Paris Exposition: map, Paris, France, 1900. Courtesy of The Commons, Flickr.
Dear Internet,
I’ve been writing this in my head for days and yet here I am circling the aggressive blinking cursor with trepidation. It begins back when Dr. H upped my lithium dose to 1500mg a day (Two pills in the morning, one in the mid afternoon, last two at night). He soothes that things will change within a week once the drug metabolizes.
And he’s right, it does.
The world clicks into focus a bit better and I do not feel the crushing tiredness that plagued me through most of June. But perhaps it is too soon to tell or it is too late to tell. For the relief is short lived and I’m back to finding myself at a cross-roads, again, with what I need to do.
Or what I want to do.
At my most recent appointment with Dr. H., one where it had been sometime since we had seen each other due to schedule conflicts, my lithium levels were still in the therapeutic range. But all of the symptoms I recounted then in our session in June still exist., the biggest culprit is lethargy.
Lethargy, in any form or from anywhere, is a cruel bitch of a mistress. In my head, I am writing short stories! I am getting projects done! I am curing cancer! In reality, I feel so drained and physiologically exhausted I find myself taking short cuts to save time such as stop washing my hair daily, stop wearing make-up, and pushing off as much as I can to another day.
It’s a relief when daily chores are done because I can curl up in my bedroom and do nothing until I fall asleep, usually to some Britishism. I’m not reading, still. I’ve touched nothing in terms of projects or hobbies.
The days I am home alone in Grand Rapids, when TheHusband is up at Throbbing Cabin, I don’t cook dinner, I graze. I am exhausted walking six blocks to get hot dogs. There are five bag of treats of some sort on the counter, the fridge is full of easy to eat food like hummus and pre-made salads. I have lots and lots of liquids on hand, because sometimes I can’t even be bothered to eat, but I can be bothered to drink.
I medicate my tiredness with Sugar Free Red Bull, starting in the morning and then administrating as needed through the course of the day. Sometimes there is coffee, other times, Coke. Before I could not drink caffeine past early afternoon hour, as a rule, because it would amp me to all hours of the night. Now, I can’t seem to live without it.
There are times I’ve been so exhausted I’ve taken 3-4 hour naps and then still went to bed at a decent hour and slept for at least 8 hours. Then woke up as if I had barely slept at all.
Dr. H’s argument to me is that I’m not taking my Klonopin at night, as I should, to help me fall asleep and sleep deeply and as such, it’s fucking with the rest of my day. Is there some truth to this? Maybe. I’m running out of drugged options here and I’m grasping at straws. I want to have some semblance of life, not a shell of a life viewed through opaque windows.
So here’s the deal: Dr. H. AND Dr. P. have asked me, for months if I’m truthful, to track my moods and experiences, at least daily summary of what’s going on to better serve me and thus them. I haven’t been doing that. My reconstruction at my sessions are faulty at best, which makes for sketchy advice. I am an unreliable narrator.
I have decided, then, after this last session with Dr. H. that I needed to make a change. I needed to change – not me waiting for change, but I needed to change. For months I’ve been darkly hinting like a punk Cassandra that a big THING was going to happen. So maybe part of my lethargy is the waiting for a THING that can finally kickstart into gear.
I miss so much from a life that is just beginning to bloom. So I need to change and I need to figure out how to make these changes to make a real impact and not superficial. It needs to count.
Dr. H. said a week of taking Klonopin at bedtime should help shake out the symptoms from the lithium. It hasn’t. But as I don’t have a clear, written record of what is and is not working, I don’t feel as if I have the evidence to show that it’s not working. Oh, I feel mellow, but my tiredness and energy levels are still in the gutter.
So I’m going to start slow and I’m going to start week by week. The first week, starting with this entry, is to write every day, even if it is only 250 words, how I feel that day. It doesn’t have to a treatise on the condition of modern man, but it does need to be a record of what I’m doing. I may include how much I sleep. What I ate. What I saw.
Each week, I’ll add in something new. I want to start rowing again, to take a yoga class, to swim in a pool. I want to put my Fitbit to work for me instead of just acting like a post-modern adornment on my wrist. I want to cook. And adventure. And a million other things. Friends that are bipolar say exercise helps them immensely, writing helps immensely, talk therapy helps immensely. Remember a decade ago when you were used as a chemist experiment and for a year you felt miserable?
Slow. One thing. At a time. A week.
Then the choice will be easy to make.
x0x0,
Lisa (Day #7)
Tag: Klonopin
Wolf who fills himself with all who die and will swallow the heavenly bodies
Dear Internet,
Sometimes there are no words to express what is going on in my head, so I’ve made the executive decision to use animated gifs instead.
The last few weeks have been a shit hole of catastrophe in my brain.
When I started back to work after my lay up, Dr. H. was of the mind that since Concerta only seemed to work some time, I needed to try something else to find something that worked all the time. The following Monday, I went up to two Adderall XR in the morning, with no effect. Spoke with Dr. H. that evening and he moved me back to Concerta 36mg. Tuesday was fine. Wednesday, I was an idiot and accidentally took double my Concerta dosage in the morning, so instead of 36mg, I was high as a kite on 72mg. I immediately dosed myself with Klonopin to keep me more even and brought the bottle with me to work.
By mid-day Wednesday, I was quietly having a meltdown in my office. I was reading something about something and got so intensely frustrated, I wanted to start punching holes in the brick walls. I kept myself together by duct tape and string. Thursday, my dosage was normal but I was so tired, I broke my no-caffeine rule and drank a Coke that evening to just get over the hump. Friday was much the same as Thursday. Saturday, I was heading to MSU as a panelist at the MSU Comics Forum.
Even after taking my regular dosage and my lithium early on Saturday morning, I could not function. I had to drink a Coke to keep awake to drive to Lansing and by the time our panel came up, I was manic in my head. Kristin and I were supposed to head to Gizzard City for dinner but I felt so whacked out, I didn’t know if I could make the 1/2 hour drive to the restaurant eat, and then drive home. So I bailed and drove home on a wing and a prayer.
Sunday was glorious. I felt like my body had finally been reset. Monday, I spoke to Dr. H. and he was concerned about Concerta’s effects during the week so we’re going to try Adderall XR again except this time, we’re going to split the dose: half in early morning, second half later part of the morning. Makes sense. I’m on spring break, let’s give it a try.
Didn’t work.
