Psychiatry Appointment

Late tomorrow afternoon, I have an appointment with my psychiatrist. I’m really nervous about this appointment. He is going to go over my Clozapine blood level with me and change my dose. I’ not really worried about that, but I have just decided that I don’t want to do ECT anymore. I’ve been thinking about this for a while now, but I finally made my decision (I think). Right now I’m going every four weeks. So at the very least, I could just start by taking an extra month off and seeing how that goes. If it’s a disaster, then I can think about going back on it.

I wrote down on paper what I want to say to him because I don’t normally stand up for my opinions.I don’t like any type of disagreements. Since I wrote it down, then I know I will be able to say exactly what I want to say. I’m going to tell him, ‘I am no longer willing to do ETC treatments. The stress on my body, the memory loss, and the loss of words in conversations is too much for me. It has been this way for a while. I tried putting it off, but I can’t wait any longer. I’m not willing to do the Ketamine treatments at this time.’ Hopefully I can stick by what I say. There’s a better chance of that happening since I wrote down what to say.’ I’ll let you all know how it goes.

Celebrating My Husband’s Birthday

Today is my husband’s birthday. We’re going to celebrate at his mom’s house with anywhere from 5 to 19 people. I wish I knew how many people to expect. However, I should be used to this by now. This is how it usually ends up going for every birthday and holiday. I’m looking forward to seeing my step-kids and my granddaughter. I have a good relationship with my step-kids; it’s always nice to see them and be a part of their lives. I get along with everyone in his family; I just sruggle with not knowing what I’m walking into. I also struggle with crowded spaces, but it will be fine. I’m grateful to get together with his family.

I plan on taking today off from working out. My husband and I have been enjoying great workouts. Yesterday we ended up just doing cardio, but it was a good workout. I’m hoping to lose some weight; I’ve gained a lot of weight during this depression that I’ve been going through. To be exact, I’ve gained 39 pounds. That’s way too much; it’s time that I turn this around. And it’s so much easier working on losing weight with my husband. I’m happy to have the support and encouragement; we are there to help each other reach our goals.

Physically And Mentally

My body is just as screwed up as my brain. I had my first surgery when I was 16 years old; it was a cardiac ablation. My heart rate would randomly jump from normal up to 200 or more, and I would pass out. A year later, I had a tonsillectomy. In 2009, I had surgery on both of my knees. A year after that, I had a tubal ligation, which I will explain. I had a total hysterectomy in 2014.

The tonsillectomy is pretty much self-explanatory. I chose to have my tubes tied in 2009 when I was living in Connecticut. This was after my total breakdown. My psychiatrist had to write a letter explaining that I knew what I was doing and was making a sound decision. I decided that I have a hard enough time managing my life. I’ve had ups and downs; no matter how hard I try, I can’t always take care of myself. I’ve seen many people struggle with being a parent; it weighed on them so heavily. I didn’t want that to happen to me or my child. I decided it was better for me not to have a child. For me, this was the right decision, but it has been really hard. It’s been extremely difficult for me to not be able to have children. I often cry uncontrollably because of that fact. A year later, I ended up having to have a total hysterectomy because of severe endometriosis.

I pretend to be okay with the fact that I can’t have kids of my own. I’m a 31 year old grandma, who has never been a mother. Of course I wish I could have kids, but if I had to do it all over again, I would still make the same choice. I made the decision because it was the right thing to do for me, not because it was easy.

Right now, the most difficult problem I deal with physically is the interstitial cystitis. I currently get treatments every week; sometimes I can stretch it out to as much as every 3 weeks. The treatment involves getting catheterized so the doctor can put medicine directly into my bladder. This problem has been getting worse over time. I also have chronic bronchitis and pneumonia among other conditions, but luckily that’s not acting up as well.

I know that I’m luckier than many people, but I’m also worse off than a lot of others. Why do I have to have both physical and mental health problems? Why are all my problems chronic? Living with and managing physical pain as well as mental health is exhausting.

