Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Wednesday, October 31, 2007

Locked emotions

I am not entirely sure about posting right now. I'm generally grumpy at the moment. I'm supposed to be trying to act moderately not depressed this week and it is much more difficult that it should be because for whatever reason I am not sleeping. So I increased my Seroquel dose yet again (500 mg) and then try to make some balance between what I'm supposed to be doing and how little I feel like doing. Last night was the first night at the higher dose and should have been the night I was most sleepy. I was making grilled cheese (something I crave every time that I'm depressed) at 2:30. Yes, I know I shouldn't do that at night but I.don't.care. However, I'm really touchy and not necessarily in a place to be very nice to other people. I am very limited in what I can do (almost no energy, absolutely no money, very little interest), so my crabbiness further extends to the things I am capable of. And some things have happened that I have every right to be crabby about, which of course doesn't help either because sorting out real from imaginary is not my strong suite. Oh, and Halloween disrupted my carefully adhered to med/TV schedule.

But the real thing that is driving me up a wall is something that comes with depression. I'm sure it has to do with the high doses of mood stabilizers; it didn't start until high dose Depakote started a few years ago, but high dose is the way they work for me. Anyway, if I am depressed I can't cry. It's really not good. I can cry with my therapist. I can get teary at stupid things (football (when your team stomps the other) bother anyone?), but I can't just cry and let out all that stuff.

I know that crying all the time is no good. But crying some is, (something I admit only after ridiculous amounts of therapy which involved actually practicing saying it aloud), good. And I can't. I think not being able to cry makes me even more depressed because I wind up curling up in a ball and staring at a wall and just being sad, instead of feeling bad and then moving on.

I wish there was another option....

Saturday, October 27, 2007

WHY am I making decisions?

I just forced myself to drive to the nearest town to the pharmacy. Not easy with no energy and feeling sick. It's just a stupid old side effect, but I'm just not feeling great. I needed some OTC fiber supplement meds to help with my belly.

I got overwhelmed by options, as per usual. And I got home to find that I had purchased something with a supplement I can't take (risk of mania). I have no idea how I didn't see it. But I didn't, so now I have a useless bottle of fiber and will have to go back to town tomorrow.

So frustrating. Why can't anything be easy?

Also, WHY is football making me cry today? WHY???????

Friday, October 26, 2007

Post #Many for Today

I'm going to sound like I'm having a pity party. Maybe I am. If I am I'm going to go with the thought that I'm allowed, that I'm in the middle of a really hard time.

A great deal of what I'm struggling with is some serious anxiety. It's the cause of the broken (yet again) sleep. It may be part of why I don't want to stop sleeping. I'm frustrated with this entire thing that is my life and I need to just cry. I seem unable to do so unless the psychologist talks me through it, and that is really not so much fun.

I did take a shower today. That's 2 in a row, which is good since before that was like 3. I also have the dishwasher ready to run.

I'm not eating well. I have eaten, but not based on thought out meals.

I also just can't believe my disability is messed up. I need that so badly, and not having it makes things worse. I can't spend any money so I have to not leave home, or if I do it has to be to go somewhere money isn't required.

It's so hard to believe that only a few weeks ago I felt essentially the opposite.

Dear Neighbor Kid

Memo: To the teenager/young adult neighbors in my small part of the world

Dear Teens:

There is a certain thrill that comes with the independent ability to drive. We have all felt this. Apparently it is a great deal of fun to rev your engine and take turns fast, with gravel flying and tires squealing. Playing music so loudly that my house, which is set apart from yours by a pretty good distance, actually shakes, well, I guess that's fun too. Somehow.

But please, GROW UP. I've been here 4 years. And for 4 years you've been making me jump, making me cover my oversensitive ears, making me hide in my own home.

I am so tired of you. I just yelled at you, but you can't hear me.

I'll never understand, so please just quit.

Going for Broke

Each time I've been on disability getting the paperwork in has been an issue. Various screw-ups have occurred on different levels--the doctor, the insurance, my company. Funnily, the person who is off work due to cognitive inability has never been the guilty one.

I hate asking my doctor to do the paperwork. She simply doesn't have time. I'm well aware of this, yet it's my only option. I need it so I get paid.

I've still not gotten a disability check. I'm now due for 3 or 4 weeks. I really need the money; my credit cards are going up and I had worked so hard to keep them heading steeply down this year. I owe my mother a lot of money. And bills keep coming due.

The doctor told me the papers were sent. My company and insurance haven't received them. My doctors office only said "we'll tell her". I don't think the receptionist has a lot of empathy about why not being paid for a month is hard. Why should she?

Because I known how much extra my doctor gives me I have a harder time than I normally would pushing about these papers. She said she did them, so obviously they need faxed again.

Deep breaths......

Thursday, October 25, 2007

Random thinking

When I saw my psychiatrist last week she asked something that's sticking with me: Am I this much better because of the Seroquel or because I'm under so much less stress? Since my improvement hasn't been monumental but does increase as my dose increases I'm assuming it's mainly meds, but I also know not having responsibility is part of this.

I've now reached the point where I sleep all.the.time. Yesterday I woke up having a major panic attack. I had weird dream number eight million of this episode. This was more than a nightmare though. This time I could "see" a hand holding me down in bed. It was not my own hand; my hand is easy to see due to a birth defect. It was on my chest pressing as hard down as possible. I fought and fought and could not move. Ultimately I woke up and was ok. Again, I think my brain is being psychotic again, in an atypical way.

I just ran out of tomato soup. I can't explain what a big deal this is. When I'm depressed tomato soup is one of the few foods I'll eat. I either have to go to the store this evening or manage until tomorrow. If I could find something else tomato based I might be ok. I must have eaten a lot more than I thought of it, because I generally keep about 8 cans around. Oops.

I want to go back to work. I miss people. I miss patients. I miss routine. Heck, I miss knowing what DAY it is....I also miss paychecks. No disability yet. Tomorrow is my weekly call to human resources and I'm going to have to probably start pestering my insurance too. I really hope they tell me "oh, check's in the mail". I should be getting a large check. And I really, really need it.....

Wednesday, October 24, 2007

Caught up

I increased the Seroquel to 450 mg last night. I believe there is some major difference between that and 400 mg because I feel really bad today. sleepy and nauseous and strange bad dreams. I ate lunch and really wish I hadn't.

Unless I feel better, we'll talk tomorrow.