Not only did the Adderall XR do nothing for me, but it turned me into this moody, depressed, state of an animal. I didn’t want to leave the house, I didn’t want to hang out with friends, I didn’t want to do things with my husband. I just wanted to wallow in bed and watch terrible TV. So the long ago set plans to do something on spring break week were all mostly broken. When I was feeling up to doing something, it was mostly writing and working on my cadre of websites. Except, there were massive problems on my host providers end and my website couldn’t stabilized all fucking week. 504 and 502 errors all over the place. Which wasn’t super helpful when this happened:
TheHusband wanted me to stop taking the Adderall XR and I refused. I had to see if I could finally metabolize the drug AND I had a phone appointment with Dr. H. on Friday (yesterday). I’ll be fine.
Except, I wasn’t.
During my phone consult on Friday evening, I was nearly hysterical. Dr. H. had no idea why this was happening because chemically, Adderall XR isn’t supposed to effect serotonin levels. But obviously something was happening because it was fucking mess in my brain.
Here is how it is supposed to work:
I take Lithium (1200 mg, half in the morning, half at night) as a mood stabilizer. With my mood stabilized (and I get blood drawn to check my Lithium levels every couple of weeks), the ADHD drugs work better. If I feel too amped up or I can’t sleep, I take Klonopin as needed. When the ADHD drugs don’t feel like they are working, then we ramp up the Lithium. Except now I’m at the therapeutic levels of Lithium (known via the blood tests) so I can’t amp that up, so we have to work on the ADHD drugs.
Or go on anti-depressants for more stabilization to make the ADHD drugs work better.
Which I’m rejecting.
A decade or so ago, I was seeing a medicating therapist when I lived in DC area, who decided to cycle me through almost all known (to her) permutations of various SSRIs/Anti-$whatevers in her drug book. So if X combination did not work, then, we’ll try something else! Then try something else! Then try something else!
The hitch in this giddy up is I metabolize drugs fairly quickly. For SSRIs, if it takes 14-21 days before the drug stabilizes on me, it could take as little as 7. Rather than up/down the dosage, she just changed me to something else. I was cycled through so much, over the course of six months, my life fell apart. Granted, the relationship I was in then was already on the rocks, but everything else that may have been okay such as job, professional and personal relationships were all hit hard by this. It was fucking terrible and a fucking nightmare
The other hitch is I’m one of the rare cases of people who get suicidal thoughts on anti-depressants. I’ve been on varying doses of:
- Wellabutrin
- Effexor
- Celexa
- Prozac
- Paxil
- Zoloft
XR or not, doesn’t matter. On or off Lithium, doesn’t matter. I start taking an anti-depressant, I want to kill myself.
When I went off the drugs a decade ago, I swore I would do whatever was necessary to stay OFF the drugs. Change diet, living, jobs, whatever, I’d do it. But DBT and yoga can only do so much; I recognized I needed to be more proactive in my mental health. But this last few weeks has shown me glimpses of what that life was like a decade ago, and it is NOT one I want to repeat. I have too much at stake to lose all of it due to my fucking terrible brain chemistry.
There was no fucking way I was going back on an anti-depressant.
So there I am, nearly hysterical on the phone with Dr. H, very emphatically without a goddamned moving an inch to my voice, that I will not get on anti-depressants. We agreed to keep me on the 1200mg of Lithium and go back to the Concerta 36mg, since I can tolerate that and it works somewhat. The rest is up for discussion when I see him in a few weeks.
My hysteria got worse when I got off the phone and was talking to TheHusband about the whole phone call ordeal, then my mood shifted in to self-protective mode where I did not want to be touched, stroked, talked to, or anything. I remember wrapping my arms around myself while TheHusband tried to sooth me during this depressive spike. I cried. A lot.
After I made the decision in October to start seeing Dr. P. again, he collated in later sessions the depression I was experiencing was more than likely stemming from the untreated ADHD which was creating a vicious circle of frustration and all the life changes that had happened in the last few years and were not dealt with. So, more normal life stuff rather than chemical.
This is how I knew what happened this week was different, even despite the chemical incredulousness of it, the mood shift down this week was caused by Adderall XR. This WAS chemical, and it was crippling, and it was debilitating. How fast I shifted during the day, before the phone, while on the phone, and then after the call was huge.
Today, I started the morning with half of my Lithium dose (the remaining dose will be later) and Concerta. I’m still feeling prickly, my eyes ache as if I had been crying for hours (though I haven’t), and I am still in my pajamas. But for the first time in a few weeks, that I feel okay.
And this is how I absolutely do know, it will be sunny one day.
x0x0,
lisa
Better living through chemistry, round two: Saturday
Dear Internet,
It was a little over two months ago I started taking my ADD/ADHD medications or as my friend Liz calls them, legal meth. I live blogged the first weekend diligently, and the experience convinced Dr. H. Ritalin was not the drug for me. Additionally, I needed medicinal help with my bipolar so the legal meth of any flavor could work properly. I was then started on to lithium and switched over to Concerta.
Ritalin is short acting and could be taken over the course of the day to keep the strength up. Concerta 36mg, on the other hand, is longer lasting but it needs to be taken before 9AM in order to allow me to sleep at night. On the weekends, if I woke up too late, I would take one 5mg of Ritalin instead of Concerta to get me over the hump I needed to get tasks done in a timely manner.
In the beginning of the Lithium/Concerta combo, it was fucking glorious. I was productive, I was focused, the quirks about my personality I always attributed as just my personality, turned out were actual symptoms of both diseases and were tempered with the drugs. That small period from end of December to early January was a golden age. Sure, there were some kinks in the process like no caffeine as it made me feel like I snorted 10 lines of speed even if I had caffeine in small doses and my anxiety would sometimes get out of control, but who cares? I was feeling really fucking good and I was productive.
Work started back up on January 9 and things were hopping. I could complete tasks, organize myself better, I wasn’t short with co-workers, and if a difficult situation arose, I could handle it with aplomb. Everything was awesome.
During the initial period of Lithium/Concerta, I was super productive with my writing because it was all done during the day when the Concerta was peaking, ergo it makes sense I was super productive at work because the Concerta would be peaking during those same prime hours.
Then, the downside.
