Category Archives: Meds

A Hopeful Few Days

Well, I’m still depressed. But the anxiety has a reason! I saw a new psychiatrist last night. His theory is that I get more anxious when my mood changes. And since I’ve had so many mood changes over the last many years, that would produce more anxiety. And the times that I went in to the hospital with anxiety that led to suicidal ideation, I was having mood changes. So, besides social anxiety over the past several days, I am in a mood change. Which I thought. I didn’t start feeling depressed until I had been anxious for a couple days. Then there was some suicidal thinking, but nothing to worry about. Just thoughts.

He also increased my antipsychotic, is thinking of increasing one of my anti-convulsants, and stopped my anti-depressant which will just add to my anxiety he said. I agree, but it seemed to be the drug that worked to make me stable the last month. He said it may have brought me out of a depression, but ultimately won’t work to keep me out of one. Since it costs so much any way, I’ll go with him. He also wants me to consider an injection of an antipsychotic that lasts a month at a time. It’s a drug I’ve been on before with disastrous weight gain and very little if any effect on my mood. But the injection is very different he said. The research I did seemed like it would still cause weight gain. Having just passed the 30 lbs lost mark, I don’t really want to make it Harder to lose weight! But I’ll think about it.

I left thinking there were treatment options and that he had my best self in mind. I can like and trust him with my mental health.

Today I saw a new spiritual director. I haven’t seen anyone formally in close to 10 years I think. A pastor acted as one informally but more as a spiritual friend, which technically is what a spiritual director is… I shared with her the torn identity I have between my ordination history and nurture, and the new place I am, which is not feeding me as well as I hoped. I talked. She listened. She heard that I very much wanted to act on the great compassion I felt for the world. She heard that I was searching for who I am. These are things that I have discussed with my therapist ad nauseaum, but not in those exact words. It’s great when the two people you share your innermost life with are on the same page!

I’ve lost a sense of my contemplative side and of who I am and want to be in the world. I’m running in different directions trying to find places to volunteer only to have doors and windows slammed in my face, all saying not now. I guess it’s time to figure out who I am. I’ve made drastic choices to get help by moving here. By not having to think about some aspects of living because I don’t live alone, I have the opportunity to figure out who I am, even if I’m not stable. And I’m not. I’m depressed again. At least I know the feeling. I can summon some energy to act human.

Reaction to a Medication

Psych meds are no joke. Just when you think “This might be the pill that saves me,” that same pill threatens your life.

I was put on a brand new antipsychotic on a Thursday night. Within half an hour I was feeling more depressed. I woke up the next morning heavily depressed and thinking constantly of suicide, with a very specific plan.

I still went to my therapist appointment that day. I told him what I feeling and asked him to talk me out of going to the hospital. He asked what I wanted to do. God I hate that question! My therapists and doctors always ask me that. As though I can tell if this will be the time I’ll act on the feelings.

He said he knew I was going to the hospital when I wouldn’t even crack a smile at a corny joke. He had seen my flat affect (stony, not-moving face and not showing emotion or animation). He saw the psycho-motor retardation (little movement in the face and body due to a psychological issue such as depression).

He surmised all of my symptoms – including the suicidality – was from the one dose of the antipsychotic.

I called my family to come take me to the ER of the hospital with a psych unit that was recommended. This was instead of getting a police escort to drive myself.

I was in the ER for 6 hours while waiting for the antiquated Texas system to place me somewhere. Days later I found out the psych unit at that hospital has its own assessment office! Wouldn’t have taken so long!

The doctor I saw inpatient concurred with therapist that I reacted to the antipsychotic med. Of course I didn’t take any other doses. He increased one med and added a new kind of antidepressant.

Five days into the hospitalization and I was free to go! I was feeling back to my normal self and almost – wait for it – happy! I haven’t felt happy and optimistic without an irritable hypomania since, well, since my last manic episode. But this almost happiness wasn’t a chemical defect. It was me. I found me!

