An update

So I’ve been seeing my psychiatrist for 11 months. I can say with some certainty that my depression has lifted, but that my anxiety continues, and every day I battle with it. The med combination that I’m on now seems to be working and both my dr and I are hesitant to change it.  Dr. L. allows me to determine how much clonazepam I need daily. I vary between 1 – 2 mgs. It honestly depends on the day. The other two meds are fixed doses and we are going to stick with them right now.

This year (it will be a year on June 6) has been difficult, but I have noticed a difference in the past three months. I feel better about my thesis and doing work in general. I have more calm days than agitated ones. The days that I am agitated I try to remember to take the higher dose of clonaz. I’m kind of working on a “Let Go and Let God” sort of mantra. I do not consider myself very religious but that phrase does help me, and I do consider myself to be spiritual.

I am still me, a year later, and I’m pretty happy about that. I’m still afraid that I’ll jinx it somehow, if I say that I came out on the other side, but I do feel like I survived. And for anyone who has ever battled depression and anxiety, survival is what we’re going for. So here’s to you, fellow survivors.

What if you can’t tell?

Had another psychiatrist appointment today.  This dr is keeping good tabs on me, which is a good thing, I guess.  I see him monthly.  I guess I didn’t expect to see him that frequently, seeing how overbooked and overworked our mental health system is.  But, hey, I’ll take it.

My anxiety is through the roof.  The house is up for sale but we haven’t had any offers.  The new house is built, and they are in the process of putting in the hardwood floors this week.  Every other day I have a meeting with my partner, the designer or contractor, or a house showing. I feel like I’m going insane.

But then there are times when I’m fine. I feel calm. I feel okay. I wouldn’t say that I’m super happy, but I’m definitely okay. Unfortunately, these days, the days when I am fine are infrequent.

So today, when my psychiatrist asked how I was doing, I didn’t know what to say. How do I sum up that I feel mostly okay depression-wise, but not so okay anxiety-wise, but oh, it’s not all the time, but most of the time?  Well, I think that is pretty much what I said.  But what really sucks about having depression/anxiety is that my concentration is shit and my comprehension is sluggish.  So, self-assessment is not exactly my forte.  I try to “check in” with myself, to compare myself to last month, or two months ago, but I find it incredibly difficult.  Am I better than I was last month? Worse?  I think I had a good bump up when the remeron was increased, but the dr decreased the prozac, which I think probably didn’t help the anxiety. So today he bumped the prozac back up. The medication balance is very tricky. And frustrating.

So what do you do, dear reader, if you can’t tell if you are better or worse? I am looking for insightful ways to figure out myself.  What works for you?

p.s. here’s a great blog post. I love her language.  Three Things You Need to Know about Mental Illness.

By the way, I have decided I am vanilla bean ice cream.

Taking care of me

So, one of the things my therapist told me when I was really depressed was to try to have fun, to play. It was as if he was speaking Japanese to me, it sounded so foreign a concept. The vicious cycle of depression makes you not want to do the things that you used to enjoy. And by not doing those things, by staying in bed, or just sitting in front of the TV, you can make your depression worse. You don’t do those things you like because depression robs you of the will to do them, to your agency, and energy. That’s why depression is so horrible. It is literally a thief. Of your time. Your happy feelings. Even your will to survive.

Because of a combination of meds and therapy, my depression lifted. I feel very lucky that I was able to get through it. That I had a good support system and the tools to ask for help. I know a lot of people suffer because they can’t ask for help, for a multitude of reasons.

I still consider myself to have severe anxiety and moderate depression, even if the depression is in remission. But I am back to doing the activities I like, the ones that make me happy. From April to July I was unable to do them. Things like baking and cross-stitch. Tonight the simple act of making blueberry muffins made me feel good. And they were tasty too!

I guess I am coming to the realisation that I have to be careful. Treat myself kindly and keep doing my self-care treatments. Because after three major depressive episodes, it’s a certainty that I will have another depressive episode in my life. Likely more than one. Knowing that, maybe I will be able to recognize it earlier, and help it to be less severe.