Tuesday, October 23, 2007

What goes up, must come down

I have a bitter resentment of the nature of this disease, the part where I must live with near certainty that if I am manic that sometime very soon I will almost certainly be depressed. Depressed has hit. It is not that bad, random tears, a desire to sleep all the time even though I can't sleep, more cognitive confusion than a week ago.

There are reasons for depression to hit. It's still hard for me to cope with the way Seroquel changed my appearance. The weight gain did level off, as my doctor had told me it might, and I still have tons of fluid to get rid of, but it's still hard. I bought a 3rd attempt at finding jeans that will fit today; I really need just one pair. My psychologist's notes are probably full of the observation that I'm alternating between 2 outfits lately.....Nonetheless I'm having a really hard time accepting this new look. It also is a result of having passed what I had to look forward to (my trip). Now I only have 6 weeks more (or so) of psychologist appointments complete with 2 hours of driving, occasional trips to my mom's, a psychiatrist appointment, and a doctor appointment with my regular doctor that will include at least 2, and quite probably 3, pokes. I don't even feel blood draws anymore, and one poke is a TB test which doesn't count either, but one is a flu shot and those have been known to sting. I get them annually because of the working with elderly people thing and the last 2 years have been particularly bad ones. I'm also frustrated because argh, I don't remember why, because I'm still waiting for disability approval and therefore haven't made any money in weeks? Oh, I know. The hope is to lower the doses or remove some of my existing meds as Seroquel increases. The thing is that at this point it just looks like things are getting added on. My blood pressure looks like it is trending up, which matches my swelling. I may need meds for that. I'm taking meds to try to get the swelling to go away. My thyroid med will probably need adjusted since I've totally screwed up taking it. I started a med for GERD after the doctor the other day; now I'm taking something for further digestive issues.

I should mention also that today just wasn't the best day. I made myself leave home and had all sorts of negative adventures, including being rear-ended when I was totally stopped at a red light (which was red). I'm fine and my car is fine, but my body is under so much stress from inside already that I shook so hard I couldn't drive for 20 minutes. I was practically in shock when I got out.

The one good thing is I figured all this gives me lots of reasons to eat chocolate :).

Monday, October 22, 2007

Why I'm so tired

Today has been wild moodswing day. Today has been an example of why mixed episodes can be so difficult. They are difficult in other ways, depending on how the combination of moods are presenting themselves, but today is the kind of day that is just exhausting.

I woke up depressed, having slept many hours. I continued in depressed mode with the psychologist, crying for the entire hour. I didn't even talk much today, I just cried. Thankfully I get the occasional "allowed to feel sorry for myself" day from him. It's odd; he will always take the opposite side on that from me. If I think it's ok to pout he'll try to convince me otherwise. If I'm mad at myself for feeling bad he'll let me feel bad. I'm very glad to understand this because it used to confuse me. I sort of know why he does this, and it's better than just telling me I'm right all the time, because I'm not.

I went to a seconds store to try to buy more sweatshirts or something appropriate to wear. As it is now I'm alternating 2 or 3 shirts all the time and that's just not quite appropriate. I found 2 shirts but I didn't buy them because they didn't have pockets and I need pockets because my pants don't have pockets. Plus I was getting teary over trying to find one pair of pants that fit. Pants have me so confused. One size is too small in jeans, yet slacks in the SAME BRAND fit loosely. Another brand of jean I tried on and purchased with a slightly loose fit; they are now far too large. They are one size larger than the ones that don't fit. So apparently I don't wear any jean size now? I'm so tempted to get elastic waisted maternity pants for now. Because my weight is a lot of water weight my pants don't fit in the evening nearly as well as the morning. Elastic would be so much more comfortable. But I don't want to attract weird looks or cause misconceptions. By the end of 10 minutes there I was nearly crying. So I left.

On the way home I switched for a bit to hysterical giggles over nothing that funny. And now I'm sad again.

This takes too much energy. No wonder all I want to do is sleep.

Sunday, October 21, 2007

Confessions

I'm discovering that I have a real issue with something fairly stupid. I don't particularly want to be in the end of the bipolar spectrum where I'm at the high end for severity and functioning. I'm an outlier and I'd really rather not be. It took me a long time to accept that. Yet I have to keep it in mind because there is a lot of the time I have to remember that yes, I can function, or I have to remember that I actually am very sick a great deal of the time and when I am sick I am too sick to do some things. I've tried to develop a layer of pride around all of this because the truth is that my succeeding is something to be proud of. I don't hold back from giving credit to the people who have treated me or helped me along the way, so I also need to be proud of myself. (My psychologist would have a heart attack if he heard me say that).

This can however cause problems. I know there are people worse off than I am. I also know there are people who think they understand what my life is like and they don't. I struggle with this from outsiders and also from people with different diagnoses on the BP spectrum. I'm certain that there are aspects of my own illness I don't realize how fortunate I am to have. I am very aware of the benefit of having the treatment team I have. I know how rare it is to have a psychiatrist who is willing to spend over an hour a month on a Saturday, plus many emails during the month, in an attempt to stabilize me. I have a good psychologist and have been going to the same counseling center for so long that I have absolutely no doubt it is the best for me.

Having said this, I have developed that same kind of dull pain that is like a toothache in response to certain reactions. Partly this is because of someone in my real life who has cyclothymia who tries to tell me how I should alter my meds and how she is much sicker than I am. By nature cyclothymia isn't BPI; if it were they wouldn't be 2 things. All it takes is a look at my med list to see my treatment hasn't been typical. When my doctor had paper charts mine didn't even get filed because it was needed so often. My bad med reactions overflow the major university hospital's computer program. I am very ill much more than I am well, even with taking meds like candy.

For a long time after I was diagnosed I tried to shove myself into other categories. I was very upset to hear "bipolar I" because I WANTED to be bipolar II. I freaked out when told I had mixed episodes, even though I knew perfectly well I did. I guess this follows fairly well my history of positively refusing to consider the diagnosis, then I wanted it to be mild.

After I came to terms with it though, now I have this bruised fruit sensitivity to the words that mean someone else's experience is level with mine even if I have a ghost of a doubt it's true. I have some kind of weird qualifier system in my head that wants to determine if someone is well enough qualified to "really" understand. It's not fair of me and it's partly just my way of being oh-so-angry about the course my illness has taken.

