This really can't be as good as it gets

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

Maybe some background:

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

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

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

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

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

But that terrifies me.

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

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

That really. Fucking. Terrifies me.

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

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

I'M DOING EVERYTHING RIGHT.

I really, actually am.

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

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

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

I really, truly, fucking hate bipolar disorder.

Yesterday I was mostly okay. Kind of.

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

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

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

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

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

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

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

Until I wasn't.

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

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

Until it wasn't.

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

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

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

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

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

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

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

fuck

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

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

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

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

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

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

No.

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

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

I'm so fucking sick of this.

My Brain is Stupid

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

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

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

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

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

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

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

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

Which fucking sucks because I feel like shit.

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

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

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

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

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

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

Well, it's Friday

I want to start by saying that I fucking HATE bipolar disorder. I really, really, fucking hate it. Like, a LOT.

I worked on Wednesday and it was a horrible day. It was busy, which was probably good, because it kept me distracted. My mood was awful. I was depressed, tired, full of despair, angry, and a host of other negative feelings. I cut (I have my scalpel in my locker). When I got home I lost it. And I lost it good. It was the ugly cry X10 and I wanted to die. Or, at the very least, I wanted to cut my arm to shreds. Hubs and kiddo had to work overtime pulling me from the brink. It was so bad.

Then yesterday, Thursday, I had a mandatory class for work. Knowing how my mood has been I was dreading it. But I ended up hypomanic. I was inappropriate and obnoxious. I was entertaining. I had fun. It was wonderful! It was glorious! Thank GOD!

After class I had therapy and we started trauma work. It went well. M gave me some ideas on how to manage my overreactive emotions. Yesterday was a good day. Hooray!! A good day!

And then there's today. A day that's really not a good day. Again I want to curl in a ball and not exist. I'm trying. I'm trying so hard to be okay. To interact with people. But I'm so fucking angry today. At everything. And I feel exhausted and overwhelmed. And depressed. And like everything is pointless and stupid. I'm trying to counter, trying to stay positive, trying to remain calm and destress . . .

I really hate this. Why can't I just be normal? Why can't I just be okay? Why do I have to fight depression so much? I don't want to feel everything so much.

I'm meeting a friend for coffee which means interaction which will exhaust me more. And I work tomorrow which will mean interaction which may exhaust me more.

Or maybe I'll be hypomanic again, who knows?

That's the thing though - I never know. And that's exhausting.

I have more I want to write I just don't have it in me right now.

Depressive Symptoms Coming Back

Just got back from a week long vacation to California.

We spent a couple days in Orange County visiting my family. We stayed with my Grandma (on my dad's side) and spent time with my aunts and uncle. It's always great seeing them but it was taxing. Interacting with them really took it out of me - more so than I thought it was going to.

Then we headed to San Diego for Comic Con and the zoo. We spend 5 days there, stayed in a little studio apartment. And I didn't handle it as well as I wanted to.

What was going on, you ask?

I've been having some depressive symptoms coming back. Getting overwhelmed easily, turning into a horrid rage monster at the slightest provocation, having intense feelings of despair wash over me for seemingly no reason, wanting/needing to cut, suicidal thoughts. . .

Let me give you some examples:
 
     - We're at comic con, waiting in a line. The line starts to move forward but the person in front of us lags and isn't moving forward right away. My blood boils, fists clench, teeth grind. It takes every ounce of self control not to shove the person and tell them to MOVE THE FUCK FORWARD ALREADY!! ARE YOU THAT FUCKING STUPID??? CAN YOU NOT SEE THAT THE FUCKING LIKE IS MOVING?? FUCKING MOVE!!!!!!!!! I shake, I take deep breaths, I try to think of calming things and then suddenly I feel like crying because everything is too much to handle. Everything is too hard and too overwhelming.

     - We get home yesterday and hubbs and I have sex. And it was good. And we're snuggling after and I get flooded with despair. Life really has no meaning. I spend every day fighting my distorted thoughts and fighting my feelings and it's not worth it. It's not going to get better. I need to cut. I need to feel a blade slicing through my skin. That's easier than dealing with this. I start to tear up, start to cry, and I know I'm going to lose my shit and I DO NOT want to lose my shit because if I do I won't be able to stop the tears and I KNOW I'll end up cutting. So I talk to hubbs and somehow - don't ask me how - I manage to not lose my shit. I push on and we go shopping and have dinner and watch some tv, but the whole time I'm still struggling with feelings of despair.

