Anxiety, reading, and progress

I’ve been a reading fool the past few weeks. Now that things have settled down some, and my mood is back where it should be, I’ve dived into all the books that I’ve wanted to read for quite some time. One example is the Midnight, Texas series by Charlaine Harris. I really enjoyed the Sookie Stackhouse books, so after watching the Midnight, Texas show on NBC I figured I’d check them out. There’s three books in the series, and they’re easy reads that lets you dip your toes slightly back into that supernatural world. I read all three of the Robert Galbraith books, a few that I’ve been eying for a few months (namely Startup by Dorree Shafrir, and The Seven Husbands of Evelyn Hugo by Taylor Jenkins Reid). Startup was… ok. I enjoyed it and the glimpse into startup culture (which I’m sure was highly fictionalized for the book), but the plot didn’t really get moving until the end, and then the story just… ended with some loose threads dangling. Wasn’t a big fan of that. The Seven Husbands of Evelyn Hugo was also quite good, although not what I expected, admittedly. All the same I blew through both books in about a day and a half each.

Reading is very much my favorite way to unwind. If the book is good and well-written, it’s easy to get transported into another world for a short period of time. (Being that I’ve read 29 books this year, most of those since June, I’d say its one of my favorite ways to pass the time.) One of the issues I have with the Midnight, Texas books vs. show is that the character descriptions don’t match between the book and the show. Since I saw the show first that’s who I would picture while I was reading. But some of those characterizations were way off. I would have to consciously think, “no, that’s not what he’s supposed to look like” while reading that would jolt me out of the world.

Onto the bipolar-y goodness. Things have actually been pretty ok. Maybe even good. My moods are stable (my mood tracker shows me floating around in the “balanced mood” numbers). My anxiety is, at least to a degree, better under control, although still a concern. My biggest source of anxiety at this point is people and being around them. For me, being around a lot of people, people I don’t know, people that are drunk, being touched by people, is incredibly draining and anxiety-ridden for me. Mike and I went to a concert last weekend with a few of his friends. When the headliner came on stage people just absolutely crushed forward. After about three songs I told Mike I couldn’t do it and I’d be hanging out on the edge of the crowd where I didn’t feel like I was going to lose my mind surrounded by all those people.

One of the things that I’m working on with my therapist is training my rational mind to be more dominant and not let the emotional mind govern so much. Easier said than done. When I have one of these irrational thoughts, and I know this is going to sound weird, but I picture Leonard Nemoy as Spock, dressed as a crossing guard holding a stop sign and saying, “that is illogical” or “that is irrational” depending on what the thought it. As bizarre as this sounds, it helps to a degree. The thing that really sucks is I used to be able to do all of this, without even really thinking about it. But since that damned depressive episode in August I apparently lost this skill. It’s frustrating.

Finally got the official anxiety diagnosis

My shrink for years has been wary of adding an “official” anxiety diagnosis. He believed that it was really a minor problem that reared its head only now and then. But I think the depressive episode that was literally brought on by anxiety opened his eyes a little bit. Not that in the grand scheme of things it matters, but on some level, it’s almost nice to know that it’s a recognized thing and not just a minor annoyance. My team recognizes that it’s actually a problem. Just having it acknowledged makes me feel less like I’m making something out of nothing. If that makes sense.

The Zyprexa has been a godsend. We upped the dosage a little bit at the last appointment, to 7.5 mg as I’m still getting what I call flashes of mood aberrations. Hours where I’m irritable to the point that I retreat back to the house and try not to interact with anyone as little as possible /(including the cats – yes, I can get irritable with them). Or maybe half a day of mild depression where the negative thoughts start to creep in. I’m able to beat them back for the most part, but the underlying feeling is still there. So we decided to increase the dosage by 50% to try and even that out.

Something happened recently that put my life in stark relief. Last year a friend of our’s wife was diagnosed with melanoma. She’s spent the last year in treatment, but at this point, she’s literally dying. The cancer has spread to the point where there’s nothing that can be done. It would give her a few more months at most. So she’s decided to stop treatment and just treat the pain. Part of me feels like such an asshole, thinking about all of the things that I’ve been worried and fretting about over the past few months. Money, jobs, all of the normal things that people worry about. But our friend is about to face the reality that he’s going to lose his wife. I know that people’s pain is an individual thing, we can’t quantify how much we love or how much pain we feel based on other people and their experiences. But I feel like my problems are so trivial compared to theirs. I feel guilty for being depressed for four weeks over nothing compared to what they’re going through. I know I really shouldn’t, but I do. I feel like despite all of our problems and worries, I still have a husband that loves me who I’d move the moon for, a nice little house, four great cats, supportive families, I don’t know. I feel like I don’t have the right to be depressed.