The whole thing is especially stupid given that I really do believe everyone has a right to their own pain and I have no desire to compete. It's just that knowing I'm in the "really badly affected" group, the group of people my doctor who mainly works with very involved patients calls her "very fragile" group, annoys me. Which then makes me want to take that out on anyone who tries to make themselves seem this sick because to me it is something I so deeply don't want. I know though, even though I may never say it again, that even bipolar that is much, much less complicated and symptomatic than mine is still horrible. And it could be even worse for me. I must always remember that.

Saturday, October 20, 2007

Psychiatrist says....

I'm still pretty sick. No surprise. A bit weird because I'm not sure she really knows how immense the improvement has been, but I need support to remain peaceful with staying home longer. I know I have to, and I'm doing really well not panicking about it, but I still need reminders every so often.

It was strange because she didn't follow the usual routine in the assessment. I think she knew it wasn't great. I realized after I left I wasn't even making eye contact at all. I'm definitely still looking off.

She did tell me that there is further research now that indicates lithium may be neuroprotective. I just wanted to throw that out since it came up last week.

I'm going to keep increasing the Seroquel dose. I think she'd like me to be at 600 mg or less. I'm at 400 right now.

I also have to go to my regular doctor because I haven't been taking my thyroid medicine routinely. It's hard to take an AM med when you sleep through it. I have a feeling I need to start totally over there. I also am due for the semi-annual loss of a LOT of blood. I did make it 2 months without a needlestick though. That's a record since May 2006 I think.

She gave me, by my request, a few diurectic pills to try to get the swelling in my legs down. It's uncomfortable and my shoes don't fit which makes it hurt even more. Diuretics and lithium aren't a good combination, but can be done for a few days. I have a history of leg edema being associated with high blood pressure, so this is a proactive move. My blood pressure has been great, I really want to keep it that way.

She also agrees that I'm not ready for SSDI. I really needed to hear that from her. Everyone who counts agrees with me. I am ready to learn about it, but I can keep working for a while longer.

And she wrote another work excuse. She wrote for 6 more weeks. At that point I'll hopefully go back part-time and slowly increase. Actually it's hopefully I'll go back a little sooner, but we all seem to think that moving slowly is good this time. Not just because it is helping with not having crazy med reactions, but also because I'm benefitting from the lack of stress and noise. It's weird to think I'm going to be off 11 or 12 weeks when we all thought 2 weeks when it was apparent I needed to be off in general, but my body has said slow so slow it shall be.

I proceeded to drive home, stopped to get my prescription filled and pick up a med for heartburn, and when I got home I fell sound asleep almost immediately. Even that is a huge day I guess, and all I did was drive up (2 hours), kill some time, wait 5 minutes, talk for 75 minutes, get lunch, and drive home with a quick pharmacy stop. Oh, and I didn't scream at this extremely rude man in the store who was trying to select pull-up depends. He was talking on a cell phone loudly and had his body and cart directly in front of the meds I needed. He did not move, nor did he really do much looking. Basically he was just standing. I stood and wait for over 5 minutes before deciding he wasn't going to let me grab my Xantac, nor was he going to be the slightest bit polite, and I couldn't trust myself to not be rude if I asked him to move.

So that was my day. Pretty glad for boring.

Friday, October 19, 2007

Bland brain soup, please

My brain just decided to give me a good strong reminder that all is not well in chemical-land. I don't know what happened, I suppose it was some sort of hallucination except thatI was more aware than I should have been. Then it was a panic attack but I was positive my cat was killing my other cat, so panic was reasonable, except that the so-called "victim" was at the other end of the house...

Whatever, I'm less than thrilled. I'm actually still scared and this happened nearly an hour ago. My poor cat may never be the same again.

Tomorrow is the psychiatrist. Maybe she can explain.

Sad

My vacation had its sad moments, because it isn't easy to see all the ways your life isn't exactly the way you hoped, and being with my sister and her very normal life somehow emphasizes that more than ever. It's hard to see her beautiful and clean home, how she operates on a schedule, to hear her talking about having children, etc. It's hard to watch how much she loves my brother-in-law and how smoothly their marriage operates.

There was a time that it appeared she'd be the one with "problems". I worked very hard to move beyond some of the things we both faced in our childhood, and she didn't choose to try. And I am the one who wound up with this illness and with all the changes to my life. It was another reminder that we just don't get to plan our lives ourselves.

One day we went to a state park. I went to the bathroom and saw one of the saddest things I've ever seen. Someone had scratched into the bathroom stall door "I hate my kids". My guess is they were frustrated and had cranky children who were tired from the hike. But I just can't quit thinking how sad that is, because not being able to have kids makes me pretty sure I'd never hate them. Or it makes me much more aware of how important it is to remember the value of kids. Something.

Thursday, October 18, 2007

The state of the union

I saw my therapist tonight. He was pretty happy with how I'm doing. I've actually come to an acceptance of my current limitations over the past few weeks, and that really is working. He told me this is one of the days he got a glimpse of what I would probably be like without this disease. That, of course, is very good. It turns out that not fighting how I feel is maybe even letting me feel better, because it wastes less energy. It also is encouraging me to take it slowly, which is simply not my usual style. I'm trying so hard to follow my body's lead this time, and it is just possible that if I had done this sooner like everyone encouraged I might have suffered a bit less. I think I'm going to be out of work 3-4 more weeks, period. Fighting that wouldn't help.

It appears I have very different short-term disability coverage. I think I have the option of partial disability, allowing part-time return to work sooner. I also have a longer covered period. It's really, really good insurance. If I am correct and I have that, I'm hoping to use it to work 2 or 3 days/week for a while and slowly increase, using up the whole 6 months if needed. The holidays are always brutally difficult for me, and the season change does not help. I have SAD for sure. I did better last year, and have been working as hard as I can to be ready for this year in advance, but unfortunately part of the annual reaction is from bad associations, and I can only control that so much. Also, December is the busiest month for having rehab patients as people choose elective procedures while their co-pays are paid and the weather is not going to allow them out anyway plus injuries and illnesses from bad weather. So cutting my stress some during all that may be good. I'm very nervous about going back to work and facing all that stress at once, but I also want to go back when I am ready. I know my being off is hard for my company because they are very short-staffed, plus I just miss working. I'm somehow not feeling particularly guilty anymore, which is good.

