Letters To The World

Natural

2007-12-10T20:05:00.000-06:00

Six months after my brother died I wrote something I'm very proud of. It was one of the few pieces I've ever written that really conveyed the emotions I felt, the train of thought up the mountains of my memories of him, and around the sharp cliffs and down the seemingly bottomless valleys. At the end of the piece I chugged slowly into a paragraph of what I could find of truth, at the time. It was a short paragraph.

Truth is difficult to identify when it is shrouded in the mists of emotion. It's hard to see all but the parts of it that are closest. The truth was I hadn't called him the night before he died. The truth was he was dead. The truth was also something more, something of an unknown size and shape. It could have been anything. I ended the piece there.

This past Thanksgiving marked exactly 5 years to the day since I had last seem my brother. I remember him walking out the door of my parent's townhouse with his girlfriend, Amy. I was annoyed with him, and relieved he was leaving. I've thought of that last hour of him countless times since.

It's hard to believe 5 years have come and gone since that day, and that nearly 5 years have come and gone since his death. Sometimes in the evenings I feel a pull towards simply thinking about him, feeling what I feel about him, and when it happens I usually turn off the television and welcome it. I gave up trying to figure anything out about our relationship long, long ago and so those moments of silent remembering are very free-form and bittersweet. I welcome them. They don't, in all honesty, happen very often, but I felt one come over me tonight. I am home alone, it is cold and rainy outside, and dark, and quiet, and so I switched off the television and allowed it to come, invited it in.

Something unusual crossed my mind tonight, though. I simply thought that really we'd never been close. What sparked it was a television show about drug intervention, and a recent story I started about time travel and going back in time to tell your family what their future is going to be. The two came together and I asked myself - how truthful was I with John when he was alive? Was I so busy climbing the mountain that all I ever saw was the anger or hurt or disdain that were right in front of me? Did I ever know the truth well enough to tell him about it or were we both in such a constantly emotional state that neither of us knew what the truth was?

And then, in a very gentle way, I asked myself what that truth was that I thought I hadn't told him. The answer was not how angry I'd been with him, but how angry he was with us sometimes.

In fact, in the past few months I've wondered, every once in awhile, if he ever tried to tell me truths about me that I refused to hear. This is the flip side of truth-wondering. Did I tell the truth? Did I hear the truth?

Was there truth beyond emotion that either of us knew?

Of course emotion is truth as well, and certainly it can be very in-the-moment in a way that's important to share. Even anger. Even all the anger and drama between us. There are families where emotion is never present and that's probably more damaging, I would think. Emotion is a truth but it's like sugar - it burns out quickly. The bigger truths I am wondering about last longer and matter more.

In all of the bitter exchanges we had, was I ever able to not be bitter and say, "Sometimes, out of nowhere, you are aggressive, angry, violent. I think you are that way when you've been taking drugs and drinking. You are hurting us all. Let's talk about it"? And when would I have done that? Not when we were in our twenties because he was too far gone to listen, then. And not when we were teenagers because I was too naive to think it might have been drinking or drugs then. And maybe it wasn't all drinking and drugs because it happened when we were children, too.

I walked to the kitchen. Pacing helps me move on in my thinking, sometimes.

When we were young I felt, I felt....

I paced some more. Tried to continue. Why should it be hard to think silently to myself how I felt?

Was it rejection, exactly? No, it was too persistent for rejection.

And that's when I thought: when we were small children he wouldn't play with me. Not with me. He would me he would play with me if I would let him lead, but it was only a way to get me off his back. He simply wouldn't engage with me.

He never did.

I stopped for a moment - stopped pacing, stopped trying to label things. There, spread out before me, was a mountain of truth. Look at that, I thought to myself, what a relief to see through the fog. There's nothing so terrible or unfamiliar there. What is this truth if not simply the geologic record of my own life, the one I've lived so far, altogether familiar and survived.

So the truth is that my brother and I didn't share deep conversations. We didn't trust each other or ask for advice. My brother and I didn't get along. Ever. That doesn't mean we never hugged or that we never said "I love you". It just means we were never close.

I wanted to be close to my brother when I was a child, but he didn't feel the same way. As we grew older I stopped wanting to be close to him. Really, it's just that simple.

I loved him. I miss him. We weren't close. And that's okay.

Subaddiction

2007-12-08T10:55:00.000-06:00

On the other side of another round of medication trials. My medicine cabinet now contains the following prescription medications:

Seroquel
Neurontin
Lithium
Ambien
Cymbalta
Synthroid
Lipitor
Levoquin
Prevacid
Combivent
Advair
Albuterol

The Synthroid seemed necessary following my first blood test to measure Lithium levels, which indicated that the Lithium had caused my thyroid to stop functioning and raised my TSH level to 5.6

After spending hundreds of dollars in a few weeks on these medications and the associated doctor's appointments, however, I stopped taking most of them. I'm now taking nothing more than 25mg of Seroquel at night to help me sleep, and a few puffs of my Albuterol inhaler each day if I'm having trouble with wheezing or shortness of breath.

