Don't get your panties in a bundle. It's not that kind of illicit drug use. Or that kind of illicit drug. But after really freaking myself out this past week... And forgetting to call my psychiatrist to see if I could increase my dosage of lamotrigine in the hopes that it would be better as I decrease levels of venlafaxine...
I increased my own dosage of lamotrigine.
And really, I would rather not tell you this, because I have been so GOOD about being compliant with my medications-- taking them as prescribed, when prescribed, for as long as they are prescribed.
I would rather just pretend that either:
1. I called the doctor and he said it was okay to up my dosage by 1/2 pill
2. My mixed state mood crap miraculously fixed itself or I was mistaken and it wasn't a problem
But here's the thing: the mixed state crap was a problem. And it was scary. And increasing my dosage of lamotrigine by 50mg is probably the most responsible of the various risky behaviors I found myself considering-- either because I hoped they would make me feel better or because it just seemed like a good plan.
Other risky and/or stupid behaviors that seemed perfectly reasonable (for varying lengths of time):
Quitting my job
Shaving my head
Seeing how much force it would take to bend the metal railing on the Lake Street Bridge
Seeing if it would be possible to re-open the scar on my arm while still wearing my beaded cuff
Leaving the state without telling anyone
Climbing on to my icy roof in order to trim dead limbs from Maple Tree
Why am I documenting these things? Seems like more risky behavior in a way. But I want to remember that these are the kinds of things that seemed reasonable when I knew I was not doing well.
Really drove home the idea that treatment is not optional.
REALLY made it clear that very very very gradual discontinuation of venlafaxine is the only way to go.
IMPORTANT NOTE: withdrawal symptoms of venlafaxine (even just from decreasing dosage) have been known to cause dysphoric (hypo)mania and/or the lovely "mixed state"
fizzing energy + super depressed mood = REALLY HARD TO DEAL WITH MOOD CRAP
Was supposed to have a super busy schedule today and realized last night that there was NO WAY that I could zip from one meeting to another to another in rapid succession and hope to function. Unless my mental crap miraculously resolved itself.
Because what was going on was a lot of racing thoughts, incoherently fast speech, meaningless crying, frenzied activity... My biggest clue that it was a mood-disorder issue was that I looked up at my house and thought, "I bet if I got up on the roof I could totally get rid of some of the dead branches on the Maple tree out front." And this seemed perfectly reasonable to me. On one level. But I did stop and question if maybe I wasn't completely reliable in judging reasonable behavior (keep in mind that I am terrified of heights, I have a sloped roof, and it is covered with ice.)
And last night I also did that great thing where I can't get to sleep (awake until after 1:30 am) so I press my head against my pillow really hard to try and make myself sleep. So now my neck and shoulders are somewhat tight.
I spent forty-five minutes looking for the name badge and made my children late for school because I left too late to get them there on time. I might have, but when I went back into the house to get something I forgot that I wasn't looking for the name badge anymore and resumed frantically moving things around in an attempt to locate name badge. (Note: I do not need to wear this name badge. There will be zero consequences if I do not wear it.)
Was convinced that I could not possibly go to a work-related meeting without my name badge. That if I didn't have it I would fall to a million pieces. That not having the badge would be proof of my incompetence. And HAVING the badge (which is on a lanyard that I beaded for 40+ hours) would enable me to stay calm enough through the whole meeting without making an ass of myself.
Then cried and cried and cried and couldn't stop after dropping off all the kids. Had a bunch of semi-frightening thoughts about what it would be like if I drove my car into the railing of the bridge that crosses the Mississippi River. And what would happen when my meds didn't work or I wasn't treated and I got an idea to climb on the roof and trim a tree and I didn't realize it wasn't a reasonable idea.
And holy crap I bet this is why so many bipolar people attempt suicide and... I am pretty sure that these don't count as "thoughts of hurting yourself" like they ask at the psychiatrist's office, but what if I have those thoughts. Will I even know, or will they just seem like inevitable and sensible.
