The Med Change Blues

If you have been mentally ill for more than a week or two you’ve probably been through the dreaded “med change” before yourself. But for the uninitiated let’s just take a moment to look at it.

Generally we’ll be prescribed a medication that some marketing company is billing as the next big thing in bipolar treatment or schizophrenia treatment or anxiety treatment or some other such condition. We take it and under the best of circumstances it works great. But, eventually it’ll stop and you’ll need a new one. If you are lucky it will be years before you need to think about that, maybe even never. But, never one to be particularly lucky, I have to change mine every 2-3 years or so. In between are constant dosage adjustments upward to keep up with my bipolar. Eventually though it’s time. So a schedule gets drawn up by the psychiatrist of a weeks long dance where one medication is steadily reduced and another medication is started with the dosage increasing with the decrease of the first medication. The worst possible case scenario is when you have to come all the way (or nearly all the way) off one medication before you can start the second. But, whichever method you use, your medication levels are off for weeks, leaving you vulnerable to severe symptoms.

I’m currently on the second of 3 step-downs off Trileptal and the second of 2 steps up on Depakote. And I felt this step. Right away. I landed hard and nearly took off hubby’s head in the process. My depression is always accompanied by anxiety and the by-product of THAT is often rage. So I put dinner on the table (well, threw it) and went to bed. I cannot take a joke. I cannot deal with anything. I didn’t even eat the turkey dinner I cooked. I snuck out to the kitchen around 10pm and ate a cold piece of turkey for dinner. yum yum.

I have serious hopes for the Depakote. The Trileptal worked very well for me, very fast and with NO side effects. Yes, you read that right. None. Depakote is the same class of medication so I’m crossing my fingers that it helps just as well, just as fast. But, there are no guarantees.

I have been looking into alternative methods of treating my bipolar depression and there are some interesting things out there besides ECT (Electroconvulsive therapy). I’m going to spend some time exploring those in future posts.

Of course, first I have to get through this med change.

I figured it out

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Trigger Warning Post: Suicide Note that I am NOT suicidal as I write this

Well, this is somewhat worrisome to me,

I have figured out how to kill myself next time.

First, it’s scary that I’m even considering next time. I’ve been stable for awhile, but as I have predicted, the Trileptal seems to be losing steam. Depression is starting to creep back in. It’s not horrible yet. It’s not been long lasting so far. A couple hours. An afternoon. Nothing I can’t deal with.

The train hasn’t stopped. As long as that is the case, I’m good. It would seem, in this case, that the conductor of that train tossed this one to me, but kept on moving.

This particular method of self termination involves taking my other health conditions and using them against myself instead of trying to control them. I could just “help” them to end me. There are a couple things I could take to actually mobilize these conditions to take my life for me.

It’s interesting to me how I feel I can get these conditions to take my life for me. As if that somehow gives me distance from the actual act of causing death. What it does, is allow me to leave this life and not have the people left behind wonder why I would do such a “selfish” thing. Because my health conditions caused it. Not me. They can be mad at genetics or biology or whatever, but not me.

Because it’s important to me that people not hate me. It always has been. Other people’s opinions of me have always been important to me which is one of the reasons that an anonymous blog appeals to me. I can say things here that might make you angry, but if you met me you wouldn’t know that I had written these things. It gives me the freedom to be honest. And I have always wanted this blog to at least be honest.

And to be perfectly honest, I’m not in a great big rush to change my medications. That’s always a gigantic pain in he ass. And that assuming everything goes well. If the change doesn’t take, I risk the hospital.

I just have to get through the next 2 weeks with the Trileptal. My step-daughter and the grandkids are coming to visit for 2 weeks. It will be very enjoyable but also stressful. I will lean on my klonopin to keep things smooth for myself. After that I can switch.

I’m thinking maybe Depakote this time It’s pretty much the only one I’ve never been on.

Peace and love y’all

What if?

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What if the memory loss I’m experiencing is bipolar related?

Wow, what if it is? I don’t know why that thought hadn’t really occurred to me until now. No, that’s not right…I’ve had the thought before. I just didn’t grab onto it before this morning. Now it’s stuck in my brain and I can’t rid myself of the thought.

