My calendar said that we had our second appointment on the 29th, but I don’t remember that one. I can tell my meds have changed because I found his instruction sheet. He always writes everything out because he knows I may not remember. This visit was on 05 November.
My meds have changed again. Now my Geodon has changed from 240mg at bedtime to also include taking an 80mg dose in the morning along with a new drug called Provigil @ 200mg in the morning to help sharpen my focus and concentration. Its primary use is for the treatment of narcolepsy, shift work sleep disorder and excessive daytime sleepiness associated with obstructive sleep apnea. Other potentially effective, but similarly unapproved targets include the treatment of depression, schizophrenia, and disease-related fatigue. I guess my disease-related fatigue is the insomnia due to the depression
His primary concern is that I can keep myself safe. He has always been the only one with whom I’ve been able to be completely honest. I have been seeing him since June, 2000 when I was first diagnosed with BP (BPD didn’t become diagnosed until 2005 after my previous attempt at suicide). Aside from wanting to keep me safe, he is very concerned over my lack of sleep. He told me that I couldn’t expect to see measurable progress until I can overcome the insomnia. He’s also concerned about my weight loss. I’ve lost eight pounds since 28 October because I’m not eating. The only thing I eat is a small snack when I take my two doses of Geodon because it has to be absorbed with food.
Today he increased my Lamictal to 200mg QD. My short-term goals are 1) work on severe depression with medication changes as needed, 2) directly deal with my persistent suicide ideation as depression lessens and while my coping skills are still effective, 3) work on my rage issues as my depression lessens, and 4) work on my isolation as the depression lessens. He knows I am in the OP Therapy program Mon-Wed-Fri, so I am to call his office on Tuesdays and Thursdays and request a call back so he can check in with me. He also wants me to call his service on Saturdays and Sundays for the same purpose. He wants to keep me safe, and feels with this constant monitoring, if needed, he can make a med change on the fly. I couldn’t ask for a better psychiatrist. He gets me. And he said that once my bipolar balances out, he wants to work on my borderline personality disorder. He is more than just a psychiatrist. The time he spends with me and what we talk about is better than any individual therapist I’ve ever seen. I’m very grateful that the circumstances back in 2000 brought us together.©2009
Meanderings of my mind in comments, poetry and prose dealing with personal struggles especially relating to Bipolar Disorder, Borderline Personality Disorder, and reconciling being Christian and queer, along with the average day-to-day real-life situations: My Rites of Passage.
Showing posts with label exhaustion. Show all posts
Showing posts with label exhaustion. Show all posts
07 November 2009
27 September 2009
Joy in the Face of Circumstances?
Well, I did not throw up and I did go to church. I was sweating bullets through Praise and Worship while standing; I had no energy whatsoever and was hanging on to everything I had just to be there. My exhaustion is so overwhelming.
Pastor preached on maintaining your joy despite whatever circumstances you are going through. I’ve been there before. After I was laid off, I knew in my heart that the Lord would provide for me and just pressed onward. Sure, there were many times when I was curled up like a baby on the floor of my bedroom in utter agony not knowing what the next day would bring, yet I was still able to focus on all of the good things with which the Lord had already blessed me. That focus brought me the strength I needed to endure the unknown at the time. And that strength was my joy. Sometimes it was just enough to know that I could trust in Him to make it through.
The scripture referenced this morning was found throughout Philippians 4. Key points: 1) learn to avoid comparisons. There will always be others that fare better than you. This will inevitably spawn the “fairness” questions back to God. One comment that hit home is that the mortality rate for the human being is 100%. So, what do we do with ourselves in the meantime? What do we set our eyes upon? 2) It is a myth that I must be liked in order to be happy. Well, that’s a hard one with which to grapple. I am alone. I am unhappy. No, not everyone I will come across will like me. Truth be told, I easily piss off most people. And you’ve read my rave reviews I’ve received from my immediate family in Birthday Cards. Pastor said that all I should be concerned with is that I please God. Well, I’m in trouble here. I acknowledge that I am a lesbian (albeit celibate, although I’m not sure if that isn’t just splitting hairs). Certainly that isn’t looked upon as being pleasing (no, I’m not going to drag all the biblical references to prove that one). I also run right smack into the two verses that I have really tried so hard to pattern my life after. So, where am I really as far as the conforming and the transforming? Am I really just a poser? 3) Pray for what can be changed and accept that which cannot be changed Phil 4:6-7. Again, another sticking point. I don’t believe being queer is a choice, so what can be changed there? Also, what about the whole bipolar shtick? It’s not something to be cured. Do I believe that God has the power to heal? Yes, I do. Will He cure me? Who knows? All I do know right now is that I am bipolar which drives to the very heart of so much that is wrong with my life. 4) Learn to accept God’s power in that there are circumstances that I can’t face alone 2 Cor 12:9. 5) Learning to allow for God’s provision Phil 4:18-19. Both points 4 and 5 I’ve experienced first hand. I have seen God’s fingerprint on my life in such a way that it defies all other explanation (see My Own Personal Miracle elsewhere in this blog). 6) God will give you all you need if you put Him first in your life Matt 6:31-33. This point comes with that great caveat: IF you put Him first. Do I? I am consumed with the by-products of being bipolar. I am consumed with wrestling with the concept of being Christian and queer. Am I just wrestling with the concept of being queer? Is it internalized homophobia? No, I don’t think that’s it. If anything, all of my life I’ve been a radical, in-your-face butch dyke.