When I came home from work, however, I didn’t want to do shit. No matter what time I got home, once the pants came off, at most I could handle was reading on the Interent or watching TV. Anything other than that was either too taxing, too long, or required absolute concentration from me which I couldn’t give. This also allowed
I kept up the Collectioun of Cunnynge Curioustes because that was an easy thing to do. Open a post, format, set the post date, and save the draft. Anytime I found something that fell into a CCC post, I just had to open up that week’s post and add it. Friday nights, I would verify everything was in order before it posted on Saturday and be done with it. Very little work was involved on my part.
I returned to work on January 9th. January 16 was my monthly follow up with my orthopedic doctor, who decided I needed to have surgery two weeks hence to explore the still open wound to find out why it was not closing after seven months. During that two week period, I was a frenzy of productivity at work but at some point the Concerta stopped working as effectively, so lithium was upped. The general idea is the more my mood stabilizes, the better the legal meth works.
Other signs started to illuminate the drug wasn’t working such as I was getting easily irritable and short with people again. My productivity at at work was beginning to slow down considerably and my former bad habits started to appear. I was staying later and later in the belief I had to do the work NOW and not that it could wait until the following day. This obviously effected my home life.
Dr. H. and I were in contact either via phone or appointment during all of this. If I was metabolizing the 36mg to the point of non-effectiveness, then it was time to up the dosage to 54mg and see what happens. The catch is with the 54mg dose, I’d need to take it at 6-7AM. He thought my recovery period would be good time to experiment with the 54mg to see how I do.
A week before my surgery, all extraneous medications were stripped from my regime except for Concerta and Lithium. On the day of my surgery, January 29th, I did not take my morning doses of either drug and when I came home that evening (it was outpatient surgery), I only took my evening dose of lithium. I stayed off of Concerta for the rest of the week because I didn’t want to interfere with my antibiotics and my pain meds (sweet, sweet Vicodin). I decided the second week to stay off the legal meth as well and gloried about in the ability to drink caffeine. I spoke with Dr. H. via phone on February 8 and he upped my lithium to 1200mg and I was to start back on the Concerta the following the week.
During that week, Concerta and anxiety wrecked my sleeping. Some days I would get up early enough to take 36mg, and others it was a Ritalin kind of day. Every day was always in flux.
I went back to work on February 20th and started the morning with 36mg of Concerta, my morning lithium dose, and half a Klonopin. While this combination worked well mood wise, not so much for the focusing and concentration part. At least, not as well as I had hoped. I had still not taken the Concerta 54mg because I was afraid if I did, I’d never get to sleep.
After a month of all over the place mentally and being laid up physically, I finally got to see Dr. H on Friday to go over my therapies and talk more about what was going on. The ramped up anxiety, the heightened ability to not sleep even when sleeping aids were produced, were driving me crazy. I knew as I was on/off drugs for the better part of the last month had much to do with the problems since there was no consistency, but even attempting at consistency became problematic.
So we try another experiment, this time starting with the Concerta 54mg.
I woke up on Saturday at 6:30A to take Concerta 54mg, and then napped for a bit. At 8AM I became wide eyed and bushy tailed and started writing this post. I had a hair appointment at 10AM that would end up lasting five hours. I spoke with Dr. H. in the afternoon and he suggested I try Adderall on Sunday depending how the rest of the day went.
TheHusband and I rearranged some afternoon plans to get my Adderall script filled. Dinner was had. Shopping was done. We were home by 19:00.
The way I explained it to Dr. H. earlier was Concerta 54mg was giving me alertness for several hours, then it ebbed for a few hours, then picked up again, so when I spoke to him at about 15:30, I felt pretty together. But by 18:00, I was crashing pretty hard and falling asleep at the dinner table. I was not expecting the crashing or how hard I would much so that I needed to drink a can of Coke just to keep going for a few hours before falling asleep around midnight.
I started this post early Saturday morning and finishing it late Sunday night. Perfectly illustrating even a simple task can become highly complex when the drugs don’t work.
x0x0,
Lisa
Lithos
Dear Internet,
I’m so happy ’cause today
I found my friends,
They’re in my head
Lithium by Nirvana
Friday I had my follow up with Dr. H., my medicating doc, and I was hoping he’d say, “Yep, Concerta isn’t working, let’s put you on X and try that instead” and let me go on my merry little way. Didn’t happen. Of course, because that would be far too easy. So, now, then what do we do?
I spent the better part of an hour going over every drug that has entered my system or that I had left in the last couple of months (OTC or prescribed), and went through my entire 1.5 weeks on Ritalin + Concerta experience. Noting to him every little new “thing” triggered by either drug or was put to rest by either drug. I’m thankful that I wrote as much as I did while tracking my mania/The Sads, but I didn’t write enough because he asked me a lot of questions I could not easily answer nor were there any hints in my blog when I checked while at his office. I think it’s important to be a public voice for this drug experience, but sometimes it’s hard to keep track of what I’m doing and how I’m doing or do it in a matter that is more coherent. Maybe it doesn’t have to be?
TheHusband pointed out maybe if I wrote more stream of consciousness (which I did a lot of when I was in my ’20s), it would be easier. I think he has a point. While I plan on keeping up with writing about this publicly, I need to be more diligent on my note taking privately. I bought DayOne for my Mac, iPad, and iPhone ages ago and used it pretty heavily after for the first month or so and then tapered off. It was interesting how much came out when I was writing only for me – though to be fair, when I write here, I also am writing just for me. But writing in a matter that is more private, I suppose, frees up a lot of internal censorship that I unconsciously use on myself. The only glitch I had using DayOne was when I was on computer (like work) that is not MacOS variant based. My solution to that was either bring in my Air (which I’ve been doing more of) or use Evernote and create a folder tag for DayOne writings to transpose later.
So, more writing about this experience. Duly noted.
As I said a few weeks ago, the accepted diagnosis is ADHD with Bipolar with bits of Borderline Personality Disorder thrown in for good measure, which coincides with the diagnosis back in 2005. When I was living in Northern Virginia (NoVa) from 1999-2002, I was seeing a therapist there who cycled me through a lot of drugs: anti-depressants, anti-anxiety, anti-psychotics (alternative for the anti-anxiety) for Bipolar and definitely anxiety. I was on, then off, then on, and then off so many drugs that I felt like my brain would just explode. I swore then no matter what the fuck happened, I was NOT putting myself on any of that medicinal merry-go-round again. I’d learn to live, cope, and exist with my current brain chemistry as it is because I could not take that kind of mental anguish again.
