Started Paxil tonight. We'll see how it goes.

Trip to the Psychiatrist

My psychiatrist continues to press me about adding an additional anti-depressant to my routine. Something about taking three meds is causing me a mental and emotional block. I just don't want to do it. I've given this a lot of thought and I really don't know why.

And truth be told, I am probably continuing to struggle with more depression than I want to admit. It gets really old to go about my day - practically every day - with a constant stream of self-harm thoughts. Some days the thoughts are more intense than others, but there is an almost constant din in my mind.

And it tires me out.

I know that feelings eventually pass with time and that it's not good to make major life decisions when I'm in this state of mind. Even so, I find myself feeling very alone.

The Dream Killer

A few months ago my husband was "let go" from his job. Our health insurance will run out in about five months. (Right now we're on COBRA, 2/3 of which is being subsidized by his former employer.) And I'm REALLY starting to feel stressed about the thought of losing our health insurance.

The thought of hundreds of dollars of medication each month and visits to the psychiatrist...

Well, it's keeping me awake at night to say the least.

The nature of my husband's occupation largely lends itself to contract work, which doesn't generally lend itself to getting health insurance. And since I have a pre-existing condition, I can't buy private insurance. I HAVE to be on a group plan.

See the dilemma?

The impact of this situation hit my husband a couple nights ago. He's worked so hard to make his dream career come true, but it seems like he can't ever connect the dots in quite the right way. I think he's starting to "feel his age" and wondering if this is his last chance to achieve the kind of success he wants. But getting a steady 9-to-5 type job would probably mean letting go of his dreams forever - or at least not having time to pursue them.

He's the kind of guy who will "do the right thing," but it will break his heart all along the way and it hurts my heart to know that my disability has put him in this situation. I wouldn't blame him if he's wishing he had some kind of "rider" on that whole "...in sickness and in health" clause in our wedding vows.

Therapists are Not Magicians

Wow, it's been a while. Just a quick thought...

One of the most common errors I have seen is that people who struggle with mental health issues seem to assume that doctors and psychologists are magicians. Newsflash - mental health professionals don't have the power to "make" anyone better.

I like to think of psychologists and psychiatrists as being more like coaches. They point the way. They can give you guidance and feedback. Some coaches are better than others. Some have specialties. Sometimes a coach works for a while and then you outgrow him or her.

Ultimately, however, progress is up to you. Patients are the REAL key to successful treatment.

Stupid Television

The Fox network has a new show that centers around the adventures of a psych hospital: Mental. Unfortunately, what could be a genuinely interesting, thought-provoking, and helpful show sounds like it's really just an overblown soap opera. Here is a brief review from author and trauma therapist, Robin Shapiro.

"Mental" is Terrible

There's a new fantasy show on Fox: Mental. It's supposed to take place in an inpatient psych unit.

So, first, the new head of psychiatry strips down in a room full of clients to connect with a psychotic guy who has pulled his clothes off. Later, he breaks into a woman's house in order to check out his hunch that her schizophrenic brother is an artist. And he thinks it's a good idea for his patients to go cold turkey off their antipsychotic medications. And he doesn't lose his contract, immediately.

All the psychiatrists are cute. All the patients are reasonable. The families just don't understand. And the residents and other psychiatrists have endless time to spend with their clients. Oh, and they invented a radical new idea: intensive outpatient day treatment.

I saw bad treatment, silly ideas, and a romanticization of extreme mental illness. I saw nearly every 1960's cliche possible. It's really bad. Except that all the psychiatrists are cute. And the new head of psychiatry looks to be about 32. That would happen, too.

I'm hoping the show will bomb in the ratings and go away quickly. One thing the world doesn't need is one more reason not to get professional help for psychiatric disorders.

Breakthrough

Ever hear that saying, "It's always darkest before the dawn"? I know it's a cliche, but every cliche has a degree of truth. And in the situation of dealing with in therapy recently, it's very true.

My psychologist and I have been working through a huge issue the last several months - getting to a point of feeling safe enough in therapy that I can disclose more of myself. I hadn't realized how much my previous experiences in therapy 20 years ago were so traumatic, and consequently, holding back progress in my current situation. Processing these experiences has been the focus of our brainspotting/EMDR sessions in the last month or so.

