They're Back

Psych took me from 600 Lithium to 300 because I was showing side effects. And while Lithium at 600 seemed to stabilize my mood, it stabilized it at a moderate depression. The 300 Lithium, however, doesn't stabilize me. I've had one 3-4 day period of hypo/mania, and I crashed afterward into a moderate depression. This is hell on my relationship with Jb. It's hard to feel close--for him, as well, I imagine. I don't know how to get closer to him when I feel like this. I feel so self-centered and day-to-day. The financial situation doesn't help. We argue over spending $5. That's how bad things have become. And the IBS just gets worse and worse.

Med Update

Therapist is going to help me fill out my SSDI form. My psychiatrist is behind this as well, which helps having the two behind you.

As for meds, psych is dropping me down to 300MG Lithium. I was showing side effects: shaking hands, disoriented, walking like a sailor. He suggested I hydrate more.

Overwhelmed

I can't help feeling overwhelmed lately. I've gone to 300MG of Lithium twice a day, and whether it's that or something else, I've started getting the shakes, the spins, mild headaches, constipation (which is funny, considering the IBS alternative), and dry mouth. All this on top of an IUD period. (An IUD period means you will bleed like a stuck pig, for days and days. You will go through three boxes of tampons, having to use one every two hours at your worst, and the cramps make you feel like shit.) So. Good times right now.

Perhaps it's all the physical symptoms that are making me feel touchy. I'm reactive to every bit of criticism, every bit of rejection. When Jb's goofing around, doing a little smack talk, I get upset. I feel disrespected. I can't find it funny anymore. I'm touchy about everything. I want to be coddled, loved, take care of, and I don't feel that at all. And then Jb yells at me for not being involved in our relationship. And I'm absolutely fluxommed.

And Jb and I are fighting again. I'm supposed to clean up, do the dishes, make dinner, do the finances, plan meals, go grocery shopping. This is supposed to be me carrying my weight. But I have no interest in it. I've no interest in writing this blog. I've no real interest in anything. Thank god the book I'm reading has only 2-3 page chapters because that's about all I can manage at once. And there's SSI to think about. I should start that. I haven't the faintest where to begin. I'm just ... I'm tired.

I hate smoking out on the front stairs now because there's something about looking down the cobbled walkway that sets me shaking, that makes me want to say, "Good dammit!" And then the knives start to glimmer when I wash them. They look appealing. And I start to wonder if you can overdose on Klonopin, and if it'd just be like drifting to sleep. Because I'm a coward when it comes to suicide. But it doesn't mean that I don't want to sometimes.

Lady Lithium

I call her lady because only a female can come up on you so sly. Four days in, and I'm noticing the effects: the constant diarrhea and abdominal pain (it makes my IBS look like a kitten), the severe dry mouth. The dry mouth I can handle. The gastro-intestinal stuff ... Gah, wasn't IBS enough? I've been up and down all night in the bathroom. I haven't slept well. I'm dreading when I go to lithium twice a day. The bathroom and I will become very intimate, I'm guessing. Least the lithium doesn't act totally like IBS. I don't get the sweats, the shakes, then throw up.

And on another front, I'm still having the spins.

I was also a bad girl yesterday. The day before yesterday, I cancelled my therapist appointment. I was so down that I simply couldn't handle having to go out, much less drive Jb to work and back, then out to my therapist and back, the back to pick up Jb, etc. I just couldn't deal. A moderate depression as these things go. Not suicial like the week before, but depressed enough to be absolutely immobilized. My therapist is a doll and has volunteered to help me fill out SSI because ... I just can't get started on it myself. It's far too overwhelming. She's even volunteered to make a home visit to help. So I hope I didn't piss her off by canceling. I haven't heard from her yet.

I guess my big thing to do today will be to call SSI and get them to send me a Starter Kit. Their webpage says, "Don't worry if you don't have all the information. We'll help you get it." I wonder which information they mean, and if it's true. I've heard that you have to give them everything they want and be as detailed as possible. I kept horrible records until some time after the hospital. I thought I was merely depressed, that there was no help for people like me. I didn't know I had options, safe harbors, like the hospital, SSI.

Vertical Issues

That's to say: I'm having trouble staying vertical. I've never been grace personified, but there are limits after which I will not take blame for my own actions. For example, the other night, I nearly took a header off the top stairs of our porch. I could see that "oh shit" look on Jb's face just before he reached out and got his arms around me. My hero, of course. Otherwise, I'd have fallen backward down the stairs and busted my head. Crazy person in the hospital with a head injury. Ba-bump ching. Funny, funny stuff, folks.