I’ve been home for 4 days, and my mood is feeling “off” today. I guess depressed. Just woke up this way. I’ll take what I got of happy, and I’ll ride this depression out. I don’t feel stuck. I still have my usual suicidal thoughts, but they are fleeting and I have no intent. As I said, I’ll ride this depression out. I might find happy again. Who knows?

Mood and Life Choices Intersecting

asMid January through early February I spent in the hospital. Yes. Again. My psychiatrist was adamant we need to find another way than bouncing in and out of the hospital. I agree! The changes we agreed upon were staying with friends if I didn’t feel safe. That would allow me to ride the wave of emotions longer without using the hospital before I need it. And it would provide a chance for me to trust myself to keep myself safe. These things seem basic and “Why didn’t you try them before?” We have, but not with the same rigorous energy to keep me out of the hospital. The bouncing this time was ridiculous.

In other news, I’m still in physical therapy after shoulder surgery in early December. It still hurts, and the exercises seem to make it hurt even more. This pain has kept me from getting back into the pool for water aerobics. I’m too concerned about damaging the progress we’ve made. I could go to the gym and focus on the lower body. I’d be moving and re-establishing the habit of going to the gym. The water aerobics classes that are best for me are in the evening. But going to the gym in the afternoon and evening uses up any available energy. I’m a better morning exerciser.

A real factor in the exercise department is that I’m depressed and low energy from the depression. Any extra energy anywhere is like pulling teeth. So even though there is concern about hurting my shoulder in the pool exercises, the going-to-the-gym option seems less of an option because I am depressed. I already feel bad about myself. Now I can have guilt for not exercising added to that. Another real factor is that my drugs keep me hungover for most of the day too. And yet another┬áreal factor is that I made the decision I’d rather be healthy than skinny. That doesn’t help motivation to get back to the gym. I do still want to work out, but I’m less concerned with weight loss. Might be a mistake, but my mood affects the decisions too. I’m still trying to manage the mood. How am I supposed to manage pain and weight loss too, when my energy is zapped and I feel horrible about myself anyway?

One foot in front of the other in a boring life right now.

Winter Mood Problems

snowflakeWow, it’s been a while since I blogged. Sorry, dear readers.

One reason is that I met someone special and we are beginning to share our lives together on a more permanent basis. The process is slow because he also lives with mental illness, and putting us together means my or his illness can interrupt plans to spend time together.

Another reason is that I had shoulder surgery in December. I’m now in physical therapy and function is getting better, but strength is still elusive. All in good time.

The major reason I haven’t written in a while is that I have struggled with my Christmas delusion (that I am bringing Jesus to the world and have a special mission to bring unity or hope or joy to the world). Fortunately it only showed up a week ahead of Christmas Eve. I was on haldol to keep me in this plane of existence, but I did experience psychosis from time to time when I was not in touch with reality.

I went off the haldol – as my doctor indicated – when the delusion passed. Unfortunately my mood tanked and I ended up in the hospital for a few days before the new year. Putting me on low dose haldol brought my mood back to mostly stable so I went home for the holiday.

Then last week my mood tanked again – no trigger. So frustrating. So shameful to me to have to go back to the hospital for no apparent reason. Especially after only 10 days. No med changes were made, much to my chagrin – fix something! I thought. Suicidal thoughts eased up as did my depression, and I was discharged on Friday. Another short stay! Hooray!

Now, it’s been a couple days. I can feel the suicidal thoughts again building up steam. I can feel my mood tanking. I don’t want to go to the hospital again, but I feel it coming up again. It seems the only time I stay out of the hospital are the times I mostly seem “up” which means hypomanic or manic, usually the summer. And I hate the summer. I’d rather be in the hospital then, than the rest of the year when I like the weather better and can find some solace in the times of the year.

