Showing Some Improvement

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I'm Not Sure What to Think

I'm really not.

I'm sitting down to write because I've felt like I've needed to all day (I've been out at the therapeutic riding center all day working with both the kids and horses).But now that I'm sitting to write, I find I'm at a loss of words.

I've been struggling again, I think that's a given. I had ECT yesterday and I thought "oh good. I can talk to Dr. M and figure out something to do about these recurring depressive symptoms." I told the nurses as they did my intake and started my IV and they urged me to talk to Dr. M.

So I did.

And he really didn't tell me what I wanted to hear.

One, it can take up to 6 months to get the full benefits of ECT. Two, I need to go easy on myself, be gentle, and give myself time - it took awhile for me to get this sick, it's going to take awhile for me to get better. Three, I need to learn how to better manage/regulate my moods - it appears I'm getting triggered, having an exaggerated, bipolar mood reaction, and that I'm mismanaging that reaction (hence the episodes of despair or sobbing or cutting or intense anger).

I told him I was going back to a DBT group and he got a huge smile on his face. "Good. That will be good for you." The lead nurse, J, agreed that DBT would be wonderful for me.

So the plan stays: my current meds, ECT every other week, and therapy - both my regular and the DBT group.

Here's what's frustrating though: I'd had a couple of fairly good days and I had ECT and group yesterday. And today, today I'm at the riding center all day. Mucked stalls in the morning, work with the kids in the afternoon, spend time with my fave horse and barn buddy there, Thor (who, strangely, happens to be Dr. M's horse). All day I had to keep fighting off despair. It kept washing over me. Random times, no rhyme or reason. I'd be petting Thor and suddenly all I could think about was how nothing really mattered, everything was pointless, and that I'd eventually end up killing myself because nothing gets better. Ever.

I'd throw everything I could into fighting those thoughts and feelings. I do what I'm supposed to do: remain present, acknowledge the feelings, allow them to pass, replace negative thoughts with positive ones. Everything that I practice, that I've been taught to do . . . I do it. Then I finally resort to distraction. I go find something to do or someone to talk to or I immerse myself in grooming. Whatever I can to stay on top.

Today I had that despair wash over me at least 10 times. Even though I would count this a "pretty good" day, I still had to fight so much to stay on top.

Is this how it's always going to be? Always fighting, always struggling, every day? This is what I worry about. Because I don't want to do this every day. I don't want to fight my own mind every day. I'm worried that at some point I'll be too tired. Because what's the point? Why struggle?

I shouldn't think like that. That's not productive, right? I'm just so frustrated.

Well, I have therapy on Thursday, so we'll see what M has to say about all this.

Stupid

I had a great therapy session yesterday, I really did. Everything that was in my last blog post? We talked about that.

He pointed out that I still haven't completely accepted my diagnosis. I mean, I've accepted it, I truly believe I have bipolar disorder, but I haven't fully accepted everything that that entails. For example, even when I'm stable - reeeeeally stable - I can still have wide, wild mood swings for no reason at all. That's just part of bipolar disorder. That truly, for the rest of my life, I have to be hyper vigilant of my moods. I'll have to always monitor my moods, just like a diabetic monitors their blood sugar. There's no real way around it.

I hate that. Like, I really hate that. I wanted to have ECT and just be . . . okay. Normal. But that's just not the case. And it's super fucking frustrating. I don't want to deal with it anymore. I don't want to deal with bipolar disorder anymore.

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.

Depression vs Unhappiness

I've been pretty shitty the past several days. Very shitty. Depressed, sobbing, struggling. I've been trying to figure things out. I like having shit figured out.

My first two weeks of ECT I went 3 times a week - Monday, Wednesday, and Friday. I started feeling better quickly. I was the poster child for how ECT should work. Then we switched to weekly. I had ECT on Monday. By Friday my mood was starting to slip, starting to drop. So I saw Dr. M the next Monday and told him about that. He doesn't want to increase the frequency of ECT treatments (the goal, after all, is to eventually space them out to monthly). He told me to call his office and make an appointment so we could adjust my meds.

That appointment was last Wednesday. We're increasing my lithium from 600mg to 900mg. I'm not optimistic that this will help at all - I've been as high as 1200mg without any added benefit. But we'll see I guess. He also told me that he doesn't believe I'll ever not need ECT. Meds historically haven't worked well for me and he thinks I'll always need to have ECT. Again, the goal is to get me to monthly treatments but he sees me staying weekly for the foreseeable future.