Anyway, I really don't know if it's a side effect of one of the meds or not. Zoloft is the most recent addition. But seriously, I walk around the apartment like I'm drunk. I'm good, and then all of a sudden my entire body wants to go to the right, and my feet are trying to catch up. I trip over myself constantly, and when I get up from sitting down, I often plop right back down because I can't quite get my balance. My ex-mother-in-law had an inner ear thing that kept her off balance, but I've no inner ear thing. Thus, I can only attribute it to meds.

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.

Ha-ha!

Today, I am uber productive. I have called the unemployment, um, place and been told it's best to wait for my job to dismiss me, which I doubt they'll do. I see myself forever trailing on in this unpaid leave of absence state, arm thrown across my eyes like a melodramatic actress

On a yay note, my medical assistance determination went through, and I'm eligible for Healthchoice, which provides free doctor, dentist, ophthalmologist, psychiatrist and therapist visits, as well as cheap pharmacy costs. Jackpot! Whew. I can waive my right to insurance through JHU now and feel safe in knowing that I can get the help I need.

On an anxiety-producing note, I'm under review for food stamps, and other county programs, no doubt, on the 14th. Jb's making more money than he was, but we're still so strapped for cash. I don't know how this is going to affect their decisions. Also, I'm not sure how getting into Medicaid will affect the money I'm getting for Temporary Disability Assistance.

Both my PCP and my psych is in the managed care organization I enrolled in as well, which makes it easy to continue treatment without having to start over with someone new. I've even left a voice mail with a therapist. Now I just have to wait for her to call me back. As always, the waiting is the hardest part, to quote Tom Petty. But it's also anxiety-producing. I worry about this or that, going through every scenario in my mind, obsessing about worse-case scenarios.

Regardless, I went through all my bills, got all my medical bills sorted and ready to show my case worker. Everything else should already be on file, except for Jb's pay stubs, the new rent, and a bank statement. I'll have to talk Jb into going to get that, which he won't like. And I have to remember to tell the guy that what Jb makes annually includes a 2 1/2 - 3 month lay off period due to seasonal work. Because that makes a huge difference in whether we qualify or not.

Lot of time spent on the phone. Now, it's the waiting. And despite it all, I feel good. I have that stupid assurance that I'm fine, everything's fine, and all this medical stuff is useless. I feel like I'm fine, I don't need my meds, that going to my psych isn't necessary, that I've nothing to talk to a therapist about. Truly, I feel ... good. But put me in a situation where I'm required to do something, put me in a doctor's office, and I'm a blubbering mess of emotions. I still can't sleep at night, and I even woke up several times last night: 1am, 3am, 4:45am. I'm restless. Maybe it's the increase in the Wellbutrin. I have this "do something right now" energy and restlessness, but my eyes are so tired, my brain is tired. It feels very strange. Like part of me is sedated and part of me can't stop thinking, doing, planning, worrying, typing, on and on and on.

5:32 a.m. Lack of Sleep & Meds

Tried for an early night last night (10 p.m.), but I was up at 1 a.m., now again at 5:30 a.m. I'm not all that tired, considering I'm running on about 5 hours of sleep a night. I don't know if this is the Lamictal affecting my sleep, which it can, or evidence of a low hypomania because of the move.

On a bad note, I forgot to take my meds last night. I'd been doing so well, too, but I got caught up in watching Firefly (why Fox ever canceled it's one decent show, I'll never understand), among other things, and simply forgot. As for the sleeping, I think I may switch from taking 100MG x 2 tablets of Lamictal in the morning to 100MG in the morning and then another 100MG at night, which is how it was initially prescribed, though the psychiatric nurse practitioner told me to take 200MG in the morning if it messed with my sleep.

Somehow, it may be messing with my sleep in the wrong way. At the same time, they halved my Remeron to 15MG down from 30MG. Remeron's known to have a sedative effect. So it could be the Remeron moving out of my system. And while I was sleeping far too much before on the higher dose of Remeron, now I'm not sleeping enough. And sleep is part of the stabilization game. So many patients with mental health problems swear that they need 8 hours of sleep and a set schedule to keep themselves on the up-and-up.

Edit: According to Crazy Meds, "Another not-so-common effect [of Lamictal] is a type of insomnia where you're tired, but you can't sleep." Hm.

