Still Wounded

I wrote a post about 5 days ago, but didn’t post it because I had to drive Fox somewhere.

I just want to give a quick update before I share the post: it turns out I was transferred to Fox’s prescriber at the same clinic where I’ve been going, so I was able to make an appointment with her (just in time to refill my meds). The “epic quest” was not so epic after all – thank God. (I’m still having trouble believing it.)

This turn of events was extra good because I was able to use my doctor’s appointment to address some problems that have been bothering me for a while. I apparently have arthritis in my knees; he sent me to get x-rays, which may result in physical therapy that will (hopefully) alleviate some of the pain so I can be active, healthy, and happy(er than I am when I’m sedentary). I’m also (hopefully) going to have a sleep study done to figure out what’s causing my chronic fatigue (you know, besides the depression), and blood work for good measure. My conversation with my doctor has me feeling more motivated to try and actually eat healthy foods, which is an important part of self-care.

Anyways, without further ado, here’s the post I wrote 5 days ago:

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This Post Took Three Days to Write

As I was crafting my last post, I came to understand why I was prioritizing a game over the mountains of important things (some of them very good) that are exploding in my life. It’s a defense mechanism.

I was suicidal last week – or, at least, the voices in my head were. It took everything I had just to pay attention in piano class last Thursday; thank the gods the instructor didn’t call on me to improvise in front of everyone!

Banji came over on Friday and helped me clean the area around my computer desk. I’m amazed by how much better I feel just being in this space now! It was really awesome of her … and it was also incredibly stressful for me. I kinda want to say maybe it wasn’t the best timing, but if I hadn’t done it then the clutter would have just kept making me increasingly miserable. It was the timing we had, so I’m glad we did it. I needed her support.

I visited with her family on Saturday. Her uncle was there; he kept criticizing her cousin and making passive-aggressive comments that were too subtle to respond to appropriately but could be devastating to a child’s self-esteem. I tried to ignore him, to connect with everyone else present, to enjoy our group activities… but it grated on me. Like a mosquito bite in a very awkward place. (It reminded me of how my mom has treated me, my own inner critic, and the cognitive distortions that make depression such a devastating illness.)

After they left, Banji and I were free to enjoy each other’s company. We played duets, sight-read my current composition project on a variety of instruments, and improvised on piano. The piano improvisation became incredibly silly, referencing inside jokes that are over a decade old. It felt so good to laugh with her, especially over shared experiences that helped form our relationship. It helped restore some of the sense of continuity I’ve been missing.

Then we moved to the couch and she decided I make an excellent pillow. We talked for hours. While I was holding her, everything felt right. My worries melted away. I felt whole, complete.

And I had hope for a future where little things like eating dinner together and playing duets and talking on the couch all night can happen whenever we both want them to.

Then Sunday came, and she had to drive home. For 5 hours.

I’m not suicidal anymore. I’m just sad. It’s going to take a lot of work to make our dream of living within a short drive of each other reality. (And even then, everything won’t magically be perfect.) A lot of it is outside our control. I have to include Fox in all my major decision-making. It’s big and scary and overwhelming.

Lately I’ve been trying to do too many things that are big and scary and overwhelming:

I’m re-taking 2 classes I had to drop 2 years ago because they were triggering my worst depression symptoms. In that time I was supposed to do useful things like find a medication that works for me and improve my music skills. Well, if Lamictal/lamotrigine has any chance of working, I need a much higher dose. The APN took me off it, then had me on 25 mg; I got frustrated and stopped taking it, then realized it seemed to help reduce my suicidal ideation so started taking it again yesterday… The point is I’m kind of starting over on it, I need to increase my dose gradually, and by the time I get any clinically significant benefit from it (or a different medication, if the APN puts me on one when I see her in three weeks) the semester will be over. I’m on my own. As for my music skills… they’re not as improved as I’d like, but I’m working on them. They’re serving me better than I’d expected (when I trust them).

The point is, these classes are challenging me in every way imaginable, but I just have to keep struggling through them. If I drop them again I might not be able to finish my degree.

Even if I do everything I need to, my school has a limit for how long you can take to graduate, and I’ve reached it. I’m at the mercy of a stranger who gets to decide whether I can have the extra time I’ll need to finish my degree. My recent experience of strangers making important decisions that affect my life has not been very good.

