Pulling on the Reins

Firstly, I’d like to apologize to my readers.  I have not be a good blogger, and I have not been able to keep up with other blogs at the moment.  My emotional life has been chaotic, at best.

Lulu's Recent Moodscope

I’ve had a couple of 60’s and 70’s.  But, I’ve had many days that were in the blue.  I noticed what the defining factor of my highest days was.  Exercise.

Training is exhausting, but I absolutely love the run.  It does take a lot of my time and energy.  I’ve realized that I need to work on me for awhile.  Without this work, I will crumble beneath myself.  It is imperative that I start cementing my own foundation.  I find it crucial that I start defining myself in different ways, through expansion and reassigning attributes.  I find the need to grow beyond what I am at this moment.

I want to make this clear.  No, I am in no way leaving Pendulum, Canvas, or abandoning Blog for Mental Health 2012.

In fact, I am reprioritizing my blogging and my life in general.  Where these things make the top ten, in importance.  I’ve realized that mental health blogging, and mental health advocacy through blogging are extraordinarily important in my life.  I have not been giving them a great deal of priority as of late, and I find it incredibly unfair to others, including myself.

Shorting myself is something that I seem to be painfully talented at.  It is too easy for me to become complacent and put the needs of others before my own.  In my personal life, I need more freedoms.  I need more alone time.

I need to stop begging, borrowing, and stealing time.

I have to stop feeling like I owe things to people, and get trapped in a self-perpetuating cycle of obligation and manipulation.  As far as I’m concerned, I have paid my debts.  The rest is for me.

Selfish or not, that’s the way it is.

Again, I am too passive.  I am too complacent and find myself working too hard to keep the status-quot when I am completely dissatisfied with it.  My foot is down, planted on sturdy, firm ground.  I am taking a stand.

Instance:
We took a brisk, early morning walk to our local pharmacy.  It’s not too far, about a mile or so.

I had warned C.S. that it may take more than a few moments for them to fill my prescription.  Sometimes, I have to wonder who is the woman in this relationship.  He huffed and puffed, and we moved around the store.  I picked up some essentials, and have been craving new writing pens.

(I will have them.)  They just didn’t have the ones I liked.  But, a frivilous purchase, although I am a school teacher, was out of the question.

The pharmacist asked me what I’d like to do with my b/c script.  It’s not due to be filled until the 9th.  Except, for some reason, I’m early.  It would have had a co-pay that day, as opposed to not having a copay if I could wait it out two days.  I turned to ask C.S.’s opinion.  I do need the medication, but not that badly.  I can make up for missed pills.

He sat there, with our son and hassled me.  Get the pills.  Let’s go.  Beast is starting to get fussy..  I turned to him and said firmly, “I am making decisions about my health and our finances.  If you or T.D. is having a problem, then kindly take him outside and wait.”

The walk home was difficult.  Not in the sense that it physically bothered me.  I’m in fantastic shape, putting a many miles under my feet.  I went on this tirade.  “It is not your mind, and it is not your body.  It’s none of your business.”

To which he replied, “I’m paying for it.  It is my business.”

“It’s not.  You don’t live inside of me.  You don’t know what goes on in there.  You have no interest in it either.  Butt out.”

I despised that phrase, “I’m paying for it.  It is my business.”  On two fronts.  I pay my contribution toward the severe detriment we suffer due to my extensive medical needs.  I commute and hour each way to do so.  It is not as if I am laying around a sofa all day, spending all of our bank account.  Don’t portray me as so.

I had pointed out at one point that he was not my legal guardian, and no living will exists to proclaim him my proxy when and if I become incapacitated.  Damn fine move on my part.

He plays no role in my treatment.  I have signed releases that he has full access to my records.  He has never spoke to my doctor about any troublesome symptoms.  In fact, as much I hate to admit this, I would be likely to declare my indecisive mother a medical proxy.  She’s done so well with the rest of the family.