My taste in books has really changed. I’m not actually sure I could follow anything that requires real serious thought anymore. I’ve tried a few times, but I’m really preferring the simple easy reads. Nothing too long, nothing too difficult and good Lord no symbolism. Hate that shit. If you mean penis don’t say cigar.

I’ve been doing some political work recently and I’m doing it because it’s necessary. If you can’t get good mental health care, you better be voting Democrat this year. Regardless, I’m also doing it to keep my brain moving. Try to keep sharp.

Sometimes I wonder if it’s working.

I’ve been trying to talk myself into believing that it’s the tumor and when the swelling goes down, things will improve. I’m also trying to believe that it’s the blood puddle on the brain and when IT reseeds things will improve. And that’s probably true. But if I’m honest a lot of this has been a problem since before the PRES happened.

Now I wonder if I believe the things I believe because I just don’t remember the things that would convince me differently. OK THAT thought is probably the bipolar or the anxiety talking, but the fact that I’m thinking it kind of pisses me off.

I looked it up this morning. Memory loss is a symptom of bipolar. And one side effect is an increase in dementia.

I just can’t.

Mental Health Awareness Month…Suicide

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This post is about suicide. I am not a doctor or a scientist or a researcher. These are my own experiences and in no way should this post be used as advice…medical or in any other way. I am NOT currently suicidal.

Suicide is the boogeyman of mental health. We all know that it’s kind of the end-all be-all of worst possible outcomes when we discuss someone’s mental health journey. And of course it’s hard to understand. What could possibly be so bad that it would make someone want to end their life? Especially when you look back over their life. Some people look like the have it made and yet they make an attempt on their life. And we sit back and say “why” “she seemed to have it all“. Or worse there are the people who believe that the person attempted suicide was acting from a “selfish” place. “She had so much to live for” “what about her spouse/children/family“. But suicide is not selfish. It is sometimes the most selfless option the mentally ill can come up with. And that’s because depression is a horribly insidious liar…but it’s effective as well.

It’s important to understand that I love my life. I have a wonderful husband, two beautiful stepchildren, 2 grandchildren, parents, mother-in-law. I have a cute little house, in a mostly nice neighborhood. I have enough money to buy food and pay the bills and enough left over that we can wear decent clothes and even take a vacation once in a while. And I can afford my mental health medication and therapy. Right now, I’m stable as far as my mental health goes. Although keeping with the “you can’t have it all” mentality, my physical health kind of sucks. But that’s ok. I’m mostly a happy person.

But, depression doesn’t give a shit about any of that.

Long time followers of this blog might remember that I tend to think of suicidal ideation as a train. I stand off to the side of the tracks and watch it race by. As long as it keeps moving, I’m ok. Those thoughts of suicide have a tendency to flit by my brain here and there. It’s nothing serious, not really. It’s something to note, certainly. But, as long as that train keeps on chugging by me I can’t get onboard. It’s when the train stops that I have to worry. In my mental construction all the suicidal plans are onboard the train. If I can’t get on the train to browse through the possible ways of offing myself then the thoughts remain abstract and can usually be purged. At least for a little while. This is passive suicidal ideation. It’s the thought of suicide with no plan to attempt. No timeline, no plan in place. Just thoughts that fly by, like the cars of that big long speeding train.

It’s when depression starts to seep in that things get harder. At first I just feel deflated. Tired. Unmotivated. I know it’s coming. I hope it stays away, that it doesn’t get worse. And sometimes it does turn back. But sometimes it doesn’t. And it has never stayed away permanently. And the trip down to the depths is sometimes remarkably fast. One day I may be fine and the next I may be anything but fine. Sometimes the trip downward is so slow that I barely notice it’s happening until I’m already in the pit. The pit has smooth stone walls with no handholds. The only way out is with help. And the last thing I feel like doing when I’m in this place? Asking for help of course.

