Willfulness in the Face of Necessary Medication

Anxiety and frequent panic attacks have been the menu du jour for weeks, now.  I have had my Klonopin prescribed as a scheduled medication, have had the med treater add Xanax as a PRN, and have been trying various and different DBT skills.  Very little works.  It probably works a lot less, because I am not very compliant with taking three to four Klonopin per day at scheduled times, nor allowing myself to take any of the Xanax that have been prescribed.  I have tried explaining it to my therapist, the not wanting to take more and more medication, the not wanting to become a “Klonopin whore,” the not wanting to start an addiction (because life is rough enough with *just* your regular, garden-variety mental illnesses to combat every day).

This has been a “problem” for me over the years — my distaste for (what I see as) excessive use of addictive pharmaceuticals, and, in general, not wanting to let myself just be numbed out day after day.  Is it better to suffer the multiple-times-daily breakdowns, than it is to just take a wee bit of Klonopin here and there?  My brain and heart are in a battle over it.  Those who know me best, who see me on a regular basis, they plead with me just to take a Klonopin.  Why am I being so willful, over some damn Klonopin?  Just take one!  It won’t hurt!

I have had years worth of numbing myself out with various psychiatric medications, a very brief (very, very brief) relationship with marijuana in college, and a couple very short-lived love affairs with alcohol over my 35 years.  I say “No, thank you,” to all of it.  It may seem strange, like, “what Rosa, you don’t want to get some peace?  Even your med provider thinks it is a good idea!” but it is a different scenario in my mind.  I will never go back to alcohol, to marijuana, to popping this pill and that in the hopes that I will get a bit of relief.  I never let it get to a point where it destroys my life, but I have seen so many other lives destroyed by chemical dependency, and so it is very easy for me to say, “no, not for me.”

Could I just take a little bit of Klonopin here, a tiny nibble of Xanax there, and be just fine?  Yes, probably so.  I have a hard time justifying my refusal to take medications that are prescribed to me, and I revealed to my therapist this week that, really, what is behind this refusal to take medications is the thought, the feeling, that maybe I don’t feel I should be taking ANY medications.  Maybe I don’t really have bipolar disorder, maybe I can be one of those people with bipolar disorder that does not NEED medication, but can manage things with a strict schedule and diet and exercise and meditation.  Maybe I am meant to be medication-free.

At the exact moment these words come to my mouth, I know they are untrue.  I quickly scan through the years that I tried just that, to treat my bipolar disorder without medication, and just how very dangerous it was for me.  How many terrible situations I landed myself in, how I barely made it through living in the big city alive, how I hardly escaped not one but multiple abusive relationships, how the thoughts of wanting to die and dancing on the edge of the Earth with death and Satan, himself, were a daily occurrence.

So, yes, I am prescribed quite the boatload of psychotropic medication.  I don’t want to take it, but I will keep doing so because I know in the wisest part of wise mind, that it is that medication that is making me “stable enough” to exist as I am.  I will think some more about the Klonopin and the Xanax, and eventually the daily breakdowns will become too exhausting to continue, and I might try taking some.  I won’t like it, and I will worry that I am doping myself into a corner, about becoming a Klonopin-whore  but it is quite possible that a little bit of Klonopin and Xanax thrown down my gullet on a semi-regular basis will decrease the multiple daily breakdowns, and that is something that needs to happen.

 

 

Contentment With a Side of Panic Attacks

Life is fairly good these days.  I’m attributing it to plenty of sunshine and DBT and working hard in therapy and having more structure to my days.  There are some big changes on the horizon, like moving, and QoB *finally* retiring (maybe), but those are good changes.  While my mood has been fairly neutral, I have been having some physical symptoms that have been giving me trouble.

Physical symptoms that I decided were lithium poisoning, because that is where the problem  usually is, but when that wasn’t the answer (after a blood test) and the urgent care provider sent me to the Emergency Room, I was stunned that I hadn’t thought of this:

from http://www.slideshare.net/mwalley/panic-attacksatnight

I was having every single one of these issues, a minimum of three separate episodes each day.  So, apparently, my anxiety (that I *knew* was high, but, um, it always is!) is manifesting into more physical problems.  Also known as, multiple panic attacks a day with very high anxiety between attacks.

