Medication Pro's and con's

This is not a medical blog and I very rarely post any real facts. It's all just opinion and my point of view.
After a long journey to find the right dose of medication I was extremely happy when it happened. I'm on 1mg Fluanxol, and 200mg Epitec.

I've felt quite stable on it, but I had also been seeing a psychologist. Those who've been the meds and psychologist route knows how well it can make you feel to be able to unload every week. To get a good dose of reality check, mixed with pep talk, and some really hard self exploration.

So I want to say meds came first and then came therapy, but I'm not sure. My psychologist is very skeptical of my bipolar diagnosis, and I don't blame him. The Psychologist who saw me before meds is quite convinced about the diagnosis, so a bit of a catch 22 situation.

For the 10 weeks I saw my psychologist I was pretty stable. Had some little lows and one little high, but pretty much stable. I felt okay. I managed to snap out of any moods relatively quickly, I think. My concentration has been getting better. My productivity has been getting better. I have improved in a lot of ways that have little to do with strictly mood, and I'm not sure what the effects of psycho therapy has on actual physical concentration issues.

So all in all one has to say that the medication has had a positive effect, and an actual chemical issue has been, if not solved, at least improved.

The test of Bipolar II in many cases seems to be "If the meds work, then we know for sure" It seems it is a very slippery one to diagnose, especially when, like me, one is on the lower end of the scale. The problem is even the lower end of the scale has a big influence on your life, happiness, and ability to lead a satisfying existence. It influences your relationships and it contaminates every thought.

The problem is I am experiencing some apathy. I've always despised apathy. I just can't seem get out of it, and it is becoming more noticeable  Great when it means I don't go into a really low down down deep depression, but it doesn't seem to be able to completely prevent that. It just prevents me from experiencing Joy and Excitement, and steals my happiness.

I constantly feel just subnormal. If normal was 5, and hypo manic was 10, and deep depression was 0 I feel like I'm on 4, most of the time. I can go up to 7 and I can go down to 3. But it would be an angry 7, I don't seem to be able to do a happy 7. But I am stuck on 4, and have been for some time.

The question I need to ask is: " Is it the medication, or is it my crappy life and history?" My psychologist is convinced it is the second, but like I discussed above, there is proof or at least soft signs, that the medication is there, and is doing some good. Might it not also be that the medication could be having some negative effect. Or is this what normal feels like. Is my natural mood pessimism?

I have heard Bipolar sufferers complain about that exact effect of the medication. I now have to figure things out on my own because my medical aid doesn't pay for more psych visits till next year, and I can't afford any visits either.

I'm trying to take some positive steps to improve my situation. I need to fix some of the big obvious crappy life issues, in order to find some success and happiness. I have worked hard to grow my experience and knowledge, so it might be time to give up on being self employed, and look for an actual paying job. I feel slightly more able to deal with other people,in a work situation, so I am hopeful that this will be a possibility. Unless of course my current workload increases sufficiently to provide for us financially.

These are the thoughts I struggle with at the moment. The apathy is making it more difficult to write as well, so I might be slower with that for a while. I find at least I can fake some enthusiasm with most people, but not myself. I probably just come across as really relaxed, but I can't describe this as relaxation. Inner anxious dialogue is still there. I just don't feel it.

Boundaries

I don't have very strong ones.

For a long time I had no idea of what boundaries really are. I think if you know me, especially online and have read here, you know my boundaries are very soft.

Wikipedia explains them as follows:

Personal boundaries are guidelines, rules or limits that a person creates to identify for him- or herself what are reasonable, safe and permissible ways for other people to behave around him or her and how he or she will respond when someone steps outside those limits.^[1] They are built out of a mix of beliefs, opinions, attitudes, past experiences and social learning.^[2]Personal boundaries define you as an individual, outlining your likes and dislikes, and setting the distances you allow others to approach.^[3] They include physical, mental, psychological and spiritual boundaries, involving beliefs, emotions, intuitions and self-esteem.^[4] Jacques Lacan considered them to be layered in a hierarchy, reflecting “all the successive envelopes of the biological and social status of the person”^[5] from the most primitive to the most advanced.

 After my little breakdown this week and a chat with my psychologist yesterday it once again came to my attention that my boundaries need some enforcing.

I had to deal with a difficult client, who refused to pay me, even though I did absolutely nothing wrong, followed every letter of the law, and tried my best to prepare them for a large bill.

I took it extremely badly and ended up feeling worthless, desolate, and hopeless. For the first time in a very long while I had suicidal thoughts, I felt absolutely useless. I only realised yesterday in therapy that there is absolutely no correlation between a client projecting their own crap onto me, and my abilities.

That's very blurry to me. I take any kind of rejection extremely personally, and half my emotional blocks have been because of that. I hurt so easily.

So now to figure out where it comes from and how to repair my crappy sense of self. No self esteem is so unattractive, and yet I can recognise and discuss it intellectually and still fail to apply it.

