Transition.

a cure for what ails you, major depression, medication, ptsd, rapid-cycle bipolar disorder, three hopeful thoughts

At this point, I can’t say that I’m cured or that my bipolar is in remission, but something feels different. My mood swings aren’t as intense as they were before, and “Flat/numb” has replaced “Depressed” as my default mood state. I still can’t remember the last time I felt truly happy without also feeling some underlying negative emotion, but I actually feel hopeful.

My PTSD is still pretty bad. There’s some parking lot construction going on right outside our apartment, and when I had to walk past it yesterday to get home, I flinched, jumped about a foot, and had to clamp my hands down over my ears to get through the unrelenting roar of construction equipment. I felt embarrassed and remember thinking, “Normal people don’t act like this.” But I’m trying not to judge my reactions and emotions. My therapists over the years have all encouraged me to just experience them without having a knee-jerk response and assigning a morality to everything.

My derealization/depersonalization is present, as always, and I’ve been having unnerving spikes in severity that have unusual triggers…if I have my head turned or tilted a certain way and I say something/something is said to me, for example, the detached feeling increases tenfold and sticks around until I finally go to sleep. It seems to only happen in the late afternoon/early evening, but I’m still not sure what to make of it. But in spite of this, I feel like I’m finally starting to recover. I’ll deal with the emotional bit first; then, I’ll try to tackle my dissociation.

Medications: Lorazepam, 1 mg tablets*, 37.5 mg Effexor, 400 mg lamotrigine/Lamictal.

* I think it’s important to note that I can’t remember the last time I actually needed one of these.

I feel like a fence post today.

major depression, ptsd, rapid-cycle bipolar disorder, stigma

My current episode of depersonalization/derealization has been going on for well over a year, as I’ve mentioned before, but it’s particularly bad today. I slept way too late, until 2:00 this afternoon, and woke up feeling very disoriented and detached. I sat on the couch for close to an hour, staring out the window…it felt like five minutes. I wasn’t even thinking about anything; my mind was essentially blank.

I wish I knew of a better way to describe what the detachment feels like. I usually tell people that it’s like being in a dreamlike state, and sometimes say it’s like being incredibly stoned (if the person in question has dabbled). D. sat on the floor next to me this evening while I had a smoke, and as I described how I was feeling, I was making a fist with my free hand.

I didn’t even notice the bloody furrows my nails had left behind until I went to wash my hands about ten minutes later. I didn’t feel my hand clenching up. I didn’t feel any pain.

Today, my mind is about a thousand miles away from my body. It’s usually not this bad; I’m not sure what’s triggering it, though I suspect it’s the oversleeping. But at the same time, I can’t really help that—I’m going through a nasty depressive cycle (which, given the fact that my bipolar is rapid-cycling, should be over soon—that’s the silver lining to all of this) and tend to be especially somnolent during these phases.

I have therapy tomorrow at five. I tutor on Tuesday night, have another doctor appointment on Wednesday, and work Thursday through Saturday. I’m hoping I’ll make some decent money this weekend, now that I know how to handle my shit at work. I feel bad for not being able to work a regular full-time nine-to-five, but the combination of mental illnesses I have can be pretty debilitating. It’s hard to keep a forty-hour work week when you regularly bottom out at two P.M. and feel like if you don’t go home and bury yourself in a mountain of blankets, you’ll finally snap and do yourself in.

I hate living like this.

Breaking up is hard to do.

medication, ptsd

I’m considering “breaking up” with my current psychiatrist, and it’s a tougher decision to make than I’d anticipated.

I like her as a person, but I feel as though we’re not meshing that well on the doctor-patient front. My depression has been particularly difficult to get a handle on, and treatments that previously worked (like Cymbalta) have suddenly stopped helping for no apparent reason. Yesterday, I called and left a message for her with my third request for an increase in my Effexor dose.

The first time, I was told to be patient and give it more time. When I met with her the week after I went to the ER for my panic attack and pleaded my case (since missing a dose and having a dose that was probably too low to begin with kicked off that whole mess), she added risperidone and told me she didn’t want to increase the Effexor until we’d given the other drug a chance to work.

It’s been a few weeks and the only thing the antipsychotic has done is make me even more drowsy than usual–I’m like the goddamn Dormouse to begin with, and the only change is that now I’m really sleepy on top of being really depressed. And in my desperation, I’ve found myself turning to some pretty unhealthy methods of coping with the low-mood-negative-thoughts-constantly-wanting-to-cry thing.

I called the office again today to see if my message had gotten through; after I gave the doctor filling in a quick (probably 30 second) summary of what’s been going on, she agreed to call in a small increase to see if it helps. It might not; I might need to try another drug. But at least I felt like my concerns were being heard.

I feel like my regular doctor and I have had this disconnect for a while now, and I plan to address it at our next appointment. She’s not a bad doctor by any stretch of the imagination, though there’s a pretty clear class divide between us (she suggested Weight Watchers, which is too expensive to even contemplate, when I expressed concern/anxiety over my weight, and has recommended name-brand drugs and alternative medicine that I can’t afford multiple times, despite me repeatedly telling her that our budget’s tight as it is–therapy is expensive) and I think that’s causing some issues.

I tend to avoid conflict at all costs, so it’s going to be tough for me to broach the subject. But I feel like she really knows her stuff, so I don’t want to just “dump” her. I want to make sure we’re on the same wavelength and see if things improve from there first. On the other hand, I’ve been stuck with doctors who aren’t willing to listen to my concerns and give me what I need, and I don’t want to fall into that trap again (ask me about the thyroid debacle that went down last year).

Are you avoidant? Have you ever had to break up with a doctor? Tell me about it in the comments!