This is what led to much distress for me. As all of those feelings rose to the surface, chaos followed. But really, that's to be expected. Those traumas haven't been properly "filed" in my brain yet. They've just sort of been floating around. Bringing them to the forefront temporarily is the only way to truly deal with them.

So, it should really be no surprise that the very experience of going to therapy has become semi-traumatic for me recently. It feels like I'm constantly reliving my experiences from 20 years ago. But when I abruptly left session a couple weeks ago and then played hooky the following Monday, I felt empowered enough to go back last Wednesday. My therapist didn't lash out at me. She wasn't mad. All of the things that I had experienced in the past now had a new response. I could essentially write a NEW history. I felt freer than I ever have in 5 years of therapy with her.

I said something toward the end of the session that provided another breakthrough. I said something to the effect that I knew that giving the appearance of caring about me was part of her routine. She said something to the effect, "Huh? What do you mean?" That led to a conversation the following day about how my first therapist told me once that it wasn't her job to actually care about me, only to give me the appearance that she cared.

Now you have to understand, my current psychologist is extremely professional. She rarely shows any kind of emotion, which makes her hard for me to read at times. But in that moment, I saw of look of, "WTH? Are you kidding me?!" Then, she quickly recovered and said, "Is that what you think I do?" Yeah, I guess I did. I thought that pretty much everything she has done for the last five years has been pretense and pretending. I've wanted to believe she genuinely cares, she gives every indication that she does, but the words of my previous therapist were holding me back.

In that moment, I finally actually believed that she cares, truly cares, about me. And that, I think, will become the foundation for being able to move on to the next round of EMDR. Now the question becomes, which trauma seems the most urgent for me to process next?

It's in situations like this that I'm reminded how much courage it takes to face mental illness. But I've had enough successes to know that it really is darkest before a significant breakthrough. Chaos, when dealt with properly, can truly lead to healing.

Well, duh...

Do we really need a scientific study to tell us this?

"Bipolar patients often relapse: study"

Seriously? We didn't know this already?

Detaching

I played hooky from therapy today. I flat out didn't want to go. EMDR is just so intense. And after the fiasco last Thursday, I felt like I needed a break. But, of course, instead of just rationally telling my psychotherapist that I need a break, I emotionally detached from her and sent her a text that I wasn't coming.

Lame. Really lame.

I'm going to try and get up my courage to go on Thursday.

Updates

I finally saw the psychiatrist last week. He wants to try me on Lexapro again, to see if that will get me out of this depression I've slipped into. I'm not thrilled with this idea. I went through that routine back in January of 2006. Lexapro made me so manic that I didn't sleep for five days. It was awful - almost as bad as when I was on Cymbalta, which made me want to beat up my children and punch holes in the wall.

I'm kind of balking on this idea at the moment and haven't filled the prescription yet. Meanwhile, however, I know that what I'm taking doesn't seem to be enough. Between all of the intensity of EMDR, struggles at work, a strain on my relationship with a close friend, and my medication malfunction, I'm kind of a basket case at the moment.

Meanwhile I just keep plugging along. I haven't gotten fired from my job and my husband still wants to be married to me, so it can't be all bad, right?

Trapped

Ok, so I went to therapy this morning, just like I do every Thursday. We've been processing a bunch of memories from trauma with a previous therapist. It's been hard, intense, and overwhelming at times, but overall I think I've been managing things pretty well.

But something happened toward the end of today's session. Something was triggered.

I started panicking. I didn't want to leave because I had this overwhelming feeling that I was going to harm myself, like run out in traffic or something. My therapist's office is on a super busy road, so it was easy to envision that happening. It was awkward because we needed to end the session, but she could see that I was clearly in distress and she was worried about me. And rightly so, I think. I was in no state of mind to have clear thoughts at that moment.

