Who am I?

Therapy today.  We discussed the new doctor and mood stabilizer (Lamictal).  I’ve been depressed…very down.  All things stop when I am like this – even self care.  I had to shower today because an appointment means that I must leave the house and be with other people who know how to live – who have the ability to live life with others.  Since my daughter left for college (and even prior to that), I have not showered.  I’m guessing at least 5 days.  This is not uncommon for me (or others in my present condition).  I am told that this will improve as symptoms improve with therapeutic medication levels.    

I have a long way to go.  My therapist assures me that I will get there, but it takes time.  I’m running on blind faith here.

We discussed things to this point.  I had it all – if you can call what I was living all; high-pressure career, appreciative clients, respect of my colleagues, all of which consumed my life for the last thirteen years; there was no balance.  I had nothing left after 5:00 p.m. 

Employers love people like me.  Our ultra-perfectionist nature is rewarded with ever-increasing work.  We are the all-too-willing community teat for the rest of the fucking slackers.  My therapist said (again) that she is shocked I made it as long as I did in that position/condition.  The unfortunate thing about employees like me is that we burn out in epic fashion, leaving the employer with a bit of a mess to clean up in the aftermath.  How many people will it take to do my job?  Well, I took some time off once and five people had a hard time getting shit done.  Stupid business practice, but I was a willing participant - always ready to please and please and please the unpleasable machine. 

We discussed my OCD, specifically my obsessive planning.  Some people can just go to the beach and enjoy.  I begin three days prior to that beach trip thinking about (in exhaustive detail) what to pack, food (recipes), parking, various routes to the location, cost, gas, how many people, does everyone have a towel, do we need extra sunscreen, what about the dog…packing the car two days before, gassing it up, first aid kit…

I said that I envy people who can just grab a towel and go – without a care – and enjoy the day.  I suck the joy from everything before we even get there.  I do that with everything in my life.  Everything.  I just clicked my teeth for every word written on this page.  I will make sure that the windows are up in my car eight times before I exit.  Everything I do is obsessively and compulsively regimented.  Everything. 

Once my moods have stabilized, we will begin to discuss me.  Who am I – really?  What makes me happy?  What do I like to do?  I've discussed this before; I do not have the answers to these questions – I never really did.  I was all work and that nearly killed me.  I’ve never asked myself these questions.  Why bother?  I was already dead.

My homework is to set a single goal each day and follow through.  Today, I showered.  Perhaps I will do something else.  I will note these accomplishments and do the same the next day.  If I fail to accomplish my goal(s), I am to focus on what went right, NOT obsess over what went wrong.  I have to learn that the "to do" list never ends.  I will never finish it.  Deadlines aside (another discussion) it is ok to leave things for the next day.  When the list is finished, you are finished.  That is life. 

My response to this homework assignment was a deep, tearful breath.  It’s like starting over from infancy with crawling, speaking, walking … and so on.  I crashed.  This is the bottom.

It is a long goddamn climb back to uncertain territory.  Will the view from the top be the horror that I remember?  I am not accustomed to not knowing how things will progress, so this work is particularly painful for me.

My car needs gas.  I haven’t pumped gas in weeks.  The last time I tried to pump my own gas I kicked the ever-loving dog shit out of the gas pump (and injured myself) in a manic fit of rage.  I have set a goal to gas up the car, by myself, again today and see how it goes.

Right now. 

    

Fresh starts, sputters, and stops

My daughter left for college.  The time leading up to her departure (and for a good twelve hours following) were the hardest moments of my life.  I cried nonstop for 28 hours - gut wrenching, ugly-faced, full-body-involvement sobs, wails, screams - and some stifled moments when I was in her presence.  At one point my husband begged me to take valium to ease the pain, and I agreed.  It helped, but not enough to stop the grief of saying goodbye to my only daughter - my youngest child.

I probably needed a good cry.  I rarely cry.  It's not in my nature to let go like that.  Eventually I gave up - utterly exhausted - and drifted off to sleep with my husband holding me tight.

I woke the next morning (my daughter about 5 hours into her 16 hour drive) feeling spent and ready for the next step - finally meeting my new doctor for meds discussions.  No more Lithium and Risperidone.