Getting Through The Days

I went to the gym with my husband today. We had a great workout. I’m proud of myself for not pushing too hard. I normally push past the pain, and then I end up regretting it later. I’ve had a lot of knee pain over the years. I had a double knee surgery to correct the misalignment of my knees in 2009. I know that I’m going to need another knee surgery at some point, but I don’t want that to be any time soon. So it’s important not to push myself too hard on certain exercises, such as weighted squats and lunges.

After our workout, we went to visit with my father-in-law. We don’t see him often enough. He’s so nice and easy to get along with. We’re going to see him tomorrow too. My husband’s birthday is on Wednesday, he’ll be 42. I told him it’s like turning 21, twice. We’ll see his mom on Wednesday; she wants to through a ‘party’ for him. I’m a bit apprehensive because I don’t know who will be there. I just found out that she invited some aunts, uncles, and cousins. I like everyone; that’s not the problem. It’s just difficult when there are that many people in one house. My husband even said that all he wanted was for me, his mom and her boyfriend, his brother, and his kids to get together; but that’s not what’s happening. Plus, we want to see our granddaughter. The more people who are there, the less time we get to spend with her.

No matter what the circumstances, it will all work out okay. It just means that I will probably end up taking a Valium before I get to the party. There’s nothing wrong with that. It’s just another thing that adds stress. But I’d rather have too much family than not enough of it. We’re lucky to have loving and caring family on both sides; his family and my family. Having family that cares and supports us is wonderful.

I Did Well… For A While – My Life: Part 5

After working at the rehab for 9 months, I decided I wanted to move forward with my life. I applied for many jobs in Phoenix. I got a job as a receptionist for a legal compliance and ethics e-learning company. I found an apartment in Phoenix and moved there with a guy I was dating from the rehab, but that relationship didn’t last. I don’t know when our relationship ended, but I think we lived together for about a year. I adopted a dog and named him Cash (after Johnny Cash). He was awfully energetic and liked to chew on everything. I learned how to train him, and he started to behave properly. Cash came with me to AA camping events, which was a blast. At some point, I found a great AA club where I would go to the same meeting every day at 6pm. I don’t like change, so moving was scary. I like to keep a regular schedule. I made a lot of friends at the meeting, but I would only go to that one meeting every day. One of the guys I met was Brandon, who became my best friend. He had the same sarcastic attitude that I have and we got along wonderfully.

I was doing really well at this time in my life. I got a promotion at work, I was able to live on my own, make friends, and maintain my sobriety and my mental health. I took my medication and saw my doctors regularly. I was seeing the psychiatrist that was treating me while I was in rehab. Brandon asked me to workout with him. I told him no for months, and then I ultimately caved and decided to go with him. I was terrified because it was something new, but Brandon made me feel safe. After working out with him once, I was hooked. I loved it. We started working out together 5 days a week. It helped me get through my days at work. I would go to work, then workout with Brandon, and then go to my meeting (often with Brandon). I was happy with this new schedule; it was working well for me.

In the beginning, I wasn’t open about my mental health when it came to my AA meetings. My close friends knew, but that was all. Eventually, I ended up talking about my bipolar disorder in a meeting. I felt as if it wasn’t accepted. Several times, I was told that I didn’t have a mental health problem. It was just an issue to work on through step work. That was a problem for me. I didn’t feel accepted. My mental health was a huge part of my life. Even when I’m doing well, it’s still a large piece of my life. I was stable for years. That had never happened to me before.

My psychiatrist decided to wean me off my meds slowly because I had been stable for such a long period. It was possible that my mental health issues were drug related, so we thought it was worth a try to get off medication. I was down to two medications, and then she took me off the Seroquel. About 4 months later, I started to fall apart. I thought it would be a good idea to go to therapy again because I started to remember things that I hadn’t previously remembered. These memories triggered what was eventually diagnosed as PTSD. With the PTSD coming up and the med changes occurring, it was like the perfect storm. I started having hallucinations and was shaking uncontrollably. My psychiatrist put me on Abilify, but that made it worse. I barely slept for 3 weeks.