But this is where things start to get tricky. For me, when I start this downward trip, I become very paranoid about what people around me are thinking. I know for a fact that they are already getting annoyed. “Here she goes again” I can practically hear them thinking it. They may as well just say it out loud and get it over with. Tell me to my face. Don’t make me play this absurd guessing game. And I start to get annoyed. Any my annoyance starts to slip out in weird ways. I get upset about the way the cabinets are organized. Or WHY in the world does the dog INSIST on barking at the guy across the street?!?!?!?! Doesn’t everyone know that I’m tired and cranky and getting more annoyed by the moment? And that thread of logic that always remains knows I’ve been full of shit from the very beginning of this whole paragraph. Because NO ONE is annoyed with me. My initial paranoid thoughts are based purely on the fiction that depression has created in my mind. No one likes me. In fact….everyone hates me. There is no logic on display here. It’s pure fantasy. It’s made up to rationalize the irrational thoughts that bipolar depression has placed in my mind. And it creates the beginning of the suicidal ideation. If everyone you love hates you, well, wouldn’t YOU want to leave that place? But leaving isn’t really thorough enough. If I leave, I’m still out there. And as long as I’m still out there, I am causing a problem for those I love. And if I just run away, people are still stuck with the legal responsibilities that they have to me. I jointly own the house with my husband. We would need a divorce. I would have to move out. I’d have to go to my parents. They have enough to deal with. I’m still causing problems for those I love. And THIS, THIS is when that train starts to slow down enough for me to jump on. And I always jump on.

On the train are tables. And on the tables are different ways to commit suicide. Because, you see, at this point the thought that a more permanent solution to my presence in my loved ones lives is starting to take shape. But, at this point in my life, I have been in this place enough to know that there are only 2 really viable options for me. I’m a pill girl. Sometimes I think I’ll just put my car into a tree, but I don’t think I could really go through with it. We all have our own thoughts about the best way to kill ourselves. We have our plans and those of us who have attempted in the past, even have comparisons about what worked and what did not. We know which pills not to bother taking, which vein won’t bleed enough, what rope isn’t thick enough etc. I suppose it’s gruesome to some, but to me it’s just becoming a thought I live with. But, when I’m able to step onto that train, these thoughts become much more intense, much more powerful. I start looking at the medications that I take TO KEEP ME ALIVE and I start to consider which ones will now do the job of killing me. I’m not there yet. I’m having suicidal ideation, absolutely. It’s even active SI, meaning I know the plan and I have the intent. But, I’m not 100% of the way convinced yet. That stubborn little thread of logic that is still running through all of these thoughts knows that something is wrong. It knows that I should tell someone. It knows that I need help. But the downward slide isn’t quite over and it’s starting to feel like it would take more courage to admit what is happening than it would to just let my mind let go. But, my thoughts continue the spiral. Depression continues to plant nasty thoughts in my mind. Your husband doesn’t love you anymore, you’re just a burden. I continue to turn this thought over and over and over in my head. And it starts to look as if suicide is the ONLY way out. And when I’m in that place I can see CLEARLY how each person in my life will benefit from me being gone. This isn’t about being selfish and trying to sneak out the door without being caught. I understand very easily how everyone’s lives will be better without me in them. And, sure some of the reasons I give to some people are shallow, but in the depths of depression I don’t have the ability to sort through whether something is a good reason or not. There is only a reason. Good, bad, doesn’t matter. There is a very clear reason that every single person I know, especially the people I love, have to want me out of their lives for good. As confused as my brain is in this state, I am 100% positive that suicide is the right option. This is what my people need me to do. This is to help them, not hurt them. Twice in my life, I got this far. Twice in my life I took the pills. Twice in my life I failed to do what I intended. Thankfully. Not for lack of trying. Sadly, like anything in life, when you don’t succeed at something you learn more about how to do it right. I do hope I never make it that far again, because I fear that I’ve learned enough to be successful.

I get that far because depression takes advantage of the situation it creates. The more tired and run-down you feel, the more depression will tell you that you are failing. And the more you feel like you are failing the more tired and run-down you feel. And then comes despair and hopelessness. And the next thing you know you’re convinced that the sigh your spouse just let out was actually an expression of intense suffering and hatred. And the suicide comes as a response to this. It’s a response designed to free the ones I love, not punish them. Although now, while I’m stable, I understand that they are the only ones who would suffer with my decision.

Writing therapy

So much is going on in my life right now. But there is one thing more important to me than any of it.

I’m stable.