And I felt such soul-crushing pity for Spouse who would be forced to deal with my mood crap and my clearly off-the-rails thinking and wouldn't he just prefer to NOT have to deal with my crap. Wouldn't he really prefer to be a single parent rather than having me messing up his entire life.
And I couldn't tell him this-- any of the thoughts of hurting myself or thoughts of the world being a better place without me because those thoughts sound really terrifying. And who wants to be leg-shackled to a terrifying person. So the fact that I am having even idle thoughts about inappropriate self-harming behavior PROOVES that he would be better off without me.
Because I know he is a nice guy and he will stay with me "until death us do part" which means that his life will necessarily be a series of slightly-okay times followed by pitfall after pitfall after pitfall of problems that don't seem like problems but are clearly something... something...
Did I mention incoherent thinking? And words? And I kept repeating myself and stuttering and faster and faster.
So instead of continuing to drive around crying and musing on my general worthlessness as a human being and wondering if I could actually be considered unsafe to drive... I stopped to talk with a friend. Which was a super smart plan. And it helped a lot.
I lived through my meeting. Disclosed the recent mixed state crap with my boss and that was fine.
BUT I screwed up on picking up daughter on time and preschool teachers left series of increasingly worried messages on all of the phone numbers they had for us. I nearly got lost driving there. And when I ran in to pick her up I very nearly ran smack into a door instead of opening it first.
Also, I finished my book. It isn't really a trashy romance novel. It's just a romance novel. It's 222 pages or so. Still need to go through it once before I make my friend and Spouse read it for mistakes and crap.
Someone says: "I am really tired."
You hear, "I am really tired. I am because you spent so much time obsessing about (_________) that you didn't get anything else done and now I am forced to do all of the real life things that must actually be done. And because of this I am vaguely repelled by you and don't want to spend any time with you, I'm going to bed."
Someone says: "I think we just have different taste in movies."
You hear: "We have nothing in common. We are completely incompatible and our relationship is doomed. And I can't believe you liked that movie. That's it. We're done."
Someone says: "You are really important to me."
You hear: "You are not actually important to me. In fact I wouldn't notice if you disappeared off the face of the earth. But I find you pitiful, so I'm going to say something nice because that seems like the polite thing to do."
Someone says: "Do you have anything going on this week?"
You hear: "My god, do you have any idea how to keep a calendar? Do I always have to be the one to remind you of your obligations? Honestly I have no idea how you would survive without me."
Someone says: "How are you?"
You hear: "I haven't heard from you for a really long time and clearly I am not important enough to you that you will return my phone calls. So I am using 'how are you' ironically because I couldn't give a crap how you are."
Someone says: "Thanks for the (_______________)
You hear: "Aren't you ever going to write the thank-you notes that you owe me for all the gifts I have given you for the past four decades? I can't believe what an ungrateful boob you are. I shouldn't have even bothered to give you a gift if you aren't going to write a note."
Now for the annotations:
Perhaps you went on a crying bender triggered by an innocuous comment.
Perhaps you confess that you made this ridiculous assumption.
Now where does this leave the poor person who really was just tired and really did just want some sleep? Afraid to say ANYTHING because it will be used as a tool for self-flagelation.
Aha, but here's the true beauty...
Someone says: _________________
You hear: " goddamit I can't say anything to you because you will take it the wrong way and I am tired of feeling responsible for triggering your effing mood episodes. I am so tired of having to pay attention to everything I say, walking on eggshells, having to patch things up when you are upset about fake crap that you just made up in your own head. So I'm just done talking to you about anything. Ever. Oh, might ask for he salt to be passed. Or I might tell you that I think you are important. But beyond that... meh."
SOMETIMES (and it is impossible to tell when these times will be)
Someone says: "I am really tired"
You hear: "I am really tired."
(but you can always go back later and rethink your interpretation if the mood strikes)
I am choosing to blame the decreased levels of venlafaxine. I will work my way backwards through the days that I remember.
