A Bit Strange — More Crunch, Less Smoosh

The last bit has been so very up and down, my moods so quickly changeable, intense.  Many tears shed, even more maniacal laughter.  Sarcasm sharper than sharp, my brain is afire and I find myself plucking “damn, that’s good!” phrases and one-liners from it at random, and feeling prideful, in a sense, that my brain is so damn wonderful.  The up and down is fast becoming more of an “up” and hopefully, not a “too up” up.  If you had to ask me right this second how I will feel tomorrow, I really wouldn’t know where to begin but would bet on “elevated.”

Memories have been haunting me lately.  I attribute it to listening to a lot of different music, and also on the fact that my brain is whirring along faster than ever with the subtraction of a very sedating sleep medication that I decided I no longer wanted to take.  Belsomra…that stuff is of the devil himself.  So, I took myself off the “anti-nightmare” medication Clonidine, as well, because it just wasn’t working.  As my psychiatrist often says, no point taking something that doesn’t work.

I happen to know things are getting better (or at least more interesting) for my mental health because I can identify so closely with the word photos in this post.

I had a really great day today.  I made it back to the gym and my water-walking, I helped my mom roll almost three dozen burritos, LarBear and I have been clicking along, and I have all this new-found energy.  Great things build upon itty bitty good things, I have found, throughout life.  If I can just get started, I can be dangerous.  I’m like a snowball coming down the top of the hill that just keeps gaining new snow and getting bigger and wilder and faster.  Hmmm, this does not make it sound so positive, but it does FEEL positive.

I am working really hard in DBT on judgement.  Judgement of self, but other people, too.  First focusing on my own self-judgement, and the rest will follow.  I am trying not to judge my quick thoughts and upbeat mood and newfound energy, and to just accept them as they are, not try to label.

That’s hard, and if you have any kind of disorder in your life, you know that.  You know the SIGNS, man!  The warning signals.  I am glad the cycling isn’t so rapid right at the moment, but I WILL keep an eye on things if I continue to get racier in my brain and louder in the mouth.  I am so stinking tired of med changes and most days would like to get rid of them altogether, but the constant TWEAK that seems necessary is annoying.

I really must listen to one more song, smoke one more cigarette, drink a little more Crystal Lite, and try to go to bed.  I have a full day of things tomorrow, because I WILL be doing things, while I have the energy, seeing as it seems to be so fleeting.

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Riding It Out

Another long overdue post.  I’d say I am emerging from the ECT fog fairly well.  Memories are coming back, some with a vengeance.  Some parts of my life are getting more stable, some are about the same, some are a bit worse.

After the ECT, I started to get manic, then mixed, with the removal of most of my medication (for the purposes of getting ECT).  I managed to get put back on Lithium a few weeks ago, and that has been helpful.  I go in tomorrow to draw labs and see if I am at a therapeutic dose.  It sure does take a long time to get into my system, but it helps greatly with mania and mixed episodes.

The past few weeks, I have been very angry.  I mean, fighting mad most of the time.  That is abating, but the recurrence of PTSD nightmares has remained.  I am sleeping about four or five interrupted hours a night, due to nightmares.  I am afraid to go to bed, afraid to stay in bed, just afraid.  I had hoped I would never be back here again, but I guess that is too much to ask.

I start a new DBT group next week.  I am hopeful about it.  I met the group leader last week and she reminds me of Goddess of Mindfulness, so that much at least is comforting.  I have been probably less than honest with my individual therapist about the troubles I have been having, but have plans to really work a bit harder in there because, with Medicaid, I could be without a therapist at any time.

And yes, I do still have issues to work on.  Lots of them.  I am hopeful that, with the addition of DBT, I’ll get back to some good coping skills and maybe start sleeping again and decrease the hysterical crying episodes.  Right now the nightmares and the crying episodes are still daily things.  So, while feeling much better than before, still not quite up to par.

I know I’ll get there, eventually.  I have had great support from friends and family, and I just want to take a moment to say “thanks!” and also acknowledge that my significant other, LarBear, has been awesome overall.  There is a learning curve to each recovery period from a big fall, and I still feel like I am falling short of the curve.  At least at this point, I want to keep trying.

Open Letter to My Local Mental Health Center

Prepare for some rambling…

When I first sought your  help in 2009, I was worried I would not be accepted because I was considered out of your cachement area.  As it turned out, CMHC’s could not deny Medicaid clients based  upon cachement area.  This is a good thing, because in 2009 you allowed me to start your Intensive Outpatient Program in Dialectical Behavior Therapy (DBT).  I attended five days a week, for three hour days.  I can honestly say that this formal introduction to DBT saved my life.