I'm sleeping better, my anxiety level has plummeted, and I'm concentrating better too. I seem to have recovered from the bronchitis (or whatever it was) as well. I don't feel depressed and I don't feel hypomanic - I feel pretty even.

Once again, my goal is to wean off the Seroquel completely. I have plenty of time to do that since my prescription is for 100mg pills, I have most of a bottle of those and 2 refills left on that prescription.

I am becoming more and more convinced that I, and hundreds of thousands if not millions of others like me, have fallen in to a sort of addiction purgatory: we are not full-fledged drug addicts looking for a high, but neither are we uninterested in maintaining a drug-induced state. We are uncertain of the medical necessity of the medications we've previously been prescribed for insomnia, anxiety, depression or mood instability. These medications are ours for the asking but we're not certain we want to take them - we're just certain we feel better when we have them at our disposal. I, for one, have always done better on little or no medication - I've known this for many years and yet I still go through phases (like the one I just exited) where I end up with new prescriptions for close to a dozen drugs that I then don't take. Or don't take for awhile.

You would think that tapering off Seroquel would be easy at this point. 25mg is not a thereputic dose - Seroquel doesn't even come in a smaller dose and this one is physically tiny (trying to cut it in half would probably simply pulverize it). And yet the likelihood is that one night I will decide to take more - not because I can't sleep but because I simply have the urge to. This is what has always happened in the past. I will take more and then at some point a little more, until I am back up to 100mg again. I will see my supply of the drug dwindling and make another doctor's appointment. At the same time, my ability to focus will decrease and my anxiety and mood instability will increase. I will decide to take some of the other medications in my medicine cabinet as well and will gradually become less stable, and more certain that I need to be under a physician's care. I won't take the medications as prescribed, either - the doses I swallow will be small and sporadic. This will gradually lead to another one of the phases I just went through. If I discuss this with my doctor she will likely tell me it is all a symptom of a psychiatric disorder. I will agree just long enough to get more prescriptions, and the cycle will begin again.

Plagerism - Sort Of

2007-09-26T17:26:00.000-05:00

The following essay's format and some descriptive content was taken directly from the article, "Bipolar Diaries" by Elizabeth Swados, in the October issue of "O Magazine". I have customized it to fit my life.

I am not afraid to tell people that I am bipolar. I don't say it often, or indiscriminately. But I do tell. Not the whole story, just the diagnosis. The medication. I seem to say, "I am me, and guess what? I am bipolar." As if I am almost proud of the term. To me, personally, in a way I never describe to most people, bipolar means the same thing as strong.

And yet I hate this term: bipolar. On the surface it seems faddish and low-class, like pink stilleto heels or an herbal weight loss drug. It seems to describe people who are prone to specific behavior - temper tantrums, laziness, drug abuse, self-pity. It seems like just another word to describe a person who is unwilling to work hard and take truthful responsibility for themselves. In short I fear that to most people bipolar means the same thing as excuse. And an excuse is, of course, a bad thing if it is an excuse for something that continues to occur.

Bipolar.

I'm so detached from my diagnosis that I rarely think about how any clinical psychiatric term brands a person. Because of that I am able to think, "I am bipolar, but I am not a bipolar person" and leave it at that. Most of the time.

When the term was manic-depressive, the associations were different. In my family, manic-depressive meant my father's sister. It meant having scholarships to the University of Texas in both Latin and Harp. It meant marrying in to one of the wealthiest families in your county. It meant being one of the most beautiful women in your state. And it meant throwing everything away, creating an endless sea of pain for your mother; it meant decades of denial for your extended family, and it meant promiscuity and failed romantic relationships and just plain old quitting. It meant an early death at your own hand. But mostly, it meant the same thing as the word secret.

One year, when I was about 9 years old, my aunt was diagnosed with hepatitis. We'd visited with her recently and so everyone in my immediate family had to go have a shot to inoculate us from the illness. Maybe that was what finally pushed her over the edge. About the time I thought she had recovered, she died. The party line from my parents was that she had accidentally ingested a pill as part of her treatment, and that the pill had accidentally killed her. Somehow I knew that wasn't true. I knew it was suicide. When I was 14 I finally asked my mother if I was right, and she said that I was -- but we weren't allowed to talk about it around my father. My aunt was his little sister. The topic of her death made him angry. Admitting it was suicide would have caused him to explode. My aunt was only 32 when she ended her life and, as I learned later, she had been very determined to do just that for a couple of years. There had been failed attempts in her recent past, and her doctor actually told my grandmother that it was just a matter of time before she succeeded. It was as if she my aunt had a terminal illness for which there was no cure. An illness that nobody in the family understood. Something that was her own, as if she were a solitary case. In fact, the hepititis was the least contagious thing in our family when I was 9. The terminal illness my aunt had been fighting was one that our family would grow to learn a tremendous amount about. And it hadn't taken it's last victim when she died.