I worked from 8:30 - 3:00 with time off for good behavior near the lunch hour. It is my long day of work. Typically followed by an evening tap class. But on the way in to work I felt shaky and horrible. Hot and weepy. Disinclined to interact with people. Slow in my thought. I asked Spouse to come home early because I was "physically fine, mentally 'meh.'"
This proved to be a great boon because I could not cope with even the ordinary parenting moments. Daughter wanted to climb me like I was playground equipment. Sons got into crying screaming stomping argument over the fairness of a coin toss. And I was the tosser. (ha.)
Made every effort to not close myself away in my bedroom. I did for a short time while Spouse and daughter were fetching essentials from the grocery store. And that was only to escape the coin toss aftermath.
Continued to feel shaky and weird. My face felt sunburned. It was difficult to make facial expressions. Daughter kept pushing at my cheeks. "Don't frown, mama."
Stayed up until 2:30 pm for several reasons. I claimed that I stayed up so that daughter didn't wake anyone else when she got up to use the bathroom several times in the night. I told myself that I was staying up because of some comment Spouse made about the reasons for his chronic tiredness.
But I was actually staying up because I was on a roll in my fictional life (over 50,000 words on my trashy novel) AND because I feared that if I had so many other symptoms of venlafaxine withdrawal perhaps I would also be visited by horrendous nightmares.
The Day Previous
The morning began with an explosion of yelliness that was extraordinarily difficult for me to cope with. Children bounced back minutes later, but the negative energy stayed with me throughout the day.
I dropped children off at school and spent three hours writing at a coffee shop while the Daughter taught herself to read and made a passionate argument that v-u-l-t-u-r-e could not possibly spell vulture and I was WRONG. I was LYING. Because if it spelled vulture, then what was that e doing there?
When I returned home I surveyed the many piles of chaos that I have been afraid to touch. Afraid to tidy or declutter because I can't see any little things to do. I can only see big things. No parts of projects. Only the whole cloth. And I was fighting not to get pulled under.
I systematically, toronadically dismantled the essence of everything in the children's room. I brought boxes up from the basement and packed away every book, every toy, every single item (excluding clothing and a few popular board games) that belonged to the boys and locked them in my bedroom. On my bed.
Experienced near-crippling pain in my back between my shoulder blades. Promised a friend that I would stop. Make tea. And see my chiropractor. Which I did.
Chiropractor wondered if I had been throwing oversized shot-puts, such was the degree of tension.
Later I fell asleep with the daughter while the boys did not run away from home and join the circus. That is all I can say of them for certain. I slept soundly enough that I did not wake when Spouse returned home. Or when he took younger boy to tap dance. Or when they returned.
When I woke at 8pm, I woke the daughter as well. And heard a soft, irritated, "why did you wake her up?" Which began a great spiraling downward plunge into...
I cannot do anything right. That I had accomplished nothing. I could fix nothing. That I didn't know what to do during moments of yelliness that would not Make Everything Worse. That I couldn't repair things. Couldn't repair anything.
And even though I knew that not everything was my fault, I felt that it was absolutely my responsibility to fix things. (yelliness, stress, tension, chaos, lack of dinner plans, inappropriate sleep habits) Because that is what I do.
This was followed by an hour-long crying jag that frightened my sons and bewildered Spouse.
My co-teacher was exhausted. I was buzzed. That's all I can recall.
And now? I am without a smile. Frighteningly awake. Easily irritated by anything that is not going the way I wish it to go.
On the plus side? I am fricken' fracken' hi-larious when I am depressed. No, really. Ask my family. I have disabled them with laughter quite a few times in the past few days. A defense mechanism, most likely
The last two times that I was supposed to have a visit with my psychologist, not only was she sick... she had to be taken to the hospital by ambulance. Which seems an awful lot like overkill just to get out of meeting with me.
Apparently the second time, when she realized she was going to miss my appointment again, she tried to get the to have them turn the ambulance around.