I’ve also re-structured my personality (in therapy) to the point where I have to change the way I interact with my mom. If I don’t, I’ll just continue doing unhealthy behaviors that ultimately hurt both of us. The ways I interact with my mom have been shaped my whole life to reduce the overt conflict between us and prevent her from abandoning me or falling apart emotionally or having to change the unhealthy behaviors she developed to adapt to live with her parents, etc. Changing them means risking the very things I’m programmed to avoid happening. I don’t always choose the best alternative behaviors, and she doesn’t always react well to them.

Based on our recent conversations, we’re both acutely aware of this and feel threatened by it. We’re afraid of… whatever comes next – but we also want the ways we’ve been relating to each other to change. I don’t know whether what each of us wants is compatible – or healthy. She won’t give me a straight answer when I ask her to join me in family therapy.

On top of this I’m (sort of?) coming out as non-binary. I’m in this really painful place where I’ve fully accepted it as my gender identity, but I’m not fully out to the people I interact with most regularly. They keep using the pronouns associated with my assigned gender; every time it happens it’s like a tiny stab in the heart. I don’t correct them because I’m not sure how to do so constructively. (And somehow it’s almost comforting because it’s familiar?!)

Worse, no one seemed to notice when Fox used my pronouns (in a shining moment of glory that filled me with joy) on Saturday. There was an almost imperceptible pause (that I might have imagined), and then the conversation continued as though nothing revolutionary had just happened. No one asked about the strange way he’d referred to me (“ze”). Their brains probably changed their perception of the phonemes to match their expectations.

Finally, my plan for this semester had been to join social groups on campus that might help me feel better about existing. My contact at counseling services has been respectful of my gender identity and tried to help me join a group that addresses some of my needs. But I just can’t stop thinking of it as yet another place to be misgendered! I feel like withdrawing into what’s safe and familiar, and where I know I can be perceived as I am… not reaching out into something new and scary.

The LGBTQ+ coming out group would probably be perfect… except that it’s a new social situation I’d have to adapt to. I imagine once the conversation started I’d either find it easy to participate, or get something out of listening to other people speak. But when it’s time to leave the house I feel anxious about entering a new, unpredictable social situation. I don’t feel like I can handle those at the moment.

I’m falling back, regrouping, re-prioritizing. This isn’t a matter of entertainment, personal growth, or self-actualization. It’s about survival. (Maybe my brain wouldn’t be in survival mode if my body were consistently getting the nutrients it needs…)

Anyway, priorities. The big 3: food, sleep, and physical activity. Let’s add emotional intimacy to that: hugs are amazingly comforting. Research across psychological disciplines consistently finds that the relationship between therapist and client is the most important part of therapy. Being emotionally available and supportive and non-judgmental heals, whatever the therapist’s orientation(s), modality(ies), and technique(s).

My mental health must be my first priority (followed by my physical health). Without that nothing else matters because I won’t be alive to enjoy it…

My classes come next; it’s very important that I pass both of them. Even if I don’t get the extension I need, I might be able to re-apply to the program and keep the credits I’ve already earned toward the degree – or transfer them to a new school if necessary. I’m so close to finishing, it’s painful.

The groups I wanted to join come last – possibly after video games. I thought they would help me to grow as a person, receive support for the issues I’ve been struggling with, and develop important skills I’ve been lacking … maybe even to make friends? I also decided at the beginning of the semester that it’s okay if I just need to focus on my classes right now. Making that decision – setting that boundary – is a way I can assert myself. That’s putting my hard work in therapy into action!

The nice thing about the LGBTQ+ groups is that they happen every week and I can show up when I’m ready to. I can make the decision of whether to go up to an hour before the group meets; my decision has no effect on whether I’ll be allowed to join in the following week. This week I decided not to go, but by the time one rolls around again I might be up to it. I’m thinking of calling and asking for a basic idea of how the time in group is structured, so it won’t be quite so unpredictable.

The counseling services group isn’t like that. It’s a specific 6-week course (complete with homework) and I’ve already missed the first week. I was invited to join in the second week (that is, today), but I’m feeling very ambivalent about it. On Tuesday I was wondering why I even wanted to be part of this group in the first place. By last night I was thinking maybe it would help me feel more confident and able to focus in my Thursday class (and more likely to go, because I’d already be on campus). The group closes after the second week, so if I miss it again I can’t join. I’ve been asked to let the facilitator know my decision ahead of time.

Perhaps it would be best to tell her I’ve decided against it. I already have a lot that I’m struggling with. I want to send in my own written appeal for periodontal treatment, I need to start working on the request for extended time in my academic program, I have instruments to practice, and I have papers to write. I’m counting primarily on the paper to get a halfway decent grade in piano class. If I don’t join this group, I’ll have more time and energy to dedicate to those things. I won’t have to deal with the social anxiety it’s bringing up. And I’ll have more time to recover from waking up before I have to coordinate getting ready to go somewhere with everything I need for the day, etc.