I remember my aunt. Her youth, her beauty, her talent. I remember her affection, but mostly I remember how temporary she was. When I was growing up the comparisons between us seemed endless: looks, intelligence, habits, and most of all propensities. The age of her death became fixed in my mind. I wondered - would I survive beyond that age? My first cousin went through a Taro-card phase when I was 11 and prophesied that I would die young. The prophecy sparked determination in me. It was a type of determination that would carry me through many bad outcomes in my life.

And later, the following people in my immediate family were all diagnosed with bipolar disorder or something in the same spectrum: my brother, two of my three first cousins, my uncle, my mother, my mother's first cousin and her daughter, three second cousins close to my age. Of course, because we know so much more now, there are others we suspect would have or could be diagnosed with the same thing: my father, his surviving sister, his mother, my mother's father and some of his siblings.

Of all of these individuals I have mentioned, I am the most successful. It isn't a measure of my illness. It is a measure of my determination. I don't say this out of pride, though it's something I am proud of. You can't imagine why, but I say it with some kind of awe because of all of us, I was the least likely to succeed at anything, I think. And because it is, in its own way, a mighty burden.

But all of this tells the average reader absolutely nothing new about bipolar disorder.

If you don't immediately associate this diagnosis, this label, with a cultural propensity towards escapism, you may know that bipolar disorder (like manic depression, it's previous name) in general means wild, uncontrollable mood swings. You may think it means a few weeks of grandiose fast talking, ending with the belief that the sufferer can fly, followed by a few weeks of disabling depression during which the sufferer can't leave their bed. And if you meet that criteria very often at all you could, certainly, be diagnosed with bipolar disorder.

And yet, there is so much behind those descriptions.

What if... what if you were to awaken one day and find yourself completely out of synch with the rest of the world? And I mean... this would happen literally overnight. The day before you were normal, not manic, not depressed just... normal. And what would out of synch mean? Maybe it would mean that when you opened your eyes this particular morning you had a song stuck in your head in the very worst way. Any song. Maybe a song you hadn't heard in months. The song continues (silently) in your head and then, in frustration, you turn on your radio, hoping to tune it out. Instead, the first song you hear replaces the song that was stuck in your head, and the songs go on and on and on.

You finish your morning routine, but you're running late because for some reason, this particular day, you just don't feel very motivated. It's hard to focus so you drink some extra coffee on your way to work, and once you get to work you drink cup after cup, as if you're dying of thirst. This speeds you up and suddenly you're in the greatest mood. You're not working, but you are joking with the staff around you. You're funnier than usual and everybody laughs when you laugh. People you don't often talk to invite you to lunch.

So you go to lunch. The damn song is still stuck in your head, which is distracting, but lunch sounds good. You sit at your desk, waiting for 11:30 to roll around, getting absolutely nothing done. Every once in awhile you turn to the project you're working on - the one with the impending deadline you've done such a great job on - but you can't seem to care about it enough to do any work. White noise joins the chorus of the song playing in the background of your every thought.

But lunch is great. Your charismatic mood is contagious and soon you've led everybody on your team to a three hour drink-fest. You're finishing your 4th margarita when you realize it's nearly 3:00 in the afternoon. Once you're all back at the office, the team hovers around your cube, laughing and joking. A supervisor walks by and the team disperses and begins finishing their work for the day. You turn back to your project and think to yourself that you're such a fantastic employee, so beloved, so intelligent, that meeting the deadline isn't really all that important after all. You decide to write a funny poem about work and send it out to all the people you had lunch with. A few of them reply in appreciation.

But then you begin to worry - what about those people that didn't reply? And you're suddenly feeling so tired and run down. You take a quick trip to the bathroom and look in the mirror: your eyes are a yellowish-red and your skin looks sallow. My God, you think, I'm a laughing stock. There's something terribly wrong with me. Those people that didn't reply to my email must think I'm a lunatic.

And then the voice starts in your head. Your own voice - not something audible but clearly in your thoughts, on top of the song that's stuck there now, and the white noise: you, deriding every aspect of you. You are lazy. You are unreliable. You are fat, and you have bad coloring. You are weak. You are bad. You are everything terrible you can think of to say to or about anybody you've every met.

Your team has been back at work for a mere 30 minutes and during that time you've crashed. You decide to call it a day. Obviously, everybody thinks you're terrible - what harm will leaving early do?

So you do call it a day. But you're restless. So you decide to write. I'll write a book about myself, you think, and it will be a best seller and then I won't have to work at this office anymore. But you need to feel better to write, you need to feel more like you felt at lunch.

So you head to your favorite restaurant - the one with the patio and the great happy hour and the tasty tamales. And you drink, and you write. The entire time you're writing you believe that everybody within eyesight is looking at you and thinking, "Look at that - there's a crazy person. Look at how ugly she is." For some reason this is empowering, and you hunker down lower over your pen and paper and margarita.

