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.

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.

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.

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.

So I want to kill myself . . .

I really do. . . at times.

Like yesterday. Yesterday was bad. Yesterday I wanted to slit my wrists and watch the blood flow. Watch the blood flow and feel myself weakening as I slip into darkness.

But I didn't. You know why?

Because deep down I know that I don't truly want to die. What I want is for the pain to stop. For my constant up and down (mostly down) to stop.

Here's a story:

Friday night I forgot to take my meds. I usually take them around 8-8:30. Well, I didn't. But when I went to bed at 10, I didn't realize I hadn't taken them because I'm so used to taking them at that time. I've been late taking my seroquel before and I typically have insomnia, tremors, nausea, night sweats, and racing thoughts until I take it (even if I'm 2 hours late taking it I have these symptoms). Friday night I had insomnia - I only got around 3-4 hours of sleep. But I had no other symptoms until 6am - I didn't figure out until then that I had forgot my meds (after having the other symptoms, I counted my seroquel and yep - forgot it).

Of course I worked Saturday. All morning I rapid cycled. I'd have depression with racing thoughts, poor concentration, and irritability. Then my mood would lift and I'd feel okay, I'd giggle a little, and become very talkative. Then my mood would plummet and be mixed again.

This happened until around 3. At 3 I became hypomanic. Euphoric hypomanic. I felt amazing. I laughed so much. I laughed at everything and nothing. I talked rapidly and became highly excitable. I had racing thoughts. I said inappropriate things. I was loud, and at times obnoxious. I cussed. A lot. In my hailstorm of activity and loudness and giddiness, I told numerous people that I was bipolar and didn't take my meds (people didn't need to know that).

But I felt amazing. Like I could conquer the world.

When I got home from work I was still giggling and talkative, but my lack of sleep was starting to catch up to me (in retrospect, this was probably good - if I had gone higher, or if it lasted longer, I may have needed to be hospitalized).

I had a great day. A wonderful, amazing, and happy day. Because I didn't take my meds. So I rationalized that maybe I should stop my meds. At least the seroquel. Now, seeing how my judgement was probably clouded, I asked my hubby and my best friend if I should take my meds. They both said yes, take your damn meds. Don't be a noncompliant idiot (my friend's words).

So Saturday night I took my meds like a good girl. I went to bed around 10. Hubby came to bed around midnight to find me unable to sleep, plagued by racing thoughts. My whole body hurt because I was so tired and my mind was going so fast. He had me take a benadryl to try and help me fall asleep, and an hour after I was able to sleep. I slept until 9am (I'm usually up by 7).

I woke up knowing something was wrong. Knowing something was off. Knowing that it was going to be a bad day.

I awoke depressed. I tried to hide and ignore it. I tried all day to hide and ignore it. How could I possibly feel so bad after having a day where I felt so good??

Throughout the day I felt increasingly more depressed. My thoughts became darker. I wanted to cut. I needed to cut - but I didn't. I tried to keep my anger in check, even as it swelled and threatened to consume me. I didn't want to be around anyone - including hubby and son. I didn't want to interact with anyone - including texting friends.

I thought more about slitting my wrists.

After putting my son to bed I broke down sobbing. I couldn't take it anymore. It was the ugly cry where your snot gets everywhere and was filled with utter despair and hopelessness.

I can't go on like this.

I told hubby that. I can't. I can't do this anymore. It's too hard. It's not fair. How can anyone possibly think that I can keep this up??

Over the past 3.5 weeks I've had suicidal ideation on more days than not. There have been 3 instances where I probably should have gone to the hospital (last night, honestly, was one of them - I really wanted to slit my wrists and I was feeling impulsive). I'm doing everything right. My therapist pointed that out as well - I'm doing everything I'm supposed to be doing. All the CBT stuff I've learned in therapy - I'm applying it. I want to isolate - I'm forcing myself to interact. I'm staying busy rather than just staring at the ceiling or sleeping (which is what I want to do).

And yet I continue to get worse.

I see my psychiatrist on Wednesday. I'm guessing she'll increase my seroquel again. To either 500 or 600mg. Then probably another month of "let's wait and see if this helps at all". I'll be curious to see what she has to say about the suicidal ideation (my therapist was a little annoyed that I didn't call her office to let her know about the suicidal thoughts - well, I don't know her well and I didn't want to be told to go to the hospital; I thought I could handle it on my own).

Something has to change. It has to because I truly can't keep doing this. I'm tired. I'm not hopeful (why should I be? Nothing has worked so far).

I don't understand why I have to exist. Can't I just disappear until something manages my depression? Until I feel better? Why can't I do that?