She offered to let me sit in her waiting room while she did her next session. I thought this sounded like a good idea. I promised her I wouldn't leave (read, run out in traffic). At first, I was ok and I was able to calm down. But after a while, I started really feeling trapped. I wanted to leave. My feelings of wanting to harm myself intensified. My panic returned.

When she completed her next session, she came out to check on me and see if I wanted to come back in for another session. I came in for a minute, but then asked her if I could go home. Reluctantly, she let me go.

I felt like I was 5.

It was weird.

In the end, I know that was the right thing to do, but now I'm so detached from her that I never want to go back. What's that about?

EMDR Update

So after several months of failed attempts of doing EMDR, my therapist and I kind of gave up. Then, annoyingly, my good friend (who also suffers from post-traumatic stress) started therapy and did EMDR on her third appointment. I was pretty frustrated.

So my psychologist and I decided to give it another try. This time we started doing a variation on EMDR called brainspotting. Basically, I stare at the end of a pointer for about 30 minutes.

What has really surfaced for me is how much my previous experiences in therapy have been hindering me from making progress in my current treatment situation. So, we have started to process these experiences. And I have to say, I do think this is helping. The last two days have especially been better.

I think it's going to take a while to process all the trauma in my past, but I'm all for being diligent if it works. I actually feel like there is hope of resolution of my past.

Starting to Wonder...

I'm seriously starting to wonder whether my meds just aren't working anymore. I have been obsessively suicidal and depressed for several weeks now - and nothing bad is happening in my life! It's damn frustrating!

I'm hoping I can get to the psychiatrist soon and talk to him about this annoying situation.

About My Dad

Today I stumbled across this excerpt from Carrie Fisher's autobiography, Wishful Drinking. It's hysterical. I haven't actually read her book, but maybe I'll check it out from the library.

Anyways, that made me look up Carrie's blog. She had a great passage on there about her dad, Eddie Fisher. I could have just as easily written it about my own dad. It really sums up my thoughts about him.

But to get back to my father, he is an incredibly charming man, blessed, for the most part, with an upbeat disposition. Finding delight in places that others might overlook. Which no doubt contributed to his lifelong success with women. He asks his nurses to marry him or be his girlfriend—still the ladies man at 80. The pursuit and appreciation of women having been and continuing to be the guiding passion of his life.
He could hardly be accused of having been the greatest of fathers. Todd and I saw him perhaps once a year, if that. Same thing with his other two children by Connie Stevens, Joely and Trisha.
Still—–, he wasn’t a BAD father, by any means. Never mean or critical —–just a boyish man really, well intended, but absent for the most part—– endlessly distracted by the parade of women that crowded his bed and his life.
But whatever kind of father he may have been in the past, I enjoy being a good daughter in the present. In large part because I’m fairly certain he likes it too—–lighting up whenever I visit. And, as many of you no doubt know, a shine like that is frequently infectious.

Now if I could just explain this to my mother...

To Facebook or Not To Facebook?

My husband has recently set up a Facebook page. He's been having all kinds of fun looking up old high school and college chums and seeing what they're up to. He's been encouraging me to do the same.

I'm not quite as ready to get on the Facebook bandwagon.

See, here's my thing. I'm not real keen on reminiscing about my past. In fact, there's a lot of stuff in my past I'd just as soon forget.

Or, to be more accurate, there are a lot of people I'd prefer forget me.

Why would I want them to remember what a mental patient I was? What's fun about that? Not a hell of a lot, if you ask me.

That being said, I will say that God has been bringing some people back into my life lately from my high school years. This has forced me to face some of those old fears and confess the truth to them about my chaotic past. To my surprise, they have been very supportive. In fact, in all three cases, sharing my experiences has helped them deal with a situation in their own lives.

I'm a Bad Wife

I feel terrible. Tomorrow is my husband's 40th birthday. I didn't plan a party for him. GOING to parties is stressful for me. PLANNING a party would be completely overwhelming. I didn't think it would be that big of a deal because his parents are here and we will have some kind of celebration with the family.

I guess I was wrong.

He's hurt (I think), but won't even talk to me about it. I feel terrible and have no way of trying to come up with an acceptable alternative because he won't talk to me about it.

