Waterlily pond

So this update is so long overdue I have no idea where to start. I was really intent on writing about the goods and the bads of olanzapine and the titrating of lamotrigine, but for some reason I just couldn't do it. I even opened Blogger a few times and started the post, but I didn't feel like writing.

So yeah, I asked the psychiatrist to switch my mood stabilizer, and to my great surprise, she did right away. She gave me lamotrigine.

Weaning off olanzapine was a pain. I asked the psych if I should gradually lower the dose, but she said nah, maybe take half a pill for a few days. I was eager to get off so I only split the dose in half two times (four halves), then I stopped. I was smart enough to do it on a Friday, because I spent the whole weekend in bed and Monday called in sick. But then it got better.

But lamotrigine took ages to kick in, and the first weeks were bad again. I read all about lamotrigine on this cool site and wanted to go up really slow.
(Also I started taking folic acid, B complex and zync supplements right away because I read that:
a. anti-epileptics eat away your folic acid
b. some people experienced hair loss
c. zync might help prevent the rash and/or other skin problems.
So far so good!)

So I started with 12.5 mg for two weeks, then 25mg and then we went up to 50mg. The first days I was sleepy and phased, if I took it in the evening I couldn't sleep, if I took it in the morning I kept falling asleep at work, so taking it after lunch turned out to be the right time.

At first I felt like I didn't care for anything anymore, again. And generally, I just felt... bad. After I got to 50 I had two weeks of absolute bliss; I was happy, calm, focused. Then just out of the blue I became agitated, restless and mostly, irritable like hell. I felt really uncomfortable, out of control and also I didn't know if it would go away or not. I was also really prone to stress at that time. I just couldn't calm down in relax.
The psych wasn't of much help, said maybe I could try going back down to 25 - but I didn't want to, because 25 wasn't helpful. So, thanks to the forums on the cool site, I tried splitting the dose in half (25 morning, 25 evening) and it helped with irritability. Restlessness was still there, so for a while I tried 75 mg (50 morning, 25 evening). But then for a few days I forgot to take the evening dose and now I'm just on the morning 50mg. It's also easier because I can take my pills all at one time and forget about it for the reast of the day.

 In retrospective, switching olanzapine wasn't a very good idea. I was just getting stable, wasn't really there yet and then I went right back down in instability for another 3 months. I think it would have been better if I had waited to be really stable on olanzapine and then gradually made the switch. But I was feeling uncomfortable, physically, not only for the extra weight but because the water retention was so bad. And I did shed those 10 kg after switching! Well, 8 :) but I didn't make any extra effort. Just eating as I had before, two times a day, because I wasn't hungry all the time anymore. And swimming a few times a week.

So now I'm on lamotrigine and I'm stable. I don't really have anxiety attacks, I'm not sad, my mood is not swinging.
I'm not happy either, and I feel I can't come down and calm down. It's a strange feeling, like being wound up a little all the time. The focus isn't as good as on ola, then I felt amazing clarity, now I feel like I'm using 85% of my brain, the rest is just... foggy. I also don't hold myself together as good as I did with olanzapine. I'm a bit lazy, don't care much about things, but at least I don't care that I don't care :)

I wanted to talk about not being able to calm down with the psychiatrist, instead we ended up fighting (if you can call that a fight, her lecturing me and pressuring me and me trying to breathe calmly and holding back tears of frustration). I'm soooo pissed off at her right now, isn't it easy to be smugh from behind the desk and accusing people of feeling sorry for themselves and not trying hard enough? So much easier than actually listening to them and paying attention. Grrrrr! But I guess I'll leave that to another post.

When I calmed down a bit I decided to stick with the medicine this time, at least for a while. We'll see what happens. Either my mood will swing again or after a calm period maybe it'll be clearer to me what to do next.

Ola!nzapine

I found an interesting article about olanzapine here. It explains why people get fat on it - because it makes the body use fats as a source of energy, instead of carbs, by keeping the insulin in the blood gigh all the time. So no carbs are used for energy (well, little), instead they pile up in the body. Also, it increases body fat, but at the same time decreases lean body mass, so you get fatter.

