TGIF!

The week is done- sort of. I have to go in to work and do a lot of paperwork tomorrow. I am on vacation next week so everything needs to be in order and notes on all the patients for the per diem therapist who will be covering for me. I really need this vacation, I have been feeling really exhausted this week.

Sunday I am flying to Florida, where my dad and step mother have rented a condo for the winter. I will finally get some sunshine! I should have been gone this week, and missed the snow, but it will still be welcome. I will have a week to go to the pool, the beach, and walk in the sun. I just have a hundred things to get done between now and Sunday morning when my plane leaves.

I'm trying to decide right now whether or not to go to this hand therapy conference that I go to every year. It won't be paid for this year by my employer. I would normally have gone anyway- I have learned so much from this conference, I like going, and it inspires me with my work. But with the prospect of paying for my Provigil come April, I am hesitating. I have enough debt. But then a part of me says, the conference is in March- it will by my last hurrah for a while. Time enough to start being more frugal in April!

So I haven't decided what I am going to do.

I have to remind myself that the price of Provigil will fall, it is just a matter of time. It already has fallen since it went generic- it just started so high, and has fallen a lot less then I though it would in this time. I won't be spending all of my money on Provigil forever- I have to remind myself this or I start to get too angry and frustrated and want to do crazy things like stop taking it so that I get so depressed I have to be hospitalized and then my insurance company will really be out money.

But I don't want that. That is just stupid.

I am really obsessed with this Provigil I guess. I keep coming back to it. But I've looked at my insurance company's medical criteria, and they specifically exclude depression as an indication. I don't think I have a chance- and I don't think my psychiatrist uses the drug enough to know what to tell them (or works with insurance companies enough to know what to tell them).

My insurance company has a nurse hotline. I wonder if they can provide any information.

"They say" that when you are drowning the hardest part is the struggle, and that once you give up it can be peaceful. Maybe it is my struggle, thinking that there is a way out of paying for my Provigil that is driving me crazy. Maybe this calls for radical acceptance. Maybe that will give me at least a little bit of peace. Of course, the peace doesn't mean that you aren't still drowning!

The Dialectic

DBT is all about the dialectic. Here is one: mindfulness is good, mindfulness is bad. Both true.

There was a recent New York Times article about the downsides of mindfulness. It can apparently stifle the creative generation of solutions in certain situations and also decrease implicit learning of tasks. The implicit learning aspect had never occurred to me, but makes sense. But in my heart I always knew that my ruminations were a kind of creativity and worthy of existence and that mindfulness is great, but my brain was not designed to be mindful 24/7.

There is a balance to be had in most things. This is no different.

But I was very mindful driving home, which may have saved my life. I was driving on a back road that was still very snowy and icy. And then a deer stepped into the road. I braked right away- so I had a lot of time to pump the brakes (I don't have ABS) and not skid too much and not hit the deer. I stayed on the road. I made it home.

Winter driving is very mindful driving.

Eagles and snow

I went on an all-day bird watching trip yesterday run by our parks and recreation department. We were looking for eagles, and we saw a lot of them. What I didn't expect was how cold and snowy it would be- we went north and up into the mountains. I got so cold, it took me a couple of hours and a couple of cups of tea to warm up once I got home. I just didn't dress right. And we were doing a lot of standing around- normally when I am out in weather like this I am hiking, so I don't get cold.

It was good, but is was a long day and by the end I was pretty ready to go home. I also forgot to bring my Provigil with me, so I didn't get my second dose- so in the afternoon my mood and energy really started to plunge. I hate taking meds in the middle of the day, just hate it.  Maybe I am going to have to give Nuvigil a try, as I will soon be paying just as much for my Provigil.

It was my first time going on a bird watching trip. Bird watching is something I have thought that I would like to get into- to complement my hiking. But I am not 100% sure that I liked it- I kind of see it as a way to commune with nature. These people seemed to treat it something like a competitive sport. It was fun, but a little too much counting. Still, I am glad that I went, glad that I saw 30 eagles, and I think I will go on more trips.

Tears in Yoga

The best part of yoga for me is the end, lying on the mat with the lights turned down low, for those last few moments of peace before the the instructor rings the gong to call us back to life and end the class.

Today as I lay on the mat my mind started to wonder, as it always does. And I tried to pull it back to the moment. And then I was suddenly overcome with sadness and tears came to my eyes. I was thinking about not sending out Christmas gifts, and it just seemed like the metaphor for my life: letting people down because of the damn depression. It was sadness, but it was somehow good sadness, and I was able to experience it and embrace it instead of pushing it away.

