I spent a few moments today looking into the abyss, but not the whole day. Now I am just tired.

There is this thing called environmental press- the demands of the environment. And my work if a very high demand environment. When I am not too lost I am helpful, competent, sociable, cheerful, supportive. Even chatty at times. And today this me batttled it out with the very depressed me, the me that wanted to flee to the staff room, that thought I was melting into the floor, blicking back tears, and didn't see the point in life. The me that got a glimpse of that dark place.

Work was not as stressful today in terms if things happening, I hope I wouldn't see the darkness today. But I did. I guess I should be glad that I could take a glance at that darkness and survive. I don't know, reallly, that I am going into another depression. I am just getting little bits of it here and there- and then it is bad. No warm, no introduction, it just comes.

But it has left me very tired. And taking too much klonopin- that was what got me through the day at lunch. I was to cut back. When?  It is never the right time to to feel a lot better before I feel better. I am afraid that I am now taking enough that I might be getting withdrawal effects, which are making things worse during the day. I am talking a half milligram at night, and a quarter milligram during the day. Yesterday I actually took more than that- but I let it go too long before I took anything..

Where did today come from?

I had such a bad day today that I thought I was going to lose it a couple of times at work. I broke down and took a little klonopin (very little) at lunch- I think I should have taken more!

It didn't help that my pedometer isn't working. We are having a contest at work, and my area is a team- we have these pedometers to track our steps. But mine keeps going off and not tracking. It is like the exact definition of depression- feeling like there is no point to doing anything, your actions have no effect. And that is what I feel whenever my pedometer stops counting my steps.

I had a very difficult patient- actually it was the spouse- who I couldn't please and they were going back to tell the doctor (even though I think the doctor sent my way because he couldn't please them). There were the insurance companies who haven't responded to authorization requests, saying that they haven't received anything from me (even though I have the fax confirmation sheet)- and when I tried to refax it, the papers kept getting stuck in the fax. That is actually when I started to lose it.

Then there was the patient who came at the wrong time. The patient who came late, so I couldn't go out for lunch to get away. And my back load of things that I am so behind on, paperwork-wise, that I became increasingly unable to do as the day progressed. I had planned to stay late, it didn't happen.

So it was a rough day. And not the productive day that I needed it to be. But I do think that it was a good patient care day, and I was able to give people what they needed.

 I haven't started my synthroid yet. I fill my prescriptions at the hospital pharmacy- because I get the best deal that way- but it is only open 9-5, M-F, which means I have to go during lunch. Synthroid is so cheap I thought of buying it elsewhere- but he wrote it on the same prescription slip as my Zyprexa, and I don't think I can split those up.

So now I am just trying to chill out until it is late enough to take my pm meds and go to sleep. Tomorrow will be a better day. Maybe I will let myself do some fun reading tonight, even though it is a week night.

My trip to the shrink

I saw my psychiatrist this morning. I am staying on the higher Zyprexa dose, at least for now. I will continue taking a little bit of klonopin at night instead of switching to another sleep med for now. And I will be adding synthroid- I think. I have to think about this.

My TSH is okay, but my T4 is low and my T3 is borderline low. My T4 is always low because I take cytomel, which is T3. T4 is the precursor- so if I am taking T3, my body will make less T4. I have had to explain this to psychiatrists. But this one gets it. But usually my T3 is good- this time it wasn't. I don't know what that means. Is it the lithium?

So he wants to add synthroid. But then he didn't want me to be taking more meds- so he said probably I should switch to Armour thyroid- but he couldn't figure out how to convert my cytomel dose to Armour, so he gave me a script for synthroid. I think the plan is to switch me to Armour at the next visit (when he can prep and figure it out!)

I suppose this is a good thing- and in the past I have taken synthroid prescribed by many psychiatrists with the promise that it would help my depression or stabilize my mood. I never noticed a difference until I tried cytomel, however. And that did help my depression. My current psychiatrist thinks that it might help with my weight. I do feel like my metabolism has slowed the past year- I thought it was just age. I have to cut calories lower that to what I used to in order to lose weight.

But it just feels like more meds, more pills. Even though it isn't really a bad one.

