Now that I'm busy, I need to learn to relax and take time off again

I'm getting busier as I become more involved in my school work. I have such a lust for learning that I over do it and spend too much time on it. This applies to other aspects of my life as well. I obsess on things; but instead of obsessing on my depression, I'm obsessing on doing something else. It's an adjustment phase I'll have to go through; now that I'm not spending so much of my time lying in bed and avoiding things, I have to learn to take time to lie down. It's been kind of an abrupt night and day switch from being hardly busy at all to almost too busy. But, I have the desire to make this work. For now, I am just accepting that I obsess on things and not obsess on the obsessing.

The biggest worry for me at the current time is finances, I keep obsessing about them. I have way too much debt, and even with family helping out and my disability check, I'm struggling to pay my bills each month. And I still feel a lot of shame and guilt for having to borrow so much money from my family. Family and my therapist tell me I should just try and not worry about it, at least the guilt part. I'll try not to worry about it, and do my best to show my appreciation for what I've got.

I see that I was recently asked all the medications I've been on, I'm assuming just the psychotropics... well, here goes..(in no particular order, some of these have been in varying dosages and combinations)

Klonopin, Zoloft, Ativan, Gabitril, Seroquel, Symbyax, Zyprexa, Neurontin, Geodon, Lexapro, Xanax, Effexor XR, Wellbutrin SR, Lamictal, Lithium Carbonate, Paxil, Serzone, Risperdal, Celexa, Remeron, Imipramine, Strattera, Provigil, Adderall XR, . (yup, 24 different brands of drugs)

My current regimen includes Lithium Carbonate, Lamictal, Xanax, and Adderall XR. Was on Seroquel as well, but as of today we dropped that. I also take Omega-3, Vitamins C and E, and multi-vitamin supplements. Occasionally I'll try adding in DHEA, melatonin, lutien, iron or calcium supplements as well. I use protein shakes (although infrequently lately) to help keep my energy levels more consistent and (again less frequently lately) a "green drink"- a yucky tasting powder-drink made dozens of plants (green things hehe) that I mostly never heard of, to help detoxify my system from all these drugs.

Now that I'm getting some exercise bike riding and walking around campus a lot, I somehow need to start working on my eating habits. For too long I've been eating only one half way decent meal a day, and a few snacks. I already described what happened when I really slacked on the eating part.

More than a few people have suggested various alternate routes of therapy: variations of homeopathy, chiropractic therapy, meditation, special food diets, etcetera, to either replace or use in conjunction with my medications. Over the years I've tried some of each of these, either alone or in conjunction with my meds and regular therapy. I think they're all great tools, and have their time and place. Some of these I will probably integrate again at some point when I deem it appropriate.

Happy Birthday to me!

It's My Birthday! So get with the program and click the link to my wish list in the lower left column and get me a B-Day present! hehehe...

Anyway, on to my journal entry. Past two days I've been non-stop-go. Totally immersed and involved in working out things with insurance, schoolwork, meetings with school advisors and setting up schedules. I've been half real excited about getting more involved in school and making sure I get appropriate credit for my previous college work, and half frustrated and moody dealing with insurance and the costs of medicine and finances in general.

I'm a perfectionist when I decide I want to do something, so what might take a person an hour to do I spend 12 hours on. Or something like that. I plan on spending most of my birthday trying to get my insurance straightened out and doing some of my homework, and try to swing by the DMV to update my driver's license.

I see my therapist Friday and I think I have a lot of topics I'd like to talk about. I think maybe this weekend I'll let myself chill out again before I burn myself out.

So... all this energy. How much do I attribute to the Adderal, and how much do I attribute to being stimulated by the university environment? Ah... I love nature vs. nurture debates, and this question falls into that realm. It's also why it's often difficult to know if meds are producing a significant difference by themselves or not. I don't think I'm having a placebo reaction to the Adderal, but I do think the university environment is creating a large stimulating effect in me. To go further on with this tangent, I look back to last week and I see that I was highly stimulated the day of class, then the next day and through to the next class session this week, I was tired and out of it and didn't do a whole lot. So, take away the stimulating environment (a nurture variable), and it appears that the Adderall isn't having much of an affect. I must note however, that in this example, I was still on my starter dosage. Over the next two weeks I'll observe whether I exhibit the same behavior.