I am pulling in the reins.  This carriage will not continue until I say so.  It is my life too, and I feel like I’m being completely left out of it.  This is my stand.

But, verbally sparing and expressing emotion is a tricky engagement in my household.  So, pulling in the reins is more than taking full control over own life and those dealings.  It is pulling in the reigns of my marriage.  I am pulling back.  Plans change to suit him.  I am disappointed.  Therefore, I am pulling back.  I don’t depend on him for my happiness.

I want to, I want to be someone else or I’ll explode.

Radiohead - Talk Show Host, most commonly known from Romeo + Juliet

Oh, Fluck!

With enough wits, a person might be clever enough to deduce the meaning of this Luluism without the aid of a definition.

Fluck (fah-lah-uck): a combination term used as an alternative to a swear. It is used to describe an intense negative reaction. Derived from “f***ing luck”.

As in: Oh, fluck! I forgot to pick up my Lamictal from the pharmacy! On a Sunday night. When they close early. And I won’t have enough time to grab them until after work on Monday.

Fluck.

This realization didn’t hit me until I was going to make the attempt to refill my weekly pill case. I finally broke down and started using one. A lot of good it did me. I ran out on a Saturday.

I stood there and stared at the empty container in disbelief that I could have forgotten something so very important. I have taken my Vitamin L daily, without fail for so long. I just plain forgot.

Understandably so. Production on Thursday, sleigh ride in the van-buggy on Saturday. I don’t believe I even called it in until Saturday night. Sunday morning mass and Sunday afternoon family function. In all of that travel, I passed the pharmacy at least four times!

Oh well. A day without Lamictal never hurt me before.

Quite reassuring now that I’m in the hot seat.

I woke up late, and seemingly amongst chaos. I could not wake up this morning for the life of me. I literally stumbled around, trying to get my footing. I never did find it, honestly.

C.S. left for work, and everything was mostly typical. I should have felt it happening. Slowly, the reigns slipped out of my grip. The horses started running more freely. The ride became bumpier. When I did notice, it was too late. Each time I’d made a solid grab, I opened my fist to have them fly further away.

I dare say that my emotional stability is crumbling under the very path I’m walking on!

By afternoon, I was spitting certain phrases like a bad taste in my mouth. “I hate my effing life!” “That irritates the hell out of me!” “Shut up!” It’s as if I were dangling by a flailing string. The wind would shift and suddenly, “I’m so sorry. I’m sorry. I hate myself for being so horrible.”

Over little things. T.D. got into my makeup and my jewelry again today. He has made a real mess of things in my room. I was infuriated. Makeup and jewelry are expensive!!! But – they are just stuff. The world was ending! I couldn’t find my good headphones where I can actually hear music and conversations on my Blackberry! And I carried on about it to C.S. for at least fifteen minutes of his break.

Yup, there are plenty of reasons to hate myself today.

Then, the ultimately bad phrase popped into my head. I want to kill myself. Red flag. And I threw it out there on my playing field, oh so silently. I don’t want to rouse suspicion. I am at work after all.

I should have realized this was going to be the result at the very time I skipped the dose. Not even an hour later, I had the best sex of my life. It was complete with saturation of every sense from every nerve. My brain was throwing out visual and auditory stimulation that it doesn’t usually do. I don’t know why I don’t find the clearest clues, right in front of my face.

Live and learn.

Don’t sound the alarm. I’ll be fine, but it is my top priority to get some medicine into me, fast. Something is going very, very wrong. But, until at least 7PM, I’m stuck in the hell of my own making.

Lesson learned. Don’t skip your medicine. Ever.

Antidepressants – Which Witch

“Can you turn the light off?”.

I touched the brushed metal lamp, and the dim light flickered off. There was a quick glance at the alarm clock – 12:38PM in glowing red numbers. Only a computer monitor playing Netflix illuminated the room. I was like a moth to a porch light in the summertime. It’s not the light you have to worry about. It’s just the attraction.

