Tag: psychiatry

About depression that I have to get off my chest

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, CRPS, depression, mood disorders, suicide, suicide attempt

About depression that I have to get off my chest

There has been a LOT of talk lately about depression being treatable. Let me say first, that for some, it is. Therapy has been helpful to some in dealing with it. Medications and therapy still prove to be useful in treatment of depression or actually any mental illness. It was once thought that schizophrenia was a medication only illness. But I learned through one of my suicidologists that isn’t always true, as there was a paper written by him about he helped decrease an individual’s suicide risk by seeing him weekly or more if suicide was more present. It helped the patient feel cared for. If I find the article in my files, I will share it if you care to read it.

I am in no way saying you should NOT get help if you are feeling depressed. But my experiences (which are not the same to the whole depression population) beg to differ. I have yet to find anything that helps the mood shifts. Since my long time therapist stopped seeing me for reasons I have still yet to learn, I have been the most unstable and hopeless I have been in the 16 years I was in “treatment” with her. We had our disagreements about treatment. Transference and countertranferences were helpful at times but were no long lasting. She stuck with the way she was treating me and I stuck to being, well, depressed and suicidal.

What I have to get off my chest is that sometimes, depression is untreatable in a small percentage of people. There is such a thing as treatment resistant depression. Despite ECT (“shock” therapy), medication, and therapy, one can still feel depressed. There are a trillion reasons for this. Sometimes it has to do with the trauma one experienced. Some has to do with biology itself, that the genetic predisposition of a person makes them depressed. Other times it has nothing to do with a trauma or situation. It just happens that you start withdrawing from life, slowly at first and before you know it, you can’t go back to things you loved because, frankly, you are too depressed. Sometimes you maybe too depressed to seek help and a friend or family member needs to push you to get it. The thing is, depression still exists despite treatment. Some people have suffered depression for years and have never told a single soul. They are the small percentage that still go on with their episodes after they pass. They are less likely to die by suicide. Hell you don’t NEED depression to end your life. It has happened. Look at the Shawshank Redemption movie. The warden was “well” mentally and rather than be arrested and humiliated, he killed himself. Would anyone have thought he would do such a thing? No. And that is what my point is. Although we know what the risks are for suicide, depression and mental illness is only a small window into those risks. There are some people who die that have no history of mental illness yet die by suicide. I won’t go into more discussion about it because this is a loaded issue. I suggest reading the Myths and Facts of Suicide by Thomas Joiner. It is a really good book about what I am talking about.

I can only talk about my experience, no one else’s. I have been depressed since I was 8, maybe younger. I only know this because I started thinking suicide was a good idea at that age. I was 10 when I tried to end my life for the first time. I suffered from depression and after taking Prozac, became bipolar because the medication caused mania like symptoms. Not once during my years of being on medication AND therapy did my thoughts of suicide leave me fully. Neither did depression. There were brief times where I felt contentment. I honestly don’t believe in happiness. Like anger, it is a fleeting emotion and doesn’t last. But feeling contentment does happen for me and I sometimes feel comfortable in it. I know it isn’t going to last long. It never does. The depression always finds a way back, maybe not right away but it does come back. Despite some of my successes in life, graduating from high school, getting my Associate’s degree, publishing two books, I still was depressed. I was elated for a little while but it was fleeing. Just like when I wrote the article for the New York Times. I couldn’t believe and still don’t, that it happened. I still have the check that one day I will frame along with the article. But soon after all the paperwork was filed and I was waiting for it to be published, I was intensely depressed. The New York fucking Times was publishing something I wrote and instead of being happy as a pig in shit, I was depressed. I learned that no matter what my success in life was, no matter how much money I made, good job that I had, I was going to always be depressed. I could do one of two things. I could accept that this was the way it was always going to be or fight it. I chose to accept it.

