You know, I had so much to write the other day that I decided not to put all in one post. What the best thing ( did in 2010? Well, on July 27th I quit smoking cold turkey with none of those nicotine patches or gums. I just made up my mind to do it. The first couple of weeks were hard, but by the third week, the cravings lessened

I miss going to therapy, but each therapist I’ve seen (3) just didn’t seem all that interested in what I had to say. Once actually clock-watch during the whole session. I want to return to therapy, but now I am not sure where to go. I think I am going to call the head therapist I worked with during that intensive three-month outpatient therapy. Maybe I can get her to make the appointment for me in case they it to be a referral requirement.

I’ve been fairly balanced bipolar-wise (BP). And what is interesting, when I am feeling balanced, the Borderline Personality Disorder (BPD) doesn’t seem to be as pronounced. However I feel myself slipping into a manic phase. I’ve had all this energy and haven’t been to sleep in 4 days, but I feel fine. My biggest weakness when I am manic is my need to spend money and collecting things I shouldn’t have. Those items always fall in the “want” category!

Well, my psychiatrist was me to have another neuro workup considering the fact that my short-term memory is sporadic at best and I can’t concentrate or focus on tasks. I’ll start working on ten things at the same time, yet make headway on none. So, I am no going to work on one item at a time from start to finish. Not sure what my productivity will be at work.

Speaking of work, I have been staying on top of my projects and my email. My boss hasn’t had to deal with me for the whole month of January so far. I know I am supposed to be getting my performance appraisal this month. I can hardly wait. I rather doubt that it will be as good as last year.

I have perfected the smoothie! I have a 1200-watt blender that will crush ice. I can make gelatos and ice cream and frozen Margaritas. Well, I look at my poor absorption of vitamins and minerals, but instead of taking all these vitamins and minerals in pill form, I am adding leafy green veggies and such (spinach, kale, broccoli, carrots not peeled). I put the veggies in with the blender and all you can taste is all the fruit I usually add to my regular smoothie along with the protein powder and flax seed meal (the actual flax seeds are hard to digest).. Maybe my blood results will look better this time when I go see my regular doctor.

Back to my dysfunctional family. I decided to send everyone framed pictures of Mom following her 90th birthday, evening including K, the niece from hell. I called her out on it and she claimed she didn’t know what I was talking about. Never mind that for the last 10 years I have been patently ignored when the family gets together for the celebration at K’s house. Well, I sent the framed photos to K and today is Jan 17. I actually was expecting a thank you call or card, but nothing has been forthcoming, so I have now washed my hands of her.

You know what else hurt my feelings? Now that I have a dependable car, I have the ability to drive the four hours to her house. WhenI was visiting her back in November, she told me that staying for four days is just too much for her. Three will suffice. Well, that’s hard on me considering it’s practically a quick turn-around trip. And on top of that, she doesn’t want me down there too often (like once per season). Well, she is 90 and has every right to dictate who can and for how long someone can visit. Ah, yes, family. Just warms the cockles of my heart! ©2011

Week in Review 20 February 2010

I apologise for the delay in posting my weekly reviews. I have been so busy at work that time has just flown by. So let me catch you up since my last entry of Week Ending 30 January 2010 (see post below).

Work: My job is slowly piecing itself together. My confidence has risen a little bit and I finally got ahead of my emails. For the past three weeks, I have ended the day with as many as 90-100 unread emails. By Wednesday of this week, I finally tackled them all and now I may only have 6-12 emails I have not gotten to. What an improvement.

I feel as though I am actually accomplishing tasks at work and being able to scratch off items on my to do list. I still have about 20 requests I have not handled—some more complex than others.

My circadian rhythm has settled now. I am going to bed around 1930-2000 each evening because I am awakening on my own around 0345. My job requirements changed while I was out on medical leave. Before, if I was in the middle of something crucial and it went past my eight-hour workday, being salaried but non-exempt, I would be paid overtime. I ended up working 10-hour days frequently, which very easily made me feel burned out. When I came back to work 04 January I was told no more OT would be approved which really lightened my burden. Oh, sure, that always left me with not enough time to get my daily job done, but I was freed from the expectation that I would work the OT if I had to. So, I clock in at 0700 and clock out promptly at 1530. Because I am getting up so early, it gives me a chance to drink my hot tea, eat breakfast and stay on my strict medicine schedule.

Now, here is the bad news. Now they have decided to make us salaried exempt meaning if I have to, I am expected to work additional hours without being paid for it. In my book, I think that is a punch in the gut. That is management trying to cut the bottom line while still expecting superior work effort. Not sure when it goes into effect, but this had the potential to increase my anxiety levels.

My Psychiatrist: I had my appointment back on 03 February. He seems pleased with my progression, but concerned that I am still battling the depression. Overall, since the mood swings have stabilised I can see some improvement. He did not make any changes to the cocktail and now I have graduated to only having to see him once a month for the time being. I am looking forward to reaching the point when I only have to see him once every three months.

We talked about my residual symptoms of incurring Wernicke’s Encephalopathy which is still lingering. I am still having problems with my eyes as I am still experiencing saccadic movement  which slows me down at work. It is very frustrating. Also, I still experience short-term memory loss which is equally as frustrating. I have to take copious notes during integrated phone/data conferences so I do not forget anything. I cannot tell you the number of tablets I go through just collecting facts and action items on my part. My psychiatrist believes that my brain will heal slowly over time.

Individual Therapist: My last appointment with P was 03 February 2010. It was a non-event because I told her I was going to have to switch to a different therapist. P’s last appointment of the day is 1300, right smack in the middle of my workday. I need someone who can meet with me at 1600 or later. She highly recommended one of her peers equally qualified, but when I tried to make an appointment with S for two weeks, she was booked. I now have to wait until 09 March—one month out. I will try her on for size in hopes that we can make a connection. It is going to be a bummer having to start from scratch even though she has P’s notes in my record. I just hope she takes the time to read it before our first appointment.

My Car: Well, I am now the owner of a 2010 Honda Fit Sport. I have had it since 06 January and have only put 78 miles on it! I just do not have any long rides to takes around the city. Almost everything I do is right in my own neighbourhood. There is a small part of me that is excited by the fact that I have a new car. However, what is first and foremost in my mind daily is wondering if I can really afford this car. I did well in negotiating it down from the MSRP, but a car payment is still a car payment. It still has that new car smell. Also, I have made the decision that I will not smoke in this car. Hasn’t been too difficult. I just make sure I do not bring my cigarettes with me.

