Sunday, November 27, 2016

Halfway down the rabbit hole

I live in two worlds. I am a doomer- I think our civilization is going to collapse. Between climate change, loss of top soil, resource depletion (including oil)- that civilization as we know it cannot survive. I just don't know the time frame. Will I live to see it? Will it be my nieces' children who see it? I don't think we have much longer than that. I'm not necessarily of the opinion that we will go extinct as a species, as many doomers say. But we could if our nuclear reactors don't get shut down properly.

I've done a lot of grieving over this, and somewhat come out the other end. I want to keep living my life. I don't want to get pulled down by this. I want to go on with my daily life, because I don't know what else to do.

I tried demonstrating and it seemed pretty useless. I have written my congressmen. I tried getting involved with a political group, only to realize that I have nothing to offer- I am no good at a anything political. I am not a social being. I don't know if there is anything to do anyway.

So I focus on fixing my patients' broken wrist and fingers, helping their pain or manage symptoms. I am effective on the micro level, just not the macro level.

Mostly, it is just another thing that makes me alone. I haven't met other people who really seem to feel the same way- except online. And people think it is my depression talking, but it isn't. Perhaps my depression has allowed me to see it- people with depression are better at perceiving negative probabilities.

When I grieve for my mother, at least other people understand somewhat. When I grieve for the world, then what?

If an asteroid were going to hit the earth, would you want to know? And if you knew, would it change how you lived your life?

Saturday, November 12, 2016

I still can't believe it

I still am in shock that Trump won. I didn't think the polls could be so wrong. I didn't think so many women and non-whites would vote for him. I just didn't think he would win.

I know he spoke to the issue of the declining middle class- and he even had an explanation: globalization and immigration. But I think the bigger issue is technology, and no one is talking about that. What do we do as technology takes away our jobs? 

Trump's election makes me that much more a climate change doomer. China is the only hope to do anything about it now- they have the size and the economic clout to make an impact- plus they are not a democracy. And perhaps they could get America to follow. 

I don't know what is worse- if these climate change deniers are lying or that they really believe it. Don't you care about your children and grandchildren? Or perhaps you think it is too late- and maybe it is- and some people would rather not know if there is an asteroid heading towards the earth. What is it about America that has produced such a large number of climate change deniers? I suppose it is a type of "American exceptionalism," But the not the good kind.

Whatever our legacy to future generations- what they will care about most is how much of a habitable planet we have left them. How much arable land. How much fresh water. How much land that is not under water. How much land that is not too hot during certain times of year to survive exposed. How much land and water is not poisoned with chemicals or radiation.


You can't have everything

When I am extremely depressed, all I want is to feel nothing. When I am numb, all I want is to feel. When I am extremely depressed I would give my right arm for the pain to stop. When the pain lets up, I start to care about my physical health and worry about the long term effects of my meds, and how they seem incompatible with a long and healthy life.

I am trying to make me peace with Zyprexa right now. The higher dose seems to be going a little better this time round in terms of feeling out of it and wanting to eat everything in sight. However I still need to sleep a lot. I hope that gets better.

I hate antipsychotics but recently I have hated living even more, so I have to chose.

I had high hopes for the CPAP. I have sleep apnea. From one perspective- total number of episodes a night, it isn't too high. But during REM sleep it is severe. So now I have a CPAP machine. I hoped it would help the depression. It hasn't- or maybe I'd be worse without it as it is my bad time of year. I am less sleepy- or was until I increased the Zyprexa.

Maybe I need to move to Florida. I have a light box- and it helps, I used to be in the hospital every December and that is no longer the case- but it doesn't help enough.

I am grateful it is the weekend. I have a little time to breathe. And try to get outside- it is very sunny out. That has got to help. And stay away from news. That is very depressing.

Thursday, November 10, 2016

Hello Vraylar, goodbye Vraylar

I tried it, it didn't work for me. Maybe I had given it more time- but I am in a place where I cannot afford to get worse before I get better. I really cannot get worse.

So I am going back to my old standby, raising the Zyprexa. And hoping that I will eventually stop feeling sleepy and out of it- maybe that part will not be so bad now that I am on the CPAP machine. It is one thing that it makes me hungry and raises my cholesterol. It is another to not feel good because I feel out of it. No, that is not true. If I truly felt good I would want a long life, and then I would care more about the physical side effects too.

Anyway, so far it seems to be making life more bearable, each minute isn't such complete agony.

Politics is affecting my thinking too. Obamacare is probably toast with Trump in the White House. That means there will probably be no way for anyone with a pre-existing condition to get health insurance except through a job. So there is no way for me to work part time, etc. I need to keep my job and work full time.

I cannot believe that he won, on so many levels. But mostly because the polls were so wrong. I went to bed early because it seemed like it would be a long night- but expecting her to eventually win. And woke up and I was shocked.

It's not like I was a big Hillary fan. But the lesser of two evils- that was what I thought. And at least she admits the climate change is real and caused by humans. That is probably my biggest issue. Climate change. I have nieces. I think the biggest thing that future generations will care about is how much of a habitable planet we have left them. Everything else is secondary.