Basically - the insulin is always high, so the body thinks it didn't get enough carbs. That's why you get carb cravings. Also, because body thinks it doesn't have enough carbs, it starts using fat for energy. But the carbs are there, and if they're not being used for energy, they get stored somewhere. Also, because it's always hungry, the body starts to store more fat (as it happens when you're on a diet, and you're always hungry, instead of burning fats the body starts storing them, because of the "famine").

Interesting.

On it goes

I haven't really been ok in the last weeks, but in these last days it got a bit better.

I've been really anxious and tense, then the culmination was when I went to an agility competition. The anxiety almost killed me, seriously. I was really disappointed because I really thought I was a bit better, and then it turns out I'm not there yet.

:(

But after a day or two I kinda just snapped back and was better. So at least in that part the meds are working.

But then I also discovered I gained 10 kg in three months, since I started the Olanzapine. And today, reading the older posts, I realized fatigue, carb cravings and constant hunger are also part of the olanzapine side effects.

So tomorrow I intend to somehow persuade the psychiatrist to change the mood stabilizer. I do expect she won't say yes. I'm trying to get prepared in my mind, to fight her and make her understand I really need it. But I'm also toying with the idea of going to someone else.

I think I need someone I should be able to trust.

I haven't done any meditation since that acute anxiety attack last week. Will probably start today again. I have been able to exercise quite some (especially after the weight gain shock). And I have been able to keep up daily vacuuming and weekly bathroom cleaning.

So all in all not a very positive report. The general trend is not going upwards anymore. And now I have to shed that extra 10 kg (although I have high hopes at least half will go away by itself, after I stop the Olanzapine).

But panta rei, I hope.

Nevah

The worst thing about this anxiety is that it completely supresses true feelings.

You wish for something, or for a second forget about restraining yourself and have a positive thought, a glimmer of hope, and right away there's this evil voice, like some witch in children's stories, cackling "don't even try, don't even hope, don't even think of trying, you're bad, you're so bad nobody will ever love you and you'll never be normal, never, NEVER, NEVAHH, ahahahahahah!"

And you try to fight it, you really do (and then you keep meeting therapists who don't believe you), but you're never succesfull. And eventually you stop feeling, wishing, thinking, hoping, because the voice is so bad and scary you never want to hear it again.

gnirpS

I'm tired.

Like, really tired.

On Sunday I slept till 1.30 PM! and even then I only got up because my mom called to ask why I was being late for lunch.

I have trouble going to sleep (I'm too wound up) and in the morning I can't get up for the life of me. I had set 4 alarms for this morning and still got up 10 minutes before work.

Also, I'm hungry. Mostly I crave sugar. Or carbohydrates. I think it may be partly from the Olanzapine. But I stuff myself everyday with chocolate, sweets or salty sticks and pretzels.

It shows too, of course... those 4 kg I got by stuffing with Mars bars didn't go away, on the contrary - I think I might have gotten 2 more.

Hm, but now I'm starting to think the two might be connected... the fatigue and the CH overdose. Hm.

I keep planning to eat less, but then I get hungry. And then I tell myself I'd rather have a few kg more and be happy then be really thin and depressed.

I got over the shock of the therapist quite quickly, actually. I was really surprised. I spent the weekend with my sis and came back home refreshed and calm, almost soothed. And last week was pretty good, actually. But the weekend saw me slipping down again.

But, also, I managed to meditate a little bit, and it is very refreshing. Sitting down and trying to stay erect hurts a bit, but when I open my eyes it feels ok.

So I have good days and bad days; and while good days are really good, bad ones are still quite bad.

(Today is one of those really bad ones. My limbs are heavy and my brain is like frozen. And I can't really think of a good way to finish this post.)

Fear

Scared, scared, scared.
Want to curl into a ball and hide, hide, hide.

So I went to the psychiatrist expecting a new medicine, and instead it turns out I lost her.
Well, not yet, but she said she doesn't know what to do with me.
And that makes her person nr.7 who couldn't help me.

Scared, scared, scared. Hide, hide, hide.

I feel a milion miles away from everybody else. And everytime I try to reach out and the person out there doesn't reach back, the distance grows a few miles longer.

Am I really that broken, that nobody can help me with my pain?

Scared, scared, scared. Hurt, hurt, hurt. Hide, hide, hide.

