I have no voice

There is something about not being able to speak that I find disempowering and disturbing, even though I know my voice will soon come back. I have to be patient and let this virus work itself out of my system.

There was another time I lost my voice that was a lot more disturbing. I had overdosed- it was very bad. I had to be intubated, and on a respirator, and spent a few days in intensive care. Afterwards I could only speak in a whisper. They told me that this was an effect of the intubation, and that as my vocal tract re-epithelialized, my voice would probably come back. But they also told me that there was a small chance that I had sustained a vocal cord injury and that it wouldn't. It was a very long wait, wondering if I had destroyed my voice.

The whole episode was very traumatic. You don't just come out of a coma like it happens on TV. It happens in stages. And for a while I was very confused. I saw that I was in restraints- but the other patients in room (there were 4 of us) were not. I thought that they had succeeded in breaking out of their restraints- I thought that this was what we were supposed to do. I saw all of these monitors- I thought they were TV's. I thought it was some kind of game show- to have people break out of their restraints. So I kept trying, and then pleading for them to let me out, telling them that I give up, I lost the game, I can't do it.

I had the worst bruises on my arms and legs from where the restraints were. They eventually faded and my voice came back for which I am very grateful. They had told my parents that I might either die or have brain damage, that they would do what they could. Sometimes, when I am having trouble concentrating or remembering something- I wonder about the brain damage.

I did it to myself- and yet it was a very traumatic experience. I know it was traumatic for my family, too. I think I am glad I didn't succeed. Most days.

Sick- I hate being sick

I just got back from my conference, which was great, except that I am sick. The good thing about the conference is that I didn't have to talk much- and as of yesterday I really can't. My throat is killing, I am coughing, and now I can't talk. I got though the conference by living on cough drops- which don't work as well as I thought they would.

I am guessing that I won't be going in to work tomorrow. I really don't want to miss work, I really don't want to stay home. I didn't see patients for 2 days, I have all of these new ideas from the conference, I want to go in. And I don't want to use my PTO.

I think if I didn't work, I wouldn't mind being sick quite so much. I could just say, OK I am sick. It is just another state of being, a temporary thing. It will end. But now I want it to end right now! Or at least before tomorrow morning, when I have to decide to call out or not. I already gave my boss a head's up and told her I might not be in. We are a very small department.

I am supposed to see my primary care doctor Friday for an unrelated matter. But I wonder if I should try to get in tomorrow. They probably won't do anything for me- I don't think they give antibiotics for upper respiratory infections anymore unless you are deathly ill. How can they tell if it is bacterial or viral? I don't know.

I have to admit to feeling proud- going to this meeting this year as a CHT. I wonder how long I have in this profession before the Medicare and other regulations and paperwork get so onerous that I want out. But for now, it is a good feeling.

No mindfulness for me

I had signed up for an 8-week mindfulness based stress reduction course. I was looking forward to it, I thought it might give me some of what I needed. But it has been cancelled due to low enrollment. I am very disappointed. Unfortunately I live out in a semi-rural area these days and there aren't a lot of groups going on. I think I really need a group.

My hospital has a depression support group- I don't know if it free or paid group- but it is in the middle of the work day, so that won't work anyway. DBSA has two groups about a half hour drive away from me that I could make- if I am able to get out of work right on the dot and have no traffic, etc. Which never happens. And I have been less than impressed with the groups. I think I was spoiled- the group I went to in the city was just so good. And there were more people there who were in a similar place as I am.

I've thought of trying to create a group on meetup.com for peope with mood disorders- but I am too afraid that no one will show up and I will be left feeling depressed and lonely at whatever venue I choose. But maybe I will, eventually.

Things have been challenging recently, in part because I messed up my meds when I went out of town this weekend. I think that yesterday was the first day I started to feel like I was getting back to equilibrium. I actually left work early on Monday my headache was so bad.

But I am excited because I am going to a hand therapy conference starting on Saturday. I love going to conferences and courses. I always come back so inspired. Except for the ones that I have gone too extremely depressed when I was wiping away the tears half the time. Those were bad. But this won't be like that.

Just what I needed

I spent the weekend out of town visiting my brother, his wife, and daughter. My niece! She is so precious. And they are just so- normal. Not in that they are ordinary- but in the absence of pathology sense. I always feel grounded after seeing them for a little bit.

How did my brother turn into this person? He has always been an amazing person- I just didn't know that fatherhood was in his future when he was younger, let alone that he would turn out to be this amazing father. It is nice to see.

I'm reading a book, "The Power of Habit" which is really good. I am starting to hope that I can change some of my habits- or create new ones- and create some order in my life- and that some things can get easier.

I've been thinking about plans for the next few months, things I want to accomplish. It is dangerous to make plans, too often depression or a spring-time hypomania will derail it all. I have paid for vacations that I never went on (I stayed home and lay in bed) because I was too depressed. But you can't stop planning. You can't give up on life. And so I plan.