As the sun begins to set more diners show up so you head home. "I shouldn't be driving", you think, but you do anyway and nothing terrible happens except that you feel as if every other driver on the road is looking at you and thinking, "Look at that - there's a drunk driver. Look at how paranoid and ugly she looks". Your heart begins to beat wildly in your chest.

And then, finally, you are at home. You go over your day in your mind and you believe you need company. You need to get back to where you were at lunch time.

You start calling people. Your speech is slurred and you don't sound like yourself. This is due partly to being drunk and partly to the additional voice that's now joined the choir of banshes in your dead that are deriding you - this voice is saying, "everything will be fine and quiet just as soon as you find someone to accept you." But the only person who responds is a horny ex-boyfriend. You figure he'll do.

Later that night, back at home, your head hurts and your body may hurt and now you have a new voice in your head. This new voice is telling you what a slut you are. You try to sleep but you can't. You toss and turn and worry. Finally, around 4:00 in the morning, you decide to try to catch up on all the work you missed the day before. And you do. In four hours you do eight hours worth of work and not only that, but the work you do is miraculous and fabulous. You've met your deadline and - more than that - you've gone way beyond anything you had to do and entered in to the realm of near perfection. You'll get a bonus for this later, as if in payment for the voices and songs stuck in your head.

And those voices and songs, they begin to follow you everywhere. Not only that, but now you can actually audibly hear music, from a distance, all the time, as if somebody with a mamoth car stereo has parked his car underneath you apartment window, turned his bass up to full blast, and started playing rap music. It isn't in time with anything else going on in your head and it irritates you terribly. You think the music is real. You walk downstairs to tell the culprit to take his damn music somewhere else, but you never find him. At work, you walk the cubes in your area to see if someone is playing something on their computer, but nobody is. You stare out the windows, looking for a car, but never see one. Kids these days, you think.

But the sound keeps you awake. You try putting a pillow over your head, but the sound gets louder. So you get up, and you decide to paint. To watercolor. In fact, you decide to take the biggest painting in your apartment - the one your boss gave you when you were 23 - and cover it up with gesso and create a new masterpiece on top of it. You figure you'll clean the paint spills on the carpet when you move. Sort of the like the burned places and the places where melted wax has piled up from the candles you keep burning for atmosphere. Sleep deprivation begins to feel exciting. You almost feel as if you are on drugs, or are gliding through the atmosphere. You believe that you can answer any question, can solve any problem, so long as you don't sleep.

But you do sleep, eventually, and when you do you dream the entire time. You dream that you are lost in a parking garage and can't find your car. You dream that your arms and legs don't work properly and that you can only walk like a cartoon gorilla, with your arms dragging on the ground and your hips swinging your legs from left to right. You dream that you can only move if you are sitting in the lotus position on and skateboard. You dream that someone is trying to kill you and you can't get away from them. You dream, and all of your dreams are terrible, and you remember every one of them when you wake up.

Suddenly, getting to work on time seems to much less important than simply getting to work whenever. You take a couple of days off here and there in an attempt to mask what's going on with you but on the days you are at work you show up later and later. 10:30 becomes your starting time and for some reason, you still have a job. 3:30 becomes your quitting time and still, you have a job. You can't understand why this company would want to keep you and you become terribly embarrased. After all, your cubicle is stacked floor to ceiling with books you've planned to read and papers you need to analyze, and you've worn the same pair of jeans (the ones with the hole in the crotch) every day for two weeks running. Surely they can tell you're sick, you think, since you know you've lost about 15 pounds since you pretty much stopped eating. Can they tell I'm sick? you ask yourself. And you hope they can.

And so you sit down with your boss. "I think I'm sick" you begin, and they stare at you with what appears to be irritation and distrust. "I'm going to a doctor" you begin again, but they say nothing. You wonder what they want you to say. Maybe they actually want you to say, "My boyfriend and I broke up recently," or "My mother just found out she has terminal cancer" - anything to simply explain your behavior. Finally, you simply say, "But I'm getting better. I think I've had some stomach problems or something. I just wanted you to know I'm fine." They grunt and nod. You still have a job. It's only later that you realized that nobody ever asked you for an explanation.

At night, the insomnia and nightmares continue. You begin leaving every light in your one bedroom apartment on at all times because you are certain that the impending feeling of doom that you carry with you all the time means that a mass murderer is going to find some way to climb through your 3rd story balcony and attack you. You try not to spend too much time thinking about what he might do to you.

And then you begin to imagine animals and children being harmed. The thoughts are random and horrifying and frequent. You are a freak, you think. Your voices are right.

And that's when you decide to quit your job. It's a sudden decision. On afternoon you're thinking about leaving early again, feeling ashamed of it and embarrased and angry and about what you think your coworkers might be thinking about you, and you think "I know what I'll do - I'll start over!".

And so you simply stop coming to work. And then you call to see if you still have a job and, for some reason, you do. You give two weeks' notice to finish up whatever you're working on and come back to work.

You have a weekend of despair. Sobbing. Self-recrimination. I will overcome this. Two weeks of seriously hard work.

