Monday, October 18, 2004

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.

Thursday, October 07, 2004

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.

Tuesday, October 05, 2004

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. ;-)

Saturday, October 02, 2004

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.

Tuesday, September 21, 2004

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.