So while I thought that I was mentally very healthy, because I was not feeling extremely depressed or extremely elevated, and because I was not having more than my usual amount of generalized anxiety, I misdiagnosed myself as having lithium poisoning or something wrong with my heart because it has been so long since I have had full-blown panic attacks.  I should note that these attacks almost always additionally come with gasping, sobbing, and cursing on the side.

I beat myself up that I didn’t realize my anxiety was so out of control before having this little Emergency Room epiphany, but I think that I was just so grateful to not feel extremely depressed, that I decided everything else was “fine” and that I was just “physically ill.”

I still “don’t feel good” physically and am going to need to get in to see my psychiatrist this week, but I am really not looking forward to that.  I reported increased anxiety at my last appointment, and I do have a PRN for anxiety that generally works.  It is only when the anxiety gets really blown up and into a full-on attack that seemingly nothing makes me feel any better.

I am curious.  Have any of my readers ever had something like this blow up out of nowhere?  I mean, it probably isn’t really “nowhere” and I just can’t pinpoint where it started.  Thoughts, feelings of commiseration, home cures (hahahah!!!)?

 

Ten Things of Thankful: Coping Skills Edition

 

Through living most of the last twenty years of my life with Bipolar Disorder and PTSD, I have picked up a trick or an idea or a method that works to help calm the pain inside my addled head.  Much of it is learned from DBT (Dialectical Behavior Therapy), a lot of it is common sense, and so much more came to me through the process of trial and error.

Captain Jack is right — it is often how you think about a problem, and your attitude toward a “problem,” that is the issue.  While I don’t often think of these skills after the storm has passed, when I am in the thick, I am really thankful for the ten random things listed below that help me get through:

1.  An extreme attempt to change body temperature.  From going and standing out in the winter air in shorts and a t-shirt, to a cold compress to the back of the neck, this is my number one go-to coping method.  It also works in the form of a super-hot shower, a super-cold shower, frozen bag of peas behind the knees.  I don’t know the science, but the temperature change trick almost always snaps me out of hysteria.
2. Coloring or doodling.  I have several “adult” coloring books and a seriously large collection of markers, pens, colored pencils, crayons.  This is becoming a more popular choice among many anxious people, and has even turned into a big of a “fad.”  The thing about this “fad” is that is REALLY works.  If you can get yourself coloring or doodling, you will find that you can turn your mind over much more easily than if you are just sitting and angsting.
3. Phone a friend.  Not just for “Who Wants To Be a Millionaire?”, this coping strategy works especially if you have one person in your life that can talk to you for five minutes and bring you outside yourself.  For me, this person is usually my dad and sometimes my mom.  They both know me well, and often five minutes after picking up the phone, I am mostly calmed down, or at least I have a plan to calm down.
4. Get a hug.  A hug, or really any physical contact, can be helpful.  LarBear knows that if I am really upset and he rubs my neck or my back, that I can start to calm down.  There is something reassuring about human touch, something that makes us not feel so alone.  Sometimes I can calm down if LarBear simply sits and holds my hand for awhile, even if he says nothing.
5. Get up and move.  Of course, this is easier said than done.  In the midst of hysterics, its tough to get up and do anything, but I find that if I can even get up and do a little pacing, or, even better, find a small area of the house to organize (like a drawer or a shelf…think small!), I can calm myself.
6. Five senses meditation.  This is a great grounding exercise and it is exactly what it sounds like.  Out loud, name five things you can see, five things you can touch, five things you can taste, five things you can smell, five things you can hear, five things you can feel.
7. Get it in writing.  Blogging is great for anxiety, but journaling or even free-writing can be helpful.  I have numerous written pages, where I have been extremely anxious, and have put pen to paper for a set amount of time (usually five minutes) and written down things as they flew through my brain.  It is an excellent way of letting thoughts go on down the road.
8. Mind your breath.  After the temperature-change exercise, the thing I do most to calm down is to focus on my breath.  There are many ways to do it, but my favorite is to do a breath in to the count of five and a breath out to the count of seven.  You might have to play with it to see what works for you, but if you can put all attention on your breath, you may be able to calm yourself that way.
9. Hug a tree.  No, seriously, I mean it.  Go outside and hug a tree.  Panicked, anxious, sobbing your eyes out?  Go hug a tree.  This is a very grounding exercise, and, similarly, sitting or laying in the grass can be almost as helpful.  Concentrate on the textures and feelings through your hands or on  your legs.
10. PRN medication.  As an opportunity of last resort, after I have tried all of these things, or if I have tried several and none are working, I will take a teensy dose of Klonopin.  I don’t do it everyday anymore, or even every other day.  It is meant for short-term, very occasional use, and I really don’t think there is anything wrong with using that tool in my toolbox, as long as I am not abusing it.

