Perspective

I have always been a bit of a doomer. Worried about peak oil, national debt, the aging population, the depletion of resources, etc. Well, this past week I have been stuck in bed due to an injury keeping me mostly off of my feet, and going on the internet. And it is much worse than I feared. There is no way that we can easily make the switch to alternatives. Yes, they could provide some of the energy that we use now, but not all of it- and it would take so much energy to build the infrastructure to start them up and get everything electrified. By the time that it make economic sense to do so, society will not have the money or energy to do so.

We are living in the petroleum age, and we think that it will last forever. All civilizations rise and fall. This one is going to fall. OK, it has happened before. Life will go on, for those who survive. Maybe we won't lose everything. And maybe some things will be gained.

But I think that a lot of people are going to die in the next 2-3 generations. And that is really awful. But I don't think that we can support this level of population without a lot of energy for farming and distribution that we just won't have- and we will have depleted our soils and deforested the environment, and old places will no longer be habitable due to global warming.

Everything is temporary. Nothing lasts.

And perhaps this insight is what is giving me some solace with my depression, despite my fears for my future and my society. I don't know how fast this is going to happen- people who predict the future tend to do so too early, so that they can be ridiculed by those who are clinging to the status quo because the sky hasn't fallen yet.

I would like the space program to continue, because that is our only hope to protect us from the next asteroid or comet that is headed towards earth. But I really don't know that is will. It is pretty damn energy intensive. But that is something that I think that we should try to save.

I wonder how many people know how bad the situation is? How many politicians? We are such optimists, especially in America, that whenever I try to bring up the subject, people just say something like solar, or wind can save us. They don't understand the scale of the problem. Geothermal can't do it either. Nuclear could do it for a while, but with a lot of start up costs. If fusion is going to save the day, it had better come fast.

You would think that we would make this another Manhattan Project. Where is our future energy going to come from? The problem is, so many people think that we already have it solved- a little solar, a little hydro, a little wind, and maybe a few nuclear reactors. If only. And we would still have to build the electrical grid to use it, and better batteries.

Some people think that private enterprise will get us there. But I think that the problems are too big, and the start up costs too high.

I think we are in big trouble.

Falling Down Again

The day has progressed, I have not. I am feeling more depressed. Of course, I have not left the house. I am hoping to still make my dinner plans. Maybe I can do one thing today.

Like any good drug addict, I am already thinking of my next pharmacological escape. Which means, calling my psychiatrist and asking for a new drug. Is it time? How long do I wait? How bad do I let things get?

I'm thinking that this is my fall/winter SAD depression kicking in. All the rainy, cloudy days that we have had recently hasn't helped matters any.

I really don't want more meds, I want less meds. I think meds made me bipolar, I started out with just depression. I think my meds are making me stupid, and taking my drive away. They have certainly made me fat. But when you are lying in bed, and life is just slipping away, and death seems like a comforting thing- well, you will try anything. What is there to lose?

What I am doing today is spending hours in front of my light box- I've set it up so I can lie in bed and still use it. It's cheaper than going to Florida! Which I can't afford, in large part to all my medical spending!

I really don't want more meds. But I know if things get bad enough, I'll change my mind.

Very Strange Dream

I dreamed last night that I was a part of this group of scientists that was doing experiments on rats. We were trying to teach them enlightenment by nearly drowning them over and over again, only to give them a breath or two at the last minute. I have no idea what the theory was, only that there was one.

In the dream, I was torn. My mind said that the theory works, and we will have a bunch of enlightened rats. But my heart said, what we are doing is really cruel. Look at these rats suffering!

When I was in college, I worked for two years in a lab where we routinely killed mice and rats. Not for their benefit, but ours. No enlightened rats. Only theories about the neurotransmitters in human brains.

I woke up feeling a little strange, but less depressed.

I turned on the TV while drinking my morning coffee. Of course it is all about 9/11. Until today, it has been all about the floods.

I remember where I was on 9/11, as I'm sure everyone does. I was living in Philadelphia in grad school. Someone called me up to ask me if we were going to have class that day, and I asked, why wouldn't we have class? And then they told me. I ran to the TV. It was like looking at scenes from a horror movie, I couldn't believe it was real. My dad was in NYC that day, very close by. After the first plane hit, they kept going with their meeting. After the second hit, they stopped. It took him all day long to get home to Brooklyn.

