Missing a certain kind of community

When I lived in the city there was a really good mood disorder support group that I went to semi-regularly. It was big- they had to break it up into different rooms. The people were interesting, and ranged from psychotic manics and just-out-of-the hospital depressives to people with families and professional jobs. It was never boring. I could always find someone in the group to relate to, and I made friends there.

Now I am living in a much more remote area. There is one club house type organization in my town. I went there one day when I was so desperate to tell someone who I really was- I was severely depressed, and tired of the act I was constantly putting on, feeling like an imposter (and an increasingly bad one).

But I went there, and the people were nice and welcoming, but no one else there worked. No one else was an imposter- they just were. And while I was worried about keeping my job, they were worried about SSI benefits. I have been there- I was on disability. But that is not were I am now. These were not my issues. I didn't fit in.

There is another, slightly further away meeting just for mood disorders. I have gone, but not usually felt like I connected very much. But I should try to go again. Maybe it will be different.

There is a cost for being "high-functioning." And that cost is that I feel like the real me isn't known. If I make it in to work, I must be okay. That is what the world thinks. I may have spent 2 hours to get myself to stop crying so I can get dressed and in to work. It is this huge denial of self sometimes, it feels like quite a cost.

The cost is worth it to me, of course. At least so far. I love my work, can't imagine my life without it. But what I do is not without cost. I suppose that could be said of anything. Maybe I am just complaining.

But I would like to again find the company of people who understand this cost, and who understand the sometimes precarious nature of our recovery. Miss a few light sessions. Throw up a couple of nights worth of meds. Things start to unravel for the smallest of reasons. I think I am starting to mend- but it has meant two days of not doing much paperwork at work, and I will have to catch up. Am I supposed to tell my boss that? I never want to use my illness as an excuse. But it is a reason.

I am mending. I like that word. It sounds like an active process and not some kind of passive thing.

Kept my meds down, feeling much better

I think maybe I was in a little bit of med withdrawal from all my GI distress the past couple of days. Last night soon after I took my night time meds I started to feel so much better. And no vomiting, no diarrhea last night- I kept them in my system. I woke up feeling fine.

The only good thing I have to say is that between my GI problems and being too depressed to grocery shop I have finally lost some weight- 5 pounds in the past couple of weeks. I hope it wasn't all water, I hope I can keep it off.

It seems that I am a lot more sensitive to dairy than I used to be. I used to be able to get away with a little bit- which was what always got me into trouble. A little would turn into a lot. So this morning I went to a Dunkin Donuts which is the only thing near me and got a bagel with egg and cheese, and a coffee with milk. My stomach is not happy. It was too much. I have to make it to the grocery store today.

It feels like it is going to be a better day than I have had in a while. And yes, I remembered to take my morning meds.

Really bad day

I've been missing my morning meds too many mornings recently. The reason is that I don't have any food in the house, and I don't like to take meds on an empty stomach. So I put them in a container to take later when I can buy a breakfast sandwich or protein bar on my way to work. Only sometimes I will forget to take my meds then.

The solution is to eat breakfast at home- which means being less depressed so I can go grocery shopping. It also means figuring out what I should be eating for breakfast. My IBS has been so bad recently I am really tired of it. And I wonder even if I have been able to absorb all of my meds. Last night I woke up in the middle of the night and I had diarrhea and I threw up a couple of times. Maybe I ate something bad.

My moods today were really bad. I woke up feeling not too bad. Then I started feeling really bad- but realized I forgot to take AM meds. I did, and felt better. But then, unexpectedly, my mood crashed again. I got out of work, could barely walk to my car, and just sat there in my car just trying to figure out what to do for 10 minutes. Finally I summoned up the energy to drive home. No banking done, no food purchased, no yoga. Just home.

This would definitely be an ice cream day if it weren't for the IBS and my lactose intolerance. It is all that I can really think about eating, and I don't have anything at home to eat anyway.  There is a convenience store about a half a mile away that is my only hope of food tonight.

Christmas Eve- and my trip to my shrink

In healthcare we don't get too many holidays. Not only was I working, so was my psychiatrist. I had an early morning appointment before work. We agreed that I am improving and I just need to get back on track with light therapy and keep the previous scheduling of my meds and get back to my yoga and such, and I will probably get out of my funk. No med changes for the moment, which is good. He also gave me another idea about how to get my Provigil- although he couldn't be too specific for legal reasons I am sure. Of course one day it will be affordable in the US, but I don't know when that will be. It has been generic for over a year and a half, it seems as though it should be cheaper than it is.

He didn't seem too concerned about the quarter of a milligram of klonopin I am taking in addition to the ambien to sleep- but did say that when I am feeling better I could try to get off of it. I didn't push the Lunesta- I am ambivalent about it. I tried it before and it worked very well- but I thought it made me more depressed- but I'm not sure. I was very depressed anyway at the time.

Work was surprisingly busy, all of my appointments were filled. One of my patients brought in some goodies that she had baked- which made me all the happier to know that she had made them, because I have been treating her for a very bad injury to her dominant hand. She is doing so much better.

With my mood I have not been feeling very Christmas-y this year. I was going to go to church tonight but I think I will just go to bed. Tomorrow I will drive to my dad's for Christmas dinner. I still have to wrap presents.

A really important program on C-SPAN2

I think I watch the most TV on weekends. And most of it is C-Span and C-Span2!

This weekend seemed to be an energy themed week. On C-Span there was a really important talk by two people whose names escape me on whether or not geo-engineering should be part of our thinking about what can save us from climate change. Basically one person was saying that cutting CO2 emissions would be great but we will never do it in time- so this will buy us some time and will help to mitigate some of the damage. And the other person argued that we shouldn't even be talking about geo-engineering because it takes our eye off the ball- lowering CO2 emissions, and lets us think there are alternatives.

I fall into the geo-engineering camp. Which is to say that I think we should be at least researching it. I see no evidence that we will lower CO2 emissions significantly, meaningfully, in time. And perhaps by talking about geo-engineering we can get climate change deniers into the conversation. Because if there were an alternative to a massive scale down of industrial civilization, they might be willing to open their minds to what is happening. I think geo-engineering is going to happen. I think it is our only hope. I only hope that we don't mess up the earth too badly in the process. I do admit, though, that simply cooling the planet does not undo all the effects of rising CO2 emissions. Ocean acidification may have to be addressed as well.

On C-Span there was also a forum on the energy forecast for 2014. A lot of talk about natural gas and shale oil and fracking for the near future as alternatives to oil. But no one was talking about EROEI- energy returned on energy invested- which is becoming much less favorable. And no one was really talking much about alternatives to petroleum. Because there aren't good alternatives. We are screwed. Peak oil vs global warming: which will hit first?

After that I watched "Elysium" which I rented from my cable company. That is my new resolution. Watch one movie a week. It was an okay film. But Earth- where all the poor live in the movie- really didn't look that terrible. I mean, it wasn't like the garbage pickers living in the slums in India. People had apartments, and there were hospitals. In fact, I couldn't help noting the irony- one of the main characters is a nurse. And at the end of the movie, they get the med pods from Elysium to come to earth- so that means they no longer need nurses and hospitals and some of the few good jobs there are.

But I guess if you are like me and you work in healthcare, your dream is really to be out of business, because no one is sick or injured. I remember when I worked inpatient at a hospital with a 4 bed stroke unit. It was right next to the rehab unit, so I walked by it every day. And every now and then I would walk by, and it would be empty. And I would smile, and think, today is a good day. No one is having a stoke today.

A little better today, I think

I am feeling a little better today- but it could just be because I did a second night of increased Zyprexa and I don't have to work today. Tomorrow is the real test, when I go back down to my normal dose- and then go in to work and try to have a normal day. I have to to the last of my Christmas shopping, which has been particularly difficult this year.

I have been doing some thinking about what got me into the place. Unfortunately insight only goes so far if you are too depressed to make changes. I hope I am not.

I see my psychiatrist on Tuesday. I really hope I am feeling better enough by then not to want to change anything. I don't want to raise anything. And I am not confident that I could change anything and  maintain my ability to work through that process. I just want this depression to go away.

When little things feel like big things

Getting dressed is a drawn out process today. Getting clothing from my closet, then going back to lie on my bed some more. Then taking off pajama top. Looking for my bra. Going back to bed. Pulling on a sweat shirt. Back to bed. I have finally managed to put on my jeans, but I am dreading my shoes. When I am depressed, I hate to tie shoes, but it is too muddy outside to wear anything slip-on. And then there is brushing my teeth. Forget a shower- but thankfully I glanced in the mirror and my hair doesn't look too terrible. It can wait another day.

With depression, sometime the little things are the hardest things for me. I have called out sick because I couldn't get dressed. Usually, but not always, once I get to work or out of the house, it is a little bit better. But getting started is the really hard part. Initiation. That's what I lose. Like a car that won't start.

I really have to go grocery shopping today. I ate my last can of soup for lunch.

No matter how depressed, I can still eat- thank you Zyprexa. To think that I used to stop eating when I got depressed. That was a long time ago. In my pre-Zyprexa life. Every depression I would lose weight. Now I continue to be hungry, even when depressed- although when depressed I do have this sense that I can't figure out what I am hungry for and nothing is quite right. And sometimes I get so depressed that I will eat nothing that I have to chew. Just yogurt, pudding, ice cream, protein drinks, etc. Sometimes some creamed spinach will be acceptable.

What I find very hard to do when depressed is to grocery shop- I think it is even harder than cooking for some reason. Sometime about making decisions and suddenly I'm thinking about the future and whether I even need to buy food for next week because I don't know if I will be around for it. It is just very hard.

So now I am off to put on shoes and go grocery shopping.

