Thursday, July 31, 2008

Crazy-Ass Welcoming Committee

This blog is not entirely solopsistic, though it might seem so. But truly -- beyond wanting to bash my head into a wall -- I am putting this down for posterity. Because no one invites you into the Bipolar, unemployed, uninsured, disability club. And frankly, someone should. There should be a full-blown, crazy-ass welcoming committee. And in it, there should be information on FMLA, the American Disabilities Act, the EEOC, and your local Department of Health and Human Resources. Because you will never see Oprah touting the latest diet craze: The Poverty Diet.

Department of Health and Human Resources: Your state has one. It is like the DMV. No one will explain anything to you. Checkmark anything that might give you money. They would be very happy not to give you any resources at all. They are helpful like that.

SSDI/SSI: Whether you are truly disabled or not, you will not get this. If you even apply for disability insurance (i.e. the government's money), they will reject you off-hand, and if you truly want to be stubborn, you need a lawyer and copious notes of dates and days before the government will let you pry any money at all from their cold, dead hands.

Hospitalization: There are good and bad mental wards. Your PCP probably knows something about this, as might your therapist or psychiatrist. Ask. All mental wards are not the same, but they are a little like prison. Keep juice boxes and fruit to trade for other useful items.

Food Stamps: Do not be fooled by the rhetoric. If you want your SO to be able to use the card, he can. No one checks who it belongs to. Do not, however, put their name on your application for food stamps unless you are married. If you do, you will not receive enough money to feed a gerbil.

The Poverty Diet: When the DHHR determines that, though you've been fired and have no money of your own, you aren't eligible for emergency food stamps, become religious. Religious charities are the number one place to receive donated food. Humbling, yes, but your stomach ain't rumbling.

Temporary Disability Assistance: There is such a thing, but you aren't supposed to know. This is why you check every box when you are in the DHHR. This can be hidden under something called Temporary Cash Assistance. Do not be fooled.

FMLA: Yes, you can take nearly 12 weeks of leave under the Family Medical Leave Act. Your employer, however, will not like you, and most likely, they will find another reason to fire you -- if they don't force you into a voluntary resignation.

EEOC: You will spend half your day waiting for the three appointments they have available that day. In your appointment, they will listen very kindly, then tell you they cannot help you -- unless you wish to make your employer conform to the American with Disabilities Act.

ADA: The American with Disabilities Act does, indeed, protect your right to certain accommodations within reason. Your employer, however, has a much different definition of "within reason" than you do.

Unemployment: If your doctor has signed a paper telling the State that you are unable to work for a year and if you receive temporary disability from the state, you cannot get unemployment. Unemployment is only for people able and willing to work (i.e. though the body may be willing, the mind is not; your mileage may vary).

Medical Assistance: You can apply for this, too, from your local DHHR. While you're virtually guaranteed some sort of declaration about your food stamps and temporary disability within 30 days, medical assistance is a totally different beast. The medical assistance board is always backed up, and apparently, no one has -- or will divulge -- their phone number. You will rot for three months or more before you hear anything about this. Once you do, you'll understand why it's worth the wait.

Medicaid: Your medical assistance has been approved. If you're lucky, you get a nice shiny packet explaining things. If you're not so lucky, you get a phone call telling you that you have two days to find a Managed Care Organization and a PCP. However, once this is achieved, you will realize that when politicians talk about the Health Care Crisis, they are not talking about Medicaid. Medicaid is what it must be like to live in Canada. Your prescriptions are $1, your visits to your psych, therapist, dentist, and doctor are free. As are a host of other disasters.

Bankruptcy: It happens. You can't get unemployment, the state barely pays you enough to eat, and it could be months before you get medical assistance. In the meantime, you are accruing debt and medical bills as if you can afford to. Call your Credit Counseling Service. Then call your local Legal Aid office. They will waive all fees for their assistance. Go figure.

Psychiatrists/Therapists: Believe it or not, the title does not always fit the figure. Psychiatrists and therapists, the ones with the shiny credentials, may suck wombats. Most nurse practitioners and licensed social workers are far more caring. It can leave you dumbfounded when they actually listen to you.

Seriously, these are all things I wish someone would have told me. I learned it all the hard way, and not everyone wants to self-educate. These tidbits are valid, however, and have been learned through harsh real life experience or from other patients in the mental ward.

Here's The Thing

Complete and utter breakdown in the middle of a movie that triggered me, right? Today? Zilch. Some anxiety about going to the class on being your own defendant for a bankruptcy suit, which would probably cause quite a few people anxiety, but otherwise, nada. Course, the extra dose of Klonopin could be helping with that. As soon as I feel The Nerves coming on, I pop my mid-day pill. It seems to work quick enough, or so my mind thinks.

But some days, like today, I'm still amazed at all the fuss, the taking of pills, the two sessions a week of therapy. I feel -- really feel -- that I could handle this on my own if I'd only pull myself up by the boot straps and be brave. And get this, of all the things I remember today when writing about this, I remember a random Dolly Parton song I caught while changing channels past CMT:

"A girlfriend came to my house
Started cryin' on my shoulder Sunday evening
She was spinnin' such a sad tale
I could not believe the yarn that she was weavin'
So negative the words she had to say
I said if I had a violin I'd play."