Then last Thursday night, as I was getting ready for bed, I realized I couldn't remember if I had taken my meds. See, I normally take my night meds around 8:30, and here it was 9:30 and I couldn't remember if I had taken them. Well, I couldn't take a dose at that time because I can't double up on my Seroquel. That's a bad idea for me.

Thursday night I didn't sleep. Maybe 3 hours? Which means I probably hadn't taken my meds (Seroquel knocks me out). So now here I am, having missed meds and not slept. And Friday was horrible. I spent the majority of it sobbing uncontrollably. I cut. And I cut deep. Deep enough it needed stitches (which I did not go get).

Saturday I worked and my mood was equally as bad. I hid. I didn't want to interact. I tried though. I forced myself to. My coworkers knew I was struggling and they rallied around me. Gave me hugs, words of encouragement, and checked on my patients for me when I was unable to do so (I spent a good hour hiding in the break room sobbing). I wanted to cut so bad, but I didn't. I folded paper cranes instead. On of the labor nurses cleaned my cut and put steri strips over it for me (kind of like stitches but it's really sticky tape).

Sunday I was still crap. J and I went to the gym (I really didn't want to, but I really fucking need to). His brother wanted to go bowling with us. I didn't go. I couldn't. I desperately didn't want to. It didn't sound fun and I didn't want to interact.

Today I had ECT and I talked about all of this with Dr. M. Asked him what more I could do. His response was classic: "Well you could stop cutting yourself for starters!" He said the cutting is probably related to trauma or unhappiness. I asked him, "So I have to be like Billy Crystal in City Slickers and find my happiness?" (I've mentioned that to M as well).

It got me thinking: how am I unhappy? What's making me unhappy? I did an inventory of symptoms:

- difficulty waking in the mornings
- increased appetite
- consistent weight gain
- no motivation to workout
- no motivation to clean the house
- not wanting to do things
- not caring about my appearance (I've been wearing hardly any makeup, haven't been doing my hair, wearing gym clothes)
- not wanting to interact with people
- feeling worthless
- feeling like things are pointless (why should I bother? nothing matters)
- feeling like life is too difficult, people would be better off without me (suicidal thoughts, can't do this anymore)
- not finding joy in things (doing things, my artwork, working with the kids at the riding center - I like spending time with the horses, but working with the kids isn't feeling rewarding like it used to)

All of that stuff right there? That's depression. Those are symptoms of depression. Now, last few days aside, overall my depressive symptoms have been better. Overall I feel a hell of a lot better than I have (because, to be perfectly honest, had I not started ECT when I did, I would have killed myself - I was planning it). So I'm better. I am.

I've been trying to figure out the last few days. Did I become exponentially worse because I missed a dose of Seroquel and didn't sleep? Can that really fuck me up that much?? Am I that sensitive?

And so then the cutting. And the uncontrollable sobbing. Is that unhappiness? Trauma? Depression? All of it?

Like, if I had taken my meds Thursday night like normal and slept, would I have been fine this past weekend?

And how fucking frustrating is that?? I don't sleep one night and I completely lose my shit.

The past few weeks have made me realize how much I truly need to take things a day at a time. How much I truly need to stay in the moment. I'm not going to have the answers for everything and I have to be okay with that.  I also do have to remember that I have bipolar disorder - a chronic, progressive illness - and that I will have days that are worse than others. That I will have times where I will lose my shit for seemingly no reason. And that sucks. But that's reality. I think another problem is I was secretly under the impression that I would have ECT, start feeling better, and then miraculously not need it anymore and be essentially "cured" of my symptoms. Bitch, you're bipolar. For life. Fucking accept and deal with it.

It also doesn't help that I think personality wise I tend to lean towards more melancholy. Always have. I need to focus on little joys. Keep forcing myself to interact and be upbeat - even when I don't feel it.

And I need to not cut.

Frustrated

Well. I have 6 ECT treatments under my belt. And overall, I'm feeling better. Hubbs has noticed a positive change. Yaaaaaay.

But I'm fucking frustrated. Why? I seem to have slipped into a mixed state. Meaning? I'm hyperirritable. I'm a cranky-ass bitch. And I feel like I may snap - either go off or break down, I'm not sure which. This is a shitty feeling to have - especially after starting to feel better.

I'm trying to keep things in perspective.  First and foremost - you were close to killing yourself. ANY reprieve from feeling that shitty is to be cherished. Secondly, the majority of your days over the past 2 weeks were an improvement over where you had been.

I don't know what it is, really . . . .

