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.

Axis of Evil

I'm slacking on my meds again. I got myself a day/afternoon/night pillbox to deal with all the meds I'm on because, frankly, at 12:30am, I'm not thinking the clearest; I'll pass up my meds if they're too much damn trouble. And that's what I've found myself doing. Late night can't be buggereds and early morning forgets. On top of that, my stomach and gut are acting up real bad.

It's the meds. It all comes back to the meds. It takes me roughly 2-3 hours to completely wake up in the morning. If I get caffeine, I can muddle through on 1 1/2 hours. But that's just it. Having to get up and drive Jb around in the early mornings, I've started chugging caffeine again after being off it for nearly a year. On top of that, I'm smoking more often. American Spirit Menthol Lights give me a slight buzz that Marlboro Menthols never did. The combination is chewing up my stomach, though, and it's creating this "axis of evil," where I'm using caffeine to get me up, cigarettes to bring me down, and meds to keep me level.

Monday

I always go into the week determined to do better, do more, feel better. The past several nights I've had problems getting to sleep, staying up as late as 3am. Not surprisingly, I'm sleeping later in the mornings--until almost 11am. When I wake up, I'm still groggy for several hours. I've read more than one article in the past that directly links insomnia and hypersomnia to episodes of depression and mania, so I think it's important to be noting this change in my sleeping habits. For example, right now, I could really use a nap. I slept until 11am, and at 3pm, I'm already tired.

Having said that, I started off on the right foot for once on a Monday. I spent much of the morning fleshing out characterizations for the series I'd like to write. I think I've done enough characterization to actually start writing. On a side note, one of the reasons I think I'm staying up later is the books. For some reason, at night, once the lights are out and the tv quiet, I start hashing over the plot and characters in my head, imagining scenes, narrating them to myself. It's an important process, though, and I hate the idea of curbing it, as these characters are real to me, and they talk to me and reveal themselves to me during these times.

I have also found the paper for the printer and envelopes. That means I can begin typing up a letter to HR telling them to shove it, as they've given me no further documentation of my unpaid leave of absence, a bill for the amount they overpaid me while on FMLA, information about Cobra, or a copy of my file, all of which I asked for back on May 9th. Cutting all ties makes me nervous, though, as I'm still able to get insurance with them for roughly $100 a month. I'm terrified of not having insurance, of being unable to pay for my prescriptions or the necessary doctor visits. Hopefully, unemployment and Cobra will help with that. I also plan to send in an application to the county for their adult pharmacy care program.

On top of that, management is bringing in inspectors to check out the apartments tomorrow. Ours is really fairly clean. I need to do dishes, pick up some trash. But overall, far more clean than our old apartment. I attribute this to the fact that we've actually tried to keep the place clean and to the fact that we now have hardwood floors. With Jb's dirty, outside work, there was no hope for keeping a carpet clean, add to that a sick cat, and well, good luck. Our new cat, however, is so low-maintenance, we're stunned. She leaves no mess, except right around her litter box. But that's very manageable.

I am, I admit, starting to feel a little overwhelmed by all the things I need to do. And the anxiety and IBS is there in spades. I'm due for another appointment with my PCP for blood work and with my gastro doc for a check-in. I really don't want to do either. And I've an appointment with the county to reassess my need for county assistance on the 14th. And a class on bankruptcy at the end of the month. In the meantime, we get by as best we can, and Kat Eggleston's "One More Step" is my theme song:

So you walk like you've never faltered
So you move like you still had faith
Head down and a turned up collar
Through a string of long, hard days
Walking through the darkest passage
Though you saw no light ahead
And your greatest act of courage
Was in taking one more step.

So you raise your voice in sorrow
'Til you heard no other sound
Saw nothing but your own shadow
With your eyes turned toward the ground
And when at last some kindness found you
Then it was as though you had slept
And the crowd in the dark around you
Were all taking one more step.

Oh, the warmest of standing water
It may some day come to freeze
So you'll tell your sons and your daughters
How to live with times like these
Tell them when their hearts are frozen
To trust their feet instead
When there is nothing left but motion
And taking one more step.

When we find that we are laughing
And we're running in the sun
Then we know that we still are breathing
And the longest night is done
And finally resting from the battle
Wondering where our feet have led
Amazed at how we traveled
By taking one more step.

Mixed State?