I don’t know what to do now. I committed to teaching middle school at church next week. But I might be in the hospital again. I see my psychiatrist tomorrow and she may send me there. I try to make plans and my mood always wins. This is so freaking old. And I always feel ashamed when I walk onto the adult unit – again. Why can’t I take care of myself? And it’s hard to explain to a new person in my life. Though being in and out of the hospital shows part of the story.

 

Eighty Days In

My longest stay occurred from early March to late May. I was mostly confident I could discharge since I was going to a friends’ house to stay and daily spend some hours at home for a couple weeks.

2016-01-18 21.08.16I was overwhelmed with my first time back at home, even with friends there. And then again today when there alone. It’s filthy, with even just one cat living there alone. I guess she really does need staff to look after her. I called a cleaning service but they are booked out till the following week, which is probably the case for most places. So, I’m looking for teens who need spending money. ­čÖé I can’t do this alone. I’ve got to keep asking for help. I spent 80 days institutionalized. Living on the outside takes some time.

Some details about my time inside. My doctor increased my mood stabilizer and lowered my anti-depressant. That led to a depression that led to a suicide attempt. So we spent 6-8 weeks coming back up from depression. Then we tried a different mood stabilizer cocktail. That didn’t seem to help. Then we added an additional anti-depressant to help the one I was already on. That would take 4-6 weeks to kick in, and we figured I’d be out before it kicked in but ECT would speed up the process. So I tried one ECT again and called it quits. It’s just not for me. Never got results from it anyway. And as it turned out, I was in the hospital the 4-6 weeks needed for the second anti-depressant. Meanwhile I’m taking heavy duty prns to handle anxiety and agitation. Finally got a day of stabilization without having to take haldol or thorazine on a huge increase of mood stabilizer. I got sent home with haldol and accompanying drugs just in case.

Whirlwind, right?

All the while I’m in daily group therapy with a very good therapist. And we uncovered the shame and anger and embarrassment of being in the hospital again, of having and living with bipolar and having to ask for help. Lots to talk with my regular therapist about.

For about 9 weeks I felt like this:

Death is not. It is nothing

I am not. I am nothing.

I don’t want to die. I want to die.

Make it end. Make the thoughts of hurting myself end.

Make the emotional pain end – anger sadness.

I am less than human because of them – thoughts, feelings.

I am pain, a hemorrhage of negativity.

No one understands unless they know this darkness.

Black hole, sucked into nothingness from images of gruesome death.

 

Am I romanticizing it, or speaking truthfully from a hurting being?

I am not thinking of others.

Their pan will be deep and unending.

I will not be in pain anymore.

Whose pain is worse?

Do I deserve to be less human because others will have pain?

 

One Week Done with DIY Residential

It’s been about a week of the DIY Residential Program. Following the strict schedule has been moderately easy. Dealing with suicidal thoughts has been HARD. As happened at my residential therapy experience in February, and is happening again – a rather normal reaction – I felt challenged by the material and resisted what my therapist and group therapy and classes presented. I’m resisting the ACT requirement of Committed Action toward your values, because I’m not at all sure I want to live or have a meaningful life. I think I’m just resisting and I’ll eventually break through, provided I don’t end up in the hospital first.

I looked up on the internet overdosing on my many medications, I called a suicide prevention hotline (1-800-273-TALK – they are amazing!). I keep a bag packed in the car in case I need to drive to the hospital. My support system has been life-saving, and I’m so sorry for dragging them through this horrible journey. Partly it’s because I don’t have residential staff to talk to about the terrible things I think about or see in my head, so I’m sharing them with my support system, local and national. Y’all have been great at encouraging me to keep moving forward and not follow through with the thoughts and visions. But as one of the images below says, I feel like I’m on a never-ending treadmill of suicidal voices and visions that I use defusion on every time they come up. Which is A LOT. In the middle of conversations, in the middle of reading, when I’m laughing at something someone said or at a funny show. Any time I’m alone, or with people. There they are, waiting for me to give in this time.