My job let me work from home, but after a little while, I couldn’t even manage that any more. I went on short-term disability, which then turned into long-term disability. There were times that I struggled to feed the dog. My mom came out to stay with me for a little while, but she couldn’t be there all the time. I decided to move back to Connecticut because I couldn’t be on my own anymore. I’m lucky that she was able and willing to let me and my dog move in with her. My long-term disability turned in to Social Security Disability.

I thought writing my story would help my memory, and it has; but it has also become difficult for me. There’s a lot that I struggle to remember, and a lot of other things I wish I didn’t remember. I think I’m going to take a break from writing my story for a little while.

The Beginning Of It All – My Life: Part 2

Trigger Warning: The following talks about drug and alcohol abuse, cutting, and suicidal gestures.

I believe that I started to change when I was in 7^th or 8^th grade. The friends I chose were different from before and I became a sad and angry person on the inside. Many kids go through changes around this age, but I took it a bit too far. Then, one day, I was told that my dad was diagnosed with multiple myeloma (bone marrow cancer). I was devastated. My whole life was turned upside down. The day after I found out about my father’s diagnosis, I remember walking into town and feeling very upset. As I was walking, one of my new “friends” saw me and asked what was wrong. I told him about my father and how upset I was. He gave me cocaine and told me it would make me feel better. That was the start of a treacherous journey over the next many years. Cocaine made me forget how horrible I felt, although it caused so many other problems.

My dad’s diagnosis was a trigger for me, but if it hadn’t been that, it would have been something else. My drug and alcohol use as well as my mental health problems were not my father’s fault; in fact, they were no one’s fault. It’s just a part of my story. I couldn’t believe I was losing my father and I didn’t know how to handle it. My parents had me go to therapy, but it wasn’t helpful because I wasn’t honest with the therapist. Over the next six or seven years, I tried just about every drug except for meth, and that’s only because it wasn’t available where I lived. The beginning of my drug use was the beginning of my downfall, mentally and emotionally. I also started cutting around the same time that I started using drugs and alcohol. Cutting caused physical pain, which replaced the emotional pain. It was another outlet that caused more harm than good.

I remember that I got caught smoking one day. My parents confronted me about it and I lied to them, which is what they were more upset about. Instead of grounding me, I was allowed to do whatever I wanted, but I had to be with one of my parents at all times. My mom said that I lost their trust. The punishment lasted several months, which felt like forever, until I could prove that I was trustworthy again. I didn’t understand then, but I get it now. Trust is something that’s earned; it’s not a right for anyone.

When I was 14, I made a suicidal gesture. I took a lot of a medication, but I took just less than what would kill me. I knew exactly what I was doing; it was a cry for help. This was my first hospitalization. I met my first psychiatrist at this hospital; he treated me while I was admitted and I kept seeing him after. I was diagnosed with bipolar 1 and borderline personality disorder. I think the only reason I was diagnosed as borderline was because of the self-harm. I still think about cutting, but I haven’t done it in well over a decade. My family was very supportive and caring. I even remember at one point, my mom and sister completed the Family to Family course offered by NAMI so they could better understand me.

I tried just about every medication and med combo available, but nothing really worked. They probably didn’t work because I was also self-medicating with all sorts of drugs and alcohol. I actually told my psychiatrist about the drugs I was using. I often went to our appointments high. He did nothing about it except ask me not to do that again. Of course I didn’t listen to him. There were also some medications that caused me to gain weight. One med caused an 80 pound weight gain, yet he never mentioned that it was an issue at any of our appointments. Now, as an adult, I’m surprised and disappointed that he never informed my parents about my drug use or the side effects such as weight gain. It never seemed as if that psychiatrist at that time cared about my well-being.