Or... (hehe, this is the point where my therapist interjects and tells me to quit analyzing everything) is this a situationally induced mild manic state, falling into a blunted, slightly depressed mood state when the stimulus isn't present? I'm sorry, I have to keep analyzing things. I'm training to be a psychologist for Christ's sake. ;-) Don't worry, I don't plan on being a therapist, so you can relax and not worry about me analyzing you and charging you for it.

Problems interacting with people, especially those close to me

I have a problem and have had for a long time that's becoming more and more obvious. It has to do with how I react to people who want to talk to me or ask me to do something. The way I initially react seems to cause people to feel that I don't care/respect enough or they're not important enough and I don't want to bother with them. It's especially worse when it's someone who has been gone out of their way for me many times.

I don't yell or scream at people. The problem is centered around the fact that I often have too much going on and/or have to many things going through my head (which is pretty much most of the time), and knowing how easily I lose track of what I'm doing, and how hard it is for me to switch gears, I give people the impression through body language or tone of voice that they are interrupting me. Also, when asked if I want to do something, it can take me a while to try and remember if I already have something else planned, so it ends up sounding like I say no to easily, even though I'm really just hesitating until I'm sure I haven't forgotten anything important (thank God for palm pilots). Otherwise, the opposite happens, and I say yes too easy and then forget I have something else going on, and I end up in a tug-rope contest with myself trying to figure out what I should do.

It's not that I want to make people feel this way. I just need a bit of time to write down what I'm doing or thinking about before it's lost forever, or look at my calendar to remember what's going on.

I know there are pleasant ways of saying, "What you have to say or ask is important to me, but could I have just a few moments to sort some things out before we start?". However, just knowing that isn't enough. For one, because I'm wrapped up in things, I forget about the importance of pleasantness and showing a caring response. I don't realize that I gave a negative impression until after the fact, sometimes long after, and that can have some bad consequences.

I'm trying to think, for example, how I could jot down my whole train of thoughts while the phone is ringing and get it all jotted down before I answer the phone so that I can be more pleasant and caring when I answer. But, just not enough time there.

I do write notes down often during the day to keep me reminded of things. It's just that it's like spontaneous things jumping through my head in different directions, ideas to do things, and the compulsion to get them done and finished before they're gone out of my mind, pretty much totally forgotten.

So, I don't know. The best I've been able to do is talk to the person afterwards and explain to them that they are indeed important, and ask them if they can understand why I sound or react the way I do.

I'm not sure I'm explaining this in a way that I feel gets the right point across, but I felt the need to journal it.

Oh and anyhow, my psychiatrist doubled my dosage of Adderal XR. Hopefully that will help, I wasn't noticing any consistent improvement at the lower starting dosage. 'Course, problem is, twice as many pills can cost twice as much... but I don't think I want to start complaining about the financial costs of my illness right now. ;-)

Tired but ok

Didn't realize it's been this long since I last posted. So far I haven't been able to notice a change since using Adderal XR, I see my doctor on Monday and I'll see if he wants to increase the dosage.

I'm still pretty tired most of the time, groggy and out of it. I still enjoy my class.

Starting Adderal XR, learning more about drugs

After having my psychiatrist once again go over my chart and test results showing indications of attention deficit disorder and prefrontal cortical dysfunction, he still wanted to postpone putting me on Adderal, an amphetamine stimulant indicated for ADHD. He was glad that we were finally getting some improvement in my mood stability and my anxiety symptoms, and he stresses that stimulants, like Adderal, can worsen symptoms of panic attacks, anxiety, and mood swings. I acknowledge this and explained that if the symptoms got worse, I could likely handle it long enough to know to stop the medication and give him a call. I used the line of reasoning my therapist recommended I use, basically that, why don't we just give it a try and see what happens?

I've only taken my first daily dose this morning. I had a good day, got up early to see my cousin in the hospital, was fairly attentive and engaged in my class, and was able to come home and study for a good 2 hours, and then again in the evening for another hour.

I'll have a better idea of how this medicine effects me within a few days, since it isn't supposed to require a long time to build up in the system. I see my therapist again on Friday, I'll bet he'll want to do a follow up ADD test to compare results. I forget the name of the test, but it is done by me sitting at a computer and responding to things on the screen. It could be letters flashing and I have to press a certain key when a certain letter appears, or having a shape flash on the screen and then try to duplicate it, or read a short story and then later answer questions about it, things like that. I'm making an early prediction that we'll have to increase the dosage to notice a significant positive effect.

In any case, I'm really enjoying my class, I'm developing a much deeper understanding of how drugs, especially psychotropics (both illicit and licit) work in the brain and with individual neurons and their receptors, how the drugs get metabolized in the body, how they are removed from the body, how tolerances are formed, etc.

