Category Archives: Moods

Things Are Looking Up

17 days in the hospital, 3 ECT, 1 new med, 3 meds stopped, and 1 med in a different form. Its been a busy time in here!  So far my responsiveness is better and brighter, as is my affect. My mood is a little higher than when I got here, and suicidal thoughts are more academic with less intent. Although, death is still appealing to me. It’s all progress, and I’ll take it! Best guess is that I’ll go home on Monday after ECT #5. Friday was a possibility but we’ll have a better sense of whether the treatments are working if there is sustained remission with the extra day over the weekend. And I’d like to be thinking about suicide less before going home since going home will increase anxiety which will increase suicidal thinking (how it works for me at least).

I’ve read 4 books so far and am a third of the way through a 5th. Watching tv a lot, since there are only 2 groups a day plus meals to occupy our time. Played some games, talked to people too. Such is life in a psych unit.

Early ECT

On Friday I had the first ECT in this series. It went smoothly with only the expected horrible all-over aches for two days now. I have the next three this week, Mon,Wed, Fri. When I am adjusted to the treatments AND I am no longer suicidal, I can move on into outpatient ECT treatments. Logistics for that is a bigger issue than it should be. Sigh. Family. Sigh.

I did not take on ECT lightly. I know I could lose more memories and cognitive function. But I can’t live with suicidal thoughts Every.Fucking.Day. I can’t live in the depths of despair Every Day. Medications are not and have not worked to keep me stable. Hospitals have lifted me out. Time with family has held a fall at bay. I have been told that ECT changes lives. I’m trying to have hope that it will change mine.

See, there’s a contradiction. Hope that it will change my life presupposes that I want to live. I don’t want to live suicidally depressed or cycling rapidly into and out of it. AND I have little hope at all that ANything can work. So death is my best option out of this quandary of hades’ making.

Want to know why I am still in the hospital then?

New Hospital…and ECT Again

I have been staring into the abyss for two weeks. I have been very close to suicide, even in the hospital, where I am right now. I didn’t get to take my Chicago vacation because I was in a New And Good hospital. Excellent doctors and staff, comfy bed, decent food.

And still I struggle with life and death. It is deeply agonizing. Good doctors have taken me off three of my meds and added one. Med changes are miserable but usually necessary. One thing to discern is whether my suicidal visions are from depression or OCD, reopening an old argument. I want the death, but the visions come unbidden. So the argument remains.

With only a little persuasion, I have agreed to a full course of ECT – 12-20 sessions, three days a week. Yes, I have had bad experiences such as long-term memory loss and cognitive loss. I’m at the end of meds I can I can try. I’ve been told I’ve taken enough that I have a 5-10 percent chance of Any working at this point. I never did a full series of ECT before so I don’t know if it will work. I’m going risk further memory and cognitive issues because sometimes I want to live.

I need your love and support. I’m very alone at the edge of the abyss.

In a Dark Place Again

I’m of two minds again. One part of my mind wants to go on the trip to Chicago next week. I’ve got plans to do some fun things and to catch up with friends. In theory there are other trips I want to go on, and I still wonder about going back to school for a ph.d. some day (next year? ha! like my brain could do that). I’m also thinking about moving back to Chicago again where I’d be happier, as I discussed in my previous post.

But.

I’m in a dark place again thinking about suicide and imagining how I’d do it. My plan is clear, as it always is. So that’s not new. In fact none of this is new. I have sorted all my blog posts into topics for the book I’m writing about living with bipolar. So very often I have written about suicidal thoughts and how they keep after me, nipping at my heels on a constant basis. I have written of wondering if I should go to the hospital and how badly I am suffering in the pit of suicidal depression.

I’m in the pit again. I work the coping skills All.The.Time. I contact people. Now I even have my therapist in the pit with me, saying he will stay until it’s not a pit anymore or until he or I finds a way out that hasn’t been tried before. And he said he would tell me when it’s time to go the hospital. Both of these tactics are different from other providers who always left it up to me and kept telling me to work the skills as though things would be different this time. They never were. I would end up in the hospital as a cry for help instead of following through.

I hate the hospitals here. Nothing to do. Substandard care. Bad food. I miss my hospital in Chicago-area. Being as bad as I am, I would be more likely to go to the hospital in Chicago. Here in TX, I’m desperate to stay out. So much that I might push myself to do it, although I’d just end up in the hospital if I lived.

So morbid.

I’m ashamed of being this bad again. I know in my heart that it’s not something I’ve done. It’s something I live with. The thoughts pound against my skull. When I’m thinking about the trip, I know the suicidal thoughts are lies. But the next minute I’m sinking into despair.

Revisiting Moving

So I’m going to Chicago-land next week for a vacation. I’ll see a lot of friends and I thought I’d see some sites I never saw when I lived there and revisit some too. I also researched a bunch of apartments I could afford in areas close to friends. Which brings up the idea of moving back to an area where I have friends and like the place and weather better.

My therapist reminded me that when I have repeated thoughts – or any thoughts really – I can decide whether to think about them and give them attention, or not.  I’m still wondering if I should move, especially back to Chicago. Hence, I have been looking at apartments in my old area. And maybe I should find a roommate so I wouldn’t be living alone.

Pros of Moving: culture and weather I enjoy, better situation for my cat, lots of friends in my life, good care team including excellent hospital, value of independence lived out, not living with family

Pros of Staying: live with supportive mother, partner in healthy behaviors,  money available for travel, good psychiatrist and therapist

Cons of Moving: extra cost and stress on mental health of moving, extra cost per month (less of an issue if have a roommate), take care of health alone, daily responsibilities harder cuz alone (unless have roommate, then this is not an issue)

Cons of Staying: living with family, not best place for cat, hate culture and weather, little independence, bad hospitals if needed, few friends

Either way I am taking care of my health and have a good care team, except for a hospital if I stay in Texas. With a roommate in Chicago I would still have some money for travel. With moving I would be living out my value of independence, though I would be starting fresh again which is hard on my mental health (changes are hard!).

