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Disclaimer: Although I have worked with persons with mental illness for twenty years, I do not have a Master's Degree or a license. This is not meant to be a substitute for mental health care or treatment. Please obtain professional assistance from the resources listed on the right of the page, if needed. And call 911 if you or someone is in immediate danger.
A key word that you will see:
Fragmentation: a mental process where a person becomes intensely emotionally focused on one aspect of themselves, such as “I am angry” or “no one loves me,” to the point where all thoughts, feelings and behavior demonstrate this emotional state, in which, the person does not or is unable to take into account the reality of their environment, others or themselves and their resources. This is a term that my therapist and I use and is on the continuum of dissociation.
Saturday, May 31, 2008
Friday, May 30, 2008
Now I'm scared. I feel like something bad is going to happen and that no one will like me or read my blog anymore. I know I am not thinking straight about this. All sorts of insecurities and bad thoughts in my head. It just makes the abuse more real and a part of me doesn't want it to be real and I've avoided it for many years.
I am proud of myself for doing it, but there are repercussions. I keep thinking that I did something wrong and that someone is going to yell or hit me. It has also increased my depression and desire to cut or bruise. So, I know I need to take PRN's today.
What I wrote are some of the things that I'm starting to integrate in therapy which sucks. I think it helps to put things into context. The biggest thing is that I told. I actually told anyone that visits my site and reads the sidebar. Feeling very vulnerable, raw and tearful...seeing on the computer screen makes it so much more real. I am beginning to have more compassion for my little girl instead of hatred and wanting to kill her off.
It is triggering more of the flashbacks that I've been having anyway, but it has increased them in intensity and frequency. I'm also feeling pretty disconnected. Writing helps even though, I am rambling and jumping thoughts. I still am in a little bit of shock, but the responses have been great. Thank to those who have been encouraging. Can I take it down now...I don't really mean that I would. It is just really tempting.
Thursday, May 29, 2008
3) if there was one thing that you could do, with no limits of any kind what, would it be? Have enough money to earn my doctorate in clinical psychology and provide free to low cost long-term care for those who need it and have the funding to have a clinic for this type of service plus a fantastic hospital program and to provide the same type of service and training for my church including outreach to homeless and other needs in the community (i.e. nursing homes, board and care, outpatient programs etc...)
4) what’s the weirdest dream you’ve ever had? My husband is the one with the weird dreams, but I can't tell his stuff. All I can really remember is having nightmares and flashback dreams. Not so weird as disturbing waking up screaming or unable to do so.
5) what is the weirdest thing about you? I don't know if I would call it weird, but one thing that surprises people (Sorry, Bradley) is that I can be very intense and serious and extremely silly, playful and humorous. (You know that my spelling is getting really messed up because a lot of people I correspond with on the Internet are from UK, Australia and Canada...now, I don't know how to spell at least I don't have to deal with pronunciation.
6) what’s your favorite self made philosophy? My philosophy, but from God, "...love the Lord your God with all your heart, all your soul and all your mind...love your neighbor as yourself." (Matthew 22:37-39, NLT)
7) what question has been the most annoying unanswered question of your life? I don't know about annoying, but I have many questions to ask God. One is why do men sexually peak in their teens and 20's and women in their 40's. Okay, that is a silly one, but one I'd still like to know. The most bothersome one is "why does he allow people to do such horrendous things to each other?" Theologically and cognitively I understand, but I will never truly understand this...but, I'm not God...I'm not Dog either which is what I first wrote.
8 ) Why do you blog? As a form of therapy and to really tell the truth of my life and have someone listen. It is a place that I can be completely myself, faults and all (thanks Shiv). A place where I can express myself, receive and give support, encouragement and validation.
[This entry is directly following the session where I read my last post and we talked about my inability to stop bruising and how overwhelmed, out of control, my inability to focus and how bad the flashbacks were. He suggested that we slow down a little. Additionally, the pillow that I had been hugging for the past year and a half, I was now taking home which was a huge source of comfort. It is three years since this period and I still have it and need it.]Like a security blanket. It was my transitional object (a representation of the "good mother," a source of comfort and reassurance that Geoffrey still existed even when I couldn't hear or see him.) Geoffrey was the "good mother," my source of comfort which was and is really scary to feel.]
...Today in session, I was really anxious, but tried really hard not to go away...felt buzzy and my hands kept getting numb. I find the writing extremely helpful and although it is difficult, I like sharing it with you...feels like I often share what I may not have if it were not written down. Also, surprised by what I do write. What I shared today was really difficult and I felt so vulnerable and exposed...said somethings that I was not even aware of or could not admit to myself before.