I will try to be better at really trying to nail down a weekly review on time. It’s hard to remember the small, but important details two and three weeks out.©2009

Week in Review 30 January 2010

Not much to report this week. I had no therapist, psychiatrist or GP appointments for a change

Work: This full-time work week hit me like a ton of bricks. It is as if all my clients all knew I was back in the office all on the same day. I simply cannot keep up with the email, nor respond as quickly as I used to with some of my more high-profile clients. I still have emails unread dating back to this past Monday 25 January.

I had one major escalation that was a forefront priority for me that I had to stay on top of from the start. The problem was presented to me last Friday afternoon and it resulted in a client wanting a particular service on a product we offer. I let the client know that I understood the importance of a speedy reply to see if we could accommodate his request. No one on my team could give me a firm answer, so I was directed to Technical Operations.

Well, that group did not respond back as quickly as I hoped, but I dropped the ball by not keeping the client completely in the loop in just continuing to communicate that we were still looking into it, but so far, we had not heard back from Tech Ops. The client decided to escalate the issue above me that did not put me in the fairest of light (sometimes you learn your lessons best the hard way).

When all was said and done and Tech Ops told me that we could not accommodate the client’s request, my main concern was regarding who should be the one to tell him: someone from Tech Ops or me (I figured Tech Ops could explain better the technical details of why we could not provide the requested service).

After getting a few other emails from the account team who was also working with this issue, including my manager, and realized that no one had STILL not communicated anything to the client—now a week later—I decided to be proactive.

I called him and reiterated just how important this issue was for them; I told him I that I was remiss in not keeping the lines of communication more fluid in the intervening time, and offered my apologies for the duration of time it took for me to give him a final answer that we could not technically provide the requested service. He was very understanding. He said that he knew I was working hard behind the scenes. I still took responsibility for my lack of communication, and we parted amicably. He said he would contact me next week about some other information he would be requesting, more notably the specifics of the services offered by the products we were supporting for them.

This whole ordeal probably put a smear in my column in my manager’s eye, but I just have to chalk it up to an experience learned. I have always felt very strongly about providing excellent customer service to my clients; I do not know why I dropped the ball on this.

My other problem, which might have leant itself to the aforementioned issue, was the enormous amounts of email that kept streaming in. At the end of every day, there have been approximately 80-90 emails I still have not read, some stemming back, as I said, from Monday the 25th. I only have eight hours in a day (no overtime allowed) and can only process so much. I quickly scan throughout the day the subject headers to ferret out what might be higher priority items. I catch what I can, but I know there are clients who are still awaiting a response from me. In some cases, the questions I am being asked require me to run reports which take 24 hours to run, so that already puts me behind a day. Then I get emails where I simply do not know how to take care of the problem (my memory is still wreaking havoc). Thankfully I have a 12-member team who I can reach out to, but I fear they will get tired of my questions soon enough. What I fear is that they will not remember that I was only on this new job for two-and-a-half months before being out on a three-month medical leave. Essentially, I am still on my learning curve. There are parts of this job I just have not been exposed to yet which is resulting in me being slow on the uptake.

The bright side of this week was my performance review that my manager held with me on Tuesday. He said he was remarkably pleased at just how far I have come in gaining experience in the position and how fast I was learning everything. He pointed to my desire to provide superior customer service as one of my strengths, and the one thing I needed to develop was my sense of self-confidence in performing my job. If he only knew! I did discover that the company approved raises for everyone and I merited a 3.5% increase. Well, it is better than nothing! I also found out that the company has approved a performance bonus this year payable in early March. I am not sure what mine will be, but I will be happy to receive whatever I get. (business has been good, thankfully).

My Car: Well, ole Betsy (never her real name, just seemed fitting at the moment) has retired. I have been spending the last two weeks searching for another car. I want to stay with a Honda as mine lasted for 16 years with mega-mileage. I looked at several dealerships thinking I would examine their certified used cars that came with a warranty. In each case, all they had were Civics comparable to mine —somewhat new, but with massive mileage. Sure, affordable, but I would be right back where I was in a short time. The other choices were the high-end Accords that were not affordable. I had already examined a new 2010 Honda Fit Sport that, when we got down to negotiating, was a far cry lower than the Accords. At this point, why should I pay more money for a used Accord when I can have a brand new Fit for a few thousand less? Moreover, this one comes with a lifetime power train warranty (the very thing that went out on my old car that never had more that the standard bumper-to-bumper three years or 36,000 miles). I did negotiate a good deal and got rid of the sales person and dealt directly with the manager who ultimately had the final say so. We must have pushed the proverbially piece of paper back and forth about five times. Nuts and bolts, I will be getting the car at $3500 less MSRP plus some of the options I wanted. I have never been afraid to negotiate and walk out the door, and this particular dealership (the last of the three locally, two of which I had already walked out when they didn’t meet my price) started hedging when I said that I was prepared to drive 90 miles or so across the state line to get a better deal. Then they started singing my song. I will be picking up the car next Saturday.


General Info: Aside from the constant anxiety at work, my bipolar appears still to be in balance. In addition, my sleep patterns are almost back to normal. It has been such a long time since I have been able to say that. Currently, I am not depressed or manic. Is this what “normal” is supposed to feel like? I would not know; I have never been here before.

Next week I have my appointment with my therapist and psychiatrist. I did have quite an unexpected expense this week. I had to get my bipolar meds refilled. I already know that I have to stay on them, so I bit the bullet and called my insurance’s 90-day prescription by mail program. I had to fill my Geodon and Provigil (not generic) and my Lamictal. Because I still had $1150 of my $1200 deductible, one or some of those meds were going to have to be a full retail price. I almost fell off my chair when they quoted me the Geodon at roughly $1172 for a 90-day supply. So, that drug alone covered my deductible and I got the other two dugs with the insurance cap. Now, how many people can say that they’ve met their medical insurance deductible by the third week in January…LOL.©2009

My First Day Back to Work

I woke up yesterday morning about 15 minutes before my alarm had been set. I got six-and-a-half hours of sleep and felt well rested. I woke up earlier than I had to in order to enjoy some time drinking my hot tea and settling my anxiety about this eventful day. I had no idea of what to expect.

I spent my last day on full time disability (Monday) talking to my manager. He assured me that everything would be fine. The disability claims group approved me to go back to work from the 5th to the 11th at fours hours a day and from the 12th through the 18th I’d be working 6 hours a day. I explained to him the downside of my vitamin B1/Thiamine deficiency with regard to my short-term memory loss and he understood that it was going to take some time for my brain to heal.

This first week back all he wanted me to do was to go through my email inbox and blow away the majority of the unread emails as my back-up team members were taking up the work covering my clients while I have been away. For these two weeks, my out-of-office email auto reply and my outgoing voicemail message still shows me being out of the office. My manager does not want me to interact with my clients for these first two weeks. He felt that I needed a gradual immersion back into the fold. I am so grateful to have such a wonderful manager. After talking with him, my anxiety levels were reduced.