Driving to the city is always very stressful for me, but I managed.  I arrived early, scoped out the place, decided on parking, went up to the office to double check the appointment time (a bit of OCD was showing under my hoop skirts there), and went for a quick lunch salad.  After lunch I arrived early (of course) for the scheduled appointment.

It's always hard to start fresh with someone new.  Its hard to tell your story AGAIN.  I tell it so often that I wonder if I should just write it down and provide a written copy ahead of time for new people - just to save a half hour and most of my sanity.  It's hard to tell The Story; it drains what little reserve you have in the tank. 

The doctor is only there for med management and accepted the prior diagnoses without question.  He prescribed Lamictal (what my therapist wanted me on from the start) and I took my first dose that evening.  I have several issues that require medication (he said I will likely be on 4 total), but suggested that we start with one med at a time and add others on as we go - just to be sure that we know what to blame in the event of any sort of allergic reaction.

 Fresh start.

I woke this morning feeling relaxed and loose - not much in the way of pain or worry.  I spent most of the day like that and then at around 5:30 this evening, the shadows crept in; slowly at first and then all at once.  They (the feelings of doom) are very much like shadows in the corners of my vision, taking over my body...surrounding me...suffocating me...and eventually taking over completely.  They fill the room. 



The depressive side of bipolar disorder is a very dark place, and I hate being there.

  
I am very impatient and waiting for this fresh start to make a difference - over the course of many, many weeks AGAIN - will be difficult for me.  I just want to be better now.

Then again, what is better?  I don't have a clue.  We have to find out what normal is for me, because I honestly have no idea what normal is; I have nothing to draw from for normal.

Now we wait.  We have to titrate up slowly with the Lamictal to therapeutic levels to avoid any potential adverse reactions, the most serious of which is a skin rash which, in some cases, is fatal.  http://www.lamictal.com/    

Meanwhile, I have to stay out of my daughter's room for a bit, and have plans to keep busy with other things until I am ready to clean that out.  It is hard to say goodbye.  It's hard to give her up to her own life, especially now.

Aftermath

Yesterday was rough. Very rough. I am still in a state of shock. I met with my therapist today and she apologized a hundred times - had no idea that the program I entered yesterday lumped criminals and addicts together with people like me.  It was not her decision to put me there so I gave her a pass.  The rest - fired.  Done.  My therapist agrees and understands.

I'm ok.  My therapist said that I disassociate when faced with very difficult situations.  I kept it easy today - no challenges, no triggers.  I also have a private psychiatrist and will see him on Monday.  I reviewed his available resources and they impress me.  He seems to be just what I am looking for - a partner in my care. 

I have been physically ill today (dealing with other health issues at this time), but took a nap and that helped a great deal.

Not much to report today.  Yesterday was so traumatic that my brain is just too tired to function right now. 

Intensive Care

I don't want to go to the hospital tomorrow.

I am afraid.

I no longer wish to take this medicine.

I am so tired.

I want my old life back.  It sucked, but it was something.  This is a whole lot of nothing.

I am losing the ability to do the things I love.  I am losing the ability to love.

I am falling apart.

Crawling

The bitch psych nurse upped my lithium even though I told her that it was NOT WORKING.  "You have not reached a therapeutic level," she said.  FUCK YOU.  I'm taking almost 2000 mgs now, all at once, all at bedtime, along with other antipsychotics.  My body wants to turn inside out.  I feel like absolute shit.

Everything is crawling.  Everthing hurts.  I feel wretched.  There are no words.

She made a point of telling me that she has been able to prescribe medicine for a year - like it was 25 years.  I laughed in her face.  What a self-absorbed bitch.  I told her it's not working.  She has a duty to find something else. 

And so it begins ... losing control of my life.

I start intensive care on Monday.  That will remove this bitch from the equation and put real doctors on the case.  I hope that they can figure this shit out because I am ready to take a nap on the tracks. 

Learning how to let it go

There isn't much to share today.  I set a goal to walk (waddle) a mile and did just that.  No fanfare needed.

I had a few issues that upset me, but worked my way through them and that was that. 

I have an appointment with the hated psych nurse in the morning, and also with the billing department for the Intensive Outpatient Program.  They will give me a tour of the facility at that time. 

I am scared.  Scared was the word of the day today but in the end I had to let it go.  I realized that it did no good to hold on to it.  Scared, scared, scared, scared....is this doing anything?  No. 

