RealMental

It has been so long since I have written anything really mental.  My life has been caught with mostly good things.  Good things.  Some travelling, spontaneous purchase of a new house, won a trip to China to go to the Olympics, went to NYC for the first time, stayed with a fabulous hostess and the most terrific time.  I did see a Surgeon who wanted to Surgeonate my knee.  I scheduled and then cancelled.  It didn’t feel right.  All the Good Things were and are overwhelming me.  Change is overwhelming me.  I changed from Paxil for my anxiety, which I didn’t believe was doing anything to Effexor, which I think is doing something, but we are tweaking the dose.  If you read my regular blog, you would also know that I had weight loss surgery in December, just before Christmas.  More change.  Rules.  Rules are meant to be broken and CONTROLLED when people tell you what to eat, even though I am almost 40 years old. How to exacerbate an eating disorder: give someone rigid rules about what to eat and when and how much and then a list of vitamins and activity or your expensive paid for out of pocket operation will be for naught.  I got it done to gain health, and the losing of the weight surprises me a bit.  My clothes fit differently, but I feel the same about myself.  My skin is drooping, sagging, my boobs, oh dear, my boobs. 

I am still on the lamictal for mood stabilization, and the effexor, but still taking a fair amount of klonapin to keep my shit together most days.  Still taking diabetic meds, except have pretty much stopped my injectible insulin altogether.  My sugars were so low after the surgery and I honestly haven’t been monitoring them.  I am 3 months late getting blood work.  Ok, I lie, I am 4 months late.  I am not monitoring my blood glucose levels.  I am shit at self care right now.

I am scattered and paralyzed.  I wish I could add the adderal back into the cocktail of drugs for the ADD.  My memory is sketchy, I miss appointments, I have to write almost everything down.  I am very jumbly and klutzy and trippy and my word aphasia is bad.  It is a good thing I am not working a full-time job right now.  Self imposed deadlines are killing me.  Deadlines like let’s say, packing.  We are moving into the new house on May 15.  I have done nothing.  The spouse has all sorts of boxes, his office is packed.  I just lie in bed or watch tv or flit away time on the computer.  That reminds me I have an eye appointment sometime in May.  As usual I am trying to keep up the ok, functioning façade that only so many people in my life even buy anymore.  Even when I am feeling jitter anxious and tell people so, my affect falls flat and I wonder if they believe me.  I am having a bad day, like a computer reading it. 

I can’t tell hypomanic from feeling less anxious.  Initially the Effexor made me feel a little hypomanic, but I think that has subsided.  Still seeing psychologist and psychiatrist.  The meds are ultimately what is helping me right now.  I don’t even want to talk about coping mechanisms.  They might make me give up my ostrich like behaviour.  Sleeping, shutting doors, television, senseless errands.  I sit here in my home office and the debris is everywhere.  It has been for months.  I don’t even know where to start.  Last week I lost my wallet and became obsessed with finding it.  Looking in the same places over and over and over again.  I felt I could not do anything but take my kid to playschool and back.  I felt lost and annoyed because I knew I has misplaced it IN the house.  My husband found it 5 days later and the relief I felt was disproportionate to the actual event.  I felt freakish.  I feel freakish and crazy.

I have been having little paranoid moments where I keep needing reassurance that people like me and aren’t going to leave me.  Seriously, do you really like me or are you going to change your mind once you find out the mysterious secret thing that is permanently flawed about me that even I am now aware of.  That is why people leave me, or reject me, or ignore me. 

I have been chastising myself for not writing here.  Reneging on commitments that I made.  I hate breaking promises or not following through.  Or not even starting, finishing.  You know, classic ADD.  I do stupid things all because of my mind?  No, I make choices for certain, but sometimes it doesn’t feel that way. 

By Fiddley Gomme

Tuesday, April 15, 2008

The past few weeks have found me struggling, and mostly failing, to stay out from under a fairly heavy malaise. Simply functioning has been painful at times. At work, I’ve been hard-pressed to perform at the level for which I’m generously compensated. At home, I’m not even coasting. At night, I drag myself through the motions but fail to follow through.

Falling short in my personal and professional performance leads to feelings of failure and shame. The failure and shame inevitably leads to more feelings of remorse and defeat. And thus the cycle turns. What it doesn’t bring are those manic, desperate artistic outbreaks like you see in movies.

So I finally got my sorry ass back into my therapist and took his advice to get myself some crazy pills. And by took his advice I mean that I told him I was doing it and that I needed some advice on staying conscious during a trip to my physician’s office. He told me to stop being such a pussy and make the appointment.

So I did. I risked the threat of public unconsciousness and did nothing more than sit there and sweat and shake and effortlessly convinced my doctor that I needed something to alter my serotonin uptake thingies. Very brave of me, I know.

Seriously though. The doctor was very understanding and probably waited until my check cleared before sharing a laugh with the girls in the office about the full-grown man who can’t get his blood pressure checked without very-nearly blacking out. And he gave me Zoloft. And Xanax.