Anyway, she suggested I get hospitalized at some psych facility, for 3 months of intensive psychotherapy. I googled it a bit and it doesn't sound all that bad.

But, I wonder, could it really help me? And going for 3 months to a psych hospital! What do I tell people? The rumor will spread and I'm afraid I will lose people I know (couldn't call them friends, but yeah).

Why is she so set on this Zoloft? I mean, would it hurt to try another AD, instead of telling me I am medicated enough and it should be helping, when it's not?

It's spring

And my mood is infinitely better. Things are not ok yet, far from it. But I simply can't feel bad in the weather we're having. So I'm gonna enjoy it while it lasts (no more than a few weeks, I presume).

Things we learned this winter:

- my mood disorder is definitely sunlight related, as much as I hate to admit it
- so winter really isn't my season, and I'm not very much of use November through February
- I need to adapt to that fact and try to take necessary precautions and measures to help things run along as smoothly as possible, given the circumstances
- I need to organize in such a way that most of important activities in my life are done spring to autumn (like moving, changing jobs etc.) - winter is supposed to be for slumber
- I should save my vacation days and sick days for winter
- I should invest in a SAD light (I need to start saving for it, right after I save enough for the iRobot)
- long, slow walks in nature help; getting in tune with nature helps (slumbering when nature is in slumber, being active when nature is active)
- I enjoy taking long walks by the sea
- also, changes in season, especially rapid changes, are going to affect me, no matter how much medicated I am - that means end of February and some time in September (damn global warming and disappearing spring and autumn)
- but medication does seem to help me get better after that, quicker and also, at all
- a lot of what I thought I am is really just my depression; the few times I've been ok in the past months made me realize I'm actually a nice and good person; when I'm not, it's a red flag and it means I don't feel good
- my brain actually still works amazingly, I'm still really smart (who would have thought); when my brain shuts down is actually because of depression and/or anxiety, and it's another red flag
- one of my problems that hasn't been adressed yet is my constant anxiety, and that's not season related
- I put A LOT of pressure on me (and people around me), pressure to have things done RIGHT NOW and 100% good and accurate; I simply can't allow myself enough time to do things right (so it's not so much that I need to be perfect, as much as I need to be PERFECT RIGHT NOW)
- most of my problems with dogs arise from my anxiety and how I push others when I'm anxious, not from my lack of knowledge or incompetence
- also, goji berries protected me from getting a single cold/flu this winter.

And that is all.

And also

http://www.imdb.com/title/tt1012729/

The fight goes on

http://thebloggess.com/2012/01/the-fight-goes-on/

It's a journey

It's a journey, not a destination. It's a journey and there will be ups and downs.

Of course, when I'm in the ups, it seems obvious. Like, d'oh.

But when I'm down, I'm like, 'journey, what journey? I don't want to feel like this, make me better now'.

And maybe I shouldn't feel like this. I mean, for sooo long I've been telling myself, 'it will pass, it will pass, it's just a down, it will pass'.
But when it never passes, or when it passes for a few days only, and when I can't link it to an event in my life, then I think medicine should help.

The problem with the downs is, I still haven't quite figured out what to do with them. I mean, how to react.
Anxiety has been gripping me for the last month or so.
The problem is it's gripped me right after about a week after I started the olanzapine. And that week has been fantastic, and calm, and I was home and happy and it made perfect sense to take things slow and rest and take time to get better.
And when the anxiety started, it was like a crash. Suddenly I didn't know what I needed anymore, and I was home and I felt alone and dissociated from the world, and felt this pressure, this need to DO SOMETHING, and everything fell apart.

I've realized that this need to do is actually a response to anxiety and not so much a pressure from my childhood. I feel anxious and I WANT to be better, and so the logical thing is to do something to feel better - but when nothing really helps this pressure actually makes it worse.

I know by now that this anxiety is some kind of improper response to the environment. Like some limbic reaction, a response so ingrained in my brain it starts up even in moments that shouldn't trigger it.

But knowing doesn't stop it. Maybe it stops it from getting worse. But it's like a pain in a broken leg. You know it's broken, but you can't stop the hurt just by acknowledging it.

It's also very difficult to define it. I was at the psychiatrist two weeks ago, and I was already anxious, but I couldn't really tell her how I felt. It takes a few weeks, it seems, for me to understand what's going on inside of me.