Physically, I have some issues. I have a growth in my brain so I needed Gamma Knife Radio-Surgery to make it stop growing. Otherwise, it would eventually blind me. My cousin just died. Like 3 days ago. My blood pressure is up and down and all over the place and we’re having trouble controlling it. And I have had at least 2 incidents of Posterior Reversible Encephalopathy Syndrome (PRES) which leaves behind some blood on the brain. I’m very dizzy as a result, can’t drive, can sometimes barely see from the double vision.

But, my moods are stable.

The last time I had this happen was in 2019. It was the first time I experienced PRES and I was stable then as well. The only conclusion we could come to was that the PRES was causing it. Was the blood covering something crucial for the bipolar to exist? Was it in someway affecting the chemical reactions required? We don’t know. I would like to know. Very much. Because I think it’s happening again.

Now, it doesn’t affect anxiety. THAT is raging. But, once I medicate that, I feel fine. My mood swings right now are completely appropriate to the situations I find myself in and aren’t too big. It’s a wonderful feeling.

When this happened in 2019 I had a nervous breakdown and tried to kill myself as the blood receded. What I have to do now is figure out how to not let that happen again. If it truly is the blood on the brain, then that will slowly go away. I already know that. Theoretically I should be able to plan for that.

Yeah I think my therapist and I should start working on that.

Brain “Tumor”

It’s called a meningioma. It’s not strictly a tumor but it’s close enough that the doctors count it in the tumor category. And it’s in my brain.

MY!!!

BRAIN!!!!
WHAT THE EVERLASTING FUCK???!!!!

I’m back and forth between so depressed I can barely move and so anxious I can’t sit still. And the whole time I’m on the verge of tears.

I found out Thursday. Meningioma aren’t big growers. They get in there and just kinda hang out. A lot of women have them and they are no big deal. You don’t even know it’s there because it causes no problems so unless you need a brain MRI for something else it will go undetected for the rest of your life.

But not mine.

Mine has grown .2 cm in the last 6 months. And apparently that’s a lot. But beyond that it is pressing on the pons. I have limited understanding here, but it appears to be on the brainstem…maybe it is the brain stem…I’m uneducated in this area, but I’m working on it. What I do know is that the pons is in one way or another responsible for SO much. Most every symptom I have can be explained away by what this fricking little meningioma is doing. Dizziness? Yep. Forgetfulness? Sure. High blood pressure? Throw it on the pile. And on and on and on.

And now we come to the part that I’m SOOOO bad about. Patience. Have to wait for an appointment locally. I’m getting another opinion at Mayo, so wait for an appointment there. Wait for repeat testing locally AND at Mayo. Although I have to say that all these hospitals that talk about how long stuff takes??? It doesn’t take that long at Mayo. They are quite good at getting patients through the bullshit.

But I digress.

Options that I’m aware of:

  1. Wait and see…we just did that (although not for that reason) and it got bigger and more intrusive.
  2. Radiation
  3. Surgery

Now the one good thing is that meningioma are rarely cancer although the potential exists. Radiation and surgery could work easily but they could also fuck up my bipolar something stellar….or make it better I guess. Or kill me I suppose. Which scares me…which is weird since I’m often at least passively suicidal.

Y’all I’m a mess. This entry is a mess. I need to vent. I need to SCREAM!!!! I need to sob hysterically.

I need answers.

Pray for fast appointments for me!!!

Peace and Love

IOP Day 1

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So, not bad. I’m a veteran of this particular program so I wasn’t nervous going in there. At least not too much. My counselor, Patsy, from the last two times is still there although she is in more of a managerial position now. However, she will lead groups this week and next to cover vacations so YAY! Ah…what makes me happy these days is some pretty simple shit. There is a male counselor there, Sean, that I’m not over the moon about but it’s more of a style issue than it is about him knowing what he needs to know. And there is now a third counselor, Sarah, who is on vacation this week.