Well, the moment I had been dreading was finally upon me—opening up my email account. There were 1000+ unread emails just waiting there for me. I took a deep breath (and an Ativan, I will admit) and sorted by sender. It turns out that there were so many I could just delete. When all was said and done, I ended up keeping 73 emails that I felt I had to read which I did. Many came with important attachments about my specific accounts that I would have the need to use later. I saved and filed all of those in the appropriate folders; the next thing I knew, it was 1100.

Oh yeah, my boss did agree to letting me change my work hours and now I will be working 0700-1500—no more overtime hours allowed. I am so grateful for those two situations. I wake up so early anyway; to have to wait until 0800 would be counter-productive. In addition, the upside is getting off at 1500 while there is still sunlight. This gives me the chance to accommodate any doctors and therapists appointments. I never did like working the normal eight hours where the sun was just coming up when I started work and already set by the time I was finished. I hate Standard Time and the sun setting so early in the Winter.

My day actually went quite smoothly. I was very methodical in how I approached the day; I received excellent support from my boss; what more could I have asked. Since my day started at 0700 I was done at 1100. I had the rest of the day free and I realised that I needed a distraction so I would not dwell on what may or may not occur my second day back. A friend of mine had been sick over the weekend and I called her up telling her I was going grocery shopping and asked her what I could pick up for her.

When I arrived at her house, my heart just went out to her. She looked liked she felt so miserable. We settled in and spent about two-and-a-half hours just talking. It was exactly what I needed to divorce myself from anticipating the worst for the next day.

Overall, it was a good day. I am not going to fret about the upcoming days or pile more on my shoulders (emotionally) by projecting outward on the worst-case scenario. I have hope that my job will be far more manageable now than it ever was before. Staying in the moment—what a marvellous tool!.©2009

Anxious About Returning to Work

Well, tomorrow is my first day back to work after almost 12 weeks of short-term medical disability. I had only been working in my new job for approximately two-and-a-half months. I am afraid that I will not remember how to do my job. This is a high-stress work environment and I have a lot of high-profile clients that I serve. I am not sure I am ready for this.

Last week my psychiatrist faxed in a request so that my first two weeks back be half-days only. The disability group is scheduled to review that and decide today. I sure hope they approve this request. I have also left a voicemail with my manager requesting that my work schedule be shifted a tad earlier in the day so that I will be working 0700-1530 (not that I have ever only worked eight-hour days). In reality, this time around I am not planning to work any overtime. Working all those extra hours before set me up for my eventual downfall (aside from the very important fact that I went off my meds). I have not heard back from him yet; I hope he agrees to my request. Being able to be off the clock by 1530 will give me the chance to accommodate any doctors’ appointments I may have.

I am looking over at my corporate laptop which has been turned off for all of this time. I am even anxious about booting it up. Not that the laptop will not boot, but I wonder if all my access passwords into the network have been changed since I have been out all this time. I have to have access in order to be able to work from home so I can VPN into the network. I remember what all my passwords are, but they all have time limits on them. Some are only good for 90 days.

I am not even sure how to begin my workday. I ordinarily receive anywhere from 150-300 emails a day. I cannot even fathom how many unread emails are in my account. That thought alone has my hands shaking. Just as I was starting my disability time off, my department was being reorganised and eventually was slotted to be under a new management chain. My manager is still my manager, but the food chain on up from there changed above his level. I hope I am not in for any nasty surprises when I return (meaning I hope I still have a job). I know that my job has been protected while out on FMLA, but that doesn’t mean they can’t come back to me as soon as I get back and say to me, “Oh yeah, Alix, while you were gone we eliminated your position. Thanks and have a nice day.”

I have left another voicemail this morning for my manager to call me back at some point today. I hope he is in. Chances are, he may have taken a few vacation days before the New Year during the time I left my previous voicemail; I need to talk to him today before I report back tomorrow. That is the downside to working remotely from home. My team is located all over the country. The only communication we have is via phone calls and email.

Well, I have planned out my day today to reorganise my office space back to the way it was before I took all this time off. I am also planning on reviewing all of my training notes to have everything fresh in my mind before tomorrow. I woke up this morning at 0430 and am already feeling tired. This does not bode well for my sleep patterns the rest of the week. I hope I can sleep a more work amenable schedule tonight.©2009

Outpatient Therapy-Final Session

Yesterday was the last session of my group therapy program. I began this intensive program 21 October and we have met three hours/day on Mondays, Wednesdays and Fridays. Yesterday marked my 30th session.

Initially, I was very phobic to these sessions. Similar to my attitude when I was involuntarily committed , and knowing I was only obligated to attend for two weeks, my original intention was to skate through those six sessions with no effort on my part. I was still pissed off at the world for how I had been treated to date; I did not want to be in therapy and I certainly did not want to get better.

You just cannot imagine the amount of rage that pulsed through my veins—think Incredible Hulk. However, as the mandatory two weeks came to a close, something was triggered inside of me. Somehow, I came up with the idea that I no longer wanted to go on feeling the way that I did. That level of rage and profound depression was eating away at me and I simply had no more energy left. I voluntarily agreed to stay in the program having no idea that it would take this long.

There was a very detailed daily check-in sheet we each had to fill out. It was basically a way for the therapist to determine and track our progress. The dynamics of the group evolved over time with old patients being discharged and new ones being admitted during my stay. While the overall group was large (in my eyes), averaging around 18-20 folks, once everyone took the 10-15 minutes to fill out the check-in sheet, we always split into two smaller groups. The groups remained split while everyone reviewed their sheets, and we all came back together as one group after the break to start the second half.

I could handle the smaller group in which we each shared what was on our sheets. Based on our input, the therapist would probe further with each of us and ask penetrating questions. The sharing half had a tendency to be somewhat tedious at times. Every so often, there would be patients that liked to hear themselves talk. Repetition is the key word here. They would go on and on about one particular issue and even talk over the therapist as if they had no interest in listening to her feedback. I could see the frustration on the therapist’s face every once and a while. As a result, sometimes the first half of the session would take a long time.

After the break, when we all gathered back together, I had a major problem. I had a rough time being around large groups of people. The noise level would always increase and sometimes everyone would talk at once. That started freaking me out. Therefore, I retreated from the large table in the room (it was actually five conference room-sized tables arranged in a large square) and sat in the chair against the door right by the back emergency exit—it was as far as I could get from the group. The emergency exit was not wired to an alarm, and when it got to be too much for me, I’d walk out the door and take a breather. Being that it was the end of autumn as winter approached, the cool, brisk breezes usually refreshed me.

