Adventures with Psychiatry pt2

So it’s been a few days since I began taking the full 300mg dose of the bupropion. And so far, the patterns that seemed to be emerging before are consistent:

  • Increased irritability. It’s stuck around, but I think I’m starting to get the hang of handling it.
  • Much lower scores on the Burns check list: the highest this week has been a 12, with four different instances of a 9 representing the low. In fact, my weekly average dropped from a 14 to a 10 (technically a 9.8, but close enough).
  • An easier time actually getting going. Four days in a row of paid work (all successfully done) is a good testament to that.

The only difference I have noticed is something I was warned about: if I take the second dose too late, the 6 hour jolt of energy is enough to make it difficult for me to get to sleep. Mostly, this is a problem when I wake up late (ie, 1 or 2pm), rather than the drug acting in some weird way. The other thing I have noticed has been an increase in headaches; but that could simply be attributed to general lack of sleep. In fact, that’s probably what it is; headaches are a fairly common result when I get less than four hours of sleep in a night.

All told, I’m mostly liking the bupropion so far. I’m thinking of doing one more part to this series after a few weeks on the full dose when I’ve gotten a better picture of how it’s affecting me.

Adventures with Psychiatry pt1

Following in Ziya’s lead, I also recently had a psychiatric appointment. I made it the same date as zir appointment, and it was supposed to be for the day after zir appointment. But of course, things happen, and five days later (the 5th), I had an appointment with the same psychiatrist that Ziya had so many problems with the last time.

My appointment thankfully went much smoother, and since I’ve been doing the Burns depression checklist every night for the past three weeks or so, I had a pretty good sense of what my symptoms really are. This made his choice of medication easy: the generic of Wellbutrin (bupropion). This post (and the next few parts) will consequently track how I’m feeling on the medicine as I ramp up to the full dose and beyond.

So far, I’m a little more than halfway through the ramp up period; I have two more days of just one 150mg pill a day, then I progress onto two. And so far, it seems to be helping with my main symptom: the incredibly low energy (as well as the motivational problems that follow from that). Prior to starting it on Wednesday, my typical score on the Burns was in the 17-26 range; basically, the upper end of mild with the occasional break into low moderate. Since I’ve been taking the bupropion, the highest I’ve gone is a 13, and I’ve seen my second 9 in several weeks. So while I may still hit the low end of mild, I’m seeming to stay more towards normal but unhappy.

I feel significantly more energized and capable of actually getting things done. This is a huge improvement.

But I’m also finding myself more susceptible to distractions (for example, people talking near me or Ziya humming a song or thinking aloud). And those distractions are definitely hurting my ability to focus. I’m also finding that, so far, I’ve been becoming more prone to irritability. Little things that didn’t use to bother me are starting to and with an ease I haven’t felt in awhile. It is possible that the latter issue is (at least in part) due to having the energy to actually feel those emotions again. But I’m not sure if the bupropion is the cause of the former, and I’m hesitant to look at the side-effects; I don’t want my brain to get any ideas. I’m hoping that the former will become easier to deal with; I like this new energy far too much to want to try some other random drug.

Maybe things will shift when I start taking the full dose next Tuesday. Part two will probably go up after a few days on that dose.

Dancing in the Eye of the Storm

So I’ve been officially married for a little over a day now (by about three hours), and that’s been enough time to process a decent amount of what happened yesterday.

Ziya and I started yesterday off tired. I was running on less sleep the ze was, and had just enough time to shower, shave and have a weak cup of tea; particularly since we were meeting Banji for breakfast. That breakfast was good and calm; we got back with just enough time for Ziya and hir mom to head out for their hair appointments.

And that’s where the chaos started. Earlier, Ziya and I agreed that chocolates from a nearby restaurant/confectionery would make a good gift for our officiant. Since Ziya had a hair appointment, it was up to me to pick them up and choose the assortment. I did so with Banji’s help after I got dressed (including a new element that I decided to bring at the spur of the moment); she drove Ziya’s car to the restaurant and back. The drive over was calm enough, and gave us time to talk. But of course, we arrived 45 minutes before the place opened. So we did the only smart thing: drove back, and decided we’d head out just after opening time. The remaining half-hour or so was a blur of nervous movement; my double-checking that we had everything we needed to bring with us, getting Banji’s help with preparing a cross that showed up better on the shirt, and then finding myself with more time than I had things to do with it.

