This is the third post in my series on the In Our Own Voice talk I prepared/am preparing/will always be preparing for NAMI (National Alliance on Mental Illness).
Click here to read the prequels...
Part 4: Treatment
I found that being treated for Major Depressive Disorder when I actually had Bipolar Disorder was particularly NOT effective. I had found antidepressants to be sporadically effective... but I was also only taking them sporadically so it was hard to tell whether they were doing anything for me.
Once I made the decision to really deal with my mental health issues, I embarked on the long (and neverending) journey of finding the appropriate treatment plan.
The first step toward stabilizing my bipolar symptoms was beginning to take a mood stabilizer. The mood stabilizer that I am taking is an off-label use of an anti-seizure medication commonly used to treat bipolar symptoms. As a bonus, it has some anti-depressant qualities as well.
The goal was to make it less likely that I would have manic or depressive episodes, or that the episodes would be less severe. I think of it as providing me with a smaller roller coaster... a kiddie roller coaster with the highs not so high and the lows not so low and the changes not happening in such rapid succession.
Keep in mind that for me that by "highs" I do not mean an excess of happiness and joy. It meant an excess of irritability, rage, boundless and unfocused energy and sleeplessness. "Lows" meant being chronically tired, afraid to leave the house and very withdrawn from friends/family/coworkers.
I have what is referred to as "rapid cycling" bipolar disorder, which means I have more than 4 mood episodes per year. I am likely "ultra-rapid," because sometimes I cycle in the course of one day from hypomanic to Depressed and then back again.
This type of bipolar disorder can be particularly difficult to treat because you use different medications to treat Depression or hypomania. Many anti-depressants can provoke manic episodes. And the one time I was on an anti-manic medication it made me cry constantly.
There is quite unfortunately not one pharmaceutical treatment plan that will work for everyone with bipolar disorder, and even when you find a good combination of medications... they may not continue to work. This means that as part of my treatment plan I maintain regular contact with my Psych Nurse Practitioner who prescribes my medications.
I am currently taking only a mood stabilizer. I have a one-month supply of an "atypical antipsychotic" that I can start taking if my Depression seems to be settling in. My instructions if that is the case is to start taking the medication and call to see my Psych NP as soon as I can get in.
Another important part of my treatment plan is having a team of mental health professionals helping me navigate what is working and what is not. I see a Behavioral Health Nurse Practitioner who prescribes my medications, and a psychologist who works with me using Cognitive Behavioral Therapy.
When I was in the first phases of treatment (while still trying to figure out the appropriate medications) I had weekly visits with my psychologist. Now I only see her on an as-needed basis when things are not going well and I am having a hard time putting my CBT skills in play. I meet more regularly with my Psych NP who not only monitors how well my medications are working, but will let me know if she thinks I need to schedule with my psychologist.
It has been vital to me to have a treatment plan that includes more than just medication. Nobody would ever tell a person with heart disease to just take heart pills and change nothing about their lifestyle. The same is true for mental illness.
The non-medical parts of my treatment include regular exercise, scrupulous attention to getting enough sleep, and eating healthy foods. I was surprised at how effective making these changes was in improving my mental health. I had never thought of mental health as being part of overall health... but your brain is part of your body and needs nutrients, rest and exercise too.
I was dismayed to find that eating vast quantities of Belgian chocolate, sitting around the house, and staying up all night watching science fiction shows was NOT the key to recovery.
It is entirely possible that I am getting really nervous about the coming school year and feel the need to plan a whole ton. Like a lot. I need to get my prescription refilled. I am scattered and stressed. Stressed and scattered. Today I felt like my brain fell out and I couldn't think of anything. It felt like Friday afternoon, but it was Monday morning.
We talked about the importance of having a "Growth Mindset," in which you don't see your knowledge and skills as fixed, but as things that are plastic and dynamic.
I explained to my supervisor that the growth mindset does not come naturally to me. There are times that I acknowledge my general awesomeness (as a state of being) and other times that I acknowledge my complete worthlessness. This growth thing-- that I see, value and encourage in others-- is not something that I readily think about in a positive fashion.