I'm depressed and irritable. My irritation is extreme. For example, Jb and I went to the store the other day. He usually can't stand the store, tries to rush me, acts out, won't go unless I have a list, but yesterday, he is all good humor, making smiley faces on the freezer doors, chattering at me, trying to get my attention, and I keep brushing him off, keep giving him looks, rolling my eyes. I cannot stand the constant nattering for attention. I'm irritated, so irritated I don't even want to be touched. Jb's ADD-like conversation and actions are overwhelming to me. I don't want to be pestered. I am upset at having to be at the store, at having to focus on the list I've made. I am functioning because I have to, because I can't let Jb down, but even then, the aisles are too many, the list too long, and I don't give a damn what kind of bread we get, or how much anything costs. I know I'm being cold to Jb, hurting him. But I can't help it.

We get through the store with only two brief brushes of rushing, snapping words. I can tell I'm wounding Jb when I don't appreciate the humor of his actions, or the way he's being so good at the store, helpful even. The rest of the trip goes fine. We drop the groceries off, pick up food. We get home, though, and it's suddenly a whole other game. We're arguing again. I'm not even sure about what, except I know, I know, Jb is trying to box me in. There's a sort of hopeless anxiety about it, where I want to cry because I can't do something simple like watch a movie. The argument gets way out of line, as they seem to these days. I'm going places I don't mean to go, saying things I can't take back, and Jb's had enough that he won't put up with it. I am being irrational. When we quit, Jb's the one who comes over and tries to talk to me, to tell me that I need to be more proactive in our relationship, that I need to participate in it. I have, obviously, been withdrawn. Jb is frustrated because I am not accessible. I am the burden. The depression deepens and I withdraw more.

Today, I know I am supposed to unpack something, one thing, sort through a bag of clothes, but I wander around, knowing I should do something, but unable to make myself do it. Instead, I'm online, in-game, blogging, reading, getting up, sitting down, and none of these activities last for more than 10 minutes at a time. I am unable to focus. I am writing in fits and starts. I am thinking about calling Jb to tell him I love him and that I'm sorry. I am thinking about cleaning. I am thinking about eating. I don't do any of it. There are things I should be doing: following up with my unpaid leave status at work, calling the county to check on my assistance and status, calling the credit counseling center or rescheduling my bankruptcy class. I have done none of these things. I break down and take Protonix and Levsin for my stomach and IBS. My stomach has been killing me. I only eat to calm it down, and that only lasts a little while. I probably wouldn't eat otherwise. IBS tends to be seasonal, and stress-related: both conditions are being met.

My symptoms are symptomatic. I can't focus, I feel awful. When Jb asks me how I feel, it's always, "I don't feel well," or, "I'm tired," things that mean, "I'm depressed. I'm unstable right now." Sometime toward the end of the night, during a CSI episode, I suddenly have this need to just kick and thrash about. Jb looks at me awkwardly, and asks what all that was about. All I have to say is, "I don't know. I just had to." A sudden surge of hypomania? Of wanting to crawl right out of my skin? I honestly don't know. Is this a mixed state? The depression is there, my anger and irritation are extreme. I don't care about anything. I have very little focus. I'm wanting to do something, then not wanting to do it. I stumble from one "diversion" to the next, not diverted, not really interested in doing anything at all. The tv annoys me, the internet is boring, gaming is unsatisfying. Of course, the IBS takes everything to another level. Not only do I feel mentally unstable, but I feel physically ill, as well. It's a double-hitter that makes the depression and irritation worse.

Slippery Slope

I'm heading for a depression. I can feel it coming on. I've lost interest in most everything again: reading, computer games, movies, sex, going places, doing things. I am angry at myself about this, so I'm cranky all the time and restless. Sometimes, instead, I'm listless and passive. The IBS and GERDs is acting up as well. I'm beginning to stress about things like Jb coming home at night. While other things, I don't care about at all: like whether the bills get paid, whether we have money or not, whether we have food or not. When Jb tries to ask me about these things, I get annoyed, short with him. He is constantly yelling at me for snapping at him. My temper and patience are nonexistent. I resent Jb's intrusion into my "world." More and more, he says things to me like, "You know, maybe you should try living here in reality, like everybody else."