I left high school after my sophomore year and went to college at the age of 16. The college was meant for “younger scholars”. I did meet some great friends there who I’m still friends with now, but I also started using more drugs. The actual school part was not a problem. I still did well in my classes, but I stopped caring about school in general. I only lasted one year at that school before dropping out. School was interfering with my drug use, and my mental health was a huge endeavor. I couldn’t do it all, so I left college and eventually got my GED, since I left high school before graduating.

I think that the biggest reason that every attempt to stabilize my mental health didn’t work when I was younger was because of my drug and alcohol abuse. I don’t know how to use anything in moderation. I could never have a drink, I would have a bottle. I couldn’t take just one hit; I had to smoke the whole thing. Even if I was doing well, the drug use would screw me up completely. I also didn’t work very hard on my mental health, I didn’t care very much. Now that I know how much of a difference I can make on my own mental health, I take responsibility for my teenage years being mostly a disaster.

Further Frustration with My Pharmacy

I’m beyond frustrated at this point. I’m so annoyed and pissed off. I’m still having problems refilling my Clozapine. Yesterday, I had to call the pharmacy 6 times. I finally found out that the problem with my prescription is because of the national database. I don’t know what problem the national Clozapine database has found. My blood work is better than it used to be, it’s finally back to normal. My doctor waited a few extra days to write my prescription because he was waiting for my Clozapine level blood test to come back. That test took a few extra days. I usually get my script on Sundays or Mondays, and this time he didn’t write my script until Thursday. Maybe that’s the problem.

I have an appointment to go do my weekly blood work today. Part of me is wondering if I should even get it done since my script from last week hasn’t been filled. I’m out of Clozapine. If I can’t get my script to be filled today, then I have no Clozapine to take. I wonder if there will be bad side effects or withdrawals. I’ve forgotten to take the medication by accident once or twice. When that happens, I usually end up feeling sick to my stomach, more like a stomach pain. I have no clue what to do. I keep calling the pharmacy, but I’m getting nowhere.

Clozapine Refill Frustrations

I started my Clozapine rechallenge on April 3rd; I have now been taking it for close to 8 weeks. My doses have increased slowing over that time. I’ve had some side effects, but nothing that can’t be managed or dealt with. Some of the side effects have gone away over time and others I’ve learned to deal with to the best of my ability.

I just had my Clozapine level taken and the results finally came back yesterday. My level came back at 80, which is very low. I’m assuming that my doctor is going to be increasing my dose, but I’m not sure. I don’t really know where he wants my Clozapine level. A low level is between 50 to 150 ng/mL, 200 to 300 ng/mL is a medium level, and 350 to 450 ng/mL is a high level. I’m pretty sure that the therapeutic level begins 100, which I haven’t reached yet.

Every week I seem to have problems with my blood work and filling my prescription. People at the pharmacy tend to lose track of my blood test results, which they need in order to fill my prescription. I have finally learned that if and when the pharmacy says they haven’t received my weekly blood work, I just need to tell them to look in my file. I thought getting my script filled would be easier now that I’ve figured out that part. However, this week’s prescription has been difficult for another reason. First, my doctor wanted to wait for the Clozapine level results so he knew how much to prescribe. I normally get my script filled on a Sunday or Monday. It’s now Thursday, so I can’t last much longer without a refill. My doctor has called the prescription in twice to the pharmacy. He said that he was on hold for 10 minutes just to leave a message. I’ve called the pharmacy 3 times today regarding this script, and it still isn’t filled.

I don’t know why it’s so difficult to get this prescription. It seems to add a great deal of anxiety to my life every week. I’m actually taking Valium just to deal with this situation. I wonder if it does more good than harm.