My eyes were fixed on the screen. I was entranced by the show, but it was just one screen in my mind’s eye. On another screen were stacks of paper and nameless faces of children. The tube next to it featured me, practicing endless monologues of the words no one will ever hear. Notebooks, pages flipping, with black cursive scrawled across each page. Blurry flashes of days, nights, people, and places past.

Yet, I was not compelled to do anything but sit idly and watch everything fly by at a speed that could’ve put a breeze through my hair.

This brain is entangled in itself while trapped in this useless body.

Another glance – 1:31. While my body was finally exhausted, my mind was still churning out the video feeds.

Finally, I let the screen go black. 2:14. And T.D.’s Developmental Therapist was scheduled for 9AM, which meant that I would have to be up at 8AM. Another less than 6 hour night. No dreams. Just darkness.

Why did I suddenly stop dreaming?

In A Mixed Bag, we determined that it was ultra-rapid cycling, probably brought on by a med change or an antidepressant.

I stumbled upon an article from psycheducation.org about controversies with antidepressant treatment with bipolar disorder. Here’s the problem. The depression and fatigue were crippling before. I couldn’t hold a job or take care of my life. Now, I am hit with rapid cycling every three months for about two weeks as opposed to four month of depression and one week of hypomania.

Which witch is the good witch and which witch is the bad witch?

Debt of Explanation

What do I say now?

I’ve written and rewritten and edited this draft for the last three days.

It originally started out with a rationalization:

Lamictal and hormonal birth control don’t play nice. When I first started Lamictal, I would take the bc placebos for that week and start exhibiting symptoms of PMDD. My Pdoc recommended that my OB/Gyn consider putting me on a continuous cycle for three packs and then have the off week. And I’ve been doing that for almost 2 years.

I have that liberty to schedule when Aunt Dot comes to visit. Risking a complete mental break down every 63 days was better than having to do it every 21. In the last year, the last couple had been pretty mild. I thought I was in the clear.

I lost track and went 5 months this time.

What person with bipolar disorder wouldn’t want to be able to blame conditions that are within their control?  I was telling myself that Monday would come, I would be back on the BC and all would be right with the world.  In the meantime, I adjusted my dosages – with no effect.  I did that a couple of days ago thinking I could put a bandaid on the situation until there was a real fix, meaning I straightened my meds out and all of this moody woman bullshit was over with.

PMS was a word invented by men to explain women’s emotional behavior.  (No offense intended to my male readers).  My husband discovered my self-inflicted injuries today.  Actually, more like he discovered the band-aid that I’ve been hiding under layers of bracelets all week.  He said, “What’s that?”  I answered in a low voice, with T.D. on my lap, “Nothing.”  I won’t lie.  I’m sick and tired of cowering in fear for someone else’s approval.  I didn’t lie to him.  It means nothing to him, but it will stay with me for a long time.

He asked again, “What is it?” And once again I replied in a murmur, “It’s nothing.”

“Every time you get your f***ing period, you have to go and cut yourself!!!”

I don’t recall being afflicted with such in my very first post, “To See If I Still Feel”. And I can honestly say that was the very last time I engaged in self-injurous behavior.

I’m starting to suspect it isn’t completely me.

Originally, I wrote:

My marriage has been on the rocks lately. My kid is raising hell. I have the crushing weight of being solely responsible for T.D., anything domestic, and work. I am expected to have time for everything. I am also expected to take all kinds of crap from everyone when something goes wrong. That is, surprisingly, with the exception of my boss and co-workers.

I have dealt with be mistreated and disrespected in my home. I have endured vicious criticism and blame. I am overwhelmed and over burdened. And anytime I speak up, not only am I wrong, I am intentionally starting trouble. Suddenly, my condition becomes a reality because it’s convenient to blame me “being a bitch” on having bipolar disorder.

I am falling apart and it’s not even at the seams. It’s from consistent strain and wear on my fabric. And when someone I let close enough to me starts taking swipes… it’s enough. It’s more than enough to come undone.

