Friday, February 21, 2014

Picking up after a flare-up.

Well, it is late and my brain isn't working superbly, but I'll go ahead and try to write anyway. Because I want to.

Recently, for whatever reasons, probably including being sick and cloudy weather, I had an anxiety and depression flare-up. It is dying down now. And it is a relief to see that. There are still extra sparks, like right now, my staying up this late (although it is a Friday night, so that isn't so far off). Or my having trouble getting myself to eat supper (put it off too long, so it got harder).

But there are also signs of returning to normal. My house is slowly getting cleaner. I've almost inspired myself to clean my guinea pig's cage. I actually spent 23 minutes exercising at the gym yesterday.

And then there are the tools that are out because I needed them again. My lists of "5 good things" that I sometimes write every day. My mental health blog. Seeing my counselor this week.

And there are the reminders; I had wanted to see my counselor a week early, but would I actually call her to see if she had time? No. Why not? Because I wasn't sure I felt bad enough for it to be worth it. Oh, the cognitive distortions of worthlessness. I can see it better now, as I come out the other side.

I suspect these flare-ups will follow me for a while, but I am a lot more able to handle them. My brain takes considerably longer (much longer) to jump into suicidal ideation (at my worst, it came up multiple times a day with urgency), and when it does start, I know better what it means (i.e., it means my depression is getting worse), so it doesn't freak me out as much. And...

Oh, I was going to say, I was remembering back to worse days and going through my depression and OCD flare-up, and I thought to myself, "How on earth did I do it?" It takes SO much energy to live in spite of depression and anxiety. Just having a fraction of what I had at my worst left me wondering how I did it back then. So, kudos to all of us who have fought to get through the hard days. It was no cake walk, but we did it.

Friday, February 14, 2014

Just Checking, and you know what I found out along the way? I'm still experiencing OCD. Not that I expect that to surprise you.

I saw the new Doctor. My opinion has been put on hold while I do some checking.

She recommended - very strongly - a test.

I agreed, then waffled, then agreed... And did a lot of research. I like to know my facts. Which, of course, boil down to probabilities, not black and white, if you want to be really, really precise. Which, of course, I do.

So finally, I decided to take the test because I didn't think there was any other way to shut my brain up. (Best reason ever for Exposure Therapy, by the way.)

But even that decision had to be checked. Do I feel good about it? Yes. Good. Now, let's check again. Do I still feel good about this decision? Yes? Ah, very good.

Set up appointment. Did I feel relieved? Yes. Good. Do I still feel relieved? Yes. How wonderful. Do I still feel good about it (the decision, I mean)? Yes. But if I keep asking myself, chances are I will at some point answer that I'm not feeling so good about it.

And I'm big on knowing facts like probabilities (not precise probabilities every time, just knowing what is more and less likely to happen).

Well, finally, it hit me. I might have scheduled the test for the wrong time! Oh, that lovely (sarcasm intended) terrible feeling. The feeling of OCD hitting a home run, scoring a touchdown, whatever you are supposed to say in sports that I only know a little about - I know a lot about a lot, but just a little about sports, in case you are checking). The feeling of impending disaster, of the OCD variety.

Well, I haven't been through three and a half years of therapy and multiple medications for nothing. I reason out what I'll have to do to sort through my dilemma. Who I'll need to talk to, in what order...

And then the another strong and familiar feeling from that familiar OCD companion. Urgency. The test is not urgent. My anxiety is. The schedule isn't even so important, although it does include taking time off work which means it involves multiple people etc., etc. But the anxiety? I want it gone. NOW. Well, really, several days ago. And that is why this whole scheduling and test taking tangle is messing with me. It really isn't. The anxiety is.

In conclusion, I still hate anxiety. I still think OCD is a very creative monster (I can appreciate its creativity, though, along with its intelligent ability to follow patterns and generally manipulate me into a knotted feeling in my stomach - at least, the feeling I think people are referring to when they speak of having a knot in their stomach). And I still think depression is a lousy energy zapper that, combined with depression, can leave me in a hole that is not so easy to climb out of. And right now, that hole is just annoying and inconvenient. It is a hole that involves very little housework - not sure why it is so difficult to pick up a few things around the house, but trust me; it is. It is a hole that involves watching TV and surfing the internet and pondering whether or not to ponder deep, philosophical/depressed thoughts. It is a hole that irritates me. And a hole that leaves me grateful for my counseling appointment this coming week. This was quite a long month. I think when I go to schedule my next counseling appointment, I should not be quite so optimistic. Maybe two weeks is too short, but four weeks is too long. Maybe I'll try three weeks. After all, I am an intelligent problem solver, and if two weeks is too short and four weeks is too long, then logically, somewhere in the middle might be just right.