By the by, I've found Crazy Meds to be an excellent resource for looking up a medication's side effects, and often, I find the collection of patients' experiences with the medication a better indicator of side effects than what my psych doesn't tell me. On the other hand, I've been sore all week, but I've also been cleaning and packing a good deal, so I'm not going to attribute that to Lamictal right away. If it keeps up after the move, it may make me more thoughtful.

12:01 p.m. Pharmacies, Insurance, & Copayments, Oh My!

Thwarted at the pharmacy. I swear. Took a bus all the way out to the hospital, and I could only get the Lamictal filled. Luckily, it was the one I was completely out of. Since I seem to have dropped off prescriptions elsewhere, insurance won't pay for them until June 13th. Nevermind that my prescription has changed. But I've enough Remeron and Klonopin to last me a couple days more. I checked out my receipt for my Lamictal and about went into sticker shock. $20 with insurance. Without? $276. My god! I need to look up one of those free prescription programs my nurse practitioner (PCP) told me about. (This is when I seriously consider moving to Canada.) Health Insurance will certainly be a big influence on who gets my vote, that's for sure.

On another note, side effects today. I was falling asleep on the bus and in the pharmacy waiting room. And walking was this odd sort of seasick weave out to the bus stop and down the halls. My feet kept wanting to go in front of each other, and my body kept wanting to gravitate toward the nearest wall. It's a strange sort of gravity, this dizziness thing. And I feel weak, unable to really get to work and start cleaning the kitchen and the bathroom, both of which need it. I was also planning on making this Creamy Sausage Casserole with Biscuits, but that might be overkill for today. I hate having to conserve and space out my energy. I understand how, even when a patient might be feeling better, that person might still be unable to work. I do believe it'd be frowned upon if someone was found, head on their keyboard, at work. Not to mention the walking like you're drunk. Stellar review, I'm sure.

By the by, I love my nurse practitioner. She gave me two months worth of samples of Benicar so I wouldn't have to pay for them because she knew I'd lost my job. Psychiatrists, on the other hand, are stingy bastards I'm finding, and look at you like you're a junky if you ask for samples. Given the fact that they're the ones prescribing the medicine, it just makes me wanna slap 'em.

Smoking & Mental Illness

Hi, my name is -----, and I'm a smoker. I started 2 1/2 years ago under a period of great stress: a separation from my husband, a new boyfriend, financial stress due to both, my father's bout with a tumor in his colon, and the unexpected death of my wet-headed ninja kitty of 9 years. It didn't help that my boyfriend was also a smoker. I didn't originally know this. He'd been hiding it. Once I found out, I preffered he smoke than continue lying about it. And so, it was readily available. If not the best of options for dealing with my stress.

Before any judgments are made, yes, I know the risks. I've had an uncle who died of lung cancer, a great uncle who died of lung cancer, possibly two grandfathers who died of lung cancer, and a grandmother with empysema. Both my parents smoked for years. I know the risks firsthand. Most people don't need studies to understand that smoking often starts under duress of some sort. But the most interesting thing, in my mind, is the link between smoking and mental illness. According to an article on Bipolar World, 70 percent of bipolar patients smoke. Sixty percent of patients with major depression smoke. The numbers go up for those with schizophrenia and down with panic disorder and Post Traumatic Syndrome (PTS).

Even more surprising is the controversial subject of marijuana use among bipolar patients as a mood stabilizer. Try the following Google search: (marijuana or cannabis) "mood stabilizer" (bipolar or mental illness). There's ample anecdotal evidence on the subject, but no real clinical research. Although, the BBC News might disagree with that. According to a news report based on clinical trials in New Zealand, cannabis doubles the risk of developing mental illness. To slog through the actual report that the BBC story was based on, you can view it for free on Blackwell Synergy's website. Whether mentally ill patients are using smoking or marijuana, the underlying issue is the need for those with mental illness to find some control over their moods, sometimes even over the side effects of other, more popular, and more "accepted," pharmaceutical drugs.

So, do I smoke? I do. I'm around 4-6 cigarettes a day. It's gotten higher since the depression and the hospitalization, though the hospital was a "smoke free campus." For days, I was in nicotine and Cymbalta withdrawal, and no one on the staff educated me to the fact that I could ask for either the patch or the gum, as well as Ativan, which is commonly prescribed for withdrawal from alcohol and substance abuse. Again, it was a case of the patients educating the patients in the hospital, which seemed to happen far too often. Because almost all the patients smoked. And this is perhaps the crux of the problem, when you can't find help and what little help you can find feels far too insignificant for the uncontrollable illness wrecking havoc in your mind, where do you turn?