     - Today I had ECT (would have normally had it on Monday but was in California). I would prefer to have ECT on Mondays because I know my mom can pick me up and I have Mondays off. So I told the nurse that I would need to have ECT next Monday, not Wednesday. I'm waking up, getting my shoes on and whatnot and she hands me my discharge paper which has my next appointment on it. Which is for a week from Monday (meaning a week and a half between sessions). I guess my expression gave away what I was feeling because she asked what was wrong. I told her I didn't feel comfortable waiting that long (but Dr. M doesn't want me in earlier than a week). It felt like my world was crashing down around me. Like I couldn't possibly cope, I can't possibly handle this. I'm already struggling and now I have to wait a week and a half. I nearly broke down sobbing.

Scenarios like those? They happen a lot. A lot. Several times a day, every day. For the most, part I can keep them under wraps, these stupid fucking mood swings (and by under wraps I mean I haven't attacked anyone, screamed at anyone, curled myself into a little ball and rocked myself while mumbling, break down sobbing uncontrollably, or cut myself). But I come close. Scarily close. And even though I don't "officially" lose my shit, I'm still dealing with these feelings. I'm still struggling to manage them.

I keep reminding myself that I'm doing way better than before I started ECT. Way better (considering I was planning on killing myself if I wasn't approved for it or if it didn't help - scary, but true). I spend more time feeling "okay" than I do feeling like shit - and that's good. (Though I wish I spent more time feeling happy).

And again - take things a day at a time, a moment at a time. I also think I need to lower my expectations. It's just so frustrating.

In a bad way

I'm in a bad way again. A very bad way.

Every day is a struggle. I don't want to exist. It's too hard. Everything is too hard. Being awake is too hard.

I wake up every morning not knowing how I'll make it through the day. Not knowing how I can possibly do it again. I tell myself over and over again that it's worth it. Living. That living, pushing on, existing, is worth it.

I often don't believe it. I mostly don't believe it.

But I tell myself that. That it's worth it. I have my son and my hubby and friends and family and my dog and my job and all that shit and that's why it's worth it.

I tell myself that all the time. Because I have to remember. Because otherwise . . .

. . . otherwise I might forget.

I take naps. Naps to escape my mind. Naps to escape my feelings. Every day, every night, I look forward to bedtime. An escape . . . but I dread it, too. Because I know I'll have to wake up in the morning. Wake up and do it again. Struggle again. Push again.

I don't want to. Sometimes . . . I'd rather forget.

I'm tired. I'm trying, but I'm tired.

Ugh.

Been awhile since I last wrote. I don't know how long. I don't really care, either. I really don't fucking care about much right now.

Why?

Fucking depression. It won't. Fucking. Leave.

I was started on Lexapro, 10mg. Then we increased it 20mg. Then we increased my Lamictal from 200mg to 400mg. And you know what? Fucking nothing.

Nope. Depression is hanging on, gaining strength, trying to overtake me completely. I've cried so much today it's stupid. It's pathetic. It's tiring and I'm so fucking done with this.

Hubby tells me to hang in there. This will get better. We'll get you better.

Really? Because the depression is fucking here. It doesn't go away. From where I stand, it's not getting better.

Everything is overwhelming. Interacting with people is overwhelming. Going to the store is overwhelming. Packing is overwhelming. Everything is fucking overwhelming.

I put on my happy face. I try to "fake it till I make it". I do all of my positive CBT stuff I've learned. But I'm dying on the inside. I'm shattered and broken and I'm trying so hard to hide it.

I'm fucking tired and I'm sick of it.

Today I should have gone to the hospital

I worked today. I was on the floor, backup for trans. I had easy patients. Nice patients. It should have been a nice day. An easy day.

It wasn't.

I knew this morning when I woke up that today would be difficult. I knew I would struggle. I just didn't know how much . . .

I avoided people. Coworkers, my patients even. Go into a room, do what I needed, and get out. I was irritable. I was angry. I didn't want to be bothered. People asked questions. Questions I'm sick of answering. Have you sold your house? When are you moving? Where are you moving to?

I don't. Fucking. Know.

And I'm tired of everyone asking.

Wait.

It's a simple thing. It's not a big deal. People are curious, interested, caring. Making conversation.

But it filled me with rage. I couldn't handle the questions so I withdrew a little more. I gave short answers.

In the afternoon I hid.

I stole away to the report room, sat in a chair in the corner behind the door so people wouldn't see me. That only lasted for half an hour before I got a call from a patient. I left my chair, my temporary sanctuary, to bring my patient pain meds.