And that's why we have therapists. Because I mean, truly, who wants to listen to such a person. Waiter, pity party for one please, with some cheese and whine to go with it. I'd certainly rather belong to Our Lady of Piss and Vinegar and show a little more backbone. Sometimes I wonder how much of the mental illness is what impairs me and how much of it is my grief over the diagnosis. In time, the mental illness I can manage, and God knows, I'll get over the grief.

Wednesday, July 30, 2008

Big Mistake

HBO had Girl, Interrupted on their OnDemand channel listing, so I told myself I'd watch it, when Jb wasn't home. And it's not me, it's not what happened to me, or where I went. It's the 1960's for Christ's sake. But there's so much there that rings true, and when the head nurse dumps Winona Ryder in the bathtub... I had to stop the fucking movie.

Valerie: You know, I can take a lot of crazy shit from a lot of crazy people - but you... you are *not* crazy.
Susanna: Then what's wrong with me, huh? What the fuck is going on inside my head? Tell me, *Dr. Val*. What's your diag-nonsense?
Valerie: You are a lazy, self-indulgent *little girl*, who is driving herself crazy.

Is that all I am? A lazy, self-indulgent "little girl?" Because I don't fucking feel crazy. I don't talk to myself, I don't cut myself, I don't lose complete touch with reality. But I can't stop crying, and part of me wants to be back in the hospital, back where I had friends, where I knew people, where seeing someone get discharged was enough to blow you over so that you were lying in bed all day. And each day new people rotate in and out, in and out. But you know the score, and when you snap, the staff is paid to deal with it, not like your boyfriend, not like the ones you love. And every day gets harder and harder.

Jb and I had a fight last night, and he walked out on me this morning--without even a word. Got dressed and left. And it's my fault. It's my fault. I feel like I'm going to explode. Like that game you played with dandelions, singing, "Mama had a baby and its head popped off." At least in the hospital, you all spoke the same language, and when someone broke down, you understood. No one judged you, no one asked anything of you, no one cared what you did as long as you took your meds and showed up for meals. But now things matter, and I can't even commute to the therapist without feeling like I'm going to throw up.

Jb and I

It's cliche. The way, when someone asks about your relationship, everyone almost always answers: It's complicated. Aren't all relationships? But ours has gotten more complicated. My irritability doesn't help; it puts him on the defensive, and there's nothing that can be said from there.

But therapy is going to open old wounds as well: the neglect from my parents, from my husband, the realization that as mother to my mother and roommate to my husband, I've had very few people -- hardly any -- who ever took care of me. I've been taking care of myself so long, of other people, that right now, I need someone who wants to take care of me. Who wants to put my needs before their own for once. And that's a tall order for any relationship.

I'm not sure Jb is up to that. Not with all the work he does to bring money home, or the way he feels as if I'm telling him he never takes care of me when he must feel like he always does now that he's supporting me. But it's a different kind of need, and one that's truly hard to explain to him. How do you tell your boyfriend you need affection, and lots of it, because you never, ever had it as a child. It's a tall order. Especially when your own experience has made you stingy.

The Therapist

Skinny as a whippet, but I'll try not to hold that against her. Despite that, she listens, and mirrors some of the things I'm trying to say. She thinks I'm reflective, intelligent, and brave. Flattery, of course, will get you anywhere. Bottomline: I like her. She wants two sessions a week. And with Medicaid, I can do that. I've had a good therapist want that before, but was unable to for lack of money. I have to relearn to drive, though. It's a 5-hour commute by bus and rail.

Monday, July 28, 2008

Psych Check-In

Haven't been sleeping well. Unable to fall asleep, so up until 3am, etc. Wake up feeling like I have a hangover. Using caffeine to get me functioning after being off caffeine for so long. All things I tried to convey to my psych today. She still considers me unstable, which is frustrating, and yet, true, and while she doesn't think I'm stable enough to consider a part-time job, she thinks some volunteer work would be good for socialization at this point. Happy to hear I have a therapist appointment tomorrow, as well.

My change in meds:

Benicar 45/100 -- 1x a day (Same)
Klonopin 1mg -- 3x a day (Upped)
Lamictal 150mg -- 2x a day (Upped)
Remeron 30mg -- 1x a day (Same)
Wellbutrin 300mg -- 1x a day (Same)

Since I'm having trouble sleeping, she's given me some leeway to mix my drugs around (i.e. taking Lamictal all at night or all in the morning, taking half a Klonopin in the morning if I'm groggy, etc.) The problem with the Klonopin is that it has a 12-hour half life, so if I take it all at night to help me sleep, how does it help my anxiety during the day?

I'd also be curious if anyone else experiences episodes of hypomania or anxiety that seem to be directly set off by doctor visits. I always seem worse when I go.

Oh, we also discussed my driving. I haven't been driving in a year or two. Jb's basically been using the car and what not. Lately, he's been encouraging me to try to get behind the wheel again, but it's causing me such anxiety that I don't think I'm ready for it. More importantly, my meds keep me off-balance, dizzy. The psych agreed that with my meds I probably shouldn't be driving until I'm more stable.

On a side note: The nation's health care system may suck, but state insurance for the needy, such as Medicaid, is a godsend. All of my prescriptions cost me $4. Free psych and therapist visits. Free doctor visits and lab tests. That's such a financial relief right now when I can't be working.