And by the way, Mr. Psychiatrist my first, I have tried to be a creative writer who uses words skillfully to communicate. If that means I have "primitive" communication skills, I'm sorry you think that way. Oh, and I think star people are really fun and star cartoons are a good thing, not a sign of my mental inability to cope.

Monday, February 10, 2014

opening a bit of my medical history...

I've wondered what the psych doctor at the hospital wrote in my charts. But I've never actually gone to read them. Until today, when I was looking through my previous primary care provider's file for me (they gave me an electronic copy so that I could pass it on to my next primary care provider, and said I could make myself a copy...). This would only be the summary. And it was interesting. And it supported my suspician.

My first psychiatrist seemed to have preconceived notions about me. He also seemed to view me out of his particular lens. A lens that said my problems were largely just coping skills. That I had very deficient coping skills and was struggling to live on my own after living at home. And that I had borderline traits. He seemed a bit stuck on that due to my having a relative that he treated who had borderline personality disorder.

And then there is me from that time. The agreeable me. If a counselor said, you might be having trouble living on your own; it is a big move to start living on your own (never mind that I had moved to Puerto Rico for two school years without anybody I had previously known). And I would be like, yeah, it's hard. Of course it is hard! I was depressed!!!

There was the counselor who talked to us as a group about being codependent. I immediately hopped on that bandwagon. That must be a problem I have. I depend to much on people. I even didn't tell one of my friends that I was calling from the hospital (she was a couple states away on vacation and invited me to come see her after she returned). I didn't tell her because I didn't want to bother her. And because I didn't want to be codependent.

Because you know me; suggest I have a problem, and suddenly I can see it. If you give me a few hours including time away from the person suggesting the problem, I might realize that that isn't the case. But if I'm in the hospital for depression? Really? Of course I'd be agreeable.

Which was probably good since I've heard that the disagreeable aren't released as fast.

Anyway, about my cartoon I'd drawn the doctor to try to express myself (I can express myself, but I do so better in writing or in cartoons usually, because then I can think it through without the anxiety of talking to someone changing what I say), the dear doctor took it strangely. As in, he thought I had a strange way of expressing myself, a rather fantasy way. He said, (approximate quote), "clearly" the thoughts I was attributing to the star person were my own thoughts.

DUHH! Okay, allow me to explain something: Yes, Dr., I was trying to express my thoughts to you. No, I was not confused about who was thinking those thoughts. It was late at night, I couldn't sleep, I like drawing star people, I wanted to express myself to you and it wasn't working so well, so I drew a star person cartoon! Seriously? I thought that was simple creativity, not poor coping skills.

Alas, that doctor seemed nice, but I grew to dislike him, and I wasn't the only one. He was a behavioralist with depression. Fix your actions, fix your depression. Maybe cognitive behavioralist. He liked CBT stuff. Change your thoughts, change your actions, cure your depression. Hence, my problem would have to be life stress and poor coping skills. He told me, at my last visit, that if I had schizophrenia, it would be different. If I had schizophrenia, I'd need medication, and that would be about all I could do. But with depression? The medication was just to let me do the therapy work I needed to do so that I could feel better.

That, and the fact that since I didn't respond as wished to two SSRIs then I must have a depressive personality disorder that wouldn't respond to antidepressants, and the marvelous fact that I got onto my parents insurance for a year and a half, is why I switched psychiatrists.

Well, the Dr wasn't all bad. Let's not jump into black and white thinking, since that can cause depression. He did recognize that my counselor was helpful to me. And when he said I was improved when I left the hospital, he was right. And he was the Dr. that passed on another doctor's words... well, actually, one of the hospital counselors did, too... see my thoughts as ships going by on the horizon. Let them come and go. And doing that to my probably obsessive suicidal ideation did actually help me.

And with the counseling I got at the hospital, I did get a jump start into learning to love myself. Which still sounds so contrary to the way I grew up. Perhaps sinful or at least prideful. But now I know it is important.

And finally, remaining from that hospitalization I have something like a $5,000 debt to pay back - it is a no-interest medical loan from my county. So I'm paying it back $50 a month as agreed. And I really am grateful for the loan. Just I'm also a little grumpy knowing that other people have gotten that sort of thing written off... my counselor is in the neighboring state and she tells me it would have been written off by now in that state.

Wow, I wasn't going to end up grumping about finances.

The side story is, I'm really grateful for the new healthcare legislation that has enabled me to get back on insurance. So trash it as you will, but I'm still grateful.

The moral of the story is, my mental health journey wasn't all pleasant. But then again, I don't know how being severely depressed can be pleasant even if there was an absolutely perfect doctor helping you. Reading about my depression and OCD experience from my primary care provider's notes was saddening, too. It was just a hard time. And reading the papers from the other side, I know I wasn't always understood. But sometimes I was understood. And either way, I'm out the other side now, at least for the most part.

And now I get to prepare to see a new primary care provider tomorrow. Yay. Reopen my medical history. I'd better hurry towards bed tonight.