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
There are subjects that I have not caught you up on since returning to work full-time. I am going to use this week in review to address the various issues that actually encompass more than just this past week.
Iron Infusions: The study included receiving 1000mg of IV iron infusions. I received 200mg Mondays and Wednesdays for 5 days. Throughout the process, the clinical specialist drew blood to check my haemoglobin and ferritin levels. This study will go on for a year although no more iron infusions are to be given. All subsequent visits are geared towards monitoring my blood levels to see how I fare over the course of the year. On day 35, after the final infusion, my haemoglobin only rose to 12.1 (normal is around 12.3-16). However, my ferritin level (one of the key indicators in my case) rose from 5 before the study to 96. While I am pleased with the ferritin level, I still have borderline iron deficient anaemia. I am disappointed that my haemoglobin did not rise any higher. I am curious to see how the blood level results will be over the rest of the year. My savings grace is that I have not had to pay for any of this as being part of this clinical trial, and the added bonus is, once I have completed the yearlong study, I will be compensated for my travelling costs.
Vitamin and Mineral Deficiencies: If you recall, I began having symptoms of ataxia on 13 November 2009. It began with being unable to keep my balance then progressing to ocular involvement called nystagmus then to short-term memory loss. I failed certain neurological tests (most notable the Romberg test. The combination of all three symptoms indicated that I had Wernicke’s encephalopathy that does, in effect, eventually causes organic problems with my brain. If left untreated, the transient symptoms will become permanent. It was suspected that mine was caused by a vitamin B1-Thiamine deficiency. As a result, my GP decided to run a huge panel of vitamin and mineral blood work. The results showed that my B1 levels were undetectable as well as my Selenium levels (essential for the proper functioning of the immune system). I was ordered to start taking 100mg of B1 twice a day and 200mg of Selenium once a day. After six weeks, the repeat blood tests showed marked improvement and my balance had almost come full circle, although I still have some ocular involvement and short-term memory loss (my brain is healing slowly). Another level that was far below normal was vitamin D. Instead of taking an OTC version of vitamin D, my GP wrote a prescription that I am to take once a week for eight weeks, then once a month forever. This does not even include the fact that I have to give myself 1000mcg vitamin B12 shots monthly forever. My doctor essentially told me that I would be taking these vitamins and minerals forever, along with a multi-vitamin that I am supposed to start taking. Coupled with all of my bipolar medications and the ones for my continued high blood pressure, I am swallowing a horde of pills a day.
Individual Therapy: Now that I am no longer in group therapy, I have starting seeing an individual therapist. 20 January was actually my third visit with her following the intake assessment and one follow-up appointment a couple of months ago (my group therapy took precedence). This visit I determined that one of the first factors I had to deal with was my borderline personality disorder. You’ll note further down in the link what the causes are—I meet all of them. In examining the causes, I decided to deal with my disruptive family history first. I have discussed at length in previous entries how I have been treated as a pariah at holiday gatherings these past seven or eight years always celebrated at my niece’s home. She patently exclaimed that I was not welcome the first time she hosted these events. I ended up attending, even though I had not received an individual invitation, as a result of my nephew’s insistence. He said, “Alix, family is family. You belong there.” When I showed up at the front door with my nephew, my niece clearly displayed her anger and let me know I was not welcome, but she could not refuse my entry because other people had already noticed me, so she was stuck. The entire time, even my mother showed her displeasure, I was uncomfortable. Always the queen of protocol, she said I should not have come because I did not receive an invitation. To this day, I have no idea why my niece hates me—my mother will not volunteer any information and my sister even told me not to confront her daughter. So much for my supportive family.
Getting back to my early years, I was sexually abused at age five. Upon my mother and older sister finding out, my mother shook my shoulders and told me I was never to ever speak of this to anyone. This was during a generation when it was not understood nor dealt with. I was made to feel as though it was my fault. The family dynamic changed forever after that. I felt abandoned by everyone because no one would help me with all of the shame and guilt I felt. Years later, those memories were buried during the haze of my years-long addiction to smack and coke (I used to shoot speedballs). I eventually cleaned up and have been clean for 23 years. However, during my detox period, all those memories came flooding back. I worked up the courage to confront my mother about the sexual abuse and at first, she denied it ever happened. Then, with further insistence, she simply said it was in the past and refused to discuss it with me ever.
A few years later, my parents had a huge celebration for their 50th wedding anniversary. I was living out of town, but my mother wanted my son and me to attend. I simply asked if that particular family member who abused me would be there and she replied yes. Then she told me that I was only welcome if I did not create a scene. I promised I would not (always being the dutiful little girl trying to find that ever so elusive but never found approval). However, I was very anxious about seeing this family member (whom I shall refer here as L). I had not seen L since the memories surfaced. I was not sure how I would react. When I saw him I felt a flood of emotions wash over me and I was not sure I would be able to control myself, but I remembered the promise I had made to my mother. He acted as if nothing had ever happened. I kept my limited contact to perfunctory responses and immediately found someone else with whom to interact.