So I finally managed to see her this past week. She had a few things to say that I want to remember:
1. I have done a pretty good job of figuring out a way to make my life work out for me
2. In general I have become good at identifying problem and fixing it on my own
3. I need to work on making it okay for me to disappoint people
Number three is where I plan to be stuck for some time.
At my core is the people-pleasing part that believes that it is my job to live up to other people's expectations... to make them happy or proud or at the very least not disappointed.
Surrounding this people-pleasy center is the rest of me that routinely seeks out and calls attention to all the ways in which I am actively disappointing people right and left.
So my job seems to be figuring out that people can just suck it. Without being an ass about it. That's the tricky part for me. In what way can I decide that it is okay to disappoint people that does not involve believing that I can do whatever I want because it's good for me and to hell with everyone else.
Because these are kind of the examples I have. Martyrdom on the one hand and megalomania on the other. Exaggeration? Probably. We're talking about me, after all.
P.S. I discovered another binary description of my alternating poles.
When I am doing not so well people call me: "Oh, honey!"
When I am doing a little too well, people call me: "Are you for real?"
Today my students took their placement exam at the college during class. Typically our class runs from 9:15 to 11:15. Today it ran from 8:45 to 2:45.
Longish for me, but interminably long for them. The test was untimed. I just sat around waiting, writing, and attempting not to fall asleep.
Once returning home, I was predictably exhausted. Still pretty tired.
Note: forgot to take venlafaxine this morning. Taking it now. Have not refilled bupropion prescription. Need to go to Target and pick up the refills that are waiting for me.
Passed down through generations of my Calvanist forebears, I retain the ability (without the theology) to accept responsibility and feel guilt for any number of things that have nothing to do with me.
Part of what aids me in this diabolical plan: I do have a great many things that I am actually responsible for and legitimately feel guilty about. Mind you, I am most likely off on the degree of guilt deserved by my various actions.
The most irritating guilts-- the ones that I cling to desperately-- are things having to do with how other people feel. If I have done something to make them feel sad or angry or upset or abandoned... yup. Those are the horrible ones that give me an ache in my gut.
Unfortunately, I really have no control over the way other people feel. So trying to fix things is just an exercise in never-ending... guilt.
Also, because I beat myself up about my deficiencies quite sufficiently with great efficiency... I am wary of entering into communications where someone else might join me in criticism of my behavior.
This is all a very confalutin' way of saying that the longer I go without contacting people the more difficult it is for me to do so. Pretty much.
Why couldn't my ancestors have been Buddhist? Then I could have an inborn tendency to just let go of the negative crap that holds me to the neverending cycle of suffering. Because they are such a cheery lot.
I have not yet eaten lunch and it is possible that low blood sugar is having some impact on my prose.
But I just feel like when you haven't written thank you cards and its been months. Or years. Or you keep paying for a gym membership but never go and it's too embarrassing to cancel. Or you borrowed something from a neighbor and they moved away. It all is just so slippery.
I am not making sense even to myself.
Also, I am absurdly nervous about going to see psychiatrist today. And I am missing a possibly stressful but optional meeting at work.Which is also stressful. See, I get to stress about it whether or not I go.
P.S. I have written over 40,000 words of my new trashy novel.
took meds (ran out of bupropion this morning. will refill or whatever the doc says)
stayed up way super a lot much too late. Which I just remembered. Crap. I refused to look at th clock because I didnt want to know how lat it was. I went to bed at midnight (after writing for a solid four hours) and then read until I was unable to see.
gonna go eat now.
I have felt overwhelmed and... well, overwhelmed.
Keep running through the list of people that I am supposed to contact (but have not).
I missed a meeting at work (I was sick that day, but I would at least have emailed to tell people I wasn't coming if I had been on the ball.
Then I failed to show up for a meeting that I had scheduled. BIG bonehead move.
Each time the children were too loud after school I put earplugs in my ears and hid in my dark bedroom until Spouse returned. Not Optimal.
Completely stressed out about get-togethers with people and flaked out and huddled in a corner berating myself for my lack of organizational skills and attention to detail and care for other people and ability to cope with a schedule... questioning my competence as a human being.