I don't have many psych visits left that the medical aid will pay for, and there is no way I can afford any more visits on my own, so I am very scared that I'm going to just revert to old behaviour and thoughts when I don't get my weekly dose of reason. My psychologist is very honest and I have learnt to trust him, even though that's hard for me, and I still hold back sometimes. It feels like we are making progress.

I don't like to see the hurt and pathetic little lost child part of me, but recognising and fixing that is what will bring the healing in all aspects of my life.

Low down mucky stickiness

What's really crap about being in a low down depression is

1. Everything you do seems too much effort

2. You feel stuck

3. I don't even feel sad or "depressed" just tired and blah.

4. I'm scared of this 'not feeling' state. It feels like this is how people feel before they do stupid dangerous things.

5. I see Caitlin trying her best to make me react emotionally but I don't know how

6. I can't make the bad thoughts go away

7. Everyone seems to see my reaction of depression as removed from their action in being an asshole. So they say "oh it wasn't me being an asshole that caused it, she's just all screwed up"

Yeah I am but you're still an asshole

No I am not going to jump of a bridge. but fuck it this sucks......

I think it might be the meds making me feel blah. I think i should see a psychiatrist even though I don't have money to pay now.

I want to crawl into a hole. I feel so stupid...so fucking stupid for feeling this

UPDATE: 8 Feb 2012

I started coming out of that funk after 24 hours, could definitely feel a slow improvement. It's quite weird when one pays attention to it. I'm feeling much better, thoughts are normalizing. I did try to force myself to just go on as normal and not just crawl into a hole like I wanted to.

Forcing movement when one feels frozen seems to help.

Now I just need more sleep.

History with Mental Illness. Part 1: Childhood

I’m trying to force myself to do the things I am promising to do. I said I’d do a post about my history with Depression, no matter how little I like to dwell on that issue.

I’m doing this as I believe everyone asks themselves the question at one time or another. “Is this feeling normal?” “Am I normal?” “Is there something wrong with me?”

Those are some of the things I have been asking since I was a child. I started reading self improvement articles in magazines around the time I was 10, because I knew something wasn’t quite right.

Obviously my environment was slightly dysfunctional as is about 80% of Families.

So my first documented, recognised episode came when I was in Std 4 (Grade 6) age about 11, I think.

My home-room teacher was on Maternity leave, and her replacement did not like me at all. To be honest I don’t remember much about what was said or done to me, if anything, but my perception was of feeling threatened to the extreme.

I was an extremely shy child, quiet and good in every expected way, maybe slightly dreamy and unfocused. I always did my homework, was never disruptive in class.

Somehow I did upset this teacher, and her, me, like I said I can’t remember the details of the Why.

So one Monday when my mother dropped me off at school, on her way to work I lost it. I was hysterical; I refused to go to school. She forced me out of the car, and drove away, and I ran after her. She probably didn’t know how to handle this, and took her only option (She had to get to work, kids don’t get this) so she kept driving.

What did I do? I went into the class to my teacher, face a mess of tears, and still ever so obviously upset and uncontrollably crying, and told her I need to go home I feel sick.

There’s very little of what happened that day that I still remember feeling, but being unable to stop crying is the most prevalent feeling still. I just could not stop and I did NOT want to be at school. I wanted to crawl into a dark hole. I wanted my room, my stuff, my safety. I felt embarrassed by my actions, I felt scared of what my mother would do to me. Being unable to stop crying and the horror of having to go to school that day was stronger than anything else.

The teacher phoned my mom and she picked me up again. I don’t remember the consequences of my actions. I have no idea what happened after this or the next time I went to school.

This event has stayed with me though because it led up to my mother taking me to a child psychologist.
I don’t know if she told me what was going on, but I was clever enough to know this was a head doctor and if I don’t tell him what he wants to know, what “normal” people would say and do, then I would probably be put in an insane asylum. I just didn’t want anyone to know I was crazy, as I felt I was.

So when he asked me questions I told him everything I thought would be the “right” answers. I’m not quite sure how I managed to know what the “right” answers where, but for instance, when he asked if I really liked spending every break in the library, or if I would rather play with friends outside, I told him I like playing outside, but sometimes my friends aren’t there.

This was Bullshit; I didn’t like the other kids. I got teased mercilessly, I felt self conscious, and I felt different. It felt like I was an alien, mixed in with humans. I knew none of the rules, and I couldn’t please anyone, even though I tried. I had been asking questions about my school work, that the teachers couldn’t answer.

I always seem to notice discrepancies, and I guess they felt threatened that I wouldn’t just shut up and conform. This was done quietly though. I was a “Good” Child in school.

I loved the library. I could read comics all break long, I could read books, I could explore everything I wanted. The Library teacher also loved me, so I felt safe there.

So almost everything the psychologist asked I answered non truthfully. His diagnosis, there was nothing wrong with me, it was probably a normal childhood stage, I would outgrow it.

So obviously I started thinking, if the lies I told meant I was normal, would that mean if I told the truth, that I was not? See too clever for my own good.

Well this was my first look into the world of psychologists. It took me many years to return, more successfully to the world of Therapy. By that time, though, I was forced to get help as I was at the point of no return