The next two obligatory times I had to be around L was my father’s funeral and my nephew’s first wedding. I could not keep my distance as far as I wanted because these events were small family gatherings, but I was determined never to attend any events where he would be present with the exception of my mother’s eventual funeral.
Or so I thought. My sister called me this week and told me she wanted to do something special for my mother’s 90th birthday in September. She wanted everyone to be there. Not only will I have to deal with my niece (a favoured one as she has produced my mother’s only great grandchildren), but there is an outside chance that L will be there. My sister did mention that L had declined because he had already booked a hike in Italy and that was his priority. To tell you the truth, that pissed me off. Isn’t my mother’s 90th birthday, an occasion that will never come again, something that should take precedence above all else? Tell me that he did not know that the week he booked his hike was during my mother’s birthday and that it was her 90th. How callous can someone be? Of course I already had a very poor opinion of him (to say the very least), but this was the last straw. As oxymoronic as this sounds, I hope he changes his mind, if only for my mother’s sake.
So, getting back to my therapy session…I made it a special point to tell P that this celebration would be coming up in September, one that is creating enormous anxiety for me, even now. I need to process all that has happened since childhood. Since the event is not until September, this will give me quite a while to try to come to terms with everything. I wonder what the process will be concerning trying to deal with everything. I can only afford to see her every two weeks, so I hope we can accomplish a lot.
My Psychiatrist: I am now seeing him every three weeks—a far cry from weekly appointments along with daily phone check-ins. R seems pleased with the state of my bipolar disorder, and so am I. The cocktail he has me on (Lamictal 200mg 2/day, Geodon 80mg in the morning and 240mg at bedtime, Provigil 200mg 2x/day, Lexapro 40mg daily, Ativan 2mg 4x/day, and Ambien 20mg at bedtime) has been very productive. I am being cautious about the Lexapro since it is an anti-depressant. In bipolar patients, while these types of drugs can battle the profound depression I found myself in, I have to be aware if I progress to any mania since these drugs can produce this side effect. I am monitoring this very carefully. I do not want to mess with this cocktail as it is servicing a precious need of keeping everything in balance right now. However, R has discussed getting me down to a maintenance cocktail that would probably result in taking me off some of this medication. I do not think I am ready for this yet. It been too soon since I tried to commit suicide. While I have made great strides, I still feel as though, at times, I am teetering on the edge. Even though my next appointment is not until 04 February, I know I can call him at any time. He always calls me back and spends however much time I need without the cost of an office visit. I am very blessed to have such a wonderful psychiatrist.
My return to work: The days leading up to my first day back to work on 04 January was met with much trepidation. I was full of fear and anxiety as much as I tried to stay in the moment. As part of my medical disability status, R sent a letter to the group managing my FMLA program indicating that I should only work four-hour days the first week and six-hour days the second week. My manager was very supportive about that suggestion. I also asked my manager if I could adjust my schedule to work 0700-1530 opposed to 0800-1630 which he agreed to. This serves a two-fold purpose. First, it frees up the afternoon to make available opportunities to have my continued appointments without missing work. Second, I am finished working while the sun is still shining—something that is important to me. I used to hate waking up in the dark and finishing my day in the dark, especially during the Standard Time Zone in winter.
The first two weeks my manager wanted me to concentrate on taking some mandatory computer-based training that was indicated during my absence. Then he wanted me to cull through the 1000+ emails that had collected during the three months I had been away. Just as an aside, no one from work ever knew why I had been on medical leave. Nevertheless, I had to explain to my manager that one of the side effects of my “treatments” was a vitamin B1 deficiency which resulted in a transient short-term memory loss. He seemed to take that OK. But that factor gives me a lot of anxiety as I don’t remember how to do a lot of my job. I was only in this new job for two-and-a-half months before being gone for three. So, I am still on my learning curve. My team may not appreciate the fact that I still have to ask questions, especially on some things of which I had already displayed knowledge.
After the first two weeks, then all of my clients were informed that I was back to supporting their accounts. Just when I had cleaned up my email box, as of the 19th they started flooding in again, yet another source of anxiety. I made it clear that I was not capable of working any overtime, so I am always left with emails that I have not read by the end of the day only to snowball into the next day. Too many critical projects are all happening at the same time. Meanwhile, my day-to-day responsibilities go on.