I had a NYC psychiatrist at the time. And he didn't think I was sufficiently traumatized from 9/11- but then he could never read me. He told me it was because of some medication I was taking that had been shown to protect from PTSD in some study. I can't remember which one now.

I was traumatized, but I think not like New Yorkers. And I think that was why he wasn't seeing what he expected- I was living in Philly. Also, I tend to keep my emotions inside a lot. He didn't see what was there.

OK, So I Didn't Make it to the Gym Today

I am depressed today, the first day in a few days. But I'm handling it. I went out for lunch, got a fast food cheeseburger and shake, and sat in my car in the sun and listened to music on the radio. It helped, and I didn't cry.

Now I am home and just want to curl up in bed. And eat chocolate ice cream, which I don't have.

I'm trying to stay in the moment, and not wonder if I will still be depressed tomorrow, and think about potentially how long this depression could go on. Maybe this is the onset of my fall depression, despite my light box. Don't go there. Maybe this is because of going off of the Abilify- don't go there. I'll find out soon enough if this is a trend.

So the mindfulness people, and my therapist in particular, say that when you are feeling bad, it is enough to be feeling bad in that moment. Don't project into the future. But at some point, don't you have to make plans, make decisions? Like am I going to be too depressed to do the things I have planned for tomorrow? And should I make adjustments? Should I cancel anything?

Nothing is simple, not even mindfulness.

But for today, I will try to accept what is, and hope tomorrow is better.

Abilify is Not Good for Me

I have been feeling like I have ADD on steroids recently- which is why I went off of Abilify the first time. I can't focus, I can't sit still, I have a lot of irrelevant and obsessive thoughts racing through my head. It is horrible. It took me a little while to realize that it was happening again.

So on Friday, I didn't take my morning 5mg dose. I have been so much better. So far, I am still taking my nighttime 5mg dose. I don't know what to do about that, only that I shouldn't go off it right away, if I do want to go off of it. Which I think I do.

I think that the Abilify does help with the depression, in some ways. But, at quite a price. If it makes me stupid- that is too high a price. Because I was starting to get depressed over how out of it I was feeling! Really depressed. Because I started feeling like I couldn't even function, and that is depressing.

Sometimes the problem is the medication.

I can't for the life of me understand why we are putting so many people on antipsychotics who are not psychotic. Now when I went on zyprexa, you could have probably made the case for it. But the Abilify was just added for depression. There were other things to do. There are other things to do. Abilify was just an easy thing to do, especially because I had a slightly agitated depression at the time, so there is always the fear of triggering mania. I had mentioned going back on wellbutrin to my doctor, but he suggested going back on abilify, and I agreed. Silly me. Next time my depression cries out for pharmacological intervention, I am going back on Wellbutrin. No more Abilify. One antipsychotic is enough.

A Little Bit Better Today

I feel a little bit better today- not a lot. But enough that it makes a difference. I function a little better at work, I don't drown so much in the paperwork. When I remember, I say my "loving kindness" mantra to myself.

But it is still bad. And I come home and collapse in front of the TV, and I do nothing. I eat comfort food. I know that what my body needs is to exercise, but I don't. I am disgusting. Dishes pile up in the kitchen.

I know that it is never going to be easy to do the right thing, to do the things that I need to be doing- but today it is just too damn hard. I don't even try, beyond work. That is enough for today.

I didn't cry in my car at lunch. That was an improvement. I wanted to, but I didn't. I did yesterday.

I think I feel better physically today. The past couple of days I have felt bad physically, like I was coming down with something. I was sneezing a little, I felt chills, but it didn't get any worse than that. And getting a virus is often enough to through me into a depression. Today I feel better, just tired, and with terrible heartburn. But I had pizza and a chocolate bar for lunch, what did I expect?

I know that I have a lot to be depressed about, if I look at my life from a certain perspective. I feel like I don't have the life I want, and I feel incapable of working harder to make a better life. I feel like I am stuck.

Then again, I am alive. I have a job, and they have not fired me. I have parents who care about me. I have a brother I love who is going to have a daughter this year. I have relatively good health, especially given how much I weigh (thank-you Zyprexa), and no diabetes.

I need to find ways of making some things in my life easier, so I can do the things that really matter. Like studying hand therapy. Like doing yoga and hiking and going to the gym. Eating healthier- but making it easy. Somehow, something has to get easier.