Like how I went right there?
Also guilty for not blogging.
And for making too many trips to the Goodwill for a few things that we do need along with a larger quantity of things that we don't need, but which just seemed too good to pass on.
So what have I been doing otherwise? Beading bracelets. Um... writing a lot.
I have written 37,000 words of my trashy novel so far. When I am feeling more... something, I will give you the rundown of the plot (without the trashy bits)
I have been taking my meds every fricken' day.
This coming week I a bunch of stuff that I will not forget:
I feel like I have to go back through all of my blog posts to see when the last time I saw the OFP was... it was a long time ago. I was supposed to go once a month but it hasn't worked out that way. I'm feeling like I have a bunch of behavioral crap that I should cover with her. She's gonna make me cry again, I bet you a dollar.
And with the psychiatrist? I really do want to get off the venlafaxine, but I'm wondering with my downward tendencies lately if it is such a good plan. That's why he gets the big bucks. Also wondering how to tell when dosage of lamotrigine is correct. Could it be that I could go off the venlafaxine but up the dose of lamotrigine, which has an antidepressant affect on bipolar people?
Oh... one sorta good thing that I contributed to: we came up with written rules for computer use after holding a family meeting. It was very "after school special." (do they have those anymore?)
The rules are:
people can only play games on the wii on the wiikend. (not wiikdays)
flip a coin to see who goes first
write start and end time down before you begin playing
make sure you are sitting where you can easily see a clock
And Don't Be an Ass (okay, that's an unwritten rule, but I feel like if you follow it, everything just comes out better.
I didn't want to check my email because I didn't want to see any responses from the people whose meeting I skipped (after setting it in the first place).
But the most organized one of the bunch, for whom I have a great deal of respect, sent me a very nice email. She told me that no one was upset about it, no problem. They were just confused because I had always been at the meetings-- early, even.
She also shared with me that she had been working real hard these days at not feeling terrible about things that aren't terrible.
Embroidery on my next beaded bracelet: not feeling terrible about things that aren't terrible?
too long. It would have to be a beaded necklace.
Wrote a bunch of stuff and it disappeared.
Upshot? Spent a super long time being really exhausted today.
Daughter raised by wolves.
Peanut butter on DVDs
Paint on table, floor, curtains, bathroom towels and sheet of my bed
robotic dinosaur hiding under a pink and yellow quilt
dolls receiving their first haircuts
And I slept every moment I could through most of the day and still feel tired.
Spent about an hour in overdrive cleaning mode to try and counteract the disasters that occurred during my absentee parenting. (well, technically present, but not in any meaningful way.)
Posting now before I accidentally delete this too.
Oh, forgot to take Lamotrigine for the first time ever last night. Didn't realize until just now that I should have taken it this morning. Now it is too late to make up that dose. According to Dr. Google, there seems to be no great worry about missing one dose and should not be any great adverse side effects.
followed by hypomanic cleaning
followed by exhaustion.
Grateful Crap: 12yo who fixed dinner for himself and younger sister which they ate by candlelight (which their mom never lets them do because she has terrible night vision and likes to be able to see her food)
rested (although this seems bad, somehow)
Saturday January 10 I taught my Saturday class and for some time after that was bouncing off the walls. The slightly-hypomanic pos-teaching high wore off quickly and I settled back into a minor funk.
Sunday stuff happened and I was socially responsible and attended meeting and did some volunteer work for my kids' school. Where I talked to new people that I had never met before.
I noticed something about the nature of my "small talk." And it is not going to paint me in a very positive light, I'm afraid.
I have very little interest in talking about the whether and football scores and umm... fashion and barbecue? Crap. I don't even know. I don't want to ask strangers about stuff that I just don't care about. And I don't like getting my information in little snips.
Where did you go to school?
Oh, that's interesting. Did you play any sports there?
I like soccer too. Say, what do you think of the funding cuts to school athletic departments.
Yeah, a real shame.
I like getting my information in stories.