I'm really surprised I don't feel guilty because I really don't want to be working right now and I'm not even really feeling any desire to go back. I think it's mainly a generalized indifference that comes from the meds and fatigue, combined with feeling at peace with letting this recovery occur at its own pace. I will admit that after fighting taking Seroquel for literally years, I really like this med. I just started 400 mg tonight, so I've really gone up slowly, and I'm glad for that. I have a bunch more adjustments to do before things are good, but it's looking like I may even wind up on less total meds. I think in the end I may only be on Depakote, Seroquel, lithium, synthroid, vitamins, and questionably Provigil. I've been on Provigil for years and need it to work, but I'm not sure the doctor is going to be much of a proponent with this much mania. I stopped it immediately, just as I've done with every mania before, but I don't know if we'll be trying to do absolutely anything to avoid mania forevermore now or not.

Anyway, from an outsiders' view things still have a long way to go, but at least for now, from my perspective, at least things are tolerable.

Three-Two-One

There's a lot irritating about this stage of recovery from an episode. I feel better but am still far from well. I'm tired all the time and still not always sleeping very well. My daytime pill schedule is off and taking meds for anxiety during the day makes me very sleepy, but I need them. I am afraid to try to switch my daytime anxiety meds to Seroquel, even though that's allowed.

I've come up today with the top 3 irritating things. In short they are:

3)I keep setting fires. I really like my house and don't want to burn it down.
2) I insert the wrong word into what I'm saying. I don't always catch it and it makes written stuff seem ridiculous and spoken stuff hyseterical.
1) I start to do something and forget what I started to do 5 seconds later, before I've finished the first motion to do it. Then I have to backtrack and see if I can find the thing that triggered me to attempt to do whatever mystery thing I was trying.

Tuesday, October 16, 2007

Kindling

Taylor asked for a definition of this. I need something to do to start to settle from 13 hours of travel so I'll answer. Later I'll have more to say. I think.

Taylor, kindling is a theory that is tossed around for BPI patients (BPI and BPII have different courses; BPI tends to generally get worse, BPII is gender-related in how it progresses). According to the theory bipolar episodes affect the brain so that each episode or med can influence the course of the disease essentially by damaging new areas. If the disease is controlled then there is less damage from ongoing episodes, and if the number of episodes are limited then the risk of brain damage is lowered. It is an attempt to explain why I can do well on a cocktail for so long, have an episode and those meds won't work anymore. It also helps explain rapid cycling/mixed episodes as a result of that brain damage. The theory is based on a guess that BPI and seizures have some shared causes/triggers, although they don't know enough to know why. What I have read is pretty specific about this being a BPI thing; I'm not sure what the BPII story is.

My story of kindling, since they believe I am an excellent example, is this: I was diagnosed with depression, anxiety, PTSD, primary insomnia, etc. for quite a while because I lied to avoid diagnosis and because I don't act very typical for someone with my kind of bipolar. I think the idea danced through people's heads and then they'd decided if I was bipolar then I had to be BPI and I had to have this and this and there was NO WAY I'd be doing as well as I was in grad school and working and dealing with some extreme family stress and whatever else. That continued when I was a new professional with this great career; I just didn't seem like my life was falling apart enough. So I was treated for depression. I wasn't just treated, I was really treated. I just didn't respond well to the meds and kept getting worse, making it more desperate to fix me before I killed myself. I had a nice pattern with most meds (check out my meds blog for the specifics; it is sequential) of going on it, feeling better for a few days, getting worse, increasing the dose, feeling better, getting worse, etc. Eventually I'd max out, have to taper off and start something else. I never felt good on most of them and now know that they were making me hypomanic. I was incredible blessed that Remeron seemed to act as a mood stabilizer for me. It gave me several years of feeling good. Eventually though it wasn't enough.

Added to this mix was inconsistent medical treatment. In college I had a great psychologist and was treated for the depression by the campus doctor who didn't seem to know much. In grad school I had many attempts with therapists, none of which worked out. I had a psychiatrist who seemed pretty disinterested, and then he died suddenly. His replacement was the first person who said she thought I was bipolar, but she was far too aggressive and that suggestion was thrown away. I was treated by several family doctors for a while after school, then a really, really bad psychiatrist. Finally I started with a good therapist and then really good psychiatric care and that has continued.

Several months before I was actually diagnosed I was put on lithium to see if it would help me not want to kill myself since my antidepressant wasn't doing so well. Lithium had the interesting effect of making it extremely clear that I was cycling. Even I knew it without question.

The problem was that I had been on every antidepressant available, pretty much, in a very short time, and on many doses. I went from what would be more traditional rapid cycling, defined as 4 or more episodes per year, to what I call Superballing. I easily shift from very manic to very depressed 3-5 times per therapy session sometimes. I can't track my cycling very well because it is too fast, but during the hour someone else watches I know we've seen some intense changes. I am absolutely unable to do mood charting because my cycling is too fast. I was in a clinical trial and even they quit trying to make me do it because it was a losing battle. I also have very severe mixed episodes, where my thoughts are depressive and my energy is manic or vice versa or some other combination, and those also probably are related to the early treatment mistake.

Then, just to make me even more fun, I don't respond to meds normally. So in 5 years time the longest I've been remotely stable was 5 months and even then I had episodes on a mild scale. All that I've said about dose changes and med switches not being so good? I have had 2 months in 2 years without, and most months I have 2-3. I have not gone 4 weeks without email discussion with my doctor in so long I can't remember. 22 months? So every change just adds to my messed up brain soup.

In addition is the "Just Me" theory, which says that if your body has been through as much chemical onslaught as mine it will react strangely to anything introduced. I can count on needing more or less than recommended of any med and I will have at least one oddball side effect.

There's a long answer when I thought this would be short. Long, long day. Manic thoughts. Must shut up.

Monday, October 15, 2007

It is defintely time to go home.  The mania was much more present today.  I have felt so irritable and have had racy thoughts etc. all day.  I barely managed to not cause arguments and just to generally be patient.  I need alone time.  I need time I can get into my blog.  I need my  bed, my house, my cats.  I need a dose increase.  It's just time to be home and I'm so glad I'll be there tomorrow at this time.
 
On the other hand I had a good experience today.  The year that things started really getting out of control for me I came to this same place for vacation.  I had begun having periods of agitation, depression and easily upset/easily hurt feelings about 3 months previously; here was where I felt very overwhelmed.  I had been having crazy mood swings for a few months and had been aware of it, but attributed it to depression, PMS, stress, whatever.  One day while we were here we went to a state park and did a nature tour thing.  I remember two things:  it was beautiful and something made me that burning hot manic mad.  I didn't know what to call it, but that was the first time I had been that sort of angry in public over something stupid.  I blamed it on several things, but it's always been a memory I held on to.  Today I went there again and got to form some happy memories.
 
