||[Dec. 1st, 2010|08:56 am]
Kelly J. Cooper
|[||Tags|||||2010, add, adhd, anxiety, b12, depressed, depression, drugs, life, pills, psychiatrist, ribose, therapy||]|
Sometimes, when I haven’t finished something, I have little notes in my head along the lines of “something’s unfinished… whoo… you should go finish it… oooOOOooo” cuz they sound kind of like fake Scooby Doo type ghosts. No, I don’t know why.
Anyway, I decided to re-read my LiveJournal entries for this year and find those loose threads and tie them up, both to explain some things to my friends and to settle some things out, for my own peace of mind.
Late last year, I started seeing a psychiatrist. On her recommendation (because she did not want to make me drive down to Norwood on a weekly basis for therapy and because she’s not much into therapy these days), I then started seeing a very nice local therapist. I saw the therapist until mid-July and, due to her having emergency surgery and going through recovery, haven’t seen her since. I’m still seeing my psychiatrist every 5-7 weeks.
In January, I told you some fun facts about B12 (here: http://kjc007.livejournal.com/207493.html and here: http://kjc007.livejournal.com/207859.html) like how the highest oral-bioavailability of B-12 is in breakfast cereal and that SSRIs can deplete you of your B-12. When the test results came in, I told you about how my B-12 levels were low and I was taking shots to bring them up cuz my psychiatrist told me that was the best way to handle the issue (http://kjc007.livejournal.com/208271.html). She even talked with my primary care physician. NONE of my doctors have EVER talked with one another, so this impressed me right off.
Ultimately, I was supposed to get a blood test when I finished eight weeks of getting shots. I completely forgot about the blood test, although I did mostly manage the eight weeks (with only one or two skip weeks in there). I finally got the blood test much later in the year which showed my levels were still pretty low, although they had climbed into the normal range. I got another B-12 shot a week or two ago and I’m hoping to try and get them third week for the next couple of months. I’ve heard anecdotal evidence that four weeks is too long to go without a shot and I don’t think I can manage every week, so every other or every third seems good to me.
NOTE TO ME: I hope that I implement this plan.
In February (http://kjc007.livejournal.com/212841.html), I got my official Attention Deficit Hyperactivity Disorder (ADHD) diagnosis. A HUGE amount of my internal thought processes since then have centered on coming to terms with that and integrating it as a fact into my life. As a result of the diagnosis, I went off antidepressants (except a small amount of generic Paxil) and onto ADD medication, specifically a generic version of Adderall to start.
Also in February (http://kjc007.livejournal.com/214965.html), I told you about a couple of strategies that have helped me get/stay organized in various contexts. I told you I’d just bought Kolberg & Nadeau’s ADD-Friendly Ways to Organize Your Life but hadn’t read it yet. Well, I read it & it helped HUGELY to the point that I recommend it to all my ADD and maybe-ADD friends & acquaintances. It also provided a little bit of structure for me to think about my ADD, which was useful as well.
In March (http://kjc007.livejournal.com/215127.html), I mentioned antidepressants are bad for people with ADD. I still haven’t nailed down where I got that impression but subsequent research tells me that ADD is a dopamine-related issue while SSRIs work on your serotonin. So it’s not ALL a-d meds that are bad for ADD folk, it’s the SSRIs.
One thing this helped me with was to crystallize the idea that my self-harming thoughts are specifically the byproduct of the small amount of generic Paxil I continue to take to help minimize my Irritable Bowel Syndrome (IBS). No, I won’t bore you with bowel-related details, but it helps enough that I’m loathe to go off of it. I’ve been on the generic Paxil a LONG time now and continue to remain on it, so it was an undercurrent for this entire year. Anyway, crystallizing that thought, being able to attribute my return to self-harming thoughts I haven’t had since I was 19 or 20 years old to an outside agent is very reassuring.
Also in March (http://kjc007.livejournal.com/215908.html), I tried to read a bunch of medical articles about sleep issues. Essentially, I was trying any and every way I could imagine to attach a handle to my hypersomnia so I could WORK on it. I skimmed a couple of articles, then quickly got discouraged and haven’t done more in this area. I really want to, but I don’t know how to narrow down my search.
A final note about March (http://kjc007.livejournal.com/217090.html), I told you about my new nighttime regimen to try & slow my brain down & prep for sleep, which I got from a combination of personal experience and Kolberg & Nadeau’s ADD-Friendly Ways to Organize Your Life.