Wiped out

I went up on my Zyprexa by 2.5mg last night. Sometimes if I do that for a few days I can get myself out of a dark place. But I am really wiped out today, more so than I expected- or maybe it is just that I had wanted to do things today, and usually I am content to spend the time in bed.

I am sleepy. My body feels weak. I don't want to move. I didn't go to yoga on the grounds that I think I would be a fall risk. I am hoping that by late afternoon I will be up to a walk and a quick trip to the grocery store.

On the other hand, the screaming inside of me has stopped, if only for a little while. My mind isn't going to those dark places. But the price is too high if I can't get out of bed. I won't be doing this again tonight.

I found myself wondering if I could get the same effect by lowering my Zyprexa for a few days- (if I was able to survive the lowered dose period), and then my body would be less adapted to the Zypexa, and so when I went back up, it would be like an increase to my brain. And ditto for my antidepressant. It seems like a better solution than ever increasing dosages.

I do think there are things for me to learn from this depression- beyond the lesson that I can's skip light therapy sessions. But my life has seemed to be in s rut after what felt like progress, I do have this sense of, "is that all there is for me?" in life. I have to figure out what I really want in life and what I am capable of. And I have to get out of this rut. I had to stop giving in to winter- which is leading me to run home after work instead of doing the few things I had started to do.

Another rough day

Looking back, I can see a lot of things that have added up to darken my mood. I haven't been that consistent with my light therapy. I missed morning meds twice in the 2 weeks- usually it is no more than once a month. I have been exercising less with the cold and dark. Missing yoga sessions. Worrying about paying for my provigil. And trying to change the timing of meds to lessen my morning spaciness. Oh yes, and cutting down on coffee, my favorite antidepressant, due to headaches.

Maybe it is these things- or maybe it isn't. My depression tells me that it isn't. My depression tells me that it is my life- how empty and futile it is. And if I want to stop the depression, I have to "fix" my life (whatever that means). I wonder if I am having a mid life crisis. Is this all that there is? And is this the most I am capable of?

So do I fix my brain or my life? Right now I don't know how to do either. I just want to lie in bed, although I know that is not the solution.

Tomorrow yoga. And walking along the river. And Sunday church and going in to work to do paperwork, and going to the gym to swim. That is my plan. And somehow I also have to get to a grocery store. I should have known I was getting depressed- it has been getting harder and harder to grocery shop.

Very moody these days

I've been very moody. I think it doesn't help that I am cutting down on my coffee, or that I am changing time timing of one of my meds to try to reduce the spaciness factor (it seems to be working). But the past two days, although in some ways I don't feel terrible, I am having terrible thoughts.

I don't seem to be depressed enough to be thinking so much about suicide, but I spent much of the day thinking about it. No, I am not going to do it. I think my brain was just kind of window shopping.

DBT teaches distress tolerance skills. But the premise is that you want to survive the distress. What if you don't? That has been my problem with DBT. That when my distress seems very existential- I am trying to figure out why I should be alive- it really isn't about distress tolerance. I guess that is what DBT's Wise Mind is about.

And sometimes I think that the best answer for why live is this: we all die. I will be dead soon enough. But life it a one time deal- so I might as well stay on the ride until the very end to see what happens. Death will come to me soon enough- I don't have to go looking for it. 

I'm giving up coffee

I had been drinking too much coffee lately, and my headaches are back. It is also worsening my heartburn. Today I did not have my afternoon cup of coffee- my headache was so bad I left work early, but I didn't have to reach for the Tums that I keep in a drawer in my desk at work. So I have decided, no more coffee.

Well, I'm not going cold turkey. I'm going to keep drinking just one cup until the new year- then no more. Maybe I will drink tea instead. I need my waking up ritual. My cup of coffee was always that. Tea still has a little caffeine, but not too much.

I want one less drug that I am addicted too. Caffeine. I really consider myself addicted to all of my psychiatric meds in that I would be very scared to go off any of them cold turkey. I hardly ever miss a dose, because if I miss my meds I go into withdrawal before the end of the day The joys of being on Effexor.

I think I will actually wait to talk to my psychiatrist, for once,  but I do think I do want to try going back down to 5mg of Zyprexa. I just feel too fuzzy on the higher dose. I think I was drinking more coffee in part to deal with the hunger from the increased dose, and in part because of the fuzziness.

There is the possibility that some of the fuzziness is not from the Zyprexa, it is from the lithium They were both raised around the same time. But my lithium level is low enough that I suspect the Zyprexa.

The other med change I want to make is to go from extended release to instant release lithium, for a number of reasons. And I want to ask about changing from ambien to lunesta, because Ambien no longer works unless I take a quarter of a milligram of klonopin along with it. Which I would rather not do. And I want to ask about which amphetamines are least likely to cause tachycardia, and if they are worth trying before I start spending almost as much as my rent on Provigil

Therapy or meds?

I didn't realize that I would have to choose, but I think that by April I will have to choose between continuing therapy or continuing to take Provigil. I can't afford both. And I will choose Provigil- I don't think I could continue to function at the level at which I do at work without it.

I'm not sure it is entirely a bad thing to be quitting therapy. Sometimes I have found myself wondering "when I will be done" with it. How will I know? Although really I have started and stopped therapy multiple times in my life, so if things change, I might go back to it. If something comes up. I'm sure that eventually something will.

Stopping therapy does not mean that I am totally satisfied with my life and am not trying to make changes. It just means I do that on my own. Just like using mindfulness and DBT skillls- I will be doing that on my own too.

And I will still have my psychiatrist who I am currently seeing every two months or so.

Therapy is actually cheaper than my Provigil. But it will work. I will be better with money. And I will stay in this tiny apartment instead of moving.

But I have 3 months of Provigil left, so three months of therapy.

Movie night

I watched "Oblivion" tonight, I rented it from my cable company. It was a good movie, just up my alley. It took a while to figure out what was going on in the story. Now my brain won't turn off. How will I sleep?

I was looking up the movie on Wikipedia (and made a donation to them- who knows how much longer I will be able to do such things). It stated that one of the actresses had been in the the movie "Never Let Me Go." I did not even know it was ever a movie! It was a truly disturbing, haunting book that I couldn't stop thinking about when I finished. But it was a really good book. Another book where the reader really doesn't know what is going on until the end. But if I knew it had come out as a movie, I would have gone to see it. I think..

I suspect that my cable company doesn't have it. I may have to get netflix.

While I was looking at the on-demand menu on my cable, they were showing scenes from Homeland. The female agent is being told by her father that she didn't miss something or other because of her meds- but she is saying that she missed catching something because of what her meds do to her. And in the next scene, there is the obligatory toss your meds down the toilet that any story about people with bipolar has.

I have stopped meds, but I have never tossed them down the toilet. I just stick them in the back of the panty. Hey, I might need them someday- even if it is to overdose the next time I decide to kill myself. But 5 years after the expiration date I will toss them.

It is not crazy to want to stop your meds. It is hard to know if you are more impaired on your meds or off of the. I do know that Provigil helps me to be less impaired by my meds. If I have to take less Provigil, I think I have to take less meds.

Back to my provigil dilemna. I think that if I quit therapy, I might be able to afford my provigil. And if I really, really find myself needing some kind of therapy- maybe I could try harder to find someone in network. It hasn't worked so far. But I could try.

But what I really want to do is try to appeal it again, and write in a letter myself, detailing my problems with ritalin, detroamphetamine, and adderall. I just don't know if my insurance company will take a letter from me- but my current psychiatrist was not my doctor during the times when I was on these drugs- so how would he be the better authority?

Just when I thought my meds were set

I have been doing really well recently. I am trying to resist all urges to lower meds because I am in a really good place, and I don't want to lose this. Maybe in the future. For now, I just need this.

Except that it seems more and more like my overseas source for my Provigil is no longer reliable. And I don't know what I am going to do. It is a really expensive medication, and in recent years I haven't done well on amphetamines, which would be the logical alternative. My insurance company has very strict criteria for Provigil coverage which I do not meet. They denied me for both Provigil and Nuvigil.

Provigil has gone generic, but the price in the US is still pretty high. I take two 200mg pills. The cheapest price I can find is $344/pill, with a coupon- and I am assuming I could get that coupon every month. Maybe not. That is $688 a month.

I have about 3 months worth of Provigil left, I can only hope that the price will continue to drop, and will do so significantly in that time period. I have tried cutting down on my Provigil before, but never felt good. I could afford 1 pill a day maybe. I'm paying $100/month right now. I'm sure it will be a long time before it gets that cheap in the US.

I was just starting to feel financially secure. I was paying off debts. Making plans to move from my efficiency apartment into a full one bedroom. Not going to happen.

I think, maybe I should try lowering my Zyprexa and see if I need less Provigil to function on a lower dose of Zyprexa. I think maybe I should try a stimulant again and hope it doesn't give me anxiety and tachycardia. (I had thought of taking a beta blocker for the tachycardia, but the one time I was on a beta blocker I had swollen ankles and chest pain). There really aren't good options. And then I think that maybe the antipsychiatry people are right. I just don't want to be on meds, if for no other reason than because I don't want to be in this vulnerable position.

I am just frustrated. Maybe my psychiatrist will have some ideas. I think last time I brought this up he mentioned one of the new amphetamines.

47

I've had a birthday this week. I cannot believe that I am 47- but not really in a bad way. Not until 50- then I will freak out. But this almost feels good, like an accomplishment. There were so many moments in my past when I didn't think I would make it this long, and nearly didn't a couple of times. So I guess it is an accomplishment.

My late 20's and early 30's were really awful and I was so awful. And I think half the time the meds I was getting was being given were only making it worse. I never knew I could get that bad. It still scares me when I think about how bad I was. Mania turned me into someone else, someone I didn't even know, and someone who was totally out of control.