Single digits! That is all that I want with my meds. Granted, they are not all psych meds. There is my blood pressure medicine, the BC pill, and the metformin (to prevent diabetes and Zyprexa weight gain). But the rest are all psych.

I was at 11, counting the klonopin. This will put me at 12. Yikes! I better get on armour- so I can get T3/T4 in one pill and I don't have to take two separate drugs. That will get me back to 11. I used to say I only took 10 drugs- because the klonopin was only prm. But I am now taking it regularly, so I think I have to add it to my tally.

Back to where I started

Last night I gave in to the insomnia and took klonopin- which I had been doing until a few weeks ago. And I slept- and woke up feeling great.

So now I am back up to 7.5mg of Zyprexa and on half a milligram of klonopin. I am back where I started. I am a little sleepy- but not nearly as sleepy as I was yesterday from not sleeping. And the best thing is that I am actually getting some things done today- little things, like doing laundry and cleaning- but it is easier than it has been in weeks. I don't have that feeling that I can't move, can't initiate.

What does this all mean? Could I do the klonopin but not the Zyprexa? I don't even know. 

I guess I have to see how things go with weight gain and if I am sleeping too much. If those things are okay, I might not try to lower it. I haven't dared to step on a scale since I increased my dose. I know I am up, just don't know how much.

I need to stop reading all the anti-med stuff. I need to figure out what works for me. 

Today was bad- maybe it was meds

I felt very strange today, like my brain wouldn't work in certain ways- I just couldn't make myself do anything. I did one load of laundry, but couldn't do two loads- it was like my mind wouldn't work. No initiation. And also some light headedness and exhaustion. But I wasn't sure this was from the Zyprexa, even though these are some of my same complaints from Zyprexa.

And then I found two Effexor and two Zonegran on the floor. I take two of each of these at night. Perhaps I dropped them last night and didn't take them. I take one of each of these in the AM, and I did take my AM meds today. So that probably kept me from really bad withdrawal symptoms.

However, I was able to read today. I am reading "The Circle" by Dave Eggers. It is really, really good. I don't even know if it qualifies as science fiction- it could just be the headlines from today. Or maybe tomorrow, but not too many tomorrow's away.

I also spent the day watching BookTV on CSPAN2 and watching some of the news coverage of the California mass killing. CNN finally has something to talk about other than the missing airplane. They had a lot of people talking about these "welfare checks" that the police do, and emphasized how little legal power the police have to actually intervene.

All of which makes me wonder what I was doing wrong! Whenever the police came to my door during my manic years, it always ended up with me going to the hospital.

I hope I feel better tomorrow. I have things I need to get done. And I need to walk.

I think I even went home with clay in my hair

I went to my first pottery class today. My first time using the wheel- I took pottery lessons as a kid but never got to the wheel. It was not easy- and frustrating at times- but it was fun. And fun to go home covered in clay.

I was the only beginner- everyone else had been doing it for a long time, and had their own projects that they were working on- really impressive stuff. I had to push back some negative thoughts and try to be mindful as I tried to figure out how to make the clay on the wheel do what I was supposed to make it do. Two times I really failed, and had to start over. I now have one bowl- although not quite in the shape that I was supposed to make it in. That is for next time.

Once making pots and such out of clay would have been a useful skill. Technology has made so much of what we do kind of pointless. I can go to the store and buy any sized container that I need. What once would have been a useful skill for survival is now a recreational activity or an art form.

I am glad that I am seeing my psychiatrist on Tuesday. I continue to feel better today, but I am frustrated by how sleepy I am. I don't know if I should stay on the increased Zyprexa, or if I should use it at the higher dose episodically- and if so, how much longer I should stay here before I go down. I know that he may not have the answers, but at least I can discuss it with him. And I want to find out about re-trying Lunesta- am I really going to be that impaired the next day as the FDA is saying? I don't think 1mg is going to be enough for me, and I will need a higher dose. I think last time I tried it I took 3mg.

A better day

I slept last night, and this morning I didn't feel drugged. I could function at work- but it was a really busy day. No getting caught up. That will have to happen over the weekend.

I also didn't get that anxious agitated feeling in the afternoon. That was really good. I felt almost back to myself.