When I was in high school I played soccer on the Junior Varsity team even when I was a senior. It was something I loved doing, but I was always just on the good side of mediocre. My senior year we had a male coach who had never coached a girl's team before. We didn't realize that was a problem until our first game. We played a terrible first half. At the break, the coach yelled at us and told us how terrible we looked out there. He said we were falling apart and there was no way we could beat this team the way we were playing. We were pathetic. To his shock we went out on the field and finished the game in truly miserable fashion. And a few of us even burst into tears at his tirade. This was not what had happened when he gave the same "inspirational" speeches to his boys' teams. They got mad, went out to prove him wrong, and won the game.
So because I don't ask the little questions and most people don't launch into stories, I talk WAAAAAY more than anyone else. The best defense is a good offense, I guess. And it is once again the all-or-nothing me. Either I sit in a corner and say nothing, or I just can't shut up.
Grateful Crap: something or other
went to meeting
talked to people (even if I felt like kind of a jackass)
took meds (only I forgot to take them in the morning-- so I took the venlafaxine at night)
Had a small case of the shakes at night and a larger case of clinginess in recent days. Some sort of sinus/tension MASSIVE headache. Spouse stayed home and allowed me to sleep a lot and get rest that I needed to recover.
But I am not sure what the ratio of physical to mental illness was. Because while I definitely had physical symptoms (horrendous headache, fatigue, body aches, chills) I also just really really really want to go into my room, line the walls with something soft and never never never come out.
Really. And I still don't wanna go out of the house. Or go to work. Or see anyone. Or talk to anyone. And I don't want them to see me either. Or want to see me.
I listened to the parents at the preschool making small-talk with one another and connecting socially with one another. And I felt sad that I was not making these connections and that I had no desire to make the connections.
What is the point? I'll just know them for this year and maybe a few of them next year, and then I'll never see them again. Why invest the emotional capital in getting to know them.
Just call me Little Mary Sunshine.
I don't think that having two weeks from my regular routine is a good plan. And I also think that the amount of time I spend in my room is a good indicator of my teetering on one polar opposite or the other.
It has been more on the Depressed side.
Here is a really good joke:
I called the psychiatrist office to see about tapering down the venlafaxine starting NOW instead of waiting for the Spring. They called me back and said that since my psychiatrist was out of town, the on-call doc was not willing to make that change since she didn't know my case history etc. She also mentioned that we are just entering into the worst part of winter.
Fine. I think that is probably reasonable and responsible. So I did not taper down the level of venlafaxine. Which is also responsible and completely unlike what I have done with my medications in the past (pre-blog days)
Here is the punchline: after I got off the phone with the people who said I couldn't taper of my antidepressant, I felt super sad about it and have been edging more toward that end of the spectrum since.
This morning I was having very maudlin thoughts about our Place in the Universe and why the bloody heck do we think we are the pinnacle of existence and maybe I'd really rather be a tree. Writing it down, it sounds absolutely ridiculous. But it just felt achingly sad at the time.
A teacher of mine noticed (pre-blog) that when I do my detailed beading projects I turn ever more internal-- I am not available to people around me. I shut them out. This was in a group class with much social interaction. When I knit or sewed in class I was a much more animated participant.
It was in part her observation that led me to realize that my Depression was not well-controlled. I explained that the withdrawal was the cause of the beading and not the other way around.
As I find myself engaged in ever-more-detailed bead embroidery projects with seed beads on leather, I wonder... is this a symptom?
Things I have noticed (the harbingers of Depression):
Not fine, not really. I will be. I have faith in persistence and support and pharmaceuticals and the fact that the stupid things that my brain tries to convince me of are horrendous lies.
I just need to keep track of how many days these symptoms have lasted so I can share info with my therapist. Frelling hell.
I teach tomorrow. That should shake me out of my shell. And the new semester teaching at the college begins on Monday. So I am almost guaranteed to swing back in the hypomanic direction.
Definitely feeling the fugliness of Bipolar Disorder today.
Quaker, teacher, parent,