I wrote to a dear friend that I used to be able to depend on C.S.  I described all of the wonderful things he had been to me.  But now, I feel like I’m being pushed off the ledge and then kicked in the face when I finally hit the bottom.

Each morning, when I awake, I have been telling my dearest friends here that I’m doing better.  And each afternoon, I’m doing worse than the day before.  After that comment, “Every time you get your f***ing period, you have to go and cut yourself!!!”, I’m about to give it up.  I was mistaken when I said to my dear friend that I wasn’t sure that he was even aware of what he was doing to me.

We don’t get to choose our family.  Sometimes, we can’t choose who we fall in love with.  But we always have the choice to make the decision to devote ourself to each other through marriage.  How could someone who chose me, who is supposed to love me, be causing me so much hurt?

Where I End and “It” Begins

There is great mystery and confusion that surrounds us when we try to differentiation symptoms and personality. James, who writes the award winning blog James Claims, inspired me to finally write a piece on this subject with his shout out. Which is which? Episodes surely have a profound affect on our cognition and behavior. Then, what about medication? Does medication give or take when we are defining traits and types in studying our own personality?

Have you ever taken the Myers-Briggs Type Indicator personality test? If not, take a moment to review the MBTI. It doesn’t matter if you’re having an episode. The results are very reliable on a test-retest reliability scale, regardless. Don’t worry, I’ll wait.

(Pause.)

Anyhow, this subject of personality and the MBTI spawned from a conversation with Brandon who writes The Daily Bipolar. I had mentioned the MBTI and how we can get a more stable idea of ourselves.

I started taking the MBTI in 2007. I have taken it every six months since then. Each time, I scored ENFJ (Extroverted, iNtuition, Feeling, Judging). That is, until the most recent retest. Suddenly, I scored Introverted, iNtuition, Feeling, Judging – INFJ. How could a person go from a well established extrovert to an introvert?

Before I was diagnosed, I was all over the place. When I was hypomanic, I was the life of all of the parties. I could throw down with the best of them. I was always prone to doing things that were strange, dangerous, and / or illegal. And having friends that would be in awe and amazement at my latest stunts only added fuel to thay fire.

But in those days, I didn’t isolate myself when in a depressive state. I really leaned on my friends. I had no other support system. If I lost my friends, I lost everything. In those days, friends would take 3AM crying phone calls. A boyfriend would dedicate his Friday night to talking me through a depressive compulsion, like self-harm, and not think of me differently. Before we were together, C.S. used to insist that I come to his apartment to stay for awhile.

I was already married with a baby when I was diagnosed. I have been in treatment for Bipolar Disorder II for two years. By treatment, I mean several different psychiatrists have shuffled pills at me, and I faithfully swallowed them. I went through a lot of life changes in that time, too. I settled into my domestic life and started a career path.

What’s different now?

Firstly, I am a mother and a wife. Week long benders and non-stop parties are out of the question. In fact, most of my social life crumbled. I have a strong dedication to my family. I will do anything to ensure their health, well-being, and happiness.

I had dedicated myself to school and am beginning my career. I have great enthusiasm for teaching and music. Many of the dreams and ideals that had been trampled in my past have begun to emerge once more. Arts, music, literature, philosophy, politics, and the pureness of real love were all resurrected.

My vast social network dissolved. And do you know what? I don’t really care. After all of it, I’d rather be alone. I much prefer using my time to enjoy family and intellectual pursuits. These activities would be art and literature mainly. That is opposed to wasting time investing in people who will never be a good friend.

Much of this wouldn’t have been possible for me without the medication. I have more control. Having the ability to regulate my emotions has enabled me to have a more solid marriage. It allows me to be the best possible mother I can be. Even on a bad day, I can still pull myself together and responsibly honor my obligations. My judgment is better and I’m more logical than ever.