What do you think is best with these pros and cons??

In other news, my doctor is confident the Abilify injection I started this month will have a HUGE impact on my mood swings – fewer and less intense. That has been his experience with many, many patients. He said that if I didn’t experience success with this treatment, I’d be the first. Yay! There is some hope?

Restarting Coping Skills

With the limited amount of faith I have in myself (not much), I’m going to follow my therapist’s suggestion to restart my coping skills with curiosity about them and deciding as though from the beginning if they are working for me. I feel like I am doing Everything Possible to manage bipolar. And still functional depression is my baseline mood. I fluctuate from functional depression to regular depression regularly. In August or December or both, I may have a manic episode. Not every year, but with regularity enough to look out for signs of them. But depression is my regular existence.

I feel as though I have no control over my life. Bipolar moods dictate energy, mental ability, cognitive ability, and emotions. Medication has been able to stop the fluctuation among forms of depression, but never out of depression as the baseline. And I’ve had well over 50 med changes in the last 8 years since diagnosis. Medications have sent me spiraling into despair and soaring into mania, but stability has been elusive. I use coping skills and a healthy lifestyle because I am supposed to because they are “good for me,” yet I see no effect on my mood. Since I can’t influence my moods with skills and lifestyle, I don’t think I have control over my moods, and therefore my existence.

With the extremely little hope and faith that I can have an effect on my mood, tomorrow I will beg my new psychiatrist for help on the medication front. I will also follow my therapist’s advice to re-examine coping skills and restart them as though from the beginning. First, I need to list what those skills are. So many come naturally now that I hardly think of them. So a list to remind me.

These are the elements of a healthy lifestyle I practice:

  • A regular bedtime, 8-9 hours of sleep and rising at the same time every day
  • Healthy eating and regular mealtimes
  • Exercise, 30+ minutes 4-5 days a week
  • Social contact at least 2 times a week (could be better, but I have no friends in my current location yet)

These are the coping skills I regularly practice:

  • A breathing meditation every day
  • Deep breathing to manage flare-ups of anxiety and depression
  • Examine recurring thoughts and feelings with curiosity and work to accept them as existing, no judgment
  • Defuse from unhealthy recurring thoughts
  • Ask myself if a course of action is in accord with my values, and take actions that are
  • Distract from moods and anxiety with diversions such as reading, movies, tv and social interaction
  • Distract from escalating emotions with grounding exercises such as paying keen attention to the moment, to sounds, to visual cues, with calming scents and with soothing things to touch
  • Ride the wave of emotions
  • Blog as journaling to help with introspection into what I’m thinking and feeling
  • Spend time with my cat, petting, talking, playing
  • Reach out for support or practical help from friends and family

 

Mania or Depression or Ennui?

I’ve been thinking of going off my meds. Several people have discouraged me from doing it, citing deleterious side effects, including seizures and the inevitable crash. Several have insisted I do so only under a doctor’s supervision. One person reminded me of a med wash I did in the hospital a few years ago, when a doctor took me off all my meds in order to start me on new ones. That was miserable.

Somehow I still feel like I need to go off my meds. It IS something of a gut feeling with no rational logic to it (though my therapist says it is logical – see below). I know that there will be side effects initially. Yet I persist in this belief that it would be a good idea. I’m feeling agitated and frustrated and desperate for a change. I suppose I’m hoping that going off my meds will lead to a manic episode which would be different and life would be exciting again. I miss my old life. A lot.

I finally contacted my therapist, and he immediately called me back after a text. He said it DID sound logical, that in my quest to feel better – to feel like I used to – when I wasn’t on meds – I would rationally think Not being on meds made sense. So maybe I’m not crazy in my ideas? He encouraged me to call my psychiatrist. I explained that he didn’t know me yet after just one visit. He said it would still be a good idea.

So I called my psychiatrist finally. He thought I might be experiencing depression. I have been what I call “slightly depressed” – still functional, not in despair or suicidal, but still feeling lethargic, sad, unhappy with life. So maybe I am more depressed even with this agitation. I was thinking that maybe I was starting to experience some mania or dysphoric mania with the agitation. Or maybe ennui with my dissatisfaction with life and a need for more excitement (hence, inducing a manic episode). But maybe I’m just more depressed. Does it even matter what mood state I’m in?

Oh, and he insisted I stay on my meds. Right. As expected. Same as everyone.

My therapist helpfully returned me to my values and asked what action would be in line with them. This is a major tenet of ACT, Acceptance and Commitment Therapy, something that works for me. In my previous post I outlined a few of them, including Health and Independence. For the life of me, I can’t decide which action is more healthy: going off my meds to bring back the more meaningful life I had, or staying on my meds to treat bipolar and keep the life I have, as someone in treatment for life. And which would give me more independence? Not being on meds?

I know you all are going to tell me to stay on my meds or only to go off them with my doctor’s supervision. That’s what I tell everyone too. Stay in treatment! Maybe my meds aren’t working anymore and I need new ones. Maybe I’m in a mood state and I need to remind myself that it is not permanent, none of them have been, and I’ll cycle out of it eventually. I’m choking down the meds right now. I don’t have to. The choice is mine. I don’t know what is in line with my values or even which I fear more, the side effects or staying the way I am.