Then came Zyprexa, and I have not been seriously manic since. Only seriously fat. You can't have it all I guess.

I have found, like most, that the mania's are easier to keep at bay than the depressions. That is where
I still struggle.

Still, I have much to be grateful for. I have a good job, a wonderful niece, a car that is paid off, parents who love me in whatever way they can, and relatively good health. I think that 47 is going to be a good year.

Too much lithium?

All summer I drank water constantly. Suddenly, as the seasons have changed, I am no longer drinking a lot of water any more. And today I feel really weird, really out of it- and like I did when we tried going up even higher on my lithium (which I decided was too much and went back down).

Drinking a lot lowers lithium levels. Maybe I was keeping mine very low with all of the water, and now it is higher. I don't think it is toxic, as my level was only .59 when last tested- it could double and I wouldn't be toxic. But it could be enough to be making me feel not very good.

Or it could be the fact that I didn't eat breakfast this morning...

I have decided that I must be on too much Zyprexa because my mother was here for over a week and we did not fight. Well, I did yell at her once when she did something very stupid and dangerous, but otherwise no fighting. I did kind of zone out during some of her lecturing but I did so mindfully, if that makes any sense, and just let her talk without really hearing her.

I'm a real American now- I went shopping on Thanksgiving eve

Thanksgiving was a good day. Mom was here, and we did the local "Turkey trot" in town. We walked of course, as they had both a walk and a run. It was fun. We went home and read and napped. Then we went out to a very fancy restaurant for Thanksgiving- no way I was cooking for two people. The food was very good. Afterward we went to Staples.

I have never gone Black Friday shopping, let alone on the Thursday before. But I needed a new computer, and there was one that I wanted that was hugely discounted, and my coworkers pointed out it would probably be sold if I waited. There is a Staples pretty close to me, so on the way back from the restaurant, we went. I think that Staples opened at 8pm, at least that is what the website said. I think we got there at 8:10, and it was pretty crowded. I was amazed.

I went home with my computer after a very long line. I convinced my mom to get a Kindle Fire for pretty cheap- at it was their last one. It was pretty successful. If we had waited, mom would not have got her kindle. I don't know how many of the computers they had, and if they would have sold out by the nest day. I am glad we went.

Wonderful weekend

I went to my brother's this weekend. I saw my niece, who is almost 2, and just adorable. It was great. I have also learned that my brother and his wife are buying a house (pending inspections, title search, etc.). We went to see it- it is very nice. And it is a sign that hopefully my brother will be staying put for a while- for much of his adult life he traveled overseas, and I was afraid of a return to that.

Now I am home and my mother is staying with me for a week. It is going to be a hard week. She is cleaning, and for that I am grateful- but she cannot stop talking. I feel like she takes up the oxygen in the room. And we are so different in so many ways. There is no harmony, no easiness in our relationship. I just want to get away, I just want her to stop talking.

To klonopin or not to klonopin?

I started feeling increasingly anxious and depressed as the day wore on today- despite being busy and productive at work. And I had a bunch of errands to do this evening as I am going away this weekend.

I went in to Panera bread for some soup and a sandwich, hoping to relax and feel better. I didn't. I decided to take a quarter of a milligram of klonopin. It helped.

I don't know. Should I just fight the anxiety? Try to push through on days like this? Just be miserable, and hope that in the long run it will make me a better person? Is taking the klonopin on days like this only giving me more days like this? I never know.

I think that if I take it too frequently, and give in too easily, it becomes a problem- it will actually start to affect my mood. Then again, my mood is not so good if I am taking it a lot, so I don't know which came first. But I also know that not taking it does not keep these days away, and that taking a tiny bit can be the difference between getting things done vs going home to be miserable.

And I did get a haircut, go shopping for presents for my niece, and do some grocery shopping. Not too bad for a work night for me. The only think I haven't managed to do is clean. I'm not that good. I'm going to get up early and see if I can clean a little before I leave. I get to see my niece this weekend!

A slow, mellow weekend

I didn't do that much this weekend except laundry. I watched bookTV on CSPAN2, and learned of a new book, "The Unwinding," that sounded good. So I bought it and got it on my kindle (instant gratification) and have been reading that. I was very bad and made an ice cream run. But I actually think that, calorie-wise, I did okay today. Just way too much sugar.

Even though I didn't do that much of what I wanted to get done- grocery shopping, exercise, church, etc., I still feel good. And I can't decide if that is a good thing or a bad thing. Maybe I do need to be harder on myself at times. But instead, I just feel mellow today.

Keeping with the good mood I gave 100$ to the American Red Cross. Why do good moods make us feel more generous? Why do bad moods often have the reverse effect? Our brains could have been wired the opposite way. I wonder if you get the same effect in primates.

I have a lot to do in the coming week. I have some paperwork to get caught up on an work. And we have a journal club meeting that I am organizing, and I have to finish preparing. I have to go grocery shopping. Buy a present for my niece before I see her this weekend. And do some cleaning before my mother comes. And yes, I am going to make it to all of my yoga classes. In fact, I am going to try out a new class on Wednesday evening as well.

Winter Sucks

The past week has been a good week at work- but I run home at the end of the day. I don't want to do anything. I want to eat and sleep. I cannot believe how hungry I am. But before sunset, my mood is pretty good. After sunset I just want to hibernate. I even blew off yoga yesterday.

I am struggling with trying to lose weight, or at least not to gain. I know the season is a factor- but I know that the Zyprexa increase is also a factor. I am also tired of always being hungry and thinking about food. I am thinking about trying to decrease it back down to 5mg. But mood-wise, I really don't want to have to do that. I will give it another week, and see what the scale says.

When I first went on Zyprexa, I gained tremendous amounts of weight. So I'm not surprised that the increase is doing this to me. I just was hoping that I could fight it. When I first went on the Zyprexa, it made me so numb in the beginning that I really didn't fight it at first. Plus, I didn't realize a drug could be that terrible when it came to weight gain. It was still pretty new. Now I know.

This week I have got to get myself together and start doing things.

Next weekend I go to visit my brother and his family, which will be nice. My mother will be coming, and then coming to visit me for a week. I have mixed feelings about this. I hope it goes well. The key to having good visits with my mother is to keep them short and to have activities planned. We will go out for Thanksgiving dinner. Normally I go to my dad's, but I don't think this would work.

Not sick, just cold

I was so cold at work today. I have a sweater, but it is really light. Usually I don't get cold, I am always the one who is hot. I wonder if my thyroid is running lower because of the lithium.

I thought I was getting sick. I started getting getting so achy by the end of the day. All of my muscles were hurting. I thought I must be coming down with something. And then when I got into my car to go home, and put the heat on full blast- I realized that I wasn't sick, just cold.

Now in my warm apartment everything is starting to feel better. I'm just sorry that I had to run home. I really needed to get a haircut. And I wanted to go to the gym afterwards, but I would have settled for a haircut.

Otherwise it was a good day, and my mood and concentration continue to be good. Interesting patients, and some good challenges.

Now I just need a life outside of work. I really do. I just need to find the energy to create that- energy that is harder to come by this time of year.

Really good day

My mood was really good today. At one point, someone said something funny as I was walking out of the room. I laughed and smiled. And then I realized that when I got to where I was going, I was still smiling! My smiles never last that long.

It was a light day, so I managed to get all of my notes done. I was able to concentrate. This is good.

The only bad thing about today is that I am still not used to the time change. It was one of my late nights when I work evenings, and my last hour at work I was losing it. Thursday I think I will resort to coffee, and hope I can take it late enough to be helpful, but not so late as to stop me from sleeping.

I am grateful for today. I hope it continues. But I know not to try to hold on the good times too hard- just enjoy them. Isn't that supposed to be the root of all suffering? Attachment?

I was attached to having sunlight when I got out of work. It made it easier to do things and have a life. Now I just want to go home and bury myself in my comforter. I will have to get used to a world without sunlight. Maybe I will become a vampire for the winter.

Doing better

I am doing better. I backed off on the meds that I had increased over the weekend- they did their job, and I am a lot better. Evenings are still very difficult for me with time time change, but hopefully I will continue to adjust.

Yesterday it was good to have yoga to go to after work, so I didn't go home and go straight to bed. I think I would have been tempted. Since the time change, I start getting really tired really early. But it was a good yoga class, and my back didn't bother me at all- but I did limit my forward flexion a little bit. Just in case.

I am very frustrated with my weight. I had been using this calorie counting app, and lost a few pounds. Then I had one bad week of depression, and I didn't even think I was eating that much- but I gained it all back plus a pound. So today I am back to counting calories.

I am trying to get my breakfasts and lunches the same every day, so then it is just the snacks and dinner that I have to count. I can't make this too complicated. And I am guessing that I really have about 4 dinners that I typically make. And I don't eat a lot of snacks- just a chocolate milk on the nights I go to yoga straight from work (I know bad, sugar). Or a protein bar or soup on the nights I work evenings.

I have to lose a little of this weight. Otherwise I have to lower my Zyprexa. I'd rather not right now- maybe later but not right now. So I have to make this work and lose some weight. I can't keep gaining.

Experimenting

I'm experimenting with meds over the weekend, to see if I can feel better. I'll call my doctor if I have too- but there is a part of me that feels like that is failure (as in I couldn't figure it out myself...). Plus, I really don't to bother him between sessions if I don't have to.

I have a good psychiatrist right now, I really do. I have had some unbelievably bad ones at times in the past, which has warped my thinking about psychiatry, but the guy I am seeing now is one of the good ones.

