I can talk to him about stopping the geodon (I'd really like to have my sex life back). And I can get refills on all my meds.

See? See how I'm trying to justify going? All because I can't trust my own instincts. I think that everyone will think that I'm weak if I go on an antidepressant, that I should be able to handle this and besides, I'm pretty stable after all. Just work through your codependency issues and you'll be fine.

But I feel so empty and lost and down all the time. I can't help but think that there's more to this.More to life than feeling this way. Or maybe this is as good as it gets for me. I don't know.

But I guess I solved my own dilemma - I'll keep my appointment with Dr. C and hope it wasn't made in vain. I may or may not change my meds. I don't know what to expect. Hell - I may have another depressive downswing that will justify me going. I just don't know.

I wish this were easier.

Let's talk about things

This post will be . . . difficult I think. And personal. Because I don't see my therapist again until next week and I need to get shit out. Air out some bones.

Friday through Monday (starting last week) were horrible days for me. I was irritable. I was depressed. I felt awful. I had feelings of despair and hopelessness. I broke down crying on Sunday. It felt like the old me. The depressed me.

The familiar me.

I did what I could to brush off the feelings. I minimized them. I ignored them. I tried to stay in the moment. I took it day by day, hoping the next day would be better. I didn't catastrophize, I didn't ruminate, I stopped negative thoughts and replaced them with positive ones.

And it worked somewhat.

On Sunday after crying I was able to joke a little - I could move past the despair. On Monday it was difficult. I was at work and I was down and withdrawn and irritable. I hid a lot. I avoided people (which didn't go unnoticed). But I got through the day despite how tired and drained I was.

Yesterday I was at the riding center most of the day. I mucked stalls in the morning which lifted my spirits. Now, I was withdrawn there - I usually talk with the other people there but yesterday I pretty much kept to myself. Interacting proved difficult. I was horribly drained from the previous four days, but I went back in the afternoon for the classes - which was probably a mistake - it took everything out of me.

But I pressed on and last night I was more light hearted and able to joke a bit.

So I'm taking things day by day. I have to - I have no choice. Day by day I have to be acutely aware of my feelings. Day by day I have to check in with myself to make sure I'm not swinging outside the realm of normalcy. And day by day this is exhausting.

It has to be done though. Because here's my problem:

I think I may be starting another mood episode. Possibly caused by the stress of being back at work. And that's not the only problem.

I like to self sabotage. We all know this, right? We all know that I have issues with being "normal", with being "okay". We all know that I'm used to being depressed. I don't know how to not be depressed.

And this is a HUGE problem. See, part of me is excited at the prospect of another mood episode, of going into a state of depression again. Part of me welcomes tis whole heartedly. It's like visiting a friend you haven't seen in a long time - where you pick up as if no time has past. It's like being home. It's familiar and comfortable and part of me longs to be there again.

I hate admitting this. I hate this part of me.

And I'm stamping it out. Or trying to. Which is harder than you think. I'm already dealing with looming depression (it truly is there) and to add to this . . . it's hard. It takes it out of me. I'm already drained and now I'm exhausting myself by fighting with myself.

Jealous?

This is what I'll be discussing in therapy next week. It troubles me and I want it to stop.

I want to stop having to check myself all the time. However, I think with this illness, that will never happen. Maybe it will lesson over time, but I think it will always be necessary.

And I say boo to that.

Therapy and other stuff

I have a feeling this post is going to turn out more stream-of-consciousness than anything else. And I'm fine with that. This shit's for me anyway.

I had therapy this morning and it was a great session. I talked a lot about work (which surprised M as it's a subject I usually steer clear of), my mood swings as of late, sexual dysfunction and whatnot.

There's a few things I'm trying to figure out right now. First and foremost, my recent mood swings. I had some days where I've been downright depressed, where I've had irrational anger and irritability, or, on rare instances, where I've had fleeting moments of hypomania. The hypomania lasts around 30-60 minutes and is punctuated by racing thoughts, rapid speech, and inappropriate speech. In between this I'm usually okay. Typically down and withdrawn, but okay.