If I try to follow my heart, I know His word tells me that so much of what I am internalizing are just the lies of the devil, but the bipolar keeps getting in the way. I can’t keep all these racing thoughts straight in my head. So, I end up not knowing what’s real and what isn’t. It’s information overload. I am drowning in the sea of “oughts” and “ams.”—who I should be vs. who I am. Am I who I should be? Why can’t I answer that question?©2009
Pastor preached on maintaining your joy despite whatever circumstances you are going through. I’ve been there before. After I was laid off, I knew in my heart that the Lord would provide for me and just pressed onward. Sure, there were many times when I was curled up like a baby on the floor of my bedroom in utter agony not knowing what the next day would bring, yet I was still able to focus on all of the good things with which the Lord had already blessed me. That focus brought me the strength I needed to endure the unknown at the time. And that strength was my joy. Sometimes it was just enough to know that I could trust in Him to make it through.
The scripture referenced this morning was found throughout Philippians 4. Key points: 1) learn to avoid comparisons. There will always be others that fare better than you. This will inevitably spawn the “fairness” questions back to God. One comment that hit home is that the mortality rate for the human being is 100%. So, what do we do with ourselves in the meantime? What do we set our eyes upon? 2) It is a myth that I must be liked in order to be happy. Well, that’s a hard one with which to grapple. I am alone. I am unhappy. No, not everyone I will come across will like me. Truth be told, I easily piss off most people. And you’ve read my rave reviews I’ve received from my immediate family in Birthday Cards. Pastor said that all I should be concerned with is that I please God. Well, I’m in trouble here. I acknowledge that I am a lesbian (albeit celibate, although I’m not sure if that isn’t just splitting hairs). Certainly that isn’t looked upon as being pleasing (no, I’m not going to drag all the biblical references to prove that one). I also run right smack into the two verses that I have really tried so hard to pattern my life after. So, where am I really as far as the conforming and the transforming? Am I really just a poser? 3) Pray for what can be changed and accept that which cannot be changed Phil 4:6-7. Again, another sticking point. I don’t believe being queer is a choice, so what can be changed there? Also, what about the whole bipolar shtick? It’s not something to be cured. Do I believe that God has the power to heal? Yes, I do. Will He cure me? Who knows? All I do know right now is that I am bipolar which drives to the very heart of so much that is wrong with my life. 4) Learn to accept God’s power in that there are circumstances that I can’t face alone 2 Cor 12:9. 5) Learning to allow for God’s provision Phil 4:18-19. Both points 4 and 5 I’ve experienced first hand. I have seen God’s fingerprint on my life in such a way that it defies all other explanation (see My Own Personal Miracle elsewhere in this blog). 6) God will give you all you need if you put Him first in your life Matt 6:31-33. This point comes with that great caveat: IF you put Him first. Do I? I am consumed with the by-products of being bipolar. I am consumed with wrestling with the concept of being Christian and queer. Am I just wrestling with the concept of being queer? Is it internalized homophobia? No, I don’t think that’s it. If anything, all of my life I’ve been a radical, in-your-face butch dyke.
If I try to follow my heart, I know His word tells me that so much of what I am internalizing are just the lies of the devil, but the bipolar keeps getting in the way. I can’t keep all these racing thoughts straight in my head. So, I end up not knowing what’s real and what isn’t. It’s information overload. I am drowning in the sea of “oughts” and “ams.”—who I should be vs. who I am. Am I who I should be? Why can’t I answer that question?©2009
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My Head in a Vise

The kicker, sleep-wise, has been the depressed phase. Ordinarily, while it doesn’t amount to anything close to refreshing, at least I do spend some time asleep. However, in the last three weeks I’ve noticed a new wrinkle. Every morning, far earlier than when my alarm normally goes off, I suddenly awake with a bone-crunching headache. The pain is searing and tears spring to my eyes. At this point, despite however exhausted I still may be (whether I’ve had three or even five hours of sleep), I simply cannot roll over and turn off the light. I’ve tried popping a few Exedrine (the one OTC that usually works), but, of late, it hasn’t made much of a dent. Due to some relatively recent oral surgery, I have a few Vicodin laying around, so I tried a couple of those. Mixed bag of results: the headache eventually wears away; however, I am left feeling rather drowsy which is often compounded by the fact that the quality of sleep I did experience wasn’t great. That won’t do during the work week. Can’t log onto the network if I can’t first log into myself!
I don’t normally experience headaches, so I am rather concerned at the turn of events. I also don’t appreciate the nauseous feeling I end up with after taking any meds so early in the morning on an empty stomach. I even tried eating a few Phenergan with either the Execdrine or the Vicodin, but that just compounds the ensuing drowsiness—hard to look sharp as a tack at work if you can’t talk without a thick tongue!