It's at times like this that I really HATE having the psychological challenges that I do. Normally, the limitations only affect me. But this time, they hurt someone I care about very much.

The Winding Road

I haven't had much to report lately. Same old thing. Therapy twice a week. EMDR. Trying to learn how to feel attached and not freak out while learning how to be physically absent from someone also without freaking out.

In other news, I have decided it's time to get real with myself about my addiction to food. And I'm not using that word in a flippant way. Food is something that I use to comfort myself. I have taken pride in the fact that I don't have addictions to alcohol or drugs. But my food addiction has sort of passed right by me.

So I have been trying to focus some thought on getting insight into what food is about for me. The best I've been able to come up with so far is that food has been a constant companion with me through all the turmoil of my life. I haven't been to control who's in my life or who's abandoned me, but I could control what I put in my mouth. It truly feels like it is a compulsion for me at times.

With this awareness, I'm trying to be more mindful of what I'm eating and why I'm eating. I can see that this is going to be a long haul, but for the sake of my health, it's a journey I need to begin.

Making Amends

There is a good article in the current issue of BP (bipolar) magazine about trying to make amends with those who have been hurt by the chaos induced from your disease.

"The Power of Amends"




I especially liked the sidebar in the article.

TIPS FOR HEALING

• Bipolar disorder is what you have, not who you are. You still must live with it, stand up to it, accommodate yourself to it, resist it, accept it, manage it. Separating yourself from the problem in this way will allow your true character to help you decide how you want to live with your illness and its consequences. Stability begets stability.
• Apologize—genuinely, sincerely, deeply, specifically, and directly.
• Make reparations as best you can.
• Try to accept responsibility.
• Redouble your efforts to do the right and virtuous things to show that whatever behaviors you exhibited were the exception, not the rule.
• Remain humble and well-connected to treatment and find the best treatment providers you can.
• Everyone makes mistakes, but avoid repeatedly making the same mistakes.
• Strive to demonstrate good character by being responsible, reliable, trustworthy, competent, and focused.
• Recognize that rebuilding trust is a process, a staircase to climb at times, not an event.

I couldn't agree more with the point that making amends is usually a process, not a one-time event. I heard Patty Duke say once the one thing that still haunts her is the pain she caused her children as a result of her disease before she was diagnosed. Her older son, Sean Astin said some rather nice things about her, which I find rather remarkable given the rough times he must have endured. I hope my children will be as forgiving someday.

My own struggle with making amends with my loved ones is on-going. Some relationships have been repaired. Others have been lost. Much progress has been made in the last few years to repair the damage I did in the first 13 years of my marriage. Even so, there are some things that seem irreparable. I try to hold out hope for complete forgiveness, but some days (especially lately) I feel very discouraged.

Guilt is a difficult emotion to deal with. It's the gift that keeps on giving. Making amends relieves some of the pressure, especially when people are gracious enough to forgive me and see enough value in our relationship to move forward and build new memories.

In Mourning

I am continuing to silently mourn the loss of my friend, M - while feigning happiness to those around me, especially my friend/boss, P. What a freakin' mess.

I am praying the Lord will somehow work in this situation and salvage my friendship with M. Either that, or reveal a side of her that I haven't seen. Maybe I was deluded after all (but I refuse to believe that until I have concrete evidence). Humanly speaking, that seems impossible. But I sincerely believe M is a godly woman and wants right things and I just have to believe that somehow God will be glorified through this mess.

I returned M's Christmas present to the store. Broke my heart.

Imploding

Well, things are still unfolding in my situation with my best friend (we'll call her P). Here's the longer version of what's been going on.

Basically, the whole thing started several months ago. I have been getting to know a new friend (we'll call her M). M and I have a lot of fun together. She is the first person I've ever had in my life who I can relate to in terms of my psychological struggles. This is largely because she's dealt with many of the same issues. But the relationship worked because M is spiritually mature enough to have an eternal perspective on these difficult circumstances. We always tried to keep each other's focus on the Lord rather than what has been challenging for us.

The complication is that M works at the same place as P and I. Adding to the complication is that P is also my supervisor at work.