I know that the Paris agreement wasn't enough- but it was a start. If Trump gets rid of that we have no start. And the CO2 levels keep rising. It's not like we can just decide at some future date to stop burning fossil fuels and they will suddenly come down. Not in time frames meaningful to human beings.

I'm basically a doomer, and Trump's election only strengthens my position. No wonder I'm depressed. Although that is a different kind of depression than the one I have had the past couple of weeks. I have sort of my chronic depression and then my depressions when I am sure that my brain is broken. When it is on fire.

Sunday, October 30, 2016

Still in my loop

I still haven't decided what I am doing about the Vraylar. But I won't start it now anyway- not until another weekend. And next weekend I am at my brother's, so it will be at least 2 weeks away. Could I really get off of Zyprexa? I have tried so many times, failed so many times. But what I have done this weekend is cut my Effexor, and it seems to be helping. I think I was blaming the wrong med for making me tired and out of it- it isn't the half milligram of klonopin I take at night, it is the Effexor I take in the morning. How low will I go? I don't know. So far no increase in depression.

Westworld is on tonight, my current favorite show. I don't watch a lot of shows- Mr. Robot, Game of Thrones, the Daily Show, and now Westworld. It has even given me a way of thinking about my life. I am living in a loop, just like the "hosts" on the show. I need to break out of my loop. Because it isn't a very big loop, and it isn't a very happy loop. And too much repetition.

Today is my monthly Costco trip to fill my Provigil. And to buy as much food as I can for the coming month, because I am not into grocery shopping these days. That is one of the first things to go for me with depression. It's not in my loop!

Saturday, October 29, 2016

Slaying dragons with Vraylor

No, I didn't make it up- I saw a post in which someone said that Vraylor sounds like slaying dragons, and it does. Maybe it is the name of some great dragon-slaying sword. Or just another sign that there are way too many drugs in this world and the names are getting ridiculous.

But I don't want to slay dragons, I want to swallow one. My life has been so blah recently, I need a little fire in me. But a dragon slaying sword by my side, maybe that would be OK.

The past few times I have seen my psychiatrist I have come up with all kinds of excuses to explain my bad mood. Maybe I was right, but I was still tired of doing that- and my mood has dipped recently with the season change. So I decided to see what he might have to offer, medication-wise. And his answer was Vraylar.

He said he has had good results with it with bipolar. The goal would be to eventually get off of the Zyprexa, but not yet. It is a new drug, there is not a lot out there on it. I have looked up all the side effect rates and efficacy rates and receptor occupancy rates and compared them to everything else I have been on- driven myself crazy, basically. And finally decided to give it a shot. Something has to change- and I'd probably have more energy on that than Zyprexa, if it works.

But the problem is insurance. My psychiatrist gave me a card for 30 free days of it- and said that if it worked he would deal with the insurance pre-authorization. And I didn't think it should be a problem- I have been on risperdal, seroquel, zyprexa, geodon, and abilify. But when I looked up the medical bulletin on Vraylar for Aetna, they want you to have tried at least 30 of a generic antipsychotic (I have), and also Latuda (I haven't). Latuda is a brand name drug, and must be giving Aetna a really good deal with rebates. It is really practicing medicine without a licence to say that you have to try a specific drug before you can try another.

I haven't taken Latuda and I don't want to take a drug just because my insurance company tells me that I should. So I don't know if I will get Vraylar approved, and I don't want to start it if it isn't going to get approved. And it is over 1,000 a month- truly ridiculous. I just think this is going to be too much drama dealing with insurance companies and I can't handle it. It makes me feel so vulnerable.

I don't even know if it would work. I find it hard to get too excited about another antipsychotic- I hate antipsychotics- but Zyprexa got me off of disability.

I got a call from CVS. My prescription is ready. I can pick up my Vraylar. I don't know what I am going to do, I suppose I should call my psychiatrist.

Saturday, October 15, 2016

I think I'll be writing again

I've been on an unsuccessful quest to find a new therapist after a break. I'm trying to find someone who takes my insurance, and that is no easy quest. The last therapist I talked to told me that no good therapist is in-network anymore. She may have a point- I have tried a few in-network therapists and it hasn't worked out. I tried to tell her that she should change her listing on Psychology Today which states she takes Aetna (but it only meant she would send the bill to Aetna if you are lucky enough to have out-of-network benefits, and then balance bill you for the rest). I no longer have out of network benefits, so that doesn't help me at all.

The last person I called never called me back. I think I have another couple of prospects, but again I don't know if I can trust the listings anymore. If it says they take my insurance, does it really mean that they do?

But maybe all of this means I am meant to do without. That therapy is a luxury, and I'd rather spend my money on other things. I could go to my hospital's clinic, but I have never had good luck at clinics. I'd really rather not. And I don't want my therapy records anywhere near my work- with everything electronic.

I am still so mad at my hospital for getting rid of out of network benefits. In almost every field of medicine it is easy to find a provider who takes my insurance- except for mental health. People with mental health issues are the most affected. But we don't matter. 50% of psychiatrists don't take insurance, and I am sure it is much higher in my state- it has one one the highest levels of doctors overall who do not take insurance.

Of course if insurance companies paid more for mental health, more mental health providers would take insurance. My last therapist looked into getting a contract with Aetna, but they would have paid half of what she normally charges.

So that is my vent for the day.