I have a feeling that I'm in a for a few hard days here.  I think I made it through this vacation by pushing very hard and I'm done managing with the extra force.  I'm exhausted.  But I have many things to talk about, so I'll be really glad to be at my own computer tomorrow night.
 
Until then....


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Sunday, October 14, 2007

In addition to last night's entry, I had a few things to say.  First, for anyone thinking this is something to worry about, first know this is something I am terrified of.  I have good reason, but my fears are also beyond the real risk.  I didn't mean to scare people describing the dementia as so bad.  One reason I am very frightened/aware is that I worked with people who had been bipolar for 60 plus years.  Lithium was the first effective treatment and it's only been around since the 1970s.  So these people had been subjected to bad stuff.  Plus, my patients were always representative of the worst end of the sprectrum, just short of state institutions, and not really all that short of it since it was basically what the state did with these people when they weren't in state facilities anymore.  These were really, really sick people.  Many of them had been left in institutions early on so that they had even more messed up lives.  There were some we had no clue if they had any family or if they ever had.  If I had worked there a few years earlier I would have had lobotomy patients.
 
When I worked there people would ask how I could work in psych without my own feelings about myself being taken over.  I asked that a lot at first too.  Usually it was no big deal because there were such huge differences in the treatment I was getting and what they'd experienced.  This was one of the things I did emotionally focus on too much.  So forevermore be cautioned.
 
Also, I freak out about any changes I see in this area of myself.  I don't know why.  I am not nearly as bothered seeing other things change, but cognitive changes scare me.  Even when I know it will pass I am afraid.  Partly this is because I survive because I have this incredible cognitive control over the whole thing.  Going on disability this time had a lot to do with my knowing I was not going to control things much longer.  Partly it just embarrasses me; I laugh about these things, but it really does upset me to do things like set a paper bowl on a burner because I forgot the pan I am holding just came off that burner.  Instant burning.  So these things then seem exagerattedly awful.
 
There are positives to the whole mess that I need to focus on.  There is evidence that lithium is protective of the brain and I've been on lithium since before diagnosis.  Some of my cognitive changes are from meds and if everything goes beautifully well maybe someday there will be meds that don't overdo the sedation.  Right now I complain about feeling stupid, but the truth is that I'm taking an impressive dose of sedatives, I'm taking 4 or 5 types of sedatives, and my body has been constantly adjusting to this.  That's not good for the thinking. 
 
It also is the one area I feel like my psychiatrist and psychologist both are more unwilling to tell me everything.  I have a very upfront relationship with both, and I need that.  But in this area neither will give me firm answers about what precisely they see.  There's a lot of diversion and redirection when this comes up.  My professional status doesn't help a whole lot there either.  I can't be tested with most standard screens and so they have to make things up.  Sometimes I know what shows and sometimes I don't. 
 
To make that even more complicated I realized just today that I have developed a strong tendency when manic to attempt to hold back when I'm with them.  I have started trying to say as little as possible so that they won't see reality.  Probably this hasn't gone unnoticed, but it also colors how much they actually have seen of the changes I'm complaining about. 
 
Having said all that I do know for sure I've had huge changes.  I attribute a huge amount of that to kindling, which I was very didactic about yesterday, also unintended.  I meant for a tone of "this is where I know my cognition falls apart" and that didn't come out.  Quite simply, this terrifies me.  I worry about it too much and have read about it too much.  I also see typical dementia patients every day I work.  They're one of my specialities and I'm good with them.  Partly though I'm good with them because I know that I am likely to be one eventually and so I treat them with respect. 
 
Anyway, I need to go take all those pills.  Tomorrow is my last day of vacation.  It's been nice, but I cannot wait for my own bed.  Tuesday I'll be home again and normal blogging will return.


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Saturday, October 13, 2007

To Jon and anyone else

This is a comment response plus further discussion if anyone wants.   I just can't get into my comments until I am home.

Thank you for the very, very kind words.  I need to hear those about daily right now; this particular disability period is so hard.  Although I'm learning;this "vacation" is very hard, even with me trying hard to rest at every opportunity.

I just wanted to throw one thing out before I forget; more discussion of the SSDI thing when I'm home.  Lots in fact as it's time for me to start learning and seeing a lawyer just so I know some of what to expect.  My hope is to do it with a lawyer the first time and to have so much documented I'm in the lucky 1st time applicant group.  My doctor is documenting that way as well, being extremely specific with every note and every loss.

Anyway, re: cognitive changes.  My understanding is that being on meds helps, being stable helps more, and it is no longer a certainty that bipolar people will develop dementia.  In the past the disease combined with the "treatments" caused horrible dementias, so bad that I can think of one lady alone who broke my heart for years.  However, when I was diagnosed I was told that damage done couldn't t be undone.  In my case I had been on bout 11 antidepressants in rapid succession over a few years, and each one I had started at a low dose, escalated to the max dose, doing well for a bit on each dose, then maxing out and coming off.  Each one of those caused more damage and I was told that this is undoubtedly related to how severe my rapid cycling is.  Truth be told I am sure I would have been a rapid cycler anyway, but all those antidepressants turned me into a human Superball.  That's the whole kindling thing.  I also have read that there is evidence kindling can occur every single time we miss a dose of pills or have to change or the like.  And then there's the whole other bag of worms for me, lithium toxicity.  When that was really bad my cognition was so poor that I would cry because I could not complete sentences because I couldn't find words.  Nothing has made me more patient with stroke patients than those couple of weeks.  When that occurred combined with my dragging my foot and tripping over my feet while walking as if drunk my psychologist became suspicious I was toxic, and well, I was.  I had to work my way back through things as simple as what day it was last year.  I eventually got the basics back and returned to work to learn that while I was better I had some changes forever.  I have always relied on my memory much more than I can now.  Now I have a notepad that is off-limits under penalty of death to all others.  One thing that was so bizarre was that my memory for ICD-9 codes was essentially gone.  I never did learn nearly as many as I previously had and now we're computerized and I don't need to know, but it was terrible because I lost so much time looking up simple stuff.  I also have a lot more trouble with numbers; my billing accuracy is much less than it was before (well it was until the computer).  I was really upset for a long time because of knowing I wasn't fully regaining what I had, and have just come to accept it over the last few months.

This round my cognition again really went downhill.  Not from toxicity but from not being able to slow my thinking.  It was bad enough several times my psychologist tried different tests; I passed some and did ok with the rest.  But I'm still working on remembering the day, how several days coming pan out, what I need to do/what I'm doing (the number of burned meals says that all well), to place clothes IN the machine before running it, etc.  I overdrew my checking last time because I paid my car payment weeks early.  That kind of thing.