So when Dr. H. said he was putting me on lithium today, I burst into tears in his office.
With the exception of Klonopin in the last ten years, I’ve been mainly drug free. I was hell bent on going holistic on the vapors of my brain, but that apparently hasn’t been working and so, where we are.
This where the helplessness started to become so overwhelming that I nearly bolted from his office. I came to him, as a recommendation from Dr. P. to get the drugs for ADHD and monitor them, and now he’s putting me on this medicinal go around for the bipolar, which is apparently triggered by the ADHD? The way Dr. H explains it is that if Ritalin AND Concerta are triggering mania, depression, and other traits of the bipolar, those need to be addressed first before Concerta (or any related drug) can really be effective for me. I’m unlucky in that not only do I tend to metabolize drugs more quickly than other humans, and I also tend to pick up the rare side effects from the drugs. They can’t plaster me with a catch-all drug to cure X because that triggers these other things that have now sprung up.
Dr. H. gets my hesitancy about this, but he feels pretty confident we can find that sweet spot where everything plays nicely and I can feel some sense of normalcy. But it will be tricky, which means I have to be more diligent on keeping track of my moods and everything else in between.
This isn’t the first time I was on lithium, as I was on it during the first chemical-go-around when I was living on NoVa and I remember that sweet spot for like 3 days when I was on lithium and something else where everything was fucking awesome. The world seemed brighter, the colors were deeper, food tasted sublime, and I did not feel like a scatterbrained idiot. Here’s to hoping that we can get there again.
ProTip: Don’t ever read forums, regardless of the reliability of the website, about drugs, drug interactions, or their side effects. Because you’re going to end up self-diagnosing yourself with consumption or the vapors, and never want to leave your house again.
TheHusband, who rejects “white man medicine”1 for most everything gets that in order to make his Pookie Bear better, she’s got to swallow the poison. We’ve been big supporters of whole foods lifestyle for a long time, and while we tend to fall off the wagon here or there, for the most part, for fat people, we are pretty fucking healthy fat people. But we know we can do a lot better, so before this drug shenanigans came into play, we planned to kickstart our healthy eating and exercise again. To be more whole, mentally AND physically just reinforces the idea that we really need to get behind this and stick with it. The goal is that with a better balanced diet, more exercise (as I am more mobile now), and seeing Dr. P. every week and Dr. H. monthly, things will (hopefully) start to get better.
Kale smoothies, here we come. Rah. Rah. Rah.
But darkly, in the shadows lurking, I also know, as it is with any kind of drug that is taken for the brain, there is almost always a dark side before the dawn. That is the risk you have to take.
My regime is 600mg of Lithium (1 300mg tablet taken twice daily), 36mg of Concerta, and my usual assortment of multivitamins and supplements. Because of the Concerta, I’m off caffeine (and have been for 11 days as of this writing). because of Lithium, I cannot take NSAIDs (aspirin, ibuprofen, etc) and I should watch my salt intake. Dr. H. also wants me to refrain from alcohol while I’m on lithium, which means I can’t dip into the Absinthe my brother got me for Christmas.
I’m also allergic to dairy, so there is also that to add into the do not haves.
It’s a good thing I like water.
x0x0,
Lisa
1. He’s Native American.
Live Blogging the Ritalin Experiment: Sunday
Dear Internet,
We shall begin this entry by noting the time I went to bed Saturday night: 2:23 AM.
—-
I woke up this morning at 9:26A, ON THE GO, with a list in my head of a million things I needed to do. After morning absolutions, I ended up in my office where I thought to do some work. I popped the first dose today sometime after 10:30A. In the last 30 minutes, I was all over the place on the Interwebs from reading my site stats, to creating an account on MetaFilter to answer a question, to finding that someone on Tumblr quotes me (and gave me attribution!).
I took the second dose sometime around 11:25AM because I lost track of time as I was talking to Jessica, Kristin, and O during the last hour. I’ve also been fielding questions about my dairy allergy on Facebook and researching something else that I’m now forgetting.
I am feeling manic.
It’s 11:55AM and dose three has been consumed. I have yet to eat breakfast and I can’t convince TheHusband to make me a spread (eggs, bacon, toast). He’s probably already eaten himself. I could head down and have left overs, which might not be a bad idea as I need to refill my coffee. I also need to take my 1/2 dose of Klonopin for the day as well as my vitamin supplements.
But now I’m thinking, “If I’m heading downstairs, I might as well start laundry and since I’m downstairs, vacuum the living the room.” And so it will go on that a single action “get food” has turned into a war campaign to get everything else done so that I don’t waste time. How is time being wasted? I could never really answer that question, I just know if I have time to do X and possibly Y, then I should do those things.
I’ve pulled up Evernote and Wunderlist to track ToDo items as they occur so I don’t start doing them this very minute. Items added, I’m now clicking aimlessly across the open tabs feeling as though I have forgotten something. I need to go eat.
5PM. As I had expected, I asked TheHusband to take laundry down to the basement for me to start (going up and downstairs is still cautious thing for me to do, so when something large has to be carried, I ask him to do it). After he throws the laundry in, he heads to make himself a bowl of cereal, for I was wrong, he has not eaten. I heat up leftovers, he eats his cereal, and we start having a discussion on something benign which ends up in a four hour philosophical discussion about hunter/gathers vs agrarian communities that meanders towards the argument of what demonstrates equal rights.
The discussion leaves me exhausted but I’m thrilled to find that during the verbal sparring, my brain does not feel muddled or confused. I can articulate my points, I can speak eloquently, I’m able to recall something from two sentences ago to build a rebuttal or to agree. I do not feel like I am gasping at air to make a point, and more importantly, I do not feel like I am stupid. I can hold an intellectually stimulating conversation and it is glorious.
I get angry, however, because while the exercise above was something that I want to be able to do, I am angry at myself for not setting boundaries on my time. Every single instance I’ve read of someone on Ritalin all note the same thing: How drastically short the drug lasts. Today is better than yesterday, but that could be for any number of reasons such as time when I started the doses and my own hormones playing havoc.
What I desperately wanted for that time was to do the things I had planned on doing, the sublime capability of being able to start a task and finish it in a manner that does not look like it came out of a Picasso painting. I should have said something to him, and I didn’t, and that is something I need to learn how to do.