I feel bad about slowing down a bit, but also relieved...not so much pressure. I felt so much like crying. It feels kind of stuck. I still feel like crying...I think some of it is the pressure (I really don't want to go to work tomorrow) of work and trying to manage my emotions and defenses. Also, feels sad realizing that this is how I felt everyday after the Tylenol [my overdose at 15 that I wrote about in Entry: May 29, 2005 - evening] ...felt like crying, but so much pressure not to, thinking about killing myself, the self-injury...and just generally feeling awful...just a mixture of stuff. Felt food to talk about PRT (pain, rage, terror) versus hurt, anger and fear [I had only been using the milder terms to talk about my feelings when the other ones were more accurate because I did not want to deal with the intensity. Usually, I am very exact in the words I choose which is also why using awful indicates how young my trauma began because I couldn't find any other words.] I think PRT is a more accurate description of how I felt from a very young age.
I keep wondering if you are really okay with continuing the five days per week and with being so available. I think I'm having a really difficult time not going into bad. Everything seems to make me go there even the "positive" feelings. It really feels like quite a bind that I can't get out of. Sometimes, it really feels like I need to justify existing. Not even sure I understand what that means. I'm really wanting to take the pills and bruise myself. But, I keep remembering the promise I made not to do so until I see you tomorrow.
Sometimes I feel like I'm in trouble with the suicidal thoughts, but not hospitalization trouble...or maybe it is just being on the edge. When I'm in the "fuck you" mode is when it gets scary for me because then there are not as many limits. I suppose I could leave you a message during those times as I really haven't been. I try to tough it out and shut you out which just makes the pressure worse...the like I'm going to implode...like when I took the Tylenol...I was angry and in the "fuck you" mode along with, so many other feelings.
Sometimes, I wonder if you are really okay with continuing to work with me...there it is again, "are you angry and are you going to leave." So, many conflicts within...often times quite overwhelming.
Observations: This time I viewed things in terms of borderline personality disorder one with the self-image of being bad; two, the abandonment issues; and three the extreme thinking, splitting, all or nothing. Additionally, the going away and the numbing of my extremities was part of dissociating. All evident and all out of control some. I was a mess and having difficulty not dissociating (borderline and PTSD symptoms).
Wednesday, May 28, 2008
Tuesday, May 27, 2008
I had been tagged by Shiv's Brain to do a viral linking post and here the benefits of viral linking go:
One of the fastest ways to see your technorati authority explode!
Increase your google page rank quickly
Attract large volume of new traffic to your site
What more does a blogger want? :D The not-so difficult rules:
I am selecting 5 of my favorite bloggers and all you have to do is tag 5 other people and the list goes on.
Writing To Survive
The Hopeful Borderline
BPD in OKC
Thoughts and Musings of a Girl... Interrupted
One important rule is just keep adding your blog to the long list! Do not delete the other blogs. This is a viral linking post!
And the blogs tagged are:
Here comes the loooooong list! Add your blog to the end of the list!
The Strategist Note Book
The Classy Life
Agenc Was Here
When Life Becomes a Book
Super Hero Extraordinare
Everyday should be Christmas
The Gadget Guru tech
What Goes Under the Sun
One Quart Low
Search for Blogging
The Sleeping Turtle Art Gallery
Olga the traveling bra
Concept is addict
Into the Rabbit Hole
Smile! Tomorrow could be a lot worse!
A Mind Boiling Over
Discorax’s House of Woot
Blogging from the Bog
Secret Spiritual Dance
Jay's Art & words
How Is Bradley?
Have fun doing this fruit-bearing meme.
Finger painting completed during this day, 6/10/05, two picture out of three. More of the same feelings just being more focused and the rage increasing which is part of the bruising. However, finger painting is not helping me to stop from bruising.
Monday, May 26, 2008
Again, colors mean the same to me:
Blue/light bluish/lavender/grey=sadness, crying, tears, hopelessness
This is your brain on drugs!! No, just kidding, but that is what was jokingly going through my head. I'd rather joke then tell you what I really see. First off, the orange is actually red with only a small amount of orange in the lower right corner. I think that little funny looking thing in the middle is me curled up full of fear and sadness and surrounded first by sadness that is completely surrounded by terror with protrusions of rage, pain and terror. There seems to be a lot of movement and intense feeling in this one. I still feel unsettled by it now.
This one scares me the most because it is the most intense and filled with terror, deep sadness/emptiness, loss, pain, rage, death, dying and hopelessness. Which matches the way I've been acting out, my bruising. Acting out meaning telling you what I feel or think through my behavior instead of other means, telling you behaviorally. All behavior is a way that someone communicates a thought or a feeling, usually feeling. Speaking of that. This one feels a bit out of control and all over the place which would match how I was feeling then as indicated in both my behavior and journal entries.