And then you wake up one morning and everything's back in synch. Suddenly, everything is normal again.

And so you unquit your job. They let you. Because when you're fabulous, you really are fabulous.

And two weeks later it all happens again.

But it isn't that predictable, really. Because the next time, the symptoms are more intense and more disruptive. You begin thinking about death all the time. The fun lunch, the charisma, the humor - never emerge.

Eventually you do seek help. Initially, the drugs may drive you farther into the darkest aspects of who you are - that is, when you aren't in a zombie-like state. It takes a long time (for me, two years or so) to figure out what works and to get in to a state where you can become determined to manage your symptoms and to face the reality (or what you hope is reality) of your life.

Many people believe that mania is a happy situation. I only ever had one happy manic period in my life. It happened the summer I turned 30. It made such an impression on me that I often manage my illness as if that summer is the shining example of who I could be if only I could overcome all the thought-related obstacles bipolar disorder brings in to my life. I've even tried going off of all medication in an attempt to find the road that leads back to the me that I was that summer. It didn't work.

Today I am married. I help my family. I make a lot (to me) of money. I've even been able to say, more than once, "I'm in a bipolar crisis and need time off work right now" and it hasn't seemed to hurt my career or my reputation. I can't exactly understand why.

I think that all this means is that this is where I am right now in my understanding and acceptance of whatever it is in my brain that goes haywire and causes me such pain.

The "strong" part of bipolar means just this to me: I know that whatever I am going through will pass. I know I will come out on the other side of it employed, married, and loved. Somehow, I will manage to do those things.

And I will grow more stable and more knowledgeable over time. I've only known for sure that I have this affliction for about 8 years.

Bipolar disorder gives the afflicted a lifetime to learn, a lifetime to overcome.

Off Again

2007-08-23T07:25:00.000-05:00

Ok, I haven't had a Seroquel since ... well, probably since Friday night although I have to say that time is simply flying by. I took 1mg of Atavan Saturday night, which I probably didn't need. I didn't sleep great but I felt find the next day. In fact, I felt fine until day before yesterday when my allergies kicked in. To counteract the allergies I took a Claritin, which did a nice job -- but I was pretty sure I would have trouble sleeping that night so I took 1.5mg of Atavan and went to bed - but couldn't sleep. After an hour of tossing and turning I got up and took another 1mg tablet. I finally fell asleep but didn't feel great when I awakened. I took another Claritin along with another .5mg of Atavan -- and felt really awful. Sick at my stomach. Lurchy. Tired. Bad.

After I took David home from work I took the rest of the day off and ended up sleeping straight thru from before noon until almost 5pm. I'd felt so terrible from the Atavan that I decided not to take any more and so when I finally went to bed - around 2:30 this morning, I didn't sleep at all. Just tossed and turned and dozed in and out until my alarm went off at 5:30.

This morning I remembered my last year or two at Price Waterhouse. I seemed to be very well liked by so many people - and so disliked by as many more - at work. With my peers I was always laughing and joking and seemed to be able to solve any problem very quickly. But I took it a bit too far sometimes - sending long, rambling poems or personal emails to some coworkers, talking so fast and furious in a haze of comedic frenzy to others that at one point the guy on the other end of the line said, "Are you all right?". And then there was the flip slide of me - the side that felt angry all the rest of the time. The side that simply sat in my office, or drove to San Antonio, and didn't do any work at all. The side that took off for the Dallas office and never made it there over and over and over again. I felt so much worse then than I do now, despite the fact that I looked physically better - was much thinner, much more physically healthy than I am now. Some time in the middle of this period of time I started taking Paxil, off and on. In hindsight it seems to have made things worse, probably because I was constantly going off of it. Dysphoria and suicidal ideation set in.

And now... now I have a big, big problem, because I'm not doing my job. I get paid. I go online. I complete the biggest assignments a little late and the smaller ones not at all.

But beyond that, here are the negative things I'm experiencing:

I don't feel happy or joyful

I always feel terribly worried/stressed out

I keep fantasizing about an alternate life where I have no responsibilities

I'm spending too much money

I'm not exercising at all

I don't feel in control of myself

I can't sleep at night

I am completely, utterly distracted... by the Internet, by potential remodeling projects, by potential business projects, by potential art projects ...
I am completely self-absorbed

I started my period day before yesterday so it's not unlikely that I'll feel a lot better in a few more days. Maybe I'll start sleeping on my own again. Maybe I'll feel happy (I'd even welcome hypomania). Maybe I'll get a handle on my responsibilities around work.

Or maybe I should take a short leave of absence, find a doctor I trust, and start again at square one.

Unmotivated

2007-08-16T15:58:00.000-05:00

It seems that I got my Seroquel refilled back on the 19th of July. I started my period the next day, which means that today is the day I should start my next period. This isn't much of a surprise to me as today is a work day... and I haven't done any work. I say not "much of a surprise" because the past few weeks have passed so quickly. Time, in fact, passes more quickly now than I would ever have imagined when I was younger and the future seemed an eternity away.