8PM. Lindsay has come and gone for she is housesitting this week while we go up north. When she called, right after TheHusband and I have finished our discussion, I was able to make clear my boundaries which she understood. That seemed so easy, something I could never do before. She came, we hugged, we talked, and she left without me feeling like I had to entertain her for hours. Dinner was consumed, laundry was finished and put away.
I still have loads of things to do tonight, and it’s getting late, but I do not feel like the world is going to end like I usually do when my brain starts to feel this way. I still feel focused but I am finding the focus comes and goes, as the drug wanes in and out. I found myself not as eloquent when talking with Lindsay as I was talking to TheHusband, shortly after the last dose was taken. Words trip out of my brain and out of my mouth, but two days in and I can see that there is some hope. TheHusband notices a difference today from yesterday.
Brendan said that a big problem he had with Ritalin was the headaches, something echoed by many others. There was also discussion about the lack of creativity, that some thought was too high of price to pay for taking the drug. For me, I’ve never known to not have a headache of some kind, where my brain was fuzzy and struggling to even do a simple task made me feel Herculean. I can take the headaches. And so far, I dont’ find the argument about loss of creativity true with me, if anything, this will be the push me to the other side. I have always been an idea person, but when I can take an idea and bring it to fruition, I can only imagine the joy of being able to do that. I’ve never been able to do that.
I’m aware I’m possibly romanticizing a drug and that for the benefits, there may be some tradeoffs. But if the relief of finding out that after all these years, if a good chunk of my problems/issues/whatever that were often just dismissed as being a personality quirk or that I didn’t try hard enough or that I was incapable of doing the job, to find that there is a solution, even a minor one?
To me, the freedom to be able to express what is in my world is the biggest freedom I could ever be given. I’m holding on and never letting go.
x0x0,
Lisa
Maiden guarding the bridge over the river Gjoll (Hello, Ritalin)
Dear Internet,
A bottle of Methylphenidate (the generic for Ritalin) is currently keeping me company this evening, while I’m writing, staring at me from across my desk. I eye it precariously for starting Saturday, I begin the regime that could potentially change my life. My prescribing doctor dressed up the benefits like snake oil – allllll of the problems I’ve been experiencing for years that were often described as being part of my charming personality and/or because I was lazy, lacked focus, or motivation (to name a few reasons) now has an official name. That name is ADHD and with that single diagnosis, my world just got a little bit clearer.
I say potentially for I’m scared. And skeptical. Delighted. But skeptical.
I’ve been rather sporadic about writing about my mental health updates, and I think part of it is how much I need to get clear in my own head before I present it to the world. After I wrote this in October, I finally got the courage to call my old therapist and he scheduled me to meet with him within a few days. Since our first meeting, I’ve been seeing him weekly and having someone there, for it is the one true safe space I can dump, dump, dump and not have to explain, slash, define, remove, or edit in any form my thoughts, has been glorious. There is lot that is going on emotionally in the last year (lots and lots of loss) that I haven’t been dealing with coupled with all the new responsibility (house! job! husband!). I’ve been documenting, rather sporadically, my depression, anxiety, and other brain malaise this year but it’s not enough. I felt like I was at the end of my rope; not suicidal, but feeling like I was teetering on the edge. So much was happening! No explanation on how to handle or even, to cope. I felt like I was swimming in murk with no way past.
A month of visits goes by and Dr. P. makes a comment that perhaps I was ADD and further clarified that while the Borderline Personality Disorder (BPD) was more than likely correct when I was diagnosed way back yonder, it’s not as evident now. This blew my mind. Finally, a diagnosis that made sense and explained not bits and pieces of my mentalness (as BPD did, as did Bipolar), but seemed to tie everything up in a nice tiny bow.
Except, I was diagnosed with ADHD (and bipolar) in 2005. For the last seven years, I’ve been clinging to this idea that I was strictly BPD and totally forgetting about the bipolar and ADHD. Seven years. Who forgets they were diagnosed with ADHD/bipolar for almost a decade? Apparently me. My then therapist sent me through DBT training, which I still use, but I dont’ remember doing anything for the bipolar or the ADHD. I remember she weaned me off the drugs that the medicating psychiatrist prescribed because part of the regime of DBT was that I was to be as drug free as possible. The only drug I remember being on, at that time, was Klonopin, which I take very sporadically now. (A prescription of 15 pills can last me a year, that is how sporadic it is.) [When I started writing this in late November, I was taking Klonopin on a as needed basis. I’m now taking 1/2 of a .5 mg pill day. It’s helped. Tremendously.]
I have no memory of why the bipolar and ADHD were never addressed then. I also have no idea why my then therapist seemed more fixated on BPD then on the other disorders. The more that I’ve thought about it, the more I’ve come to the conclusion that she thought the DBT would give me skills that would carry over into the ADHD/bipolar world.
But no matter, let’s look to the present, and the future. Not wonder about what/ifs, for we’ll never get anywhere.
So, then, to the now. Dr. P. sends me off to a local ADD expert, who also has ADD himself. Today I spent an hour and some change working through the questionnaire and every light in my head is burning bright. Things that were often associated with other things (like I used to take work-ordered anger management class for my outbursts of anger — turns out, this is because of ADD). Things are finally starting to make sense. I knew I wasn’t depressed in the traditional sense, just always frustrated. Always not being able to figure things out. Dr. P. says the cycle goes from ADD causes my frustration, which builds up my anxiety, which then leads to my depressed state which starts the cycle all over again.
So tomorrow we start the Ritalin. I start with 1 pill, wait and document how I feel, take another and document how I feel and max this out at 3 pills. Ritalin is instantaneous. Effects are short (a few hours), which is why the build up the dosage. Clear head? Not wanting to be so damned obnoxious (also apparently a trait – the talking out of turn)? Can this legal drug be my new snak eoil of hopes and dreams?
We shall see.
Love,
Lisa
conversations about mother (part ii)
To support NaNoWriMo this month, I’m finishing the 30+ odd drafts laying about and posting them through the month of November.
Part I: Conversations about mother
Part III: Conversations about mother (part iii)
I lied.
But I’ll maintain it was for the sake of good copy. The realization to write about my family is not something that came to me in an instant but something that I’ve been struggling with for months. My panic attacks and anxiety levels, which have been fairly dormant these last few years, have come aggressively to the surface with the move to Grand Rapids. My precious supply of Klonopin, when before I used so sparingly and only when under extreme need, I’m now eating like TicTacs.
