Obligated

I feel somehow obligated to put up a post, to talk about what's going on with me. But I don't have anything to say. I can't get up quickly, or slowly, and I can't bend over or else I lose my balance. I smacked my head into the closet door yesterday and nearly went down on the Ikea rug. The shakes are worse and are making it hard to type or use the mouse. I can't tell if the lymphedema is worsening because of the lithium or the deteriorating stockings because I can't afford new ones. And I forgot to eat dinner last night. It sat there right next to me, but I kept forgetting it was there. Jb tried to make me eat it. I just put it in the fridge. I am ... nowhere. I see the psych and therapist on Wednesday. Until then, I remain tired (I'm not sleeping well), unmotivated, and I feel like an old lady at 33. It's wearing on me. On a scale of 1-10 today, 10 being the best I've ever felt, which is more like a 12 when I'm hypo, I'd say I'm walking around at about a 3.

"Major Life Events"

More than once, I've heard talk about "major life events" having a direct effect on your level of stress. There's a whole worksheet on the subject. According to the worksheet, my score is somewhere around 1000, putting me at "an increased risk of illness." Though it says to look over the past year, I took stock of the last three years, and this is what I came up with:

An illness that sent you to the hospital 74
Change in your responsibilities at work:
fewer responsibilities 21
transfer 32
Troubles at work:
with your boss 29
Loss of job:
fired from work 79
Major change in living conditions 42
Change in residence:
move to a different town, city, or state 47
Change in family get-togethers 25
Major change in health or behavior of family member 55
Spouse beginning or ending work 46
Change in arguments with spouse 50
Separation from spouse:
due to marital problems 76
Divorce 96
Change in personal habits 26
Change in social activities 27
New, close, personal relationship 37
Girlfriend or boyfriend problems 39
Sexual difficulties 44
Major decision about your immediate future 51
Major change in finances:
decreased income 60
investment or credit difficulties 56

Additional:
death of cat
death of grandma

Quite a resume, isn't it? All of this is brought on by an e-mail from my "husband." He's prodding at me to start the divorce process, and while it's been nearly three years, which means it's certainly high time to get this taken care of, I feel lost at sea in terms of how to go about it. There's cost involved, which I can't afford, and a sort of panicky anxiety that kept me awake last night. And I can already feel myself slipping toward a depression.

I wish I could say it's only the paperwork and proceedings that are bothering me, but there's an old grief there, and a fear, that I don't think I've dealt with entirely because I happened so quickly into my relationship with Jb. And while there's nothing I regret in doing that, in being with him -- he's better for me and so important to me -- it's hard to shake off the memories of a ten-year relationship. It's surreal looking back, as if it were a life ago, and I can't remember who that girl was who got married, bought a house, lived this life with friends and family. It was a several states and a lifetime ago.

I definitely need to bring this up with my therapist. And I feel a little desperate about wanting, needing, to see her, but I'll find a way to get through until Tuesday. Until then, I hope Jb can understand if I'm a little more down, a little more distant. He has all my love still. But he knows how difficult it is for me to let go of the past, and today, it feels like the ghost of it is enough to overwhelm. It makes me shake when I go for my Klonopin like a druggie needing a fix.

What's worse? Jb's had almost as many major life events, and who and what is there for him?

8:24am Aargh

Could not go to bed last night. Tried. Honestly, I did. Sort of. Jb crashed around midnight, and I was still wide awake. Read some of Nora Roberts' Blood Brothers. Still convinced that she is a deceptively good writer. Stupid me, I held out for years thinking such a prolific writer must be a hack. Way to go, jackass. Granted, her novels--the ones I've been reading, the more supernatural ones--have the same structure: 3 women and 3 men brought together to battle some sort of evil, and in the process of the three-book series, they all hook up. But she does a wonderful job of characterization and creating a sense of a non-nuclear family, but a family all the same.