1. Go to bed before 2am.
2. Write down things I really gotta do tomorrow and a separate list of things I gotta or wanna do soon.
3. Write in a notebook about my day.
This is still working. My main problem now is remembering to actually LOOK at the damn lists. My memory gets cocky and is all like “I know we put stuff on the stupid list cuz you don’t trust me, but I remember what we wrote so I don’t gotta look at it” while the other parts of my brain are all nervous and feeling forgetful and then forgetting what they were nervous about and then the day ends and I didn’t get half my things done. Stupid brain.
In April (http://kjc007.livejournal.com/220160.html), I told you about “Some of the Many Faces of Depression.” Still a true list.
In May, the BF and I went to Brazil. First to Rio, then to Sao Paulo. The time we spent in Rio was lovely. Sao Paulo was torturous. This was probably one of the least successful vacations I have ever taken. Due to unknowingly drinking a metric buttload of guaranine, a natural form of caffeine that’s several times stronger than coffee, I had what Paul Simon might call “a little bit of a breakdown” in Sao Paulo. I returned more miserable than when I left, which almost NEVER happens (I love being in other countries and cultures). This has not helped with the overall stress of this year.
Back in June (http://kjc007.livejournal.com/225557.html) I talked about needing gold stars for a project and that I’d talk about it if it worked.
It sort of worked. I tried to start a Happiness Project along the lines of Gretchen Rubin’s book, also called The Happiness Project (a very good book which I highly recommend, by the by). This was in tandem with seeing the local therapist who’s been trying to help me with my depression.
However, Rubin’s design for her monthly Resolutions Chart was far too ambitious for me. She did eight or more NEW resolutions EVERY MONTH. I scaled it down considerably, and ultimately couldn’t even keep up with the six categories I was trying to maintain, even when I continued them along to the next month.
Then my therapist had emergency surgery and she’s been out of commission since July. Without her to report to, I did not manage to maintain the project beyond the summer. It did have a positive effect in that I thought a lot about happiness and how I might get there and what works to make me happy. It also helped me boil down what was important to accomplish regularly for me to FEEL good.
In July (http://kjc007.livejournal.com/226649.html) I asked ya’ll about your Disaster Recovery plans and we talked about contingencies and stuff. This became important later.
In August (http://kjc007.livejournal.com/227986.html), I mentioned I’d be doing a worm demonstration. At the demo, I started a new worm bin, a stackable one that I hoped would be easier to manage than my all-in-one-big-freakin-bin one. Unfortunately, I was still in the throes of sufficient depression that the BF was feeding the worms & aside from this demo, I was otherwise ignoring them. He thought I’d completely switched bins & stopped feeding the old one. All the worms there died, and we only have the new bin, which has turned out to be a complete PITA. Boo. But it’s a learning experience which, while painful, is also educational. Boo.
Later in August (http://kjc007.livejournal.com/230172.html), I lamented that I feel like I don’t know how to think. You folks gave me fantastic feedback and I thought a lot about thinking. This also became important later.
Even later in August (which turned out to be a very THINKY month; http://kjc007.livejournal.com/230728.html) I talked about mood swings and how it’s difficult for me to track my mood swings. This resulted in tracking down and starting to keep a 5-year journal. Because it only offers a couple of lines to fill in each day, I end up distilling my day to the most memorable bits and putting them into the journal. This has supplanted the long rambling daily updates in a notebook (see March) which were helping, but were also becoming oppressive and I was starting to dread them. And I’m hoping I can use it to track my moods, as I annotate the margins with a mood measure ranging from OK to GOOD to GREAT (to solve a problem I articulated here: http://kjc007.livejournal.com/230728.html where I can’t tell whether my mood has improved or if I have cycles or what).
I don’t know if I made it clear while chattering about my medication, but both the generic Adderall and the melatonin gave me headaches and I had to stop using them. The Adderall was mainly when I hyperfocused for more than 3 hours, but sometimes just randomly at the end of the day. The melatonin was just regular low-grade headaches. The two usage cycles were months apart, so I’m pretty positive they weren’t related.
I have subsequently been prescribed generic Ritalin (started at the end of May, http://kjc007.livejournal.com/224462.html), which I only take when I wake up before 3pm or so (which is “late” for me). Ritalin actually works in concert with caffeine pretty well, so if I’m exhausted because my sleep is messed up, combining them gives me energy AND focus in a way that neither does on its own.
The next big thing I chewed on was in September (http://kjc007.livejournal.com/231488.html), envisioning the “Perfect Life.” Again, lots of great responses there, good stuff for me to think about. Here, I was trying to envision what happiness or a good life might be so I could work toward that. One thing I learned from various happiness literature is that when you’re hoping for “happiness” as a vague, indefinable concept, it’s tough to pull together a plan to get there. I was trying to make this vague hope into something more concrete, although I didn’t really realize it at the time.