I learned to let it go - like that WOPR computer in WarGames.  I feverishly played the game of tic tac .. err... Scared until I finally realized that there was no possible winner, and then let it go.

  

I am not ok

I made the call to enter the intensive outpatient program at the local psych hospital.  It was difficult, but not as difficult as living inside of my own head - that place is full of pain.

I am not ok.  I am very down right now.  While I enjoyed my day and time on the coast this afternoon, the shadows moved in without my consent and have taken hold.  Every movement is a cut from a razor.  Every breath is a raging fire.  It hurts to speak, think, hear, type, sit up. 

It hurts.

My mental illnesses are going to take this poor family down.  We certainly weren't living high off the hog before (what a dreadful saying), but we did have a home, vehicles, jobs, support from family and friends - we had things.  Now I no longer have a job, unemployment will not happen (you have to be available to work), I am unemployable, entering the hospital for weeks and weeks, and somehow these bills that we barely paid before - with help - will still have to be paid without my paycheck.

HOW DO PEOPLE DO THIS?  HOW?

My husband is furiously working on this house - working against a deadline uncertain.  When will the money run out?  Will we make it that long?  Will the house be ready, show and sell before that moment when the song stops playing?

Will we be ready?  Able? 

I am not ok. 

The one thing I cling to is a statement made by a person who probably doesn't really give two shits about me - my therapist.  She said that it will be ok.  I keep saying that, but it's bullshit - how can we know?  We can't.  We don't.  We do not know. 

I am afraid to buy a bottle of water for fear that the $0.99 used to purchase that bottle of water may be necessary one of these days.  We've had those days over these last few years - not enough money for food or bills - but always paying the bills first because that is the right thing to do.

I am frozen in fear - unable to allow myself the luxury of taking a walk around the block because I should be at work right now.  I should be working.  Instead, someone else is sitting in my chair ... doing my work ... collecting my paycheck. 

I am not ok.    

Asking for help

Today I said the following to a dear friend and my therapist:  "Losing your greatest asset - your mind - is a scary thing."

It is scary.  It is frightening as hell to agree that you need help and submit to an intensive outpatient program or inpatient care.  How do I know that I won't be one of those crazy fucking whack jobs running through the ward halls with my ass hanging out, drooling, screaming...

How do I know?  My mind fails me all the time.  I no longer trust what is real.  What if I walk through those hospital doors and never exit?  What if I am lost forever?

My therapist assures me that things will get better and that I will be better and that I will get my life back.  I don't know what to believe.

Do you have any idea how brave one has to be to walk through the doors of a place and not know if you will ever exit?  I will - very soon.  I am scared to death. 

Get on board or get the fuck off

I have no idea who I am anymore.  This person who gets painful rushes of adrenaline just getting up from a chair - has no strength to roll over in bed - hates strangers - frustrates and angers so easily ... this person who feels so fat, ugly, breathless and useless ... this person is foreign to me.

I want to be left alone while I deal with this.  Unfortunately, I have to perform each day.  A requirement of life is that you live it.  I have to find a job.  I have to deal with a psych nurse I hate and sit with a therapist I love, but who has reached the limit of what she can do for me.

With regard to my therapist:  she is wonderful, as I've said, but during our last meeting I asked her what came next ... where we went from here, and she did not have an answer.  I do not do well without a plan - that's just me - illness or no.  If you do not have a next step, you are not going to make it with me. 

The psych nurse is an asshole.  She is inappropriate and stupid.  She forces me to do things that I do not want to do, and threatens to do them without my consent if necessary.  I showed her self injury wounds that had healed and she grabbed my cell phone to call my husband to discuss blue papering me.  I explained that I had no desire to actually kill myself - self injury is rarely about that.  If I wanted to die I would not be at that appointment.  She asked me to share all and I did, only to have her grab MY phone?  Without asking?  I do not trust this person so she will never get the real me.  I plan on telling her just that tomorrow, along with my husband as he wants to be there as well to support me.  I also plan on telling her that I need someone else to manage my medication because she does not give two shits about my weight gain.  Thirty six pounds (it could very well be 40 today) IS NOT GOOD.  It must be dealt with.  Perhaps there is another health concern that has crept up.  Perhaps my thyroid is fucked up.  Dear nurse - do you not recall that thyroid issues were one of the things that we checked prior to Lithium therapy?  Don't you think we should check it again, given that it was borderline to begin with?!  WHY IN FUCK do I have to think about these things?  Isn't that why I am paying these professional people $500-$1,000 an hour?   