Anyway, off track. Could not sleep last night. Woke up several times. Up at 8:24am. Groggy per usual, but I don't know, my sleep pattern is definitely shifting. I'm finding it harder and harder to not stay up half the night like I used to. The fact that I resist sitting there watching Adult Swim all night helps, I'm sure. But reading with the light on probably doesn't. Still, I can't just lie there and think, and think, and think. Because I start thinking of blogs to write, or scenes to write, and what's happening in the book, or what I'd do or say if X, Y, or Z happened. Feh. Useless, stupid things.

Depression

The depression is still with me this morning. Coming up from sleep is like coming up from deep water, and I'm confused and off-balance when I wake. I realize I didn't take my meds last night. I am up at 1am, 3am, 4:50am, 8:30am, 9:40am. Something in me is empty, and it registers as hunger, so I eat two South Beach granola bars at odd times during the night. I feel nothing but this plateau of emotion that walks a straight line, never rising above the depression, or dipping below it. It's like the static buzz of white noise in the background, constant, consistent. When I am depressed, the only things I seem able to do are the passive things. I can read. I can watch movies. I can--without effort--fall into someone else's story, someone else's life, and subsume my own. In fact, I want to. I don't want to think about myself, or I how I feel (or how I do not feel, which is more accurate).

I know why everyone prefers mania, in whichever way it manifests itself. Because then, you're active. You may be crawling out of your skin, your brain may never stop, but you're productive. You can pretend normalcy. You can achieve things. Sometimes. When it isn't too bad. Yesterday, I accomplished so much, so much more than I had in days. But that night, I was left feeling depressed and bodily tired, while my mind wouldn't let up. It kept going and going and going, despite my body's inability to keep up, but that never shut my brain down. And so I laid in bed, anxious and restless, and unable to stop thinking, but heavy and leaden feeling, depressed at the core.

This is when I'm unsure of this "bipolar" diagnosis. In the past, yes, I've had full weeks, even months, of depression, or mania-like symptoms. But these days, nothing lasts. I don't have hypo/mania for more than four days. It's usually for a day, even an afternoon, then down into some anxious, irritable mixed mood, and further into depression--all within two days. The downs last longer. I'm almost positive of that. Or maybe I was feeling fine, happy, wanting to get out of the apartment, do things this weekend, and then, like a punishment, several days later, the depression hits. And it is like a punishment--for having too much normalcy. Always, it is: this too shall pass. And it does. The good and the bad. Round and round in an unbreakable cycle.

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.

6:00 a.m. Med Check

Woke about 5:45 a.m. Took my meds. Ate them with some cheese and crackers--got my protein in. I now sing Kate MacLeod's "Me and My Medicine" in my head every time I have to take my meds:

"I'd rather be a pillar of salt
Then to leave my self behind"

Didn't sleep very well. Vivid dreams again. More on those in the next post. Woke up achy, probably still because of sleeping on the floor. Went to bed around 11ish last night.

8:10 a.m. Meds Check

Saw the psych doctor on Monday, the day after the move. Told the psych nurse practitioner that I had been feeling depressed, wishing I were back in the hospital, thinking bad thoughts, but not to the point of having a plan. Just the beginnings of them. I was crying more, acting out and difficult to handle, and not interested in much, despite the obvious need to pack and move. I told her that I know change is a trigger for me, and that I usually go depressed afterward. I'm still sleeping a ton. So she tweaked my meds and actually put me on an antidepressant along with the sleep aid and mood stabilizer. Why I wasn't on one before this, I've no idea. There was also talk of raising my Lamictal because of the anger and irritability, but we never settled on a dosage.