I also made sure to have my window shades up today (although I did not make it out of the house). And I did my light therapy in the morning. And I am trying to eat healthy today, but that is hard as I really don't have much food left in the apartment- I am reduced to eating backpacking food for dinner. Gone are the days when I lived in the city, and I could just call for delivery!

Phone call with my mother

I had a phone call with my mom, with whom my relationship is tricky. She also doesn't believe in psych meds. Or that I have a mental illness, for that matter.

I'm not really sure how to define a mental illness, I'm not going to argue with her that I have one. But I do have the experience of depression, and at times hypomania and even mania, that becomes intolerable and stops me from leading my life. And my depression right now has been getting to that point.

But I didn't want to tell her that, because then she would only say that I shouldn't be taking all of these medications if I still feel this bad. I tend to agree- but I don't know what else to do. I tried going off of my meds twice (although not in the best way). The first time I become psychotic and wound up in four point restraints in the hospital, while the second time the depression, which I didn't think could get any worse did get worse, and I tried to kill myself.

She doesn't have any answers for me. Or at least, not answers that I agree with. I don't think I am possessed- one of her theories. I don't think a nutritionist will cure me. She once took me to a nutritionist who put me on a bunch of supplements- it did not stop my plummet into depression. And now I take more supplements than she does. I really do believe in them, but I do not think that they can do it all. Also- perhaps this is just the control freak in me- while my mom wants me to go to someone to tell me what to take- I feel like this is the the one thing I can "prescribe" myself, that I don't need to go to a doctor for. And I'm not going to give that up.

I know she wants to fix me. I'm guilty of the same thing, I want to fix her life. I can't. She can't.

My mood continues to be challanging

I am still really struggling. I think the season changing and the time changing has just pushed me a little too far. I am still hoping to just come out of this, but I am less and less confident that I will. I am trying to will myself not to be depressed, to make myself function. But I am starting to give in to it- I didn't go to yoga today. And I can feel my mind starting to go, my paperwork time is pretty unproductive.

But hopefully the weekend will give me what I need. I wish that there was something I could do when I feel myself falling into a depression, to catch it early, to stave it off- but if there is anything to do, I haven't discovered what it is. Sometimes temporarily raising my Zyprexa has helped, and I'm open to that as long as it is temporary- but it can be very sedating too. Which doesn't always help with functioning.

It was dark and cloudy today with a little bit of rain- really not what I needed. I fled to my car during lunch time but didn't get to sit in the sun. There was no sun. I wonder what the weather is tomorrow.

I have a social obligation tomorrow. I am wondering if I should cancel it. Maybe I won't be able to make myself go tomorrow- or I'll just hate it anyway. And if I am not going, it is better to cancel today than the last minute. I don't know. This is the dilemma the depression gives you. How hard do you push yourself? And do you take on commitments that you know you might not keep? Do you say yes when the depression is saying no? Or do you spend the rest or your life in bed?

Feeling somewhat better

Yesterday had started out as a really bad day. I was still in that bad place, telling myself all the bad things that were going to happen. I started thinking I was really going into another depression. I really felt myself sliding down the hole. And then, miraculously, it started to lift at lunchtime. I didn't bring lunch, so I went out for pizza. Then I sat in my car in the sun and listened to music on the radio. By the time I got back to work, the dark spell had started to lift.

It hasn't totally lifted, but I don't feel like I'm doomed to another depressive episode the way I was feeling. I am better but not all better. But it is good to know that I can get so close to the edge and not go over it.

Otherwise nothing too exciting. I got out early from work because I had to go to the dentist. But I actually had patients to treat today, that was good. And tomorrow I have a fairly full day as well. I don't like it too busy- but too light can be even worse I am discovering.

I'm trying to get used to it being so dark so early. I hate the time change in the fall.

Why I eat fast food

There are two times I eat fast food. The first is when I am travelling, usually taking a road trip, and don't want to take much time to eat. And it is kind of a tradition for me. The other time I eat fast food is when I am too depressed, irritable, hypomanic, etc., to walk into a grocery store. And that is what happened yesterday.

Sometimes I can manage a convenience store even if I can't make it in to a grocery store- and the options are getting a little healthier there. In Wawa's I can find salads and humus with pretzels, along with subs. But sometimes I can't even manage that- and I go to a drive through. I don't have to get out of the car, I barely have to talk to anyone.

Yesterday I had a bad day. With the time change, I had a really hard time sleeping. Then I had something happen at work that was very little, but enough to get my mind running through a hundred negative things, and decided my life was over. I was also feeling anxious and irritable.

I did drag myself to yoga after work- no easy feat- but that was all that I had. I couldn't go grocery shopping afterwards, I just did a drive through. It seemed so wrong to be eating a burger after yoga. But I did.

Today, hopefully, I will make it to the grocery store.

Despite my mood, and despite the fact that I was totally not present for the yoga class, it was good to be back. And my back did okay. I just have to remember to keep the curve in my lower back and not do too much forward flexion at my lower back. It is good to know that I can still do yoga.

I woke up today feeling a little better, I hope that it lasts.  

At peace with my meds, for now

I made my peace with the Zyprexa increase after going down, and having to come back up on it. And now, I have made my peace with my very high dose of Effexor, as I have had to go back up on it. I am willing to take these meds and doses if I need them, I just want to be sure that I need them. For the moment, I am pretty certain that I do. By "need" I guess I mean that they give me a better quality of life by taking them. Although if I gain anymore weight on the Zyprexa, I will really reconsider.

I wanted to get down to 300mg of Effexor. It doesn't do such bad things to my blood pressure. My insurance company will gladly pay for 300mg, but for 450mg I have to get my psychiatrist to appeal. And some psychiatrists don't feel comfortable with such high a dose- once when I was looking for a new psychiatrist because my insurance changed, the person I made an appointment with said that I was taking too much Effexor, he would switch me to Cymbalta. At the time I was doing very well, and had just started working after 7 years on disability. This made me feel very vulnerable- although I was ultimately able to find someone who would prescribe my medications. But not in my plan.

I think I have tried going down on everything that I take. And some of the meds I used to take more of, so over the years I was able to cut down a little. But for the moment I can go no further. And other than the weight gain, side effects are really not too bad- although it is annoying to have to pee so much in the mornings with the lithium. It seems like mornings are the worst- and I take extended release lithium. I wonder if I took instant release lithium instead- if it wouldn't last as long into the day. Or maybe then I'd wake up in the night to pee. That would be really bad.

So I am generally at peace with my meds. I can't make any promises for the future. But for now, I just want to think about life, not meds.

The waiting game

I went up on my Effexor yesterday. I know it was the right thing to do. I have not been feeling very good recently, just not very alive- even though I wasn't really identifying it as depression until yesterday. I took the higher dose again today. I did feel that norepinephrine kick, it helped- but I know that the full antidepressant effect will take a little bit of time to really kick in. And in the mean time, I am having some side effects going up. I know they will go away, but for now the higher dose is making me anxious.

So I have to wait out the side effects, wait until I get the full antidepressant effect. And be patient with myself in that time. And not let my life fall apart in the meantime- keep doing the things that I really have to do.

I actually think that the higher dose helped my cognition already. It was easier to focus at work. And work went well today, I had a good number of patients. I didn't feel useless. After work I impressed myself by making it to the bank to get cash and quarters for laundry. But then I didn't make it to the grocery store, I just wanted to go home. I stopped at WaWa's (I love WaWa's). I bought a salad, a soft pretzel to eat with hummus, and some milk. And then I came home and plopped in front of the TV.

I watched about an hour of CNN's coverage of the shooting at LAX. These shootings are getting so frequent- MSNBC and Fox News weren't even covering it. But really, there wasn't much to say at this point. CNN is good at saying nothing over and over again. I want to know who the shooter is, what his story is. That is what I want to know.

But I actually think the shooting is big news- because it just points out what I have often said. It easy to attack an airport as long as you do it before you go through security. Airports are becoming "soft targerts," and our security is not set up to address that. I'm not sure you can address that without becoming a police state.

My mood is dropping

My mood hasn't been very good this past week. No yoga because of my back hasn't helped. And it hasn't helped that we are so light at work that I feel bored and useless, and feel brain dead at the end of the day from spending the day doing mostly paperwork. And the seasons changing is always huge for me. Plus, I decreased my antidepressant a few weeks ago. Plus I am trying to diet- not very successfully. I am so incredibly hungry. And it is not like I am eating 1200 calories- I am eating a lot. Just not as much as my body is asking for. It is really frustrating. I don't want to think about food all the time- but the only way to do that is to eat. Otherwise I can't stop thinking about food.

Anyway, after a rough morning I was really crashing, and realized that I had been on a slow crash for a while. I fled to my car at lunch. I felt like I was shutting down, I couldn't think or focus- no energy. I wanted to curl up into a ball. No, I didn't cry. But I did pull out my spare meds (I keep an extra day's meds in my purse), and take an Effexor pill. I'm going up on the effexor again, I had to do something. I couldn't let things keep going like this. But as it turns out, at the huge dose that I take effexors, it really has a little bit of a kick to it with all it's norepinephrine and dopamine effect from the higher dose. So, I didn't have to wait the 3 weeks it takes me with antidepressants usually to get an effects- I had a little bit of almost instantaneous brightening. Enough to get me though the day.

Hopefully that kick won't fade too quickly. I'm going to need it in the coming days, I think. 

Maybe tomorrow will be better. It is at least a Friday. Although I did decide to skip Friday' yoga class. I'll go on Monday, I hope I will be healed enough to go then. But I do have good things planned for the weekend. I am getting a massage, a pedicure, and going to a drumming circle. I haven't had a pedicure in 2 years. I want to get one before it gets too cold. I want to get a really cool color polish, too.