I had brought my Nook with me so I decided to try reading. Reading should help, right?

Normally it does. Not today though. Not today. Today I couldn't really focus. After a few pages I would have to take a break. Walk, stretch, check my email. I couldn't focus. I couldn't focus why can't I focus what the hell . . .

My mood was worsening. I grade myself on a scale of 1-10. Five is "normal". Below is moving into depression, above into mania. I started the day at a 3.5. Yes. By 4:00, I was a 2, threatening to go lower. Ever lower.

It can't go lower.

It was. I hid. I hid in the report room again. It was dark in there, the sun was already going down and I left the lights off. I wanted the dark, the quiet. I wanted no one.

Leave me alone.

The charge nurse came in. She didn't know I was sitting there, alone, in the dark. I said boo. She jumped and immediately asked if I was okay.

No. I'm not okay. I'm far from okay.

She offered to take my patients and send me home.

I'll be alright. I'm not okay, but I'll be alright. I can last the rest of the shift. It's only 2 hours. I can do it.

She took my face in her hands and told me to let her know if I needed anything.

Wait. I need help.

Wait.

She left and I sat in the dark, alone. I started to shake, to tremble, lip quivering, tears welling up. I wept. Silently. I tried to stop. I can't have someone catching me crying. Sitting alone in the dark is one thing . . . but crying . . . no.

I stopped crying and I sat, drying my tears, blowing my nose as quietly as I could.

I felt worse. So much worse.

I need to lie down.

I laid down on the floor, in the shadows, behind the door. No one could see me if they were just walking by. Perfect.

Wait.

I was worse. I felt worse. I'm lying on the floor alone in the dark at work and no one knows I'm here and they don't know how bad I feel how bad I've gotten again and that I'm lying here and what I really want to do is die but I can't do that not here not at work and maybe not anywhere but I still kinda want to die and why isn't anyone looking for me?

My mind was racing, I was praying. Please, someone, anyone, find me. Find me and HELP ME. I need HELP don't you understand I NEED HELP!! Someone. Please . . .

Stop.

If someone finds me, if they ask me, I need help. I need to go to the hospital. I want to swallow all of my pills and slit my wrists and  want to go to sleep and not wake up and I know that that's not what I really want. What I really want is for the pain to stop. The pain to fucking END ALREADY.

I'm lying on the floor at work in the dark, hidden from everyone, praying, praying, PRAYING and no one comes. No one comes into the report room. I'm on my side, curled in a ball, full of despair and hopelessness and I start to cry again because no one is coming and no one is helping me and please just someone come and help me because I'm afraid I might hurt myself and it might be real bad this time and I'm scared. No, I'm terrified. My mind races with scenarios of my death and how I might be saved if someone would just FUCKING COME INTO THE ROOM.

But no one does.

I'm miserable. I text my husband. I tell him it's bad, I'm having a rough day, I'm hiding. I don't let on how bad it is because I don't want him to worry. I make him worry so much and I don't want him to worry because I'm okay, really, I'll be okay, I'm fine actually. Just fine.

Stop.

You're not fooling anyone. At least, not yourself. You need to get up. You've been on the floor for 2 hours.

Get up.

I can't. I need to stay longer. Someone may find me and I can get help. I need help. Remember?

Get up.

I sit up. I feel defeated. I feel empty and hopeless and scared and depressed and I don't want to move but I have to move I have to check on my patients and no one is coming to check on me so I have to get up.

Get up.

I stand. I look into the hallway to make sure no one is around while I make my way to the bathroom to clean myself up. I need to be presentable. People can't know that I was crying. That I was silently breaking down and losing my shit while they were doing their work and being happy and normal and not looking for me or helping me because apparently I still do a good job of hiding my suicidal thoughts and depression and no one seems to be the wiser.

Wait.

I check on my patients. They're fine. I was on the floor for 2 hours and they didn't call me and they didn't need anything and they're fine. I sit in the nurses station staring at my phone, scrolling through facebook, trying not to think about how much I hate life and how much I really want to die and then countering my thinking because I know I really don't want to die, remember? You want the pain to stop. You want to not feel like this anymore.

Please.

My shift ends. I give report. I drive home. I tell my husband if I have another day like today I need to be admitted. I need to go to the hospital.

I don't want to go to the hospital. Not again. Please not again.

Help.

 I feel empty and drained and horrifically sad and hopeless and it's maybe more than I can handle. Is it more than I can handle? I wish I knew. And how will tomorrow be? The same? Worse? Better?