The lighter orange is actually red. I think the last one scared me so much that this one became more subdued and structured. It seems like a reaction to the other one. Just more of the same feelings. I think the last one represented the most of how I was feeling at the time. In this particular case, this was one of the times that finger painting increased my anxiety and thoughts, so did not help in preventing me from bruising. (Bruising to the point of drawing blood. I have to call it bruising, for now. Just as I am having difficulty accepting my self injury, I am having difficulty accepting my painting and the feelings that I am still trying to integrate now.)
Sunday, May 25, 2008
Now, that I've shared what I wrote above, even though it was three years ago. I still have much shame in sharing this. I'm feeling almost the way I describe above...the shame is almost overwhelming. Feels like everyone is going to leave me alone now. The only person that really knows the extent of it is Geoffrey. Now, I want to disappear because I feel bad and that everyone is going to think I'm weird even though cognitively I know better and know that I was out of control and needed help. My thinking is still all upside down. This is a case of being clinically clueless, but I'm not clueless. Yet, I don't have enough in me to not turn everything upside down and feel like withdrawing from everyone. Yet, I am proud that I was able to put it out there. I feel sick to my stomach...maybe, I won't post this.
I can't seem to apply it to myself even though I've worked with others with this issue...I could just delete the whole blog and pretend like I never existed (BPD thinking ~ all or nothing). If you read this, please provide some feedback or my thinking will become more and more distorted. Not that it is your responsibility, but it would be helpful. Thank you.
Saturday, May 24, 2008
Yesterday, in my session, with Geoffrey the pointed out how hard it is for me to accept that I need attention. I started to cry because it touched the empty black hole in my heart that really needed and wanted attention when I was a child and and didn't have it met. I just wanted to be noticed
Now, when I do received any type of attention, I immediately feel like I'm a bad person and think that even wanting to be noticed is a bad thing, and wanting attention is even worse. And liking it almost make me evil. Also, a part of me thinks that this is the reason why the sexual abuse occurred even though I know differently. Plus, I liked the extra attention. So now, I don't trust that it is not going to be used against me. He mentioned that the blog indicates that I want attention to be heard and I feel really bad about that, that I am doing something wrong.
This week I received a lot of attention from Go! Smell the Flowers to introducing my finger painting. I've received compliments mostly via email either liking the emotional quality or the artwork it self. To me they were just something to help express myself, no artwork by any means. Well, I had to have a therapist who was an art major and a good artist in his own right from what I hear!! He said he knew it was art to begin with, but to tell me would have changed what I was doing, besides what was I going to do with it. It is extremely hard to admit that I liked the attention and I immediately think that everything I've said is now going to be used against me. Like with the sexual abuse. Attention is also painful.
So, what in the world does that have to do with our anniversary...everything!! I feel like I'm going to burst into tears when he gives me my present...one part of me liking it, another condemning, and another hidden part hurting because it wasn't touched when it need to. A part that I never wanted revealed, so I thought.
Friday, May 23, 2008
6/4/05 ~ Four of four
I don't really feel like commenting on them other than I feel at peace with these and the colors have some consistent representation.
I just happened to notice today (5/24/08) that I omitted Blue=sadness, crying, tears; The area that I am having the most difficulty with now. Hmm...wonder how I missed that one!!!
Black, Grey and dark areas=hopelessness, death, darkness
Wednesday, May 21, 2008
Well, this time some of you know that I've been having a particularly difficult time with not wanting to talk about my abuse flashbacks which have been getting more intense, more frequent and more intrusive causing me great anxiety and fragmenting everywhere. I just did not feel stable...not that I'm sure what that feels like anymore, but I know what it isn't. I am on a load of medications which I evaluated, thoroughly discussed and researched them with my psychiatrist and pharmacist. Plus, I had a ton of knowledge myself.
Also, I have a couple of PRNs (as needed) medications to take for anxiety and/or to help me to stay less fragmented and make the thoughts of suicide, wanting to self-injure, wanting to die, needing to die and feeling like I am a bad person quieter. Well, I know this, but I wasn't taking them because I felt a little better. However, feeling a little better doesn't mean to that I did not still need them!!
Geoffrey reminded me of that today and had the nerve to tell me I was acting like someone with bipolar disorder or schizophrenia. There is absolutely no ill-intent about this statement. Patients with these disorders have the most difficult time with maintaining a medication regimen partly due to the same reasoning that my own clueless brain had. I immediately understood what he was saying and I just looked at him and said, "I have absolutely no defense." Now, I've been leaving comments to several people about the importance of continuing to take your medications even if you are feeling better. Well, I got that thrown back in my face today.
Today, I finally talked about the one persistent flashback, but not before I took a PRN right in Geoffrey's office!!! I took another one when I got home. Guess what!! Despite being the toughest therapy session of the week, I am the calmest and least reactionary I've been for weeks!!! The medication really does work.