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 . . .

3 weeks later . . .

It's been around 3 weeks since my last post. Why so long? Because I don't want to post negative post after negative post. I've written some, I've just never published them.

I saw my pdoc, oh, I don't know, 2.5 - 3 weeks ago? Something like that. She said that we should be able to manage my depression better. So she upped my seroquel from 300mg to 400mg. She said that on doses up to 300mg seroquel works on mania and as a sleep aid. At doses over 300mg, it works on mania and as an antidepressant. She's confidant that this will work. I see her again on the 17th.

Long story short, it's not helping much. My depression is still bad. Most days I battle with suicidal ideation. This past Saturday was particularly bad as I was actively suicidal and wanted to slit my wrists. Luckily hubby was with me all day. I didn't quite let on how bad I was though (I don't want to go back to the hospital).

I want to spend all my time sleeping. That way I don't have to deal with how I'm feeling. I've been reading a lot to escape too. And art. I've been drawing.

I'm really getting tired of this. This stupid depression. I'm trying so hard to stay positive and yet it beats me down. I tell myself over and over that life is worth living, but the majority of the time I don't feel that way. I do have good moments, sometimes even a pretty good day, but they're few and far between. It's mostly me trudging through, faking it, forcing myself to talk and interact. I had started pulling away from hubby and son and I talked to him about it - I can't let myself pull away.

I still feel distant though. I feel like a lie.

I'm trying not to talk about this much, to anyone really, because 1. I don't want to be a burden, 2. I don't want to seem selfish and self absorbed, 3. I don't want people to think I've brought this on myself, and 4. I'm hoping minimizing/ignoring/denying how I feel will help (I'm aware that this is not the best tactic and usually doesn't work - and yet I try it anyway).

I'm done for now. Maybe I'll write more later, maybe not. I'm trying not to go to in depth as I don't want to break down right now.

Ugh.

Well fuck . . .

So here's the scoop. My depression is kicking my ass. For reals. This past weekend was particularly bad - lots of crying, wanting to die, suicidal ideation. It was not pretty. Yesterday I spent the whole day alternating between reading and sleeping. Two ways to escape how crappy I was feeling. Today has been better - thank God.

All this got me thinking. About a lot of things. Where to start . . .

I'm not taking my Brintellix anymore (antidepressant). I've been on it for like 14 weeks now? Something like that. And the past 5 weeks I've been in a depression. I've been depressed despite my fancy antidepressant. So I stopped it. Might as well save myself $60 a month if I'm going to be depressed on it. I stopped it cold turkey and have noticed no ill effects.

But I still have this damn lingering depression. I see my pdoc tomorrow and I'm faced with a decision: do I start a different antidepressant? Or not? It's this decision that's had me thinking.

The past 3 years have been a struggle for me. No one would argue that, and if you read this blog you know this. The past 3 years I have fought against my diagnosis, never really accepting it. I've tried many different medications trying to "control" this illness and my moods, certain that once I had the right combo I'd be happy and never have to face my violent mood swings anymore.

Well that's not how bipolar disorder works. That's not how the medications work.

The medications are designed to manage the major mood swings. True mania, and, to a lesser extent, major depression (medications sadly don't do that well with bipolar depression). My combo of lithium, Lamictal, and Seroquel are doing what they're supposed to be doing - managing the huge swings. My hypomania has been virtually nonexistent since my hospitalization for it last November. The bipolar expert agreed that this was an excellent combo.

But then depression rears its ugly head. And these meds let it happen. So I try Brintellix. It starts to work, amazingly, it starts to work. But it caused crippling anxiety and I had to stop it. After a time, the depression came back. I had since switched from geodon to Seroquel so we went ahead and tried the Brintellix again. Guess what? I didn't have the same results that I did the first time. I didn't really get the anxiety, but I also didn't really get any benefit.

And so I stopped it. Four days ago.

My depression persists. So, do I ask my pdoc tomorrow about trying a different antidepressant? Part of me says YES! Try something! Maybe this will be the med that gets rid of your depression!!

Or maybe, like every antidepressant I've tried (6 of them), it won't make any real difference. Maybe I'm still in denial of my illness and I'm still convinced that it's more meds I need (even when I state, often, how I don't want to be on more meds). Maybe I'm still holding out hope that I'll reach that place of always being happy and never having to worry about my illness if I just have the right meds . . .

Like I stated in my last post, this is not how bipolar disorder works. I can be on all the meds and still cycle. That is the nature of the beast. This recent depression while on Brintellix proves it.

Part of me doesn't want to accept this.