Learning Norwegian is a way that I am going to have a growth mindset.
Oh blarg I wrote a whole bunch of other stuff but just didn't save or post or whatever and now its gone.
Anyway, growth good, fixed bad.
Not in the mood to write at the moment.
Need to fill my meds tomorrow
Grateful Crap: on Summer Break until after Labor Day
talked with people
slept a lot
spilled plum juice on my shirt (pretty sure that is excellent for mental health)
I'm looking forward to the school year while simultaneously not dreading the end of summer. I think having a sneaky little break in between teacher workshops and the start of school helps there...
My school is directly across from the state fair grounds and we choose not to attempt the impossible by holding school while the fair is in session. Instead we rent parking spaces in our lot as a school fundraiser. Brilliant.
I don't think that blogging every day is something that I am going to shoot for. Not while things are relatively stable, anyway. More than once a week would be nice.
I could shoot for 3 times a week posting and 3 times a week working out. Physical and mental health guideposts. I can try using a to-do list again (only if it won't cause me anxiety... which it did after a while when I was using it before.)
I am reveling in being surrounded by other educators; people that I know and admire. It is good for my brain.
And even though I don't like meetings and I don't like ice breakers, I haven't once sneaked out and tried to hide somewhere.
I don't remember anyone's names. Except people I eat lunch with. And my supervisors. Other folks are a bit sketchier. I need a picture dictionary... no, I need a photo directory of staff. I wonder if there is a yearbook somewhere that I could lay my hands on...
For the most part, other than the fact that I keep asking every ten minutes (or however often I see an admin) what classes I will be teaching... I feel like I am dealing well with the ambiguity. The knowledge that I will not know what I am teaching until it is too late. Until after the school year starts.
It looks like I will be collaborating with at least two other teachers, which is awesome. And possibly a third. This will have some logistical complications, but no worries.
I was only really thrown for a loop when I realized that I would not be returning to teach my "college prep" class. I know these students and thought that I would follow them through to their senior year as their homeroom teacher.
I have realized, though, that it's not as if I have been exorcised from their classroom. I will have some flexibility during their homeroom and my desk is still right there... so it's not like they will even miss me!
I'm going to go write some fiction now.
Have a nice night.
Grateful Crap: synapses firing
going to work
talking with friends/coworkers
I am in the state of trying not to be overwhelmed. There are many things that need doing. They are the things that in my imagination were going to happen during summer break.
I thought of summer break as this long unending supply of days in which I could be productive and motivated.
I'm not sure what gave me that idea. Summer has never had these qualities. No... that is not true. When I was NOT on mood stabilizers and I WAS on venlafaxine I got A LOT done in the summer. And I think I am trying to hold myself to that standard.
In that summer I built a terraced garden by hand and had growing things ALL OVER the place thanks to my efforts at zombie gardening.
This summer I have failed to put in the patio/walk in the backyard and my entire tiny yard/garden is taken over by giant and terrifying weeds.
No one can tell that I planted anything on purpose. I still haven't planted some things that i purchased in May. We're pretending that they are intended to be container garden plants.
My garage is a mess. Although less so because Spouse cleared it out.
When I have time I have no motivation to do things. And vise versa.
I am learning Norwegian as a completely unexpected tangent. Mine is a mixed marriage, doncha know. My mother is Swedish. I married into a Norwegian family. Spouse thinks we should go to Norway for our 25th anniversary.
I wonder how much Norwegian I will be able to speak in 4 years? I wonder if I will be able to study regularly and sustainedly enough to make any progress in the language. It can be a way to bond with my beginning language students. We can share our pain at how difficult it is to pick up a foreign language.
I am nearly done with a beaded cuff (bracelet) that I made for a woman who came to my last art show. I am scared to contact her to pick it up, though. Scared is maybe not the word. Nervous maybe? Anxious? Arranging to meet someone one on one is very different from having them walk by in an art fair.