I am almost saying, I could live with this. If I just know I need this much Zyprexa, I could live like this. But I am still very hungry. However, I know that it gets better. It is worse in the beginning.

Today I have made better food choices- I have eaten a lot of vegetables. But nothing I have eaten is what my body really wants, which is carbs. I will see how I do tonight.

I think I am going to be much more active. At work, I agreed to sign up for a team- we count our steps for a few weeks, and the team who walks or runs the most steps wins. I just got my pedometer. The contest starts Monday. Maybe I will go for a hike! I am going to walk a lot of steps. I am going to help my team.

And maybe in the process counteract the effects of the Zyprexa.

I don't want to take Zyprexa, or any antipsychotic. I don't want to take so many meds. I want to think there is a better way. And yet, here I am. That seems to be what has fixed me. And really, in the time I was on the lesser dose- I was always surprised at how I wasn't getting much done. It wasn't that much better (other than losing weight).

There is theory, and then there is practice. In theory I wouldn't take Zyprexa. In reality, I do. I just have to deal with it.

I ate a whole pizzza

I am on the higher dose of Zyprexa for the second day. I felt drugged for the first part of the day- but then it got better. Except for the hunger. I was determined to eat my normal small lunch and breakfast that I have been eating recently- and I didn't bring any snacks even though it was a late work night for me, because I have been able to get by without them. I forgot about the Zyprexa increase. It was two hours before work was over- and I wasn't just hungry- that was all I could think about. I thought I was going to pass out from hunger. This isn't normal- this is Zyprexa.

I didn't have much food at home- the plan was to stop at the grocery store. But I was too hungry for that. So I ordered a small veggie pizza to pick up on the way home. And I ate every slice. And I do not feel sick, my stomach does not feel full- I feel good. I usually eat more slices than I would prefer- but never a whole pie.

I see my psychiatrist on Tuesday, not a day too soon. I'll spare him a phone call. I think that between the increased Zyprexa, a little klonopin, and melatonin that I am going to sleep tonight again.

If I weren't working, if I could afford to wait it out (maybe with some klonopin on board), then I'd never be taking the extra Zyprexa. I have to figure out if I a more or less functional on it- and I haven't figured it out. It definitely keeps me from going off of the deep end, but I was feeling too drugged for most of the day as well. Not to mention the hunger.

Not exactly depressed today, but something

I was better in the morning- perhaps a lingering effect of the increased Zyprexa the night before.  But by afternoon I was in the grip of this horrible anxiety- if that is even the right word for it. There was nothing cognitive about it- it was this visceral thing that made my chest feel tight and like I wanted to scream but I didn't know why. I couldn't even finish out the work day, I left a half hour early. I ran home- took a little Zyprexa- and felt like I was pouring water on flames. Like that was what I needed. But why? What is it doing to my brain?

So that is where I am right now. More zyprexa until my brain stops screaming, or until I see my psychiatrist next week. Not where I want to be.

This is how it starts

I spent the first half of my day telling myself that I really wasn't depressed, I was just in a bad mood (again) and having a bad day. Whenever I have to tell myself I am not really depressed, I'm usually wrong. By the end of the day, I knew. This is depression.

Somehow I made it through the day. Treated patients. Did notes. Even went out for lunch and got some sun (didn't help too much). Most importantly I did not cry, although I could feel the tears welling up at times. But I have that black hole inside of me- I can't stand what I am feeling. I just want it to stop. I just want to stop feeling for a little bit.

So I gave in- I went up on the zyprexa- I don't know if it is temporary thing or a permanent thing, I just need it now. I want this not to be the answer, but I need to do something. And I need to be able to go to work tomorrow and function and not cry.

What I really wanted to do today, while driving home, was to cut. Even though I haven't done that in over a decade- when I feel really bad the desire is still there. Of course I didn't.  But it is good to know that it is there, if I need it.

I can think of a hundred reasons why I am depressed. I don't really care why- or know what to try to fix first. If I can fix anything. I just want this not to be happening.

I'm not very good at doing opposite to emotion action today

"Opposite to emotion action" is a DBT strategy for managing moods. What I should be doing is getting some exercise. I know that is what my body needs. And probably what my brain needs. But anxiety is kicking my butt today, and I am staying in.