The second half of the session was psycho-education [I’m sure that Alfred Hitchcock could have had valuable input here :)]. This outpatient therapy program was based on dialectical behaviour therapy (DBT).  When I tried to commit suicide back in 2005, I went through a DBT program after I got out of the hospital. At that time, I thought that DBT was pure bullshit. It all centres on learning tools or coping skills to manage various stressors (depression, anger, rage, anxiety, etc). Being that I had been diagnosed with Bipolar I Disorder (BP) and Borderline Personality Disorder (BPD), everyone thought that this type of therapy would be one from which I would benefit. Back then, I thought all these coping skills were stupid. Sure, it might work for some, but I just could not imagine me taking the time to think through whatever emotion I was feeling at the time and remembering which tool would help me through that situation most effectively.

When I realised that this time around would be centred on DBT, I was quite cynical. However, after about four weeks into it, I discovered some tools that could actually serve me well (see this for a list of tools). Without a doubt, using these skills effectively requires constant practise. You cannot expect to utilise a skill and then have it at your fingertips until you practise it. Once practised, when you face an emotional obstacle, you can more readily adapt effectively.

I also realise that there is a lot of controversy around DBT. Some who have been through the training think that it is bunk as I did. I can say that I do not agree with the entire skill set. I learned what tools I knew I could use and left the others behind (there are some I still think are bullshit). All I can say is that it is up to each individual to determine what works in his or her best interests.

That being said, the first half of my last session was great. Our small group only consisted of seven patients and our small group never had the loud mouths (I am grateful that Mr. Noisy was in the other group!). I knew three of them; the rest were new patients. When I finished sharing my check-in sheet, I received wonderful feedback from the therapist. She basically said that I had done a 180˚ from the time I started the program and was extremely pleased to see the progress I had made. It had taken me all this time to see the huge steps I had made. Don’t get me wrong; I am far from being all fixed up. That is why I am going to continue with an individual therapist. BP and especially BPD can take quite some time to manage. While some professionals banter about the word recovery, I think the best I will be able to muster is to manage my BP and BPD to a tolerable level. Only time will tell.

The second half of my last session was surprisingly smooth. While Mr. Noisy was present and accounted for (as well as the other few loud mouths), the group discussion on the continuing module of assertiveness was quite ordered. It was quite appropriate that my last module would be on this topic. As I have mentioned previously, despite my butch bravado, I really could bolster this skill.

Saying goodbye was harder than I thought. All of the patients who had been around for a while (with the exception of one other patient, I had been there for the longest duration) took their time saying goodbye to me and wishing me luck for my future. As someone laughingly said, “Hope to see you at Wal-Mart should our paths ever cross again.”

Overall, I have to agree with the therapist. I have come a long way since I tried to commit suicide on 10 October. It has been a long road for me, some of it fought tooth and nail against any type of recovery. I know I still have a long way to go, but for now I will just accept the fact that I am in a better space than I was almost 12 weeks ago.©2009

Outpatient Therapy-Day 29 (28 December)

Because of the Christmas holidays, the majority of the folks did not attend on Monday. After that last fiasco the previous Wednesday, I was glad the whole group was not present. In fact, with the exception of two other people, everyone else was from the other small group. I was concerned because Mr. Noisy was there, but when it came time for him to share the information from his daily check-in sheet he took a direct approach and did not go on and on about everything for a change (as he usually does when both groups join back up for the second half of the session).

It was odd sharing among this group; only two other people really knew me. My check-in sheet was pretty much straight forward. This was the second-to-last one I would be filling out and what a comparison to the first one I filled out 11 weeks ago. So much had changed over all this time. I knew that this coming Wednesday was going to be my last day. The input I received from the therapist was very positive. She couldn’t be as insightful as our small group’s regular therapist (ours was out for the holidays), but she still remembered the state I was in when I first joined the group. I at least appreciated that. She saw the tremendous difference in my attitude, but mostly how much I had changed in the anger area.

The second half of the session was spent still going over assertiveness. Much like the anger management module, this was a long one as well. Being more assertive is something I need to get under my belt. Much like the self-esteem module, the two seem to go hand-in-hand. The group discussion was far more controlled than last Wednesday and Mr. Noisy was less dominating throughout the discussion. I didn’t really have much input that day; mostly I listened to what the therapist was saying.

There is one tool I have been taught that has served me well. It’s called Using Your ABCs. “A” is awareness: the acknowledgement that an event has occurred—it is what it is and no value judgement is placed. “B” is your belief of what that event is. “C” is the consequential emotion of that belief. A ≠ C, but B = C. The theory is if you can acknowledge what the event is and form a healthy belief about that event, the consequential emotion will be a healthier emotion rather than a destructive emotion. Here is an example. “A” = my family has refused to invite me to family holiday celebrations. “B” initially was that I felt unwanted. “C” resulted in an emotion of anger and hurt that escalated more than the situation warranted which cascaded over the rest of the day and then some. If you can change the “B” to equal a response more like “Well, they are the ones missing out on my joining them,” then “C’s” consequential emotion will be healthier along the lines of perhaps still being hurt and yes, somewhat angry (there are times when anger is a perfectly rational emotion), but the intensity of the emotion will be far more controlled and not spill over into everything else that will ultimately escalate (or for as long as you repeat the same thought process).

These tools are serving me well, but I acknowledge that it is up to me to practice them so they will be available for use when I need them. Going into this program, I initially thought these tools were just a bunch of bullshit, but over time, I learned that they merited some attention on my part and realised their value to my success. I will be discharging from this group therapy this Wednesday, After doing this non-stop three days a week @ 3 hours each day, I have found the experience to be quite beneficial. While I am looking forward to being finally discharged since joining this program 21 October, I imagine there may be some group therapy withdrawal I may have to go through initially. This program has become part and parcel of my life since being committed on 11 October as an inpatient.

I have a follow-up appt with my individual therapist in early January to segue into a continued therapy module rather than just quit. I still have unresolved issues to deal with, most notably the tremendous stress I am feeling about returning to work. Yes, I am going to feel somewhat disconnected when my group therapy sessions come to an end this Wednesday.©2009

Outpatient Therapy-Days 27 & 28 (December 21 & 23)

Monday was supposed to be my last day of group—the insurance company had only authorised sessions through then. I was not prepared for it to end. Despite my attitude at the beginning, I have gotten a lot out of this therapy and I think that I have made significant strides. I asked my therapist what process I had to go through for discharge and she told me she didn’t think I was ready, especially with the Christmas holidays coming up—she knew I would be alone as, once again, my family enjoyed their celebration with no nod to me. I am beginning to get used to the idea of spending the entire holiday season alone. My son came to visit me two years ago, but he lives out West and, for both of us, it can get rather expensive just to fly in either direction. So, the therapist told me to return on Wednesday as she was going to submit a request to see if the insurance would authorise additional days.