 

The things no one tells you

All things considering, I was lucky when I was depressed. Despite the fact that when I originally reached out for help my shrink was out of town and none of the other resources in town would help me because I wasn’t suicidal, I still got help within about a week of reaching out. I was able to make an appointment with a new therapist relatively quickly. Once my doc was back in town he reached out his first day back and we spent the next six days (playing a bit of phone-tag, I admit) working through things before we ultimately decided on a med change. As much as we both complained that it was taking too long, in reality, the whole process went pretty quickly. When I was in college I fell into a pretty deep depression, and it took two and a half months to get in to see someone and in the meantime, I literally couldn’t get out of bed. I essentially failed a semester of college and was only able to keep my financial aid by the grace of God and a letter from my shrink. This could have been a lot worse than it was, with far worse consequences of having to repeat a few classes.

I was able to go to work during this. It was hard, and exhausting, and took more effort than I can even describe to work a 12-hour shift, but I did it. I’m sure it was fairly obvious that something was up – I didn’t wear make-up or my contacts, I hid in the lab whenever possible to keep from interacting with anyone that I didn’t absolutely have to. But when I was out and about in the building at lunch or dropping paperwork off to someone, the thing I heard the most was “are you feeling ok? You look really tired.” Part of that was definitely the not wearing make-up thing, but I was exhausted. I kept trying to keep in mind that these people really meant well, and they didn’t know what was going on, and they were concerned or at least wanted to put on the appearance of being concerned. But what they didn’t realize was that answering that one simple question, even with a well-prepared lie was absolutely exhausting, and meant that I spent the next two hours in the lab interacting with people as little as possible trying to recover. I’m an introvert by nature, but that surprises most people as I’m very friendly and while at work do my best to friendly and upbeat. Maintaining even a fraction of that personality was almost more tiring than anything else. I’d get in my car at the end of the day and just sag into the seat and try to muster the energy to drive home and collapse into bed. People’s concern made the day worse than they’ll ever realize.

The other thing that I wasn’t used to was that everyone had a suggestion to help my “sleep.” Vitamins, yoga, sunlight, shopping, cuddling my cats, taking a walk, etc. When someone is depressed the last thing that they want to hear is “I’m sure you’ll feel better if you do this or that!” No. That’s not what I needed. I needed a med change. I needed therapy. People were absolutely well-meaning, and maybe because I’ve been there, but the last thing I’d tell someone that I even maybe suspected was depressed that they’d feel better if they just went outside, or cut gluten out of their diet.

But things are much better now. I’m sleeping normally, I’m getting stuff done on my days off, I’m being social and not hiding in my house, laughing and joking again, pretty much back to normal. I get flashes of irritability and anxiety, and I think the dosage of the Zyprexa may need to be slightly increased, but generally speaking, I’m back on my feet.

One thing I learned from this experience is that there are no resources for people who aren’t suicidal or having a total psychotic break. I heard a lot of “you’re under the care of a psychiatrist, even if he’s out of town we’re not going to change your meds” or “you’re not a danger to yourself, so you’re going to have to tough it out until he gets back” or “there’s no room in the hospital so you can’t voluntarily commit yourself unless you’re suicidal.” My therapist and I have talked about this, and he agrees that it’s a problem. Like I said to him, what if my doc wasn’t back for another three weeks? Would I really have had to keep suffering until then? What if by that point I actually was suicidal? What if the mere fact that I had reached out to so many people only to be rebuffed made me not reach out at all in the future? I mean, why should I? No one is going to help me. I don’t know what there is that can be done. I can understand not wanting to screw with meds, but why isn’t there such a thing as emergency therapy appointments? At least in my city you can call in the morning if you hurt your knee and get in with an orthopedic doctor or PA. There are emergency appointments for injuries, but not mental health? Seems kind of dumb and almost counterintuitive.

There’s an idea somewhere in there, we’ll see if it germinates into anything.

Anyway, I’m done rambling.

There’s a light at the end of the tunnel

My shrink changed my meds last Sunday. I started feeling slightly better by Monday afternoon. To be fair, I was in a fog and exhausted all morning, but it was still an improvement. Tuesday was a bit better – the fog only lasted until about 10, but I was exhausted. By Saturday, mood-wise, I felt pretty good. Pretty good to the point where I was concerned I was swinging the other way and becoming manic. My shrink pointed out that when you’re feeling as low as I was, even for the short four weeks that I felt that way, feeling normal feels deliriously high, even when you’re really not. The exhaustion I felt from taking the Zyprexa lasted until about Saturday. Now I seem to be able to (mostly) get through the day with a little help from my friend Diet Coke.

