The state of things

I realized that I haven't posted much of an update since my rather dark, dire post a couple of weeks ago . So I wanted to give you all an update to let you know how things are going.



At last check, I had been searching for a psychiatrist to help me handle my meds outpatient. So I looked up some on the Medicare website who were relatively close. I left 5 messages. I got zero calls back. (And in the messages, I asked them to give me a call back, even to let me know if they simply weren't taking on new clients.) It just seems like psychiatry is a strange profession if you're not timely with calls. Most people only start seeing a psychiatrist when they truly need help.



So I decided to look for a psychiatric nurse. I couldn't tell from the Medicare website how to distinguish between regular nurses and psychiatric nurses. Instead, I worked backwards. (Generally a good tactic with bureaucracy, since that's generally how you feel you're moving anyway.) I googled "psychiatric nurse seattle" and found a whole association. I then found one half a mile from me, and looked her up on the Medicare webpage. Voila!



I lucked out, actually. April is very nice and really listens. She asks a lot of questions, too. I saw her today for the second time. I told her that, overall, my functionality is getting better. I don't feel as reluctant to leave the house; I can accomplish tasks without feeling overwhelmed. The sadness feels more transitory, too. It doesn't feel endless or all-consuming.



But on the other side of the equation, my mood swings are still terrible. They might even have gotten worse. It's hard to tell, since they're not something Tim and I catalog. Usually, I'm grumpy and easily irritable. But these days it's practically a flash-flood of emotion. I'm fine, right up until I'm not. The angry mood swings almost feel like PMS: everything drives you insane and makes you want to hurt someone, even as part of you knows that it shouldn't be such a big deal.



The flash depression is almost scarier. On Saturday, I was a little antsy all day; but Tim came back from a Magic event around 9 p.m. and I was happy to have him and our friend Seth there. Then Seth needed to go home, and Tim walked him out. In the 10-15 minutes they chatted, I became forlorn. There's really no other word for it. By the time he got back, I was knee-deep in malaise. I was sad and distracted, but couldn't (as I usually can) pinpoint why. I couldn't talk through it and come to a reason, either. I simply felt sad and lost and low.



Listening to all this, April decided we should try a mood stabilizer called Lamictal. There is a very, very small chance of a serious side effect, so if I get a rash I need to see a doctor immediately. Otherwise, she's going to slowly raise the dosage every two weeks until we find a level that works. If it helps me get to a more even keel, I'll be thrilled. It's terrifying to be a spectator in your own emotional outbursts.



I also had a blood draw so that April could check my thyroid and my Vitamin D levels. Let's hope that tells us something, though my thyroid has always checked out in the past.



After that appointment, I went to see my regular GP down the street. I had wanted to talk to him about weight gain. I constantly want to eat. And willpower doesn't seem to be kicking in at all. I'm up to 210 lbs, which is alarming for me. It's the heaviest I've been in several years and close to the heaviest I've been ever. (I should point that I've been told 175 would be a good, healthy weight, given my overall stature: big hips, big bust, thick bones. And Tim has threatened to sleep-feed me if I ever get close to my 1500-calories-a-day-and-jogging-most-mornings, skinniest weight of 155-160.)



I had considered trying Alli, but was taken aback by the cost ($60 for the starter pack). I read up on it and discovered it is actually just a half-strength version of Xenical (Oleostat) which helps block fat absorption. I reasoned that it would be cheaper to get a prescription than pay for the over-the-counter thing.



I wanted it, not only for the extra help in losing weight, but also because taking that stuff guarantees that unhealthy eating has an immediate consequence. I figured it was what I needed. If I knew that I would undergo severe "intestinal distress" (to put it politely), I would be unlikely to indulge in sweets and fatty foods.



Unfortunately, it appears that I'm overreacting. Which is to say: I need to eat better and lose some weight, but the gain hasn't been as drastic as I thought. Apparently, I've only gained about 3 pounds in the last two or three months. And back in September, I weighed in around 207, too. So this seems to be a case of my not acknowledging reality.



At any rate, my doctor said, given these facts, he wouldn't recommend Xenical. Too many side effects -- which was why I wanted it, of course. Still, based on the facts he was looking at, I probably wouldn't have written a prescription either. (Assuming, of course, that I could write legit prescriptions.)