The second half was on self-esteem—something I am sorely lacking. Despite my butch bravado, I saw traits from the description of those who have poor self-esteem and I ranked right up there. That actually pissed me off a bit. Nevertheless, in reality, I do not always stand up for myself and usually take a back seat. I am not exactly a doormat, but I am not as assertive as I could be. It’s odd as at work I can take the lead with regard to directing projects (considering I have taken that blasted Six Sigma training), but when I am relating to others on a personal level it is more apparent.

As the session drew to a close, I wondered if today was going to be my last day. I gathered my stuff and flew out the door as I had another iron infusion directly after group.

I came back Wednesday morning and was pleased to find out that the insurance company had authorised three more sessions, including Wednesday, through December 30th. That would take me through the New Year’s weekend leading right up to when I was supposed to return to work. When our “small” group was sharing, I tried to process the difficulty and anxiety I was feeling about returning to my job. I fear that I do not remember how to do what I have painstakingly spent three months trying to learn. I try to stay in the moment as I still have another week to go, but I cannot help worrying about it. I feel stuck and do not know how to reinsert myself into the routine. I got a lot of good feedback from the therapist and others, but it did not necessarily quell my anxiety.

The second half of the session was on assertiveness—something that I am not very good at as I am more than likely to be either aggressive or passive aggressive. The entire group, as usual, gathered for this part and our entire group is getting way too large for me. It is enough that my little group, when we split for the first half, has too many people. I have discovered that there are a couple of noisy “talkers” in the other small group. As the therapist began her discussion on this topic, those talkers always had something to say about everything and would get into their own discussions if they disagreed with each other. The more they spoke, the louder they got and more people started getting into the action.

It was becoming too much for me. I wanted to listen to what the therapist had to say and ask my questions if any came up. After a while I thought, hell this is a topic on assertiveness, I think I will try it on for size. Rather than just jumping into the fray as everyone else had been doing, I raised my hand (OK, that does not exactly project an assertive position). The therapist piped up (she was pretty good about keeping the group on topic) and nodded to me. I waited for everyone to get quiet, looked around, and gave everyone eye contact. Then I explained that it was hard for me to be around large groups of people, especially when it got loud and everyone was interrupting each other. I told them that when they got carried away, I felt anxious and asked everyone if they could respect my position.

At first, everyone just stared back at me and then the therapist chimed in first. She said she was glad I spoke up and voiced my concerns and told me that it was an assertive position I took and was very appropriate (I thought to myself, “So there, hah!”). Then the noisiest of the bunch jumped in and said to the therapist, “Excuse me, but don’t you control our group?” She said it was a group discussion, but everyone had to be aware of each other. Then Mr. Noisy said, “Well, I’ll respect your position.” I looked at him and wanted to say, “What am I, chopped liver?” What I really wanted to say was, “Fuck you” but I did not (so OK, I was not completely assertive). For a while everyone seemed to settle down, but it did not take him long to go back to his diatribes and, once again, everything exploded. There were ten minutes left to go, so I just decided the statement I would make would be just to pack up my stuff and leave the room. I was not that quiet about it (here is where I was being passive aggressive), pushed back my chair and got up and walked out of the room. I though, “Well, we’ll have Friday off for Christmas, so that will give me a breather.” However, I was glad my insurance had authorised two more sessions.

Two more days until Christmas. To tell you the truth, this year it has almost snuck by me. I do not get out much so I have not been too exposed to the shopping traffic. Moreover, I definitely do not go to the mall. I have forgotten that it was going to be Christmas on Friday. For me, it will just be another day.©2009

Outpatient Therapy-Day 25 (Wednesday 16 December AM)

My group therapy session today did not go as well as I had hoped. I am feeling more depressed these last few days, since Saturday, but I did not realize how much until it was my turn to share. As I was going through my daily check-in sheet, when I got down to the section marked “current stressors,” I had written that I was facing huge financial burdens due to all the medical bills coming in and that I still had to find the extra money to support buying another car. As I was talking about this, the tears just started rolling down my face. I hate crying, especially in front of other people, but I could not keep up my façade. I was not even sure what the catalyst was of my recent downturn of my mental status, but as I was sharing this, it became apparent to me that my money issues must have been playing a good part of my increased depression. Of course, there was no real tool to deal with these emotions—anything I tried was fruitless. My bills were not going away and there was nothing I could do about it. The latter concept should have given me a clue as how to handle this situation—to accept it at face value and deal with it. But, how can you deal with knowing you have much more outgo that income?

Just to add to my worry and anxiety, today is the last day of my short-term disability. Both my group therapist and my psychiatrist have submitted extension requests, but when I called the third-party vendor that administers disability claims, I was told that the decision would be rendered tomorrow, my first day back to work. I am definitely not ready to face that stress. I left a voicemail for my manager indicating that, while tomorrow is supposed to be my first day back, I was unable to return and that the claim decision would be made tomorrow. I indicated that if the extension is denied, I would like to take my remaining vacation days through the end of the year (I had 14 days still coming to me, and while I was going to be using up 10 of those days, I would end up losing the other four as my company does not allow someone to carry over any vacation days). Then I sent him an email saying the same thing. If they do deny the extension and my manager does not go along with my vacation request I will risk losing my job according to the FMLA rules—I would no longer be protected by the federal guidelines imposed by FMLA. Why can’t the disability group make their decision by the end of today to give me a heads up as to what I should do about tomorrow in case I do not get a reply from my manager? My psychiatrist submitted his request along with the supporting documents on Monday, two days ago. They have previously decided with paperwork only submitted 24 hours ahead of time. Why did they need 72 hours this time?

I also have to go by my GP’s office right after group to get my third round of those iron infusions. I am not looking forward to that considering how many times they had to stick me Monday just to find a vein. I also had that weird reaction when I got home, but when I reported that to the clinical specialist yesterday, she looked up the reported side effects. While feeling tired was one, feeling that extremely tired along with the muscle fatigue and feeling bone-chilled made me think that something did not add up. I do not want to get the same reaction again this afternoon. I am worried in case these side effects start appearing while I am driving home. To be on the safe side, I put a tablet of Provigil in the pill container that I always carry with me. I just hope they can find a vein much easier today. I still have bruises from Monday’s attempts.©2009

Outpatient Therapy-Day 24 (Monday 14 December-AM)

I have been somewhat disappointed these last couple of days. I was doing so well last week. Since my short-term medical disability is only approved through December 16th, so I thought I would be ready for discharge from this group therapy program. The therapist recommended that I return today to wrap everything up, but after this weekend, I could tell that I was more depressed than last week. I do not know what the catalyst was, but I am glad I had the chance to return. My daily check-in sheet showed a marked decrease in my level to function since last week.

