Notes to Self

Dear Self:

You were asking me how I was doing the other day, with this whole bipolar thing and the whole meds thing and the job thing and the mom thing. I thought it’d be nice if we made a date to sit down and just see where things stand.

So, how you doing? How you feeling? How’s the Better Half doing with all of this?

Lots of love,

Me

Hey, Me:

I’m OK, although I feel like I am riding the dippiest but shallowest roller coaster right now. The meds thing? I don’t feel bright eyed and bushy-tailed yet, but I am not catatonically depressed, either. I think I’m feeling a little more blue from the step down on the Effexor a week or so ago (you’ll recall I was starting to get a little hypomanic, all irritated, angry, and unable to pay attention), but that could be due to the uncertainty about my job situation, too. I also know I am depressed because I freeze up a little when the phone rings– I just don’t feel like going out or talking to anyone, some days. But then the next day, I feel OK, and send emails, and return calls, and have lunch and do things with friends. And then, the next day, I’m pooped, and need to hide from the world a bit more. See what I meant about the short and dippy rollercoaster?

I know I’ve still got a bit to go on the meds, as I work away on this 1200 mg dose of lithobid CR and 75 mg Effexor XR. I had a wash of anxiety the other day, seemingly out of nowhere, while I was reading an email from an Interfriend with a really cool, really exciting, really scary offer. And despite mostly sitting on my ass doing nothing writing and researching various pieces I am writing for on and offline, including working on my maternal bitchfest book, I am still exhausted when I go to bed, and sleep much longer in the mornings than is usual for me. So I could definitely stand to have a higher dose. The trouble with the lithium is that you have to titrate so slowly, given the risks of toxicity if not carefully managed, and I feel like I am measuring my mood improvements in increments of Geologic time.

Me, I am trying to focus on the glacial improvements– sleeping through most of the night, and only being awake for one insomniac period, invariably at 3 am. (Hello, West Coast midnight bloggers! Thanks for the Google Chats!) Not wishing I was dead, or other passive ideation. Being able to get out of bed in the morning, having lost the “pinned to the bed” side effect of Lamictal. Laughing at things. Still feeling creative, and having lots of things to write.

But then there’s a short dip down– my thoughts are hard to organize, and I feel like I have ADD all the time. It’s not something that’s been a characteristic of my prior depressions, so it’s got to be the lithium. I am hoping it’s an impermanent side effect. It’d be impossible to go back to work and not be able to keep track of anything. “Excuse me a second, your honor, while I write down this next thought so that I can then say it out loud…” Not good. At the same time, there were three jobs I’d be really good at in the local legal paper yesterday, and I know one of the hiring people. Since those jobs wouldn’t require me to manage individual cases, they might be better for the way my brain is working these days. Over the course of the day, if I write stuff down, I can get it down, and can remember to go look at my lists, but I am starting to worry that this expansion of mental processing time is permanent.

At the same time, though, it doesn’t seem to impact my being able to write. I’ve got a list of about 15 things that I am working on, aside from my attempt to affix blame where blame is due, rather than just get over it book, and new ideas for writing pieces and photo projects all the time. The sitting around the house part doesn’t help, though, and I get distracted and check the web. I’ve got to get better about going to work at the coffee shop around the corner, or the local library branch, and just committing to a chunk of uninterrupted time. I’ve got that alarm clock on my computer, I can work 2 whole hours at a stretch.

And the mom thing? I don’t know. She’s got her doctor’s appointment. We’ll see if she keeps it. Neither my brother nor I want to move her back here, but we’re both concerned that even if we hook her up with a Dept. of Mental Health caseworker, she will either be noncompliant, or her bipolar will turn out to just be hard to manage or treatment resistant. Neither one of us wants her back here. Respecting her independence aside, I know that having her here will just invite me toward elder abuse. (Yeah, I know, I remember that talk we had about my horrible temper.) But letting her run around in Cali unstabilized and at risk of spending all her money isn’t tenable, either.

Thank heavens for the Better Half, who has been patient, and loving, and understanding, and gently nudging me to do things I know I enjoy. Me, I’ve been an anxious, nervous wreck. When the job situation started acting up, I couldn’t help but tell him I was afraid he’d leave me. I sometimes still am– all those deep insecurities from having to parent myself and my brother and my mother, and avoid the wrath of my father run deep– but he’s been nothing but reassuring. I have a nearly disassociative block when it comes to talking about money, and so does he. I hate to put this on him right now, but he’s being a champ.