I am trying not to take much klonopin- as I think that some of this anxiety may be a rebound effect from what I took last night to get to sleep. I just took a quarter of a milligram this afternoon, and I will talk a quarter of a milligram tonight. And if I don't sleep- maybe that will just have to be what it is. I do have some melatonin, however, that I just got. I am going to try that tonight as well. Sometimes I think it has made me depressed- I have never been sure- but I am going to give it another try.

I am doing online window shopping. I am going to two Bat Mitzvahs this summer- and I really have no fancy summer clothes. All my fancy clothes seem to be black or very dark. I did have one summer skirt but the elastic finally went and I had to get rid of it. So I am looking for something to wear- which is not easy when you are plus-sized. It is really hard to find anything plus-sized in the stores near me, unless I want to drive a long way away. So I usually shop online. But I can't find a dress I like- all the dresses seem to be sleeveless and/or "maxi" dresses- which go down to the ankle. I don't want these things.

My day of rest

I am just chilling out today. I finally managed to fall asleep last night thanks to klonopin and benedryl. I woke up feeling much better. Except that my IBS is really bad today- I feel like my insides are coming out of me. I feel so drained. It has been getting worse all week- but I have been eating beans and lentils all week for dinner. Probably not a good idea.

I want to go for a walk this evening if I feel better. And I need to buy some soy milk or lactaid for tomorrow morning's coffee. And figure out what I am going to eat for dinner. What is safe to eat? I don't even know. Just not my red beans and lentils- which are so yummy.

Today I will do laundry and clean. I also have to do some reading to brush up on a diagnosis that I have not treated in a bit and I have a new patient coming in for that. But I am looking forward to it.

I can't believe that next week is Memorial Day weekend. It will be nice to have a three day weekend. I have so much going on this summer- three trips and pottery lessons. And a 3-day continuing education class in August. I just hope I am up for it all. I have been so tired recently. And the past couple of weeks I have struggled with my mood. I think that is mostly hormonal, but still, it is worrisome.

A hard day

It is a Friday, and I am worn out. And to top it off- I had to remake a splint for a patient, and I am hoping the material I chose (which I chose for comfort), will hold. I am feeling very anxious about it. The anxiety just really wore me out. And I am more behind on paperwork than I thought I would be- I really have to go in tomorrow. And I promised my dad that I would go help him with his bees on Sunday. I don't mind doing it except that the drive is so far that it takes the whole day. I just want to chill out.

I guess I am just complaining. And I also had a conversation with my step mother yesterday- I told her about the study about coumadin and schizophrenia. And then she made the comment about "maybe you can get off all of your meds someday." Which just bothers me more than it should.

She used to be the most pro-drug person in the world. And even just a couple of weeks ago when I was trying to cut down a little further on my Zyprexa, she told me that maybe I shouldn't mess with success. But she has become increasingly anti-med, and I can't take it. It it too late for me to go the no-med route, whether or not it was ever possible. And I can't feel like I am defending my use of meds to her of all people- who got me hooked up with all of her connections to these NYC doctors who prescribe tons of meds.

My mom is already against me taking meds. My dad doesn't say anything, I'm sure he wants me to do whatever my doctor says. But we don't really talk about that kind of stuff. It is my mom and my step mom who have opinions. I don't want them to have opinions. And I can't take all of the little comments that they make. I just have to not talk about meds.

In an ideal universe I would take less meds- maybe no meds. Who knows. I can't take a year off of work to find out. Not even just for financial reasons- my work is what keeps me going. Without that, I might just need those meds even more. Or maybe less. I don't even know.

I tried to find the email of the lead author of the study on coumadin and schizophrenia. I wanted to email her about my mother. I couldn't find the email- I am feeling very frustrated. I am just feeling frustrated and out of sorts today.

I want to go to sleep- but it is too early, and that just messes up my sleep for days. So I will try to stay up for a little bit longer. Arg!

Sometimes it is all biology, part II

My mother had a mild stroke in her 50's. Prior to that, she had been very psychotic numerous times. After that, never again. Yes, still some magical thinking, vague paranoid thoughts- but no one was driving her car at night to commit crimes and frame her anymore. I never understood why. Was it the stroke- did it do something to her brain? Was it the experience? What?