I slept for a couple of hours today. While I slept I dreamed that David and I were living in a rambling, ramshackle place out in the country. People visited us all the time, as if we were having a perpetual party. Finally, they left and we were alone. I asked David some question and followed it up by telling him that I was incredibly unhappy. He asked me if I meant it and I repeated myself in a way that indicated I did. And then I went off to find some place on the property where I could be alone, although I thought of him the whole time.

These days - these months, these years - at this time in my life my PMS seems as bad as it's ever been. In titling this entry "Unmotivated" I'm referring to what happens to me on the downside of my cycle - the last 2 weeks or so before I start a period. I feel so unmotivated about work and about myself. Not uninterested, just unmotivated. I look at my computer screen and everything seems to require more brain power than I'm willing to apply to it. I feel an irresistable pull towards simply doing nothing. More and more often, nothing is exactly what I do. Sometimes my anxieties pile up around me during this phase of my cycle and by the day my period is due to start I am certain that I am doing the world, and especially my family, a great disservice by attempting to handle my life without a team of professionals and a medicine cabinet of pills to prop me up.

But it's just my hormones.

Isn't it funny that we women say, "It's just my hormones"? Just something that disrupts our lives, that drags us down, month after month and year after year. As if it were unimportant. I suppose we know that anything that is certain to be as impermanent as PMS is comparitavely unimportant if we also believe that we do very well the rest of the month. And I think I do, actually.

I'm writing this today because last month I tried very hard to put some kind of marker in my mind that I wouldn't forget; something to pop up on this very day and say, "It's just your hormones. Remember last month."

I think it's at least helping to keep my anxieties at bay.

Surprise

2007-08-10T12:38:00.000-05:00

After I picked up my old 2002 psychological assessment I drove to Opal Divine's and found a shady spot on the patio where I could read, smoke and drink a beer. I read the first paragraph and smiled in both relief and surprise because there, in one of the last sentences, the doctor had listed the questions I had hoped the assessment would answer all that time ago:

During the initial interview with the client herself, Ms. Sullivan's questions for the testing included: 1) Can she trust her own perceptions? 2) Is she "paranoid" and, if so, under what circumstances" and 3) Why does she have such difficulty connecting on an interpersonal level?

And in the second paragraph, a reminder that this is not the first time I've tried to get off all medication:

At the time of the evaluation, Ms. Sullivan had discontinued all the medications prescribed by Dr Seremetis which included Risperdal, Neurontin and Lamictal.

I'd forgotten about that.

I read through the entire assessment once, and then again, and then again. To my further surprise I found that in the whole I agreed with many of the assumptions the doctor made, and with almost all of the conclusions she reached. I didn't feel offended, and I didn't think she focused on narcissism or masochism... rather, her focus was primarily on my fears, how those fears affect my behavior and perception, and how fear, behavior and perception all impact eachother and gain momentum and become skewed, one because of the other, in a circular way. She did a far better job of describing what I've been experiencing that I ever could, I think.

What I'd like to do next is to have another assessment done by a different doctor. I'd like another opinion about how I'm doing now. I can compare the two assessments and use the information to inform the decisions I make about my next steps. What to focus on in therapy. What kind of therapy and therapist. What medications, if any, to stick with for awhile longer.

One things that's certainly changed over the past five years is my perception of this specific analysis. Somehow, that makes me trust the process more than I did a few days ago.

Fear

2007-08-08T15:17:00.000-05:00

"Everyone has characteristic patterns of perceiving and relating to other people and events (personality traits). That is, people tend to cope with stresses in an individual but consistent way."

From the Merck Manual's Personality Disorders page

I haven't stopped taking medication, yet. In fact, night before last I took a Klonopin (my last), a Rozerem, and a Seroquel. Last night I simply took 2 Seroquel. Thing is, to get to the point where I'm able to get myself to sleep and handle my life without a sleeping pill, I'm going to have to make a couple of life-style adjustments that I haven't made yet. And it would probably help to go into it having gotten caught up on my sleep, instead of being behind on it. But I'm looking forward to the day I stop taking Seroquel (or anything, for that matter). I'm looking forward to it almost as much as I'm dreading it...

Because, in fact, there are behaviors that I've never changed. Medication has helped me get through my days and nights without any huge bumps in the road - I'm relatively demotivated on medication and so I tend to let a lot of things slide that I wouldn't otherwise. In part because of this there are important lifestyle changes I haven't attended to. Not to mention emotional baggage I've yet to sort through, despite years and years of supportive therapy.

In fact, I would probably just stay on my drugs except for one thing: my health. My cholesterol. My weight. My prolactin level. My breasts. My blood sugar. My belly fat. All directly attributable to the medication I take to keep myself demotivated so that I do not, in fact, have to learn how to live with the bigger emotions (want, impatience, irritation, anger - even happiness).