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Sad

Meds update. I’ve been on remeron for 5 weeks now. I see a big difference. I am able to do work again. The crying spells have lifted almost completely. I still have what I call “blue funks” (my own combination of anger/irritability/sadness) but not as frequently. I still have general anxiety daily so I’m continuing on with the clonazepam on a low dose. The addition of remeron was making me quite sleepy with the prozac and clonazepam, so the psychiatrist lowered the prozac dose by 20 mgs. Since the prozac has a long half-life in your system I’m only starting to see a difference now in regards to sleeping, after a week. I’m taking fewer naps and I’m getting a full 8 hours of solid sleep each night. Granted I have bizarre dreams, but it’s a side-effect that is not a deal breaker. Oh,  and I’ve put on 10 lbs. I’m trying to exercise more to combat the weight gain that remeron can (and has) caused. Also because exercise is “good” for me. Blah.

But what I really want to write about is that my therapy with M has ended. I’m pretty upset about it. Two weeks ago he told me that he had done all he could for me, that we have used all the resources available to us and that it was up to me to do the work, outside of sessions. It really came out of left field for me. Of course I didn’t expect therapy to go on forever, but I don’t think I am ready to leave the proverbial nest quite yet, either. I feel like there’s a ways for me to go yet, in terms of learning to cope with daily situations, work on my thesis, and especially in terms of my personal relationships. He thinks he’s done all he can.

I’m not sure I buy it. Maybe it’s because I don’t want the sessions to end, because I’m losing my support system. He wants me to lean on friends. I told him I didn’t have any local friends that I felt I could share my deepest feelings with, and he told me it was time to reach out, make new friends, outside of my partner and sister. I have no idea how to do that.

Maybe it’s my ego talking, but part of me wonders if he felt anything for me, beyond being just another client. Could that have been why? Or maybe he terminated sessions with me because he saw that I was starting to care too much for him. Not romantically, but as a friend, instead of a therapist. And therapists frown on that sort of thing. Maybe that’s why I feel like I was dumped.

He knows I’m upset and not ready to let go.  We talked about it for the entire session today, our last session. After our time was up, he shook my hand. He refused a hug.  It’s over.

And I’m more than a little sad and confused. He was my shoulder, and now I don’t have one anymore.

 

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I don’t know how I feel.

Does that make sense? I am just there. Not happy. Not terribly optimistic. But existing, sometimes peacefully, at moments. Then there are times when the agitation comes back. I just want to scream! Everyone’s voice grates me. The dogs’ barking goes right through me. I don’t want to answer the phone or read a book. Or do anything.

So I go through the motions, get up,  drink coffee, force down breakfast and my iron pill. Take my meds. I might sit there for awhile, read news online, check Facebook. As often as not, I go back to bed. The new med is making me quite sleepy. I need at least 9 hours sleep. And often, a nap for at least an hour in the afternoon. Seems like a lot, and it gets me down. I keep thinking what a waste of time sleep is. And how if I was at a full-time job, how would I manage?

Tomorrow marks 3 weeks on the remeron. I am definitely more sedate in a general sense. Especially if I take my clonazepam, which I’m supposed to do, but I still struggle with, because then I feel especially stoned. It works for the general anxiety, but the cost is great. I am definitely more foggy when I take it.

I have had more than a few good moments in the past two weeks, so there is reason to be optimistic. My partner and I went camping for a long weekend and it was a lot of fun. Sunny and warm where we went. I am feeling blue again now, as we are back to the grey, foggy city. Sometimes I really hate living here. It’s just so dark, rain,  drizzle and fog. For days on end. It really gets to me.

Anyway, I see my new psychiatrist again tomorrow. I will tell him about the increased sleep and see what he says. It’s really going much better than before, even though I don’t feel well today. Maybe there is something to keep me more alert, or maybe he will reduce the prozac.

Made a little progress on a chapter for my thesis. I feel a bit like it’s pulling teeth. And my motivation is still lacking.

I know depression doesn’t go away fully. I am trying to learn a bit about mindfulness. Maybe if I can learn how to practice it, it will help. Meanwhile, if you could say a little prayer, or send a good healing vibe for me, I sure would appreciate it. I need all the help I can get.

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My dogs in the trailer, looking cute.

Thoughts on my session today

I’ve been on the remeron over a week now, and I’ve seen a difference in my mood. While I am more sedate, calmer, and a little sleepier I am definitely not as agitated. It feels like I am starting to get back to myself and that’s a really good feeling. I worry that this is temporary, and feel a bit like I’m waiting for the other shoe to drop, but I know that’s my anxiety talking. I am getting well.  I have periods of feeling quite a bit better.