With all that said, I thought that I would share with you what I take for Major Depression and Post-traumatic stress Disorder which is only supposed to take the edge off of things so that I can manage to do the hard work in therapy...if I follow my medication regimen. I know many share their medications, so I thought that I would too. Please keep in mind that I am totally against over medication and fought psychiatrist and physicians regarding what they were prescribing for my clients. I also advocate for myself in the same way and know that this is the right combination for me and my symptoms.
By the way, I am going to list everything that I take and I keep a piece of paper behind my wallet with my allergies/reactions to medications and my current list behind my driver's license in case I am unable to speak for myself or am so anxious that I forget. It also come in handy and prevents miscommunication whenever I visit a doctor or hospital because they just copy the list and put it in my chart. I also include what it is for since some medications are used to treat more than one type of illness and I don't want any confusion or the wrong diagnosis included in my medical chart. I suggest this to everyone. In another post, I'll write about what trials, thrills and tribulations my medications have taken me through to find this imperfect combination:
BID=twice per day
Effexor XR 375 QPM for depression
Trazodone 150 mg 1 tab QHS for depression/insomnia
Clonazepam (Klonopin) 0.5 mg 1 tab QAM for anxiety; and 3 tabs HS and PRN for insomnia/anxiety (no more than 5 mg total /day)
Risperdal 0.25mg PRN (extremely limited) for insomnia/anxiety
Invega (paliperidone) 3 mg QHS for insomnia/anxiety
Lunesta 3 mg QHS for insomnia
Cabergoline (Dostinex) 1 mg twice weekly for Invega side effect of hyperprolatinemia ( I'm lactating without being pregnant, woopie!!!)
Synthroid 0.05mq QD for thyroid suppression; s/p carcinoma (I had thyroid cancer)
Astelin Nasal Spray BID PRN for nonallergic rhinitis
Allegra 24H for nonallergic rhinitis
1 multivitamin w/Calcium & D QAM for supplement
Amitiza 24mcg 1 BID for chronic constipation (which is part of the Post-traumatic stress disorder and I've had problems for as long as I can remember which is mostly likely due to the abuse and complicated by stress and medication side effects now. I have tried everything and used to watch my clients carefully because we had several clients die from constipation complications)
Epidrin PRN for migrane 2 caps @ onset, may repeat 1 cap after 1 hr up to 5/12 hr
So there is my lovely list. I know that it is long and the psychotropic (psychiatric ones are many), but I feel really good that this is the proper regimen for me at this time, but I am constantly re-evaluating. I have also been told that it is not expected for me to remain on them forever, just to get me through therapy. Even still, sleep is elusive most evenings. But, since I can't work I can nap and rest is good even if I am not sleeping.
Please do not leave posts on any recommendations regarding my medications. I trust my medical team and my own research, experience and judgement regarding what I need. I just shouldn't when it comes to taking the PRNs when I should. But, what do you know I took them and feel much better today!!! Today, I am clinically clueless!!! (listen to yourself and own advice, cc!!) :-P
To five inspirational people, I pay forward the award of honourary Flower Smeller badge from Go! Smell the Flowers.
We’d like to present the honourary title of Flower Smeller to the following 5 who have either contributed to this community since the founders have been on board, have recently grabbed our attention in the blogosphere or are smelling their flowers in life in general."
Since I've only been around for 14 days, I have not had that much time to feel my way around. However, there are five people/blogs that have been supportive, encouraging, understanding, allowed me to feel helpful, helped me to be even more vulnerable in my healing journey and are definite bright spots in my day. They lives are inspirations to me!!! They are (not in any type of order):
- Catatonic Kid at http://catatonickid.wordpress.com/
- Shiv's brain at http://shiv379.blogspot.com/
- The People Behind my Eyes at http://www.sundrip.com/journal/
- Untreatable at http://www.untreatableonline.com/
- Something Just at http://somethingjusttostart.blogspot.com/
Thank you for being inspirational to me in my 14 days. I really appreciate you!!! You are my fellow traveler's in a difficult healing journey. No one give up now!!
To obtain your badge and for futher information about the badge go to http://www.gosmelltheflowers.com/archives/3172.
The suicidal thoughts have been really strong today. When I went to pick up my prescriptions, I looked at the alcohol and considered purchasing the watermelon or peach vodka. Just the thought of dying seemed comforting...makes everything go away and quiets everything.
Went home and made some phone calls. Called my insurance company as the guy who called me yesterday directed me to call someone else in appeals...anyway I have instructions on how to request more sessions for this year. Makes me feel really anxious because I have to ask you to do something for me. Afraid you'll say, "no," or become angry. Think, maybe, I shouldn't bother asking and just leave it alone.
Did some fingerpainting...not sure what I was feeling, but became tearful and stopped myself from crying. Too wet still to share with you. Feeling like I really need to cry.