And thank God for lower Fall temperatures! Reminds me more of home, and makes the bike ride to school that much more relaxing.

Return to college

Well, I'm officially back in college now to hopefully finish my Bachelor's in Psychology. Yesterday was my first class, called Psychopharmacology, about drug interactions, specifically psychotropics. I'm only taking one class this semester to see if I can handle it. Baby steps. Long term goal is to go all the way to a Doctorate and in the process pull myself out of enough of the disabling effects of my co-morbid disorders to move on in life and start pulling my own weight again. But first things first.

I was really anxious during the orientation period last Friday at the university, but yesterday at class I felt at ease and enjoyed it. I even rode my bicycle there, so I got some good exercise! (didn't have much of a choice though, since the battery in my truck is dead).

Big problem I'm having now is that I am so tired all the time, which I attribute to all the drugs. I'm on Seroquel again, an atypical antipsychotic (tranquilizer). So it's real hard to stay awake at all. I'm still trying to get my psychiatrist to try me out on Adderal, a stimulant, which is what the plan we had worked up called for, and is what me and my therapist have been thinking for quite some time should be a real help for me.

Better eat and drink properly and regularly

Well, I learned the hard way how important it is to eat and drink properly and consistently, especially while on meds like lithium. I ran into a problem were the Lamictal I'm on was causing me to not want to eat or drink, and after a couple of weeks of hardly eating or drinking at all, my lithium levels became toxic for a while and my electrolytes got off balance and I became VERY sick. I really thought I was going to die it hurt so bad. I ended up spending 3 days at the hospital hooked up to an IV to bring my electrolytes back into balance and to nurse me back to where I could start to eat and drink again. I'm still recovering from it, I still have the shakes, a little dizzy, and a very mild pain in my abdomen, but over the next week I should be back to normal and be able to go back on the lithium.

So, my advice to others in a similar situation: even if you feel you can't eat or drink, force it down. Otherwise call your doctor and tell them the meds are causing you to not be able to eat or drink, and they can adjust the meds before you get sick enough to go to the hospital like I did.

Lesson learned!

But, on a positive note, this mishap seemed to improve my attitude and I feel a little more motivation to once again put effort into getting on with life as best I can, both with the small things like helping out around the house more and the bigger things like going back to school.

anxiety and trance-like states

Wow, my internet connection is actually up at the moment, hope it stays up long enough for me to type in this entry and get it posted.

I've noticed my anxiety slowly increasing in intesity over the past two weeks or so. My guess is that I'm again growing tolerant of the Xanax. But, no panic attacks yet.

Over the past couple days, and especially yesterday and today, the conversations that I have in my head have been increasing in length, but also in terms of how much they take over the focus of my thoughts. Today it's occured to me to describe it as a trance-like state. I've snapped out of it enough at least for a while to be able to look back and think about it.

Take yesterday, for example. I got home from my visit with my therapist a little after 4pm. I immediately began to have a hypothetical conversation in my head describing in detail my entire life's story. Pretty much next thing I knew it was about 6:30 am and I fell asleep even though I wasn't tired. I was basically unaware of the passage of time, of the sun going down, getting dark, and the sun coming back up. I was only vaguely aware of the fact that I was moving from room to room in the house. Basically only vaguely aware that I was in a different room sitting in a different chair, not aware of actually moving between the rooms. Thankfully the cat knew when I'm supposed to take my medications, he would meow and distract me enough to know to take my meds and give him his food and his antibiotics.

My guess is that the Provigil may be causing these conversations to expand in length. I've had complex conversations constantly going on my head pretty much all the time, but I usually don't go into a trance like state, I have, but not all that often, usually just the hour after I get out of bed, and these states, in the past as far as I can recall, have never laster longer than an hour or two.

I also feel compelled, when I do snap out of it, to return to that state to finish the conversation, because in that state I can focus on it. Whereas when I'm not in this state, and going about my day, I'm dealing with various intrusive memories and still having conversations with hypothetical people, it's just that it's usually more in the background, and the intrusive memories are pretty much all negative, like a crowded noisy bar where everyone is criticizing me or calling me names or something.

Anyway, it's always been difficult for me to describe just what it's like, but I've made another attempt here, wanting to note the dramatic change, it seems, that has started to occur.

not a new doctor, please!