I don’t think it’s anything organic. My last major BP crisis in 2005 resulting from a failed suicide attempt that landed me in a psych ward for quite some time resulting in some rather uncommon after effects. This admission bought me a new diagnosis to add to the BP: borderline personality disorder. Oh goodie, yet another tag. Didn’t know so much about it at the time, but after doing some research, it sure did explain why I was so heavy into the self-mutilation for a while, even at the later years of my life. One new symptom I began experiencing (not that I hadn’t already—it’s just now that I know what to call it!) was states of dissociation. One particular incident brought EMTs to my house, ones I evidently called myself according to the taped recording of my 911 call.
I don’t remember most of what happened (hence the dissociation). I have fleeting memories of being on the floor in my living room trying to reach for the phone. That’s it. The next thing I can remember is getting into a taxi after being discharged from the ER the next day (according to 911, I called around 0200 in a panicked state mumbling something about passing out after bouncing my head off my heavy glass coffee table). When I got home, the house was a wreck. There were pieces of pizza all over the floor between my kitchen, dining room and living room. When I got into the kitchen, after following the trail of pepperoni and mushrooms on the floor, I found what appeared to be the dough from a frozen pizza tightly bound into a mangled ball. Whatever happened had been extreme…I just can’t remember any of it.
The ER did a CT scan that proved no injury. All of the medical notes from the intake nurse to the doctor’s comments proved inconclusive. The ironic part is that they all referenced having a normal conversation with me in that I did not appear too distraught and was able to answer questions. Mind blowing to me since 1) I can’t remember any of it, and 2) what the hell threw me into such a frenzied state in the first place that resulted in attacking a frozen pizza…a frenzied state that must have lasted a long enough time for the frozen dough to have become malleable enough to shape into a crumpled ball while traipsing through three large rooms of my house resulting in passing out and hitting my head on my coffee table. The level to which I attacked this pizza is mind blowing enough in and of itself.
The next day (or maybe it was two days later), armed with my medical records from my ER visit, I went to see my doctor. It was then that I began experiencing some dizzying headaches. My cause for concern was that the CT was clear, so why the lingering headaches? I was referred to a neurologist is fairly short order and over the next two weeks MRIs and EEGs also proved inconclusive (however, during this time period I evidently had a single-car accident which I cannot remember, although the front end of my Civic will tell you otherwise, so something was still going on).
To make a long story short, nothing organic was ever proven. After consulting with my p-doc, I decided to transfer from my current mode of therapy, CBT (cognitive behaviour therapy), to DBT (dialectical…a story in and of itself). I learned more of the impact of borderline personality disorder while now learning to handle these fugue states of dissociation—each event always accompanied by extreme panic disorder according to the wreckage evidenced in my house at a later time along with a headache and, of course, the absolute memory loss. The one precursor to the dissociation was the headache, and then easily handled by the Exedrine. After months of DBT, I never got anywhere with learning the cause-and-effect of the dissociative periods (the memory blackouts were distraughtful enough), much less anything BPD- or BP-related, so I quit. The dissociative states, after a while, disappeared (no, the memory loss is still permanent) and the lingering headaches eventually did as well.
OK, so now it’s 2009. No more dissociation (at least no evidence of it!). But, now, I’m being jolted awake with these piercing headaches. The quality of my sleep has lessened; I always awake exhausted even if I am lucky enough to have six hours of it. My almost-regular popping of Exedrine while I bolt down my morning hot tea helps me orient somewhat to my workday, but now I am beginning to question the headaches, their causation. I thought about going back to see my regular doc, but I’m not sure where that will get me. While I’ve never presented myself with drug-seeking behaviour, I certainly wouldn’t want him to think I’m just hitting him up for more scripts of painkillers. No point in pulling in another round of neurologists—that’s already proven useless and far too expensive. There are no other underlying processes going on to further define this malady. It’s just damned inconvenient and, truthfully, quite bothersome. So, now I face my bleak spiraled-down states of depression with a constant state of exhaustion. It’s truly as if I haven’t had any sleep whatsoever. Yes, my depressive states are always associated with exhaustion, but the state of exhaustion has worsened suddenly with the onset of the headaches.
This morning I have only enough energy to drink my hot tea, sit here, and write. In a few hours, I will go through the motions of getting ready to go to church, but even this morning I question why I will go. My mind won’t be where it ought; it hasn’t been for a couple of weeks. Yet I still feel compelled to go. I can’t escape the fact that God has blessed me quite graciously when I was laid off earlier this year. Regardless of what anyone wants to think, I know the circumstances that took place that resulted in my new job—to me, personally, is nothing short of miraculous, say whatever you will. But, my focus is shifting. My attention is drawn to the BP that is consuming me along with all of the questions suddenly surrounding me of who I really am. The queer question. The Christian question. Right now, I just don’t give a damn. My head hurts, I feel like I am going to throw up, and I just want to crawl back into bed and shut out the world. If only all these racing thoughts in my head would just shut the fuck up.©2009
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