But I’ve been thinking about it. How do you explain what depression feels like to someone that’s never experienced it? And if you really get down to it, depression feels different for each of us. It’s more than feeling sad. It aches, deep in the center of your joints, between each vertebrae. It’s an all encompassing hopelessness, the feeling that no matter what you do nothing is going to turn out right so why bother trying? The sense that you’re just a burden on your entire family and all of your friends. An exhaustion that seeps into your every pore and makes it impossible to get off of the couch.

But we live through it. We come out on the other side and work to pick up the pieces, get back to life. Back to routines. Back to remembering to feed the cats without them sitting on your chest and glaring at you. You make a peach cobbler for your husband as a way of apologizing for putting him through it. And you do what you can to hit life with a renewed vigor to prove to yourself that you’re not worthless, and things can work out in the end.

Here’s to hoping.

Fuck you, Depression

The worst part about bipolar disorder is that you’re swimming along, nice and stable, maybe with a little anxiety thrown in on the side (but it’s manageable), when BAM! Depression.

I’m not used to depression. I tend to stray more to the mixed or hypomanic side of bipolar disorder, so when it’s depression that rears it’s ugly head I’m never prepared. And I don’t know if I have a hard time dealing with it than most or this just is what it is, but I struggle.

It started about two weeks ago and creeped in very gradually until I spent three days on the couch last weekend with no motivation to even move, while I stared at the TV without really seeing anything, napped, and just felt so despondent that I stopped caring about absolutely anything.

I managed to pull my shit together and go to work this week and act like nothing is wrong (can’t let anyone see a sign of weakness, that good old Italian Catholic upbringing kicking in as well as the fear of making sure I didn’t give anyone anything that could be used against me later), and would come home and be worse off than I was to start with. I’d go through the day mentally chanting “fuck you, fuck this place, I hate you all, I just want to go home to my cats” while trying to act as normal as possible. Meanwhile, there’s a cold, dark, heavy ball of misery sitting inside of my rib cage keeping constantly alert to its presence. Every morning on the way into work I’d wall off that ball, keep it contained so I could get through the day.

I’m pretty sure this whole thing was brought on by anxiety – I haven’t found a job yet, our financials aren’t in a good place now that some more of my student loans have exited their grace period, the stress of trying to live up to people’s expectations, the stress of working a job that I really don’t like very much most days, and now the stress of not letting the world see that I’m drowning.

And then there’s my shrink. I emailed him Friday to let him know what was going on and he was out of town until Monday. OK fine. Called the local crisis hotline, I’m not suicidal so there’s nothing they can do. Same thing from my PCP – you see a shrink, he needs to be the one to treat you. Fine. Totally understand. I can get through until Monday.

Doc emails me back after 5, he wants to talk. Am I free the next day? With my job we really don’t know what the day is going to be like until we get into it and see how everything unfolds, so I told him I’d email him the next morning when I have a better idea. Emailed him, gave him a few options for that afternoon. They don’t work. What about Wednesday? Same thing happens. No worries, I’m still surviving, and I’m off all day Thursday and Friday, and while my in-laws are in town, I’ll tell them I have a doctors appointment and stay home from whatever they and my husband are going to do and deal with this. I email my shrink a time. He. Never. Calls.

I just can’t at this point. All I want is help, and I’ve reached out to anyone I can think of that would be qualified to actually help me and I’ve gotten nothing in return. I’m about done asking. I’m also about to switch doctors (which sucks because I’ve been seeing him for almost six years and I really enjoy working with him, but this is ridiculous).

I’m tempted to just say fuck it and keep the status quo and hope that it goes away on its own. I’m done caring. I don’t ask for help – it’s not in my wiring to do so. And the fact that I’ve asked for help from multiple avenues and gotten nothing in return is so disheartening that it makes me just want to stop asking.

So yeah, fuck you depression.

How do I know what’s real?

Some of us are perfectly content with normal life. And some of us feel like we’re destined for more. But how do I know if that feeling isn’t the bipolar talking? Do people other than me actually feel that way? Or is it the delusions of grandeur that come along with the manias putting ideas in my head?

Can I even trust what I think? I don’t know what other people with bipolar go through, but I swear, I question every thought, every feeling. Are the genuine? Or are they the product of the disorder? I talked a bit a few weeks ago about negative thoughts and understand that they aren’t real, but can’t the same be said of positive thoughts? Of positive feelings? How do we know what’s real and what’s not?

It’s exhausting going through every day questioning everything that goes on in your head. The paranoia that comes from it is brutal. It makes you question all of your decisions – did I make this decision based on good information or was it a mild delusion? It makes you question all of your feelings – is this a normal feeling for this situation or is this not the proper reaction?