11:02 a.m. Stupid, Stupid

Stupid, stupid me. I didn't take my Lamictal or Klonopin this morning. I wonder if it's too late to now. I wonder if I forgot to yesterday, too. I'm not used to taking anything in the morning. And I wonder if this has anything to do with the tireds. I think I took my Lamictal last night without thinking and wonder if it's worth taking two this morning or waiting now.

And speaking of stupid, my morning dreams are coming back to me now. I'm in a college dorm and Jb and B, an old co-worker of mine, are stripping naked and jumping out the window to a snow-covered ledge below to... flaunt their nakedness? I've honestly no idea. It's clear they think it's a good idea, despite the snow. There is some public security officer talk out on the roof, and a little defiance, but eventually, they come back upstairs. I, of course, am only afraid of getting into trouble and don't see the humor in the whole thing. This is typical of me. Everything must be just right, I must be just right, I must not get into trouble, I must keep the status quo, I must be perfect.

Because deep inside I know how truly imperfect I am.

Later in the dream, I'm frying my uncle Frank a salmon sandwich, except the salmon curls up into grey little elephants that talk to each other in the pan, and I'm wondering how I'm going to be able to serve this on a sandwich, and they're certainly not big enough for two sandwiches.

Strange take on the usual pink elephant dream, especially considering I was completely sober this morning. Unless a lack of meds can simulate such things.

10:51 a.m. Wasted Time

Slept again from 8-11 a.m. Unsure why I'm tired and sleeping so much. I don't feel depressed, which means side effects. The sugar cravings seem to have lessened, too, with the halving of my Remeron prescription. I did ask Jb to bring me home some chocolate last night, but it wasn't the jonesing for pure sugar that I'd been having. Too tired yet with waking to say much else.

1:16 a.m. Drained

Up at 1 in the morning. Maybe the lamictal. Psychiatric nurse practitioner mentioned it might mess with my sleep. Will start taking 2 lamictal in the morning and none at night.

Otherwise, woke up from a sex dream, again. Vivid. But I've forgotten it now.

Before bed, Jb and I were at it again. touchy and upset, arguing. Jb has a way of instigating things that makes me want to hurt him. He's the one who started off with the sullen, passive-aggressive shit, but he won't admit to it. So he goads me, which I don't deserve, and I end up confused and hurt and yelling back about what, I don't really know. Sometimes it just drains me.

2:32 p.m. Feh.

Might be hitting a downswing. Might be the change in meds. Stayed up late last night, got up earlier, around 7ish. First time I've seen Jb before he headed off to work in a while. Played with a "new" pally on WoW for a bit, then went back to bed. Woke up again around noonish when Jb called.

Actually, now that I think on it, woke up cranky this morning. Jb and I got into it before he left without so much as a kiss and a very meh "goodbye." Was cranky, too, when Jb called around noon. I'm just loads of fun after being woken up and waking up already in a "mood."

Was thinking last night before bed that Jb ought to be a co-author of this blog. It'd be interesting to see what he has to say about how I affect him, and what sort of symptoms he's seeing in me. It'd be helpful to have some of his thoughts down if I have to go for disability. Because I'm not always rational enough to be objective about how I'm acting or what I'm doing. I doubt he'd be into doing something like that, though.

I have been feeling the compulsion to buy things and go places. Luckily, we don't have money, so the trips I used to take spur of the moment aren't possible anymore. When I discussed this with Jb, he took our bank card out of my wallet and took it to work with him and proceeded to tell me that if he ever came home and found me gone, I'd come home to an empty apartment. I vaguely mentioned taking the car to go see my parents for a week or so. This was vehemently veto'd.

I was productive today, but only because when Jb called at noon, he sorta got on my case about needing to pack. So I packed the booze with a winter coat (for cushioning), I packed the binders with our cds, movies, and games, as well as his Magic card binders and transferred his loose cards to a sturdier box with a top. There's some miscellaneous cds in ziploc bags in there, too, as well as my knitting and another winter coat (again, for cushioning). I taped up the box of my Framboise, too, because that's the important stuff (i.e. my favorite).

Doctor!

So, um, it was good: I took a list. Kinda scattered, very talky. She made me eat a piece of candy 'cause I hadn't really eaten all day. She says I should get blood work to make sure it's manic and not diabetes, but I told her I'd had all that blood work 3 months ago, but she said do it anyway.