Later in September (http://kjc007.livejournal.com/231786.html), I told you about Dr. Jacob Teitelbaum’s book From Fatigued to Fantastic. I haven’t gotten much further in the book, so I haven’t filled out his extensive diagnostic criteria nor added any other supplements to my diet besides ribose. And while the ribose seemed to make a HUGE difference when I first started taking it, the effects have since plateaued. However, when I stopped taking the ribose for a couple days (I ran out & didn’t make it out of the house to buy more) I just slept and slept and slept. It’s either helping or making me ridiculously dependent upon it. Jury’s still out, but I seem to have more energy while taking it. Unlike other projects taken on this year that have been abandoned, this is still an active project. I’ll give the lack of movement a few more months before I declare this one abandoned.
In October, I went back to my psychiatrist and said something to the effect of, “It’s great that we’ve diagnosed the ADHD, but I’m not getting any help from the Ritalin with my depression or my sleep. What if I have anxiety? Is there an anxiety-related antidepressant that could help me?”
Now this simple idea, “What if I have anxiety-related depression?” was the culmination of a LOT of different pieces coming together into one really important thought.
Because to me, people suffering from anxiety-related issues are clearly ANXIOUS. They fidget, they fret, they complain, they whine, they make everyone around them crazy, etc. I didn’t feel like I fit that mold at all. But then I started thinking about my therapist’s comments and my scenarios (or my “scenario thinking” as I sometimes call it).
1. Atypical depression. My therapist (the lady I saw weekly from December 2009 to July 2010) regularly commented on how my depression wasn’t typical: I was still very engaged in the world, I cared about other people, I made an effort on their behalf, etc. She just felt like my depression was atypical and couldn’t leave that thought alone. She came back to it frequently, as if there was something important there, but neither she nor I knew what that important thing was.
2. Scenarios. Like with the Disaster Recovery post, I frequently think in terms of scenarios. What will I do if X or Y happens? How will I react? What do I need to have on hand? One of the reasons I became an Emergency Medical Technician (EMT; the folks in the ambulance who mostly take you to the hospital) was so that I’d have enough medical training to handle most emergencies.
3. I also noticed the intense sense of relief at having automatic back-ups and it got me thinking.
4. The not knowing HOW to think post made me aware of my racing thoughts, all incoherently disorganized in my head. Most other people don’t have these.
5. My dreams, especially my nightmares, are all anxiety-based. From running away from serial killers to fretting about getting a body out of my pantry to hiding from zombies to being frustrated over getting people to do things that would help them, my dreams all involve being ANXIOUS or WORRIED.
6. I DO fidget, fret, complain, whine, and make everyone around me crazy. Sometimes. But I’m so used to managing it that most people, INCLUDING ME, don’t often see it.
I don’t think I knew I was going to say “anxiety-related depression” until it popped out of my mouth. But in that moment, all kinds of things I’d been thinking about, writing about here, and working on all came together with a perfect little click.
My psychiatrist thought a moment and then agreed.
So, I went on generic Wellbutrin (http://kjc007.livejournal.com/233531.html) on October 7th, 2010. And it has made a HUGE world of difference.
Also, unlike working through being ADD, realigning my thinking on my depression has been a quieter thing. It’s more like tectonic plates shifting deep beneath the surface. I haven’t been actively thinking about it at all (until writing this post), but all kinds of different memories and habits and thinking processes are all being reevaluated as anxiety-based and EVERYTHING has fit neatly into place, like a puzzle. I’m infinitely calmer. The depression itself makes so much more sense. It’s more of a frustration with futility; an inability to get shit done grinding down my ability to stay positive.
To be honest, I haven’t worked through all the details yet in a conscious way. I’m letting the unconscious stuff grind its way through. It’s still a process and it’s still pretty active. But it’s dramatic and important and life-changing.
After being on generic Wellbutrin for 5 weeks or so, I asked for a slow-release version or something similar and my psychiatrist increased the number of pills I’d get in my prescription and directed me to take half a pill when I wake up and half a pill with dinner (or at least 2-3 hours before going to sleep). And that’s improved things immeasurably.
My hope, a fragile little thing, is that the drugs will minimize the anxiety dreams and improve the quality of my sleep. That having discovered that my depression is a result of anxiety, I can use that fact conquer the hypersomnia.
So far, no luck. But we’ll see.
And that’s most of my 2010; or at least my last 12 months. This has been a HUGE year for me in a lot of different ways. I think I’ll be feeling 2010’s impact on me for quite some time.
This is SO very tl;dr, I'll be quite impressed if you made it thru the entire thing.