Confronting my mortality

I had my yearly mammography today, and my every 6 month ultrasound of my left breast. My left breast has cysts which seem to be benign, but they want to keep an eye on them. The radiologist said "Cysts are not cancer and do not become cancer, but some types of cancer look like cysts."

I really wasn't worried. In fact, during the mammography, as I was twisting my body with my arm held out to the side and holding my breath as I was instructed, it occurred to me that this was a little bit like yoga. Only topless and with x-rays.

But when the ultrasound tech told me that she had to talk to the radiologist- and then took a very long time to return with the radiologist- I started to worry. I really wasn't so much worried about dying- as having cancer and having to treat it. The surgery, the chemo, the radiation, etc. Even if I lived- I have enough trouble with just the bipolar. Would I want to go through all that?

This is why I used to NOT get mammograms. But my primary care doctor kept getting on my case about it, so finally I did last year.

The radiologist came in and it turns out she just wanted to look at a couple of sites that the tech couldn't get very well. Everything is okay. I just have to come back in 6 months again for another ultrasound.

I am very worried about false positive findings, getting screened this regularly. I can't help thinking they are going to find something, eventually. I hope I am wrong.

Exercise is over-rated- Or at least, not without risks

Every now and then I have low back pain that is very bad. The last time I had it was after a very rigorous workout with a personal trainer. This time it was after a yoga class. To much forward bending- I think I have a herniated disk.

I felt it after one move during the yoga session, but it wasn't too extreme. It wasn't until a couple of hours later when I was putting groceries away, and I leaned down to pick something off the floor- then it really hit. I thought I couldn't get up. I was in agony.

I've been taking lots of naproxen, even though I really shouldn't with the lithium- but desperate times require desperate measures! I somehow got myself to bed last night, and kept my phone within an arm's reach, in case I couldn't get out of bed to go to work. But it was a little better in the morning. And I work with physical therapists who have been telling me what to do. I'm doing back extensions, and it really seems to be helping.

Work was hard, but I managed. I do outpatient, I am not transferring patients. If I was, I couldn't have done my job. I would have been in too much pain.

I'm going to do some more press-ups before bed. I never realized when I had this before what it was- disk herniation- and it has never gotten this much better this quickly. I never did back extension exercises before, like I am doing now.

What I don't know is how soon I can go back to yoga. I don't think I am going to that class again. It was a harder class than my normal one. I think too hard for me, or at least too hard for my back. I hate to admit defeat. And I also liked the time of the class- there is nothing else Sunday evening that I can take.

I didn't go to yoga today. Maybe by Friday.

What constitutes an Occupational Therapy Emergency?

Sometimes getting someone occupational therapy services is urgent. I have stayed late to make a splint for a patient who has had a fracture. Or to start ROM exercises with a patient who just got out of surgery before scar tissue sets in. Or to teach a a patient who has had a hip replacement who is going home and straight to outpatient physical therapy how to dress with adaptive equipment and to order anything needed.

But sometimes there are paperwork emergencies. Today a patient needed an OT evaluation to go to a rehab hospital. The OT evaluation was just a formality, it all comes down to PT: can the patient walk? That is what the insurance company cares about. But they do require an OT eval.

And it was a Friday, and the inpatient therapist called out sick and so I had to go cover and do that evaluation just to get that done so he can go tomorrow. So that was the OT emergency that kept me late at work today.

Generally, it was a stressful day. I got some negative feedback at work. It was not unjustified, but it was also a freak event and I don't know how I could have handled the situation differently. It is not something likely to happen again.

Still, it hurt. But not as much as it might have. I am very sensitive to criticism. I think on the lower Zyprexa dose, I would have been more devastated. Instead, it just hurt, it stung, but I didn't get stuck in it.

I know that is what the meds do. And at times I complain that they make me numb- but the also give me freedom to live that I don't have when I am trapped in my negative emotions that arise from every day events. I think I am less inhibited on meds, which is generally a good thing.

I'm becoming more high maintanence

It seems I have nothing but medical appointments recently. Yesterday the dentist- where I was told that I am grinding my teeth- to the point that a couple of them are loose. You actually have ligaments that help to hold them in place- I did not know this. So I need to have a mouth guard made. I am going back in two weeks for it. Fortunately, it is a covered benefit through my dental insurance, as it is pretty expensive.

Then next week I have my mammograms, and possibly an ultrasound of my left breast again. I have nodular tissue in my left breast that they are keeping an eye on- they keep taking great pains in the letters they send me to tell me that the tissue is abnormal but not necessarily in a bad way. So I have this again.

Three Wednesday afternoons in a row I am taking off for medical/dental. Thankfully we are very light at work.

In my really bad years, I never went to doctors or dentists (other than psychiatrists). I was young enough not to need any chronic medication- now I take high blood pressure meds. And when you don't know if you want to live, why would you do anything preventative? I wasn't together enough to think about medical appointments, anyway.

I had years I didn't get a mammogram because I was too depressed. Too depressed to go, and too depressed to know what I would do with the information if there was something suspicious. I didn't know if I wanted to live. I started going again last year- and then they told me about my left breast, and that I had to come every 6 months and get ultrasounds. I wasn't prepared for that. I thought I was just checking this off my list, doing what my primary care doctor wanted me to do.

During one of my worst depressions I became convinced I was dying of cancer. I took a very long time for that fear to subside. But just the memory of that conviction makes it a little more unnerving to get a mammogram.

I hibernated this weekend

I stayed in all weekend, which wasn't a good thing. Yesterday I just wanted to stay home, and didn't feel like going on an 8 mile hike I had signed up for. Today I had plans to go out- but I had a really bad sinus headache that even naproxen couldn't get rid of, and I can't take decongestants with all my meds. So I stayed home. 

It felt good to stay home at first, and I even got two loads of laundry done and did some reading for my sci fi book club. But now, Sunday evening, when I really have nothing else to show for myself- I am feeling bad. 

Next week will be different. There is a new Sunday evening yoga class starting up at my studio, so I will start going to that. Right now the only Sunday evening yoga class is a hot yoga class- I think I would hate that, but with the lithium, I think I shouldn't do it anyway. It is nice to have an excuse not to do it!

I'm still logging my food. I will have one more glass of milk today to take my night time meds- which will put me over my calories slightly. It will just have to be okay. It is better than what I would have eaten if I wasn't counting.

More Antioxidents, less food

It's my making peace with Zyprexa program.

I went on Pub Med today, and was looking at studies about how to prevent tardive dyskinesia (other than the obvious- don't take meds or be female or get old). It turns out that if you are a rat, there are some anti-oxidents that seem to be protective. Some of them I am taking, a couple I am not- or at least not very much- so I just ordered some from vitacost.

There aren't a lot of prospective studies with people. What they seem to do is give these supplements to people who already have TD and then see if they get better- which it may be too late by then. But the one that has been shown to work is gingo. I already take that one. Good.

I already take a lot of supplements- but now I am adding a little. I take more supplements than meds right now. But many of the supplements that I take are to counteract bad effects of the meds- I don't think I'd be taking all of these supplements if I weren't on so many meds.

I also stepped on the scale this morning, and it was more than I wanted it to be. And more than it was last week. It has been going up and up- just in tiny bits, a half a pound at a time, but it is going up. My weight had been stable- and now with the med increase and maybe the change in seasons on top of that- it is increasing.

So this morning I signed up for an online food tracking site. I think I might have to go to bed soon because I don't have anymore calories left to eat and I am hungry! But so far I stayed within my calories- but not easily. And I didn't weigh or measure, so I may have underestimated.

I am hopeful that I can do this. I have to do something.

TGIF, and a good yoga class

I do not have the body for yoga. You really need to have a flat stomach to do forward folds- my stomach just gets in the way. But I love it anyway. And it was a good class. Unfortunately, I lost my yoga glow afterwards when I couldn't find my car keys. It turns out they were in my purse all along, but it took me many worried minutes to find them.

I have been missing too many yoga classes due to my moods, and then vacation. And my body can tell. It doesn't want to bend as much, and my arms aren't as happy during the planks and downward dogs. But the hardest arm work today that we did was just doing Triangle and Warrior and holding, and holding, with the arms stretched out. It is amazing how heavy our arms can be!

I didn't have to force myself to go to yoga today. It wasn't the battle that it has been in recent weeks (and not always a successful battle). I just went. Amazing. OK- not entirely true- I did have a few thoughts of, wouldn't it be nice to just go home, etc. But these thoughts just came and I said no, I'm going, and that was the end of it.

There is a new moon out tonight, just beautiful. Recently I have felt like I have been worse during the full moon, but this time I feel like me mood is really good.

I don't know the mechanism, but when a full moon is low on the horizon, it looks bigger. Driving home it looked huge. I wanted to reach out and touch it.

A good day

I just felt very blissful today. I was in a good mood, and feeling grateful for all that I have in my life. Plus I made a cool splint today. That always puts me in a good mood.

Work might be getting more interesting. I might be getting involved with a new pain management program. Or maybe not, it isn't certain. It is an interest of mine. A strange interest- but I think maybe physical pain is close enough to depression that it is compelling to me.

I always say, if I were a wedding planner, I would probably have killed myself by now. But in my line of work, it is pretty hard to feel sorry for yourself (although occasionally I still manage it), and that is a good thing.

We;;, the federal government is open again. And we didn't default. What drama. This congress makes me ashamed to call myself an American- we are the country that can't govern ourselves. We create our own crises.

Interesting thought

"Just Me" commented on my last post that maybe I might need the higher dose of zyprexa on my bad days, even if I don't need it on my good days, or every day. And that constantly playing catch up with med adjustments based on mood shifts doesn't work very well. And that is very possible.