Still, I got pretty upset, tearing up. I guess just because I hate to feel so out of control. Which, when you get right down to it, is a strange turn of phrase. I'm not sure we're ever really "in control" of ourselves. It makes me think of taming and training, that there are right and wrong emotions. I guess that mindset isn't really a very healthy one either.



At any rate, I feel unable to effect change, which isn't giving myself enough credit.

• I found a psychiatric nurse and even go willingly to her appointments. (I am prone to find reasons to cancel or skip medical stuff.)

• I'm taking walks relatively regularly: 3-4 times a week for the past three weeks. I have to say that making it more of an adventure/challenge (find cans to pick up and recycle) definitely makes it easier to get out of the house.

• I took out some yoga DVDs from the library. Nothing intensive. I finally tried the first one yesterday. I did the "Stress relief" part, which was mostly gentle stretching and loosening. The most intensive pose was downward-facing dog. Next, I want to try the "Stress prevention" chapter. If I like the DVD enough, I may try to find it cheaply on Amazon.

So I am able to affect change. Just not as quickly or effectively as I might like. But that's a Type-A personality for you. It's a reminder to accept what I can and can't do. (I've decided the word "limitations" is too negative for the moment.) To accept myself as whole and not in need of fixing. But that's a major flip from my usual mindset. So it will take time.



Did I mention I'm not a patient person?



In other news, Tim -- Mr. "2-liters-of-Mountain-Dew-a-day" -- is now off soda completely. The citric acid in that much Mt Dew would flush the Adderall out of his system. So he had to quit, cold turky. But he started chugging water like it was, well, Mt Dew. He refills his 62-oz water bottle about 4 or 5 times a day. It's insane. But he managed to avoid any headache the first day, getting one at bedtime the second day and a slight one on the third day. So, as long as he avoids water poisoning, I'm happy.



Now we just have to figure out how to return the Mt Dew stockpile we have without a receipt. There's always a new adventure in our household...

Me & the big black dog

Alane's response to my last post about Shoot the Damn Dog made me need to write more. Ginger also responded in a very personal manner.


I often forget, until I am actively discussing the matter, just how quietly depression steals our lives away.


I have been depressed for as long as I can remember. A smart kid and an only child, I never really felt comfortable with people my age. I was always self-conscious. Always felt that I was missing some vital ingredient that everyone else had naturally. In addition, one parents suffered from severe depression, the other probably did but refused to seek help.


The worst depression, though, hit during the times when I was unable to work. I would be home all day, every day. I would worry about money. I would be dizzy with fatigue. And I would be terrified that I would never be able to have anything. Who would want someone who couldn't work? Who would build a life with her? Who would see value in me? I certainly couldn't find it.


I've pushed away (or scared away) more friends than I care to count or admit to. I would withhold being dependent for so long, that I would crack and the need would come flooding out on the poor people. The sheer volume of my need terrified me. I think it overwhelmed and bewildered them. I was so desperate to appear strong and not in need of anything or anyone -- because people who need are unlovable; only people who can give support, not take it, are worthy of love -- that they couldn't understand who this person was.


As I watched myself frighten them away, I would wail. I would rock back and forth and repeat that this "wasn't me." Because it didn't feel like me. It felt like an evil twin taking over. I was still in there, somewhere. But I was consumed by this need for something I couldn't explain. I was full of need. It was constant and ugly. It was forceful and humiliating. But if they had asked me what it was I needed from them, I would have had no answer for them. Few of them asked anyway.


The summer before I applied for disability, I became suicidal. It's a misnomer that we want to die. Sally Brampton notes it too. We don't want to die. We just want the pain to be over. We want to stop hurting. And death seems appealing if only for the quiet it offers.


I couldn't breathe through the sadness. I was drowning in it all the time. It was a tide, a current flowing through the apartment. I trudged through, and the tide was almost visible to me. Some days it was knee-high; others, it was up to my waist. Whatever the level, it acted as a real obstacle. I often felt that I was, in fact, walking through water: onerous and slow.