My suspicion?  I won't be getting everything back this time either.  This time I don't really mourn that because I know now.  I feel I'm doing what I can do.  I take vitamins that may help.  My doctor has kept a few meds out of the line that she feels would be worse.  I trust her.  I take lithium despite it and my body hating one another because lithium helps me cognitively and I'm just willing to accept the consequences. 

So in total, I think if you have an ideal case of bipolar, the kind where you get sick, get diagnosed, get treated, and never have a bad episode again then maybe you won't have cognitive probems with age.  However, given the nature of bipolar, I'm just not sure that's very common.  I'm certainly not in the same cognitive place most people my age are, and my abilities on a standardized test would be very, very different than 10-12 years ago.  One of the things people try to say positively about bipolar is "but such intelligent, creative people have it!".  Well, I may have (and did) fit that back before I was sick, but I know my intellectual ability is so far declined it is pathetic.

It's concepts like this that lead me to 3 weeks of deep depression when I realized that I don't get my life from before back.  I really think people get a little excessive with this positives sometimes.........


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Friday, October 12, 2007

Well, hopefully this post works.  This is my first attempt at a real post from a computer where I won't pull up the blog to check.  Please forgive typos; they tell me laptops are the same size keys but it never is the same feeling to me.

I survived a long day of travel, both air and driving.  I only took 2 PRN anxiety pills for making it through the airport (noise) and flight (general overstimulation).  Not bad. 

I did accidentally totally get with something.  I traveled with a pill splitter with a razor edge in my carryon.  I didn't realize until I was here.  Oops.

Still all kinds of cognitive symptoms, but I'm doing a bit better overall.  Starting to be able to focus more, starting to care a little.  Yesterday was a little tough for a while when I got a recruitment ad for my job, but after a few hours I found out it isn't for a permanent replacement.  I'm having a hard time believing I won't totally be replaced though.

Emilija, thanks for the financial info.   Interesting about the homeowner thing; part of my fear is losing my home.  I have a kind of loan that discourages sale for 5 years.  I'm almost there, but now I'll build a lot more equity and I want that, obviously.  Too bad my employer won't match house payments!:)   I'm going to at least talk to my doctor about when she thinks the time for disability is.  I'm really struggling because voc. rehab says I shouldn't work and everyone else says I can.  I also want to say more about your other comment but I want to think first.  It's hard doing this via email because I can't go back and see what I wrote.

I'm going to actually try to go to bed.  Who knows what that means.  But hopefully this is the first night of miracle sleep caused by changing states.  It could happen, right?




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Thursday, October 11, 2007

This is simply a test of blogging from my email.  It will probably come down as soon as I remember to do so. 
 
Expect a fascinating update of flying while manic tomorrow.


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This is simply a test of blogging from my email.  It will probably come down as soon as I remember to do so. 
 
Expect a fascinating update of flying while manic tomorrow.


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Planning ahead

Planning ahead is clearly not something I can be doing right now. I'm too close to the edge, too able to totally forget how to cope. Yet my mind races ahead, and it's always nice to counter with answers. So this is what I'm pondering tonight. I reserve totally the right to change that at any point. (ie 2 hours ago I was freaking out about losing my job)

Anyway, my situation is this: I'm going to be 32 fairly soon. Retirement age for people my age is in the 70s and after Medicare will have died or whatever happens to it happens. Except that I'm not necessarily going to be working that long. Right now it seems like I may manage a few more years. It a way I want to just give in now and do the minimal amount of work that I would be allowed to do on SSDI. But work still is too beneficial to me, and is too much how I define myself, to do that. Which means I may try to cut to part-time, but that's just thinking.

Anyway, it's time to set up a 401k. Except that I'm not sure this is a wise move. I can't get enough money into it in the few years I probably have left working for it to matter, and getting more equity out of my house seems more important. It doesn't seem likely that I won't be on disability within the the next 5-10 years; let's assume I am not. Putting anything into a 401k is a hardship because my budget is so tight anyway. But my employer has a really good matching program.

Anyone with any thoughts? Caveat: Please don't tell me not to think of the likeliehood I won't work a tremendously long time. I know things change. I also know my situation and that all involved believe this to be true.

Wednesday, October 10, 2007

Better day. Need more of these

Well, I made it through a whole day feeling a tad better. Some is hypomanic, some is just joy at any changes no matter what it might be. I probably jinxed the sleeping because I crashed at 8:30 and took a short nap. It's so hard because that is when my body seems wired to sleep. The problem is that it doesn't stay asleep at that time and I've deemed waking for the day at midnight even worse than not falling asleep until 4. That's probably a personal preference? So typically I force myself not to nap during the one period of time I am most sleepy. I'd think that would make me sleepier later, but it doesn't work.

Today I even read some. Not tons, but some. Better by far than I had been able to do. I am pretty sure I'm even following the story. Half the time lately as I read I realize I have no clue what the plot is. This book has been more simple than my last choice.

My biggest accomplishment was certainly my most recent. I made an actual list of what I need to pack tomorrow for vacation. I always pack this way, but at the moment making a list is a big effort. I'll still have my mom check it but I think it is complete.

YAY!!!

I slept. I don't nkow how nor why, nor if it will repeat itself, but I slept from 3:30 until 10:30 this morning with only 2 quick bathroom breaks where I barely woke up. There are no words for how much better I feel.

Of course my manic mind wants to pronounce me "better", but rationally we'll just say "this is a reminder there is hope".

Maybe not so good

I tried laying down for a bit somewhere around midnight, thinking that I'd at the very least get a little bit of rest. As this episode has become mixed I've been able to lay under my weighted blanket and get my sensory overload slowed a bit while my body is physically resting a little. In a way it feels cruel to let it physically rest knowing that this just gives it more to burn for tomorrow, but rest is also so good after these last weeks. So anyway, miracle of miracles I drifted off.

I woke up a little bit ago thinking "wow, I slept really soundly! I feel GREAT!!! I must have slept for hours!".

Then I looked at the clock. 2:13 AM

Words elude me.

Tuesday, October 09, 2007

I need a dime

Actually I need about 4 of 'em. And 3 or 4 quarters too. Mania has taken over. All it takes is one goal-oriented project and off we go.

I was cleaning this evening and discovered that not only did I have enough coins saved to make sorting them worthwhile, I had a huge amount of change saved up and already rolled. So I ran everything through my sorter machine and came out with an unbelievable amount. Enough my vacation will not be an issue.