I think my biggest fear, however, is that whatever I take my brain just eventually adjusts to- and so eventually the doses always seem to go up. And I don't want to keep going up on Zyprexa. I don't even want to be on it, but I had finally come to terms with the 5mg. And so I am just worried- if I start to get manic on 7.5mg, will it now get raised to 10mg, etc. 

Plus I feel a little spacey on the higher dose, and I really don't like that feeling. 

But for now, I am back to 7.5mg, after talking to my psychiatrist. What did I think he would advise me? What psychiatrist has ever advised me to go down on meds? Except for klonopin. That is the only drug I have had a doctor want me to decrease or go off of. 

But I do like him. He checked me for lithium tremors (none), and did a screen for involuntary movements for tardive dyskinesia (none). Most psychiatrists don't do that. Or at least the ones that I have had. But I really think that if you are prescribing antipsychotics, you should be doing regular involuntary movement screens on those patients. 

The Zyprexa issue is still not resolved

I was feeling very bad yesterday- after a string of bad days, and I realize that I had been making a lot of excuses for feeling bad. Really good excuses, but still. I was feeling bad. And I thought that yesterday I would take a little extra Zyprexa just to get me through the day. And then go back down to the lesser dose. And I felt so much better. Plus, I started to get things done- something I had given up on being able to do until Monday came.

So then last night I took the higher dose. I don't know. I do feel a little out of it at times- but not that much. And I was able to go grocery shopping, something I have not been able to do in the longest time. And I filled my prescriptions too. I got all my notes done at work- although I had a lot of time do do it (a light day).

I see my psychiatrist tomorrow. Do I want him to give me a script for 7.5mg? 5mg? Both? I don't know. I guess I go with the 7.5mg- and I can always cut them. Or I'll take both if he will give me scripts for both. But I really don't want both. I want this to be settled. I want to know what I need.

I went down to 5mg because I felt depressed again on 7.5mg for a couple of weeks. But really, that may have been triggered by going out of town and forgetting to bring some of my meds. Maybe I would have been doing fine otherwise. And it wasn't the Zyprexa that let me down. Obviously I'd like to be on less- if for no other reason than the risk of tardive dyskinesia. But I have been functional at the higher dose- but then, I think I am also sometimes a little spacy on it too.

I guess that is what my psychiatrist is for, to talk about these things. And see if he has any answers. But unfortunately, psychiatry is more art than science. And everything about these meds is a quality of life issue- which ultimately can only be determined only by the person taking them.

The Walking Dead, again

After watching a number of episodes of the Walking Dead today, it occurred to me that the title did not apply to the Zombies, but to those still living. But I am probably not the first to think this.

If I'm going to watch a Walking Dead marathon, I'm going to need klonopin to sleep

I had never watched the walking dead. But there was this marathon of last season's episodes on today, all for the roll out of the new season premiere. I thought maybe it was a series that might interest me- I had a lot of busy work to do anyway. But it was too much- I need drugs if I am going to sleep tonight!

Maybe just seeing an hour a week would be okay. But several hours (while trying to clean, sort papers, etc), was too much. It was as depressing as reading "The Road," but with more gore and suspense, which has my stress level up too high. So now I am depressed and stressed.

I don't get the Zombie thing. I think that there are enough things to be afraid of that are real. We could have environmental,economic, and societal collapse without zombies. We could have killer viruses that don't turn people into Zombies. We could have a few more atomic disasters. I don't get Zombies, they don't make sense to me.

Won't the zombies die of starvation as all the humans and animals die off? Can they eat plants? Can they eat each other? Do they age and get infirm and die? These are questions I want the answers to.

Knowing this has absolutely nothing to do with meds

I've stayed home the past two days. I've done some cleaning, which is good, but mostly done nothing. I've isolated. I'm lonely. I can't get going.

I came home early from backpacking, so I had no structure to the rest of my vacation- and I can't get myself together. All that will change Monday morning, when life gets back to normal, but until then I am off.

I have plans for tomorrow- but I didn't keep my plans for today. I don't know if it makes sense to even have them. Will I get myself going?

I need a certain amount of structure, I know that. And I am also disappointed in my trip. And now disappointed in myself, my life. I'm not good left to my own devices for too long. I do need my down time, my alone time, but there has to be a limit to it. And I have passed that limit.

I am diligently doing my light therapy, so hopefully I have the seasons thing under control, as much as it ever is.

I just have to get myself to overcome this inertia. I need to get out of my apartment tomorrow. Walk or hike. Go to church. Visit my dad. Go grocery shopping. Those are all good plans. All doable. I just have to do it, and get out of bed.

Maybe we are stronger than they know

I just read a blog post about how barbie dolls can make girls feel bad about their bodies.

I played with barbie dolls. I didn't want a barbie doll's body- they looked so strange to me. And barbie's feet were permanently deformed, so she could fit into high heeled shoes. This always bothered me. Her neck was too long. She was just a doll.

I also had a Ken doll- and he was so stiff that I couldn't move any of his limbs. I couldn't even rotate his neck. So I decided he was paralyzed. I had a paraplegic Ken.

Of course I didn't play with dolls like most girls. I would play with my barbie dolls and my brother's micronauts and we had space adventures.  And my paraplegic Ken had telepathic powers and could steer the space ship (which was a shoe box), with his mind.

No doll ever made me feel bad about my body. It took actual people to do that.

I no longer feel bad about my body. (I really think good sex cured me of that- but that is another story). I would like to lose weight for various reasons- if for no other reason than to put less weight on my knees when I backpack- but I don't hate my body.

Stayed home today

I didn't leave my apartment today except to take out the garbage. It was raining anyway. But I skipped yoga. I just needed to veg out, have a nothing day. Thru hikers talk about taking "zero days," in which there is no mileage accomplished (usually a stop over at a town). I really need a zero day every week or so or my mood starts to go. But too many zero's, and my mood is pretty bad too. So this means I have to get my act together for tomorrow. I plan on hiking and then going to a meetup group for a hay ride and corn maze in the evening.

I read and watched TV, I cleaned a little and did a lot of unpacking. I am living on backpacking food, because I haven't made it to the grocery store. What I really want right now are fresh veggies. That is what I miss the most when I backpack.

I spent the morning looking at gear on line, and thinking about how I could further cut my pack weight. I know I could get my pack weight down at least another 5 pounds if I get a couple of new new pieces of gear and get rid of a couple of things. I'm not planning another long trip until the spring, so I don't have to buy anything now. I'm just looking. And maybe by then I won't be so broke.

I found myself thinking about meds again. I have sucessfully decreased my Zyprexa and Effexor this past month- and I'm almost weaned off of the klonopin I needed to lower the Zyprexa. Should I try for lower?

Of course I have yet to tell my psychiatrist I am on these lower doses. This is not a function of me trying to hide it- rather the fact that I see him every couple of months. But I don't think he will want me to go any lower on the Zyprexa- not that this would stop me- I don't know what he thinks about the Effexor. I am interested to hear what he thinks.

If I thought I could take all of these meds and never have another serious depression again in my life, I'd take the deal. I really would. But thoose bad couple of weeks I had even on the increased zyprexa made me realize, there is no deal to be had. Our brain is plastic, it adapts to whatever we throw at it. Higher is not always better, it is just higher. Maybe it takes a little longer for the brain to catch up, but it does. It I could feel that bad on 7.5mg of Zyprexa, there was no need to be on that high a dose. Lower doses have been shown to be useful as antidepressant augmenters, and that is really want I think I'm going for.

Back home, earlier than planned

My backpacking trip was only 2 days. Between the federal government park shut down and an out of date guide book, and last minute change of plans, looking for a place that no longer existed, then not knowing where I could leave my car overnight- I did leave it for 1 night in a state forest, not knowing what they would do. It was a good trip, but I was worried about my car.

I have the backpacking bug again. Maybe I can get in another trip this year- even if it is just another overnight. I know one thing though- I am never, ever scheduling a backpacking trip again for the October- when the fiscal year turns over- because I never want this to happen again. I suspect that these government shut downs are going to become a lot more common.

Well, by spring the parks should all be open I hope! I am going to do a big trip then.

My ankle held up surprisingly well- I used that ankle support. My right hip also isn't bothering me much- I think the yoga has really been helping it. I think what bothered me the most was my right knee as I was driving home! When I drive too much, it hurts. It is all the right side that is messed up.

Back home, back to normal life. I have errands to do tomorrow. And yoga in the evening. And I have to unpack. And do laundry and clean. It is supposed to rain. But hopefully it will clear up for the weekend and I can get in another hike.

Frustration, thanks to the US Congress

I am all packed. My pack weight is 27 pounds, without water. Not too bad. I am starting to get excited. Then I go on to a backpacking forum for some inspiration. And I read that the AT over many National Parks is closed. Why had I forgotten this? I thought that I heard someone say that primitive hiking on the AT was OK. I must have heard wrong. I wasn't sure if where I was going was federal or not- I looked it up. It is federal, and it is closed. And my plans are in trouble.

So I spent the afternoon trying to find a part of the Appalachian Trail where I can drive to, leave my car over night, and don't pass over federal lands. I think I finally did- but not before a certain amount of panicking, and almost tears. A part of me considered giving up, staying home. But, I was all packed. If I wasn't all packed, I might have stayed home.

So thank you US congress for almost ruining my vacation. I know that other people are having a lot of bigger problems with the shut down, but this is my experience with it.

I fell for an infomercial- but who can resist Montel Williams?

I have postponed my backpacking trip until tomorrow, because I am having such a hard time getting organized and packed. It is overwhelming.

One of the things I am bringing- well, wearing as opposed to packing, is a Jimmie Copper ankle support. I saw a Jimmie Copper infomercial a couple of weeks ago, and decided to give it a try.