And I'm now understanding its physical effect. I can feel my throat constricting and my limbs turn to lead. Every physical movement that's more than a walk becomes an effort - running, stretching, climbing the stairs.
Which is why I think I need to move more, not while I'm anxious but when I'm ok, or at least not made from lead. So my body will be exercised and bearing the anxiety should be easier. I think.

A thing for spring

Yesterday I took a day off work because I was supposed to do a thing in the capital... but at the very last minute, it got canceled.

So instead I packed up the dogs and headed for my favorite dog walking beach.

It wasn't as good as last time, when we were completely alone. There were quite some people, and I kept running into them, and they were loud and chatty.

Surprisingly though, I still relaxed and enjoyed myself. At the tiny part of the beach that is sandy I even took off my shoes and socks and wandered a bit in the water. (cold! brrrr)

In the afternoon I thought I'd finally kick my butt to yoga - something I've been planning to do for about two years! - but in the end I managed to misread the hours and missed the right time.

It's like I'm trying to avoid it at all cost and I don't know why. I can feel my body needs to stretch, what with sitting behind my desk for 8 hours straight and then spending the rest of the day on the couch.

So instead I read another chapter of the midnfulness book and did another exercise.

And suddenly I' remembering how much I used to enjoy meditation, and suddenly I'm realizing just how wound up I am.

I couldn't fall asleep until 2 AM, I kept thinking about why I'm so wound up and about Cc... even cried a little bit... finally I gave up, put on 3rd rock from the sun and 3 episodes finally rocked me to sleep.

Last week and part of this week were terrible, I was anxious and restless and didn't know what to do with myself. So I was surprised to feel better yesterday evening and today, too. It's sunny outside, the spring is coming full swing and something inside of me just wants to get outside and be outside.

So for this afternoon I plan a shorter walk with the dogs, a short rollerskating session and a short jog.

Sunshine makes me feel giddy.

:)

Body scan

Yesterday I finally got to try the first of the midnfulness exercises.
I really enjoyed it. It was like a kind of a mindful body relaxation, the type I did when I did relaxation exercises. And I was able to focus through it to the end. Even though I stopped in the middle of it to answer a phone call, I was able to continue on without problems. And even though the guy that reads it gives you about 2 seconds to focus on each body part and hurries on, so I had to pause the CD every minute or so, in the end it didn't bother me.

And when finished, I was there, lying in the dark, actually awake (because it's emphasised that you're supposed to stay awake, not fall asleep doing it) and I was relaxed and focused, and I couldn't get up. Not to shower, not to brush my teeth and not even to move to the bed. Not for the life of me. Not even to set my alarm clock. So I improvised with my phone (without turning the lights on), called the big dog back to my feet (during the exercise he kept trying to get my attention and I got quite nervous at one time and scolded him to his bed, where he then lay - and when I called him back he sprung up and raced to me; sweet thing :) ) and just fell asleep.

Girl, interrupted

I guess an update is long overdue. I don't feel like writing as much as I did then, but reading the older posts made me realize it's important to somehow follow the progress. And today I finally feel like I have something to say.

So things were really bad. Then they got beter, then worse, then better again, then really bad, then really better, and now I'm slipping downwards again.
Although, in overall, I guess the trend is that of going upwards. I just wish the downs weren't such a pain in the ass.
But the ups are way better, and the downs are a bit easier, even if it's just slightly.
It's such a great feeling when you try using your brain and it actually works!

I can't help but smile when I remember I thought St.John's wort was gonna be enough :) All the bad episodes so far have been interrupted by introducing a new medication, or a higher dose of it. As of today I'm on 100mg sertraline, 300mg bupropion and 2,5mg olanzapine.
And I guess that's not even the final combination, given the state I'm currently slipping in.

I'm sometimes upset with the psychiatrist and really angry, because she makes me feel like I don't try hard enough. I feel like she lets me slip really low before altering my medication protocol. It seems like I can't make her understand I know myself and my feelings enough to know when I need more help than just a, "you're doing good".
Yeah, I guess my progress is OK, and it does feel like I sweat blood for it, but that's really not the point; the point is I'm not stable enough, yet, to be able to work on myself. And so when I tell her that, the first thing she thinks is that I'm looking for an easy way out, which, OF COURSE I AM, doh. It's not like I enjoy feeling THIS bad.