One thing that I am disappointed in is that there have been a lot of new admission over the last couple of sessions. I still cannot handle being around many people. When the entire group gathered this morning to fill in the daily sheet I sorta freaked out. I moved from my spot at the table to a chair against the wall in the far corner until everyone finished and the big group split. Unfortunately, that still left a lot of people in my own group. I miss the folks that were part of my original core group when I started, but with the exception of two other people, everyone is fairly new. I have no rapport with them. They do not know my history. When it comes to my turn to share what is on my daily check-in sheet, how can they determine my level of progress (or in this case, the steps I have taken backwards)?

Even though there were still a lot of people, once the group split, I assumed my seat at the table (I always sit in the same chair—the one closest to the back door leading outside if I have to escape for a short period of time). Luckily, the person already sitting there was part of the other group. The therapist asked who wanted to go first and I groaned because we go around the table and it was going to take forever to get to me. As much as I put forth when it is my turn to share, with all these new people I had no idea how long it would take them to get through their sheets. Some people have been known to go on and on about not much at all. Not that I am trivializing their plight, but to repeat the same scenario over and over again from one person can get to be a bit much.

Actually today, it was interesting to hear the new folks share. So many of them were in exactly the same mental space I was in when I first started. It gave me a new appreciation for the strides I have made even though I feel like I have taken a few steps backward these past few days. Then, finally, it got to be my turn. One of the things I processed was my interesting reaction to my first visit back to my church after a nine-week absence since I tried to commit suicide. Here I was anxiety-filled at facing all these people for fear of what they would all ask me about my absence. Sure, some of the folks knew the truth, but there were a bunch that did not. I can still remember how stricken I was standing outside at the front door for fear of what would happen once I went inside (see post below).

Once I described how lonely I ended up feeling after the service was over since no one approached me (I had to keep telling myself it was because they were respecting my privacy), the therapist thought it was quite oxymoronic.©2009

Outpatient Therapy, Day 15

I have skipped posting on these group sessions on a regular basis because there was nothing unique about them, or anything of substance. However, I had some good news to “share” with the group this time that allowed me to rate some good scribbles on my chart for a change. I was able to successfully demonstrate skills that deals with my isolation issues since my past weekend had me actually enjoying time spent with friends outside of my house. The key factor for me isn’t just being able to connect with people, it also has to do with getting me out of the house and exposing myself to conditions that actually force me to isolate (being in situations where there are lots of people). However, it was no small feat for me to have initiated those phone calls that resulted in those plans.

While there are still four more problem areas as outline in my treatment plan, I obviously have much more work to accomplish. My therapist still feels I am not ready to go back to work this coming Tuesday and will be putting in an extension for my FMLA for an additional two weeks. I am frustrated with this because, while my job is incredible stressful, I love what I do. She just firmly believes I am in no shape at this point to handle that level of stress.

The second half of the group was spent on anger management issues, something that directly applies to me. While I have been able to deploy some of the tools to combat my isolation issues, I have so many additional skills that I have been taught that I still cannot use. Therein lies my problem. Anger is a big one for me. When I become rage filled, that last thing to enter my mind is any of the tools.

I wonder how many more of these sessions I will have to attend. What once started out as a two-week requirement for discharge has now stretched into five weeks (the additional three were not under any requirements, but voluntary on my part).©2009

Momentum

This past weekend has been a banner one for me as far as decreasing my isolation and reaching out to my friends. Of course, you’ve read about my coffee date with K on Friday and my grocery trip with A on Saturday. Well, I discovered that I needed to go out once again, and to the mall no less where it was teeming with people. Mind you, I am not a mall rat; in fact, I cannot remember the last time I was there. However, there is one thing I need every year and can only find it when the independent vendors set up their kiosks at Christmas time. I use this huge grid calendar that I hang on the wall right inside my bedroom door. Each square is large enough to accommodate multiple entries and to write them in large letters so I can read them. Therefore, I called K and asked if she would mind taking me to the mall.

We were not sure at which end to park, so we picked one anchor store and went inside. The idea of walking all over the place to find this particular vendor was rather daunting to me. However, we spotted a mall security guard as soon as we got there. He did not know where it was, and upon spying a walking talkie radio, I suggested he call out and find out if anyone of the security guards knew where it was.

Now that we knew where to go, we started negotiating our way among the throngs of people, impatient kids running away from their parents, and a mass of strollers with shrieking babies. I hugged the interior wall for fear that someone would kick out my cane from underneath me. I was not handling the mass of people very well, but stuck to my guns as I looked at this adventure as a mission to complete. Having K there made all the difference as I could focus on her and keep up a running dialogue as we walked.

I espied our target and once acquired we headed directly there. I got my calendar and out we went. That said, I am still fairly sure I don’t want to return, at least by myself as the crowds were somewhat suffocating. However, I did accomplish my stated mission and nothing happened to me. A week ago you couldn’t have paid me to insert myself into that situation. K has been a valuable friend as she knows my boundaries and is more than willing to be there whenever I need her. Lesson learned: I can tolerate what I most fear, even if I have to have a friend walk me through the process. I am still not capable of doing these things alone; having someone with me allows me to concentrate on my continued conversation and ignore the people. I did not have a panic attack.

Afterwards, I invited her back to my house where we talked for about an hour before she had some things she needed to attend to. This is the first time I have let anyone into my home since that fated night. All in all, I feel as though I making progress as far as my isolation goes. Now I have something to talk about when I go to group later this morning.©2009

More Baby Steps

I have to start by saying that Friday afternoon, when I got home from going to Starbucks with K, I had an uneventful evening at home. I was not anywhere close to being suicidal as I sat in my house at home all alone and my depression did not seem to be as severe. I actually felt somewhat content. I am sure it all had to do with the fact that I got out of my house and went somewhere with an understanding friend where we just talked about normal stuff for two hours—what a difference 24 hours can make.

Well, I must be on the good vibrations roll this weekend. Friday, when I got home from coffee with K, I called my other friend A (who provided me with all those safety gadgets for walking late at night). Due to my limited mobility right now, I asked her if I could go grocery shopping with her the next time she went. She mentioned that she was planning to go Saturday around 1100 and she said she would be happy to take me along.

As it approached 1100, I began to feel the anxiety rising. I had not been inside a grocery store since I egged those patrol cars three weeks ago. I was not sure how I was going to deal with all of the people and noise. When A came to pick me up, I was somewhat calmer because I knew I could step outside the store if need be. It was good to see her again. I have never gone grocery shopping with a friend before. In addition, pushing the cart gave me more stability than my cane since I could hold onto it with both hands (no, and that is an emphatic no, I am not got to get a walker!). I was doing pretty well as we traipsed through the aisles until I forgot something and had to go all the way back to the beginning and retrieve it. I was alone, faced a slew of oncoming people, and had a mini-freak out session, sorta like a “deer-in-the-headlamps” experience. I just grabbed the cart, stood still and closed my eyes and took some deep breathes and just concentrating on standing outside in the sunshine. Well, it worked and I did not have to actually leave the store.