I'm trying to figure out why I've had this spike in emotional lability. At first I was thinking hormones (I never know when my "menstrual cycle" would be as I have no uterus). But it's been roughly 2 weeks of this now, more markedly the last week. So I'm not so sure this is it.

My other theory is work. Namely, the added stress of being back at work. I've been back for 3 weeks now and it's exhausting. The stress and drain I feel with it might be causing the cycling (which stress can do for us bipolars). And this stress is something that, sadly, I can do nothing about. I can do relaxation exercises, take hot baths, drink tea, whatever, but that doesn't remove the problem.

Now, about work . . . people have noticed a change in me. Several have remarked about how "quiet" I've become. Or how "tired" I always look. And I am quiet. I am tired. At work I've become more withdrawn. I tend to do okay with patients, just not with coworkers. If a conversation lasts longer than a couple of minutes I start to shut down. I can't handle it - I simply get overwhelmed and can't cope. And I hate that feeling. And people notice. And comment. And wonder if I'm really okay.

Work drains me. By 2 or 3 I'm pretty much done. I'm in shut down mode. My processing slows, I become more withdrawn, I can't concentrate or focus or cope with problems. People notice this too. And ask if I'm okay. I don't want people to ask if I'm okay. I don't want people to notice.

I've been doing some reading in bipolar magazines and on forums and the fatigue with work and with stress of work causing symptoms is pretty common. So at least I know I'm not alone. I guess. Go me.

I wish I knew why work tires me so much. I wish I knew why I find it so overwhelming and difficult to cope with. I want to know the what, why, and how of it. Why does stress trigger mood episodes? Exactly what the hell is going on inside my brain?

I'll probably never know the answers to those questions.

And while I'm writing, let's talk about the whole "I don't know who I am" bullshit. I know who I am. On some fundamental level, I know who I am. I still have the same sense of humor, the same loves and other "same" shit. But I have changed. I'm different and I am having to find and reinvent myself.

I don't like the process.

I find that overall I'm more down. Overall I'm more irritable and easily annoyed. I'm hoping this goes away because I don't like myself for it. It takes everything I've got not to beat myself up over it, too (something I'm brilliant at doing). Hopefully with time it will subside. But in the meantime it's quite bothersome.

My sex life is also bothersome. Or lack there of, I should say. No desire, no arousal, no orgasm. I got nothing. I might as well be watching cacti grow. I know it's a direct result of the geodon but I can't go off it now - I'm too terrified of what would happen.

But I want to actually enjoy sex. I'd like to actually have a sex life. Typically, sexual dysfunction is a deal breaker. But, I'm going to give it time in hopes of my body "growing out of" this whole sexual dysfunction phase. I don't think time is going to make one difference but hey - what else can I do? I plan on talking with Dr. C in April about it (that'll give me about 3.5 months on the medication) and see what he thinks. Originally the antipsychotic was going to be a temporary thing - maybe it still can be.

I guess that's all. For now at least. I have a headache and it's hard to concentrate on a computer screen when your eyes want to jump out of your skull.

Hey I'm at work!

No really - I'm totally at work right now.

And I'm bloody exhausted. I'm in disbelief at how drained I am right now. The morning was busy - very busy. I didn't get a chance to sit down and eat breakfast until 1:30 (meaning I ate my lunch instead). And it wore me out.

The sad thing is, 4 months ago that wouldn't have been a problem. It wouldn't have phased me one bit. I've been forgetting things all day. Lots of things. Printing face sheets, calling a physician, calling the NNP about a c-section, giving report, putting in orders . . . I charted things under the wrong time and had to go back and fix it. Luckily I've caught all these little errors and nothing was major. But the fact that this is happening . . .

It frustrates me to no end. To know that my level of functioning is so deteriorated so much from what it has been. From what it used to be . . .To know that I'm struggling more than I ever thought I would. It frustrates me and depresses me - and I'm trying desperately not to become depressed about this (and sadly, it would be easy to slip).

I've reread this post 3 times because there have been so many errors - missed letters, extra letters, words completely left out, words out of order. What the fuck is going on??? I shouldn't be having issues like this.