I knew I had been fighting it since I was 16 that I would always have to take medication for my mental illness. It wasn’t easy but I knew if I was to avoid a lifetime of hospitalizations, I would need to take medicine to hold off the demons. Yet despite this theory, I was still hospitalized. Many times. Some times it was like a revolving door during my worst episodes. In 1994, I suffered a huge major depressive episode. I was hospitalized almost every two weeks and then for two months because I tried to end my life. It was one of the lowest periods of my life. I couldn’t bring myself to do anything. Showering didn’t matter. I gained a ton of weight from the meds I was put on. I started living an almost double life. The life the psychiatrists wanted to see and who I really was at home, when I was by myself. Hopelessness was rampant and totally lost on me. I can’t say that I got better. I just got better at hiding from myself, to keep the darkness at a minimum so I wouldn’t be committed at the age of 19 to a state hospital. Even then the façade I built was hard to put down. I just did what I was told to do and when I felt like acting on my feelings of suicide, I told my therapist or psychiatrist, which inevitably led to another hospitalization. But the hospitals in the 1990s were different than they are today. Today they are nothing but holding pens. Two maybe three days you are in and then you are out. If you need more help and have an outpatient therapist, you see them. You don’t need to be in. Maybe you stay for a week or two. But never more than that. Insurance won’t pay for it. And you don’t really get “treated”. You are watched 24/7 to make sure you don’t harm yourself. You might find a “treatment team” that listens but that is ALL THEY DO. They don’t help you in what you came in for. That is for you and your outpatient therapist to work out. If you don’t have one, you might get referred to someone. I’ve never been in that situation so not sure how that works.

I have lost faith that my illness is “treatable”. Seems no matter what I do, I end up depressed or just stay depressed. I am okay with that. I’ve known for a while that there is no longer an antidepressant out there for me. I am grateful my mood stabilizer still works. I just hope that it does fuck up my sodium levels and I need to some off it. Then I will be really screwed. In that sense, I still take my meds because they help. I no longer have commanding voices every day and the accompanying paranoia and delusions. I have to take a med for that every day. But therapy is still elusive. I honestly don’t know if it helps. Talking with someone honestly, like writing this blog, has been useful. Sometimes it feels good to talk to my therapist and leave knowing that someone understands, even if he thinks I am crazy. He said that he is “taking my lead”, which I am not sure about but it is a learning curve like anything else. And I will stress again, that if you aren’t comfortable with the person you are talking to, if they make you uncomfortable or just not getting it, find someone else. There are a lot of different therapists out there. A lot of different degrees as well (but all should be licensed by the state you are in, if they aren’t, I wouldn’t see them). It will take some time to know if they fit with you. The average is about 3 or 4 sessions. Any more than that might be a waste of time if there is no connection.

a little bit of everything Monday

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, depression, mood disorders

A little of everything Monday

I got about 5 hours sleep. I then went to Starbucks after making a PB&J sandwich for lunch. I ordered 6 shots of espresso and a donut. I wrote a little bit before I had to leave to see my psychiatrist. I kind of left early so had like a half hour to kill. I didn’t want to check in that early so I just found a bench outside the office and wrote a little more in my journal.

The appt did not go very well. I told her about having to go through withdrawal last week because I was late in taking my pain meds and she called me an addict. I tried to correct her saying I was dependent but it fell on deaf ears. She kept repeating addict and it make me hurt so bad. I seriously didn’t expect this from someone I have known nearly 25 years. She was being ignorant but it hurt none the less. I vented to my support group about it. I would school her later.

After the appt, I went to the Sprint store to change my name now that I have changed my license. It took maybe 10 mins. Crap. I still had like 2 hours before I had therapy. I went to a Starbucks by my therapist’s office and just ordered hot water for tea. I made Earl Grey. I waited for it to cool so I wouldn’t burn myself. The water was wicked hot. I wrote in my journal about what my psychiatrist had said. I then posted to a Facebook pain group if they had any information about the difference between addiction and dependence. The bathroom at Starbucks was out of order so I left to go to my therapist office. All the drinking fluids was building up and needed relieving. I just made it to the bathroom in time.

Therapy sucked. I told him about what my psych said and he said I should ask her what she meant. After discussing that, I just rambled about anything to make the time pass. I didn’t bring up mommy and daddy issues but the idiot asked me again what was my pain like. I swear he thinks I am making shit up. I told him it varies and depends on where the pain is. It is usually half my foot/ankle going outward starting about the 3rd toe. I told him I got depressed and hopeless and it was hard to keep up the mental stuff with the PT exercises the PT gave me. He said just do them. Yeah, cause it is that fucking easy. Are you serious?? He just annoyed me more than my psych ever did in all the years we worked together.