Xanax is a palindrome. I know this because I’m not wired right.

What? How did the first day go, you ask?

Well, I spent today quivering like a bundt-pan-shaped jello ring. So, really, about the same as every day. Not surprising as Zoloft takes some time to take the desired effect. That’s sad but the good news about The Big Z is that the side-effects are available immediately.

The first twelve hours were fine. Mostly because I spent most of that time asleep. By lunchtime today and right up to this very second however, I’ve pretty much wanted to throw up nearly constantly. And in the middle of the afternoon I got simultaneously lethargic and totally disconnected. Oh, and did I mention? This is on half a dose? After just one day?

I’m saving the Xanax for a special occasion. Like maybe tax day.

Originally posted here.

There comes a time when we all have to stop offering excuses, and pick up where we rather messily left off.  I’m at that point, and feeling rather proud of myself for doing something really incremental– taking the call of a creditor on some health insurance payment snafus.  It’s a drop in the bucket of all the stuff I’ve got left to wade through, swim through, not drown in, but until the last week or two, I just haven’t felt up to the task of being functional.  I still don’t really feel up to it, but I do feel more up to it than I have.  And I’ve got to start sometime.  But I still want to excuse myself from my behavior– I’m not normally like this, I’m usually more of your 45 day billing cycle procrastinator, every three week housecleaner and laundry doer, who still gets stuff done.

“My mother went rather spectacularly mad,” I could say.

“I have bipolar and have been having a difficult time adjusting to my new medication,” I might put it, mildly.

“The endless winter this year has made me even SAD-der than usual.”  That’s true.

If I was feeling really TMI?  “My thyroid is also falling apart and I am a rashy mess of brittle nails and hair, swollen hands and feet, and lumpy throat.  And I’m even colder all the time than I was before.  And I could lie down on the subway and sleep, I’m that tired.”

“I’m depressed and scared and elated and paralyzed and whirring with activity all at once at potentially leaving litigation forever, and starting a whole different career,” I could also say, at least as if I was in my therapist’s office.

All of these are true.  And they’re what come to mind when I wonder why my house is a mess, my bills are a mess, my life is a mess.  But at the same time?  I’m tired of making excuses.  I think I’m almost recovered enough that I just need to start plowing through, as painful as it is, and start taking those creditor calls, opening those bills, slaying those dust hippos, climbing those mountains of laundry.  In short, sucking it up.  No more excuses– even though I’m still tired, even though I can’t wear a turtleneck or scarf because my thyroid’s so tender, even though I don’t fit in my normal-sized clothes, even though I’m still not at a fully effective dose on my meds, and therefore prone to weepy-whiny-crankiness.

But life is what happens when you’re making other plans, or even just lying down in the middle of it, letting it wash over you.  I’m going to get more than a bit winded, trying to keep up, but I’m restless and productive enough now, I think, to pick myself up slowly, painfully, start catching up.

Sometimes, it’s possible to overthink things. I had a mild toxicity episode after starting what was hoped would be my effective dose of lithium, characterized by nausea, dizziness, a head that felt like a heavy water balloon, bad GI effects, and tremendous sleepiness. The nausea was not the mouth-watering, bile-in-your-mouth type, but pretty close. And throughout that time, it felt like there was 2 pounds of puke pushing up on my epiglottis, just waiting to hurl. (Is there a medical term for that? Imminent pukerizing? Yak-readiness?) After four days on the new dose, and two days thereafter when the nausea and dizziness got more severe and more constant, the little dim bulb popped on over my head– toxicity! I called, I got the blood draw, the doctor said yes, I decreased the dose, and three days later, I was feeling better, physically. I was, however, cranky, because right after (no, really, right after, because never say the universe does not have a sense of humor) I called my doctor to say, “um, toxic, I think I am, and talking like Yoda, too?” (ok, not that last part), my mood snapped into place, like a dislocated joint. It was such a relief that it almost hurt. But the mood dissipated back into okay-not-too-bad- occasionally- laughing-but-usually-just- meh-ness. Fortunately, so did the physical symptoms. Mostly.

See, I continued to have this mild what-I’ll-call-epiglottal pressure. I figured it was some weird malingering effect of the nausea. Or an emotional lump in the throat– something psychosomatic having to do with my telling my mother never to call me again the day before Easter, after she told me that I had no idea what it meant to be depressed and unhappy.   (Insert confused Scooby-Doo noise here.)  But I didn’t really think it was the Mom thing– even though I have sometimes been “all choked up” physically about things I’ve been mad about in the past– because when I hung up on her, I felt five hundred pounds lighter, so I didn’t think I was suppressing anything.

Friday I saw my psychiatrist to check in and discuss alternate dosing options, to see what we could do between 1200 and 1500 mg. to make my baseline mood a bit better. And I mentioned this lingering lump in my throat, along with the relevant bits of the story above. She scooted over, had me lower my turtleneck, and palpated my neck. “Your thyroid is inflamed.” Oh. And hadn’t I complained about gaining weight recently? Double oh.