And yet I am.

To be healthy I should accept my new level of functioning and move on. But that's near impossible for me right now. Maybe someday I will - but I can't now. Not now. Maybe it's my pride. Maybe it's my high standards for myself. It's probably both. And maybe more.

All I know is that I'm tired and drained and frustrated and down.

Internal Struggle

I have a pretty awesome internal struggle going on right now. Of the kind that causes anguish, fear, nausea and the trots (no really - I totally have the trots). Here's what's up:

Yesterday hubs and I made a huge decision - one that completely changes our lives.

We're going to foreclose on our house and file bankruptcy.

Why? Because of my stupid fucking brain. No joke. I'm going to be going part time to give myself a break, decrease my stress level, and hopefully keep my stability longer than a month. Which means we can't afford to stay in our house.

The decision is made, we know what we're doing. So then why the internal struggle . . . ?

Because I am me and I suck.

I like to self sabotage. I do it subconsciously, but I do it. I had this revelation almost 8 months ago. Since then I've been working on curbing it. And I've done relatively well.

But this . . . this is difficult. It's a shitty situation and exceedingly stressful at best. And then you throw in my marginally stable, self sabotaging mind and, well, you get the idea.

Today I've been pretty down. I keep having negative thoughts invade my mind. I keep thinking about how all of this is happening because of me. This wasn't supposed to be how things played out. I was going to be better and move on and work and everything was going to be perfect and fall into place. I should be better. We shouldn't have to do this. It's my fault. If only I was stronger or not sick or sucked it up more . . .

See the trend? Great fodder for a downward spiral. And 9 months ago the spiral would have been immediate and devastating.

But not now. Not today. Because I know more about myself. Because I know that I can self sabotage. And because, while technically this turn of events is because of me, I know that my health and my ability to be a wife and a mother are more important than the house. We'll find a house to rent. And eventually we'll buy again. In the big scheme of things, this isn't all that bad.

Now, that being said, this isn't easy. I'm fighting against everything that is me. I'm fighting against my nature, my coping mechanisms. And it is anything but easy. Stopping the negative thoughts is exhausting. It takes energy. It drains me. It would be so much easier to give in. Give up and give in.

But I don't want to. I really don't want to. I don't want to be sick anymore. I can't be sick anymore. So I'm going to fight it and curb the negative thoughts and not start a pity party of one.

My health is more important than the house. My health is more important than the house. 

(I'll probably need to say that several more times)

And so the REALLY annoying thing is . . .

. . . I want to see how sick I can get. How fucked up can I truly get?

Now, let me start by saying that this is not entirely true. I want to be better. I want to not have to deal with these constant mood swings. I want to feel normal.

Except that I don't.

This isn't some weird attention seeking thing going on here - let's get that straight. This is something, I think,  that almost every person with a chronic illness feels at some point. You've been through med change after med change after med change. You still feel like crap. Nothing you do seems to work. Everything starts to seem hopeless and pointless. Nothing has worked, so nothing will work.

It's frustrating. It's overwhelming. And it seems so much easier just to give up. Let the illness take you.

That's where I'm at. I've just made yet another med change - dropping Zyprexa and starting Latuda - hoping that this time it will work. That my mixed episode will finally end with minimal side effects from the meds. That for once, maybe, I'll feel okay.

I'll be honest - I'm not optimistic. I've been through this. Several times over the last 2 years (I've probably changed up my meds 10 times or so). I'm so fucked up, in fact, that my diagnosis has been changed from Bipolar 2 to Bipolar 1, ultra rapid cycling. I'm so fucked up, in fact, that my pdoc is trying to get me in to see the mood disorder specialists at Mass General in Boston. I'm so fucked up, in fact, my pdoc said that if I stopped my meds I would go psychotic - I would completely lose my shit.

And you know what? So be it. Let me completely lose my shit. Let me see how sick I can get. Am I really that fucked up? Am I really that sick?

Let's find out. Let's not take anything. Let's see what happens. Let the world sort it out for me.