I have always had weak ankles. And then in high school I had a very serious right ankle sprain playing tennis. Back then they didn't do much for you if there was no fracture, just gave you crutches and told you to stay off of it for a few weeks. I have had trouble with it ever since.

And whenever i walk more than a couple of miles it hurts, swells up, and my foot starts to turn in. I'm sure there are ligaments that were torn, and when the muscles get too tired to compensate, the ligaments can't hold things in alignment.

When I walked the 10K this summer, I could hardly walk the next day, was limping for 3 days afterwards, and felt it for a good week. The only thing that saves me with backpacking is that I am wearing boots that go up to the ankle, and I use hiking poles. Still, it is not good.

I tried out the ankle sleeve this weekend on a 4 hour hike. It is not as supportive as I thought it would be- but a lot more comfortable. I wore it driving to the hike, during the hike, and then the rest of the day until I went to bed (I didn't think I could sleep with it on). I have to say, my ankle felt pretty good. I did have a little pain, but no swelling. And while I felt like my foot wanted to turn in a tiny bit, it really wasn't visibly doing this. I would say, a success.

Or maybe it is all placebo effect. I do want to believe this is going to work.

What I really need to do is to see a physical therapist to get a good home programs of ankle strengthening exercises. One of the PT's where I work said she would give me some exercises but she didn't. So I should break down and make a PT appointment.

But would't it be nice if my ankle sleeve were enough?

Not a good day

I am feeling depressed and lonely. I'm really feeling bad. I hate this. I hate the not knowing. Is this temporary. Is this a sign that lowering my meds  recently was a bad idea. Is this just a bad day, what. I hate having to analyze my moods. I just want to be.

I used to have the 3 day rule, and I should try to stick to it. It has be be 3 bad days before I worry, before I examine meds, change light therapy, etc. I have 3 days to just deal with it and hope it goes away on its own. Sometimes I've had to act a little faster with a mania, but with a depression I can usually wait 3 days before things get too out of hand. So I wait.

I am in bed- I keep thinking I want to nap, but then I can't. I just want to lie here.

Ice cream would be nice. But I only have healthy food around. Damn. What is the connection between ice cream and depression? I don't know. That is what I want to eat when I am depressed. Otherwise I hardly ever let myself eat it. And when I am depressed, I am usually too depressed to go to the store to get it anyway.

The blackness is spreading

No, not the blackness in my soul. The blackness on my cracked computer screen. Which is strange, because for a few days it was stable. And now it is branching out into two other directions that I didn't even know were cracked. I need a new computer. That sucks, this one is less than 3 years old- I can't remember how old it is, only that I bought it after I moved here a little over 3 years ago.

I'm trying to figure out what to buy. Do I want a touch screen feature? Not really, I have my phone for that- but maybe I will in the future. Do I buy a computer for what I want today, or for one that will stand the test of time and new innovations- that will undoubtedly include more touch screen features. And do I want a big one like I have now? or a smaller screen? I don't know. I'll go to staples and look. But after my trip.

I started packing today for my backpacking trip. It is both tedious and exciting. I made some very yummy if expensive trail mix: almonds, dried blueberries, and dark chocolate M&M's. I also has some jerkey, protien bars, and dinners made with dehydrated ingredients. I'm still trying to find some Starbucks Via iced coffee. I had to heat anything up in the morning, I just eat a cold breakfast. Iced coffee and a protein bar or some GORP.

I felt really blah this morning, very hard to get going. I slept badly. I had cut down on the klonopin I am taking at night- something that I had added on when I cut down on the Zyprexa. I am down to 3/8 of a milligram at night. It was a small decrease last night, but my body felt the difference. I tossed and turned, and had a lot of racing thoughts- and some really strange thoughts.

But then this morning I got up at 4am, only to go back at 8am to nap. Now I have had a second coffee, and I'm feeling some better.

I do have some unpleasantness today, however. I have to go into work to do notes, and get things ready for the person covering for me. I will try to reframe it, however. I will have time to get things done when I am alone and can be really productive and blast music and get things behind me that I really need to get done.

Reminding me why I live out here

I went hiking today. And it made me appreciate living out where I live now- away from the city. There is a lot that I miss, but in the city I missed nature. Unfortunately, as soon as I moved out here I went in to a severe years long depression so didn't do much hiking at first. But now that is changing, and I am taking advantage of where I am.

It was also a good opportunity to try out my new hiking boots, that I bought enough years ago to not even remember buying them. I thought I still had the old ones. I guess not. But these feel like they might be a tiny bit tight on the left toes- I can't decide. I hate it when boots are too loose, I think that is what was wrong with the last pair.

I leave for my backpacking trip on Tuesday. I really don't want to buy new boots. I haven't decided. Maybe I can buy thinner socks.

Meanwhile the crack in my laptop screen has expanded, although the black patch has not. I am crossing my fingers. A new computer is not something I want to buy either. And I am telling myself I will wait until the iphone 6 comes out!

It was good to go to yoga again

I think it is three weeks since I had been to yoga. First I had that dip in my mood when I stopped going. Then I had a tooth pulled. Then this Monday I felt like I was coming down with something. This was my first day back.

I was hoping for an easy class. It wasn't. There was a substitute teacher, and it was hard. I was really sweating. But it was also good. We did some "flow yoga," which I have been wanting to try, but which doesn't fit into my schedule. All and all, a good class, even if it was not what I had wanted. It worked for me.

My mood was a little shaky today. I actually broke down and took a quarter of a milligram of klonopin. Maybe that is just okay, and I have to accept it. It lets me take less of other meds.

Tomorrow I am going on a group hike. The location was changed because of the government shut down. It was supposed to be on a federal wildlife preserve, but now we are going to a different location that is not on federal lands. This is so stupid.

I think Boehner is a coward. What is the point of having power if you won't use it? All he cares about is getting re-elected, the best argument for term limits I have seen. He has the votes to pass a continuing funding resolution for the government. He just won't bring it to the floor. Just do it. Do the right thing. Be a leader.

But I shouldn't be thinking about politics. There goes my post-yoga glow.

Still on less Zyprexa, still doing well

It seems that the transition from 7.5mg to 5mg of Zyprexa has been sucessful. And I feel better: more alive, more connected, my mind sharper.

But, there is a cost. There was a reason I stayed on the 7.5mg so long. On the higher dose, I just felt this sense of relief. I wasn't scared of my emotions anymore. I wasn't afraid of the next thing to hit. I felt at peace. I wasn't waiting for the next shoe to drop, as they say. And I started doing more, getting more things done, because I think a part of me felt freer because of this. But I was also number.

So on the lower dose, I have a little of the apprehension again- not so much of anything happening, but of my emotional response to things. It isn't bad, it is just there in the background. I know if something bad does happen, or if the bad feelings do come, I can use DBT skill to work on it. But that is not the same as never having to experience them first.

Perhaps is was good for me to be on the higher dose, just for a little while, just to start to jump start some things in my life. But long term, I think that the numbness would hold me back. And I think it was starting to hold me back. I know that the higher dose is always there for me, if I ever need it for a few days because I start to get manic, etc. But I also know that it is not a dose that I ever want to take again for any prolonged period of time.

The question remains, do I want to try to go lower on the Zyprexa. And I don't know. I have tried so many times and failed- but I have been trying while I was working, so I couldn't tolerate a few really bad days. Maybe if I did it over a week's vacation, while taking a lot of klonopin, I could. I really don't know. But not now. Not in 2013, I think. Maybe 2014.

I want my mother to be happy

I saw my therapist yesterday, and was expressing my frustration with things with my mother. She is getting more and more overwhelmed by caring for her mother- and she is not dealing with it well. And then there are the usual problems she has with other family members, and her own history of illness.

She lives in a far away state. I can only listen and give advice. It is getting harder and harder to listen, and my advice is never followed. I think I see solutions, but they are my solutions. Not hers. I want her to be happy. I can't make her be happy. I hate seeing her unhappy, and to be unable to do anything about it.

Anyway, I felt like I had to defend myself to my therapist- why do I want my mom to be happy, why do I want to fix the situation, why do I want to make it better. She wanted to know, what is my need, my angle. Why should I have do defend myself on this? I just do.

But the truth is, a part of my wonders if she wants to be "happy." And if the chaos of being needed and in the midst of things has actually held her together in recent years, and that is why she hasn't been as bad as she was in the past. And maybe if things were "better," she'd fall apart. That is what I fear.

But my days of giving advice may be starting to come to an end. Her hearing loss is really getting more noticeable on the phone. She can't hear well on cell phones, and I don't have a land line any more. She wants me to get a land line, I want her to get a hearing aide. The problem isn't her, it is my phone. And my brother's phone- who also only has a cell phone. This last conversation I had with her she didn't hear a lot of what I said.

I stopped trying to talk to my grandmother on the phone years ago, because of her hearing loss. Now it may happen to my mother. These stubborn women don't believe in hearing aides. I swear, I will not be like that. When the time comes, I will get one- and the best one I can afford.

But mostly, my mother doesn't seem to understand that my grandmother is very old, and probably doesn't have too many more years. If she does, okay. If not- it is not her fault. And taking all these blood sugars, blood pressures, and generally trying to make the home a hospital is going to wear her out. At some point, she is going to have to let go. And let grandma let go.

I don't know if my mom is going to be able to leave grandma at all before the end. Because my aunt won't do as much for her- and they won't hire anyone. So mom can't go visit her grandchild. Or her daughter for that matter.

I am not going to visit any time soon. I was just there in July. It was overwhelming then- and I would handle things so differently. I just can't deal with it. I know my limits. But next July I'll be back for the 10K Peach Tree Roach Race (assuming I get in). I'll see them then.

Should you be forced to get the flu shot?

