I Don't Feel Like Writing A Post!!

Well, I don't!! I have no motivation today to write a post. Last week, zapped me of my energy, so did this weekend and lack of sleep. Well, you already heard about last week if not you can read it. Then, I completed the Retaliation slideshow which is really disturbing to me and I watched it with my therapist today. I started to go away and fragment afterward, but I was able to speak with tonight once I stopped fragmenting, so much.

That was helpful because I need to feel reconnect to me and to him in order to handle my session tomorrow evening with my husband where I am going to tell him more about the sexual abuse in the garage. I just hope I show up. That is the goal that I am trying to focus on...just show up, be present, don't go away, don't fragment, don't dissociate before I even start talking. Just simply be and be present. Sounds simple, but it isn't in practice.

I also see my psychiatrist tomorrow. I am going to tell him what has been going on. This will include that I am not sleeping well. For the past several weeks, I have only been sleeping two to three hours at night. And for the past four nights, I have been sleeping two hours or less than I am up for the day and take a nap around 2 pm or 3 pm. I tried to stay up and not take naps, but then I still only slept the short amount of time.

Two weeks ago, my psychiatrist said that it had to do with the emotional work that I was doing in my therapy and the accompanying flashbacks/nightmares. I start getting into the deeper REM, dreaming sleep, and I have a nightmare and wake up. I am beginning to feel sleep deprived. However, there are no more medications to add. Last time, he felt it was temporary...sigh!!! I'm frustrated. I guess, I did want to write a post about what is going on currently...I'm exhausted physically, mentally and emotionally...need sleep!!!

Medication Change ~ More Effexor XR

Medications are such an exact science and I'm so glad that psychiatry knows just what to do. You know, I'm being sarcastic, but it is hit or miss and let's try this and see how it works. I am really glad that I know a lot about medications, have a good pharmacist and a good psychiatrist.

Well, I saw my psychiatrist today and told him that I am feeling more and more depressed. This may have to do with just talking about the things I've been talking about and its intensity. My response always to asserting myself or talking is to become more depressed, suicidal and the urges to cut all increase. I am also waking up with the first or second thought in my head is that I need to die. It is natural for the material itself to cause depression.

Also, I noticed a pattern that during the summer toward the end of June that I become more depressed. I spoke with my therapist about it briefly. I brought up that during the summer is when I would spend almost everyday at my step-father's parents house. He was just musing about what was going on with my mother a couple of months before I was born or what was going on when I was ten months. Both of my hospitalizations were in the summer July and August (but should have been July). Just a thought.

Today, I did something that I've never, ever done with a psychiatrist. I shared really personally. I let him see my first two Wordles and let him keep it. I also went away in the session and really teared up. Scary to begin to trust him with this stuff.

Anyway, bottom line is that the swapping the Invega for the Risperdal is working with my PRNs. Now, no matter what the reason is we are trying to address my increasing depression with increasing my Effexor XR from 375 mg to 450 mg. Now, I know that the recommended ceiling dosage is 225 mg which I spoke with both my psychiatrist and pharmacist about a long time ago when I was upped to 375. Both stated that, that is a recommendation, but they had patient with much higher dosages without problems and with successful treatment. I know that this happens frequently and for most medications there are no problems. So, no lecturing me on this.

I just hope it works because both my therapist and psychiatrist have discussed whether or not hospitalization would be beneficial. I've been wondering that too. It isn't something that I want, but maybe it would help get through this really intense time...I don't know. There are pros and cons. Either way, I think, I'm scared.

However, it just feels like it is taking so much energy to do anything. I didn't have anywhere to go Friday, Saturday or Sunday. I stayed in my pajamas for three days, didn't comb my hair, change clothing, brush my teeth and now, it feels like slogging through mud to get things done. And, the suicidal thoughts/plans and urges to cut are really loud. I haven't done anything. I just know that I am getting discouraged, fragmenting more, reacting more and I'm really tired of the flashback...when do they end?

My Truth ~ My Childhood

Click picture to see full size or make your own courtesy of Wordle.net.

"A rock and a hard place" ~ two posts today

To be honest, I have not been doing very well for the past few weeks and especially this week. I'm just more depressed. So, one I want to apologize as I have been having difficulty responding to comments on my blog and actually reading other people's blogs. I may visit, but I'm really not there.

Even with the concert, I'm not sure I enjoyed it or not. And, to really know I'm more depressed, I don't want to go shopping at Nordstrom. I used to go at least once a week. Even the store manager hugs me when he sees me. Everything is taking so much more effort and today for the first time in a long time, I woke up with the first thought being, "I want to die."

I saw my psychiatrist yesterday and he expressed some concern and he doesn't want to make any changes yet with my anti-depressants. He stated that he thinks that part of the increased depression is due to my weight gain which is due to my medication. This week I couldn't fit into any of my pants except for newly purchased expandable waist capris and shorts. Normally, I'd be happy to go out and purchase a new pair of jeans, but I was not. I now have officially in two years time, but especially this past year have gained enough weight to have clothing in seven different sizes. It is discouraging. My eating disorder symptoms have increased. I just feel fat and dumpy.

Anyway, I suggested changing the Invega to Risperdal which both have the same side effect of hyperprolactinimia which is basically I start to lactate. It actually is quite fascinating since I've never been pregnant and my little barely A cups have grown to D cups. But, all of this makes me feel as if I am in someone else's body. Anyway, the Risperdal doesn't have the weight gain side effect for me. I sure hope I can lose some weight. Oh, my psychiatrist was in agreement with the change. Once this is settled, we will discuss the anti-depressants.

Also, in therapy, I'm kinda stuck between a rock and a hard place. My depression, suicidal thoughts, and wanting to harm myself, increase when I talk about my feelings or being abused and they increase when I don't. So, either way I'm more depressed. I know talking about it is better, but I so don't want to feel the pain, sadness or rage. So, as a defense I go into all that other stuff. This week and the end of last week, I've been talking about things that my step-father's mother did to me or had me do. I have never, ever, ever talked about it before of even let myself think about it, so this naturally makes me more depressed and overwhelmed. I'm just not in a good place and I keep thinking "I want to die."

Medications: Do as I say, not as I do!!!

Okay, this is one area that I appear to be clinically clueless and Geoffrey uses it "against" me all the time. I hate taking medications. I have a stigma about them when it comes to me. I feel like I've failed, I'm not doing something right, that I can handle things or I'm not that bad off. However, what I've been leaving in comments, have told my clients and really do believe is that medication is helpful and extremely useful to take the edge off things, so that one can manage life and therapy.

Even so, I fight it every step of the way despite knowing a great deal about them and their usefulness. Sometimes, I even cry when I have to increase or add because I feel like I've failed. God has a way of making me speak to myself. See, the two times in my life that I was prescribed medications, I was really "fighting" the whole process. However, at the same time, I just "happened" to have at least two families and clients who were doing just the same thing and I was talking to them about the benefits, etc... Yes, I was listening to myself and telling God that I don't like his sense of humor.

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:

Q=daily
HS=bedtime
PRN=as needed
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