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.

It's been a bit . . .

So it's been almost 2 weeks since my last post. I haven't much felt like writing.

But I do today.

I've been on the Brintellix for around 3 weeks now. My anxiety had started to get bad 2 weeks ago and I was worried that it would get as bad as it was the last time I was on it. I've noticed, however, that over the last week the anxiety has lessened. It's there every once in awhile, but it's manageable and not terribly bothersome.

And that's good news, right?

Sad thing? The Brintellix isn't really helping my mood. Not like it did the last time I was on it. I've had one good day (last Sunday) - a day where I felt "normal", happy, and content with life. I was at work, it was busy, and I had fun. But every other day? Just like before going back on Brintellix.

What do those days look like?

An overall feeling of being "down". I'm withdrawn. I don't want to participate in life. I'd rather nap the day away so I don't have to feel what I'm feeling. And what I'm feeling is all muted - except for my anger. I'm quick to anger. Everything seems to irritate or annoy me. I want to be by myself - I don't want to interact with anyone - family included.

I'm doing what I can to counter these feelings - don't think I'm giving up, or giving in. I'm not. I'm forcing myself to be more positive and upbeat (I don't know how well that's working - I should ask friends and family about that). I'm not doing the negative things I used to do (catastrophizing, all or nothing thinking, shit like that). I'm trying my best to be mindful - to stay in the moment. I'm forcing myself to interact.

Here's the thing - I'm stable. I'm the most stable I've been in 3 years. I'm not having big swings. I'm not hypomanic, I'm not horribly depressed. Nope. Stable. And that's good. The last thing I need is to have a major swing and be hospitalized again. But this low level depression? I think that's my baseline. I think that I'm stuck here and that's just how it's going to be. I'll have a good day here and there and all the others I'm going to have to fight for. I really don't want to accept this, but I don't think I have any other choice.

But wait - there's more!

I've been trying hard to be more "present" at home, around hubby and son. I had been getting bad about ignoring them, taking them for granted, lashing out at them. And I've been trying to be better about it. I don't know how well I'm doing in that regard. Sadly, I've felt myself starting to slip again. Feeling myself starting to withdraw more. Wanting to be alone and to be left alone. I'm trying to ignore/counter this as it's not good for anyone. I feel my anger sneaking back in. Ugh.

And also? Seroquel. FUCK Seroquel. I've had issues with drowsiness/grogginess/somnolence since I started it. I've had issues with my appetite since starting it (I've gained 17 pounds in around 13 weeks). And those two issues are getting progressively worse. It takes me around an hour to wake up in the morning and by midday I'm groggy and a little zombie like. The other thing, which has cropped up recently, is doing things in the middle of the night and not remembering them. The other night I kinda "woke up" standing in the closet with the light on - I have absolutely no recollection of getting up and walking into the closet. I don't remember waking up to go to the bathroom. If I tell hubby something after I've gone to sleep, I don't remember it. Now, maybe that part is only mildly annoying, but I would prefer for it not to get worse.

I see my psychiatrist in 2 weeks and I'm going to request that I go off of Seroquel. I'll start back up on the Geodon, whatever, I don't care. I didn't like the side effects of Geodon but they are preferable to the side effects of Seroquel. I have samples of 150mg Seroquel (I'm currently taking 300mg), so in a few days I'm going to drop my dose down - start to wean myself off. It's not like I felt a difference from when I was on 50mg vs 300mg.

So yeah. That's it. I'm frustrated. But what else is new, right?

It's been awhile

So yeah. It's been awhile since my last post and quite a bit has happened. Let's see, last post was about depression coming back.

And that is still the case I'm afraid. But I also have this really awesome thing called anxiety. And it's been bad. I have panic attacks when I try and sleep. At first it was just with trying to nap. Then it started with going to bed at night. Racing heart, feeling of impending doom, shakiness, panic. It happens at random times throughout the day too. Sometimes it's constant throughout the day.

Hell, I'm almost in a full panic attack right now, writing this.

I've had irritability and insomnia - to the point where I've been taking klonopin to sleep.

I have all the symptoms of a mixed episode starting. At first I was thinking it might be caused by Deplin - a folic acid supplement that my psych doc put me on. I found one site that listed insomnia, irritability and anxiety as side effects. But I looked it up on my work's fancy info site and it seems that this is not the case (at least for 99% of people - who knows, maybe I'm that 1%). It can cause acne though - which has gotten horrifically bad. So I stopped taking the Deplin, just in case.

The anxiety and irritability continues (the insomnia has gotten better, thank God).

I've had some other issues (that I won't discuss here) which has led to my psych doc having me increase my geodon back up to 80mg - which I really do not want to do (last night was my first increased dose and I certainly feel the effects today - namely fatigue and grogginess). He's also considering starting me on Depakote, which we'll discuss when I see him on Monday (I have strong reservations about going on this drug because of the side effects). He's also started the process of trying to get me seen by the mood experts at Mass General in Boston. I want to go so badly but I'm not terribly hopeful that it will happen.

I've taken to rating my mood on a scale from 1-10, and most days it's around a 3. I'd like it around a 6. I've had some 2's, and I've had a few 4's as well. But, still pretty low. And did I mention anxiety? And irritability? Oh I have? Okay.