At my hospital, this year the flu shot has become mandatory. I got mine today, as did most of us at my office, when one of the nurses from occ health came around to give them. Two people have declined. What is going to happen to them, we don't know. They have to the end of the year to officially decline. Then- I don't know what will happen.

It is coming down from the government. It is something easy to monitor. It is medical. It makes money for vaccine makers. In theory, it could mean fewer flu infections from provider to patient- although the vaccines are far from perfect, and most staff people will never get the flu anyway. But I think that there are a lot of other things they could do which would keep our patients healthier. Like giving us sick days that are not of our PTO, and encouraging us to use those days, when we are sick.

I think we need some germs. We are not designed to live in a sterile environment. But I'm not sure that means we have to expose ourselves and our patients to the flu. I have more of a problem with the chicken pox vaccine- which is rarely deadly or disabling (although shingles can be). We need some germs, or our immune system will go haywire, and cause all sorts of trouble.

I take the flu vaccine because I think it might protect my patients. And I really don't want to get the flu- I think it would be miserable. But I don't know if we should force every one to get it. I can't decide. If it stops there, maybe. If this is the beginning of a slippery slope, then we are in big trouble.

What a difference a day makes

I had a long night's sleep last night, and I am feeling so much better today.

It is the day I go in late, and I am doing a load of laundry. And planning my backpacking trip for next week. I don't know why I bother to look at accuweather's 15 day weather forcast (I have the iphone app). The forcast for that week has been changing ever day. And it is getting worse- they are now forecasting rain for most of those days. But it doesn't sound too bad.

I didn't get my act together in time to order some things I need unless I want to pay for priority mail- which I don't. So I am hoping I can find what I need at the closest EMS store- about a half an hour from here.

I'm only going to go for 4 days- I'm doing a round trip so I can leave my car. But I'm not in great shape, so I'm not going to try for more. Next year, yes. I am going to go for longer.

I did splurge for a new sleeping bag. My one co-worker who also backpacks convinced me that the one I had is not warm enough for this time of year. However, looking at the forecasts suggests otherwise. It might have been okay. Or maybe not. The forecast could change again.

I think I may need to buy a new computer. I cracked the top of the screen, apparently. I can't feel the crack, but I can see blotches of black, and it looks like there are three cracks (I can't feel them though). I must have moved my computer rather roughly yesterday. I can use it the way it is, it isn't a big deal- I just don't know if it is likely to stay this way, or if it might get worse or is likely to break down. I don't want that. Just when I thought my next purchase would be the new iphone...

I want a better camera than the iphone4. Otherwise, I could care less about upgrading my phone. But if I wind up getting a computer, that is going to have to wait a while.

It is so easy to spend money. That is the only good thing about being depressed. I don't spend money. I guess I am not depressed.

Not feeling good today

I am really tired and dizzy and wondering if maybe I forgot to take one of my meds this morning. Or maybe I am getting sick. Or maybe my body is still adjusting to less meds. I spent the afternoon at work feeling like I was going to pass out. I skipped out on Monday night yoga- and I haven't been in a while. Instead  I am lying in bed, hoping this will pass. I am sneezing a little, maybe I'm getting a cold. I cannot believe how tired I feel.

I feel really bad that I didn't go to yoga. I gave myself all weekend to stay in after I had my wisdom tooth pulled, and I really didn't do anything physical. I needed to go. But I just feel awful. I think I have a fever.

There is one good thing I have to say about today. While I felt awful physically, and my mood wasn't too great either- I did find that my mind was sharper at work today. I was right, going up on the Zyprexa made me dumber, and going back down has helped. I have to remember this, the next time I am tempted to go back up on it again.

I did graduate school on 5mg. I passed the CHT exam on 5mg. I can function on it. Perhaps I'd do better even lower (or off of it), I don't know if I am brave enough to find out. But 7.5mg is too much for me to feel like my brain is functioning well. So it is back to 5mg for now. Maybe eventually lower. I'd like to be lower. But not now.

A lazy Sunday morning

I think I am adjusting to the Zyprexa decrease and no longer need the whole milligram of klonopin at night. I overslept, and I'm really sleepy this morning. Tonight I'll take less.This is good. I also don't have too much pain this morning from where my tooth was pulled- it is just a little sore- so I don't have to take any naproxen. I'll just take a little tylenol later if I need to. I'm still eating soft foods- I think I would be in a world of pain if anything hard hit that area.

Sunday mornings I watch a lot of the morning news shows- either that, or BookTV on C-SPAN2. I can't watch the news this morning, it gets me too upset. I am having one of those mornings when I think that Lincoln was wrong- that our country is too large and diverse to be governable, and that we might as well splint up.

I don't know how I feel about Obamacare. Ideally, healthcare should have been taken care of at the state level, it seems like a states rights issue. But, with the exception of Massachusetts, it wasn't. And something had to be done- and nothing had been done. Is this better than doing nothing? Perhaps. I don't know. What nobody says: there will be winners and losers with this law. It is not all good or all bad. The other things that people don't say: if you liked the health insurance you had, you probably couldn't have kept it for very long anyway. Costs were getting out of hand, and policies were covering less and less each year. I have patients with 50$ copay's for there occupational therapy visits, who tell me that they can only afford to come once or twice. Insurance isn't what it used to be. Like last year when I spent $3000 for my hospitalization- my in-network out of pocket maximum.

I'm doing laundry, and trying to clean the kitchen. Later I will go for a walk. Tomorrow it is back to work.

So far so good on less Zyprexa.

This year I also managed to cut down on my Effexor. Cutting down on my Zonegran did not work. I'm not even going to try with the lithium- I think I'm at the sweet spot, with a level of 0.6. Just at the very bottom of the therapeutic range. That leaves Provigil- which isn't my biggest priority of things to reduce- except for the cost (as my overseas supplier has become unreliable and the price still hasn't dropped much in America).

We are governed by idiots

I can't believe they are going to do it, they are going to shut down the government. And then, after that, they will probably refuse to raise the debt ceiling. The government doesn't work.

And of course if they default on the debt, there goes our low interest rates on our debt, and then we are really in trouble. I don' t know why I bother to put money into my 401K. Well, what else is there to do? Buy gold, I suppose.

Our biggest issue is climate change. I used to think it is peak oil, but climate change just might hit us first- and peak oil might not hit us in time to save us from severe climate change. But take your pick, these are two issues that rarely get talked about. Let alone funded.

We need geo-engineering. In the long run, we are going to have to do something. I'm not giving up my car- because it wouldn't do any good. Everyone else on this planet would have to as well. If my small sacrifice could save the earth, believe me, I would. But if America were to cut CO2 emissions 50% in 10 years, it would shift the power balance and China would now be economically stronger. It is game theory. That is why small nations can go green easier than big ones- they have others to protect them.

So either we need some environmental world dictator to tell everyone to stop CO2 emissions, or we have to give up on that course of action as the mainstay of preventing global warming. And go to geo-engineering. But that requires money, and that requires that the congress can actually accomplish something other than shutting down the government.

But geo-engineering requires the conservatives to admit the climate change is occurring. And it is something that most liberal environmentalists are against. So I don't know who would be for it.

Taking advantage of an unpleasant situation

I had a wisdom tooth pulled yesterday. It had a cavity - which wasn't that terrible, but the tooth above had been pulled a while ago, so my dentist thought I should just have it pulled. I took Friday off, to give me three days to recover, and had it done first thing in the morning.

I really didn't think it would be that bad, as the upper had not been. But when I told the oral surgeon that, he said this one would be worse, as the tooth was more buried. He had to put stitches in afterwards- which I don't remember him doing last time- and he even gave me a prescription for tylenol with codeine (which I didn't fill).

It has been more painful, but I have been managing with tylenol, naproxen, and ice packs. And I napped a lot yesterday too. Naproxen can raise lithium levels so I try to not to use it too much, by as my level is only 0.6, it could go up a fair amount and I'd still be okay. I just can't use it for prolonged periods of time.

What I decided to do over this 3 day "vacation" is to lower my Zyprexa. I started Thursday night. I cut my 7.5mg pill into quarters, and took 3/4ths of a pill (and I took the larger quarters, so I'm taking a bit over 3/4 of a pill). And I am taking a little bit of klonopin. So far it is day two, and I feel fine.

Right now my goal is just to get back to 5mg, I really haven't decided about anything else. When I had the mixed episode this year and went up on the Zyprexa, I didn't do what I usually do- which is to go back down as soon as it was contained. I think it was the wrong decision. But I just wanted things to be easy for a little while, I just got complacent. I was afraid to go down. I thought I was doing well. But I really felt like my mind hasn't been as sharp since I have gone up, and that never went away. I was hoping it would.

Another blah day, and question about meds

I survived another day, and generally am feeling better. I did start getting that anxious feeling again in the afternoon- and I realized that I had an extra cup of coffee in the morning. It was only half-caf, and normally I can drink a lot more coffee with no anxiety, but perhaps not now. Or, perhaps it had nothing to do with the coffee. I took a quarter milligram of klonopin, and felt a lot better.

I am wondering about lowering my Zyprexa again. When I was doing so well, I thought well, I made my deal with the devil. I am actually functioning and doing things. I'll take the higher dose of this drug I don't want to even be on if it keeps me good. That was in July that I increased the dose. But if this quickly I have felt bad again- maybe the dose increase is no longer working, and there is no point in being on it. Maybe my brain has adapted. Or maybe it was never the Zyprexa- the lithium was raised at the same time.

I hate this trial and error system of psychiatry. There is no one who can tell me what my dose of Zyprexa should be. And whether I should go back down- so that I can increase it again in time of need- or stay on the higher dose to try to prevent future episodes, etc. I certainly don't trust clinical trials sponsored by drug companies to answer these questions.