My therapist says that when I’m really anxious, severely anxious, I have little to no control over my moods,  and I have to rely on my meds during those times. That I’m doing everything I can be doing. Fair enough. It is then that I must have compassion for myself, being unwell. When I am well, I am able to take control over my anxiety, at least to a certain extent.  Mild to moderate anxiety can be worked through/on.  So when it passes that threshold from moderate to severe, to recognize it as such, and accept it for what it is.

The overwhelming theme of today’s therapy session was “acceptance”. Learning to accept me for me. Benefits and pitfalls.  What are the benefits of being me? M. asked me. I could could think of a couple of things. I need to remind myself more of the benefits.  I’m kind. I’m approachable. I’m bright. I’m passionate. What are the pitfalls? Let’s put it under the neurotic/anxious umbrella term, for now.

M. reminded me of some important things. I was talking about guilt, and how I felt guilty that I wasn’t further in my thesis work. He said, “wouldn’t you be further if you could have been?” And that is the crux right there. I was not able to be further in my work.  And I need to accept that. If I could have been done by now, I would be, for who am I/have I been hurting by not being done? Nobody but me. And why would I do that to myself intentionally? Exactly. I wouldn’t. 

So I have to accept me for me. Me, who has anxiety and depression. Me, who lost this whole semester and more to this illness. Me, who struggles daily with self-esteem.  But to also accept that I have good qualities too, and to remember  them.  I can write. I am eloquent. I have drive. And when I am well, and the anxiety is not getting in the way, you can see that. I can see that.  What I consider to be faults or bad qualities are not what they seem to be.  They are products of the anxiety. And when I have moments of clarity I can see that they are simply symptoms of depression/anxiety. They are not qualities of self. They are not who I am.

Who I am is different from everyone else. I can wish and wish that I was 6’0 tall, but I’m not and never will be. That is not something I can change. I accept that. In the same way, I must accept that I am who I am. I do procrastinate. I do easily distract. But I also am kind, intelligent, musical and hard-working. Some things you cannot change.  I cannot change that I have anxiety. I probably always will. I can change how I look at it. I can accept it. I cannot change that I lost time during this degree due to my illness. Not a damn thing can I do about it. So I must accept it. It is fact.  Now I must move on. Accept that I am being the best I can be, and doing the best I can.  That my best is different from someone else’s best.  And that’s what life’s about,  isn’t it?

I will try harder to get rid of the “shoulds” and the comparisons and the guilt. That type of thinking just eats at your self-esteem and self-worth. I refuse to indulge it anymore. I choose to move forward with acceptance of who I am.

Appointment with Psychiatrist and Santa

No, I’m not delusional or hallucinating. Santa really was there! A two foot tall standing ornament.  I guess a psychiatrist’s office that is too busy to de-Christmas (in June) is a good sign. Or,  as a friend said, it’s just a “really good conversation starter”!

The appointment went well.  Much better than the first psychiatrist I met. This guy actually asked me what my symptoms were, and focused on how I was feeling now, as opposed to my childhood. He asked relevant questions, and all in all,I left with a much better feeling than I had with the first one. It pays to listen to your gut, and get a second opinion if need be.

So, he agreed with me that the wellbutrin was too activating for me, and that it might have actually increased my agitation level. Apparently 20% of patients react poorly to the wellbutrin.  We are going to keep me on the prozac and clonazepam for now, and add mirtazapine. That might work. It will be more calming than the wellbutrin for sure. He wants me to come back in 3 wks, and he told me to be persistent with calling his secretary if I felt any really bad side effects like suicidal thoughts, and he would get me in.

I have hope. It’s been awhile since I’ve felt that, and it feels good. This dr said that it would be possible for me to finish my thesis, get out of the depressive/anxious state,  and actually concentrate. What a concept. I look forward to it.

I also got a diagnosis. Major Depressive Disorder with likely Generalised Anxiety Disorder as well. For some reason, a diagnosis helps. Just the label, I guess, makes it less of a mystery, less scary. He does not think I am Bipolar II; the sheer lack of any manic symptoms prevents that diagnosis. The agitation is likely due to the anxiety.

I apologize if I’m being repetitive, but I’m excited and hopeful. Tonight I start the remeron (mirtazapine) and maybe I will get some rest. Maybe this one will work.

Meanwhile, here’s Santa. Happy Christmas in June?

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