Well, I went to see my psychiatrist today, but instead of the same psychiatrist I've been seeing for a good year and a half, some new psychiatrist walks into the lobby and calls me back. Doesn't seem like much of a nice guy or very compassionate. First asks me the exact date, including what year it is. Then he asks me what meds I'm on. So, I'm a little miffed, here I am with a new doctor, when I've been working with my real psychiatrist on a long-term plan and we had planned on introducing a new drug this session.

When I tell this new guy I'm on 8mg of Xanax, he says that is too much, he refuses to have any of his patients on that much, and I must instantly lower my dosage to 4mg. I put the brakes on hard then. I've never heard anybody even vaguely suggest that a person should drop 4mg of Xanax in one day. Even lowering by 1mg a week is crazy. When I had to lower my Xanax for the purpose of getting brain scans before, we did one mg a week down to 6, then half a mg a week down to 4mg, where we stopped. Even tapering at that rate, the withdrawals gave me near psychotic episodes. He also flatly refused to put me on a stimulant, which was the plan that the Amen clinic and my real psychiatrist (as well as my therapist) were planning to do. And he wanted to jump from 100 to 200mg of Lamictal. A pretty high jump at once, especially since my moods seem stable, not sure why he would want to do that. He also said the reason my hands shake is because of the Xanax. He wouldn't listen to me when I said my hands have been shaky my whole life (they always called my klutz in school since I always dropped things), long, long before I started any kind of benzos.

Anyway, trying my best to be polite, I insisted that I see my real psychiatrist. Eventually this new doctor said he would try to see if my psychiatrist was available. While he did that, I went back to the front desk and asked why I was seeing this new guy when I was scheduled for my real doctor, and they said that my real doctor was trying to help out the new guy by giving him some new business.

When I finally got to see my real doctor, he mentioned that he kind of wanted to have this new guy give a fresh perspective on things. Well, this new guy sure doesn't act like a fresh thinker.

Anyway, before I complain more, I'm now on Provigil, which is a stimulant, but not an amphetamine like Ritalin or Adderal (Adderal was what we were originally planning on trying). I'll start my first dose in the morning. Provigil, from what I've read, is used more for people who have narcolepsy to wake them up, and in general to allow people to be awake and alert for longer periods of time. Not many side effects from the sounds of it, but it's still a fairly new drug. Hopefully it should be good for me, since I've been really groggy lately, even more so than normal.

We're also still increasing my dosage of Lamictal. Not really sure we have to do that, since my moods have been pretty stable.

In any case, my therapist and my real doctor have been gradually telling me I should think about cutting down on the Xanax. I told them I don't mind that, as long as we do it very, very slowly. In some of my correspondences with other people who have been on high dosages of Xanax, it's been suggested to go as slowly as one quarter miligram a month. Granted at that rate it would take me 32 months to get completely off of it. My other argument is that we'll need some anti-anxiety medication to take its place. And there aren't many anti-anxiety medications we haven't already tried without success.

So, I hope I can continue with my real psychiatrist and not this new guy.

Anyway, on to other things, I've got a stray cat living in my bedroom now, one of the strays we take care of outside the apartment, he got into a fight and got a nasty infection, so he's living in my room until he's done with his regimen of antibiotics. It's nice to have a cat, I miss the cats I used to have back home. It'll be tough putting him back outside to live.

Tired and my mind is numb, lacking motivation

Again, I haven't been posting much lately. Just haven't felt that I have much new to say. Lately I've been very tired, falling asleep easily throughout the day. Around 11pm, my mind starts to really wake up, then a few hours later I get sluggish, but unable to actually fall asleep until around 6am. I then sleep until the afternoon, and I am very sluggish the rest of the day until late at night.

My brain seems to work a lot slower, which my therapist and I attribute mostly to the tranquilizing meds I'm on. My moods continue to be pretty stable, and I haven't had any real panic attacks either. But on the flip side, I'm almost completely lacking in any kind of motivation, most days seem like a mindless blur.

I sent in my application to the nearby university. I'm not sure if the paperwork will process in time for classes starting in September, I'll just have to wait and find out. This will be my biggest attempt yet to re-enter the "real world" and see if I can get stimulated and motivated enough to not only finish my degree(s) but also see if I can take it a bit farther and work on my social skills and just plain "get out" more. Getting out isn't something I'm interested in doing, to be honest, but I know I'm supposed to try. Truth is, I'm don't see much point in this whole life thing. I'm not suicidal, but I don't see much point in even trying.