Today when I felt so bad, I tried to think of one thing that would make me feel better, that my body was asking for, and I decided that it was a massage. Unfortunately that costs money. But I get paid this Friday. Maybe it can happen. I could get massages every week, and it would still be cheaper than my Abilify.

Depression is Back

The last two days I have been very depressed. I even skipped my therapy session today because I was too depressed to go- I had to run home after work and go to bed.

I work in healthcare- basically in the service industry.Which is a hard place to work with a mental health issue, because it is not enough to do your job. You have to do it with a smile. And I understand with my patients- but with my coworkers too? I wish that I never got asked the question by a co-worker, how are you. That is a terribly personal question. I don't want to tell you the truth half the time, but I don't like to lie. So it is never a satisfactory response from my side when I feel like hell.

And that really is all too often. I am starting to wonder if I am in the wrong profession, but then I don't think that there is any right profession. I feel like I have to be so close to 100% every day to not only treat my patients right, but also to get my paperwork done, and treat my co-workers cheerfully. And I'm just not 100% everyday.

Is there a job where you don't have to be on top of your game everyday?

Is there a job these days that has no paperwork? Where you don't have to smile when you feel bad? When no one will ask you how you feel or how your weekend was, when you stayed in bed depressed all weekend? If there is, I want to know about it.

And yet, I love what I do. Just not all of the time. But I love being an occupational therapist. It is the best thing in my life right now. And the biggest burden. I guess that is normal.

When I am depressed, the one thing I have to do is work- I can let everything else go. But I have to work. So I wind up getting very angry about it, because it is so hard. But a girl has to make a living! I have been on disability, I don't want to go back there, assuming I could even get back on it. I have to make this work, no pun intended.

Today I have the running retrain "I want to be dead" going through my head, which I tried swapping out for "loving kindness." Did it help? Maybe some. But I felt bad that I was just using these words with such bad feelings, like they didn't have any meaning themselves. But I think it did help a little, and did make me feel a little more present with my patients. And I'm all about my patients when I am at work. I know I am there for them, no matter how bad I feel.

I'll feel better on Friday, when I get my next paycheck, and I can put a little more towards my new car fund and towards my credit card debt. I can't believe that it is almost the end of the month.

But for today, here I am bitching. Because in my day to day life, there is no place for this.

What Makes Us American?

The storm is over, and so I have been spending my time doing laundry and watching BookTV on CSPAN. One the the authors was Christine O'Donnell who basically said that the problem with socialism is that the state decides what role you should play, but the American dream is to work as hard as we can to get a good car and a good house. Somehow this wasn't very inspiring.

In American we have a limited social safety net, so we have to work very hard. We have to fund our own retirement, and increasingly our own healthcare. This makes it all about money, whether we want it to be or not.

How does it all come down to money? It is just a human construct, it is a make-believe thing. Why is it worth more some days than other days? I have sold my soul- or at least my time- for the make-believe thing. I go to work everyday. If I won the lottery, I would want to work just enough to value my time away from work. Maybe two days a week. That would be heaven.

Maybe someday. When I am done with therapy, paid off some debts, when all my meds go generic. Maybe I can work less hours. How un-American.

It's All a Little Disappointing

Yes my power did go off Saturday night- way earlier than I expected, but then it went back on by Sunday morning. I did get to test out my hand crank radio/flashlight, which is worked pretty well. But the storm itself seems not to be living up to the hype.

I don't know what I expected- Manhattan to float away? And I guess there is still the potential for a lot more flooding- now the rivers may flood. Which is more of an issue than the ocean where I live. But I think we dodged a bullet. Which is a good thing.

And yet the little kid in me says, is that it? After all that hype, is that it?

There are certainly enough people who are very effected by the storm, and for them, it is no small matter. But it seems that the buckets and pots and pans of water that I filled were filled for naught.

The Weather Channel in All Its Glory

We have Hurricane Irene on our doorstep, supposed to get here tonight. I don't think it will be so bad where I live, a bit inland, I am mostly worried about power outages. And maybe trees down.

With 24-hour news channels, you never know what to believe. How bad is this going to be? They will play up anything for something to say. And I guess the answer is, when it comes to the weather, we don't know. We can't predict things with 100 percent accuracy. The storm could go a little bit this way, or a little bit that way, with tremendous consequences.