I found A and we were ready to check out. I was in a single file at the checkout lane, but I went first and gave some distance to the woman in front of me—talking with A helped keep my mind in the moment. The next thing I knew, we were back in her car riding home where she helped me carry in my groceries. I really enjoyed myself.

Between getting coffee with K on Friday, and spending time with A at the grocery store on Saturday, it represented the first two occasions when I got out of my house to do something with other people that also involved going to places where other people would be. It was not as bad as I thought it could be. Yesterday, after getting home from the grocery store, I felt content yet again. I had set a goal and followed through on it. The rest of the day went smoothly, and when nightfall came, the most fragile time for me when I am in my house all alone, it was not so daunting.

My severe depression seems to be abating somewhat. I don't think it's solely attributable to the Lexapro I just started taking; in fact, I think it has more to do with the decrease in my isolation.  I got 4 hours of uninterrupted sleep last night. I went to sleep at 2300 and rose at 0300, so it still makes for a long day ahead of me, but I felt rested when I awoke. So, today is Sunday, the day I used to go to church. Nevertheless, that is not going to happen today. I am still not ready to go, and I am not sure I want to anymore ever since I got that comment from Sharon on one of my previous posts. I have to ask myself, does everyone there judge me the same way? Do they all think that I am a fraud? I have to keep reminding myself that her comment only represents one opinion from one person and I do not have to accept it, but I cannot help but wonder if others feel the same way. No, I am not ready to face them and all their questions, aside from the fact that it will be a room filled with people (albeit a small number, but people nonetheless). Right now, I’m just please with my baby steps forward.©2009

Appt with Psychiatrist Week 4

The first thing we discussed was my weird reaction I had yesterday with Outpatient Therapy Day 9 (didn’t blog about it, as there was nothing new to report). When I woke up at 0200 I felt weak, my legs felt rubbery, and I was shaking all over. It was worse when I was standing, but even after sitting for a while, those effects returned when I’d stand again. At first, I thought my blood pressure was low, but it was normal. I was hoping it would pass by the time I had to drive for my group session, but it didn’t. I chose to drive anyway, but by the time I got to the location, it was worse. I couldn’t walk in a straight line and I stumbled a few times. I went right in and sat down and that helped a lot. The therapist thought it might be a reaction to my medication as I upped the Zyprexa to 40mg to aid my insomnia before going to sleep at midnight. I had my daily call to my psychiatrist later that day, so he dropped the Zyprexa back down to 20mg. This morning I did not have those same side effects.

Later, when I saw him, He had me go through a series of neurological exercises. The only one I didn’t do well on was the Romberg test where, while standing, you hold your hands out to your side, put your feet together and close your eyes. I couldn’t keep my balance. He is still wondering about my low B-12 values and a possibility that I may be low on Thiamine. I also see my regular doc this afternoon (God, I am so sick of having all these various appointments). We’ll be discussing the results of those lab tests I had drawn last week. I’m sure I’ll be told I have to go back to injecting myself with the B-12 shots monthly (cheaper to do it myself instead of paying for an office visit for the same thing). I wonder if you can test for Thiamine. If that’s low, I may be giving myself two shots for a while. My thighs will look like pincushions!

The only other change he made was to reduce my Geodon from 240mg at bedtime to 160mg.©2009

A Measure of Hope

I don’t where to start with this one, but in so many of my posts, I have demonstrated extreme rage towards my pastor. I have also invalidated another person with whom I’d grown very close to over the course of our friendship (she is the one who brought me those nifty tools to use to keep me safe at night during my midnight walks even while vilifying her).

As much as I have disparaged my pastor publically via this venue, there is something else I must do equally as public. I realized that I had to let go of all of the anger and hostility I have felt towards him. In addition, I have to come to understand how valuable my friendship is with him. I recognize that these emotions and thoughts regarding both of these individuals were irrational.

Today marks one month since I tried to commit suicide. This afternoon they came over to my house at my request. I needed to apologize to both of them for the unkind ways in which I treated them through my various posts. I realize now that their only motivation is one of compassion and concern. I didn’t see that in the midst of my turmoil. For the first time, I believed that it was possible for someone to care for me that much. I have to learn to accept that at face value—it is what it is. To know in my heart that their friendship and just as important, their acceptance of who I am while wrestling with BP and BPD, is a hard concept for me to accept. Nevertheless, I believed everything supportive and loving they said to me.

Having rejected everyone—by any means necessary—letting these two individuals back into my life brings me a measure of hope that I haven’t felt before. I discovered that I can use these tools to overcome at least one of my BPD hurdles.  Today I took off my mask, even if it was for a little while©2009

Individual Therapy #2

I met with my individual therapist yesterday right after group. My head is certainly having the time of its life! I didn’t think I would return after my first visit. However, this session went well. I’ve never done this before as far as dealing with a therapist one-on-one. Still not sure what to expect, but I liked the fact that I seem to get along with her fairly well. She’s upfront and direct—no bullshit. I’m not sure if I am going to chronicle these appointments as it appears that we are going to delve quite heavily into my personal life—more in detail than I want to publish. Suffice it to say that I think I can derive some benefit from this. At first I thought she was sold on DBT therapy (very similar to my group therapy sessions), but it appears not so much. I can’t take any more coping skills sessions than I am already exposed to through my group therapy. I like her (not so sure I can trust her yet; time will have to be the measuring stick on that one) and I feel I’ll be able to open up to her especially where my dysfunctional upbringing comes into play.

Oh, I did find out this morning that my medical disability has been extended through 30 November due to the paperwork my group therapist submitted. Evidently she doesn’t think I’m prepared to face going back to work tomorrow. I’m not being a deadbeat when I say this, but I don’t think I am ready yet to handle that additional stress right now.

Well, my plans for my midnight walks are quashed tonight. It has been raining like cats and dogs all day today. It’s absolutely miserably outside—chilly, dreary and wet.©2009

Outpatient Therapy, Day 8 and my Phone Check-in With My Psychiatrist

This group therapy is getting old. It’s the same thing everyday—too emotional for me, at least as far as some of the others in my small group. I know this sounds callous, but from the moment I sit down, I am just counting down those two hours of “sharing” before we have our break. Yesterday was no exception. There is one woman who, they decided a week or so ago, that she needed to be hospitalized again. It wasn’t an involuntary commitment—evidently she agreed to it. Well, her first day back into the outpatient program, all she did was cry while she was sharing but refused to go into any details. She said she was afraid they would put her back inside if she told the therapist what was really evoking this emotion. I have a handle on that one—I’m certainly not going to voice that I am intentionally suicidal (they gauge how “safe” you are as to how forward thinking you are regarding your actual plans to commit suicide). I can say that I was feeling suicidal the previous evening, but I have to show a coping skill I successfully used to avert that situation. I can say without a doubt that there are nights when I am suicidal and I go through the motions of preparing everything. If I were to say that I have the intent to follow through, that would land me right back inside the Big House. I don’t follow through, not yet, but at one point when will the intent be stronger than the want not to do it?