Scared about your suggestion that I destroy one of your pillows in session. I think, if would help me feel safer and help me prepare if we scheduled a time and what..I kind of like the idea of taking apart the pillow that is already falling apart. Scares me too...feel like I'm really trusting you with this. Just doing it, setting parameters. I just feel like crying, but can't.
I feel really awful today. Thinking about ways to kill myself have been really strong even during my meetings and telephone calls. Wanting to cut or burn myself too. Defense against feeling my anger? Really, feel like crying...don't know if I'm sad, angry, scared, overwhelmed or what. I just keep tearing up. Maybe, I just feel a bit of everything jumbled.
Wanting to die...just go away. Want to just curl up and cry. I guess I am feeling a little bit of everything. Reminds me of when I used to silently cry, just rocking. Didn't want anyone to hear...seems like now I'm the one afraid to hear. I just feel awful and wish I had words or understood better. I wish I could explain how badly I feel and how much I want it to stop. Wish I could help you understand better. Wish I understood better. Feeling a bit crazy...out of control.
(Picture #1 ~ I know that the purple means fear, red means pain and blue is sadness. Too me there is a swirling amount of terror that radiates out with underlying pain that burst through the terror and behind it is sadness. I think the movement of the piece is anger. I don't know what it meant then, but it is what I see now.)
Commentary: Buzzy meant that I was beginning to "go away" or disassociate some. The suicidal thoughts were becoming more difficult to handle as they were more frequent and now intrusive. When I was younger dying was my way to feel in control. I could always kill myself if it got too bad, so it became comforting sort of. I also equate control with comfort. My insurance company, like most, just added to my stress.
I have no idea how a person who is compromised is supposed to negotiate let alone advocate for themselves. I am lucky because I can "go into work mode," and try to deal with it. They were only authorizing 30 session for the whole year even though I was receiving treatment four to five times per week and diagnosed with Moderate Major Depression, recurrent and PTSD.
Then, I needed Geoffrey to complete a Treatment Authorization for the appeal which actually terrified me to ask for anything. Like growing up I hated if I had to ask for anything. The usual response would be anger, ignoring or humiliation. So, I tried to do as much as I could myself.
I know that I was feeling really angry at this point in time as the wanting to bruise or cut was really strong and this time it was the angry wanting to cut versus the "I'm bad," or "just numb out." That was how the pillow came to be a suggestion.
The fingerpainting and writing are of great help. I discovered fingerpainting during my hospitalization in the 90s. It was a HUGE break through in allowing myself to express what was going on on the inside. It also terrified me because I did not want to see those emotions. I was also an indication of how young I was when the first trauma occurred.
At this point, Geoffrey was thinking in infancy due to the nature and severity of my symptoms and that, at times, I had no words. I am usually quite articulate and precise in my words, so when I can't explain or use vague words like awful...it is a pretty good indicator.
Tuesday, May 20, 2008
Today immediately when my husband came home from church, he wanted to talk. He asked, if I knew that he was angry about yesterday. I told him that I figured he was. He said he was angry that I left the house without telling him where I was going. I also told him why I was angry yesterday. He said that he didn't know because I didn't say anything. He said that he understood that I was going through a rough time, but that he wanted me to treat him with respect.
I felt like he was scolding me and felt really bad. I began to tear up, but I don't think he knew. Then, he said I could go back to what I was doing. I took a shower and cut. I just felt so bad.
So, now do I not only not want to talk about what I already wrote because I'm scared, but I don't want to tell you about how I acted...afraid you are going to take his side and I'll end up feeling worse.
I don't think I can handle trying to see you tomorrow and maybe the whole week. I just don't know. I just feel so bad
Feeling worse now that I left you the messages and that my husband just asked me if I was afraid of him because he said all afternoon it was like we were just roommates. I just told him that I wasn't feeling well.
Thinking about purchasing the watermelon flavored vodka and taking my medications. Just go to sleep forever, find somewhere to go to jump. Go into the garage tonight and leave the engine running after taking my medications with the vodka.
Again, not crying is an issue. It still is like the moment I feel a little bit of tearing up I shut it down just as I've always done since I was a baby. If I didn't that meant getting hurt. I've learned well.
Pushing everyone away when I need them the most. Part of the on-going borderline dilemma. It is terrifying to have any closeness and when it is there I don't trust it at all. But, I really want it, but don't believe it can happen or terrifies me.
Looking back, I was really scared because the suicidal thoughts seemed to be out of control some. Maybe, more than some. So hard to admit. During my overdose in school, both my mother and step-father started yelling at me and my mother became hysterical in the emergency room. My friend's mother had taken me to emergency, so they got there after I was admitted to the emergency room. The nurses had them leave the room. That was a good thing, but no one asked or maybe never noticed the lateral superficial cuts on both of my wrists.
