Throw Out a Lifeline

The last I wrote here I'd had a breakdown. A pretty good one. I didn't take my meds for a week. I wasn't eating. I had hit apathy so hard that nothing mattered at all to me. Part of this, Jb and I am sure is that I lost my therapist for about three weeks while she was nursing her son who'd shattered his foot and had to have multiple surgeries. I don't think I understood how very important therapy had become for me. How balanced it helped to keep me.

My dose has changed again. 100MG of Zoloft, 300MG of Lamictal twice a day, and Klonopin 3 times a day. We're winnowing the meds down, which is one of the reasons I like this psych. He had tried me on Lithium, and I couldn't stay hydrated enough to keep up with the shakes and disoriented, vertigo-like sensations. So we dropped as not a good drug for me.

In between, I've been moving along as well as I'm able. I had a week and a half after the major depression where I couldn't sleep. I'd be up until 5 am and running on 4 hours of sleep a day. I was restless in bed, could not fall asleep, thinking and thinking and thinking. I think I might have swung up into a bit of a hypo mode. Anyway, now that's gone, as if hypo episodes burn my body out, and now I'm feeling exhausted and unmotivated and all around... feh.

An amazing thing happened last night, though. Jb came with me to therapy. He actually wanted to. How many guys would do that for you? My therapist thinks he's the best thing on two legs. It was a productive session. I think he got to say a lot of things that were on his mind, and none of them exactly hurt or were negative toward me, but I couldn't help feeling guilty, and ashamed, and humbled by how much he truly cares for me, regardless of my condition. There was so much love and worry there that it really made me tear up.

So. Apparently, I have the best boyfriend in the world.

Last tidbit about what I've been dealing with. Balance issues. I'm still having them. In fact, right after the therapy appoint when we got home, I literally fell on my ass when I got out of the car and rolled down the grassy slope. I'm always tottering. I almost fell on Jb while he was lying on the bed, and when I was cleaning the other week, I feel smack on the metal garbage can we keep in the front room. I've bruises on my arm, bruises on my foot where I dropped a fan on it, and I've fallen into the closet door in the bathroom more times than I can count.

What else. I've a DHHS appointment to review my foodstamps and temporary disability. It's at 8am, and there's really no way we can work the single car situation with Jb working. I've called to see if they'll reschedule, but I had to leave a message. I'll try again later because frankly, I don't trust them to get back to me.

And the SSDI. I got the info about my doctors, though I couldn't get all the dates of tests and visits. I had to fudge and guess years of when I saw some of them. Best I could do. But I can't seem to get further than that. I brought up the online application page and just sat there looking at it for an hour, overwhelmed and unable to start it.

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.

Success!

Very brief post here, but I wanted to jot down what happened at the Department of Health and Human Services today. I got there an hour early (Because, face it, it's not the kind of appointment you want to miss; they can give and they can take away.) My new caseworker was so much better than my old caseworker, who made me cry. Of course, at the time, I'd only been out of the hospital a month. But this caseworker wasn't trying to tell me that a cell phone bill didn't count as a phone bill and yada yada. In fact, when I told her I never meant to have Jb on my food stamps account, she went ahead and took him off, even though I'm technically supposed to send in a form. And get this, with him off, my food stamps go from $58 to $168. Wee bit of difference.

As for the Temporary Disability/Cash Assistance, that's reviewed in December, and she's going to review the food stamps in December, too, since she wants to be efficient and not make me come in more times than necessary. She also said that as my medical assistance (i.e. health insurance through Maryland) lasts until April, my food stamps and cash assistance will probably be approved and renewed until then as well. Whew. One less thing to worry about.

On the down side, I still haven't received the packet from the medical assistance program that has my card or the information I need to start receiving those benefits. And the two therapists I was referred to through the mental health program don't work for the assistance program anymore. So yet another set of strike-outs. I swear, getting a therapist has been the hardest thing I've ever had to do out here. One guy offered to take me, but only for $350 up front and another $200 each session. I nearly cried I laughed so hard.

Oh! And my stimulus check came from the government. $600 big ones. And all of it is already spent. Go figure. But it's on necessary things. Some very expensive, out-of-pocket medical things, a couple new blouses to do interviews in when I'm ready for that, and a haircut that I've been dying to get. So, things are looking up. And despite the nerves, I felt okay today.

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.

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.