I got a new lens for my camera and I would love to be off walking around and taking pictures, but I really need to stay off my foot. A pity too, because it is a perfect day today. Not even too sunny. Lovely puffy clouds and all. So I'm sitting outside on a rickety table in the packed dirt that should be a patio writing this post.
Grateful Crap... 5yo: "I don't have a heart to kill bees. A bee is a part of the life cycle. I have a heart to kill weeds, I have a heart to kill four-leaf clover, but I don't have a heart to kill bees." (said as a mantra to herself)
cutting myself a little slack
spending time outside
eating mostly good foods (starting mostly whole-30 for a while until I start running again)
sleeping mostly enough
we are all inside refusing to go outside and just closeted away. i feel the need to push my children outside on general principle. because it is nice outside. and outside things are good for you. and summer is crashing to a halt soon.
and i feel guilty for not forcing more outside of house behaviors on a regular basis.
the wolves who raised my children this summer (while i was at work or otherwise occupied) did not do a good job of getting them Out Of The House.
but i don't want to leave either. i want to closet myself away and do things like beading and writing and binge-watching whatever socially unredeeming show i'm into at the minute.
right now i am babying my hamstring after reinjuring it from excess walking. i doubt it needs to be RICEd so much, but i am kind of being a pouty whiny jerk about it. so there.
crying and yelliness are the only things happening inside when video games are not engaged. i am exaggerating. there is also pouting and stomping.
i saw psych NP and she post-datedly blessed my medication changes after giving me her cell contact again, which I put in my phone. and i will give to Spouse as well for when my phone inevitably chews up and spits out my contact information.
so now i am just on 150mg of lamotrigine daily. she wondered if fall would bring a seasonal change downward or upward. i don't think so. must review past posts and hope i have been more faithful to blogging in the past.
i also have a month-long supply of lurasidone if i feel a case of the Downs coming on. Instructions are to call her and start taking the meds if i find it necessary.
she reiterated that i am NOT to cease taking my medication without her knowledge and without making some kind of plan.
i feel no real desire to be off of everything at this time. it seems like saying, "Hey, I'm pretty good at driving now. Maybe I don't need to wear a seat belt anymore." and then of course the road gets all icy and you get sideswiped by some maniac who is blitzed out of his mind.
now instead of engaging in yelliness with the teenager, i am icily typing. and realizing that i haven't changed clothes today and am in the same thing i wore yesterday and all night and i really really stink. on the basis of that alone, the boy should want to go outside.
he has been taking brief forays into the out doors and i think if i just let enough time pass he will go do something and it can seem like his idea instead of me forcing the behavior.
he just came and apologized for his behavior. i knew my stinky procrastination would pay off. go me with my lazy ineffective parenting. now i can go shower since i no longer need to use my foul smell as negative reinforcement.
p.s. i have spent the last few weeks FRANTICALLY looking for my fitness tracker. had nightmares about the bad outcomes now that i lost it. that i would gain all my weight back and eat very poorly and lose my job. because i can't find a little plastic bracelet. right.
and then finding the dang thing became a grand quest and proof of my worth as a human being. why to i go all metaphorical on the stupidest everyday crap?
Spouse suggested that i purchase a replacement since i had methodically (and not even manically) decluttered each of the likely hiding spots for the missing item... done a grand job of searching for the thing (which I KNOW is in the house)
ACK... and now i REALLY REALLY want to spend hours and hours and hours cleaning out the frelling garage because i can't find a bike helmet and when i went out to look for one i was confronted with the horror. ugh. MUST... NOT... ENGAGE...
grateful crap: having a frelling garage so all the crap is out there instead of in my house
making a PLAN to clean out the garage (with help)
eating sort of well (avoiding going to the store right now... overwhelmed)
um... getting enough sleep
saw psych NP
i am using my injured hamstring as an excuse not to do things. but partly because if i do things, i am fairly certain i will re-injure, as i already have done. it's hard to cut myself some slack when i'm afraid that i'm just slacking.
Quaker, teacher, parent,