But I can't do that. Because I don't want to do that. I have a family, a career. I have friends and obligations and hopes and dreams. And I don't want to do that. I want to get better.

I'm frustrated. I'm tired. I've exhausted my resources. I've done everything I'm supposed to do to get better. And still I struggle. Every day.

Every. Fucking. Day.

My friends are worried about me. Very worried, it seems. They see me from the outside. They see the swings, more so than I can I think.  I downplay this all. I wonder if I downplay it too much. I wonder if I'm already sicker than I think.

I worry, but I also don't care. What can I do about it anyway?

Nothing. That's what.

I'm having a hard time mustering up any feelings today. I'm flat but near tears. And that's it. My mood could change at any minute - and I don't know until it happens.

I don't even know how to explain how I feel - the turmoil and confusion and hopelessness and despair. The sadness. Breaking down sobbing for no reason but not being able to stop. And the pain in that - the emptiness and grief and pain that threatens to swallow you whole. So much so you want to die. In that instant you want to die.

But then the giddiness and excitement and outright joy. Feeling like I can take on the world and that I'm funnier and smarter and better than everyone. That I need to spend money and write and draw and paint and clean the house and run a marathon and do all these things right now and all at once! And they have to be done why don't you understand???

And the irritability. Oh the irritability. And anger and impatience. And this built up kinetic energy and hostility and the need to destroy something. Anything. Even if it means hurting myself severely. Snapping at my husband and son for the mere fact that they exist.

And I might cycle through these feelings ten times a day - or not much at all. They may be the extreme - the worst it could possibly be. Or it may be milder, a little easier to deal with. And the cycles come without warning, at the drop of a hat. One minute I'm okay and, literally, the next minute I'm not.

Does that make sense? Can you even fathom how difficult that is? To live every fucking day like that? To have it affect your family and your job? Your own sanity?

Can you understand why I want to give up? Why I want to throw in the towel and lose my shit? When nothing I do works? Does it make any sense at all?

I can't adequately convey what I'm feeling. I want to give up. I want to completely lose my shit.

But I want to get better. And I have to. So I guess I struggle the fuck on.

Where am I now?

Revolution from dissolution, hypnotizing and demoralizing
Pressure of the future, too much for today
How many hours will I let slip away
Before I realize existing and living
Are not the same
Are not the same
      -MSMR

I'm not exactly sure where I am right now. Many places, I guess. I'm stuck, I know that much. Stuck and annoyed and frustrated. Frustrated because I'm coming back to square one.

Last Wednesday marked two weeks of being on the Zyprexa. Two weeks of subdued, controlled mania. Two weeks of "stability".

Two weeks of steady cognitive decline.

Yep. Cognitive decline. Noticeable cognitive decline. It started innocent enough. Shortened attention span, being a little more easily distracted. Nothing big, nothing to write home about.

But then it became insidious, permeating everything I do. My focus was gone. I couldn't concentrate. I was very easily distracted. Everything changed.

On Monday, at work, I was going over discharge instructions with a patient - something I have done literally thousands of times. I stopped mid sentence. I had no clue what I had just said. Or what I was doing. Or what I needed to do. Luckily I'm awesome and I recovered and carried on, the patients none the wiser of my folly.

But that's not like me.

And then it happened again. And my mind would wander off as I was speaking and then I would stop, a bit confused. I couldn't focus on my charting. If there were distractions I was done. I'd have to check over everything I had just entered.

I felt overwhelmed more easily. Things that would have never flustered me were now an issue.

This past week, my first week back at work, was difficult. Because of the above. What's wrong with me?

I noticed my typing changing. I leave letters out of words or switch them around. Those damn red squiggly lines that spell check loves? Almost every word. I have to go back an recheck everything. And now? Now I leave motherfucking WORDS out of sentences.

WORDS people. Who the fuck forgets to write words? While thinking they're there? Me. That's who *points to self*.

I can't work like this. I can't. So I made a decision: no more Zyprexa. Wednesday night was the first night I didn't take it. Thursday morning my cognition was a little better. But I happened to tell two friends who made me take the one I had in my purse for "breakthrough" mania. And I was worse in the afternoon.