You brought wonderful therapists into my life, some whom I thank God each and every day for.  There are too many to mention just one, but each of the IOP therapists are very special to me.  They gave me hope when I had none and taught me the skills necessary to survive with bipolar in a unipolar world.  The IOP program was just the tip of the iceberg.

After graduating IOP, you wanted me to do weekly DBT classes.  I was working at that point again and had difficulty with coordinating my schedule.  I hopped around to a few different groups, and then I gave up.  I went back to seeing the pdoc at my county’s CMHC, and continued therapy with Goddess of Mindfulness.

For a few years, my needs were fulfilled at my local CMHC.  It wasn’t the same, though — the therapists were not as invested, it was difficult to get a med appointment where the pdoc didn’t continuously cancel.  It was a fight to get any medication change.  It was if I would just come in to get the rubber stamp and then would be sent off on my way.

In 2012, I had a major bipolar meltdown and came seeking help from you again.  I needed that Intensive Outpatient Program, I needed those caring therapists, and I needed the care that I knew my own local CMHC couldn’t provide.

I started IOP again, and stopped seeing Goddess of Mindfulness, instead seeing Marty for individual DBT therapy.  IOP was very different this time.  The classes were extremely small, participation was minimal, the therapists often didn’t keep the group under control.

The times had changed — there was no longer a ten minute break after every hour.  I don’t think the therapists realized how difficult it was to sit for 90 minutes without a cigarette or a soda or a break when you are in such a mind-addled state.

One thing for sure — IOP wasn’t the same.  It wasn’t as helpful, I didn’t feel as successful, there was not much group interaction or cohesiveness, and frankly, most of the therapists seemed bored, as if they lacked passion for the subject now.

I moved quickly through IOP this course and started just seeing Marty individually.  She was a very different therapist than what I was used to.  She called it like she saw it, and the way she saw it was often very different from my view of things.  After about a year of seeing each other, she announced to me that she would be retiring the following summer.  After that, her heart wasn’t in it.  She certainly didn’t seem to care anymore, and it was like she had given up on me.

I decided to switch tactics and go for a non-DBT therapist there at the center.  That was worse.  She seemed cold and unfeeling, judgmental even as I would describe what was happening in my life.  I started to avoid appointments, and go for long periods of time without checking in.

During a time of mini-crisis, I attended a “Building Structure” group in which you basically made plans for each day and the day after.  It was a very useful group for me and I went for three weeks, then graduated.

I ended up going back to see Goddess of Mindfulness after that.  I couldn’t afford it financially in my budget, so I had to take $15 out of each weekly allotment and put it toward therapy.  In my eyes, it was a good use of money that I may have just frittered away elsewhere.  It still didn’t add up to what Goddess of Mindfulness should really be paid, but I was beyond thrilled when she accepted my request to be her client again.  Over the moon, really.

And since my 2012 return to the CMHC, there has been Dr. Wizard.  I kid you not, the man is a genius when it comes to medication.  He listens, makes small adjustments, is encouraging, worries that I am on too much medication, and, here recently, hospitalized me when it seemed to him like I was under too much duress.

I have never had a problem getting in to see my pdoc, and I thank the wonderful front desk staff for that.  Sure, calling the nursing line works sometimes, too, but the front desk staff are better at prioritizing clients and slipping people into time slots quickly.

When I came out of the hospital on Monday, I was in a daze.  I knew they had started me on a downturn of Geodon and had started me on Abilify, but I wasn’t given any titration recommendations.  I was just told to follow up with my pdoc at my next scheduled appointment on July 9th.  That was three weeks away.  I was feeling a bit better, but as a couple days went by, it was clear I needed more  support, possibly more medication.

On Wednesday, Goddess of Mindfulness had me call the CMHC to try and get an appointment.  I called the nurse’s line first, and left a message.  They called me back thirty minutes later and tried to tell me that there were no openings and I would have to “sit tight and wait” until the 9th.  The woman I spoke to barely spoke English and I actually ended up screaming into the phone, “I hope I don’t flip out before then!” and hanging up on her.  I know, real classy, Rose.  I’m out of my mind, I guess.

I then tried calling the front desk and asked to be put on the cancellation list.  I explained my situation and I was put as an “emergency priority I.”  I told them I only needed one hour’s notice and I could be there.  The front desk girl assured me I should be able to get in soon.

Much to my surprise, I received a call at 9:15 the next morning, asking if I could be there by 10:30.  Of course I can!  I made it down and Dr. Douglas kept the Geodon the same, but bumped up the Abilify.  He said, if all goes well, we can do it again at my next appointment on July 9th.  He was very understanding and caring, and we had a nice chat.

All in all, this is a good CMHC.  I think the DBT therapy program has possibly fallen by the wayside a bit, and I can tell you that the individual therapists like my last one should be fired, but what I really need is my pdoc and Goddess of Mindfulness, and I know I will be fine.