Stop.

I wrote this. Before going to bed because if I didn't write this it would consume me and I wouldn't be able to sleep and my mind would probably race even more and I can't have that, not now. Now I need to sleep. It's the only real escape I have.

SSDD

Same shit, different day.

My mood is still shit. I'm still depressed, still having suicidal ideation, and have been cutting. That is most certainly not a good combo. I have had 2 days in the last 3 weeks where going to the hospital might have been a good idea - except I don't think it would help much (I have been able to keep myself safe . . . well, except for the cutting).

I had a talk with hubby about everything a couple of nights ago to let him know what goes on in my fucked up brain. Maybe I scared him a little, I don't know. He thinks I need to add something else to my cocktail again. Maybe I do. But I don't know what. I don't have a good track record with antidepressants. He gave me homework though - to look back through my mood journal and see if there was something that I was on in the past that helped, even if I had to stop it for some reason.

Here's what I found:

I've always been on lithium and lamictal  - l&l - (both are mood stabilizers). For awhile I was on those with an antidepressant (most of the time, wellbutrin). This combo had me in a constant mixed state. I had mostly irritable hypomania mixed with depression, with a few short stints of euphoria. Reading through my journal, seeing how much irritability, distorted thinking, and depression was there makes it obvious that this is not a good combo.

I've also been on l&l with cymbalta. This combo lifted the depression a little but still kept me in a mixed state. L&l by itself renders me with deep depression.

I was on l&l with wellbutrin when I was hospitalized last November - wellbutrin was stopped while I was in the hospital and I was started on zyprexa. That knocked out the mania, but depression was still there and I was hospitalized in December after Latuda pushed me over the edge.

While on l&l and geodon, I had depression, sometimes a little more mild, often times more moderate and I lost my creativity. Mania/mixed symptoms are gone. Then, geodon was stopped and I started on seroquel. Still no mania/mixed symptoms. Well, irritability, but I'm not sure if that's mixed or more the depression. And I've been on wellbutrin and brintellix with these combos with no real benefit.

So, l&l with antidepressant alone = mixed episodes. L&l with antipsychotic = no mania/mixed, but depression. L&l with antipsychotic and antidepressant = no mania/mixed, but depression.

I'm not sure what to do. I'm sure my pdoc, whom I see next Wednesday, will suggest maybe upping the seroquel again. But I don't know what else would be helpful. I need something. Something has to change because I can't keep feeling like this.

And how, exactly, am I feeling?

Let's take a "good" day (good being a relative term). Today is a "good" day. I start the day not wanting to be awake because being awake is pointless and stupid. I spend the day going through the motions, feeling empty, and vacant, and detached. I don't really feel anything. I'm flat, apathetic. Why should I bother cleaning/drawing/etc when everything is so pointless and hopeless? It doesn't make sense. Sleeping to escape makes sense. Cutting makes sense. If I cut at least I can feel something physically - pain. That's almost like a feeling. My urge to cut is strong, sometimes overwhelming. I float along, feeling nothing, doing nothing. Well, that's not entirely true - I feel irritability. Easily. It's the only thing I do feel. I get snippy and bitchy. And in trying not to be snippy and bitchy, I tend to withdraw more.

Now, a bad day. Again, I awake not wanting to be awake because everything is pointless and stupid. Only now, I feel despair. Overwhelming despair and depression and darkness. Not only is being awake pointless, living is pointless. I want to die. I don't know how I can possibly make it through the day. The emotional pain is so great that all I want to do is curl in a ball. Curl in a ball and not exist anymore. Sometimes I do this - even at work - because I don't know what else to do. I get overwhelmed easily, I feel like giving up, and my irritability can get out of control. I tear up easily and often break down sobbing. I want to cut - this time not to feel physical pain, but rather to numb the emotional pain. I want to cut deep enough that I need stitches. My mind fixates on death - my death. Suicidal ideation. I hurt so bad that I don't know how I can go on living. I can't live like this - this is torture, not life. I know that if it does continue to go on like this, I'll kill myself. It's a certainty I'm terrified of.

I struggle whether it's a good day or a bad day, just in different ways. Neither of these days are really okay with me. I have to feel something other than this. I'm so fucking tired of dealing with this. No one should have to - especially for as long as I've had to. I'd really love to throw in the towel.

But I can't.

So there's where I am. Stuck between shit days and shit days. We'll see what my therapist says this week and what my pdoc says next week. What else can I do . . .