There are now two nurses, which is great. John has been there and I know him well and Faye is new and very cool. They will monitor my general physical health and John is a great listener. I don’t know about Faye yet, by I suspect she is the same

The psychiatrist I was so excited to see again is no longer there. However, he has well trained his replacement. She is younger but very kind. And very eager to listen. Which is incredibly helpful. I know my meds. I’ve been taking meds for my mental health for a long time now, and I know what my body and mind are saying. I need someone to listen and have ideas, while taking mine into account. So, we increased my Trileptal, and we left my Anafranil alone for now. However, we are considering Depakote is the Trileptal doesn’t hold. It’s amazing to her that I’ve never been on it. And considering how amazed she is, I’m amazed, too. I thought I’d been on pretty much everything. Turns out, that I haven’t been on the old stuff, just the new stuff. Trileptal is old, Depakote is old even the Anafranil is old. She’s also putting me on Vistaril to go along with the Klonopin. My anxiety has been so bad lately that I’ve been taking my Klonopin 3-4 times a day instead of the 2 that I get. Hopefully the Vistaril will help.

Group itself started a little rocky because no one was wearing masks. These are small rooms. There were 12 people in there and it fills the room in chairs along all the walls. I can’t do the no mask thing. I understand why they don’t require vaccines. You can’t turn away a person in a mental health crisis, you just can’t. It is what it is and I would never suggest differently. But, COVID is here. It’s not my fault or your fault or their fault but it has to be handled. We have three elderly parents between us. Two have heart problems, one has lung problems. And I need treatment, too. So, once everyone got masked up things were better. I got out a little of what has been going on and cried some, which helped some.

If you’ve never done group therapy, it can be a little intimidating. This is my third time in this program and my sixth time through a group therapy program in general. You have to talk. You have to share your stuff and help with other people’s stuff. Sometimes some of your stuff gets resolved without even talking about it because someone else talks about the same sort of problem. A lot of people in this group are graduating this week which is actually good, because they are young. I mean…young. The girl sitting next to me was still in high school and the rest were in their 20’s. We have a lot of Air Force and Navy around here and a lot of them end up in this program. But, while the content of the story may be different, the emotions underneath are often the same. And we can all understand the emotions.

I don’t need inpatient. While I am suicidal, it’s somewhat transitory. For instance, right now? Not so much. Sunday? I was ready to drive my car into a tree. Some days it doesn’t exist at all or it’s passive. Not a plan just a general not caring if something were to just take me out.

There is so much going on in my life right now. But, I want to enjoy Christmas. I want to take some pleasure in the season and I have no chance of that without this program.

Assess Me

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Today I’m going to be assessed for the Intensive Outpatient Program (IOP) at the local hospital. I know I’ll get in but I don’t like this process.

Being assessed in general makes me angsty. I spent a lot of time being judged when I was young and it has made me skittish about it being done to me now. I don’t like my MIL to watch me do…pretty much anything actually. I don’t think she’s actually judging me when I think about it rationally. But in the moment it really really bothers me.

But these assessments that get given when you try to get into a mental health hospital or program really piss me off. I don’t want to prove myself. I KNOW I NEED HELP that’s why I’m there in the first place.

BUT…that’s not what they are trying to do. When I calm down and try to think rationally, I know that they are just trying to figure out where I’m at emotionally. They need to know if I’m going to try to kill myself that night. Or what the range of my issues are. Or what emotional problems I’m dealing with. What meds I’m on. If I’m complying with the doctors I’m seeing now. All the things they need to know before they throw me into group.

The one thing that may help me this time is the therapist, Patsy. I’ve been to this particular program twice before. Both of those times were after an in-patient stay, the last time I actually tried to kill myself. That was only two years ago and it’s why I’m being really cautious now, as is my therapist. But, Patsy has been there the whole time. She knows me, she knows my issues. She already knows the players. She has a lot of notes about all this and I’m sure she will be reading them before tomorrow. But, she’s not going to make me feel like I’m auditioning for a spot.

Of course, going into a group therapy setting during COVID isn’t really rocking my world. But, I’m vaccinated, I’m boostered, I mask everywhere I go and masks are required in IOP. I wish they would require vaccines there, but it would leave people who are unvaccinated to potentially kill themselves and that can’t be allowed.

But, I can’t allow me to kill myself either…although that alternative really sounds appealing every so often.

And that’s how I know I need help.

☮️❤️

Suicidal Thoughts

My last post was me being grateful that I’m out of the hospital. So is this one, but with a catch.