I'm happy to have dropped the she-therapist. She is, now that I can look at it objectively, so not suitable to be a therapist. She's not objective and includes way too much of herself into therapy. And she doesn't let you get better in your own pace, she pressures you, I guess ultimately to make herself feel succesful. And, I think she wasn't 100% honest with me.
I realize now that those are her problems, not mine. And while I don't judge her for having that problems, it's totally human, I think she should've worked harder on herself before starting to therapy others. Or at least, realize she's not well yet.

The Pope is good. Although a lot of the times I feel I don't want to go to the session. But so far almost every time it turned out to be a good session. I also broadened the interval between sessions to 2 weeks; a bit because of money and a bit because in this way I pressure myself less and I don't pin my moods to weekly sessions, like I did with she-t. I came to realize pinning my mood on persons, events or things I do is not the way to go; although sometimes it helps, I can't really function like that long term. I need to reach such stability that my mood won't be altered by outside things so much, neither in a good way nor in a bad way. It was kinda scary to realize that I've been doing that for the last 15 years or so... and that it will take a while to teach my mind not to do that anymore.

I'm also happy to have dropped the self-help group. Turns out it's not all that helpful afterall. It helps in understanding you're not an alien because of your mood disorder, but it lacks a professional coordinator. People who are instable, mixed together without a buffer, are hell. The woman that's supposed to be the group leader has a good heart and all the best intentions, but I came to realize getting better is not about someone telling you what you need to do to get better and then pressuring you to do it, NOW! It's about getting better in your own rhytm, when you can and in a way you can.

I'm starting to realize how important is to listen to yourself and to fine tune with your feelings. I'm also realizing the role of medication is exactly this - helping me actually hear myself, through all that noise of anxiety, sadness, anger and racing thoughts.
I'm learning (again - I've known all this about 12 years ago, but it slipped my mind, somehow) to let myself and my subconscious work things out. How to be patient, assess things and let them work out mostly by themselves, without general pressure, applying pressure only where needed and only as much as needed.
I knew all that rationally, but I couldn't feel it. But it seems the more I accept it, and myself, and the more I feel it, the more I can do it.

Still, it's SO difficult, and painful, to stay still when your body is responding with 'fight or flight' and the mind is racing 'gogogo'.
And it's SO difficult being patient when I want to be better NOW and not in a few years.
And it's SO horrible realizing that still my relating to others is nowhere near good and that I'm still an island.

I also realized I don't know how to just be. It's like my mind doesn't know how to be in BE mode, feeling whatever, either good or bad. When it's bad, it's 'gogogo' do something to stop feeling this bad; and when it's good, it's 'gogogo' to recuperate everything I (may have) missed while feeling bad.
And it's nearly impossible not being angry at myself for still being this way and not having been able to get out of it sooner or less painfully.

Eppur si muove.

I will admit tho - on one hand it's interesting, this journey, but on the other, I HATE it. I hate it that I'm like this and that I have to deal with all the garbage from the past. I wish my mother hand't been such a wuss and helped me, instead of just waiting what will happen; I wish my father hadn't been so absent and had noticed something was wrong; I wish that someone, anyone, would have noticed something was off.
And I'm angry, I'm livid, that I've been left to my premises since... since always, I guess.
And I don't know how to forgive others for that. Or if I want to forgive.

Other things I'm learning:

- how to organize my life around depression (come to think of it I've always done the opposite, try to fit depression around my life - no go),
- how mindfulness can help with that (now, with all this medication, I can finally relax and meditate again),
- how to enjoy my dogs (by dropping all activities that put even a slight pressure on me or them),
- how to teach big dog to stay calm around other dogs (by marking and rewarding feelings, not behavior),
- how to play tug with little dog (dropping all expectations and simply playing "I'll steal this from you"),
- that my job is STRESSFUL (I daresay way more than an average job),
- but that I don't hate it as much as I can't cope with the pressure (not only of responsibility but everything else, connected to various relationships on the job).

That, and I had a TALK with my parents. I was so high from it I actually thought, for a few days, that all is well. Turns out ot so much. But at least it's a start.