Today I read an article that blew my mind. Well, actually it was the summery of a presentation at the American Psychiatric Association. They found that schizophrenics at a coumadin clinic had their psychosis resolve and no longer needed medication. And these people had not had strokes. The author thinks it is the coumadin. I didn't follow all of the nitty gritty, but apparently coumadin might block some of the pro-inflammatory pathways that are overactive in psychotic conditions.

When my mother had her stroke, they put her on coumadin. They tried to put her on it sooner- she has atrial fibrillation- but she refused. After the stroke she takes it. Well, I am going to stop my campaign to try to get her on one of the newer drugs like Pradaxa until we find out if these drugs do the same thing. But I think the knowledge might be a long time coming. I don't think that most of psychiatry is ready to get rid of antidepressants and antipsychotics for blood thinners and anti-oxidants. It may take a generation- enough time for the old guard to die off- before we can think about drugs other than "psychiatric drugs" as proper means for treating psychiatric illness.

I think that someday we will think about antipsychotics the way we think about steroids- sometimes you have to use them for a short term flare up- but you do your best not to use them long term unless it is of clear  benefit and there is no other option. But we don't have all of the good options yet, at least not widely available.

Well, my mom is off her Risperdal, and taking her coumadin. Who could have predicted that this would be a better psychiatric drug for her? I was so scared when she went off of the Risperdal, but by then she had her coumadin.

Sometimes it is all biology

Last week I went back to taking klonopin on a regular basis. Two nights ago I upped my Zyprexa. Today I got my period. Unexpectedly, of course. And that explains a lot.

I take the pill to only get my period every 3 months because my PMS is so bad it has gotten me admitted to the hospital. Recently I haven't even been getting a period during my week "off." But I also know that if I miss a dose or two (they are tiny- I can drop them on the floor or leave them in the bottle of my pill box), then sometimes I will get a period. And I am guessing that is what has happened.

So I am letting myself take a little klonopin- that is really the drug that helped the most with PMS. Hopefully by tomorrow I can start weaning off it again. And going back down on the Zyprexa.

When I know I am getting my period- it isn't always that much easier, but at least I know what it is. This time I didn't know what was going on. I had no clue, it never crossed my mind.

My other drama today was my every six month mortality check-in at the women's imaging center. I had a mammogram and ultrasound of my left breast, so they could monitor the nodules they found previously. I really wasn't worried this time- and everything is unchanged. They said that if things are still the same in six months, they will release my from the six month checks. That will be good. I had been afraid that with so much imaging they would find a false positive something.

I hate that I am here again

I have been having a lot of trouble sleeping. Both falling asleep and staying asleep. And so I have been taking klonopin, much as I hate to do that. But last night I took too much, I think- because around 3pm this afternoon I suddenly started having this massive panic attack. That is when my anxiety usually kicks in- but it is not usually that bad. I took a quarter of a milligram, and it got much better. I even stay late to do some notes. But I don't want to take anymore klonopin. And yet- the anxiety is still there, although not as bad- and I don't think I'll sleep. So I raised the Zyprexa. And I hate that.l

I thought I was doing okay at 5mg. And then the insomnia started getting worse, not better. I don't know. I see my pshrink in a couple of weeks, maybe he will have some answers. Maybe I just need a new sleeping pill- maybe it is the end of the line for me with ambien. Maybe I should give lunesta another shot. It seemed to be stronger. I just wasn't sure if it was making me depressed- but I was very depressed at the time. And maybe it is time to give melatonin another shot, just as an add on.

If I had been miserable at 5mg, I would go back up to 7.5mg, and just say that is what I need. But I really thought I had been doing ok. Plus I lost a dozen pounds by going down. I thought that I was set with my meds. But insomnia is really what often breaks me, and has stopped me from getting off of Zyprexa all together.

Today I had my moment of self-pity: "normal people don't have these problems!" I guess they don't. They just have other problems. You would think that in my line of work that I would find it hard to feel self-pity- and really, I have picked a good profession. If I worked as a wedding planner I would have to shoot myself. Working with people who are injured or sick- it is very good for teaching me that we all suffer and that I have no monopoly on that. Not much room for self-pity. Except that it does sneak in every now and then.