Med changes. Yes. Of course, always tweaking. Twice the Lamictal I was on. Half the Remeron. She didn't believe me that Remeron made me crave sugar. She thinks I'm making that up, I can tell. That's what the blood work is for. She thinks I could be diabetic. But I was shaky, so she made me eat candy out of her drawer, which was sorta disgusting. It was all dusty with that powder they put on hard candy in tins, and I didn't want it, but she made me.

Forgot to take the Klonopin. Adderall now a definite probably no. Caffeine probably didn't help.

She said I'm supposed to eat three times a day, protein to stabilize my moods. I can't afford to eat three times a day. Jb jokes we'll get me protein bars, which is better than the other joke he could have made. Jb also called me "crazy" in the car. Very clearly manic. Or hypo, really. Up up. To-may-to tah-ma-to. We went to Subway after (Jb picked me up because I couldn't wait for the bus; it was too slow), and that was a great joke. Whitebread! Very funny. Can't explain more, but it's giggly good.

I need to write down my prescriptions, but not now, I can't focus, and I doubt I could read her writing. They use those squiggly things to signify how many and how many times a day. Feh.

12:17 p.m. Missed Appt. & List of Symptoms

Dammit, I've forgotten my psych appointment. I had to call them to find out because I couldn't find my appointment card among the trash, the bills, the folders of county info and medical info.

The receptionist sounds vaguely amused when she tells me I missed it; it was earlier today. I'm vaguely annoyed and feel as if she's patpat'd me via phone. They have a cancellation for later today, though, so I'll be going at 5:15 p.m. I call Jb to tell him this, to tell him I might not be home by the time he is, so, "Don't worry! Just at the psych's!" He suggests that maybe we should start writing down my appointments, like on a whiteboard that we post on the bathroom door, a cheap one with cheap markers -- since that's really all we can afford. I feel like a child now, who's been talked to like a child, and shamed into looking at her feet as she digs a toe into the ground.

Feeling child-like, and pissed at myself for what I see as continued incompetence, I tell myself I will look at my blog. I will write down the points I would like to discuss with my psych. Better yet, I'll write them down now! Here is what I will tell my psych:

• I'm am so forgetful I forget appointments and lock myself out of my apartment regularly.
• I would lick sugar off the floor if it spilled. I think this is a Remeron side effect.
• I sleep until 10 p.m., then again at 2 p.m., then again at 11 p.m.
• Sometimes, I cannot sleep because I talk to myself all night long.
• When I am not asleep, I run a constant dialogue with myself in my head.
• I obsess over lyrics, poems, my diagnosis.
• Everything seems dirty to me. I can't touch or eat off certain things until they're clean.
• I screen my calls and avoid people.
• I still don't shower for days. My personal hygiene is definitely lacking.
• I'm writing some, but it's all crap, and I've only begun to read very little bits.
• My dreams are especially vivid, but often forgotten, except in the morning.
• I am feeling somewhat better. The peaks and valleys are less extreme, but the rotation seems quicker, and it's exhausting trying to keep up.
• I saw something the other day that probably wasn't there.
  

This is what I would ask my psych:

• Is Lamictal really supposed to be used as a mood stabilizer?I read that a study from the APA said that it didn't work any better as a mood stabilizer than placebos did.
• Is there something we can try besides Remeron? Something weight neutral that doesn't make me feel like a junky without the benefit of a high?
• Am I really bipolar? Because I'm not sure I am. Shouldn't I be cycling less if I am? And if I'm not, what the hell is this? Because I'd feel so much better if I could label it. If I could hold it in my hands and work around a definition.
• And what about work? It's been 3 months. But I still feel too unstable, like if I tried to find another job now, it'd be a month, maybe more, before I'd be hey-ho! for the hospital again. Should I go for disability and will you support me?
  

I think that's all. I know I have forgotten something. I'm always forgetting something. I just worry it's not a big something. I'd rather it be a small something, like how I've forgotten which bus to take to the hospital to see my psych doctor, though I rode that bus everyday for nearly two weeks. And why is it that I can't get my mind to stop, and yet, I can't get it to function either?

Oh! I did forget. I will take a list of my meds! A list. Not my white bag. The white bag will stay home. I will take white paper instead. Because white paper is more normal. (Only the labels for my posts -- "dosage" -- reminded me that, yes, I'm going to the psych doctor to check the dosage of my meds. How clever. After all, that's what psych doctors are for, yes.)