I have to get myself out and do some grocery shopping, because I really don't have much food. I was going to go last night, but I was too upset after I nearly had a melt down at the pharmacy.

I wanted to fill my Abilify prescription. And I knew that I only had less than 100 dollars left in my deductible. But they told me that when they tried to put it though, I would have to pay the whole 525 dollars. So I didn't fill it. I still have some left- but I don't know what to do. I don't know how to fight this. Maybe because I still haven't met my full deductible, I have to pay the full thing. So I just need to find something cheaper to get to my deductible, and then I can try to fill it again, and just pay my co-pay. I do not have 525 dollars in my health savings account at this time.

Every job I have had, the insurance has been worse. When you have a high deductible plan, you feel like you don't even have insurance half the time. Plus they keep finding reasons to deny things, like lab work, etc. that they say is experimental or not needed.

So anyway, I was too upset to go grocery shopping, so I have to go today. I wonder if the shelves will be bare. I have heard from my patients that bottled water is sold out.

A Good Day to Watch CNN

An exciting news day. The rebels have entered the capital of Libya, it is happening faster than anyone expected. The TV is full of images of people celebrating in the streets. Joyous voices and faces.

I hope that there is a little bit more freedom coming to the middle east. I think America's star is waning, I am actually quite pessimistic about our long term future. But I hope that the freedom that has for so long been represented and protected by America will be found in other countries, whatever happens here.

Before watching CNN I was watching CSPAN, and Mark Steyn talk about the coming economic collapse of America. He was preaching to the converted- I have believed this for some time. But I don't know what to do about it.

Democracy has been a great experiment- but what happens when the electorate realizes that they can vote themselves more government benefits than they pay taxes for? What happens when our president tells us that we can go to war and not raise taxes to pay for it? We must not be teaching math is school anymore.

But I digress. The scenes in Libya are wonderful. I hope the joy is not momentary and fleeting, but that some of it can last through the hard process of trying to create a functioning government.

Today is Better

I'm feeling a lot better today. I'm back up to the full dose of 10mg of Abilify- this is my 3rd day at the full dose. I've been doing the light therapy for a week. And this morning, I feel like something has shifted, I feel tremendously better. I feel at peace. I actually did dishes this morning.

I hate to admit that I need so many meds. I mean, TWO antipsychotics? Am I that crazy? Apparently so. I think t0o many people are taking too many meds.I think antipsychotics are overprescribed. I think that polypharmacy has gotten out of control. And yet- it works for me. 10 years ago I was in and out of psych hospitals, on disability. Now, while my life is still very hard, I haven't seen the inside of a psych ward for 8 years, and I am working full time. Well, actually I have seen the inside of a psych ward- but as an occupational therapist treating patients, not as a patient.

I am probably on the least sedating "cocktail" that I have been on in years, so I shouldn't complain. If I can forget the weight gain- and I am no longer gaining (just haven't lost), the side effects aren't too bad, probably the best they have been in a while. Long term effects, yes, I worry about. But lets face it- I never thought that I would live this long (or want to live this long). And I almost didn't. So I'm really living on borrowed time. Without meds, I think I would have killed myself by now.

So I need to stop messing with my meds. Yes, keep taking all of my supplements, hoping that they will mitigate the bad things that my meds do- but I need to agree that for 1 year I will not touch my medication dosages.

I Need Abilify?

The past week has been the week from hell. I have been so depressed, I amazed myself by being able to get myself into work. Some days I think they should give gold medals for that- but I guess that is what a paycheck is for.

By 3 or 4pm things seem to get somewhat better, and I'm not so tearful, not so afraid that I'm going to be audibly repeating the words "I wish I were dead" that repeat constant in my head. But it is still bad. I go home and collapse.

Of course I have gone back on the Abilify. And I am doing my light therapy again, which I don't always do during the summer- but it has been so cloudy and rainy that I think I need it.

And then Tuesday I dragged myself to therapy after work. Somehow. And I am glad that I did.

I have always said that therapy does nothing for me when I am really depressed, except maybe let me vent. But my new therapist, who is big into DBT, focused on mindfulness, and that is something that I have never tried when depressed. And it helped. No, it didn't make the depression go away. But it did make it more bearable.