I think a better way to explain it is, in my humble opinion, I've already done pretty much everything I've wanted to do in life. There isn't much that excites me. When I think of something to do, or someone brings up something to do, I either have a "been there, done that, it's boring now" attitude, or it just seems like too much work for too little gain.

The only real fun I have is dreaming, these wonderful, vivid dreams that are like grand adventures... my dreams sometimes are more real than reality, I wish I could sleep and dream forever.

I spend most of my time, while I'm awake at night, either reading, browsing the internet, watching movies, or playing video games.

So, in summary, my lack of motivation is partly due to the tranquilizers (meds that alter brain activity through chemicals), and partly due to events in my history that have left me with this attitude.

Moods a little more stable, anxiety up a bit

I've noticed that my moods seem more stable now, my depressions don't go as deep, but my anixiety has been a little high these past 6 days or so, although I haven't had a full blown panic attack in at least a couple weeks.  So, I'm guessing that the lithium is helping at least a little.

I also notice that, while I do seem to sleep a consistant 8-9 hours each day, I'm not able to fall asleep until anywhere from 5am to 9:30am.  So I'm going to start taking melatonin again at night and see if that helps me fall asleep sooner.  As it is right now, I'll try to go to bed between 1 and 2am, but then I get real hungry and impulsively eat and then watch a DVD or two.

I haven't posted much, obviously, mostly because I just simply keep forgetting to.

Something I was just thinking about is how thin my "emotion skin" is.  I'm easily hurt or offended by even the slightest thing.  I asked my therapist a few sessions ago, "how do I thicken my emotional skin?", and he didn't have a good answer, didn't really know how one could be trained to have a thicker skin.  So, at my next group session tomorrow (assuming I can make it), I'll try to pose that question to the group.

Not all bad...

I'm not sure what to write, I know it's been over a week since I've posted. In the past week I've pretty much isolated myself from just about everything. I've been a little depressed, a little anxious, a little afraid, a bit paranoid, but no one thing real bad. Just a big sense of "blah" I guess. Most days not in the mood to talk to anyone, just want to be alone. But I did get out a couple times, to my therapy apointments, group therapy, and this weekend to visit with my Uncle who just moved out here, I've always enjoyed the conversations we have. He's a music teacher, and we're going to try and work out some time that he can teach me some music theory and we can play together.

One of the things that we're discussing in my individual therapy and also with my family is getting me motivated to want to do something. You know, get me in the mood to want to do something with my life. Wether it be music, going back to school, getting back into my karate lessons, whatever. I'm just totally lacking in motivation, and have been for a while. I used to be a very highly motivated person, but nothing "real" interests me much anymore. About the only motivation to do something is the social pressure to do so.

But at least I'm not suicidally depressed like I occasionally was in the past. So that's good. I'm not sure yet if the lithium is having an effect on me or not. I see my psychiatrist tomorrow, and I expect him to increase the amount of lithium.

Up, down, Up down....

Well, my mood tanked this week, my anxiety went up and my depression got pretty deep, thinking what's the point in life again. Had a lot of running around driving people places this week too, which put more pressure on me and increased my anxiety, it's hard enough for me to drive just once in a while, and some of my family members are having moderately severe medical problems too.

So, I've been mostly withdrawing into my shell, not wanting to talk to anybody. I went to the clinic today. Looking at my finances, I was going to cut down on my appointments, but they gave me a big pep talk and told me I could schedule as many appointments as I need and just pay what I can. Finances are a big worry and source of guilt for me, but they made sure I felt welcomed there and not to worry about it. I was there to see my therapist, and while there I pulled my psychiatrist aside and told him I'd like to start lithium treatment, rather than wait until my next appointment with him in a week and a half, he agreed to see me for a couple minutes and get me the script to start on lithium and also the script for the one-week follow up blood test.

So, I'm feeling a little more optimistic and outgoing, which is good, since I was withdrawing to the point of suicidal thoughts. But who knows how things will be tomorrow? Hard to predict how I'll feel.

I talked for a while with the pharmacist, he said I should notice a significant difference in about 2 days after starting lithium, but from experience, I know not to get my hopes up.

Feeling better

Doing better today. My sense of time is still a little off, but everything else seems to be going better. My therapist, like my old therapist, is urging me to look into going back to college. I'm scared about doing that, because it would mean asking my family for even more support, but after talking to my dad and my aunt, they're at least supportive of me trying to give it a shot. So, unless my mood tanks, I'll try to get an appointment with an admissions counselor next week.