Which I began to spend worrying about the unknown, small details. It took Banji encouraging me to go meditate or otherwise do something to calm down for me to actually do so. But it helped: rather than fighting to control something I couldn’t then, I worked within how the morning was beginning to flow. Then, about 11am we made the second attempt at the chocolate gathering trip. This one was successful (even though I began to get nervous about how long it was taking). But I apparently didn’t need to worry; Ziya and hir mom had arrived back later than we had expected, and were still getting ready when we returned. So in the end, our second trip didn’t mess up our timing.

We all arrived at the restaurant where the ceremony was to take place well before our original “need to arrive” time of 1:30pm. And honestly, this was where the storm really began to pick up speed. Non-essential guests began to arrive earlier than we had anticipated they would; making figuring out seating arrangements very entertaining. That also delayed critical set up elements; things like figuring out where the ceremony would actually occur, setting up the video camera, etc. And then, a little after 2pm, we found out that our original information had been wrong: we were going to have the ceremony first, and then appetizers; not the other way around.

Up until that point, I had been trying to carefully wrangle everything, and get it to fit neatly into our expectations of how the day was supposed to go. Ziya and I were standing at the edge of the storm, trying to mold it through sheer force of will. But at that moment, I did something very smart: I stood in the eye of the storm instead, and began to move with it. Ziya seemed to follow my lead on that shortly after. And in doing so, we began to “dance” with the beat the storm was providing.

And that’s when everything fell into place, and we began to enjoy ourselves. We trusted our friends and family to do their part well, and were able to enjoy the company we had assembled there. We were able to focus on the moment, and be fully present in what is arguably the most important ritual for our shared lives together. And we danced that dance for the next four hours through a five course meal, a gorgeous ceremony, inspired (and beautiful) blessings/prayers and toasts, and conversation that seemed to flow naturally. The only bump amidst all this was the semi-frequent, posed photo opp interruptions, and those only became a real problem towards the end.

We left the restaurant exhausted but happy; we danced our way through the first step on our journey together as a married couple. We were able to spend most of the rest of the night enjoying each other’s company, and the warmth and love that came through each like, congrats, and other blessings posted on Facebook. And we realized that what my cousin (among others) had said was true: the marriage did change our relationship. Not in a scary way though; the very act of declaring our commitment to each other in front of all of those witnesses made the commitment that much more important; that much more of an anchoring point for our new life together.

…and the storm’s energy too.

So it’s less then twelve hours before the legal wedding day for Ziya and me, and I find myself unable to sleep. My brain has figured out my once in a three month post that is begging to be let out, and won’t shut up until I let it do just that.

I find myself worried about later today. Not the pre-wedding jitters you might expect though: ie, is this the right decision; oh no it’s my last night of “freedom” sort of stuff. I mean, sure, we didn’t have the time to fit in bachelor and bachelorette parties. But that isn’t weighing on me; honestly, anything we might have had (and might still have before the big family gathering) would be positively tame and boring by societal standards. None of the strip club stupidity or getting drunk or anything really dumb like that; that’s just not our style, and it never will be.

No, that’s not what’s keeping me up. It’s the uncertainty of certain factors. For example, we don’t know exactly what space we’ll have to work with, and how it’ll be set up. So we’ll need to make those decisions on the fly only about an hour before the ceremony starts. We don’t know how or where we’ll be standing, if our guests will be standing around us in a semi-circle or sitting around the table. We don’t know what the optimal camera setup will be to record the whole thing for our friends and family who we couldn’t invite.

I’m also finding myself nervous about when to put on my formal wear: before we leave for the site, or when we get there. And I’m even nervous about the silly little things like whether or not to wear a tee-shirt underneath my dress shirt, or what of my normal, everyday jewelry will go well with said shirt. I’m worried about us getting out of the house on time, and whether or not my best man will be able to make it at the time we need him to be there by.

And that’s only what I’m worried about that is directly related to the wedding itself. I’m very worried about something that I haven’t had the chance to talk to Ziya about; something that needs to be resolved within the next few days. And I can’t resolve that on my own: in order to actually do something about it, I need to call in help from Ziya or my parents (most likely my parents). And that’s help that I’m still not entirely comfortable calling for – even though I know its a necessity. I wouldn’t be in this boat if I had been a little smarter about something several months back, or if my own depression hadn’t gotten (and is still getting) in the way of a critical step that would have greatly helped resolve it.