Do you have any coping skills that you use, that I haven’t mentioned?  I would love to hear from you and have a blog post full of what works for everyone!  In the meantime, as a PLUS-1, maybe take a few minutes and put a Ten Things of Thankful list on your own blog.  ‘Till next time!

The Quiet Crash and Burn

I am falling apart inside, and almost no one knows.  I don’t talk about it much, but I do cry a lot.  I find myself extremely anxious and irritable for no reason.  I find myself thinking negative things of myself and wondering why on Earth anyone would want to be in any kind of friendship or relationship with me.  I find myself worrying (unnecessarily, I am sure) that DSB is going to get tired of the winter depression and bolt.  But he did say it…every winter, here we go.

In insanely good news, I have my old therapist, Goddess of Mindfulness, back.  My previous therapist and I were not a good match, and I felt there was  more that I wanted to work on than what she wanted me to.  I saw her in early December, and she suggested that after another session or so, I wouldn’t need therapy at all anymore.  I thought on that, accepted that as fact, and then had to re-evaluate.  There is so much in my life that needs helping, correcting, tweaking, re-learning, growing through.  As long as I can afford it, and I need it, I’m going to find a way.

In terribly bad news, I have been significantly depressed since around Christmas, worsening around the New Year.  A lot of negativity, anxiety, irritability, sadness, crying spells, and three panic attacks.  I am not coping well.  I am just hanging on.

And it comes and it goes.  It’s the lovely ups and downs of bipolar disorder, those chaotic mood swings.  One minute I feel like I might be able to accomplish anything and the next, I can’t make myself take a shower or brush my teeth.  One minute, I’m cleaning the kitchen and then once I’m done, I’m sitting in my dining room crying my eyes out over some perceived slight.

This gets tiresome.  This year, after year, after year nonsense.  I should probably be using my sunlamp.  I have missed a few doses of Ritalin.  I should know what to do.  I should know exactly what to do.  It’s the doing of it that seems so impossible.  Get up and function, tough through it, stop being a whiner.  Just do it.

Is it really that simple?  Just do it?  Just get off your fat, lazy ass and do something about this terrible anxiety and depression that are pervading your life?  I think, well, no, it can’t be QUITE that simple, or I would have done it by now, 32 years later.  There are things I can do to make myself better, little things, and I am doing those little things.  Life is such, however, that all of those little things added together sometimes aren’t enough.

So you pick a fight with your boyfriend and sit and cry awhile at the dining room table.  And think about how he will probably leave you.  And think that you  have no one you can call.  So you cry some more.  And think about asking your boyfriend if he is going to leave you.  And hold your dog, it’s fur soaking up your tears, unconditional love if there ever was any.  And you calm yourself, clean your kitchen, and go to see if you can make a peace offering to your boyfriend.  And hope it works.

And for now, that’s all I have the power within to do.  Light that candle for me.

Permission to Abort Operation Anxiety

Today has been a week of realizing and, eventually, accepting that my general anxiety level has risen to ridiculous levels over the past few weeks.  For a little while, around the time that Sondra started getting sick I started having a lot of problems with depression — lack of motivation, feelings of hopelessness, extreme sadness, problems with food/eating, extreme moodiness and irritation, so on and so on.  Of course I couldn’t just accept it as that, as some situational issues going on — I had to wallow and moan about how life was just so AWFUL. 

As that depression started to lift, my anxiety became more noticeable, at least to other people.  To Dr. Love, especially, because he’s the one who has to deal with my not-exactly-rare erratic behavior day in and day out.  I’m not proud or happy to say that I really get bossy, controlling, and mean with him when I’m anxious.  I work all day long and, if I come home and there are a couple of dishes in the sink, or some project isn’t done, I’ll go off.  If it isn’t apparent to me that he’s been busy all day doing different things, I get irrational. 