I've been feeling better. I want to go do things. I want to start working out again, get in shape, eat healthier. I want to do more things with my family, participate in life again, go back to work. I'm excited to do this stuff . . .

And then this weekend hits. And my mood is crap. I'm irritable, bitchy. And today . . . ugh. The depression is trying to weasel its way back in. The despair. Everything is trying to come back. I'm on pinterest and see a post about cutting . . . I feel the draw, it's a trigger. Why? Why is it such a trigger? I'm feeling better . . .

I'm scared. I realize, I must be scared. I've struggled for so long, I don't know how to not struggle. I don't know how to not be depressed. And I realize, I don't want to struggle anymore - I don't want to have bad days. I think I equate bad days with failure. (God forbid I fail).

Again I have to remind myself that I have a chronic, lifelong, illness and that I get to battle my brain and emotions every. Single. Day.

And I don't fucking want to. I want the ECT to work and be done with it. I don't want to have to struggle every day. I just want to be fine. Yeah, I know: whoa is me, life is unfair. Stop with the pity party, right?

Well fuck you.

Thank  God I have therapy on Thursday.. Fuck.

My First ECT Treatment

I arrived at PVBH at 6:45am, the time they told me to be there. Hubby and son were with me and they planned on staying and waiting. I didn't wait long before Chris came and brought me back. Chris is a portly, young fellow, jovial most of the time in my dealings with him (from being hospitalized).

I followed him through the familiar hallways to the pre-ECT room - the room where I had done my initial intake. I sat in a leather recliner, tried to make myself comfortable. Another girl had come in with me (Samantha? who cares . . .). A female nurse whose name escapes me and a male nurse I knew, Johnny, came in to start IVs, while Jim (the RN who heads the ECT program), went through my paperwork, had me sign consents, and asked me orientation questions.

A third woman was brought back, an inpatient, and she sat in the far chair, wrapped in a blanket. She was the first to go back. Chris put the Princess Bride in the DVD player to keep us occupied while we waited.

I went back second - Dr. Chu came and got me and leaded me to the ECT treatment room. She made small talk and joked, seemed genuinely concerned about my wellbeing - the opposite of how she seemed for my intake. A pleasant surprise. She had me place my purse and glasses under my bed, and remove my shoes and socks.

Since this was my first ECT session, she explained, they do things a little differently. She has to experiment a little to find what my seizure threshold is - how much electricity to cause a 30 second seizure. She would start with a dosage and measure the seizure activity - and adjust the electricity dose accordingly (meaning I might have 2 or 3 seizures). She laid me back and began hooking electrodes to my ankles and wrists while Jim attached them to my forehead and temples. The anesthesiologist was applying a blood pressure cuff, a finger probe, and chest leads. A cuff went over my left ankle and one on my right. (The cuff on my left ankle cause my toes to spasm - the intent. When they stopped spasming the docs knew the paralytic was working. The cuff on my right ankle kept the paralytic from reaching my right foot so that they would see it spasm from the seizure).

Dr. Chu and Jim are explaining everything as they're doing it and the room seems in utter chaos. Jim remarks on my new cuts. Dr. Chu asks how bad I was getting - bad enough I almost admitted myself on Friday. "These probes are going across your forehead" "Jim, do you see the mark here?" I feel wetness on the tip of my head and what feels like a marker tip "You just have to move her hair a little - I marked your head so Jim knows where to place the probe" "Can I get another lead? This one isn't sticking" "I'm going to put this mask over your face, just breathe deeply" "If you need to be admitted, come in - it's what we're here for" "You said your cut could have used stitches?" "Just breathe. You're going to drift off to sleep now . . ."

I had felt panic welling up in me. The mask made me feel claustrophobic and the talking and questions and noise were overwhelming. And the burn of the anesthetic through my veins . . .

"Would you like some juice?"

"What? Yeah, cranberry." I'm sitting up in bed. My vision is blurred - but that has more to do with the fact that I'm not wearing my glasses rather than the anesthesia. The nurse, the one who started my IV, hands me cranberry juice and I drink it greedily. "What time is it?" I ask.

"8:30"

I was brought back shortly before 8. She asks me my orientation questions and leads me out to the lobby, where hubby and son are waiting.

We went home and I ate and had coffee, and then napped for 2 hours. I had a wicked headache for about half of the day. Around bedtime my neck and shoulders were starting to get sore and this morning my whole body is sore. Like I spent hours in the gym and ran a marathon.

Without the health benefits.

But no memory issues. So far. Hopefully that will be the norm.

Treatments are Monday, Wednesday, Friday for 4 weeks.

Cheers, y'all.