And here's my biggest fear: what if I am unable to learn how to handle my bigger emotions (which I don't feel much on medication) through therapy? What kind of damage might occur while I'm trying to learn how to cope? And how much have I learned about coping since I started taking medication - am I smarter than I used to be?

And what if my perception is so skewed - skewed in some kind of biological way that I can't detect on my own - that I absolutely must take medication to maintain myself? What kind of medication will I be able to take that won't cause these other health problems?

In thinking about all of this I recalled a psychological assessment I had done in 2002. The assessment was extreme in every respect and, to be honest, nobody who read it (including my psychiatrist) agreed with it. It hurt my feelings, and I tried not to dwell on it. Me, narcissistic? Me, masochistic? Me, unable to see the difference between my own creative and disturbed imaginings and reality? Me, distrustful of everyone?

And yet... and yet something about it struck home, too.

Somewhere along the way I lost track of my copy of the assessment. I'm heading over to pick up another copy of it from the doctor who performed it in about 30 minutes. From there I will head to one of my favorite watering holes to drink a beer in the sunshine and review the results of a test that was taken a little over 5 years ago. What hits home now? What are the most potentially dangerous aspects of the assessment?

What should I work on first, and who should I trust to work on it with me?

What next?

Distrust

2007-08-07T10:18:00.000-05:00

I met with my psychiatrist yesterday. It was a semi-momentous occasion, since it was the first time I'd seen her in 4 months and I had hoped not to see her again. Momentous also because two weeks ago I suddenly became convinced that I should be on a full spectrum of medications again. Nerve wracking since that conviction lasted for only a couple of days.

My shrink is a full-fledged shrink: an actual medical doctor who specializes in research. That being the case there were any number of topics related to mood disorders and medications I would love to have picked her brain about. However, since she is my shrink - and not just some doctor I am interviewing - I felt guarded. How much did I want to expose to her about my momentary lapse back into medication? And, baring an in-depth question/answer session (with me asking most of the questions), and given that I'd changed my mind about being on medication again, what did I want out of the visit?

One thing was clear to me: I wanted to leave her office with a prescription for something I could take if I panicked again. What was less clear to me was actually more important: how much do I trust her?

As a long-time consumer of mental health services I, and most others like me, face a delima when it comes to our diagnoses and treatment. The question that goes through the minds of many of us - sometimes loudly and sometimes in no more than a soft whisper - is this: how do I know if I am not crazy? I learned long ago that mental health is associated with a particular kind of denial that isn't really denial so much as it is a complete inability to recognize my own symptoms. The same thing happens sometimes to stroke or head injury victims: for instance, an individual may have lost the ability to move their right arm but may also have lost the ability to understand that they cannot move their right arm. So it goes in the mental health arena, apparently. How do I know I'm not experiencing that phenomena? Beyond that lay even bigger questions, such as ... how do I know if my anger is justified? how do I know if my happiness is justified? how do I know if my behavior is appropriate? What if everything feels justified and appropriate but it isn't? Who do I know, who do I trust enough to believe if they tell me that what I feel is an illusion? Do I trust anyone that much?

Does anyone trust anyone else that much?

Curiosity

2007-08-06T20:43:00.000-05:00

Ok, this is a blog, not an autobiography - I can't possibly expect somebody who stumbles across this miniscule spot on the Internet to be interested enough to read some long, rambling post about a middle aged woman's past. And besides - I'd get bored (or just plain worn out) before I finished. So let me try to summarize this for you:

1966

Born.

1967 - 1969
Move from El Paso to Dallas. Briefly adorable in a Shirley Temple kind of way. Saddest memory: my brother's temper tantrums, Dad's business trips, Mom's fear of driving at night. Happiest memories: slip 'n slide, feeding the ducks in the park, swinging, sleeping in between my mother and my brother when my dad was out of town, the farm, all memories of my brother, feeling beautiful.

1970 - 1974
Move from Dallas to Denver, back to Dallas and then on to Ft Smith, Arkansas. Too big to snuggle and too little to date, I spend my days in front of the TV and my nights immersed in "Little House On The Prairie" books. Day dream about being an orphan who discovers my own house hidden in an unused garden at the back of a magnificent English estate. Am determined to build a picket fence around a front yard some day. Attempt to make candy by drizzling maple syrup in snow (unsuccessful). Diagnosed with asthma. Saddest memories: Dad whipping my brother, second grade, being shunned by neighborhood girls. Happiest memories: tagging along with my brother, Sunday drives in the mountains, summer visits to my grandparent's farm, playing with my grandmother's makeup, watching cartoons on Christmas Eve.

1975 - 1979
Start my period, grow breasts, develop acne, become depressed and manage to skip 75% of my 6th grade classes. Kiss a LOT of boys, wear a LOT of makeup, write how-to book on beauty. Move from Ft Smith to Albuquerque to Canyon, Texas. Saddest memories: my aunt's suicide, my grandfather's death, my father's depression, my brother's derision. Happiest memories: family dinners, riding my bike to Shell's pharmacy, choir, first dates.