I can feel my depression getting worse even with my doc tweaking the cocktail. So far, nothing he has done has yielded any progress as far as my depression and insomnia go. I am living one day to the next with, at best, two hours of sleep. Oh, and get this, the results of my fasting blood work has come in. My psychiatrist always gets a copy from my regular doctor. He looked at the results while we were on our phone call check-in today (I’ve been on the phone everyday between my weekly appointments even over the weekends so he can adjust the meds, if needed, on the fly and spare me the expense of an office visit). Evidently, while my haemoglobin is 11 (low side of normal), my iron stores are pretty low. My ferritin level is only 5 (normal is 15-200 ng/mL for females). Ferritin is a protein that stores iron and releases it in a controlled fashion, in single cells and multi-celled animals. It is a buffer against iron deficiency and iron overload. The last time, approximately 6 years ago, my ferritin level was only 2. I tried taking vitamins high in iron, then iron pills to no avail. My body wasn’t absorbing the iron. I ended up having to take Infed (used to treat iron deficient anemia) administered IV. I had to have three separate infusions over a few weeks. That cost me one hell of a bundle. I can’t afford that now in view of all of my other medical bills recently incurred. In addition, ketones and protein are spilling into my urine. Ketones are produced in the body when fats, rather than glucose are used to produce energy, but my glucose is 94. Protein in the urine is a warning sign. It may indicate kidney damage or disease or it may be a transient elevation due to an infection, medication, vigorous exercise, or emotional or physical stress. Well, yeah, I am under a considerable amount of emotional stress. I don’t know the other results yet, but I see my regular doctor on the 12th. I am sick of doctors; I am sick of medical tests. I just want to be left alone.©2009

I Miss My Church

Gosh, today is absolutely beautiful outside. It’s 64˚. The sun is shining brightly with a piercing blue sky. I’m out here on my front porch just listening to the acorns pelt my roof and driveway (yeah, I know I should be out there sweeping them—they’re as dangerous as ball bearings as you try to walk among them. Here it is two weeks into November and only now the leaves are starting to turn.). There must be some truth about the sun’s effects on depression. I always feel more peaceful sitting out here, even with the noise of the steady traffic. If only I got suicidal during the daytime. The first couple of times I felt suicidal after I came home from the psych ward, I tried to retreat from inside my house to the porch, but the darkness was still around me. It’s a shame that my porch is only a safe haven for me during the day.

I’ve been out here most of the morning and afternoon. This morning I watched my church parking lot fill with cars. This whole issue about going back to church really has me confused. I want so badly to attend, but I still cannot deal with all of the people and the eventual greetings and questions. How I wish I could sneak in where no one would see me.

Even before my world came tumbling down around me one month ago, I had already begun to isolate. I’d still attend church, but I started planning my entrance just around the time praise & worship had begun. Most didn’t see me as the doors are on the side. They sat in front of the doors, so I wasn’t immediately noticed when I’d take my usual seat. Then I began the habit of leaving the building immediately after the service was over to avoid everyone. The last time I even sat further in the back to make the getaway a little faster.

There is a row of chairs right by the door I always use, but there are a couple of folks that sit there. I cannot sit next to anyone. If I sit back too far, it just takes that much longer to get away. No, I’m not ready to go back my church. So, here I sit on my porch watching my church to which I so much want to return.©2009 (continued above...)

Another Lonely Evening Comes to Pass

I’m sure where to start with this entry. The house is quiet; I don’t even want to listen to music (pause) no, I changed my mind. Just opened my iTunes and am now listening to Frank Sinatra’s September of My Years. Hmmm, maybe the theme is a little too appropriate.

How do you explain to someone that you don’t want to get better? Yes, I’m about as mental as one can be. But, it is my comfort zone; it is what I know best. I know how to operate under this cover of darkness. Oh, sure, you must be thinking, why would someone choose to struggle with being suicidal so many nights a week? I do not know what normal is. I do not remember what being happy feels like. Was I ever happy—ever? Even when I was somewhat balanced while on my meds before I quit taking them, all I remember at best was being numb. At least when I am manic, I feel energetic; I feel as if I can do anything. Now, all I experience is the crushing defeat of morbid depression. Even after three weeks, the meds haven’t kicked in at all. My doctor keeps upping a dosage of one and waits a while, then he’ll add to the cocktail (he is rather conservative about how many types of changes he makes at one time). Either way, I don’t feel any different.

I am supposed to try to add yet another med tonight as a temporary measure to break my cycle of persistent insomnia. He wants me to take 10mg of Zyprexa an hour before I take the rest of my bedtime meds, and if I am not asleep in an hour, to take another 10mg. Then I have to do another phone call check-in with him again tomorrow (the addition of Zyprexa was the topic of our phone check-in today). He already knows how I feel about Zyprexa; it became a deal-breaker for me when I discovered what a weight gainer this drug was. Not trying to be recalcitrant, I argued with him since he already knew how I felt about this drug, but he said he only wanted me to try it for one week to see if it would break my insomnia and give sleep a chance. I agreed to take it temporarily. We’ll see what happens tonight. (Now Frank is singing “It Was a Very Good Year.” I wish I could say the same).

(later) I decided that I had to leave the house. The walls were closing in on me. I already know where that will take me. The weather is perfect outside. I decided to grab my atlas and don my new toys and go for a walk. I decided to go up to the corner Starbucks (yeah, I remembered to opt for decaffeinated). That meant I had to deal with people. I had no idea how many there would be. However, the evening was too nice not to go out. I was too exhausted to go for a power walk; there is no apparent rage seething within me at the moment—a welcome change. Just a short walk up to the corner to get some fresh air was perfect.

Starbucks just had two customers that were engrossed with each other, tucked away in the corner. I doubt they even noticed me. I got to the counter and looked up to the menu. There were so many choices. The cashier was waiting for me to place my order. I couldn’t make up my mind. I froze as she just stared at me and asked, “What I get for you?” a second time. Finally, I made my choice and just wanted to get out of there as fast as I could. Once I hit the door and the cool night breezes swept my face, I felt I could finally breathe. It was good to know I still had my bearings. I promptly left the parking lot and headed home.©2009

Appt with Psychiatrist Week 3

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