On the surface, things are falling into place for TheHusband and me after months and years of sacrifice and financial starvation. Things are not absolutely perfect (I work part-time as opposed to full-time, as an example), but when are they ever? We are starting to build a lovely life – so why all the goddamned almost crippling anxiety? Again? The conclusion: If after ruling out everything else that could be detrimental to my mental health and the only thing left is my family, therefore they must be the cause of this unwarranted stress. It is also equally important, I feel, that in order to continue on discussing my familial relationships, it is also equally important to lay out the history of my anxiety.
I had my first panic attack when I was barely a teenager. What I can recall is that I was walking with a girlfriend from one class to the next when my heart started racing a million miles per minute. I can also remember looking down and seeing the fabric of my shirt move ever so slightly to the tune of my heart beat. I do not remember the eventual underlying cause for the attack but it was, in my living memory, the first real physical experience of being physically anxious. The heart racing went on for a few moments before settling back down to its normal rhythm. And as it happened, just like that!, it also ended. I must have, at the time, reported the incident to my mother who took me to the family GP who announced I had mitral valve prolapse. Stress, fear or anxiety were never mentioned in my diagnosis though much later, I would find out it is those things that triggered it.
(For many years I told people I had a literal broken heart. It sounded much more dramatic and romantic while fueling my ever active imagination.)
As I age, the anxiety comes and goes in ebbs and tides. Sometimes, symptoms are minute and barely noticeable when I know I am under extreme stress and others, it would have me convinced that I was having a heart attack, dying or riddled with cancer when I felt I had no stress in my life. Sometimes still, the more frightened, cornered, or helpless I feel, the more intense the symptoms would manifest. Others, I would be conscious that I was anxious or upset which easily could explain the flight or fight feeling while others, I could be at an event having a good time when the symptoms would begin to manifest themselves for no apparent reason.
With me, there is no straight path with anxiety, and almost always, if it happened one way before it would not necessarily happen the same way again. The symptoms would almost never repeat themselves. Sometimes it would be a racing heartbeat for a few minutes, other times it would be traveling aches/pains that would appear and disappear with no introduction or farewell. Once I had hair randomly fall out for months and then stop. This past winter, after TheHusband and I moved to Grand Rapids, I got something in my eye when I was getting ready for bed. Most normal people wash their eyes out and continue on with their life, but instead, I became ultra-hysterical and belligerent. I was convinced I had cancer, I was going to lose my eye and thus was going to die in five minutes! After washing my eye out with water AND saline a million times, on top of crying hysterically; TheHusband could not find the offending piece of whatever that was driving me insane. The only way he could calm me down was by drugging me up. Within minutes I was asleep and was incredibly sheepish about the whole incident the following day.1
To be fair, the anxiety of my youth paled to that which would come in my 20s and 30s as illustrated by the examples above. By 1997, I was desperately unhappy with my life and under the wooing of a man-boy, I sold all my worldly possession and ran to the Bay Area to start my life anew. The man-boy promised fame and fortune, but instead left me in an illegal apartment culled out of a walk-out basement, in a house controlled by a dominatrix. Within several months of my move, he and I were over and I was working for a small tech firm in San Francisco. Within a year, TheHusband (then as TheBoyfriend part i) and I were living together in Oakland. According to TheHusband, I spent most of our relationship during that time on wild bouts of alcohol infused desperation. I don’t remember much of our time together during that period other than I drank a lot, we were dirt poor, and it seemed no matter what I did to improve my life, I was still so desperately unhappy.
By the summer of 1999, TheHusband and I were broken up but still living together. I was restless and always on the lookout for an escape route to get out of California2. I found the escape by applying for and being offered a position at UUNet, located a million miles away.3 For the move, I was driving across the country alone with the most precious of my worldly belongings in my car and the rest shipped to my final destination. To make the move even more bittersweet, the day I went to hand in my resignation, I was made redundant from my current job.
While all of this was going on over the course of the summer (breaking up, drinking binges, concocting wild & desperate plans to escape), I started getting intense physical pains in my right arm – eventually to the point that it would not bend or move as it was meant to bend or move. Soon, I needed to have TheHusband’s help to get clothes on or off. This was in addition to the minute symptoms of stress also occurring, such as the rapid heart rate, clammy skin and random aches and pains. Convinced I was dying, I headed to the emergency room, where after battery of tests I was informed nothing was wrong with me. As soon as the diagnosis came, the pain vanished. I was as healthy as a horse, except for the tiny, picky little thing called stress. The ER docs did warn me, however, that if I did not do something about it soon, I may find myself slightly dead.
Sometime shortly thereafter that announcement, I bade TheHusband goodbye, climbed into my car and left San Francisco and all of my California problems behind, forever. From San Francisco to Virginia, with a pit stop in Atlanta, my drive was the 5->10->20 and then north, cutting across the lower part of the U.S. and across the widest part of Texas.
I felt fine in LA and in Phoenix (no minute or heavy stress attacks) as I drove but somewhere around Las Cruces, NM I began to have a major panic attack. It was late at night, I was stuck between two semis and the 10 had turned into single, each way lanes coupled with high cement shoulders due to construction. To top this wondrous night off, it was raining and raining hard. I began to panic. I couldn’t stop, I couldn’t breathe and I was freaked out of my wits. This stepped up the racing thoughts that any second I was going to careen into the cement shoulder, hit a semi or get run over by the semi behind me. After what seemed like hours but was probably only mere minutes, I pulled off the road when I found the first mom and pop motel where I grabbed a room for the night. Even by taking myself out of what I thought was a dangerous situation, my heart wouldn’t stop racing. I made deals, bets, begged, cajoled, pleaded and bargained with whatever deity was above me to make this end. Nothing happened. I paced my room, smoked a million cigarettes and did everything I thought of in my power but I could not calm down.
The situation was made more intense that while I was no longer freaking out about my impending death on the 10, new thoughts would appear about my situation. I was in the wilds of New Mexico! Alone! With hardly any money! No one I know for hundreds of miles! With a crap cell phone!4I was literally thousands of miles from my destination, alone, nearly broke, and frightened and scared.