I try to stay in the moment each day and that, along with relaxation techniques such as being mindful and deep breathing, are helping somewhat. I have to admit, my Ativan plays a roll here as well. My goal is to do the best I can for my clients during my eight-hour day, and when that is over, to simply walk away from the laptop and let my business line go to voicemail (I work from home). I am giving myself room to acknowledge that I am going to be slow on the uptake for a while, but I have to believe that, at some point, I will be back up to speed.
Overall, I am now in a much better space than three months ago. I am quite surprised at the insight I have discovered about myself along the way. I know I will never “recover” from my bipolar disorder and will be on my meds for the rest of my life. That is a sobering thought (and an expensive one—the Geodon alone costs about $1200 before my $1200 yearly deductible is met). It hurt to pay that much a week ago for my refill, but how many people can say that they have met their deductible during the second week of January! At least now, my coverage for everything is at 90%.
I know this was a long entry, but I had so much to review. It is my intention to do a week in review each Saturday since I am back to work full-time. I have to admit, after being on the computer all day at work, sometimes the last thing I want to do is to get back onto my own computer after work.©2009
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
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
Today our regular group therapist was out. The person taking her place normally works as the inpatient intake therapist, so I was not sure how group would go. As I mentioned in a previous post, our little group was getting much bigger. When I looked around I noticed that we had three more new admits. I feet as if I no longer have a rapport with my group now that the original members have all been discharged. I have been here the longest—two months. Most people only stick around for four to six weeks.
I no longer feel that the group sharing part is meaningful to me since the other patients have no history of my background and what I have been through leading up to my time just before I joined the group. However, the second half of the session is still meaningful since we discuss the various tools to use to keep our emotions in a healthy balance.
Well, today was a little different. This therapist had a lot more to say for each person as each patient was sharing. I really liked his style. Looking back, I wish he had been the therapist all along. This is not to say that the regular therapist is not as competent—their styles are just different. I am still trying to process the increased depression I have experienced this past week as my financial situation looks so bleak. Most of the patients are on SS Disability full time. I do not see how they can afford it. When it got to my turn to share, one of the other patients suggested that I should file for bankruptcy. Aside from using the “should” word which imparts a value judgement, I cannot fathom filing for Chapter 7. I incurred this debt and I have an obligation to pay it off. He practically bragged about the fact that he filed two separate times. I just cannot imagine someone brushing off his or her obligations like that. Besides, I still have to get another car—how the hell I’m going to afford that one is still up in the air. My car is starting to make telltale noises, so I know it is not going to be around for much longer. I will never get financing if I file for bankruptcy. I have to be practical here. Because this therapist had a lot more to say with each patient, we spent the entire three hours going over our check-in sheets.
I cannot imagine not being apart from this group therapy. Despite the fact that I whined about it so much in the beginning, I have really benefitted from it. I found out yesterday that my medical insurance will only cover 27 sessions making this coming Monday my last day. Oh, yeah, I forgot to mention that the disability group that processes the claims did approve my extension through January 4th. I would like to be able to continue with this therapy for as long as I will be out of work.
Now that I have a fixed date to return to work on January 5th, I have to start planning for it. My FMLA runs out pretty much at the same time, so I no longer have any choice. I will be going back to work so I need to get that in my head and just deal with it. Oh how I wish I could afford to be on permanent disability. It is not as though I am being a gold brick about having to work. It is just that the job I have is very high profile and creates a tremendous amount of stress and long hours. It is going to be a rough transition after being out of work for two whole months. However, I am going to try not to stress out over that. Nevertheless, I cannot ignore it either.
Well, I have another appointment with my GP again today right after group to get another iron infusion. I sure hope that person from the lab is there as he has been far more successful at starting my IVs than the clinical specialist has been. You should see my poor arms and hands.©2009
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
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
Today I am gong to try to go back to my church after nine weeks. I am feeling very anxious about this. The anxiety has been focused just upon opening that door after all this time. I plan to arrive after the service has started to avoid anyone ahead of time. I know people will notice when I come in and I am also anxious about what to do after the service. Do I leave early the same way I came in? With my cane, I am not walking as quickly as I could. What happens if someone comes out to the parking lot after I leave as I walk across the street back to my house? My exposure is greatest at this point. On the other hand, do I stay until after the service and just get it over with and let everyone welcome me back? I have 45 minutes before the service starts and I am trying to use my tools to quell this anxiety—stay in the moment and not try to project—take it 5 minutes at a time if I have to…
(later)… About five minutes before leaving the house, I decided to do some deep breathing exercise to calm me. That seemed to do the trick. I walked across the street and approached the front door having no idea what to expect. I opened the door and the service was late getting started, but everyone was sitting in their seats. When one individual noticed me, she said rather loudly, “Hi Alix,” and that was it. The service started and no one paid any attention to me. The message that the pastor preached was a good one for me to hear. It was all on how a mighty God we have. At the end of the service, I stayed for a few minutes and it was the dénouement. No one came up to me. I think I was a little bit disappointed, but I did not have to deal with anyone. Maybe everyone was just respecting my space. Therefore, I stood, put on my jacket and walked out the door feeling a little lonely. It is odd, while I had such anxiety about dealing with everyone, when everyone had the chance to say hi to me to welcome me back, no one did. Maybe next week will be different. But, I finally crossed that threshold.©2009
Today’s session went really well. My therapist said I had made such strides over the last seven weeks that she agreed that I could be discharged on the 18th. Today, in fact, we had some new people and some that have been in the group for a little while that had it rock bottom and the therapist used me as an example how things can really get better. I feel good about myself today—something that I did not foresee being able to say even a couple of weeks ago.