2:17 p.m. Tired & Cranky, Period.

Annoyed. Bitchy. Cranky. Tired. Crabby. Beginning to dislike Jb just for sitting there and watching t.v. Unreasonable dislike, even hatred. Want to crawl out of my skin. Annoyed with all things slow, dumb, insignificant. Or, at least, what I consider insignificant, which is anything beyond myself or my desires, which is completely ridiculous. And yet, the anger and annoyance are still there. Don't want to make decisions. Want Jb to intuit my wants and needs (good luck with that). Totally unreasonable expectations. Jonesing for sugar like a junky. Again, the Remeron?

Note to self: Noticing trend in mood swings. Mood seems to take a dive around 2ish each afternoon.

6:20 a.m. To Sleep Perchance to Dream

Jb's gone by 10:30. He's come down with a cold and is out like a light. For the first time in weeks, I can't sleep. I lie in bed well past midnight, words and thoughts rushing through my head. I've narrated all of my hospitalization, dissected parts of my relationships, my marriage, explained away the periods of increased sexuality, the nights I've stayed up until 4 a.m., and still the words keep flowing in my head. I try meditation, but I'm too distracted. The Tibetan monks call it "monkey mind." And when I try to relax my mind, it begins to hurt, like a bruise.

There's something else. the party line isn't there. In the past, late at night, when everything is quiet and so am I, if I focused inward, staying unobtrusive and silent, I could hear 8-10 voices paired up in conversation in my head. It's like eavesdropping on someone else's phone call. Sometimes I'd get vague flashes of context, especially if it's a family member, and sometimes, it'd merely be a low static of sounds in my head that I rode to sleep.

Don't think I'm confused. It's not the voice of my mind making these conversations up. I know the difference. Because once, and only once, there was a slick, black voice that told me upsetting things and asked for dangerous favors.

I finally fall asleep long after midnight, dream the vivid dreams I seem to have now, and remember none of them. I wake at 3 a.m. and then again at 6 a.m. It's more than that, though. I've been up and about most of the night. Because somewhere between midnight and 3 a.m., I ate the rest of the cookies I baked. Again, the Remeron. The sugar cravings are killing me.

2:27 p.m. Slipping

Not even an hour later, and I'm slipping downward again. My eyelids are heavy, and so is my head. I'd be crawling back into bed if Jb wasn't home. But he is, so I'll fight it and try to hang on. I want so much to sleep. I eat the last piece of bread and butter that's been sitting next to me all morning, and smoke.

10:58 a.m. Forgetful

I wake up at 10:31 a.m. from some dream where I'm driving around with two younger men, trying to keep them occupied, for what reason I don't know, and the front of my sweater is unraveling. The boy driving seems to be waiting for it to unravel completely, which I find flattering, assuming he has some sort of cow-eyed crush on me. The dream ends with an ego-shattering realization that he simply likes looking at breasts and it has absolutely nothing to do with me.

Waking up always leaves me groggy now, and it's not uncommon for me to wake up 2-3 times, then go back to sleep, while the morning creeps into afternoon. The latest I've slept this week? 2:30 p.m. A new record for me.

I've gotten up to get some bread, butter, and cheap brie (I'm proud that it's cheap, and that I'm eating it in quarters) for breakfast, but I'm not really hungry. If I think about food, I think about the cookie dough in the fridge. That's the sugar cravings from the Remeron. The grogginess and disturbing befuddlement that comes and goes may be the Remeron, too.

Because I'm forgetful now. Small things. And big things. Like locking myself out twice yesterday. Once because I forgot my keys, and the second time, because I picked up the wrong keys. I stood down in the mail room yesterday looking at the wrong keys in my hand absolutely unable to comprehend that I had keys in my hand, and that they were the wrong ones. Once my brain had established this in its painfully slow way, I went to try to open my mailbox with them anyway. Within seconds, I'd forgotten I had the wrong keys in my hand.

Then, this morning, I completely forget the maintenance men were supposed to come do the preliminary walk-through of our apartment before we move. The knock on the door is a complete surprise. That I'm surprised, however, doesn't surprise me. Instead, I think I should start writing these things down.

That I want to write... Now that's something that also surprises me, but in a completely different way. I haven't written or read anything since hospital. That's coming on three months now. So I wonder: Does this mean I'm getting better? Are the meds kicking in? Or is it only another up in an up-and-down world. And if so, when will the down come? And how deep will it be?