So Thursday night and last night I didn't take it. I'm focusing a little better, my typing is a little better.

But my mood? My mood is now not better. It would seem I'm going back to being in a mixed episode. Yesterday at work I started the day hypomanic. Then I got irritable. Then I spent almost 20 minutes in the back room sobbing, crying the ugly cry, while filled with crippling despair and hopelessness. I was depressed for awhile, then down, then irritable, then hypomanic.

Today I've been cycling between feeling down and being irritable. Right now, as I write this, I want to hide. I want to be alone, in bed, under the covers, crying. It's what I want to do so badly but I can't. J and A are here and we're going to decorate our tree soon. It should be a happy time. It should be fun and I just want to hide away and not exist and not deal with the shit anymore.

This is so frustrating, you have no idea. I can take the Zyprexa and be stable mood wise but lose essential cognitive functioning (not to mention the insanely increased appetite and sudden appearance of about 5000 pimples). Or I can not take it and have my brain power but be mixed and unstable again.

Why the FUCK can't I just be okay??? Just okay. That's all I want. Just to be stable and okay. But I can't. I can't have that. I can't just be okay.

Why can't I just be okay? Please. . . 

I'm scared about what's going on, about these two choices I have in front of me. My choice, for now, is to not take the Zyprexa. I'm done with it. I can't do it. But this starts, again, the search for a different med to replace it, lest I want the mixed episode to worsen.

I'm not okay with either of these choices. I'm not okay with any of this. I'm not okay . . .

Please . . .

As Good As It Gets

Have you ever seen that movie? If not, watch it - pretty good flick.

And this is how my life seems. It's as good as it gets. No matter what I do, it's as good as it gets. Which is frustrating beyond belief. I'm tired of it, and I'm losing hope that it will ever change. In fact, I'm close to giving up.

But what's so bad? It's not like I'm suicidal or even close mood wise to where I was in February, so what's the big deal? Well, the big deal is that I'm not enjoying my life. Not much at all. Watching my son play with his friend . . . I'm annoyed. He does something cute or says something funny . . . I smile and feel nothing. My husband hugs me or kisses me or tells me he loves me and I return the favor but I feel nothing, or I get annoyed or I don't even know any more. I fake my way through conversations at work and try to avoid people. I'm a hollow husk of a person.

I've written this before. I know I have. Because this seems to be my new normal. If I'm not actively depressed, I'm a flat, withdrawn, empty, lost, confused shell. People don't understand this feeling - or lack of feeling, I should say. I'm not even sure I can accurately describe how it feels.

But I'll try.

Picture this: A desolate wasteland, a desert. Dead skeletons of trees litter the landscape. It's hot - the heat blurring the distance creating mirages of unknown things. A dry wind is blowing causing tornados of sand on the dunes and puhing the occasional tumbleweed by. There are no clouds and despite the sun being high, the light quality is that of a washed out twilight. The air is thick and it's hard to breath without your lungs burning. It's oppressive. It's unyielding. And there's this overwhelming sense of . . . . something ominous. Something not quite right. You can't put your finger on it . . . . but it's there.

This is the inside of me. It's what I imagine when I close my eyes. I can see it so clearly - it's burned into my mind. On the inside, the inside of me, in the middle of this wasteland, is a robot. A robot devoid of emotion. This robot is me.

I'm lost. I'm lost here and I'm scared. Except I'm not really scared. Because I'm not sure I can truly feel that. I'm kinda wandering around, staring at these skeletal trees, and trying to figure out what is going on. And in this robot body, in this dry landscape, I see the things around me - my family and friends, coworkers, strangers - and I struggle to be a part of that world. I can see the blue sky out there, hear the birds chirping . . . . but I can't grasp it. I can't move past this desert with its skeletal trees and sand dune tornados. But I try. The robot grasps for anything tangible, anything to hold on to. But it all too often slips through . . . .

There's despair with that, but that, too, is short lived and muted. No feelings last long in the wasteland. The wind takes them away with the tumble weeds.

That. That is how I feel. I don't even know if that makes sense. It probably doesn't.