The pain was with me almost constantly. Perhaps that's the worst part of depression. It's with you because it is you. The pain is as physical as it is mental and emotional. It pressed up against my sides and my chest. An unbearable weight would settle on my chest. I would breathe as deeply as I could and still feel that I wasn't sucking in enough air.


When it wasn't pushing up against me, it was tearing out a piece of me. A sharp-yet-dull ache would settle in my midsection, just under my ribcage. I always assumed it was the physical manifestation (or lack thereof, when the pain set in) of my soul. It felt as though a hole had been ripped in it. It would become so bad, I would massage my sternum. It was as close as I could come to touching and soothing the gnawing emptiness. I have yet to figure out how emptiness can simultaneously feel so consuming.


Whatever the form it took -- water, emptiness or pressure -- my sadness was always there. I had a constant, open emotional wound, seething and raw.


I was beholden to it. I was weighed down by it. I was helpless in front of it.


It did slowly recede. But I couldn't tell you when. It was a combination of therapy -- a lot of therapy -- and increasing my antidepressants. And time. And a lot of pain. I will try to write more about it some other day. Or you can feel free to ask me questions, if you like and I will try to explain as best I can. Sometimes these things are so painful as to be word-eluding. There are, it seems, things that current syntax cannot do justice to. Perhaps we will have to become wordsmiths.


I would like to cite a couple things from the aforementioned book, Shoot the Damn Dog. As I read them, I saw myself as easily I saw Ms. Brampton. Some things about depression are completely individual -- drug tolerance, pain amelioration, coping techniques. Others are tritely universal. The terror, isolation and pain should resonate, even with those who are lucky enough to never have experienced the illness.

I am sitting on the floor, in my bedroom, curled up against the cupboards. I have given up ont he bed. I hate the bed and its soft, suffocating embrace. I would like to leave this room, but I can't. I feel safe here. Or, as safe as I feel anywhere, whihc is not very.

How fucking stupid is that? I can't leave my own bedroom. Me, who used to fly across the world and get on a plane without a moment's thought... I am fiercely indepedent. I am fierce. Or so people tell me. Used to tell me. I never used to be so afraid. When I was one of his editors, I used to stand up against Rupert Murdoch, arguing with him. I used to be so brave. I used to be somebody.

I am still somebody.

Aren't I?

But who?

I am somebody who can't leave her bedroom, somebody who can't walk across a road to buy a newspaper. I start to cry. I hate crying. I hate these tears that come, unbidden, at any time of day...

I never used to cry. I hardley ever shed a tear. I spent a whole life not in tears. And that, according to one therapist, is my problem. Is this all it is then? Is this simply forty ears of collected tears?

Why does nobody understand that these are tears without a beginning or an end? I thought sadness had a beginning and an end. And a middle. A story, if you like. I was wrong.

'How's it going?' she says. She is at work; she is the deputy editor of a magazine. The office is open-plan. It is difficult for her to talk. Sometimes I call her and just cry, because I cannot speak...

For a moment, I can't speak. 'Not good,' I manage, finally.

Her voice is gentle, concerned. I hate that concern. I hate that it is me who is making her feel that way...

I lie on the floor in my bedroom and wait. I can't imagine why she would want to be with me, can't imagine what she could do for me. She is even more powerless than I am over this thing. Today's I can't honour it by calling it an illness. Today it is just a thing that neither of us knows or understands...

I am terrified she will give up on me, that this thing will drive her away. Every depressive has that fear. Why would anyone want us? We don't even want ourselves. Sometimes, we try to drive the people who love us away. Not because we donm't want them with us, but because we cannot bear for them to see what we have become.

Someone once asked me how it felt. I lost my balance, I said. It felt as if I lost my balance. I fell flat on my face and I couldn't get up again. and if that implies a certain grace, a slow and easy free-fall, then you have me wrong. It was violent and painful and, above all, humiliating.

People rarely discuss the absolute humiliation of severe depression, the punishing helplessness, the distressing, child-like impotence. When well-intentioned friends and faimly say to the depressive 'pull yourself together', they may as well be saying it to a baby crying in its cot.