1980 - 1984
Lose my virginity, become very tan, drop out of school, have an abortion. Become promiscuous. Become sad. Become angry. Have another abortion. Write hot checks. Quit lots of jobs. Try alcohol, speed and pot. Saddest memories: abortions, father losing job, parents moving back to Denver. Happiest memories: first day of high school, tennis, starting new life in Denver.

1985 - 1989
Begin 4 year relationship with a man 14 years older than me who's big on the Denver social scene. Meet famous people. Quit lots more jobs. Have another abortion. Try cocaine. Learn how to develop software. Saddest memories: watching my brother fail to thrive, having my first breakdown in my first apartment. Happiest memories: Aspen on a summer morning, laughing with my older boyfriend, my first fancy date, recovering from my breakdown, moving in with my older boyfriend.

1990 - 1994
Move from Denver to Dallas. End relationship with older boyfriend. Move in with new boyfriend in Dallas and experience verbal and emotional abuse. Quit smoking, then start back up again. Learn how to keep a steady job. Temporarily beautiful. Move out of new boyfriend's apartment with a $500 loan from my boss. Have another abortion. And another one. Realize brother is deeply addicted to drugs. Realize mother is deeply depressed. Have my 2nd breakdown. Recover with temporary course of Prozac. Become determined to do something with my life. Saddest memories: watching my family fall apart and being unable to help, my 2nd breakdown, my lack of self-esteem. Happiest memories: finding my independence, learning how to support myself, seeing all the new construction in Dallas when I first moved back as an adult, the hills in Valley Ranch before they bulldozed them for apartments, getting Crunch Tator, taking Crunch Tator for walks around the Mandalay Canal.

1995 - 1999
Move from Dallas back to Denver to Austin, then (very briefly) back to Denver and back on to Austin again. Briefly become competitive rower. Turn 30 in the best shape of my life. Begin 7 1/2 year relationship/obsession with gorgeous attorney. Triple my income. Become anxious and start to take Paxil. Become depressed and start to take Klonopin. Start therapy. Gradually become suicidal. Have a miscarriage. Make pathetic suicide attempt and check myself in to a hospital. Have affair with assigned psychiatrist. Try Depakote, Lamictal, Welbutrin, Zyprexa, Risperdal, Topomax, Neurontin and Ambien within the space of 3 months. Become my most crazy. Drink heavily for one year. Shave my head and all body hair. Check myself back in to a hospital. Withdraw from all drugs but Neurontin. Saddest memories: Dad's heart attack and subsequent decline; brother's hospitalizations and subsequent diagnosis of bipolar disorder; parent's general financial decline; brother's withdrawal from friends, my own decline into depression. Happiest memories: Parent's move to Temple, Texas, 30th birthday party, first couple of years of relationship with gorgeous attorney, fire flies on a summer night, hummingbirds on a summer morning, Haley's comet, swimming at my parent's house, hot tub parties at Bart's house, feeling beautiful.

2000 - 2003
Get job at IBM. Get promoted. Have psychological assessment which states, in part, that I am an extremely ill woman with a narcissistic personality who believes she can do more than she can, and who should be on an antipsychotic medication for the rest of her life. Psychiatrist disagrees with assessment but, at my request, agrees to prescribe a small dose of Seroquel (a newer antipsychotic) for me. Continue with therapy in an attempt to ensure that I am not narcissistic, am capable of accomplishing what I think I can, and am stable. Becomes friends with a group of coworkers and begin socializing weekly. Become happy, stable, and cautiously proud of myself. Father losses job and becomes unable to work. Brother dies. Ask parents to move in with me in Austin. Saddest memories: everything about my brother's death, my parent's situation, reading my psychological assessment. Happiest memories: ending my relationship with the gorgeous attorney and still being friends with him, meeting my husband, falling in love with my husband, hanging out with Joe & Christie & Ed & Deborah.

2004 - Present
Become engaged. Get married. Begin paying parent's rent and car insurance. Get promoted. Run out of things to talk about in therapy. Switch doctors when mine goes out of practice, and from Neurontin to Lamictal. Try to have a baby. Find out we're infertile. Have 3 surgeries to investigate and correct anatomical issues. Learn I have GERD. Have two root canals and never go back for permanent crowns. Try IVF. Turn 40. Get pregnant. Miscarry. Turn 41. Try IVF again. Fail. Buy our first house. Father has another heart attack. Mother begins having "mini strokes". Gain 40 pounds. Cholesterol shoots up to close to 600. Asthma and allergies get worse. Decide to try life without drugs, but rebound insomnia and allergic reaction make it impossible. Try again. Same thing. Try again. Same thing. Here we are. Saddest memories: the miscarriage, feeling hopelessly fat and ugly. Happiest memories: the moment we got engaged, our wedding, Dad's kilt at our wedding, realizing that Mom and Dad are safe, napping with our cats.

And there you have it in a not-too-terribly long format: me. Thanks for reading!