But for now, the increased Zyprexa seems to be doing its job, and I think I am going to go to sleep. Without any extra klonopin (other than the emergency half pill I took at work). I did take ambien. I wonder if I could take this higher Zyprexa, and get off of ambien and klonopin. Would it work? I don't even know if I want to try. Can't think right now, just want to sleep.

My monthly trip to Costco

I had to go to Costco today to pick up my Provigil- they are still the cheapest price I can find. And yes, it is still $450 for 60 pills. Every month. I can't believe that it has been generic this long and it is still this pricy.

Of course while I was there I had to shop- in fact I buy most of my non-produce items for the month there now. Plus my Citricil and calcium gummies. And I bought some shampoo. And yes, their gigantic package of toilet paper. I still don't know where I am going to store it. All in all I spent over $200.

I did buy some pears- I am hoping that I manage to eat them before they go bad. I read somewhere that pears have just about the longest shelf life of fruits. There are a lot of pears in my package.

Costco is not for single people. It is not for people with bad backs either. I nearly bought some seltzer- but the package had so many bottles that I didn't want to risk my back. I know, I was a wimp.

I used to drink tap water all the time-  but then I found out that there is a lot of arsenic in the area and I have well water- and arsenic is linked to lots of health problems including diabetes and lowered IQ. My Zyprexa already does that- I don't need a double whammy. So now, especially because I am drinking more with the lithium, I am drinking at least some bottled water. But I feel guilty about it.

Happy Mothers' Day?

I had two people at work wish me a happy mothers' day today. It was awkward.

I live in an area which is totally family oriented. It is rare to meet another woman who does not have kids- let alone a husband. It can be lonely. It can also really make me feel like there is something wrong with me, like I am deficient, incomplete.

There was a time- the first few years after I got off of disability, when it seemed like things could only go up- when I had a good job, nice apartment, even a boyfriend- and I started to think- if only this had happened a few years earlier. I could have had a baby. A family. And I got very sad about it, but I felt like it was too late for me- even though at 40, one man told me that I was not too old to have a baby. I was. Especially with all the weight I am carrying from the Zyprexa.

But I didn't have the right man. I was still struggling just to take care of myself. And then there were all those meds- which I would have wanted to stop entirely to have a healthy baby.

So no baby. And now, I don't even regret it. I am too old, have lived alone for too long, I am too set in my ways- I couldn't do it. I just couldn't. I see what my brother and sister-in-law do for a single child, and I couldn't. It is hard enough to take care of myself.

I guess I see my childlessness now more as a sign of my inadequacy. And a symbol of my illness. If I had not spent a good portion of my adult years in and out of psych hospitals, and if I was not taking a large number of medications that are not good for developing fetuses- I might have had children. But things are what they are, and not what we want them to be.

I shouldn't care what other people think of me. That only makes it worse.

I remember once when a colleague asked me when I was going to have kids, I told her that I had a medical condition that made it inadvisable to have children. She told me that I could adopt. In her defense- she was pregnant. But it really was none of her business. And I wasn't about to tell her that I had a medical condition that would make it difficult to adopt!

I had more energy today- so I am feeling more hopeful about my life

Recently I have just felt drained by the end of the day at work. I have felt just exhausted some days, like yesterday. But today I didn't. Then again, I didn't come in early and stay late either like I did yesterday. I also took an eighth of a milligram of klonopin in the afternoon (no coffee), when I typically start to feel anxious. It is sometimes the anxiety itself that can wear me down.

I felt good today. I have interesting patients. I was discussing a patient who has some really devastating injuries going on- and another therapist said to me- "You can help her if anyone can. You like a challenge." And I realized that this is true. I like a good clinical challenge at work. Paperwork challenges are another matter.

I also made a cool splint today I think. I hope it works for her. The first one I tried- a different design- didn't. I was hoping to do something that would give her more hand function but it wasn't enough. So I made a bigger splint- and I hope that the patient doesn't think I am an idiot for trying the other first.