It’s no wonder I have anxiety. I question everything, second guess everything, worry about everything. I’m just so tired.

Things like this make me think I need to be back in therapy. It’s like having an existential crisis every day.

Maybe, though, these kinds of questions are a good thing. It means I can recognize that the disorder can put thoughts into your head. That it can create realities that just don’t exist.

I don’t know anymore. I feel like inside of my head is an interesting and exhausting place to be. On some level I wish it wasn’t like this – I wish it was easier.

Bipolar disorder and why anxiety is almost worse

bipolar

Hi, my name is Meghan and I have bipolar disorder. In many senses, I’ve had it a lot easier than others that have my diagnosis. I’ve never been hospitalized. With the right medication, I can lead a relatively normal life. I’ve only had a few major episodes – in high school I had a major bout of depression, during my first attempt at college I had a manic episode with some mild psychosis, between my first and second attempts at college I had a pretty bad mixed episode that was followed by a moderate stretch of depression, during my (ultimately successful) try at college I had a fairly major depressive episode, and since then the episodes have mostly been mixed, and only one could be considered any kind of major.

But right now, my anxiety is through the roof. My husband noticed a trend that I tend to go through this during any major life change – in this case, I just finished my MBA and am looking for a new job. I have a lot more time, and you would think a lot less stress. I’ve been trying to keep busy (see my last post about the socks and the kitchen, but at the end of the day my mind isn’t kept constantly engaged as it once was (which I’ll admit, was part of the impetus for starting this blog). When my mind isn’t constantly focused on something, it starts to run wild. It’s like a small child – as long as they’re occupied everything is fine, but as soon as they lose interest or whatever they were doing ends, that’s it. It’s off to the races. Like that small child, when my mind is left unattended and unengaged, it gets into trouble.

So, my anxiety (and to be honest, I don’t have a formal anxiety diagnosis, but when it quacks like a duck…), when it begins, manifests as negative, intrusive thoughts. And my brain is like a dog with a bone with them – when it latches on to them, that’s it. They don’t go away. Everything from my husband is having an affair and is going to leave me and take the cats, to I’m going to get fired from my job, to someone is going to break into the house when we’re not home and disembowel all of the cats. Academically I know these thoughts are not true. But I literally cannot convince myself of this. To me, they’re actual pieces of my reality, and no amount of rational thinking will make them go away. So what’s the solution? I don’t know. I’m already keeping busy (the few times I’ve been off since classes ended I haven’t had a whole lot of down time, although slow times at work are the worst as it just becomes a constant stream of negative thinking that I can’t turn off). The bipolar part is under control. But I know from history that if this isn’t tempered I could be on the edge of something bad. And that is the last thing I need right now.

As with any mental illness, having bipolar disorder (and just for transparency my diagnosis is bipolar II) means keeping a constant assessment of my mood and thought process. Not getting enough sleep can trigger an episode, getting two much can trigger in the opposite direction. Eating well and trying to stay healthy can be important. Sticking to a routine – bedtime at a certain time, getting X hours of sleep, regular meds morning and night, getting out of the house and being around people, not drinking too much (or at all), not doing drugs, etc. It doesn’t sound like much, but for people with mood disorders, these things can be incredibly important. Keeping to a schedule can be hard for me – I currently work 4 days on, 4 days off, 12-hour shifts job. On those four days on it’s nearly impossible to get anything done – there just isn’t enough time and by the time I get home I typically don’t have the energy to do anything. Getting the right amount of sleep can be difficult too – when I’m working daylight I’m in bed by 9 up by 5:15/5:30 and I’m typically exhausted for the first three-four hours of the day. When I’m working nights, though, I’m in bed by 8 up normally around 2/2:30, and I’m wide awake and totally fine on six hours of sleep. Sure, I’m getting tired by the end of the shift, but nothing that I can’t work through or make it home at the end of the day. But I try to eat right, take my meds on time, get at least some exercise every week, get out of the house and see people other than Mike and my parents. But sometimes the episodes come despite doing everything right.

And it sucks.

But it’s the nature of the beast. And it’s something that those of us that have bipolar disorder – and those in our lives – have learned to live with and deal with as they come. I know Mike’s gotten to be a bit of a pro at this. All the same, when these intrusive thoughts pop up I hate talking about them – I feel like a legitimate crazy person. Mainly because I know that they’re not real, but not being able to convince yourself of that is probably the worst part. So, Mike and I talked about them, and for whatever reason, my brain was more willing to listen to him than it was me (traitor), so for today at least they seem to have subsided somewhat. And I already had an appointment with my doc on Wednesday, so he and I will talk about it then. But for now, I’m taking a win when I can get one.