Depression takes so much away. When there is nothing that you want, life becomes just something that you have to push through, waiting to die. But I'm not suicidal, somehow. I guess there is still a part of me that is telling me this is probably just due to coming down on the Abilify, and that going back up on it will fix it. I hope. If not, I don't know what I am going to do.

Forever Meds?

How many of my meds are forever meds? If I listened to my psychiatrists, it would be everything, and I'd never come off of anything. I would just keep adding or raising at each new crisis, and never reduce. No doctor has ever tried to get me off of anything except klonopin.

But I have successfully taken myself off of a couple of things, and reduced some other dosages. And then, sometimes I haven't been able to. Maybe I didn't go slowly enough, or maybe I really need it right then.

But after going on the Abilify for a short period, I am ready to go off of it. I am better. My life is better. And I don't want my brain to get too used to it so that I will start needing it, and then withdrawal will be harder. But I am going off of it slowly. And I know that it is there if I need it again. Which I probably will, someday. I hope not someday anytime soon. But I know that Abilify really works for my depression, and fast.

I Believe in Abilify

I have upped my Abilify, and life is bearable again. The depression is not totally gone, but it is not agony anymore. And in a week, I'll be on vacation. Maybe that will pull me out even more. I'd like to think that something other than drugs can help me- especially the antipsychotics. But damn, they work so well. And the antidepressants by themselves are not enough- plus they make me manic without a good dose of my zyprexa.

The antipsychotics are the only meds I am not at peace with, that I keep trying to lower my doses of, that I don't want to be on. Between the weight gain, fear of tardive dyskinesia and other brain damage, who would want to take these drugs? Except that before I went on them, I was in and out of hospitals and had no life.

The antipsychotics are bad for your brain. But, as my psychiatrist reminded me, so is untreated depression. So I can't win. I'm going to have a damaged brain no matter what I do.

Meanwhile, I take lots of antioxidants and various supplements that I think will protect my brain. And I've started taking metformen because of the weight gain- which has helped some, but it is a little too late.

For now, I am just glad that I feel better enough to function a bit.

If only it were just bipolar...

I have learning disabilities. I did 2nd grade twice. I was in special reading classes. I did badly in school for many years. In college and grad school, I finally found out enough about learning disabilities to get untimed tests, and it saved me.

I was born before everyone talked about learning disabilities. When I was a kid, you didn't really test and label people. And when I finally was, it was dyslexia, which was the learning disability that people talked about. And I did have trouble reading, reversed numbers and letters, didn't know my left from my right, etc. So it fit.

In recently years ADHD is the in diagnosis. And I am told by some that I have ADD (I'm not really hyperactive). And that fits, too. And I have had testing, of course, where they didn't give me a label, just told me what my brain does well or poorly.

The labels are just labels. So, do you want to say that I have bipolar disorder, ADD, dyslexia, etc., or do you just want to say that I have a bad brain? That is what I think.

But it all comes together to make paperwork a nightmare- and I work in healthcare. And at my new job, we are back to paper charts. And we do a lot of the tasks that had always been done by other people- like faxing out our own charts to insurance companies for authorization. And it is really a nightmare.

If I am having a bad day, I just can't do it. And even when I am having a good day- it just takes me so much more effort than it would anyone else. Even just faxing out a chart- half the time I don't get the phone number right because I have transposed the numbers right and I have to resend it.

I had some rough weeks- and I got behind. And I am trying to catch up. And I am doing it, but it is so hard, it is taking all the joy out of my job, making me wonder if I picked the right profession. But what is the right profession for someone with bipolar and ADD and dyslexia? Is there one?

I think it will be better when we go to computer charts. Which is supposed to be coming. I had an easier time with it at my other jobs. Anything is better than paper for someone with ADD, who is a disorganized disaster.

What I really need is to work fewer hours. Fewer hours- fewer patients- less paperwork. Less chance of getting 3 evals in one day.

Something I really need to think about. I think I could cut down 4 hours a week and still have full time benefits. Of course less pay. But less worry about getting fired.

I used to think I might get a second job on the weekends or evenings to make some extra money. Pay off my debts faster. Who was I kidding? I'm going in to work on the weekends to catch up, I think. That is what I need to do. I just have to accept that.

Really, I got extra time on tests in college, I have always known I need extra time with my paperwork. I guess I just hoped that someday it would get easier- but at this recent job change, the paperwork situation seems to have gotten worse. Everything else about the job I love, I really do. And for that I am grateful. You can't have it all.