Little things set me off.  I have an obsession/compulsion about the bed being made, in EXACTLY the “right” way, all of the dishes being done and put away, the kitchen being spotless, clothes put away in closets in dressers, the living room devoid of clutter.  When I’m in my right mind, and even sometimes when I’m in the moment, I know that all of these little things aren’t super-important in the grand scheme of life, and I’m usually a little bit (sometimes a lot) embarrassed by the time I’m done throwing my temper tantrum. 

And sometimes I’ll just come home in a mood and I will sit and pick things to death.  It can get really obscene sometimes — I will sit and obsess about Dr. Love possibly leaving me or not loving me or not being attracted to me and it is a very slippery slope in my mind until it is to the point that I’m asking him ridiculous questions like, “Do you ever think about breaking up with me?”  This really pisses him off to no end and he really doesn’t like it when I go on and on about how his parents hate me, especially when I go into such detail about certain instances that I am SURE prove just how much they dislike me.  He usually ends up walking away when I start really getting into this “no one loves me, everyone is going to leave me, everyone hates me” topic matter, just because he can’t deal with how irrational I am being.  I can’t really blame him, although it really REALLY pisses me off at the time.  The problem is that, in that very moment, he can’t stop my bad behavior.  Only I can. 

Basically, my anxiety can lead to some very intense moments and I consider myself extremely lucky that Dr. Love takes these situations and generally turns them around, not getting angry or holding a grudge.  He’s really good about trying to make me laugh and get my mind off things by acting silly or distracting me with something else.  Unfortunately, there have been many days where nothing can snap me out of it.

As I said, I have been thinking a lot the past week about my ridiculous anxiety level and have decided that I really need to do something pro-active about it.  I had therapy with Goddess of Mindfulness today and we talked about what I could do to feel less anxious.  I pinpointed that my anxiety really gets ramped up after I get off work and this is when I’m most likely to go home and blow up.

During times of less anxiety, I spent a lot of time sitting on my back porch, meditating and doing mindfulness exercises.  I don’t do that anymore.  At all.  During that time, I also cooked a healthy dinner almost every night, whereas most nights now it’s just whatever I can microwave.  I’m tired of coming home from work, getting pissed off at Dr. Love, yelling at him, then eating something out of the microwave and watching TV for the rest of the night to block out (usually ineffective) how anxious I am feeling.  It’s no wonder I don’t sleep well, when I’ve been revved all evening.

As a response to fear about losing Dr. Love, I have it in my head that we have to spend every second together and I realize now that is not the case.  Dr. Love gets his “me” time while I am at work, and I come home to him every night and weekend, never having even a moment where he’s not around.  This is completely not his fault, but mine. 

I don’t take any time to meditate, practice mindfulness, cook, exercise, paint my toenails, or anything else that would make me feel good.  I’m (wrongly) driven to sit by his side, even if we’re not doing anything and are just staring at the TV together (which doesn’t usually happen because he gets tired of watching). 

I talked with him about it last night and he agrees that I need to be taking time out to do things for myself to feel better, to feel good.  When I talked with Goddess of Mindfulness about it this morning, she suggested that I need to find a way to relax at the end of the day.  When I was doing my best, I was in a routine of coming home, going for a walk, cooking dinner, and then maybe watching about an hour of TV or spending some time on the computer. 

When I come home now, my anxiety is at an unreal level and I’m so overwhelmed.  GoM suggested that, as soon as I get home, I go sit out on the porch and listen to some mindfulness exercises on CD.  She gave me a few suggestions of ones to try out and a workbook also that may be helpful.  I’m going to Amazon later tonight and will give them a try and report back, if they’re any good. 

My hope is that, with beginning to relax myself through meditation and mindfulness the moment I get home, I will have a less anxious evening and will be more amenable to cooking, exercising, blogging, LIVING.  Fingers crossed.

So this song is repetitive, but the lyrics (comments) get stuck in my head and I’m always singing it to Dr. Love.  Enjoy. 

Plain White T’s, 1 2 3 4

Recognition of Pain

So I was sitting in the back yard, real quiet-like, admiring my surroundings, practicing some mindfulness, loving that it’s green and my flowers are blooming and I have the most amazing dog and boyfriend and KA-BLAM.  Cold liquid anxiety started spilling into my chest cavity, flowing up through my throat.  I almost fracking choked on it, it came so suddenly and out of nowhere and yet, from just around the corner. 