I regained and retained all of the great things about myself with only a small fee. My short-term memory is shot. It wasn’t great to begin with, but Lamictal completely did it in. Unless I repeatedly write something down, like a name or a phone number, I will immediately forget it. And by getting the bipolar disorder under control, I unearthed a terrible underlying anxiety.

In my adult life, my attention has been focused inward. When I was officially diagnosed, I knew that I couldn’t escape it any longer. It is time to work on myself.

And my E changed to an I.

Holding My Medicine Hostage

If only there were chains...

Today was the big day. I was rescheduled to see my psychiatrist’s nurse. I had to beg my mother to babysit T.D. and bribe my father to drive me the 15 miles up there in rush hour traffic, but I made it.

Here’s the big deal about going to see my pdoc. He’s located 15 miles away, I don’t have access to a car because C.S. takes it to work, and I have no one to watch T.D.

To be honest, I don’t have a great relationship with my parents or siblings. We don’t feud anymore, but decades of doing so has left our relationships strained. The state of our relationship only matters a little. They aren’t very giving people, and each “favor” ends up being a debt that can be called for repayment at any time. I’ve known more understanding loan sharks.

My friends work. And I’m also very particular about who watches my son. I prefer mothers, experienced nannies and babysitters, or female teachers. Those seem like high standards for babysitting a kid for an hour, but I consider it to be reasonable for a child with PDD-NOS and a significant speech delay. Would you leave your baby with someone with limited experience with babies? Though T.D. Is not quite a baby chronologically or physically, the same principals apply.

I actually made it there early, despite the traffic. But, it was certainly a “hurry up and wait” situation. Not only did I end up waiting the 15 minutes that I was early, I waited an additional 15 minutes past my appointment time. That is 45 minutes that my father had to wait around in the parking lot for me.

And all for what? Exactly what I predicted – a pitiful, unproductive, and largely inconvenient appointment with a nurse practitioner who probably shouldn’t be dealing with the likes of me.

I outlined the problems and ineffectiveness of my medication very clearly for her:

      I’ve been so depressed that I gained 10 lbs in three months. She answered,

“That kind of weight gain is practically impossible on Lamictal and especially Wellbutrin.”

      Yeah, I know. Both of them are notorious for weight loss. I have a genetic predisposition for extreme weight gain. That’s why I chose them.

My anxiety is unmanageable. I have regular anxiety attacks over every little thing. I’ve developed migraines over this again.

I don’t sleep anymore, apparently. I’ve been taking supplements for insomnia and now they don’t work. I started taking over-the-counter medication for it, but you can only take that in moderation without risking frying your liver. So, now I’m stuck with increasing sleeplessness.

It’s been about 6 hours a night off and on for two months now, and has been every night for the last week. And some nights, it’s 5 or less. Last night, I slept 4 and a half hours. I used to become hypomanic when this occurred. Now, my brain and my body are so tired that I am in a perpetual fog where I am completely dysfunctional.

    My moods are all over the place and I am highly reactive. This began slowly about two weeks ago. It started as only certain things that could trigger an unpredictable response. I would laugh hysterically, cry uncontrollably, or fly into a fit of rage at the drop of a hat, for seemingly little reason. Now, it’s progressed into constant states of arousal. I’m either delirious with hilarity, extremely irritated, or crippled with depression.

The nurses solution? Increase the dose of Wellbutrin and let the doctor determine the rest two weeks from now. My suspicion? She’s not allowed to adjust any medication other than antidepressants.

So now I take my medicine like a good girl and hope that I can manage my life within my two week period of the waiting game.

I decided that I hate nurse practitioners masquerading as psychiatrists more than I hate doctors.

Ugh.

Called Off?!?!

I was prepared for my psychiatrist appointment this morning, for a change. With the help of my bipolar bloggers, namely Ruby and Manic Monday, especially when referring to the post The Case of the M&M Interactions.