I need people to either get on board or get the fuck off.  I am paying the bills and make no apologies here.  I have silently lived with these torturous thoughts for most of my life, so don't expect me to sit back and take abuse after I've found the strength to ask for help...after I continue to display the bravery it takes to carry on down this road.  Either you're in or you're out.  I am not looking for someone to say what I want to hear or do what I want them to do, I am asking them to tell me the truth and do what is right for me.  If you are unable to do that - you're out.

UPDATE @ 11:30 a.m.:  I called my primary care physician to check the status of my thyroid and diabetes tests - both of which were normal.

NO idea what to do at this point.  I feel absolutely alone in my care.  This weight is not acceptable.  I will not go on living with this weight.         

Monster

I have gained 36+ pounds in just over a month.  I know for a fact that I am not eating 6500 calories a day, so the discussion the pharmacist had with me about "significant weight gain" caused by my medications, and the worry she displayed in regards to that fact, are valid.

I feel like fucking shit.  I don't have the strength to roll over in bed, so I am stuck in one spot and wake with countless aches and pains - it's like someone is beating me during my sleep every night.  Well, when I actually sleep.  I get an average of 2-4 hours a night so that is hardly sleep.  Speaking of sore, my knees are SCREAMING from the added weight that I am carrying.  I can see my ass parked in a rolling fat cart if this keeps up because the gain has been so much, so fast, that any more weight will make it impossible to walk.  Standing is torturous.  STANDING. 

I have to stop this medication that I desperately need to stay alive.  How will I do that?  Which would you choose?  I will not survive.  I will take enough pills to fall asleep on the tracks and wait for the next train.  In the alternative, I will continue down this road - each day gaining a few more pounds and looking more and more like a monster.  Each day hiding the beautiful person beneath.  When people see fat they see slovenly, lazy, stupid, gluttonous.  They do not see illness, sadness, despair, hopelessness.

 

They do not see me.

I have been sqawking about the weight gain to my psych team for weeks now - since the beginning - and neither of my mental health team members seem to give a shit.  They are only interested in getting me into a hospital.  I was nearly blue-papered twice.  I'm not insane - I just need some assistance with these medications, assholes.

The fact is that the medications are not working.  While they may be pulling the poles in, they are not stopping the mad swinging between them.  I still go from manic to depressive in a matter of minutes, several times a day.  I don't want to kill myself - that is the only  change.

Whoopdefuckingdoo.        

Therapy

Before I begin I think it is important to note that these posts are very difficult for me to write.  I force myself to power through because it is important that I document these days as I search for balance in my life. 

The posts are difficult in that I am forced to read and re-read them over and over again.  When I read, I click my teeth once for each word on the page.  If I lose my place or train of thought, I have to start over from the beginning.  I usually write these posts in a very short period of time, all at once, and then read them over and over again, clicking my teeth or tapping my face, and then hit send -- never changing a thing from the original post. 

This is just one part of the whole messed up picture.  Still - I work, love, live, do.  I persevere.       

I love my therapist.  She is intelligent, funny, respected among her peers, and has been doing this work for over 30 years.  She knows her stuff and it shows.  I feel safe in her presence.  She focuses on results and that is something I appreciate.

I did most of the talking today (don't I always?).  Today she said, "I have to remind myself why we are here because, as a general rule, bipolar people are very entertaining. You are no exception."

Among other things we confirmed some of my diagnoses (after consult with the psych doc), and it is a considerable list: 

Bipolar disorder - rapid cycling
Anxiety disorder, to include hypersensitivity to sound and self harm
Panic disorder
OCD (obsessive compulsive disorder)
Impulse control disorder, to include neurotic excoriation
Binge eating disorder
PTSD (mild)

There is more, but the issues fall under one or more of the above-listed disorders.  We have a lot of work to do.

We discussed my apprehension regarding Lithium, and she made it very clear that it was worth trying, so I will - starting Tuesday - after my next therapy/psych appointments.  I need to have an EKG before we begin Lithium therapy (I completed all of the blood work, etc.), but finding the time to get this done is difficult in my busy life.  Tomorrow is the day.

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