I have spent many-a-year in my life feeling miserable about every single last thing going on.  I have also spent and — let’s be honest here — still spend a lot of time dreaming up and exaggerating on things to be miserable about, just for the sake of having something to do, it seems, because I am uncomfortable with comfort, apparently.  It’s been some time since anything “bad” or “negative” has happened to me, that has deeply affected me. 

In fact, things have really been going my way — great (relatively) new boyfriend, awesome new job, my healthcare is affordable, I feel at peace with a lot of things, some little, some small that I never thought I would get over.  Things have just been good.  I have no doubts that things will keep coming my way, and I will embrace them, accept them, deal with them, change with them, adapt, accept, adapt, accept.  Because I know that is what.I.have.to.do.  Sink or swim, baby, no doggy-paddling to the side for a break.

A few blogs ago, I did a post for my Aunt Laura.  Was it sad and unfortunate that she died — that she left behind a husband and two children in college?  Absolutely.  Was it necessary for me to get all bent out of shape about it?  Likely not.  Was it even that event (or maybe the presence or lack of a different event) that had me bent out of shape, or was it more of a simple turning of my mind of my mood of my mind and my mood.  I can almost see the bend in the road, easing slightly to the left, arcing out wide then, turning in, turning out, turning in, turning on, turning off. 

Sondra is in hospice and it is very hard for me.  It is harder for me than I want it to be, which is something, since I usually want things to be as painful and drawn out as possible.    I don’t even know where I’m at with all of it.  The damndest thing, sometimes all I can think about are Kubler-Ross’ stages of death and dying and how I really need to be able to put myself in a category, in a box, in a shell, in a hole in the wall in order for things to be ok.  Like, if I could just find the right size box to fit this in, it would be ok and I wouldn’t have to deal with it anymore.  That sounds crazy, I’m sure, but my brain needs me to be in a category, so I have a definition, so that maybe I can talk to my therapist about this definition in some concrete way.

As I type this, I worry if I’m being overly dramatic or if maybe the feelings that I’m feeling are not real or justified, and I have given numerous speeches on the premise that “feelings just are.”  Jesus, why do I have to judge every step I take?  I’m even judging me judging myself.  And judging that.  It never ends and it makes my head spin sometimes when I think of the vile bullshit that I spew toward myself in my head. 

I spent the morning visiting people.  I couldn’t sleep, woke up at 5:30 a.m.  I even smoked a cigarette and tried to go back to sleep and just couldn’t.  I just laid there with itchy skin and anxiety.  So I got up.  Had some coffee, some cigarettes, a PB&J.  Then I started having that frantic urge to talk with someone, to connect in some meaningful way, to let someone know I’m up and smoking a cigarette and will-be-just-fine-thankyou.  God, I’m an attention whore. 

I visited Grandma this morning.  I didn’t stay long, but she said she was happy to see me and seemed to be in pretty good shape.  Mom says that she has had a cold, but she didn’t seem sick — she actually looked pretty healthy and perky, which always makes me so angry.  I don’t know why, or maybe I just don’t care to ponder that too far.  I just know it makes me angry.

When I was at Grandma’s, I had decided in my head that I was going to take Kizz to the dog park for about 30 minutes, then swing by the hospice and see Sondra quick before her grandkids came for the day.  I even had an appointment to get my eyebrows waxed, and I had this all worked out in my head perfectly. 

When I got out of the nursing home from seeing Grandma, I felt more anxious than usual, more antsy, especially for such a short visit.  Kizz and I got in the car and all I could think about was how I wanted to go see Sondra right now, right this minute, stop the car and put it in park right now.  It wasn’t rational, it didn’t make sense, it’s just how I felt.

So I took Kizzie home and went to the hospice house.  I felt immediately better when I saw her, just seeing her smile and be aware that I am there.  Her sister was there.  I can remember almost every single thing Sondra said, maybe because sometimes she was talking gibberish and I found it so strange. 

I was there when the doctor came in and saw her.  Her heart is starting to fail and her infection is still running it’s rounds.  She’s not “with it” mentally all the time now like she was just two days ago, when I saw her last.  It’s more than just being tired, more than just taking painkillers.  At least that’s how it feels. 

Its good for me, for my mental health to spend this time with Sondra, whenever I can.  I ended up being there for almost two hours this morning and would have gladly stayed longer and watched over her while she took a nap.  I told her that I would be around once everyone had to fly back home.  I don’t remember exactly what her response was, but it seemed at the time like she would really like that.