I had determined that my medicine is not right for my current symptoms. I’m cycling faster and faster. And the irritability has returned. I’m not grumpy – I’m flat out pissed. And I’m always a ticking time bomb as a result. I can’t sleep at night and it’s hard to be motivated in the day. This med check, as annoying as they usually are, was absolutely necessary.

My doctor is located about 15 miles away, so it’s quite a trek to get there, and usually very inconvenient in my busy schedule. I arrived early only to discover that my doctor had just called off 10 minutes ago. It was absolutely enraged. I had dragged myself out of bed extra early, called my mother out to sit while T.D. slept, inconvenienced my husband to take me up there before he went to work only to be sent away. WTF?!?! I know things come up. But there was absolutely no consideration for his patients.

To make matters worse, I had to sit and wait an unacceptable amount of time to be rescheduled. Where is the level of professionalism in that office? I watched the minutes pass and knew that if I didn’t get out of there soon, C.S. would be late for work. And even worse than all of that, I had to push to be scheduled before my medicine ran out. That left me to be scheduled with Nurse Betty. I know what she’s going to say. The same thing she says every time I have a complain about my medicine, “We’ll keep you on these medications and see what happens. I’ll have you scheduled in a month with the doctor.” UGH! Why bother?! Wait, oh yeah. They are holding my medicine hostage.

I really hate doctors. Seriously.

The Case of the M&M Interactions

I had a psychiatrist once tell me that the psych meds were all “M&M’s a different color”.  Doctorspeak for, “Same thing, different packaging.”  How refreshing.  At least she was honest about it and didn’t make it seem like one thing was going to be the miracle cure.  That’s now how I refer to my cornucopia of medications.  M&M’s of a different color.  I’ve got my big white ones, little white ones, my shelled white ones, the big bulky blue breathey one, and the mac-daddy of suppliments I take to keep everything else under control.

I’ll take you through a quick run-through of the normal of chronic ailments and then medications.

Bipolar II
Mood Stabilizer:
Lamictal (lamotragine) – 100 mg twice daily = 200 mg

Antidepressant:
Wellbutrin XL (bupropion) – 150 mg once daily

Sleep Aid: (insomnia)
L-Glutithoine (nutraceutical)
L-Theanine (nutraceutical)

Generalized Anxiety Disorder
Anti-anxiety (benzodiazepine):
Ativan (lorazepam): 1 mg, three times daily = 3 mg

Asthma:
Ventolin (no generic)- 2 puffs every 4 to 6 hours or as needed

Migraines:
Maxalt (no generic)- 5 mg when you feel a migraine coming on

Tendonitis of the Knee and Genu valgum (Knock Knee):
Ibuprofin – 200 mg every 4 to 6 hours or as needed

High Cholesterol:
Garlic (nutraceutical)
Omega3 Fish Oil with DHA and EPA (nutraceutical)
L-carnatine (nutraceutical)

Regular Suppliments
Vitamin C
Vitamin E
Vitamin B-12 with Folic acid
Pantothenic Acid
Bioflaviniod Complex
Bromeline 3000
Ubiqinol (I highly recommend this one for fatigue but it’s pretty expensive)
And probably like 10 others I’m not thinking of right now.

And of course, I am a woman of childbearing age, so throw in an oral, hormonal contraceptive.

Throw in 60 mg of prednizone, and a Z-pak and you’ve got a medicine soup.

Think about all of the doctors we have. Pdoc, PCP, OB/Gyn, Neurologist, Orthapedic, etc. Now, consider that despite the hundreds of times I relay the medications from one doc to another, it probably widens the margin of error.

I’m finishing this on my phone so I have to put the full link on.
http://reference.medscape.com/drug-interactionchecker. This is a comprehensive multi-drug interaction checker. Slap ’em all in there and it’ll tell you. Of course with a little doctorspeak.

Turns out azithromycin (z-pak) doesn’t play well with hormonal bc. Pregnancy risk. Hormonal bc doesn’t play well with lamictal and prednizone by increasing the metabolism rate and having higher concentrations in the blood.

Who knew?