Back then, not much was known, so I was release because my mother promised to have me see a therapist who I saw twice. He believed or want to believe me when I said I was okay. I've never really been, "okay." We never talked about it again. Well, other than my mother saying I was dramatic...I was in deep trouble!!! No one to talk to and no one that would listen and believe me.
I mention that I cut. I cut during this event because I felt really bad, needed something calming and soothing and wanted to numb out. At this point in time, cutting meant with a razor blade at least fifty each on the upper thigh each cut had to draw blood. If it did not, I had to do the cut over. Sometimes, I would alternate side, so at times, I would have up to 200 on each leg. I made sure that it was always high enough, so I could wear my shorts and skirts without it showing even when I sat down. I did stain some of my clothing, but most of the time I was careful enough. Geoffrey did not know the extent of it, but knew that I did not need medical attention.
Monday, May 19, 2008
Anyway, this past weekend and this morning was a reactionary freak out moment. I was quite overwhelmed, anxious and felt out of control. I'm frustrated that my attorney from an auto accident in October 2006, has not been in contact with me for almost two months. He has not returned my calls or responded to my email messages. All I want is to have no out of pocket expenses after all I was clearly not at fault with the accident, but the other party's insurance is being a pain and not offering a fair deal. I just want this thing settled, but in order to, at least, get my attorney fees paid, I may have to go into litigation. I don't think I can handle that.
Then, my stupid insurance company only authorizes 20 session per year with my psychiatrist and 20 with my therapist because they are out of network and there is not justification. Well, there is no way I am going to change therapist not after more than 20 years and my psychiatrist and I have gone through so many changes in medications and they still aren't quite right. So, I have to appeal both. One was enough, but now both. Are they crazy...20 session per year, even at what used to be traditional one time a week therapy, that doesn't begin to cover it. With my psychiatrist, I haven't been exactly stable, so I was going about every other week or once a week when we would start new medications.
Both have submitted treatment authorizations and they still want justification of continued treatment doesn't Major Depression, Recurrent, Moderate and PTSD cover it and that I am unable to work. Hello...McFly!!! Now, I am not unreasonable I am not asking them to cover my therapy at four times per week, but at least one time per week and whatever my psychiatrist decides is medically necessary. And don't even get me into continuity of care!!! No they are not interchangeable.
The biggest thing that has me freaking out and something that I hadn't intended to talk about is my eating disorder. (Geoffrey, if you are reading this yes, I just admitted that I have one!) I'll save my funny medication journey for another post, but for this post all you need to know is that I have gained close to 50 pounds. It started gradually about two years ago with a change in medication, but at that time I was underweight (Okay, I admitted that one too...I promised myself that I would be open and honest in this blog...Tuesday, I'll deny what ever is in here!). Then over the last year it has really been a problem.
I went from a size 24 to a 29 or 30. Or from a 00 to a 6 or 8. Now, I've never been more than a size 4 except for in high school. My breast also have grown from barely an 34A cup to more than double in size to a 34D/36D cup. With it being so hot, I discovered that I can't fit into some of my new clothing. So, I weighed myself and freaked out especially since I know that I might need a bigger cup size. Husband very happy...wife feels very out of control.
I hate being out of control. I feel out of control right now with some of the circumstances I wrote about at the beginning and with the increasing flashbacks and nightmares about some of the more sadistic sexual abuse that I just can't bring my self to speak of again. But, I know I need to do so (Okay, now I'm tearing up and starting to go away, so I won't think about it.) This is the reason, I think my weight freaked me out so much to the point that I wanted to stop some of my medications even though I'm doing better...I'm not that much better.
My apologies to those who are overweight. I always get comments like, "I'd kill just to be your size." But, to me I hate looking at myself and I feel so fat. Sometimes, I tell my husband I feel like a beached whale. I really want to be thin again or at least have control over being able to lose. I can't seem to lose even when I exercise, change my diet or stop eating. Nothing I did before works. Today, everything feels out of control and I just want to stop all my medications...uh, oh...there goes the borderline all or nothing thinking. I just want to be able to lose weight again...it is a huge loss of something that was comforting. It makes me angry! I know that the real issue is control and not the weight, but I just don't feel good about me.
Sorry to ramble so. I keep feeling like I have to apologize when I write, write lengthy posts, or give anyone a comment. Like I need to apologize for having a voice or taking up space. I'm doing this more and more as I put myself out here in the blogsphere more and more. I also feel guilty for asking for feedback on my depression post especially since no one has responded, but it is only Monday here!! Okay, I'm just having a rough time, so it isn't time to reduce medications, huh! (Oh, it goes without saying that my suicidal thoughts and wanting to cut is really high!!) I think I just needed to vent and a little comfort and understanding. (To top it off Blogger crashed on me and I had to redo more than half of this post and I was saving after every paragraph or sooner...Grrr!!!)