Why yes, I do have the prescription information on my fridge, along with the warnings about people with thyroid conditions in the side effects section! Why do you ask? Oh, because I’m feeling stupid that it was something that obvious, weird inventions about nausea notwithstanding? (That BLC, she always wants to be unique…) And, why, yes, I am a lawyer who is familiar with medical research, having defended medical professionals on more than one occasion. Why do you ask? Oh, because I could have consulted Dr. Google earlier on? (Hey, just because I’m “smart” doesn’t mean I’m sensible all the time.)

I’ve got my lab slip to get my TSH level done when I get the lithium drawn next Friday, since I’m starting a new preparation and intermediate dosing schedule this week. Probably means more pills. F*ing thyroid.

Sometimes I think that the side effects to treating the crazy are worse than the crazy itself. But then I remember that my thyroid never nearly lost me my job. So, yeah, my latest adventures in psychopharmacology suck, but it could be worse. I could still be speaking with BipolarNarcissistMom.  Bring on the synthroid!

Hi Doctor, it’s (BipolarLawyerCook). Wanted to follow up with you about last week’s toxicity episode and the step back to a lower dose of lithium. I am feeling much physically better now– the headaches are essentially gone, as is the sensation of a waterlogged, heavy head. I am less dizzy, less sleepy, and less nauseous. That permanent lump in my throat is almost gone now.

But I’m really bummed out, because while we were waiting for my blood work to come back, my mood snapped into place, like a dislocated joint, or like that pop that your back makes when the massage therapist finally gets that one knot out. It’s since dislocated again, and I’m back to feeling a little too close to the surface. Before I slipped out of place again, the husband and I had a fabulous night, and he said “you haven’t laughed like that in a long time.” No, I haven’t.

I say “close to the surface” not in the sense of boiling over in irritation, of exploding with rage, of imploding at any minute into a sucking vortex of need. More like seeping through whatever dry, calm, surface I am trying to maintain. Cute puppies, a touching email from a friend, a favorite hymn? Teary-eyed. A sarcastic remark from the husband, a thoughtless interruption from some in-law? The eyes well, the hands and voice shake in anger and hurt. A question in an interview about some unresolved stuff from my last job? My face flushes, my voice and hands shake, I have to apologize for my “clearly still feeling angry.”

It never lasts too long, and I am learning to just be quiet through it, but I’m feeling I still need a tune-up, a popping back into place. Certainly, I could live close to the surface like this– because it’s still not the prickly cranky ouchy huffy angry enraged hurt self-conscious depressed worthless I don’t want to wake up, I’ve been holding this bottle of pills in my hand for too long spectrum. I could live like this– perhaps the inability to maintain a poker face is better for me, given my not-so-successful history of repressing my feelings. But I am getting tired of constantly blotting my now-slightly damp to outright-soggy surface– I really don’t own that many towels.

So, once we get me back down to my non-toxic dose, get my new level, and confirm the passage of the poison, I hope we can talk about some fine-tuning. I don’t know– half doses? Mega doses of B vitamins or Omega 3s? A gym membership? I feel the need to tinker, to tune, so I feel truly fine.

(Only slightly more detailed than the voice mail I left my poor psychiatrist.)

Hi —

My wife has a few different mental health prescriptions we pay cash for because we don’t currently have insurance. one that she’s been prescribed for is Invega, which is rather expensive. we pay cash for (x,y) but this one we want to be able to compare prices for. what are our legal (and quasi-legal) options for acquiring this drug?

thanks,

anon

Original post here.

The voices finally got the best of me. I couldn’t sleep one night and my head was roaring so I walked outside hoping the cold air would calm things down. It did not. I acted on the voice and injured myself. My thinking at the time was that if I bent to the voice’s wishes, do what it said, it would stop nagging and leave me alone in peace. It did not. All it did was land me in the psych hospital for 6 days. I don’t smoke any longer and I missed it. Cigarettes and copious amounts of coffee are staples in the psych ward. They adjusted my meds, notably the Abilify, pronounced me safe to my myself and society and turned me loose. So now I’m an outpatient again and I take 30mg of Alibily, 50mg of Paxil CR, 60mg of Cymbalta, 200mg of Trazodone at night and .5mg of Klonopin twice a day. Seems like one hell of a lot of pills to be pushing through my body. Maybe I’m doing better but I don’t feel it. I don’t like the sideveffects of the chemical stew I’m taking .I’m a zombie with a flat affect. I am a crying, weeping, worthless zombie. Some tell me I look and sound better, but they don’t know the thoughts that still flood my head at times. It’s more than a little frustrating being told you look better. Back to the broken bone analogy I used in my previous submission, my bone is still broken and it still hurts badly so don’t tell me I look and sound better. I cut myself again the other day. Why? I’m still holding on by my fingertips, still waiting, but I still almost daily think the alternative, the shot to the head, is the more humane way, although so violent. I hurt, in pain. I’m tired. I’m fed up with it all. I only want it to stop, to find some peace.

I signed my previous post “anonymous” but my real mane is David.