I get home and on the way, my cousin called me. He was unable to call the bank like he said he would to get information for me. Lazy ass. He said he would tomorrow. Sure, and I will win the lottery too. His mother really irked me because she called me while I was on my way to my psych appt. She wanted to know if my mother was okay. I told her she had to go to the bank, which her brother was going to take her. My mother wasn’t answering the phone. Well, maybe she was in the bathroom getting ready or taking a shit. I don’t know, I am not home. She got me fricken worried and all worked up. My psych sensed it when she saw me. I told her I would call my mother when I left as I was sure she was fine. She was. She was out and did some errands, which she obviously didn’t tell her sister. HOW DARE SHE! LOL fucking stupid bitch my aunt is. Freaks out all the fucking time over NOTHING!! I was so heated!

I get home and had something to eat before going to my room. I had a pile of mail. I brought it up to my room and then checked Facebook. The pain page responded with some links. I clicked on one and there was another link for a medical article on addiction and dependence. I opened it and read some of it. According to the article, because my pain is not adequately treated, I would have pseudoaddiction, where I watch the clock and appear “drug seeking” for relief of pain. I sent the PDF (attached to this blog APS_consensus_document here) to my psych along with saying that I felt hurt when she called me an addict. Then the tears flowed and I was a sobbing mess. It took me a good while to get composure. Then she responded and I bawled again. Fuck. She said it was not her intention to hurt me and that she didn’t want me to be dependent on the narcotics. Too late for that. And for that matter, I am dependent on my mood stabilizer, which I responded back to. I told her I didn’t want to be on opioids but the benefits outweighed the risk. I knew and accepted this just like I knew I needed meds for my mental illness. I told her the example of how I withdrew when I forgot to take my mood stabilizer for two days when my father was ill. I honestly didn’t think anything would happen but I had the same type of dizzy spell I had last week when I missed my pain med dose.

No one wants to be dependent on their meds but it happens to the best of us. I knew when I was 16 I would need to be on meds the rest of my life. There was no doubt about it. I had severe mental illness and the only way to manage it was through medication and therapy. Unfortunately, the therapy part hasn’t worked out yet. I can’t say I am cured, because I still have bouts of debilitating depression and suicidality. But lately, the pain has fucked up everything. Now I am depressed and suicidal due to a medical condition, Complex Regional Pain Syndrome. And there is no fucking way to control it because it is as unpredictable as the New England weather. I don’t even have the same pain twice during a flare up. It is all fucking different as night is to day. The only type of pain that is somewhat consistent is the fucking malleolus pain and the pain that is where my outward ankle and foot merge, just under the malleolus moving toward the foot. This pain drives me up the fucking wall. I had to text the Crisis Text line last night because I needed someone to talk to at 0100. I didn’t get a “counselor” till 0200. By then, I was sleepy and hungry. I made something to eat and then I said night to the “counselor”. The whole thing was useless. She kept wanting me to do some coping skills. I kept wanting to talk about dying. She didn’t want to hear it. How is that helpful?? Next time, I just write in my journal or maybe blog and hope the cops don’t show up at my door.

The temp dropped to 32 degrees. I had to shut the window because it was flipping freezing in my room. My feet got cold as ice so had to put on thermal socks. Then I had to use the bathroom again. I figure I would take my night meds when I came back to my room. My mother wanted me to make her bed. I did. Then got tucked back to my bed only to realize I didn’t take my night meds! Fuck. My ankle didn’t like me getting up again. I quickly took them and then got back under the covers. I put on a long sleeved T shirt. If the heat kicked on, I will take it off. Shit my foot is burning right now. Neurontin time!

Oh, while I met with my psych, we discussed the drug Vimpat. I wanted to make sure there were no interactions with the Trileptal as they both work on the same sodium channel thing. Last thing I need is my sodium (blood salt) to drop. She was okay with me trying it so I emailed the neurologist to go ahead and call it in. He hasn’t so far. The script for a refill of Trileptal my psych put it, never made it to the pharmacy. I had to email her again. For some reason, it had to be reviewed by the pharmacist so it is delayed. I’ve been on this med for over 10 years. If it is not ready for pick up tomorrow, I am calling to find out why it is not ready. If I didn’t have all my meds at this pharmacy, I would switch to another one. But this one is the closest to me and has better service than Rite Aid.

Appts for the day

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, depression, mood disorders

Appts for the day

I got about 2.5 hours of sleep. I was up till around 5 because my pain was bad. I made it to starbucks for espresso and then left to go to the registration department at my hospital to change my name. It took about 5 minutes to do as I was the only person there. When I got to my psych’s office, I had them print me an extra label so I could take a pic of it but they cut off my last name when they ripped it from the machine. Oh well. My psych took me early, which was good. She usually runs late. She signed the paperwork for the RMV and we talked about the hospitalization not being helpful. I also told her the Zoloft was making me nauseous. We agreed to decrease it to 25 mg and if it still was making me sick, I could stop it.