Saturday, May 17, 2008
It is normal for everyone to have the blues now and then, but they usual pass in a day or so. There are several types of depressive disorders that interfere in daily functioning and causes pain everyday for the person and those around them. Before I specifically address major depressive disorder, I want to briefly tell you what the others depressive disorders are in this category. There is major depressive disorder, dysthymic disorder (low-grade chronic depression), psychotic depression (depression with a break in reality, hallucinations and delusions), postpartum depression (depression which occurs after the birth of one's baby), and seasonal affective disorder (depression which occurs when there is less natural sunlight). They are all chemical imbalances.
I was in psychotherapy for 12 years and then things were pretty good until about 4 1/2 (November 2003) years ago when I figured out I was depressed. Well, I know the symptoms, but I did not pick them up. I returned to therapy and to taking medications which I had done previously for about 7 years. Even so, my sleep is all disturbed. I wake up about 1 to 3 am almost every morning and go back to sleep about 6 am and sleep during the day.
I actually cannot remember not having disruptive sleep ever except for maybe a one year period after I was married. Dr. Doobe indicated that it is common for a person under my circumstances to have difficulties with sleep disturbances. At least, since I am not working it helps because I can sleep whenever I am tired then it is usually a 2-3 hour nap and sometimes two during the day.
During this second time in therapy with Geoffrey, I began to have flashbacks and memories of neglect, physical, emotional and sadistic sexual abuse. I became incapacitated at home and would not leave the house except for work. Everything became overwhelming I couldn't shop (me not shop...you know it is serious), clean the house, cook, bake, etc. All I could manage to do was to work, which I kept up to date, and at the beginning no one noticed and went to therapy 5 times per week. Yes, I had long days. Work was my way of trying to prove that I was "okay," when I was anything but okay.
Maybe, it was my way of getting out of the housework because my dear, dear, sweet husband began to take over the household duties. This included paying the bills. I had never before had missed payments, not kept the ledger up to date and would balance to the penny. Well, let us say that he had to start from scratch. And, I was one to balance the checkbook to the penny. Oh, the answer is "no," I was not trying to get out of anything. I just want to feel normal again, but I'm not sure what that is...it seems like it has been so long.
All at the same time, he began sleeping in the extra bedroom to make me feel safer. He volunteered...imagine a man doing that. You know that God was at work here because nothing was wrong with him. Our church began to provide meals. It felt like I was living a double life...a part had it all together and the other was falling apart and a mess. I went to work everyday feeling overwhelmed and panicked. Medications helped some, but not enough.
About 1 1/2 years ago, working and going to therapy caught up with me and I was no longer able to work. It was continue to work and be hospitalized or stop working and hopefully I won't need hospitalization. The situation at work had changed, I was having more difficulties concentrating and with fragmenting and a new supervisor "re-traumatized" me due to her supervisory skills. Most of those under her left for other jobs. The unfortunate thing is that I loved my job and envisioned being there a long time. But, I figure that God knows what He is doing. Also, I would not have been able to do the tougher emotional work while being employed. This has been a good thing.
Now, I am a little better. But, I still have to gage if I can tolerate going out and handling the crowd without going away or becoming overwhelmed. Then, afterward and the next day I sleep and sleep and sleep. Also, there are days when I just don't want to get out of bed and if I do and don't have to go anywhere I don't brush my teeth, shower or get out of my pajamas. These are some specific examples of major depression versus dysthymia which is painful as well. Geoffrey and I figure that I've been depressed my whole life with periods of major depressive episodes.
Depressive disorders are mental illness that are treatable and manageable, but need to be taken care of just as someone with heart disease would. No one would dare say or think any of the above about someone who has had a heart attack. But, somehow, everyone treats mental illness differently. Sometimes, it feels like some people are afraid they are going to catch it.
Major Depression is a serious medical illness affecting 18 million American adults, men and women of all ages, races and economic levels. Unlike normal emotional experiences of sadness, loss, or passing mood states, major depression is persistent and can significantly interfere with an person's thoughts, behavior, mood, activity and physical health. It is the leading cause of disability in the United States and usually strikes people between the ages of 25 and 44.
Twice as many women as men are diagnosed with Major Depression. It is not fully understood why. After a single episode, a person is more likely to have another one and after the second the percentage exponentially increases with each episode. There is evidence that the brain may make permanent changes making someone more susceptible to another episode. I've had a least five, but only two were diagnosed and treated. The others were before age 21. Without treatment, the frequency as well as the severity increases over time and can lead to suicide. However, with proper treatment a person can recover as long as they don't give up on the treatment.