This morning, on waking, I remember having a very vivid dream about living in a city with Hitler and being somehow close to him. Because he's a despot and mercurial of mood, everyone is always on eggshells around him, not wanting to curry his disfavor. I am someone he favors, and even I am very careful about what I do and say. It is stressful, this living on the edge, never knowing whether he'll be kind or cruel. And he can be very kind, as well as very cruel. There is a small resistance in the town. They know each other by the books they read. But those loyal to Hitler know them by the books they read as well. I try to sneak past a Hitler supporter with one of these books tucked among many. I make it, barely, out to a terraced park full of students and wildflowers, and there are two women who oversee the whole body of supporters. L-----, from the psych ward, is there in my dream. She screams out at a line of nuns who walk past the park; she was always screaming out about freedom and being closed in.

The dream is telling. I am having a hard time dealing with being home all day, then having Jb come home and disrupt my little world. It's like Jayne says in Firefly, "[He] damages my calm." It also sends me back to my childhood--when I lived in fear of my mother's moods, never knowing what they might be from minute to minute. I have to admit to myself that I've felt this way for the last year or so. Even when Jb was picking me up from work, the last hour of work, before I knew he was coming, I'd start to get sick to my stomach, I'd taste cigarettes in my mouth, and my IBS would suddenly flare up, so that I missed almost a half hour of work at the end of the day, every day. I think, perhaps, this is an inability to deal with change on a small, localized scale. And like in my dream, I used to escape into books. But since the hospitalization, I've had trouble concentrating enough to read them, except in small snippets.

Jb also gets on my ass--understandably so--about not having started to unpack. I took a week off because I needed it after the move, but I've no energy for it. It's been up near the 100s this week, so I tell myself it's because it's been so hot and I've been trying to keep the A/C off during the day. But the truth is that I simply don't have the motivation to do it. And Jb's losing patience with me. We had another fight last night. He told me that I've ruined every night so far in the new apartment, that I no longer participate in our relationship. And I'm left hurt and shamed and guilty and small--and angry at him for making me face the truth. I wish, sometimes, I could not listen. That I could wrap the bubble of my quiet day alone around me.

I cannot blame Jb, though. He is working hard, for both of us. He has every right to resent what he must see as my laziness. And it's like work all over again. How many times can you say, "I don't feel well," before they begin to look at you askance, like you're lying, or making it up. Depression isn't an excuse, but it comes across as one. Unless you've been there, deep and alone, you cannot ever truly understand what it feels like. Mild depression is not the same as major depression. Trying to follow each mood swing is exhausting. Depression is depleting. You are told, expected, to be this or that, but you can't be. Part of you no longer even cares that you can't be. Another part of you is angry and bitter, guilt-ridden and ashamed. And still, even though you want to meet someone's expectations, you can't. The will to try sputters and flags like a flame about to go out, and you're left feeling helpless, and you know it's all you're fault. You are the one who is broken. You are the one who is wrong.

7:36 a.m. Early Mornin' Check-In

Was up around 5ish this morning, then again at 7ish when I heard Jb getting ready for work. Took meds with a Barq's, and here's the fascinating thing about Barq's (yes, yes: we all know "it has bite"): it also has caffeine, unlike almost every other brand of root beer out there. So I've a 12-pack of the stuff, and my stomach is not a happy camper (TM). Caffeine exacerbates the IBS, which is always fun, and feeling sick to my stomach, literally, does nothing for my mood.

Note to self: No vivid dreams of late. Or, at least, none I remember. I'd like to say there was something just on the edge of memory when I woke up this morning, but it's long gone now.

9:59 a.m. Morning

Crawled back into bed around 7 and slept until 9:59 a.m. I don't know if this is a good sign, or if it's merely the fact that the phone rang three different times waking me each time. I assume the latter, but I could be wrong. The credit card companies are beginning to call, circling like dogs, hoping to get blood from a stone.

And that's the problem with being mentally ill for a long period of time. You lose almost everything. This particular bout of depression started in June 2008 and was coupled with IBS (Irritable Bowel Syndrome), which made the whole thing twice as difficult. I'd have anxiety attacks on the way to work, I'd throw up outside the metro, I'd have to stop halfway to work to use the bathroom, I even had an "accident" once. Sometimes, I couldn't even leave the house. There's nothing more humbling and incapacitating than being unable to control your bodily functions. Then there was the depression on top of it, or wound up in it, and there were days the depression was so thick it was like struggling through deep water, and I couldn't leave the bed.