The main appeal of the group is that it’s an opportunity to practice yoga, meditate, learn ways to calm the nervous system, and cope with difficult emotions. I could do the yoga and meditation on my own … theoretically … but experience tells me I won’t. I need – and crave – structure and social support. I need to get outside my own head and receive feedback from someone other than my inner persecutor.

Just last night I had a great experience in my group music therapy class. I’d decided to show up, take notes, and role play for my group mates to the extent that I felt comfortable, but refuse to take a turn as therapist. Everyone else had taken their turn and I felt very shaken up, on the verge of tears. I felt raw, exposed; the muscles in my body tensed to the point where it felt like I couldn’t move. I sat very still for as long as I was able.

But the co-instructor came in and my group-mates told him I was the only one left who still needed to go. I couldn’t bring myself to come out as having a mood disorder, but I was as honest and vulnerable as possible: I said I’d been having a rough time and was feeling very raw and didn’t think I could lead a group in that emotional state. He asked if there was an experience I thought I could lead the group in, that might also help me to feel better.

I was going to do the intervention I’d come up with for my piano class, but sitting at the piano I had my back to the group and couldn’t find a practical way to remedy that. We were role-playing children, so my group-mates suggested I try a simple children’s song with two chords and play on guitar. I agreed to a song someone suggested, and the next thing I knew I was playing guitar fairly fluently, singing, using the song structure to maintain order while allowing the “kids” to be spontaneous and creative and interact with each other, and having fun. I was even able to take constructive criticism and try some of the suggestions that were offered.

I learned so much from that experience and felt so much better afterward … because I was present and vulnerable with others; I allowed them to support me. And they did. They were awesome! They gave me the push I needed to succeed.

I was hoping to have a similar experience with the counseling services group. We’d all be there to learn to overcome certain insecurities and practice new ways of being with ourselves and others. If I didn’t feel like it’s helping me, I could always drop out. Short of dropping out, I could decide the degree to which I want to participate (including whether to do the homework). It’s only five weeks. I might have made new friends, or at least learned something useful…

… But then I talked to my contact at counseling services, and she suggested I “put it on hold” so I can “focus on stabilizing my depression.” She seems to think it’s not really the kind of group I need right now. Perhaps I can try it in the fall.

I feel empty, deflated, tired, and maybe just a little bit relieved. and thirsty. Maybe I’ll just sit here. Indefinitely.

Transgender Tuesday: Links and Spoons

Last week I shared some of the uncertainty I’ve been feeling about my transgender, non-binary gender identity. I’ve read a couple of articles since then that I think everyone should read. They’ve helped me feel more confident that I am what I say I am, regardless of how others treat me or what they might want me to do.

I’ve experienced some harmful effects of the 10 Myths About Non-Binary People It’s Time to Unlearn, especially the myth that we don’t exist. People have taken my gender less seriously or come up with their own explanations of it under the false belief (#2) that I’m “just” confused: for me it’s not so much confusion as that gender is complicated and I’m still working things out; even if I were confused that doesn’t justify disrespect.

Mom hits me with #3 “You are a new concept” and #7 “Your pronouns are ridiculous” all the effin time. She’d try and convince me that her generation is completely incapable of learning new things or adapting to new social realities. That seems highly unlikely to me, considering how much has changed in the past 60 years. The last time she told me using my pronouns is difficult, I told her I understand and just need her to try. Things seemed to be going well… until much later when she made a scathing remark about me spending money on therapy. (You know, the thing that’s slowly freeing me from generations of emotional neglect and abuse.) She’s since apologized but… It’s a process. I just keep telling myself it’s a process.

Sam Dylan Finch’s piece, 8 Things Non-Binary People Need to Know, was exactly what I needed to read; I could swear he wrote it in response to my post from last week! I wanted to quote and/or expand on specific parts that I can relate to strongly, really needed to hear, or find particularly meaningful… but if I did that I’d end up re-posting the whole thing!

I think it’s important that he included #4 “Don’t be afraid to ask for help.” Mental health is a very important issue for everyone and especially non-binary people. Talking to Wakana about my gender identity can be difficult (and frustrating) but I think, in time, it will help me benefit so much more from therapy.