- persistently sad, anxious or irritable mood
- pronounced changes in sleep, appetite, and energy
- difficulty thinking, concentrating and remembering
- physical slowing or agitation
- lack of interest in or please from activities that were once enjoyed
- sleeping too much or can't sleep
- feelings of guilt, worthlessness, hopelessness and emptiness
- recurrent thoughts of death or suicide
- persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain.
Psychological, biological, and environmental factors may all contribute to the development of a depressive episode. Whatever the specific cause of depression, scientific research has firmly established that it is a biological, medical illness. Neurotransmitters are thought to be involved which is what medications address. There is also some evidence that there is a genetic predisposition. Also, discuss with your doctor your medical history as some illness may influence depression especially hypothyroidism.
Reportedly, between 80-90% of those treated for Major Depression return to their usual daily activities and feelings. I did so successfully for about five years, but this episode is much worse and I don't feel as hopeful. But, all indications are that I will recover to some degree although it is taking much longer than I want it to partly because it is complicated by post-traumatic stress disorder (another post).
Possible complications of depression include suicide (15% of people with major depressive disorder die by suicide), increased risk of alcohol and drug related problems, increased risk of tobacco dependence and increased risk of problems with physical health and premature death due to medical illness.
Call 911, a suicide hotline or get safely to an emergency room if you have thoughts of suicide, a suicidal plan or thoughts of harming yourself or others. If a loved one expresses such thoughts, it is okay to let them talk about it. By not talking about it, it becomes a "taboo" subject, so they may not go to you if they are at risk. If they talk about it, you can be sure that they have been thinking about it.
Your doctor needs to be called right away if you hear voices, see things, smell things, feel things that are not there (psychosis which can accompany MDD; have frequent crying spells, if your work, school or family life is disrupted for two or more weeks; and if you or someone else thinks that you should cut back or stop drugs or alcohol. Side effects of some medication includes depression, but DO NOT stop taking it without talking to your doctor.
Depression effects men and women in different ways which is a fairly new area of study. They process medications differently. Neurochemicals such serotonin (used by the brain to stabilize mood) is processed differently between men and women. Suicide attempts are more common in women, but men are more likely to be successful. Men are more likely to be diagnosed with alcohol problems, but women are at higher risk following an episode of depression.
Preventative measures include, stress management; avoiding drugs, alcohol and caffeine; exercise regularly; and maintaining good sleeping habits. If you are socially isolated try volunteering or get involved in some social group. Medications and psychiatric treatment my prevent recurrences; however, some are not preventable.
Some helpful tips if you have a depressive disorder. You are not a failure if you cannot do these. Participate in mild activity or exercise. At the beginning, I was able to exercise, but now I do not have the energy or motivation. Participate in things that you once enjoyed. I have continued to go to music concerts, at least, one time per year. I am also beginning to read my cookbooks again and look on the Internet.
Set realistic goals for yourself. Break a large task into smaller tasks, so you don't feel so overwhelmed. Try to spend time with a friend or relative and confide in them. Try not to isolate yourself and let others help you. This is difficult for me, but I have let my therapist, a couple of friend and my husband in more and more. The biggest step was starting this blog. Postpone making major life decisions.
Remember, it is normal for appetite and sleep to be disrupted. Be gentle with yourself. Don't expect to snap out of it or for you to feel better "sooner." I get into trouble with this all the time because I always want to be further than I am instead of accepting the progress that I have made.
If you know of someone who has a major depressive disorder. The most important thing you can do is to take care of yourself first before attending to the person who is depressed. Remember what they say on an airplane, put your breathing mask on first, then help others. After that the best thing you can do is to encourage them to seek a diagnosis and treatment. It is okay to shop around for a therapist and psychiatrist. It is important to have a good match because they need to be able to tell them the truth about how they feel which means they need to be as comfortable as possible.
Please, know that sharing of this sort will cause an increase of some symptoms and that you will never be completely comfortable with a health care professional. This is normal.
Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor. They maybe angry for awhile, but it is necessary. You don't want to end up at their funeral with regrets. Invite them out even if they decline, but don't push too soon or it will feel demanding or overwhelming and increase feelings of worthlessness and failure. Remind yourself and them that with time and treatment, that the depression will get better.
I hope this helps you or someone you love to have a better understanding and compassion for yourself and others with depression. I know it helped me to have more compassion for myself.
Most of the information in this post was compiled from www.nami.org, www.nlm.nih.gov, and www.healthyplace.com. You can also go to their websites for additional information and other resources. Remember there is treatment available and stick to it don't give up!!
(Disclaimer: Although I have worked with mentally ill persons for twenty years, I do not have a Master's Degree or a license. This is not meant to be a substitute for mental health care or treatment. Please obtain professional assistance from the above resources, if needed. And call 911 if you or someone is in immediate danger.)