The problem is that when I'm manic I tend to behave in some obsessive compulsive ways. OK, very, very obsessive compulsive. And right now I know that if I could only add just a few more coins to those 2 rolls I could have $15 more.

I already made a trip to the car and to the basement to the laundry room. I crawled behind the entertainment center.

I just got one more idea. But this is another sign of how badly I've lost control; I've upended my house for less than a dollar, mainly becauseI can't stand to relax and deal with it tomorrow, which would be the logical thing to do since I'm sure my mom will dig around for it or I can buy something to get change, giving me the $15.

Now, back to the ssssssssslllllllllloooooooooooooowwwwwwwwwwwiiiiiiiiinnnnnnnnggggggggg down thing.......

we'll see

My doctor told me to jump further ahead with the dose increases last night and get to 300 mg of the Seroquel. I also have just been taking a much larger dose of anxiety meds as a rule instead of waiting to see if it was needed, especially since I have given up my antidepressant (and I hate brain zaps so much.....I tapered off the imipramine so carefully to avoid them, and apparently cutting the pills down to 1/4th of a low dose wasn't enough. I've been off almost a week so hopefully it's going to end soon.

I did not sleep any better than I have been; in fact it was probably worse than some other nights and if I hadn't left the psychologist's totally emotionally worn out it would have been horrid. But the sleep I got, even broken, was more sound. I think it was more sound that even my usual 1st day on a dose sleep has been, and those have been my so-called "good nights". For whatever reason I feel more rested.

I've also been very busy much of the day and so some of it may be mania. I am dealing with some psychotic sounds which is a good way to hear my body say "stop". That actually probably should be my body saying "gone too far", but it's definetely a signal I recognize.

Otherwise, I am worrying. Which doesn't help so I'm working on not thinking. I really wish I could do that. But in a controlled manner.....Geodon did that pretty completely for me and I didn't like that much.

I need to run out to my car for a minute. Hopefully I won't scare too many neighbors since I didn't bother with getting very pretty today. Then it's shower time, which I dread because it can make me hear noises even more pronouncedly. Tomorrow I'm getting my carpets professionally cleaned (my mom loaned me money; thankfully because they NEED it) so I have a big day.

Hopefully also I won't be back on here in a few hours whining that 300 mg wasn't even close to enough.......

Little to say

Please forgive typos and spelling errors and run-on sentences. I wasn't thinking fabulously before my meds partially kicked in, leaving me groggy but awake. I am so tired.

I saw the psychologist and got confirmation that my mood shifted in a way not desirable. I knew that already but it helped to hear I wasn't (once again) making it up. I seem to be heavily cycling extremely rapidly. Cycling every few minutes isn't uncommon for me, but this is large cycles and short intervals and is occurring a much great proportion of the time. Last night I got to deal with some psychotic noises, hours of them.

Oterwise not much to say.

Sunday, October 07, 2007

Shame

In a comment to my last post (posted about an hour ago so look back), Emilija noted that disability made her feel shame. Thank you, that is exactly the right word. I feel like I am a kid skipping school and knowing perfectly well I'm just playing hooky. And in my family we didn't stay home unless we were dying. It just wasn't done. I had 2 knee surgeries in high school. The first time I went to school the next day. The second was more major and the doctor wrote for me to stay home for a week until he looked at it. The surgery was done on a semi-emergent basis, so it was done on a holiday. I stayed home the next day and went back the day after. The day my grandma died I went to the nursing home to say good-bye and then went to school. I just never missed. In my entire career I have barely missed work except for vacation and bipolar. The only sick days I've taken are when I was throwing up and I've worked and vomited. It really scares me as I see the number of bipolar days increase over time, although that has a lot to do with my current therapist being pretty good about making me consider when I need time off. It was also easier to move a day to a Saturday because of bipolar at my last job. I think I've also hit a period of being really confused. In the spring I decided the next time I was really sick I'd take time off and do whatever needed done to get better. It wasn't going to be a huge choice since there weren't many options. And then I reacted well to all the Depakote and bought time, and started believing time off was not coming so fast. Even when I started this time off we didn't think it would be that major. At least I don't think we did. And now I just keep hearing "it won't be 4 months, don't worry", but it's working on a month and nothing has changed into significantly better except that I can eventually sleep after enough days.

And for whatever reason, I do feel shame in that. I feel like I'm missing something. I feel like a failure at adulthood. I take my meds, every day. I avoid anything that might be a trigger. I see my therapist. Right now I don't feel like therapy is the biggest solution to my problems because the one thing he can't do is make me sleep. I feel like when they call to check on me from work and I sound ok that they're surely thinking I am goofing off. I feel very guilty because I'm taking a 4 day vacation. It was planned months ago, it's cleared by my doctor who I can contact, I can get back here quickly if needed, and if I don't feel well I will do nothing but sleep; I'll be with family.

In general, I think I'm just not very proud of being who I am. I am told every week in therapy that the best I can do is the best I can do, but it feels like not enough.

Yet I guess I must remember that just taking the meds I'm on right now alone is something to be proud of. Having the self-discipline to not make it worse is something good. I have not hurt myself and I have wanted to. I made myself keep the meds down when they thought they could come back up tonight.

I'm fighting. That's good. I just want to be sure that I'm winning.

I get it! I get it!

Last Monday my therapist and I had one of the talks that I'm fairly certain he dreads as much as I do. It's not easy for me to believe that I have limitations, and I feel guilty for being sick. So that makes times like now when I can't do quite a bit very difficult to handle. The conversations always include me repeatedly saying "yes, but....". I do know that he's right, but the guilt is incredible. I feel like I'm cheating everyone on earth by not doing what I'm supposed to do. Whatever, I'm sure you know the feeling and if you don't, just read for a while, you'll pick it up.

Anyway, ever since that conversation I've been upset, not sleeping, even more moody, etc. I didn't really think I was that upset by the conversation, but it is one that I have to fight with myself to accept, so I thought it probably had a role.

Last night I just gave in and drugged myself silly and I slept. Two 5 hour chunks of lovely sleep. I then overdid today. For one thing I was groggy and my stomach upset off and on, which seems to happen when I increase the Seroquel. My mom came and helped with some heavy cleaning. Then we went to the mall because she had this coupon that helped me save $50 on getting some clothes to fit now (I've lived in yoga pants and shorts for the last 3 weeks, not so attractive). The mall was sensory overload; I should have recognized that and gotten myself somewhere quiet ASAP but I am stupid, so we stopped to get Chinese take-out. Then we got home and my mom ran the vaccuum for me. That is something I absolutely can't do and she usually does it while I"m outside or something. But today it was too hot to be outside, so I just endured it with headphones.