And I lay with the sadness for a few moments, and then is seemed tolerable, and I brushed away the tears before we were dismissed. But I felt freer. I had my yoga glow going as I walked back to my car.

I'm home and reading my kindle. I just finished "The Unwinding," which was really excellent. Now I am reading a book about the case against geo-engineering. I'm on a non-fiction kick right now. I used to read a lot of science fiction- but current events serves the same purpose.

Tomorrow I am going on an all day bird watching trip that I signed up for. I am not a bird watcher, but I would like to become one. To get more in tune with nature- before we lose it all. My other interest is Astronomy- but the stars we can't touch, humanity isn't a part of their story. A stray comet or asteroid, however, could be a part of ours.

I am sure that there is life- intelligent life- on other planets. But I also think that, given the limits of relativity- it really doesn't matter. This distances are too far and can't be breached. So for all practical purposes we are alone.

Very moody but not like I have been

A part of me thought that when I made it to yoga again I must be "all better," whatever that means. Of course I am not. But I am better than I was last week, so I have to be grateful for that. I am trying to stay in the moment and use my DBT skills.

Yesterday I finally made it back to see my therapist. I hadn't been in a while between the holidays and my depression and the fact that I am now down to every other week. It was good to see her- although I think that I spent most of the session talking about my Provigil frustrations and how it is making me feel. I think I have enough to get me through most of March, and then I will be paying US prices for it- and I will probably have to stop therapy so I can pay for it.

Having health insurance doesn't always help a lot if you have a mental illness. All of my mental health providers are out of network, and my out of network deductible is $3600. There are hardly any psychiatrists around who take insurance, and I have had really bad luck finding in network therapists. And now with the Provigil, I am just really not happy with insurance companies. Plus, they are the source of most of my paperwork frustrations at work. I found myself wondering the other day if I am in the wrong field. Maybe I want to get into another line of work, something that has nothing to do with health insurance companies. I am tired of "the system."

I am not tired of my patients. I love my patients. But it was a discouraging day when I had to discharge two patients because I couldn't help them- I hate that, even when it is pretty predictable like with advanced hand arthritis. Well, I gave him one good compensatory tip, and grip strength did go up a tiny bit. I will have to console myself with that. I love discharging patients because they are better. I hate discharging patients because I can't help them.

Made it back to yoga- it was nice to be back

All morning I felt kind of sleepy and drugged- not a good feeling. But then in the afternoon I started feeling really anxious and irritable. But the last thing I was going to do was take klonopin the way I was feeling. So I just dealt with it, but I didn't like it.

I didn't want to go to yoga. I tried not to think about it- because when I thought about it, it just seemed like it was going to be too hard. And I kept thinking it would be all the harder because I hadn't been there in a while. So I just tried not to think about it.

I did go, and it was a good class. Not anywhere as hard as I had imagined- this is one case in which my thoughts were worse than reality. Although it could have been a tougher class, some times it is. It just wasn't today. It was good to be there, and I am glad that I went.

Tomorrow I see my therapist for the first time in like a month- between the holidays and me cancelling due to being too depressed to go. I wonder what I will talk about.

A quiet Sunday, a busy Monday

Today I did a couple of loads of laundry and not much else that was productive. I watched TV, thanks to the "on demand" feature from my cable company. I watched  the Syfi Channel's "Helix" and then the movie "Closed Circuit." They were both good.

But mostly I felt too tired an drugged to do anything. I couldn't sleep last night and took a extra half of a klonopin- and it seems to have affected me more than usual. I felt really out of it today. I hated that feeling. Next time I think I'd rather not sleep.

I called my mother, who I hadn't talked to very much in a while, and told her I had been depressed. And I told me step mother, who I am close to. These are big steps- because really I haven't told anyone. Not even my therapist- except to tell her that I am too depressed to go to therapy. It feels better to have it out there

The next person I really have to tell is my brother, because I still haven't sent him and his family his Christmas presents. It is pretty bad. I think really I started getting really depressed over the holidays, and I didn't feel like telling anyone anything about being depressed around the holidays, and then I just kept up with the silence about it.

Tomorrow is a big day. I have work, and I have to go in early to do paperwork as I did not go in over the weekend. I signed up for an evening yoga class- my first in a few weeks. And then I really, really have to go grocery shopping because I am down to eating my backpacking food and there isn't much left of that. I have been drinking way too much coffeemate- I only use it when I am out of milk for my coffee, which seems to have been for forever.

Some people stock up on emergency food for natural disasters- and that is always what I thought I was doing. But I wind up eating my emergency food during my depressions. It is just a different kind of emergency, I guess. But I had better stock up before the next blizzard or hurricane! Or the next depression.