M has many wonderful traits, but being tactful isn't one of them. Unfortunately, she framed a dispute with P in such a way as it came across as insulting. (Personally, I didn't think it was disrespectful, but P did and I guess that's pretty much all that matters.) This incident became another in a line of evidences in P's mind that M is simply not a person of good character and a bad influence on me. Personally, I don't see it this way. Personally, I think P is way overreacting. Is M perfect? No. She does have problems. But so do all of us.

After a week of attachment anxiety and hard conversations with P, it came down to one thing - either I accepted P's version of reality so that I could preserve my job or I stayed loyal to my friendship to M and risk losing all of the respect I have worked so hard over the last three years to regain. Needless to say, it was not an easy position to be in.

So, I wrote a loooooong letter to P apologizing for putting her in an awkward position, plus I made up some other stuff to apologize for. (After knowing her for four years, I pretty much know what "buttons" to push.) I made it sound very contrite. Then I wrote a note to M basically saying I had miscommunicated some things to her about P and urged her to drop the matter.

Unfortunately, M didn't follow that advice. She continued to pursue it. This, in turn, fed into P's judgment that M is unstable. In fact, P has even gone so far as to tell me that "M is not your friend," the implication being that M has been pretending on some level to be my friend all of these months and is now trying to paint me in the worst possible light to my superiors. Personally, I don't believe this, but I have to pretend that I do.

Meanwhile, I have hurt M deeply and violated her trust - something I promised her I would never do. I feel overwhelmed with guilt not to mention incredibly sad about the loss of a wonderful friendship. I also feel emotionally blackmailed by someone who has had an incredible positive influence in my recovery (P), but now seems to be unable to let me "grow up" and make my own choices.

My decision would have been totally different if P wasn't my supervisor and if we didn't all work together. I would have been more candid with P regarding my belief that she is being controlling and unfair toward M. But that conversation just wasn't meant to be - at least not right now. God has put me in this situation at this time for a reason, as painful as it may be.

In my mind, however, this is not over. Not by a long shot. If I'm ever in a position of being able to quit this job, the first thing I will do is go to M and tell her everything that has happened. Right now, I suspect she's extremely confused and angry at me, which makes me sadder than words can say.

Acute Attachment Anxiety

Unfortunately, my situation since Friday has gotten worse. I called my psychologist this morning before church. I thought it would be wise to let her know what's going on with me. Her assessment is that I am experiencing "acute attachment anxiety" because I am fearful that I am losing a key foundational attachment, namely my adopted "mom." I guess that is psychologist-speak for I'm freaking out!

Right now, my goals are to stay safe and not engage in self-harm and not to communicate with her in this state of mind because it would probably make things worse. I don't want to fall into old patterns of manipulative behavior in order to bully her into not ending the relationship.

And then again, maybe the situation seems worse in my head than it really is. It wouldn't be the first time.

I Give Up

This has been one of those days that I'd just as soon forget.

On and off, I have the same frustrations about communicating with my best friend. You know those situations where you feel like you keep running into the same roadblock and not making any progress? I've always sort of endured it because I really didn't know any better and figured the problems were all with me. But now that I am getting healthier and making new friends, I am wondering whether this relationship isn't as good for me as I initially thought. Or maybe that it used to fill a specific need for me that I have now outgrown.

Without getting into a long explanation about this, suffice it to say that I'm about "this close" to just letting the relationship die a slow, natural death due to neglect. I honestly feel like I'm at the end of what I can stand. She can raise her voice with me, then send me a sweet email, then I respond gratefully, then send me back a stinging email. It's deeply confusing. And for someone like me with such huge abandonment issues, it's like having someone f--- with my brain all the time.

I'm in full-blown trauma mode at the moment. It's good that I know this, however. That will prevent me from making any overly stupid decisions.

I'll just lay low for a few days and see if my emotions even out.

Abortion Connection?

Here's a story that probably won't make it to the mainstream press:

"Mental illness risk ‘rises 30 per cent for women who have abortions’"

Women who have an abortion are three times more likely to develop a drug or alcohol addiction and 30 per cent more likely to have mental disorders compared with other women, research has revealed.