I just hope that I can feel like this other days when I get out of work. Today was a late day- not much time to do anything than grab a salad for a late dinner, watch 30min of news (why do I bother?), and now I'm in bed. But if I can feel like this on my early days, I can maybe start to have a life outside of work on weekdays.

I just joined a reading group on Meetup about political revolutions and revolutionaries. In my original bio that I tried to post, I realized that I almost sounded dangerous. Of course it was too long to be posted- so I kept things pretty general. All the same- I can see this group being a ruse of the CIA, or some government agency, to seek out people interested in revolution. Maybe at the first meeting I should ask all of the government agents to identify themselves!

I am joining the group because I am interested in change. What can be changed? Where? How? How does power work?

America is too big for revolution- it is a lost cause at the moment. When I turned on the news and saw that they are going to have more hearings on Bengahzi, well American politics is a lost cause.

Coffee- my favorite drug of all

While I was studying for the CHT exam last year I was letting myself have a second cup of coffee at lunch. But afterwards I cut it out- because coffee gives me heartburn and contributes to my insomnia. But I have really been dragging in the afternoons. I keep trying to lower meds, stop the klonopin, etc, hoping to get my mental edge back. It hasn't worked that well. And then today I stopped to get a sandwich for lunch and gave in to the urge for an iced coffee- and the afternoon was great! I got so many notes done, I could concentrate so much better. And I didn't even get heartburn.

All I needed was coffee. Who knew? I think that Provigil keeps me awake and alert- which is a prerequisite for concentration- but it doesn't really help me all that much with concentration itself. But coffee does. So does practicing mindfulness.

But if my mind was good today, my body was not. I feel exhausted. My joints hurt- maybe because rain is coming. But somehow my back feels pretty good today. I'm grateful for that.

I am also grateful for the new Wendy's Asian Cashew Chicken salad. Now I can go through a drive through and get something healthy (and yummy). They are going to get to know me pretty well there.

Weekends are the hardest time for me

Weekends are unstructured. Everything I do is kind of optional in a way that going to work is not. I have a real problem with initiation, and I don't know to what extent I can blame my meds (but I do). So I tend not to do a lot. And I tend to isolate.

That is what I did this weekend.

I totally act like a depressed person most weekends. I just have a hard time getting myself going and doing things. I need structure.

In a couple of weeks I will be taking pottery lessons on Saturday mornings, which should help.

I think this is the main reason I want to go off my Zyprexa- forget about tardive dyskinesia and diabetes. I imagine that I will somehow have more energy and drive and be able to do things. Am I right or wrong? I have been on it so long, I don't even know. I only know that it didn't always feel this hard to act, to do things. But that was a long time ago. And I don't know if I have gotten into the habits of a depressed person, or just gotten old, or if it is the meds. Or residual depression. Probably some combination of all of the above.

Sometimes klonopin just helps

I am trying not to take klonopin anymore- mostly because it has rebound effects for me when it wears off, not to mention that it is sedating- although not too much at the tiny doses I take.. Still, with all the meds I take, the last thing I need is a little of anything more that is sedating.

But I have been having trouble sleeping the last two nights- and then last night took a little extra ambien to sleep. And then today I have had this terrible anxiety. Just awful. I didn't do thing things I wanted to do in the morning, I just couldn't do anything. I tried lying down, watching tv, reading, anything to distract myself. And then finally around 1pm, I broke down and took my one quarter of a milligram of klonopin- and I feel so much better. I think I'd feel better if I took the whole half milligram- but then it has been so long since I have taken that much that I think this would also knock me out. So I won't.

I definately have taken meds to knock me out before- but usually I have to be pretty depressed or manic. I'm not there. I am just a little depressed, mostly anxious. And the clouds and dark skies don't help- I need sunshine! That is what my mood needs.

I need to call my Grandmother. It is her birthday today. I am a bad granddaughter. I forgot. I forgot to order her flowers. But- this is really awful- I am finding myself thinking, on a philosophical level- does it matter if I didn't send her flowers if she isn't able to remember?  Because she really has very little short term memory anymore. She is 94.

I don't want to live that long in that condition, especially since I won't have children to take care of me like she does. She has her daughters who live with her in her own home. That's no so bad.