I have decided to go to IOP. For the uninitiated, IOP is Intensive Outpatient Program. I’ve been to the one near here twice before. There is a therapist there that I just love and an excellent psychiatrist.

I need to talk. I can’t really talk everything out with my husband. He is mourning his child and I don’t want him to know how hard things are for me right now. But, things are very hard. I’ve been having active suicidal ideations. Since my thoughts have always revolved on taking all of my meds, med times are getting harder for me.

I have talked this out with my therapist. I’m not low enough for the inpatient program. But, if I don’t do something soon, I will be. If I go to IOP, I’ll get a high level of care without having to leave my husband at home without me.

I know this is short and I’m sorry. There is so much more I could say, but I don’t want to dwell right now.

I hope you are all well and I will talk to you soon.

Peace and love

Stigma

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Ah stigma. The mentally ill person’s constant companion. Hell, it’s so widespread that we do it to ourselves sometimes. If you’ve ever disparaged yourself in anyway because of your mental illness, you have subjected yourself to stigma.

Last weekend, I happened to glance at my Fitbit. My heart rate was 110, which was ridiculous because I wasn’t doing anything. So, I took my blood pressure. And it was high. Not “run to the ER” high, but definitely “make a Dr. appointment” high. It was getting late on a Friday, so I called and made an appointment with my primary care doc for Tuesday of this week and did my best to chill out. But, by Sunday morning it was higher. So, I went to Urgent Care. The nurse practitioner at Urgent Care came in and started to get my history. I am ALWAYS upfront about my Bipolar and Anxiety issues. So I was with her as well. Her demeanor changed immediately. I saw it cross her face. It’s a split second of pity which is replaced by barely hid impatience. Because of course the anxious woman is having blood pressure issues, she’s just anxious! What followed was disgusting. She became condescending. I got a lecture on staying calm and practicing mindfulness. She left the room to order and EKG and some blood work “to be sure”.

Because, you see, she didn’t believe my blood pressure issues were being caused by anything except me allowing my mental illness to get the best of me. Stigma.

But, do you see here where I stigmatized myself? I ALLOWED her to treat me like that. I allowed her to be exasperated. I allowed her to lecture me. I didn’t correct her by saying I’ve been practicing mindfulness for years now. I didn’t tell her I’m med-resistant. I didn’t tell her that I’m on my 4th increase of Trileptal this year. I didn’t tell her to shut her big fat fucking mouth and stop assuming things about me. All of that is stigma against myself.

After my EKG (normal) and bloodwork (normal) a nurse came back to take my blood pressure again. And guess what? It was still high. She had left me there to calm my bipolar self down and my blood pressure was still high. And she was surprised. And she was nicer when she came back in with the prescription for a blood pressure pill and advice to see my doctor.

She made me sit in a room by myself and get an EKG and blood work to prove to herself that it wasn’t just my bipolar and anxiety driving up my blood pressure. And by itself, that’s not necessarily a bad thing. But, when combined with the condescending attitude it becomes very strong stigma. And it will make you feel bad about yourself if you let it.

But the stigma we perpetuate against ourselves is worse. “Negative self talk” is often stigma. When you tell yourself that you are useless because of your mental illness, that’s stigma. When you tell yourself that you are stupid because of your mental illness, that’s stigma. And when someone is rude because they think less of you because of your mental illness and you don’t stop them, that’s stigma from both sides.

Speaking out is a way to help reduce the stigma we can experience in society. A lot of it is simply due to ignorance of the topic. I told someone once that I was bipolar and he said “But you seem so smart”. And he meant it. He was under the impression that mental illness equated to intelligence. And it wasn’t until I corrected him that he knew better. He was in his late 60’s when that happened. It’s rampant and it’s almost strictly due to a lack of education about mental health. There is some talk about mental health issues being taught in school as a direct result of the pandemic. But I can tell you that here in SC there is resistance to teaching little Jimmy about anything besides Reading, Writing, Math and whatever the local approved version of history is.

But, more than anything, even if you can’t fight publicly against stigma, STOP perpetrating it against yourself! Learn some kind self talk. I hate saying mantras but some days it’s the best I can do.

I AM ENOUGH

And guess what…so are you.