Surprise Again

The medication did not make me fall asleep again.  I'm not sleeping all that well.  But I am more rested, although I've been really tired and kind of groggy from the increase.  I am hoping to be allowed to bump up a little more because I think this is going to work at some point, at least somewhat.  Somewhat seems good at this point.

Dr. Mind and I had a review of the suicide discussion plus the Dr. Brain additions.  I think I have managed to get a lot more safety in my life.  I'm still struggling with needing it and knowing that there are limits on the safety that is in place, but as I was told immediately after returning home from the hospital the suicidal time nothing can keep me safe if I don't choose for it to do so.  Valid and humbling point.

For whatever reason this is bringing out more understanding of my situation than anything else has.  A long time ago Dr. Brain would tell me from time to time that I was the highest functioning patient with the level of severity of illness that she'd ever had.  Since she sees a LOT of bipolar patients that was a big deal.

What I hadn't figured out completely was that has a flip side.  I knew my bipolar is severe.  But there are clues from the last year or two that tell me how much so and I'd chosen to ignore them or pass them off as irrelevant.  I knew I was approved through an SSDI process for people so severely ill that the computer says there isn't any chance that approval won't occur.  I knew that mental illness rarely triggers this system.  I knew that student loans are rarely discharged for disability unless the disability is very serious.  My was.  Again that's nearly unheard of for mental illness.  Then there is the way my life has been for nearly 2 years now and how much I struggled for it to be different before that.  There is the 15 months of suicide precautions just because I am considered high risk due to knowing how to do it and everyone seems to agree that I would not mess around with an attempt.  Now that's just a chronic thing that will be tightly watched.  I found out Monday that I really have been at high risk again for the last 6 weeks or so and have bordered on hospitalization.  I was also reminded that I can wind up there sometimes with this because careful is safer.  I knew I was out of meds; I didn't realize how bad Dr. Brain feels about this until she promised me to keep trying everything that comes out until something helps.

I knew other things.  I knew that I'm being encouraged to find things to do after I move but also that I've been told no matter how much better I get working is probably not a good idea.  I thought it was just because my personality doesn't do well in that kind situation but it's not only that.  It's because even if meds stabilize that will always be fragile and we do not ever want to go through more years of having no meds that I can take and that work.  It's because I need to choose whether I want time that I can enjoy with my niece and my ????? (later this week!) or do I want to risk being too stressed to handle them.  My niece is going to be SO excited about my new home.  She already thinks grandma and I are a weird unit where I'm sometimes at grandma's and sometimes disappear.  Now things will be as she has always thought they should be.  And I'm thrilled about that.  I can't wait for her to spend the night at my house and to be able to spend even more time with her/eventually them.  But I have to be not exhausted to expect that and working, possibly even volunteering, is more than I can handle. 

I'm realizing this more too as I face this house sale.  No way am I going to do it without my mom both making sure things are done right and that I have support through the painful parts.  But this is also about having someone else to cook when I can't, to help make decisions, to help with paying bills if I struggle (which happens frequently, not the money part but the mistakes part).

I somehow based so much of my perception of all this on the rather goofy fact that I go to the mood disorders unit of the hospital and most bipolar patients don't.  So if I'm so sick I would be assigned differently.  Until I realized that I have a doctor who is an attending, who has promised me "I'll never let you go elsewhere" and that for her to be able to promise that is very different than the vast majority of people who come in to the ER and who have community doctors who aren't even consulted, much less participate throughout the hospitalization in their meds.  I've had nurses say things a few times that imply I have more control about things like what day I am admitted and that I don't have to go to the ER when most people do.  I know last time I was discharged I was supposed to be sent to intensive outpatient and the social worker and ignored my repeated requests for a meeting and hadn't set it up.  The student social worker told me that she couldn't do it for me.  I was very upset and told the OT that I was no in a position to do this for myself, that I'd been trying since the 2nd day I was there to talk to the social worker and she'd ignored me.  (The social worker does not like me.  It dates back to my first hospitalization).  The people who were working scurried around and set it up immediately because "we don't want Dr. Brain to be upset".  And that's true, Dr. Brain is not fun when angered.  But it shouldn't have been about that, it should have been about everyone had agreed from admission on that I needed to go to this program and the social worker is the one who sets it up.

When you realize that your logic is both faulty and hanging on a thread a lot of reality pours in.  I'm not suicidal because I'm suicidal, I'm not being dramatic, it is part of my illness(es) (I think PTSD bears a big load in this although after PTSD therapy last year it is so much better).  I know so much about bipolar.  I know so little about MY bipolar.  I have always chosen not to know a ton about PTSD.  It is very weird the illness I tried to know everything about is the one that I have never learned much about my own case.  Possibly this is because I am an atypical case and nobody has sat down and told me "this you have, this you don't but you have this instead", etc.

I have no idea how to end this.  It's just a bunch of random thoughts right now.  I just know that I'm not really who I thought I was, which is strange.