By the time she left I was really cranky and feeling terrible about it. I curled up in a dark room under my weighted blanket for a long time to calm down and now I'm down to just really crabby.

So, in one day I was forced to admit that I cannot fall asleep until 2 AM even when I hugely increase my sedation, I still am incapable of sleeping solidly through a night even with that much sedation, I cannot possibly expect myself to get up routinely at any time that could get me to work on time, I cannot stand noise and chaos, much more so than usual, I'm still incredibly irritable, and there is no way I could work right now.

So, this lesson is learned and I REALLY would like to move on......

(Insert Smurf theme song)

I was up until 4 AM Saturday morning and did not get in a chunk of sleep more than 90 minutes after that. I finally got up at 11. I forced myself to go to do errands for several hours (this is hard work for my typically as I get overstimulated). I've cooked, I've cleaned, I've worked on planning for my vacation. I increased my Seroquel to 250 mg, I stopped my antidepressant (with approval of course), and I took extra anxiety medicine. And it's nearly 1 AM and here I am. Plus I just took a chunk of my right index finger off on a can edge. That's 4 gouged fingers.......

Friday, October 05, 2007

Not much to say

Last night I increased my Seroquel dose yet again. I was emailing my psychiatrist at about 3 AM asking if it could be making me manic because I was wide awake. A shower and Ativan finally got me to sleep about 4 AM. This afternoon I let myself nap later that I should because I was so scarily tired. I'm certainly not sleepy now and that 90 minute nap isn't the reason.

I'm going on vacation (is it vacation when you aren't working?) next week. I'm kind of nervous about sitting still appropriately on the plane. I can't forget the man who was shot after having a bipolar attack on a plane.

That's all I've got for the moment.

Wednesday, October 03, 2007

Normal is such a funny thing

It is so odd to me that my illness makes it "normal" that I'm sitting here thinking of how I would prefer to physically hurt myself than to stand one more moment of my emotional state. I am not going to do this, I have all sorts of safety plans in place, but as my mood has settled into the most dangerous phase, a mixed episode with predomoninantly depressed features combined with enough manic energy to make sleep impossible (which of course fans those flames), I am finding it absurd that I'm trying to calm myself by reminding myself this is absolutely normal for this stage. Today has been a really hard day as this has hit. I commented to my psychiatrist recently that I am doing so much better with handling this part of the illness (hate it but don't fight actual urges much, just lots of thinking about doing it) and that I attribute much of this to simply having lived with it so long and not given in yet. I know better.

I just need sleep. Sleep will bring safety back into my world. I think I'm going to really medicate tonight strongly and see if that helps. I can't stand another day being so out of sorts with the world that I don't even want to eat the food I fix for a meal because my mind has changed drastically in a short time about what I want.

I hate bipolar.

Not good

I have not slept in 2 days. I have dosed for 30 minutes or so, and I slept maybe 2 hours each night, but that's it. I don't feel manic, I just can't sleep. My mind won't shut up. Which is manic, but it's not racing thoughts so much as just thinking. It's entirely possible I'm starting nightmares when I start to fall asleep and waking from that. Whatever it is, it needs to stop.

I'm going to use ativan to knock myself out tonight. I'm hesitant to add more Seroquel without permission since this started with an increase in Seroquel. I must sleep; the risk of becoming very manic is far too high.

I'm scared. I didn't see this coming. It's almost like expressing my fears that this was possible caused it, which I know isn't really true.

I am also sooooooooo tired.

Tuesday, October 02, 2007

New look yet again

As you may notice, the face of this blog changed yet again. This has a great deal to do with my not sleeping much at all last night and being pretty wound up today. I also wasn't thrilled with the bright sun pictured on that last theme; it was a little too much sensory input for me. After having struggled with that so much the other day that I had to cut and past an email into word and back into the email program because of a blinking ad, I decided others may struggle and I don't want to cause that.

Hopefully this is the look that will stay; I'm pretty happy with it. Still fine-tuning though. My links list is pretty messed up and I'm not finding the answer. I wish I was able to follow instructions enough to read my way out, but I'm not there yet. So put up with me now if you're in that messy list. I apologize.

This part is hard

In the years I have been diagnosed and treated for bipolar I generally have had my energy be impaired or agitated in a way that required being away from other people. It has been rare that I've had productive manic energy. I've spent a lot of time trying to educate people that I'm not lazy, but that bipolar strongly effects energy levels both up and down.

This last month I have had far too much energy and it has been the kind of energy that needed me to do something productive. I have to date canned 47 pints of green beans, 27 pints of spaghetti sauce, something like 16 quarts of vegetable soup, and 16 pints of applesauce. Right now I have 2 crockpots going with what will hopefully be another 6-8 servings of frozen foods for easy, health meals. Cooking is holding me together, obviously. I need that level of activity: something I can work on but take breaks from, quiet, allowing the TV if I can tolerate it, etc. During the energetic times of the day my hands must stay busy or I start down paths best not explored. Unfortunately my sense of time is messed up from sleeping a lot and so the really manic hours seem longer than the 3 or 4 they really are. The rest of the time I'm either sleeping, trying to sleep, or depressed and lethargic.

I am really struggling with anxiety about being able to do these things. I am not well enough to go back to work. I know that. Even if I were sleeping as well as I'm supposed to, which I'm not (barely slept last night at all), my thinking is still muddy. Even my general fund of knowledge is just not present at the moment and I'm not succeeding with abstract thought. But it feels so weird to have all this energy and be home.

As long as I can't work well I'll stay here. I could not be sure of not harming a patient at this point, accidentally but it would still be possible. (Harm most likely in the form of not providing quality care.) I'm going to have to trust my doctors that I am not well enough. I'm ok to go on a fast vacation in 2 weeks because I can rest as needed and use energy as needed there, but I can't work.

After so many years of work being the priority this philosophy is really hard to follow. I know it makes sense, I just don't feel so sure about choosing me over everything else. Maybe that's because I'm not sure who me is without my work? Regardless, this is weird.

Monday, October 01, 2007

New link

I just added a link to Bipolar Quoter, an inspirational site designed by a family affected by this illness.

More tomorrow. Just not in the mood to talk right now.