I want it to be easy. Change a med, you're all good.

That's not how this shit works. Accept that.

I have to learn to accept that some days I might wake up suicidal for no apparent reason. Or that I may wake up feeling okay and stable and even. Or that maybe the hypomania will decide to come back. And that even though my meds manage most of the big swings, they don't manage all of them.

This illness is managed, not controlled.

I've been trying to remind myself of this - often. I'm trying to be mindful and stay in the present - not worrying over yesterday or how I may feel tomorrow. I mean come on - Sunday I was suicidal, yesterday apathetic, and today I'm okay. If that doesn't show you how quickly my moods can cycle, while on meds . . . (fun fact: my moods can cycle that quickly in hours).

So then what have I decided about seeing my pdoc? I'm not going to go on another antidepressant. I'm going to try managing without one. I don't have a good track record with them anyway. I'm going to do what I can to manage my illness on a day to day basis. Doing everything I've learned in therapy, exercising, eating well, and taking my other meds as prescribed (even though now and then I want to stop them all).

Bottom line, I have to accept my illness and work with it to truly manage it and thrive. I can't keep doing what I've been doing and expect different outcomes. I need to keep my head out of my ass. Besides, how can I help others with mental illness if I can't help myself?

Spoiler alert: I'm planning on switching to psychiatric nursing and going back to school to get my NP in psychiatry. More on that later.

Apathy and Anhedonia are my Friends

And I hate these friends. I wish they would go the fuck away.

If you don't know what apathy or anhedonia is, google it.

The week after my hospitalization was filled with depression and despair. Then came Boston where I was warned that my moods might get a little screwy. And they did get screwy - I cycled through depression, irritability, giddiness and feeling okay several times a day. Fucking tiring.

But now . . . for the last week . . . I have been either irritable or nothing. I touched on it in my last post, my icky feels. I just can't shake this numb feeling. I've felt it since last Friday. Almost a full week now. I have the hyper irritability - I've got that emotion down pat - or I have this all encompassing nothingness. This lack of feeling. I try to feel. I force laughter, I force myself to be upbeat (which is all fake - I don't feel any of it). I force myself to talk, to not be as withdrawn as I feel.

And it's not really working. All I want to do is lay on the couch and stare at the ceiling. I want to not exist again.

Tuesday I had no choice but to do something, to interact - I was volunteering at the riding center all day. But I was a hollow husk. Yesterday I forced myself to do things. I had to take my son to therapy, I had acupuncture, I met a friend for pie and coffee. But other than that I just kind of floated around in a numb haze.

Today is looking to be, uh, not good. Today I have more feels and they're of the bad variety. They're of the depressed, self destructive variety. I've spend all morning on the verge of tears but I can't actually cry. Maybe it would help if I could. I want desperately to not exist. I feel like everything is pointless again. I'm always going to have these stupid fucking mood swings to deal with so what the fuck is the point of continuing on?

I want to self harm. I want to burn myself again. I have a string of 4 very noticeable burn marks from Monday on my left inner arm and I want to add to them. I want to feel the searing white flash of pain. I want the momentary adrenaline rush. More importantly, I want the outward expression of the pain I feel inside. I'm hoping my previous burn marks scar. I want the reminder.

It's taking every ounce of self control I have to not burn myself right now. I'm writing this hoping that it will help dissipate the urge. I may try going downstairs to box. I remind myself that self-harm serves no purpose and can even makes things worse. But I may end up burning myself, I don't know. I'm trying not to.

I feel like I don't know what to do with myself or my life. Right now, at this moment, everything seems so bleak. I'll be dealing with these swings my entire life - which is daunting and depressing. I have all this fucking trauma work to go through in therapy which is daunting and depressing. I have no desire/inspiration/get no joy out of my artwork anymore which is depressing. I'm getting no joy out of life right now which is depressing.

All of this is the apathy. All of this is the anhedonia. All of this is part of a possible major depressive episode. I'm hoping not. I'm hoping my brain is just in shut down mode from the whole depression/suicide/hospitalization thing and that soon it will kick into gear again. Who knows, maybe this is my new baseline. Whatever the fuck it is I want it to stop.

Also? All of these thoughts, these words I'm fleshing out here, represent several errors of thinking, or, cognitive distortions. Namely, catastrophizing, fortune telling, all or nothing thinking, overgeneralization, and disqualifying the positive. There are 10 "official" cognitive distortions and I'm practicing 5 of them right now. Intellectually, I know this. Intellectually, I try talking myself out of these, point out the flaws, counter them. But sadly, it's not helping. That's part of the problem with me - I know this shit. I recognize it and work against it. I try. But I still fall prey to it and it makes my mood cycles worse. I've been working on all of this so much in therapy over the past year and still it gets me.