While I was meeting with her, my PT called and left a message. I emailed her. She told me that I could go through some pain program and sent me information on it. She said that I needed to be cleared before going back to PT and I am not sure why that is as this was a psych admission not a medical one. Even when I tried to make an appt with my PCP’s office they had no idea what I was talking about. I emailed her again for clarification. I made an appt with her for next week, which I hope I can keep.

After my psych appt, I went into Boston to find the RMV. I am so glad it is around the corner from the train station. I will go there Wed. After finding it, I came home and wanted to rest for a bit before leaving for my therapy appt but my ankle acted up and I was not able to rest. I made some tea and then went to the bus stop to catch the bus.

Therapy went okay, though I need some time processing it. He got shrinky on me as before we ended he said that my “mommy and daddy issues were the real issues not my current ones”. Basically, because I haven’t dealt with my parents’ rejection and neglect, they were causing my problems, not my physical pain and suicidality. Whatever. I’ll write a blog on that once I think more about it. I am too tired.

On the way home, my ex-ex-girlfriend texted me and then “took a nap”. She does this to me all the fucking time and I am sick of it. She asked how I was doing and I didn’t answer her. I told her I was going to bed and then she said that I “ignored her for two days”. Um, text works both ways. I didn’t hear from her either. I was in bed sleeping most of the last two days. Kind of hard to text someone when you are sleeping all day. Then she called me a freak and that I was free to delete her. I blocked her number and then blocked her on Facebook. Fuck her. I don’t need drama in my life.

Went upstairs to my room and my bones in my ankle and foot flared up. I so want to fucking sleep!!!! I was in the boot for most of the day. Hope my night meds knock me out. Day 3 of supplement and haven’t noticed anything except my appetite seems to be low. I am eating but only 1 to 2 meals a day. I made an egg and cheese burrito and then had cereal when I came home from therapy. I was going to make hot dogs but didn’t feel like making them. I haven’t lost anything yet but I am only weighing myself weekly. I really just want to lose the belly fat but don’t know if that is possible. Still have 27 days on the stuff so only time will tell.

Exhausting painful day

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, depression, mood disorders, physical pain, suicidality

I woke up around 2 in pain so got some pain meds. I woke up around 8 after falling back to sleep. I wanted coffee but the damn breakfast dude had shut the doors to the kitchen. I don’t know why they do this for every meal. Drives me crazy. While I was waiting for him to open the door, my pain spiked and so did my suicidality. I just wanted to die. After I got the disgusting coffee and some breakfast, I met with my team. I told them I would retract the 3 day and the psychiatrist asked what changed my mind. I said the thought of going to a state hospital wasn’t appealing. After we talked, he gave me privileges just like that. After I told him I was suicidal. Whatever. I knew I wasn’t going to be able to go out today anyway. I just hurt too much.

I had a mental health counselor that I liked as my check in person and told her I hated being far away from the nurse’s station. She was able to have me change rooms to be closer. I had to walk back and forth with my things. That caused a flare up. I am staying in my room the rest of the night. I need to rest. I am wicked tired, like I’ve taken a sleeping pill. I am so wiped out from this chronic pain today. It has been fluctuating all day. 

There is a service dog on the unit. He is very cute. The bugger had learned to leave the patient’s room so he has been hanging out for most of the day. This is the 1st time I have seen a dog on the unit.

It has been a really warm day out and so the unit has been stifling. I was sweating when I was done with the room change. I didn’t pack shorts so I ended up making them out of some scrub pants when I was last admitted. I am much cooler now. My room has the windows wide open so it’s nice and cool. I like it. I can not tolerate the heat, which I think has contributed to my pain being bad the past two days. If dinner wasn’t in a few minutes, I would take a nap. I will after I eat. I’m kind of hungry.

I hope that because I got privs today that my discharge date might be next week. Least I hope so. I want the fuck out of here. My psychiatrist wants me to stick it out but I really don’t see the point. 

I went to two groups today. The 1st one was group therapy and I came out to the patients that were there. Everyone was supportive and I think there is another trans female on the unit. I hope we can connect but she seems very distant.

The other group was on stigma and I didn’t care for it. It was really boring.