Family Dinner

My husband and I decided that we want to see our granddaughter; it’s been about a week since we’ve seen her, and so we invited his daughter and boyfriend over for dinner. This all happened last night, and the dinner is tonight. That’s a lot for me to handle. I have to clean the entire house and cook a meal. Then, my husband decided he would invite his mother over because she doesn’t get to see the baby very often. It’s a very sweet thought, but it doesn’t mean more work for him, just more for me. Then I realized I can make lasagna! I made some lasagna with my mom when she was out here last time. I don’t have to do anything, just heat it up from frozen!

Okay, so now all I need to do is clean the house, do laundry, and make garlic bread. That’s not that bad. However, cleaning the house will take a while; there’s dog hair everywhere, even though I cleaned the whole house just a couple of days ago. I also have to figure out where people can eat. There’s not enough room in our house for our dining room table, at least not the way I want it. A couple of people can eat at the counter, there are bar stools there. And then there’s the couch and the desk. I can make that work.

Why is it so stressful having people come over your house? Is it just me, or are other people like this as well? I feel like my house needs to be sparkling clean and organized if I’m having any company over. At least all I need to do is clean the house; I have more time to do it since I don’t have to cook. I don’t think I’ve ever had this many people at my house at one time, so I’m a bit anxious. I’m sure it will all work out, but I will probably worry about it all day.

Bipolar Risk Factors

I suppose that I’ve been in my head a lot lately. I’m trying to figure out the answers to some questions that probably can’t be answered. However, I’m going to try to find some sort of answer because that’s the kind of mood that I’m in right now. I want to know the answer to the question, “why me?” I think about this a lot, but I’ve never actually tried to really figure it all out. Bipolar disorder is not caused by any one single thing; it is instead caused by multiple factors.

The following is general information regarding bipolar causes and risk factors. The information below is not advice, and should not be treated that way.

Family History and Genetics: Individuals that have bipolar disorder in their families are more likely to develop bipolar disorder themselves. This is especially true for individuals with a parent or sibling with bipolar. This doesn’t mean that people with a family history of bipolar will develop the disorder themselves. Also, individuals with certain genetics are also more likely to develop bipolar disorder.

I know that personally, there are mental health issues on my father’s side of the family. His sister and one of his brothers have known mental health diagnoses, but I’m not sure what they are. There is also someone on my mother’s side that struggles with depression. I know that there is no one diagnosed with bipolar disorder on my mother’s side. Neither of my parents has/had mental health issues.

Brain Structure: Individuals that are diagnosed with bipolar disorder often have physical changes to the structure of their brains. There is often a natural imbalance in the neurotransmitters in the brain of an individual who has bipolar disorder. I’m not sure if it would ever be possible, but it would be great if doctors could eventually find out which individuals are more prone to developing bipolar disorder. Maybe it’s already possible, I’m not exactly sure.

Common Issues: There are many types of issues that are known to trigger the first bipolar episode in individuals. These factors include but are not limited to high stress periods, drug and alcohol abuse, major life changes, and traumatic experiences.

I experienced all of these situations. My father was diagnosed with cancer; he lived for several years with the illness before dying. I used drugs and alcohol so I wouldn’t have to feel my emotions. Because of my drug abuse, I met a guy that ended up being very abusive towards me for about 18 months. They may have triggered an episode, but they didn’t cause my bipolar disorder. My bipolar was there to begin with, and these situations probably just helped it come out.

Co-Occurring Conditions: Many individuals that are diagnosed with bipolar disorder often have other conditions such as PTSD, ADHD, various anxiety disorders, drug and/or alcohol abuse, and physical health issues. Individuals diagnosed with bipolar disorder are more likely to have both physical and mental health conditions.

I’m also diagnosed with PTSD, I’m 12 years sober from drugs and alcohol, and I have a variety of physical health issues.

There are many factors that contribute to individuals being diagnosed with bipolar disorder. However, just because some has one or even several of these causes/risk factors, doesn’t mean they have or will end up having bipolar disorder.

My Side of the Pole

Bipolar – Mental Health

Tag: Stress