Common sense roused its stately head and forced me to go wake mom and pop up to explain in very poor pidgin Spanish that I felt like I was unable to breathe because that was the first thing I could think of to tell them. I could hear the crackling of Spanish on the radio in the make-shift lobby as I spoke. I remember how warm the night felt against my skin and the air hung with wetness from the recent downpour. I must have looked like a crazy person, standing there, begging for help in a reasonable voice while my heart raged on and clearly, able to breathe.
EMTs shortly arrived thereafter and gave me oxygen, which upon my first inhale I immediately calmed down. They found, just as the ER docs found a few weeks before, nothing wrong with me. Healthy as a horse. It is like once the attack has been fully addressed in some manner, it decides to leave as quickly as it sprang up. Instead of being thankful to the EMTs for the reassurance, I remember feeling chastened. Slightly ridiculous that I called them out in the middle of the night for a panic attack. Also a little stupid, a little insane and a whole lot of embarrassed.
Moments of lucidness during my attacks, when I knew I was fine and I knew I was not in harms way were always felt to be made like disappearing bread crumbs along a well worn road by the panic. It is a struggle, still in the now and sometimes almost daily, to differentiate between the world colored by anxiety and the world in which is real. It is an exhausting struggle within my brain to fight for what could be potentially destructive behavior as compared as to what is termed normal behavior.
Intensive bouts of therapy over the years has taught me how to work with and for the anxiety, to control it, subdue it and to live a fairly normal life. In 2003, in addition to being diagnosed with anxiety, I was further diagnosed as a high functioning Borderline Personality Disorder. Treatment via talk therapy (I had a regular shrink) coupled with techniques learned from dialectical behavioral therapy (DBT)
1. We laugh about this incident now and anytime one of us has a something in their eye, it’s automatically termed the problem is cancer.
2. Which I would later swore I would never return nor step foot west of the Mississippi. That too turned to be false when I would go visit a friend of mine in Sacramento in 2003. So much for big threatening gestures.
3. Northern Virginia.
4. Back in ye olde times when cell phones were bricks, on analog service and you paid by the minute.
kava kava
Has anyone here tried kava kava for anxiety?
I’ve been on lithium, buspar, effexor, zoloft, paxil, prozac, serzone, klonopin, valium, wellabutrine and wellabutrin sr to name but a few and NONE worked (yes most are for anti-depressants than anxiety, I realise this).
I refuse to go back on prescription drugs … so any thoughts on kava kava?
barnes and noble
Brian (Pauls brother) and I hit barnes and noble tonight for me to get some quality writing in and for brian to get out of the house for awhile. I came across a book in the clearance section called Writing For Self-Discovery. I had brought along my notebooks so I went ahead and sat in the cafe and started reading the damn thing. The first exercise on the very first page (which surprised me as most books go into more theory on why you should write before going to the nitty gritty) was to sit in one spot and write about what’s around you. Pick and object and go from there. This is what occurred:
barnes and noble cafe. people. feeling anxious. left breast has slight pains from being anxious. feeling stupid sitting solo at the cafe table with my white painted fingernails, people milling about. various people studying. remembering the cool cafe in Berkeley, CA where all the CalState kids went to. drank coffee. study. college. missing school. thinking of my father. small silver urn around my neck. thin people. beautiful people. grad school. college university. hard tables/chairs. people still here. sitting with Cathleen at the cafe. her sister Carolyn who was way cooler. why is it that people with “Ca” beginning names are called “cat”? on some people it sounds wrong. on others it sounds right. what can one say about the name lisa? derived from Elizabeth. fear to run. flight or fight. i ‘m in a public place and i’m scared.
dreaming about my father more. i’m not sure but it dawns on me in the bathroom tonight that the dreams are a realization he’s okay. he was younger and happier looking. there were scars on his forehead. “Dad, I say,” where are those scars from?” and he points to my necklace — the small silver urn with some of his ashes on it that i wear daily. My father, close to my heart.
i was watching la femme nikita the other night with brian and i saw what i wanted to be — her. Nikita. she is tall, blonde and perfect. except i don’t want to be blonde, just tall and perfect. and she’s was wearing this long black skirt that hung low over her hips and there was an inch or so of skin showing between her shirt and the damn skirt. with her pale skin and deep blue eyes. she looked amazingly exotic. and that was my inspiration. that is what i want to be. i have to lose 100lbs.
fuck.
i remember when i was 14? 15? I weighed 140? 150 pounds. I was like 5’9 or so. And I remember laying on my bed at night, obsessing about my weight and running my hands over my concave stomach and thinking “i’m never going to be fat. i’m not going to allow myself to get past this point in weight.”
that was 1/2 a life ago!
been reading more journals online again. going through diarist.net and sorting by women and ages and reading generally anything of anyone within my age group. and i realize that the 25-32 age bracket is nearly empty — not empty but it’s like what overcomes people between that age group to not write. i’m looking for a REASON and i’m finding it. Ana Voog is 34. Cheryl Tigs is a mom at 54. She can, next year, legally qualify for the AARP. I have 30 whole years left before I need to. And for once I smile. At the cafe. Where the cute goth girl works.
I’m obsessed about ages. People think i’m 22. Brian thought I was 22 or 23. No one believes I just turned 28. But i’m obsessed with other people’s ages. When someone tells me a story, I almost always ask “how old are they?” so that i can make the comment of “she’s immature” or “he should have known better”. and it’s stupid to gauge other people’s life by my age. at 28 i should have accomplished many things and i haven’t. but in a way, i’ve accomplished more than other people ever will. because i took chances. i took the chance, no matter how stupid, on flying to SF with nothing and making a go of it. and when that didn’t work, of driving cross country solo to another state and trying again. and seeing those stupid “jesus knows” signs along the highway. meeting paul for the first time in atlanta. BUT the thing is, i did it. myself. these are my stories and i know lots and lots of people who don’t have the balls to leave within 50 miles of where they were born.
west texas sucked.
my dad was 45 when i was born.
and today i really like me, imperfections and all.