We cannot. It is not that we don't want to. We simply can't. But, unlike the baby in the cot, our adult brain is sufficiently engaged to know that we should, to believe that if we tried hard enough, we could. Then every attempt and every failure brings with it its own, additional depression, its own profound and hopeless despair. And every contemptuous glance, every irritated sigh from family and friends drives us still further out into the cold, black night...

Depression has its own pathology and self-absorption is part of that pathology. Telling somebody who is in the grip of severe depression that they are being selfish and self-pitying is like telling somebody with asthma that they have breathing difficulties. It is meaningless except as a statement of fact or an expression of the symptoms affecting them. They are lost in a place without boundaries or borders, where th concept of self has no meanings. They have lost their very self.

It's a little early for Thanksgiving but...

Sorry, folks, I know some of you are waiting for the second part of the "frugal hacks" post. It's done. I just keep finding other things I want to talk about. But I will post it soon.

In the meantime, I know I haven't been terribly chatty lately. Or, at least, I feel like I haven't. A lot has been going on for me and I wanted a little perspective before I shared.

Last Saturday, we went to a friend's 30th birthday party. We found out his wife (who was one of my bridesmaids, her husband one of the groomsmen) is pregnant and due in March.

Of course, I'm happy for them. They'll make fabulous parents. But at the party, most of the people there were workers in good- to high-paying fields. Most of the couples were two-income. And the friends' house is pretty nice, even if it is a bit out in a suburb.

I just started thinking about the ease with which everyone else seems to live. I know that's not fair -- every person's life has its own kind of hardship. But Tim and I are a bit weary and I've been trying to do too much lately. (Plus, as my therapist later pointed out, I'd been kind of isolated at home between work and blogging and sorting Magic cards. So it was a bit of a shock to the system to be trying to socialize.)

I just started feeling overwhelmingly sad. And angry. Or perhaps jealous is the right word. I don't know. I just sat there, watching the guests play Wii and listening to them chattering about their own Wii at home, or their jobs or whatever... And I just couldn't take it anymore.

I was able to get to the bathroom before the tears started, so it wasn't too bad. Then I just caught Tim's eye and told him to make excuses for me. I couldn't talk to him until we got home. I was afraid to start crying while driving.

Once we were home, though, I still couldn't really explain it. I was just tired. Tired of everything being so hard. And everything feeling so overwhelming. The fact is that it will take Tim and I at least a couple more years before we can even start thinking about a baby. We'll get there, but it's frustrating when you're confronted with other people's financial padding. Even though you know you're as smart as they are but won't make the same kind of money.

Probably needless to say, this was the deciding vote for whether I needed to go talk to my doctor about my medication levels. I kept getting teary for three or four days afterward, whenever I'd so much as think about the baby.

So Monday came around and the doctor ended up putting me on a THIRD medication. Turns out I'm much higher on my Effexor (which I've been on the longest) than he's comfortable with. Plus I'm on Wellbutrin for anxiety and depression. Now we're trying out Lexapro.

It was hard to stomach. I hate being on so many pills and so adding another isn't exactly palatable. But at least for now, it seems necessary. Sunday was especially bad and after quarrelling with Tim, I bawled my eyes out -- I mean non-stop, heaving cries -- for at least 20-30 minutes. All I know is, I think it was the longest I'd ever cried. And it wasn't about anything in particular. It was just that ache in the middle of your body, compiled-sadness and hopelessness sort of thing. Scary stuff.

The doc also wanted to do a blood draw in case some of this was my thyroid. He kept asking was my marriage okay, any major life changes. I said no, just that it's been forever since I've changed my meds. And while I often have cyclical downturns, this one wasn't going away.

Saturday and Sunday, I felt so precarious. I felt like all of my emotions were in this egg inside me with the thinnest of shells. And it took nothing to crack it and have them all come spilling out.

So I went in and got blood drawn. Apparently, I hadn't had enough to drink that day. She had major trouble getting a vein, which never happens with me. She ended up having to take from my left arm. She kept apologizing because she said it was going to bruise. But I bruise easily so I reassured her it was no big deal.

Yeah. You ever feel like a walking metaphor? I felt so fragile that weekend. Later Monday afternoon, a nasty-looking bruise was forming. But Tuesday morning, I woke up to find that it looked like someone had spilled wine on my arm. Tim took a picture for posterity. (There's too much flash, so picture it about two or three shades darker than what you see here.)