Soon enough, I had exhausted my Family Medical Leave, though my doctor supported my need to be out of work intermittently as I dealt with both the IBS and the depression. But work only has so much patience with these matters, and I could see the moment my boss and HR began to treat me as if I was a liar and lazy, instead of incredibly sick. My boss began withholding work from me, and my job satisfaction plummeted. So did my self-esteem. It was cyclic, and only fed the depression. Eventually, she took me down to HR to formally reprimand me for what she called "abuse of sick leave," the terms of which said I was not to miss work or be late for over a month. That effectively severed any ability for me to make follow-up appointments with my PCP or my psychiatrist. I was so overwrought at my loss of control, at how far the illness had taken me, and my inability to live up to my supervisor's expectations that I had my breakdown in the HR office. I went into the hospital that night. It took them nearly nine hours to admit me.

When the psychiatric intake social worker began asking me about how I felt, about whether I had suicidal ideation, if I had a plan, I had to ask Jb to leave the room. I didn't want him to know how far down I'd gone, how very lost I was, how out of control. It was after the Heath Ledger overdose, and overdose was foremost in mind. I remember her asking me, "Why?" And I remember replying, rather bitterly, "It worked for Heath Ledger, didn't it?" She said, chastised, "Yes, yes, it did." And I could tell she took me more seriously then. I admitted to thoughts about cutting, about knives and razors, and fantasies about my sleep apnea machine, my CPAP. I'd lie in bed at night, put my mask on, wait for that first rush of air, and pretend it was a sort of poison gas, an euthanasia of sorts, from which I wouldn't have to wake up ever again.

I was in the hospital for nearly a week, partly because I entered right before a weekend and they don't discharge patients over the weekend, and partly because for the first five days, I didn't even consider going home, much less ask if I could. Instead, I wandered from room to room: the day room, the activities room, my room, the dining room, back and forth, down the halls and back. I didn't speak for the whole first day, and then I couldn't stop crying. I was shaky and in shock. They'd taken me off all my meds, waiting for a diagnosis from the doctor and psychiatrist who made their rounds in the ward. Not everyone knows this, but even patients who go in voluntarily are put in a locked ward. You sign away the responsibility of your life for at least three days. After that, you can make a formal request to be discharged.

The hospitalization was my first, and while humbling beyond anything I'd experienced, it was also freeing -- to be in a place with people who understood, to know I wasn't alone, to know I wasn't even as bad off as some of the patients who'd been in the hospital again and again and again. Being depressed, having suicidal thoughts, it was normal in the ward, and something that us patients often talked about at night before snack and after our meds. Group therapy was a laugh, something I often left to go curl up in my bed, but those late night sessions with the other patients, those helped far more than anything else could have. I'd like to write more about the hospitalization, but I think that'll be another post. There's simply too much to tell.

Anyway, it was three months after the hospitalization that I could even begin to think about a future, and that's when my job forced me into a voluntary resignation. I'd already been on unpaid leave of absence, but without money for all that time, there was nothing to do but let the credit cards go, to batten down and focus on the necessities: food, rent, my meds. And all the while, Jb supported me, even when I lost everything, even when I took him down with me. Now we're on food stamps, the county has me on temporary disability and cash assistance, and that in itself is a coup, as I've found they'd rather not help you than help you.

I've lost my train of thought now, and so I'll end this post here. I know I'll have to write more about the hospitalization at some point, but I think it'll come in fits and starts. My writing is shoddy at best these days, but I am writing, and that consoles me. Still, as I start feeling better and better, I worry about the day when I'll have to retake a useful position in society. And a fear flutters somewhere near my heart, and my stomach clenches to think about it. So not quite yet. Not quite yet. But maybe soon. Sooner than I'm ready for. I can't help but think: What if I can't hack it? What if the anxiety, the IBS, the stomach pain, the depression all come back? I know I'll be nearly manic the first few months: overworking, proving myself, charismatic among the other employees, perfectly charming with the customers. But then there'll come that fall, like a fall from grace, and I don't know how many more times I can handle that.

It reminds me of the Yeats poem, "The Second Coming":

Things fall apart; the center cannot hold

It's lines like that my brain seizes on, repeating them like a morbid mantra, over and over: things fall apart; the center cannot hold; things fall apart; the center cannot hold; things fall apart; the center cannot hold; I fall apart; I cannot hold.