I don't know what else to say. I hate being so negative but that's where I'm at right now. I'm trying not to ruminate, I'm trying to counter my distorted thinking, and I'm trying to not burn myself. I see my new pdoc at 3 today so maybe that will be helpful.

Ugh. I'm tired of having shitty feels or no feels. Fucking brain.

So some shit happened

And by shit, I mean SHIT. Serious shit, y'all. And I'm going to write about it, and I'm going to be blunt and visceral and personal.

Because I'm lucky to be alive to be writing this.

Last week I came the closest I ever have to killing myself. And had I attempted, I probably would have completed. I had a plan and a backup plan. I had a backup plan to my backup plan.

If you know me, you wouldn't have known any of this. I hid it. I hid it as well as I could from everyone. Even my hubby and best friend. Why? Because if they knew then I couldn't carry it out. Now let me tell you something that may not make any sense - I don't want to die. I flat out don't want to die.

So why suicide . . . ?

I was put on a medication called Depakote. It's a mood stabilizer that was going to replace my lithium. I was started on a low dose - 1000mg. After 2 weeks I was more depressed. I was having some thoughts of death. And I knew it was the Depakote. I saw my psych doc and told him this. His response? No, it's not the Depakote, you need to go up on the dose. We're going to double it. I stared at him a minute. Seriously? I just told you I've had worsening depression since starting it! No, go up to 2000mg.

So I did. He knows what he's talking about, right? Wrong.

During the first week at 2000mg, I became obsessed with death and dying. I purposefully read books that centered around suicide - it was on my mind all the time. The thoughts were intrusive - I didn't want them there - I really didn't. They were disturbing. They were scary. I had my hubby lock up all of my meds.

My second week at 2000mg was the most horrific week of my life. I spent hours sobbing, curled in a ball on the floor, wishing I could just die. The pain was so bad I just . . . I needed to die.

If you've never been at this place, this place of utter terror and pain and despair, you'll never quite understand this. The pain is guttural, animalistic. It reaches into every fiber of your being. It hurts emotionally, mentally, and physically. While I cried, while I sobbed and wailed and screamed and pounded my fists, all I wanted was the pain to end. The torture to end. I hit my head against the wall. I burned myself with a cigarette lighter. I would have cut myself but the blades had all been locked up. There was no way I could go on like this. No way I could possibly continue to live like this. How could anyone? How could anyone be expected to live with this much pain?? Death was the only way out.

Last Wednesday night I told my hubby that it was a matter of when, not if, I would kill myself. I know I scared him. I was sobbing, laying on him, hurting and scared and tired. I was so tired. Tired of pretending. Tired of hurting. Tired of trying and having nothing work. I was tired. I told him that I wanted to die and that it was a good thing my pills were locked up. I knew I needed to go to the hospital then, but I didn't. He knew, but didn't press it.

Thursday morning was bad. I felt worse. But I had to press on, right? I had to take my son to his therapy session. And his therapist, upon seeing me, told me to call my therapist. I trembled. I knew I needed to be admitted but I needed someone to tell me that. I needed validation that it was okay. That I needed to be safe. I went into the bathroom and called my therapist, sobbing so hard I was almost incoherent. He told me what I needed to hear: go to the damn hospital.

And I did. I admitted myself on Thursday afternoon. Had I not, I would have overdosed on Geodon. One medication that isn't locked up because I take it every day. I have way more than enough to do the job. And had I not gone to the hospital, well . . . well those pills would have been down my throat.

I was discharged today, Tuesday. I'm still depressed. Damn depressed, actually. But I'm no longer suicidal. Depakote was the culprit in this - my first day off of it and the suicidal thoughts went away.

Last week I felt the worse that I ever have in my life. I never want to feel that way again. Ever. I can't. I came scarily close to killing myself. Closer than I ever need to come because I have wonderful friends and family.

I can't put into words the amount of pain I was in. I wish I could. I wish I could make you understand. But until you've been there, you can't possibly.

I'm alive. I'm going to Boston on Sunday to see the bipolar specialists and maybe get a new perspective. I'm trying to stay positive.

But I'm still so tired.

Some Thoughts on Suicide

Suicide is a touchy subject. It is, isn't it? The proverbial elephant in the room. Mental illness is bad enough, but bring suicide into the mix . . .

There are two things that that really get my goat about talking about suicide. Two stereotypes that people seem to hold onto.