So… any more questions? I am a little down, a little level, a little worried, a little happy. A little bit of everything. Which, I suppose, is better from all angles than feeling like a big lump of nothing under the covers. So there’s that.

Love and love,

Self

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10 thoughts on “Notes to Self

  1. Cricket

    What I would give for a SO who would roll with it. Instead, I have to fake wellness all the time. It’s wonderful that you are taking stock. Hard to interpret each little blip and figure out if it is something. Makes me feel paranoid about myself, but you seem to take notes and keep moving. You’ve learned to take good care of yourself and it shows. I wish the same skills for your mom.

    Reply
  2. Dory

    Thank God for better halves. When we figured out some financial crap seemed a hair trigger for a downward spiral into hell depression, Hunky took over entirely and it has saved me many a breakdown.

    Reply
  3. andrea

    Baby steps. No need to leap into anything. I think you should go play in the snow, perhaps, in between writing your book. And can I say, bravo for writing a book? I’m lucky if I can complete a coherent blog post.

    Reply
  4. cathy

    This sounds good. I like how you talk to yourself, actually. It’s inspiring to me.

    Have you posted elsewhere about your book? I’m still getting to know you so I didn’t know about that. Having done some writing and editing, I’m familiar with the hard work of getting a real book done.

    Good going on the Better Half, too. How weird it is to have people push us toward experiences that enrich our lives! Mine does that, too, often with me kicking and screaming. (“No… let me stay in this cesspoole of pain and semi-digested trauma a little longer, please….”)

    Reply
  5. Mariposa

    I talk to myself a lot…and it helps…but then I’m crazy…LOL

    It’s nice to give ourselves some love…then, I’m sending you more… (((LOVE)))

    Thanks a lot!!! For all…and in many ways…

    Reply
  6. masterofirony

    Be patient with the lithium. Even the cognitive issues I had after a pretty bad toxicity (the bad mainly being that I was probably toxic for 6 months which really did a number on cognition and balance) did relent. I still have some problems, mainly with getting the right word out when I want it, and that can be embarrassing, but that is probably more the amount of sedation I’m on.

    As I remember going up on lithium, even when I did it a bit quickly (going up every few days post a blood level so that I was a pincushion for about 6 weeks) the side effects were much worse for a few weeks then went away. Around 1200 was where they did bother me, although I was on 1500 for a while. I didn’t handle anything over 1200 well because I drank so much that I always had to pee and my bladder was so full there wasn’t enough warning and I hate interrupting treatments to do something like pee, so I’d hold it and spent half my time with a nearly bursting bladder.

    Another thing I remember is that I complained about the cognitive stuff for a while, but never again until the toxicity. And I would have because that is the hardest thing for me to accept, even with how things are now.

    There’s also always the possiblity of a little bit of provigil, if you can handle it, when you are back to work. Provigil is a stimulant but it isn’t stimulating the same way Ritalin etc. are. To me it feels a bit like caffeine but my body handles it better than caffeine, which I handle badly enough that I am living my life without it from now on. Caffeine free for 5 months now except for a little bit of southern sweet tea because I wanted to know what it tasted like. It helps me focus a bit and get the things I think to actually turn into real results. I take it very, very carefully. I take it at 5 or 6 am, it helps me wake up around 8. I have a scheduled anxiety pill at 10; if I’m feeling manic at all I take it sooner and take Ativan instead of my more mild usual atarax. I usually then take a dose of one or the other at 1 and then 3:30 instead of the usual 10 am-3:30 pm atarax dosing. I just took it for the first time since I’ve been back to work yesterday and it helped. I’m really afraid this time though because it does carry a risk and I’m no longer interested in mania.

    I also had luck controlling some of this by experimenting with slow-release and immediate release. I’d totally forgotten that, but when I was first on high dose lithium and struggling with side effects we switched me from lithobid to lithium carbonate. We then moved all of it nighttime so that I had less daytime issues. It worked very well that way clear up until the toxicity (which had to do with me being irresponsible about labs, not how I took it). Now I take lithobid again mainly because it slows down the entry into the bloodstream, which seems to stop me from having nausea and vomiting, which I had for years even before the toxicity. That’s mainly an association with the taste and smell of the capsules though. What can I say, I’m a Pavlovian experiment….

    Reply

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