I started a new workbook that is specifically for using ACT with depression. I have high hopes for it. Until in one early chapter it makes the claim that depression is only a little bit biological and almost all about how we respond to situations – emotional avoidance or fusion with unhelpful thoughts. I’m still open to what it says, as clearly I need new ways of coping. But even though I’m depressed, I feel like I’m depressed more from the suicidal thoughts than I am in the traditional sense. I still get up and do everything I’m supposed to do as though I am following my values. But I still feel numb and separated from life, which is a feeling associated with depression. I’m avoiding feeling the emotional pain of suicidal thoughts? or what the suicidal thoughts are trying to tell me? (that I want things to be different? that I want to be strong again? that something needs to change?)

I also think I’m lying to myself in a couple different ways.

  1. I keep saying I want to die and need this life to be over. But I keep asking for help and I keep doing the positive things such as taking care of myself, exercising, socializing, going to the hospital to be safe, etc. Those are things that seem to say that I want to live and I want things to be different, not that I want to be dead. I really like the thought of being dead though. I’m very fused to that idea and I use a lot of defusion techniques with that one. So the lie is that I want to die, when my actions say I want to live. Which is what my therapist says too.
  2. I’ve started saying that I no longer have viable options for killing myself since the information I got about overdosing looks like I’d just end up waking up in the ER or ICU with heart and liver and other damage, or if I took enough I’d have seizures and a heart attack. Not the go to sleep forever image I have in my head.┬áAnd I’ve mostly given up on slicing my arms or throat open after talking with people who have and still ended up waking up in the ER.┬áSo, the only plan that would really work involves a gun and I don’t have access to one, which everyone says is a great thing. It seems that I don’t have viable options. But I think I’m lying to myself, because maybe a heart attack from too many meds wouldn’t be so bad. I’m totally irrational on this lie. I really don’t think I’d do anything, I’d rather die from something that took my life and I didn’t have to do it. I just really want to be dead, which is the subject of Lie number 1 above.

With all of these lies and thoughts I’m continuously using skills to defuse from, to make room for them to just be, and just be words and just be pictures and not be imperatives I have to follow. I’m doing the right thing according to everyone in my care team (about 6 people, plus a bunch of auxiliary people when I’m in the hospital). I just still really want to be dead. And out of pain. It hurts a whole heck of a lot to feel like there is a black hole in the center that is slowly, tortuously sucking you dead into its center.

2015-11-22 14.24.34

 

2015-11-22 14.42.23

Lower Than Ever

So, I went to the hospital the day after the last post. I continued to spiral down to the lowest depression I’ve ever been in, or the lowest in a very long time. I had two suicide plans with details worked out down to the minute. My care team reassured me they would keep me safe and keep holding me up when the suicidality moved on and I was left with crippling depression.

As it turned out, during the hospitalization at the beginning of the month, my two mood stabilizers were increased. I came down from a dysphoric hypomania, had stability for a couple days, then tanked. The mood stabilizers were too strong and we had to let up on one of them to get me back to some stability. Then when the increased stabilizer had been down to its previous level for several days, the doctor increased my anti-depressant slightly, since a slightly larger increase than that had sent me into a dysphoric mania. Yes, I’m very sensitive to meds.

This whole fiasco of the last 12 days started with a too aggressive approach to my mood stabilizers, which, naturally, my doctor wouldn’t totally own up to. Yet he knew. My life is now in a deep depression, deeper than what is even normal for me for the change in season at the equinox (which was yesterday).

Today is my 40th birthday, and I’m very depressed. I’m more than a little suicidal and trying to take it off the table. I don’t want to go back to the hospital, AND I know it’s there if I need it. I’d like to find some meaningful activities that will begin to bring me joy that will help the depression feel a bit better until the drugs have a chance to do their thing when it is as therapeutic dosage in a couple weeks. Right now the activities I take part in, while meaningful to the outside observer, feel like treatment activities to keep bipolar at bay. I’d like to just be me. I need to figure out who that is.