What else . . . I was in on a code on a baby and the baby died. This was my first infant death (though I've coded many babies). I took it pretty hard - harder than I thought I would. So hard, even, that my brain went into overdrive giving me full blown depression with suicidal ideation for a day. And then - poof - gone. My brain does not handle stress well at all apparently.

Speaking of stress, I still get overwhelmed at work. I'm keeping my shit together just fine, I just feel overwhelmed and exhausted after working. And during working. Especially since almost every day I've worked we've done 8-10 deliveries. So crazy busy. But I'm handling it better than I was even a month ago, which makes me feel hopeful that at some point I'll be able to go back to full time. Probably not anytime soon, but at some point (I still have a hard time handling two days a week - let alone 3 right now). But I'll get there.

And lastly, my son has been having some anxiety issues of his own - mostly about something happening to my hubby or I (or his uncle). This has been going on for weeks. A few days ago he asked me tons of questions about my bipolar (not that he called it that - he's 7). Wanting to know why I act the way I do, why do I get angry or cry for no reason, why am I sad, why doesn't my brain work right, why do I have to take so many pills, will I always be like this. That kinda stuff. And he made a request that actually kinda hurt - he asked to see a therapist. He wants to "talk to someone about this like you do". It broke my heart a little because I know that quite a bit of his anxiety is cause by my instability. But I'll find a child therapist for him so he can talk - as much as he needs to. Maybe it's only one session. Maybe it's several. I don't know.

Alright. I've written enough for now. A brief overview of what the hell has been going on.

The two parts don't match

They don't. Seriously.

I wanna take a minute and talk about jumping spiders and how they're cute little motherfuckers. No really.

How is this not adorable???

These are spiders that I'm not afraid of and will actively seek out.

They wear water droplets as hats.

What's not to love??? Adorable, harmless, and water droplet hats! Gimme *grabby hands*

You know what else is new? My body fucking hates Geodon. Not complete hate, but hate none the less. Eleven days ago Dr. C had me go from 80mg of Geodon to 120mg. Now, I had issues with drowsiness when I went up to 80mg so I wasn't too pleased but I said I'd do it. 

Dumb idea.

He told me to take 80mg at night and 40mg in the morning to help with the drowsiness. Totally didn't work. About an hour after taking the morning dose I would be so drowsy and groggy I couldn't stand. For 2-3 hours. I tried this for 6 days and it got progressively worse. So I switched to taking it all at night. This meant when I woke up I was so groggy I couldn't keep my eyes open - for about 2 hours. And if I woke up during the night to pee? I had better get it done fast because I'd get so groggy I couldn't walk. 

In addition to the debilitating drowsiness, grogginess and somnolence, I also had a host of other side effects: insomnia, racing thoughts at bedtime, a constant all-day headache, tachycardia (rapid heart rate) and PVCs (premature ventricular contractions - basically like palpitations). The tachycardia and PVCs happened about an hour after taking the 120mg dose and happened irregardless of what I was doing. My heart rate would be 140-150 just laying in bed. 

And that, my friends, is not good. Not good at all.

I was also incredibly irritable during this time. I think because of all the goddamned side effects and lack of sleep. 

So after 9 days I dropped myself back down to 80mg. The symptoms all were getting progressively worse so obviously my body can't handle 120mg of Geodon. 

The day after my first decreased dose, yesterday, was lovely. I woke up feeling more rested, no drowsiness at all, no headache all day, and my mood was greatly improved. Night and day difference!

I'm still having some insomnia - I have trouble falling asleep, takes now 1-2 hours (I'm the type of person who would be out within 10 minutes of my head hitting the pillow).  

But I'm feeling better and that's all that matters. 

I emailed Dr. C of course to let him know, and I see him Feb. 3. But I WILL NOT go back up on my dose. The side effects are unacceptable. 

See? The two parts don't match.

Sometimes I get annoyed with shit.

No really. I do. Like medication side effects for example. Like side effects that I continue to get from my damn Geodon. Makes me want to cut a bitch.

So here's what's up. Last Friday Dr. C had me increase my dose of Geodon from 80mg to 120mg. He told me to take 80mg at night and 40mg in the morning to stave off morning grogginess. I had been having morning grogginess at the 80mg dose, but it was starting to ease up.

Well, guess what happens when I take my morning dose of Geodon?

That's right. I get groggy. Drowsy. Sometimes so much so that I can't even stand. Seriously. Are you fucking kidding me, Geodon? I mean, what the actual fuck??

Today I decided that I'm not taking that extra 40mg in the morning any more. I'm going to take it all at night. See what that does. If I keep getting groggy like this . . . well, that's a deal breaker. I can't work like this.

Speaking of work, I'm not going back until the 27th at the earliest. I'm not ready. I'm emotionally and mentally exhausted. Just . . . exhausted. Then add in the medication side effects and the akathisia (got that too, joy) and it's a no go. I talked with my manager at length about everything and she supports me 100%. I don't need to worry about work.

Huge weight off my shoulders.

I have nothing else poignant to say. Nothing at all.

So bye.