I have built up a small coterie of close friends that know me intimately—the ins and outs of my mental illness. This has become my support group, yet another thing I about which I did not even think about. I was isolating so much and vindictively pushing people away to purposely further isolate me. The ironic thing is that the majority of this small group is made up of people with whom I had gone to church. That is my next major hurdle—reinserting myself back into my church. I am feeling less anxious about it, but something is still holding me back. Perhaps it is because not everyone knows my complete story and I certainly do not want to share that with anyone who has not been along for the ride.
I still do not know what “normal” is, but I feel more content than I have for a long while. I have not had any suicide ideation for a while, but the main concern I have, feeling this good, is that I am not ramping up to swing into the manic dark side. I am carefully looking for signs, and my friends know what to look for, so they may see it before I do.
I am going to try to go grocery shopping by myself, cane aside, this weekend. I will see how I deal with being around a large group of people. This should be a good test for me. It has been the one hurdle I have not passed (aside from returning to church). I have gone shopping with a friend that lessened the anxiety, but it is time I try to do it for myself.
I also saw my psychiatrist this morning before group. He also seems pleased at my bipolar improvement. Now that I am getting about six hours of sleep these last two days he has agreed to start reducing my Zyprexa, yet one less pill to take. He is going to submit an extension of my disability (currently ending on the 16th) to return to work on Jan 4th for two weeks at half-time to gradually get accustomed again with full time beginning on the 18th. I hope they approve this extension, as I am simply not ready to return on the 17th. He is not sure if it will fly since I have made such improvement, but he is certainly going to try. He is going to send in the paperwork on Monday.
Well, folks, that’s my story for today and I am sticking by it!©2009
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
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
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
Waking up for the day at 0200 makes for a long day, to be sure. Sometimes it is when I am most prolific; this morning I just sat around, drank some hot tea and listened to music. I had a better day yesterday and it is good to feel this way.
I met one friend (K) for coffee at the Starbucks around the corner from my house (the same parking lot where I egged the patrol cars. Even though it is within walking distance from my house, ever since I have had to resort to using this cane, I asked if she could drop by my house and pick me up. We spent close to two hours just talking about everything in our lives. K showed me some text messages (that I do not remember sending on that ill-fated night. You could tell that I was getting progressively more drunk as some time passed; the texting in some cases was totally illegible. It was odd to see some evidence of the state of mind I was in during that whole crisis.
The time spent together was good for me. I got out of the house, which I desperately need to start doing, and I was able to spend time with an old friend whom I rejected quite despicably the night of that debacle. Although I sent her an email a week or so ago to apologize for my ugly actions, I had not seen K face-to-face since I had been committed. It was good to be able to talk with her. In one of my earlier emails to her, I established my boundaries and she totally understood my needs. She acknowledged that she did not quite understand all of what BPD encompasses, but knew, through reading my blog, the depths of what I have experienced. I was able to spend time with a good friend and did not wear my mask. It was not that scary. This has helped me open the door to more opportunities. And last night when I was alone in my house, it didn’t seem as ominous. I actually enjoyed a good evening at home by myself—something that would not have been able to say before this.
While it was hard to make that first phone call to invite K for coffee, and I was very anxious when she first came by, I was not sure what to expect. However, she put me at ease immediately. She came up to my door to help me down the front stairs and into her car (I hate that I have to move so slowly these days). We ordered our coffee, sat down and started talking as if no time had passed. I soon felt quite at ease. This was a break-through opportunity for me—one that I can continue to make, I hope. They told me in group that I just have to practice using these tools before I can become comfortable using them. About the only time I got uncomfortable was when this person chose to sit right next to us in a room filled with empty chairs and sofas. I could feel the anxiety rise, but kept it to myself not wanting to spoil the moment. I just mentally put up some blinders and avoided his presence. Thankfully he did not stay long (he did not even buy any coffee!).
So, yesterday marked a big step forward for me. And I am going to take that at face value and accept that progress for what it is.©2009