Here's my new list of psych meds:
Wellbutrin XL 150 MG 1x a day (antidepressant)
Lamictal 100 MG 2x a day (mood stabilizer)
Remeron 30 MG 1x a day (sleep aid/sort of an antidepressant; up from 15 MG)
Klonopin 1 MG 2x a day (anti-anxiety)

Other meds:
Benicar HCT 40/25 MG 1x a day (blood pressure)
Protonix 40 MG 1x a day, as needed (gastro-intestinal pain)
Levsinex .375 TIMECP 2x a day (abdominal pain/IBS symptoms)

Add to that the 2 Tylenol or Ibuprofen I've been taking for my left knee (osteo-arthritis is acting up with all the rain and change of seasons), and I'm starting to feel like I need a day-of-the week pill box with separate day and night chambers. Not to mention that you'd think someone with Bipolar, IBS, GERDS, lymphadema, and osteo-arthritis could get a response on her medical assistance application from the county. It does hurt the morale.

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.

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.

7:01 a.m. Spoonful of Sugar

So, up at 7. Taking my meds with a 7 Layer Bar from the batch I made yesterday, which, apparently, Jb doesn't like. He's more a brownie/cookie man. Ah well, more for me, I say. Being good about taking my Lamictal and Klonopin. We'll see if I crawl back into bed this morning or not. Too tired now to be coherent. More to say later.

6:03 a.m. Compliant

Up at 6 this morning. Having my breakfast, which I don't want, and taking my 200MG of Lamictal and 1MG of Klonopin. My neck muscles and shoulder muscles and most of my other muscles are sore, like they've taken a good beating. I've read this can be a side effect. My eyes are also bloodshot, which is new, and somewhat disturbing. If I had any dreams last night, I don't remember them. Too tired to say much else.

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.

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).

11:24 p.m. Wake Up Call

In and out of sleep until 10ish. Try to find it again, but my brain is wracked with scenes from the novel I woke up to yesterday morning. I lie in bed and let them play out in my mind. Question them. Turn them over. Is it too much like any other book I've read? Of course, aren't all plots derivative? It's the characters that drive the story, make it unique. I'm unconvinced. Still, the characters seem to live and breath in my head, having their own voices and desires.

I've been reading Madness: A Bipolar Life by Marya Hornbacher. Not the way I usually read, devouring books in a day's time, but in the way I read now, quick, but slow, scanning pages, but only able to ever absorb a few pages at a time. This makes Marya's book perfect, as her chapters are often only a few pages at a time. Sometimes, it's not until I've read some of her book that I understand what is going on in my own head. For example, I am, and have been, screening my calls. Not because I don't want to talk to people, but because I can't. It's exhausting. Similarly, I don't think I'll be going out today. At best, I hope to take a shower. I haven't in days. And I'm not sure if I've missed my appointment with my psych.

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.

9:53 p.m. Waning of Words

Forecast: Frustration with slow country songs scattered throughout the afternoon. Moodiness experienced in the evening with a waning of words towards 10 p.m.

2:54 p.m. And Down Again

...

What more is there to say. -poof- From up, to down.

The energy feels like it's hiding somewhere, but it's not accessible right now. My lids are heavy, and so is my body. My mind, however, continues with this subtle static.

11:26 a.m. There and Back Again

I'm back in bed by 8:30 a.m. -- just as Jb's getting up. I stay in bed until 10:30 a.m. My dreams are vivid, some sexual, though I don't remember any of them. I heard the phone ring at one point, but decided, as I usually do these days, to ignore it.

Once I'm up, I'm... up. I still have energy. I still feel good. I'm ready to take on the day. I hop right into the kitchen to make Pillsbury Sausage and Cheese Crescent Squares for breakfast. Another surprise for Jb. They take preparation -- love -- to make and bake.

I want to play WoW today too, which I haven't really wanted to do in ages, though I have -- for Jb's sake. But it was always a task, something I was doing as a means to an end: to make Jb happy. Now, I actually want to. The way I want to read. Knit. Write.

My focus still isn't what it might be. I want to do everything at the same time, or 2 or 3 things, at the very least, and so sometimes I alt-tab between 3 different wants, not really focusing on any one thing, but spreading my focus, and thus, my productivity, thin.

Note to self: I am still unable to reach for some words. "Productivity" eluded 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.