Let me just remind you this is from one poke.

It's since turned all sorts of interesting shades and is yellowing out. But it just reminds me that this isn't my normal downturn.

Clearly, I'm having a particularly bad time on a few fronts. I need to go back to taking my daily vitamins, need to start sitting in front of mom's SAD light and need to suck it up and get used to being on three meds for awhile.

And so with all this in mind, despite it being too early for Thanksgiving, I would like to draw your attention to "The Bad Old Days?" by Frugal Zeitgeist.

Amid all the negativity of the markets and economy and Congress and politics, she thinks we should take a moment and try to think of 10 things that are going right in our lives.

Here's my entry (I'm realizing that I don't think you all know about #7, but it more or less explains itself: I spent a couple years as a landlord. I'm telling you, I've done a lot of stuff...) :

1. I'm a newlywed so I'm still in that amazement stage. That's fun and exciting.

2. We finally finished off hubby's student loans.

3. Despite a lot of inner turmoil, I kept it together enough to go to a doctor when my depression started to worsen, before things got dire and talk to him about my medication levels.

4. The new levels are starting to even me out, I think.

5. My husband is a wonderful individual who accepts that I am a depressive and pretty calmly is there for me when I freak out at him or the world.

6. I'm (slowly) learning to live within my limitations and not spend all my energy fighting them. (I live with chronic fatigue, but am a Type A personality.)

7. I was in the housing market (with a loan I probably shouldn't have qualified for) but got out around four years ago. And it was enough to pay off my mortgage, my student loans (which was what the original downpayment was supposed to have been for) and pay back my mom who had lent me money.

8. I'm finally working a small part-time job, which means there's a light at the end of the tunnel of being on disability.

9. I'm still finding time to keep up the blog I started.

10 After only two months, I have 90 subscribers (yay!)

I want to encourage you guys to join in this and think up your own ten things. Shoot for ten and if you can't get that far, just be glad that you don't have to type as much, I guess. (Yeah, I'm playing Pollyanna's glad game... Don't tease the depressive, folks!)

Crying in a supermarket

It's amazing how uncomfortable people get when you are crying in public. Very strange, really. We all feel so awkward, don't we?


I mean, it's not as though any of us are new to the concept of bawling. But it's as though the person just became highly contagious. People are afraid to approach you.


As you may have guessed from the title, I had a minor breakdown today at Albertsons. And the only reason I was even able to get my butt into Albertsons was because my mom drove me. Talk about feeling mature.


I was so tired that the new layout confused me. It's been this way for about three months, but I'm still adjusting to it. And today I kept looking for things in their old spots.


We'd only made it about three aisles over -- having successfully added milk to the cart -- when I was looking at salsa. We needed some. But Albertsons charges $8.49 for a big bottle of salsa. About two blocks up the street, at Sam's Club, the same stuff is under $4.


So I stood there, looking at the list, looking at the price, list, price, list, price. And all I could think is that I didn't want to take another step. So how could I make it up to Sam's Club? But I also couldn't pay almost $5 more when the cheaper stuff was two blocks away. And I couldn't get it another time: We needed it for that night's dinner.


I went to look at pasta, because it was too depressing to be looking at salsa I couldn't buy. And that's when the waterworks started. I was exhausted, I wanted to be at home, and I couldn't even get something as simple as salsa.


Part of this reaction was simple fatigue. Between the contract work, the blog and Tim's job stuff, there's been a lot going on. The lack of job weights heavily on Tim, as does not knowing what he wants to do.


Partially because of the stress from this (my opinion), his ADD has been worse. He keeps getting very single-minded. He's been more impulsive, which means I have to put the brakes on more often and keep him from buying when he's in these modes. It's just a lot to handle.


Also, it has meant that he latches on to ideas and won't let go -- until the slightest snag shows up. Then he's ready to quit. The snag, of course, has to be something he discovers. My comments don't penetrate. So, he went off half-cocked about medical coding; a month later he's finally finding some logistical problems. Like, he hadn't realized that he'd have to take anatomy courses to do medical coding.


It's all a tad maddening; but I am trying to restrain my temper and be supportive. I remember how painful it was when I first stopped working. It's hard on the ego.