The evidence from two studies comes as the number of women having an abortion in England and Wales exceeded 200,000 for the first time last year.

Here is a link to the journal where the scientific study has been published: "Abortion and mental health disorders: evidence from a 30-year longitudinal study."

Pharmaceutical Mishap

I wanted to share a recent experience I had with my medication, just in case it might help someone else.

A few weeks ago, I had to transfer one of my prescriptions to a different pharmacy. (It was a logistical issue. I couldn't make it to my normal pharmacy.) When I picked it up later in the day, I immediately noticed that the pills looked different than usual. They were smaller and smooth, instead of chalky. I have been taking this medication for three years and the pills have always looked the same, even when I switched from the name brand to the generic. But the pills from the new pharmacy were noticeably different. I didn't really think much of it at the time. I figured pills are pills.

Within a couple days, however, I started experiencing intense depression. And as each day melted into the next, the depression deepened. I felt seriously suicidal, but for no apparent reason. There hadn't been any particular trigger in my life that would have caused this to happen. I was suddenly swept back into a flood of intense emotions that I hadn't felt in three years. I used to live every day of my life, practically every waking moment, resisting the urge to harm myself. After not feeling those feelings for three years, and then suddenly being thrown back into them, now looking back I don't know how I managed to survive. I always told people it was a miracle. Now, I think I need a stronger word than "miracle". I can't think of one, but you get the idea.

So anyways, I called my psychologist that weekend and told her what was going on. I honestly started wondering whether I should check myself into the hospital for my own protection. That's how bad it was. Her big thing is to always try and pinpoint the trigger in situations like this. But like I said, there was nothing I could point to.

And then it clicked in my head - the pills. The only thing I had changed was that prescription. So I went back to the pharmacy and asked them why these pills were different than my old pills. I showed the pharmacist an example of each. She basically blew me off by telling me all the pills are the same.

But my psychologist didn't believe it. She urged me to call the psychiatrist. He was skeptical, too.

By the next day, I became determined to get to the bottom of this issue. Otherwise, I was going to have to go to the hospital. So I called my insurance company and explained the situation. I told them that I needed another prescription of pills from my usual pharmacy.

Denied.

I explained to "the woman" on the phone that this need was urgent. I told her that the issue was not that the pills upset my stomach or that I didn't like the color. I was suicidal. She put me on hold for several minutes. Then, she came back on...

Denied again.

So, I asked to immediately be assigned to a "case manager" so I could appeal this decision (my psychologist suggested I do this). "The woman" was surprised. She tried to tell me that there was no such thing as a "case manager." So I pulled out my last card. I said, "Look, here's the deal... Either you're going to get me some new pills today, or I am going to check into the hospital. And I'm sure you can see in your records there that the last time I went into the hospital, it cost your company $40,000."

Well, suddenly, "the woman" had the magical ability to grant me a new prescription. Amazing. She called the psychiatrist's office while I was on the phone, they called the prescription into the pharmacy right away, then I picked it up shortly after that. The best news is, it worked! I started feeling better within 24 hours.

I saw my psychiatrist this week and filled him in on what happened. He was shocked. He said that he had never had a case like this in his practice before. He had other cases where one brand of generic would upset a person's stomach while a different one wouldn't, or one would cause different side affects than other. But nothing this severe. I told him that it honestly felt like I was taking nothing.

The moral of the story is, there are not only differences between generic and name brand meds, but there can also be differences between generics made by different companies. Now I know that I need Wellbutrin manufactured by Watson. Other brands don't work on me. Literally.

So if you're out there, struggling to figure out what med combination works for you, keep in mind that just because one brand of a med didn't work, doesn't mean that a different brand of that same med won't.

Celebrity Rehab 2

My favorite show, Celebrity Rehab, is back for another round. If you get VH1, it's definitely worth a watch.

Britney's Mental Illness

Did you catch the cover of this week's Life & Style magazine?

This, my friends, is what the general population think of as the "face" of mental illness. Do you think people would buy this magazine based on this cover? Or would most people consider this topic to be a total "downer"?