-finis-
so tonight, when the urge struck me to redesign again (and i really do like this new design btw), i felt it. the cold crushing feeling in my chest. and it’s different from all the anxiety attacks i had before. because this time i was not obsessing about anything — I WAS FREAKING WORKING IN PHOTOSHOP. and i start crying. paul is freaking out because i can’t breathe (or so i say between the sobs). my pulse is normal but my chest felt like a ton of bricks landed on it. i call the 24 hour hot line my hmo has set up and i get picked up on the first ring. i tell the woman, mary, what is going on. she assures me i’m not having a heart attack. “you’re on klonopin” she says. “what’s your dosage?” i tell her i’m taking the bare minimum these days – .5mgs .25 in the morning and sometimes .25 later in the after noon. “did you take a dose?” she asks. “yes, i replied — a few moments ago”. klonopin takes 30 minutes to kick in before it works. she talks to me. calms me down. turns out she has done over 15 years as a coronary specialist nurse. i’m not having a heart attack. i’m so low risk it’s disgusting. ‘but this crushing” i keep telling her. it hurts. i don’t know what to do. the klonopin has been my miracle drug for the last two weeks. tonight was worse because it was fast and furious. and i’m so scared something is going on with me. she tells me if the pain doesn’t stop within the next 15 minutes, take another klonopin. after an hour, if there is still pain call. they are open 24 hours. i can be seen.
within an hour brian and i were at 7-11 buying slurpees and a big bite.
a new psychosis
riddle me this.
What is worse: being sick or THINKING you are sick?
Anyone who has been a long time reader of the chronicle knows about the anxiety attacks I had before I left California, on my way to Atlanta and now the current batch.
Let me start with the latest batch:
My dad died on april 25, 2000. I was a wreck. An emotional and physical wreck. I took two weeks off from work to deal with myself and with the funeral and everything else combined. I laid, literally, on the couch watching the golden girls and crying. After the funeral, we came back to VA where the very next day we left to go to Virginia Beach for my court case against shelly. After coming back from that trip on a Friday (May 5th), I started feeling congested in my chest. I went to the doctor who said i was had a tad bronchitis and gave me drugs for it. Within a few days i felt better. Then starting in late june, i started feeling “weird” again (my only word to describe it). I went to see three separate doctors who said it was stress (and while you are at it, drop a few pounds quit smoking — you’ll feel better). And while that is all well and good — when i’m laid up all weekend due to such a severe anxiety attack I NEED RELIEF NOW!
so we tried Paxil. didn’t work.
and now i’m on klonopin (for schizos actually -teehee) which, after the first dose i slept for 14 hours and felt WONDERFUL when i woke up. But then the paranoia kicks in:
each ache and pain in my body is instant “i’m having a heart attack, i’m feeling sick, i’ve got cancer, i’ve got —-” and so goes in my head EVERY FUCKING DAY!
And going to bed was worse — because i started obsessing with death. oh, this isn’t the old morbid gawf crap — this was the “if i fall asleep, i’m dying. i’m not waking up.” and each fucking nuance of my body made me feel WORSE. and then i couldn’t sleep. and my heart would pick up pace and that freaked me out even more and on and on it would go. and it has been going on for a good month now.
so the other day i wrote about taking charge of my life. and i want to say a BIG THANK you to everyone that wrote me and said that they have gone through similar things because it’s so fucking lonely feeling like i’m the only one whose life is falling apart.
when I first started working at UUNet, a person i shall say became a very good friend said he thought it was remarkable that i was handling a new job, new move new everything with such aplomb. my job is fucking stressful. (sidebar: some nitwit started emailing me a few weeks ago accusing me of being someone else. and claimed something along the lines that we were lovers 17 years ago. 17 years ago i was 11. I kept telling him it wasn’t who he thought it was — i mean any idiot could find out anything about me if they tried hard enough. i’ve never been ashamed in giving out information. then he counters back “i have a few friends at uunet. you don’t work there. my bosses thought that was funny.) my life with paul is stressful. my life in GENERAL is stressful. and my body was saying LISA! WOOHOO time to wake up. And i started and am still taking babysteps in making those changes. i’ve tried giving up smoking (again, tonight, i’m smoking my last cigarette. the coughing and nasty taste in my mouth is making me sick). but what sucks is the day to day crap. because i freak out if my heartbeat accelerates and THEN i start panicking more so.
My doctor told me that when you have social anxiety disorder (or you are just darn anxious about something) every nuance of your body is explamified. Every pull, strain, bruise, tingle suddenly causes me to worry. so i sit there with my stupid “instant stress relief” music cds doing deep breathing for 10 minutes to calm down. and when i don’t? I freak again!
My heartbeat at rest is between 70-80. American Heart Association says normal is between 50-100 (thought chances are more so if you have a heartbeat over 70 of having a heart attack). Sometimes I hit 100 and other times 120. When I hit 120 — i keep thinking like fred sanford “I’M COMING ESTER! THIS IS THE BIG ONE!” and then i sit and have to do the stupid stress relief music and deep breathing exercises to bring it back down. My cholesterol, blood pressure and everything else is PERFECT. (however i am a woman who smokes/smoked and takes birth control pills). i’m overweight. but i’m healthy. i’m too young to be freaking out.
As you can see, my life is full of stressful events. But i started noticing things. When i started writing (shock) even just bullshit in my paper journal — i felt better. when i work out, i feel better. when i stretch my body out just after sitting in a cramped movie theater i feel better. i have to keep telling myself it’s anxiety and stress and that taking care of the issue NOW without living in isolation for three years (which happened to another co-worker of mine at UU. she had anxiety/stress so bad, she didn’t drive for three years and barely left her house — now she’s so easy going it’s depressing). Me. Myself. And I.
I’d like to think there is a reason for all of this. Why me? Why at such a young age? Why am i popping drugs and not looking for healthy alternatives. which prompts the paranoia that i’m gonna STOP shaving my legs, drink herbal tea and chant about my ying and yang. I’m so afraid of becoming a freaking hippie to be well. It’s like the holistic path works — but i don’t want to get caught up in those stereotypes, yo.
i don’t have a reason or a point to this. it’s mindless ramblings. but there is something i wanted to point out — when I used to discuss my past with my friend Michael, i used to get anxious and headachy stressing “i don’t want to deal with this now” because I didn’t. but i never did deal with it. I just went on my normal little way. but see the headaches have grown worse until i write about it (even if it is stupid — which i think sometimes i am — because i can be much more wittier) — and it’s like a fight against me and the world. i know i’m a strong person (nurse at the help line: you don’t sound sick. you sound actually very strong. me: look lady, if a doctor doesn’t see me today, i’m gonna kill some muther fucking someone) and I CAN DEAL with this. but it’s hard.
no one ever told me how hard it was to be normal.
my shrink apt is on tuesday. that should be interesting.
x0x0x0x
lisa