But I did what I did, and now I need to deal with the consequences of it. And worrying about it does me no good. Just like those little worries about our big day – they do nothing useful. Whether or not I travel in my formal wear doesn’t actually make much of a difference in the scheme of things. Nor does the jewelry choice; it’s not like one necklace really takes that long to put on, and changing to another one won’t kill our chances of getting out on time. And no matter how the setup changes, tomorrow will happen exactly how it needs to; it will be wonderful no matter what might come up. Because Ziya and I have faced bigger things before, and come through on the other side stronger than we were when we entered. This will be no different.

When supporting starts to hurt

It’s me again. Ziya’s recent posts should be enough to show that lately, things have been far from easy.

Indeed, it has to have been (and still be) hard for Ziya. But sometimes I wonder how often the effects of the depression are shown on the people supporting the person facing it. Case in point:

Ziya and I have been together for very close to three years now. And for a good chunk of that time, we’ve spent enough concurrent time in the same location to make sharing a bed make sense. And for most of that time, we’ve generally been able to go to bed at the same time, and wake up around the same time (give or take an hour or so). I’ve gotten used to that: it’s part of one of the reasons I proposed to Ziya; I want to wake up next to zir everyday, for the rest of my life.

And prior to the new sleeping habits, that helped to at least give some semblance of “normalcy” to the end of the day, and has typically allowed my own depression to show up far less frequently and with less of an effect. That relational pattern was enough to help me (at least somewhat) with my own emotional regulation. But the new sleep pattern is proving to have some nasty effects on me as well.

I no longer expect to wake up alongside Ziya. Instead, I’ll wake up three, four, sometimes five hours later than zir; and when I wander out to find zir, ze tends to be in the living room, having already logged a few hours in Oblivion. And that tends to throw off my energy for the day: leaving me capable of little more than basic hygiene needs, food needs, and watching hours of Youtube videos. I’m usually in a slightly better boat than Ziya in some of these areas: I’ve been doing the bulk of the cooking (at least, as far as our shared meals go), and there are certain chores related to household keeping that I have been able to do with decent consistency.

But on my own bad days, forget it. I’m only able to suggest food when I’m starting to get really hungry; and by then, Ziya’s usually been significantly hungry for a while. On my low energy days (which are occurring with more frequency than I’d like lately), it takes me a stupidly long amount of time to suggest that maybe we should start getting ready for bed before one/both of us are stupid tired (assuming I even get to that point before Ziya starts to fall asleep during whatever ze’s doing). And unless we’re both stupid tired, the general lack of down time (and activities) kill my ability to get to sleep with any sort of speed.

At its worst, nights like tonight happen. Ziya fell asleep within maybe ten minutes of climbing into bed. That was about two hours ago now, and I’m still awake. And I know it’s not my normal speed for falling asleep: that usually takes about twenty minutes or so, and that’s fine. No… this is overwhelming sadness keeping my brain from letting me sleep.

It’s sadness about the relational things that used to be common; but have become increasingly rare: things like cuddling before turning off the lights, waking up next to each other, even other forms of physical (and emotional) intimacy. Ziya’s depression has seemingly left enough room (at least lately) to play Oblivion for hours on end, grab easy food for hirself, and sleep; with little left over for the interactions that used to be more common. And to be honest, that’s probably what hurts the most: I know that Ziya doesn’t mean to do these things; but the depression is none-the-less leaving me to carry more of the relationship. At least, that’s how it sometimes feels…

But the pattern continues, and I feel like I’ve gotten caught in it too. Ziya tries to include me and interact with me during the Oblivion sessions: and I’m happy to help look things up and contribute. And the cuddling close during these sessions does help greatly. But that still doesn’t help the part of it that I feel is most effecting my own depression: the dilemma of how much time I should spend tuning in, and how much of it I need to spend completely under my own headphones shutting out the sound of the game.

Because of this dilemma I feel like my emotional batteries have been woefully under charged  for the bulk of the last few weeks. And usually, a few hours of video watching is enough to bring me back up to full (or near full) again. And most of what energy I do manage to recharge gets spent trying to help Ziya get through the day: gently pushing/encouraging zir to complete the few important tasks that are on the docket for that day. So it feels particularly devastating when the videos I am able to get something off of fill so little (particularly compared to what they used to). And this is not counting the other stuff of life (job acquisition steps, internship acquisition steps, etc), that I desperately need to focus on myself.

Don’t get me wrong: I’m not attempting to pin blame for the pattern (or its effects) on Ziya. I play just as much of a role in keeping the cycle going, especially when I stupidly don’t speak up about my own needs. Nor am I saying that Ziya isn’t trying; ze’s been sure to tell me that ze loves me and is vocally appreciative of at least a good chunk of what I have been doing. But in the midst of an episode, even those efforts don’t feel like enough. And all of the during game cuddling in the world doesn’t fulfill the needs that aren’t being met.