Because a part of my mind also is always in denial, and thinks that I have seen my last depression. Because when you are not depressed, depression does not make sense. They are two different ways of seeing the world. When I am depressed, I cannot imagine not being depressed. And when I am not depressed, I cannot imagine being depressed again. It just doesn't make sense.

What's in a label?

I knew very early, growing up, that I was different. I was extremely shy. I couldn't stand loud noise or crowds or too much stimulation. I did very badly in school for many years due to undiagnosed learning disabilities and have a genius brother. My mother was very troubled, and my father usually absent. And I discovered that by pressing my arm against the hot water pipe I could feel better.

By the time the labels came, it was too late. I had already labeled myself as a terribly flawed person. It didn't matter when they told me that I had learning disabilities- I knew that I was stupid. And when they told me that I had: first borderline, then depression, then bipolar- I knew better. I was just weak.

There was a brief period of time in which I almost started to believe the psychopharmacologists- that someday we would find this drug cocktail that would make everything alright. It was a nice dream.

But mostly I have thought that I just need to try harder. And I don't think that is exactly wrong- but I need to be smarter about it. I keep fighting the same fights over and over again. The same things keep hurting me. I keep getting the same results.

And my moods keep doing their thing. Is it helpful to label this as bipolar? I don't know.

I am not sure how to make things better in my life right now. I think I am going to do an 8-week mindfulness course given at my hospital. Maybe it will help. At least it will give me something to do one day a week after work instead of going home to crash.

Something has to change. And I don't think it is meds.

I guess my weight is still a sensitive issue

I gave in to the bribe offered by my health insurance company of $100 towards my health savings account to go to a talk on healthy eating. I really didn't want to go, I shouldn't have gone.

I got so upset during the talk. First- how I was only getting a measly $100 for this- but I am spending $450 every month just on my provigil that they won't pay for, and I have thousands of dollars that I spend each year before I meet my deductibles.

But I also felt like I was being lectured about my weight. It took me so long to get used to my body after the weight I gained on Zyprexa, and so many years not to be so totally self conscious about myself. I don't need this. I am not fat because I don't know how to eat. I am fat because I am often very hungry, sometimes too depressed to cook healthy, and occasionally I eat for comfort.

But it just made me think about how much people must  judge me, as a healthcare worker being so obese. And I want to tell people- don't judge me until you have spent 15 years on Zyprexa. But I also know that not everyone gains as much as I do. I just don't like being hungry- some people don't mind it so much. I give in too easily. I gave in too easily when I was gaining in the beginning. The problem, I was so numb and depressed that first year I didn't care so much.

All of which brought up me questioning the Zyprexa, did I need it then, do I need it now, what if I had gotten off of it before I gained all that weight, etc. All in all, I went to a very bad place during the presentation, and had to run out to my car afterwards to take a half a klonopin to keep it together.

Well, the morning had been a really good morning. And by the time I got back to work in the afternoon the klonopin had started to kick in and I was able to focus on work. Until the last half hour, when I just crashed. My last patient had gone and I was making phone calls and doing notes and checking email and I thought I would collapse. But it seemed like the whole day was a high drama day- even work. And even home- my heat went out (woke up to cold and no hot water for a shower).

Now I am in my warm apartment and it is very nice. But I still feel like there is a hole inside of me when I think about the issues stirred up this afternoon. I need to find a way to reframe things so that they aren't so painful. But I haven't thought of how yet.

I have been eating healthier recently. My trip to Costco actually helped in this regard! I have such a hard time grocery shopping- buying mass quantities works for me, for everything except fresh produce. I must have a month's worth of chicken breasts in the freezer. I just cook them on the skillet and eat them with a salad or a bag of those frozen steamable vegetables. My big weakness these days is Chinese food.

An awful week- but now I am better (but whiney)

The anxiety that I had been dealing with when I last saw my psychiatrist turned into this anxious, irritable depression. And then over the weekend I couldn't sleep. I turned to yet another drug: benadryl, which helped. I finally got a good night's sleep last night and woke up feeling so much better. I didn't even take any klonopin today, I didn't feel that anxiety. It was gone.

I even managed to get two things accomplished this weekend: I took my car in for servicing and went to Costco to pick up my provigil and shop. But these things really drained me.

I confess I am having a few "when is it going to get any easier" moments. This only lasted a week, I should be grateful- but it is so disruptive. How are you supposed to figure out how to live your life when half the time you are not sure you want to live?

But I think I am not just dealing with a mood disorder- I am dealing with the collateral damage from it. I didn't spend my twenties and early thirties figuring out my social identity, finding my soul mate, establishing structure and routines in my life. I spent these years in and out of psych hospitals. There is a lot that I never learned. This makes life that much harder, even when I am not in the midst of an episode. Plus my learning disabilities- that doesn't help either.

I'm not sure how to fix that piece. I thought that therapy might- but it hasn't. I think I need more structure. But I will have to create my own, and that isn't easy.