If you think about everything that is tied into careers: We ask little kids what they want to be when they grow up; one of the first questions people ask is what you do (not even for a living, just what you do); we ascribe certain traits to certain fields of work and certain income levels.


So anyway, I've been trying to learn to be the patient, good wife. Especially because in the past I've certainly not been patient. But it really does take a toll, doesn't it?


We had a couple long talks today and I think we've reached a point where he's going to try to be more conscious of his impulsivity.


And we're going to wait to hear from the vocational rehab center before we do any more planning. Those people can help him find a career he can do. And frankly, all our attempts just end in exhaustion, depression and general malaise.


Still, it's all very frustrating. I get up, do some of my work, take a break for breakfast, then go back. Suddenly, it's the middle of the afternoon -- even though the work is only supposed to take about 2 hours it actually takes 3-4 -- and I've only done a bit on my own blog. No errands have been done and we still have to figure out dinner.


And so I found myself bleary-eyed and at the grocery store. I didn't want to take another step. Not even to go sit down. I just wanted my bed to magically appear and cushion me. But I couldn't. Because we didn't have salsa. Or a magical, teleporting bed.


It's so exhausting trying to act like a normal person. I've even scaled my expectations way back. But there's still things I don't get around to. Lately it feels like I blink and the day is mostly over, along with my energy.


Most of the time, I let this roll off my back. I remind myself that I can't change it. But once in awhile, it just hits me, how relentless this is all is. It's not going to stop.


I know this sounds silly, but I'm still a little shocked that it's been a decade of this and I'm still so far from acceptance. More silly: I sort of half expected I'd get a break at such a big milestone.


I know it's illogical, ridiculous even. I knew it wouldn't really happen. But it still seemed so plausible. I keep thinking that if only disability were a relay race, I could handle it. If I knew that I only had to go to a certain point, I could make it there.


But there's no end in sight. No one will come up and take the fatigue for a few years.


If they did, I would come back. Not gladly, but I would. If only I could have a few years of good, old-fashioned wage earning. If I could actually affect my financial future. Then I would come back for another long haul.


I think the impetus of this particular mood -- or perhaps just the proverbial straw on the proverbial camel's back -- was reading an article on Friday about science. The article said a scientist has determined a way to get muscles to better stave off fatigue.


This may very well be pertinent to me. To condense what I understand of the articles on Guillain-Barre, essentially some nerves were damaged and regrew quickly, rather than properly. So they are inefficient and make the muscles have to work harder to compensate. So something like this could actually have some promise.


I felt so hopeful for a minute. Then I realized: This was still in a lab somewhere. Not even a pharmaceutical lab. Just a university.


Even assuming they could miraculously come out with a medicine from this compound in the next five years, there would still be years of getting FDA approval. So likely it will be at least a decade before anything is even available.


After that, everything has seemed a little harder.


So what does this all mean? I wish my ramblings had some deep import or conveyed an important message that everyone could take heart from.


In this case, though, I think it's just that it really sucks to be disabled.


It's funny: you don't ever really think that you expect life to be fair -- until it dumps a bunch of "unfair" all over you. Then you just bleat out the injustice of it, even if you know there's no point.


I wish I could say that I accept my limitations with a quiet, dignified serenity. But the truth is, I often come home and hide under the covers, hugging some stuffed animals, until Tim comes and talks me out. (Why do we think that covers protect us from monsters, let alone wordly affairs? It's a mystery I've never sorted out. But I do feel awfully safe huddled up.)


So I'm not the epitome of grace under pressure. I'm a depressive with energy limitations, which means double the emotionality and grumpiness. It means that I'm often quite a handful to be around.


It means that my limitations don't make me into some Lifetime movie with a happy ending of triumph over a disability. I won't win gold medals or even a local race. I will be lucky to be able to work steady part-time work.


And, sometimes, that just has to be enough. Because it's all I have. It's far from perfect. It's nothing like what I pictured as a kid. But it's a life and it's the only one I've got. So I pick it up and make do with it -- even if I don't always make the best of it.


Because I'm human.


Because I'm disabled.


Because I'm the kind of person who cries in supermarkets.