I can find some relief in one thing: the worst of these episodes are nothing compared to the handful of horrible ones I’ve had in the near-distant past. Those were something else, and it would take a really drastic trigger for one of them to spawn again. And I can count myself lucky that, even those could only nearly drain me of energy. I’ve never had to deal with an episode that involved self-harm thoughts, and the extent of my self-deprecating thoughts deal entirely with my problems not being worth burdening Ziya with. I’m amazed (based on what ze has told me, and what I’ve seen) at the strength that Ziya’s shown so far.

But ultimately, all the comparisons and analysis in the world don’t negate the fact that hir depression is hurting mine. I don’t like to say it, but it needs to be said: I’m hurting too. And it’s not good that I’m able to hide it as well as I have been able to.

From a supporter’s point of view

Ziya has written a lot about hir reactions and experiences with the depression, and its effects on hir life. But, I think that there is something valuable to learn from the supporters in the life of a person struggling with depression.

I’ll admit: I’ve had a few significant, yet minor (comparatively) depressive episodes in my lifetime. So I can’t strictly speak from the outsider’s perspective. But my day to day emotions (range, strength, etc) are usually stable enough that I can’t (and, more importantly won’t) claim to fully understand what Ziya goes through. I see much more how the depression effects hir behavior, mood, and ability to function. After all, I’ve been with Ziya for close to three years now.

A short “glossary” before I continue: drs = depression supporter. Anyway, onto the rest of the post.

As a drs, I get to see Ziya at hir best (ie, the moments when ze’s functioning “normally”, able to experience genuine happiness, complete common chores and generally have fun)… you know, how those of us who don’t have to deal with serious depression issues are usually able to. But then, usually unexpectedly, it’s as if someone has flipped a switch in hir brain and… boom. The lows become very low: things that leave me sad for a little bit of time have the potential to knock hir out for hours on end. Hir energy levels drop dramatically, and the very chores that were relatively easy to complete earlier become Herculean tasks.

For example, just a few days ago we were getting ready to go to a church I’ve been attending recently. It wasn’t a particularly nice day to begin with (rainy and gross; the fact that my glasses had broken the day before didn’t help much either). And, a few minor blips aside (namely our normal, early morning slow warm up), it looked to be going pretty smoothly. Until it happened.

I was almost ready to go, and basically waiting on zir; when hir anxiety flared up. I’m certain that said anxiety is tied into the depression: the two tend to go hand in hand with each other. In a matter of moments, ze went from being nearly ready to go to needing to back out; and feeling really bad about doing so.

Several thoughts/things ran through my head at that moment. The first was concern: would ze be okay if I went on my own (like I had the previous two weeks)? Or would the intense guilt lead to thoughts of hurting hirself? The second was hurt: not that ze had backed out last minute (although that was disappointing), but instead that ze was hurting. The third, to be honest, was a little bit of annoyance: this has happened before, and often when we’re heading off to something important to me. But to be honest, the third feeling was very small compared to the other two; and I do believe that those frozen moments have become significantly less frequent than they used to be.

There’s another change I’ve seen sometimes too. Rather than flipping to depressed and anxious, I’ve seen Ziya flip to something akin to manic. This is the Ziya that comes out when six+ hour long Sims sessions occur (particularly late at night) or when a sudden creative project (like a new Let’s Play) seemingly comes out nowhere. Ziya tends to get hyper focused during these moments, and I’ve found ze seems to ignore things like sleep. These “episodes” (I suppose one could call them that) seem to be less frequent than the depressive ones; although I’m certain the lack of sleep that comes from them does nothing good  for the depression as a whole.

But then there are moments like now. We’re sitting on the couch together, each at our own computer; each composing an entry for this blog. And Ziya is bright, cheerful and happy: ze smiles when we make eye contact or the little touches that we both find reassuring. There’s a natural seeming energy behind zir: an excitement over the new information ze found that reminds me of one of the reasons I fell in love with zir. Despite the late (early?) hour (which isn’t so unusual for us these days) that this is happening during, today felt like a good day: we were able to run a number of important errands (including finally getting a tv for the apartment… yay!), and we were both really productive.

If only more days could be like today, with more happiness than the sorrow; where we’re both on the ball concerning what we want to accomplish… My hope is that as Ziya continues to work through the depression we’ll have more days like today, and less like how Sunday started. And as long as ze is willing to work through it, ze’ll have me by hir side to support zir however I can.