Everything that is wrong with America

I turned on the TV and put on CSPAN as I often do on the weekends- and it was the red carpet for the White House Correspondent's dinner. Women in very nice dresses and lots of make-up, men in suits (and maybe make-up).  Some faces I knew from TV news. And some faces I knew from Hollywood. What was Patrick Stewart doing there? I like him- but he is not a news guy. He is Captain Picard.

After a couple of minutes I had to turn it off. It just seemed to represent all that is wrong with our country. It is all about money and celebrity. If you don't have one or the other, you are a nobody. If all you have is a good idea- you have nothing at all in politics.

Democracy doesn't scale up well, and we are a very big country. And not so democratic- the senate still requires a super-majority for most matters (although this wasn't always so). And the senate is the chamber that has two senators for every state, regardless of population. One person-one vote is certainly not the rule here.

I think this White House Correspondent's Dinner has become this yearly ritual to help take the attention of the masses (or those with any political interest) off the bigger issues for a little bit. Maybe that is okay. Maybe it is impossible to really fix anything in our current political system. And really, who can simultaneously think about the national debt, peak oil, resource depletion, the greenhouse effect, and growing economic inequality/loss of jobs due to technological innovation, without going mad. I certainly can't- I can only perform this feat thanks to massive amounts of psych meds. And it still has me a little crazy.

A plus and a minus

I was bad with food today- I ordered a pizza, and ate more of it than I should. That is what happens when I run out of food. And the only thing within a few miles of me is a dunkin donuts or a pizzeria.

That was my minus.

On the plus side I went walking. Not anywhere near enough to walk off the pizza, but hey, I went walking! This is big. I haven't done that since before I hurt my back.

I really need to go grocery shopping. I haven't in a couple of weeks- and I have been out of my soy milk and lactaid. And this means I have been stopping at convenience stores to buy regular milk, which is all that they sell. I can usually get away with that for a little bit- I never know for how long. But it has been too long. And I am having stomach issues. Eating pizza doesn't help- but I can usually get away with cheese.

I hate being high maintenance! I hate being lactose free. I hate needing all of these meds. I want to think that I could just throw some clothes in a suitcase or in my backpack and head off some place. And not have to worry about what I will eat or where I will fill my prescriptions.

It's funny- when I was on the MAOI's, I didn't mind the dietary restrictions that much. I had been vegan before that- so I just traded one set of dietary restrictions for another (I stopped being vegan- it would have been too hard). Plus, they worked so well for me for a while, and I had been so depressed before I went on first Nardil, then Parnate. It seemed a small price to pay.

I am not sure about gluten. Sometimes I think the times I have had more joint pain is when  someone has brought in bagels, I have eaten pizza, etc. But then sometimes it doesn't happen either. So I don't know. I probably need blood work again. I just need to know if I just have osteo, or if something else is going on. No one else in my family has arthritis in their hands. Although my mom has some in her foot- probably psoriatic arthritis. But I've never had psoriasis.

It is quite the irony to be a hand therapist getting arthritis in my hands.

TGIF again

It has been a stressful week at work. It has been a stressful week with meds- I went back up to 5mg of Zyprexa- in the end insomnia got to me, as it always does. And then my mood started to get bad. So I am back to 5mg. But then this morning I overslept and had to get ready really fast to go to work and forgot to take my morning meds. So I have not been feeling that great, and had a bad headache all day.

I used to carry a day's worth of meds in my purse. But then I used it up the last time I forgot my morning meds, and have never filled it up again. I have to do that again.

But I am really stressed out about something else too. I recently had some blood work done. My fasting blood sugar, which is usually in the low 90's, was 100. That is the very bottom of the pre-diabetic range, and not where I want to be.

I work in healthcare, I see what diabetes can do. I don't want diabetes. So I really need to lose weight, exercise more- and maybe rethink the Zyprexa. I don't know. It is terrible to have to make this kind of a choice. Diabetes vs mental stability.

One of the things I did this past year that may have worked against me is to decrease my resterotrol. I was taking it twice a day- and it seemed to help with my blood sugar. But then I saw an article stating that it can be hard on the liver, so I cut it down to once a day- maybe that didn't helped. I will try going back to twice a day.