1. People who talk about suicide are looking for attention

2. Suicide is selfish

Going into a talk about suicide with this mindset is a recipe for disaster.

Let me start by saying this: unless you've been at the point where suicide seems like the only answer, you don't get to tell me how I feel. You don't get to tell me to "buck up and look at the bright side."

There are a few things I want to address and I don't think I will do this as eloquently or as straight forward as I would like. My brain is scattered right now.

We all know what suicide is - taking one's life. We all know there is attempted suicide, completed suicide, and suicidal ideation (thinking about suicide). And there are warning signs, which often go unnoticed. I will be addressing the warning signs, don't worry.

Here's a point I want to drive home to y'all: most people who contemplate suicide truly don't want to die. They simply want the pain to stop and they see ending their life as the only way to accomplish this. Let me sat this again: WE DON'T WANT TO DIE.

Have you ever been in that much pain? That much emotional pain that you want to die? I have. Several times. Sobbing, rocking myself, knowing that things can't possibly better, that I'm a burden on my family and friends because of my constant mood swings and neediness. Knowing that my illness, bipolar disorder, will be with me my entire life and that I'll face more episodes like this, worsening depression, mania, and shorter periods of remission. I can't face the truth that I don't feel - that I often don't feel love for my husband or son - I can only fake it. That I don't feel joy or happiness and everything that once has meaning is now dead to me. That sometimes I'm so apathetic I can't even move. It's a physical pain too - exhaustion beyond belief, headaches, nausea. I'd give anything to make it stop. I'd do any thing to make it stop. And in those moments, in those moments of weakness . . . suicide seems plausible. Suicide seems like the only answer.

But I'm lucky. I'm still able to rationalize things. I think of my son and husband and I don't want to hurt them. I mainly don't want to scar my son with losing his mother. He's the reason I haven't taken pills. He's the reason I've had my husband lock up all of my pills in our safe, to which I don't know the combination.

Why am I telling you this? Why am I getting so personal with this? Because it's real. Because it happens. Because an educated, rational, once happy person has recently considered taking a whole bottle of propanolol to end her life - even though she has a wonderful family and group of friends and support system.

I've been talking about suicide lately, about not wanting to exist. I always say that I don't want to die, but that I don't want to exist. If I could just not exist until I felt better. Or that I want to sleep and just not wake up . . . those are words to pay attention to. Those are words of someone looking for help - not someone looking for attention. Do I get attention from saying things like that? You bet your sweet ass I do. I get attention from my hubby and my therapist mainly. My manager. But I need that attention. I need for someone to say, "you matter. You're important. I'm here for you." And that's all. I need to hear that. I have all the reasons I need to kill myself - give me a reason not to. And not by chastising me and telling me that I'll be hurting my family - do you think I don't know that? Trust me - I know that. But part of me thinks they'd be better off without me. Gently remind me that you'd rather have me around, even if I'm depressed and moody and sullen. That you love me no matter what. Don't make it about you. Don't tell me how it would affect you.

So is suicide selfish? In a way, yes. But when you're in that frame of mind, when you see it as your only out, it doesn't seem selfish. It seems like your only saving grace. It seems like you're doing everyone else a favor. When you go on about how my suicide will affect you, about how it will affect your family, my family, my friends, this person and that person, you diminish my feelings. You're telling me that everyone matters more than me and what I'm feeling and what I'm going through. What I'm feeling is real. Even though it may be twisted, illogical thinking, it's real. And to stomp on that, well, it does more harm than good. Acknowledge my feelings, try to understand them - even you you may not. Tell me you care and you want to help. Validate me. Hear me. Let me vent. Don't make my feelings about you.

Let's look at some warning signs for suicide:

1. Talking about suicide
2. Preoccupation with death
3. Feelings of hopelessness/despair
4. No hope for future
5. Self loathing
6. Withdrawing from others
7. "Getting affairs in order"
8. Self destructive behavior
9. Sleep problems
10. Sudden changes in mood or appearance
11. Sudden calmness

If you notice these signs in someone, talk to them. Let them know you care. Ask them about suicide - asking them isn't suddenly going to make them suicidal if they weren't before. On the contrary - it lets them know that you're open to talking to them about it and helping.

I have many things on this list tucked under my belt right now, which is why I'm worrisome to my hubby, therapist and psychiatrist. But we've taken precautions. We've talked openly about it. And I feel safe. Help someone else feel safe. Please.

If you're feeling suicidal, call the National Suicide Prevention Hotline at: 1-800-273-8255

Want to more things NOT to say to someone who is suicidal? Read this blog post.

Why is everything so hard?

Seriously. Why?