Speaking of mental health, I’m learning to have much better respect for and adapt to my need to budget emotional energy, or spoons. I’ve been feeling very anxious about my piano midterm on Thursday (2 days! AAAAHHHH!!!). I have plans to meet with a classmate today and practice interventions, I have to pick Mom up from the airport this evening, and there are the 2 LGBTQ+ groups I’ve been meaning to join… Long before I went to bed last night, I was already feeling the all-too-familiar dread.

This morning I realized it’s going to be a very busy day and I probably shouldn’t try to do everything I had planned. I practiced some self management: I wrote down everything I have planned for today and prioritized. The meeting with my classmate and picking Mom up have to happen. I should try to catch my instructor during office hours and practice piano some more tonight.

The LGBTQ+ groups are technically optional. I was feeling very anxious about the one I haven’t been to at all yet because it’s brand new and it would be the first thing in my day. In the past I’ve found myself unable to get ready on time for such things, getting extremely stressed out, and not going after all. I just can’t afford to drop that many spoons. So, today, I decided to skip the stress and anxiety and wait to join that new group next week, when (hopefully) I’ll have less important and emotionally-charged things to worry about.

I really hate having to make that decision, especially since it interferes with my goals of being part of the LGBTQ+ community, getting support, and practicing being part of a group. But today it’s the best decision for me. I can use the anger it generates as energy to help myself get through this busy day.

The second group meets at a much better time for me and I feel more comfortable going to it. I’ve already had awkward one-on-one meetings with the facilitator; if there are other people there, it will probably be much better. Knowing that’s a possibility – I’m still free to make the choice that’s best for me when the time comes – feels good.

Let It Go

One thing I’m really bad at is letting things go when they make me angry. I become kind of obsessed with them; I keep ruminating on the situation, what should have happened, why I’m right and the other person is wrong, etc. Occasionally I allow it to ruin my whole day.

Sometimes it’s a situation where Wakana would express concern if I weren’t getting angry – a situation that needs to be resolved. The anger gives me the energy and motivation to take action on it. I need to be assertive in making sure my needs are met – firm enough that the other person knows “I mean business,” but not verbally abusing them or otherwise ignoring their rights and needs. Sometimes I have difficulty finding the balance.

A prime example is trying to get treatment for my Endangered Molar, which has an infection that is causing “extensive” bone loss. (In other words, something is eating part of my skull.) My dental insurance took forever to approve a consultation with a periodontist, and then neglected to inform me of their decision. I had to call them – to learn it had been approved a month earlier!

I went for the consultation on January 22nd; the authorization for treatment was submitted on January 26th. The weeks went by… nothing.

I called multiple times and was told a variety of things, from “we never received that” to “it’s been escalated to a supervisor.” Last week I was told that no authorization for treatment had been received, but I had been approved to see the periodontist for a consultation. It had been escalated and approved just the day before.

I was furious! I told the person I was talking to that I had already been to the periodontist for a consultation and they should have an authorization for treatment. She insisted that what had been received was a referral for a consultation; the authorization was a different thing, the periodontist had to submit a “narrative,” etc. We kept saying the same things to each other over and over, with more and more frustration in our voices. I caught myself starting to slip into some inappropriate language; I knew that if the conversation continued it would likely result in me saying some very mean things. I made every effort to end the call as soon as possible without “hanging up on” the person.

I was fuming for the rest of the day. I couldn’t focus on anything else. I couldn’t enjoy being intimate with my husband. I just wanted to break things – including the skulls of the people responsible! It didn’t help that I was in a lot of pain from having Root Canal Molar extracted. I was miserable.

I thought I had to wait for the periodontist to come back from vacation to submit the “narrative,” so I decided to wait until Tuesday to pursue the matter further. After rehearsing my questions a million times – as though preparing to represent the plaintiff in court – I called my insurance. I learned that the “narrative” is basically the diagnosis and treatment plan. The person I spoke to seemed very reluctant to provide useful information … almost as though it was against company guidelines… I noticed we were starting to repeat ourselves, so I ended the conversation before I could become so angry I’d be stuck dwelling on it for the rest of the day.

On Wednesday I called the periodontist’s office and spoke to a very helpful individual who not only clarified what happened, but forwarded me the email that had been submitted to my dental insurance. To be honest, I could see how they might have misinterpreted it: the file name for the attachment was “referral,” the form filled out was a “referral” form, and the periodontist’s office also offers general dentistry. I had to (wait for it!) read the content of the form to see that treatment was being requested. I was also able to verify that it met the criteria I’d been given for a “narrative:” two specific treatments were requested by name and reference number, and it was clearly indicated that I have “extensive bone loss” in the area. I’m not sure there is any additional information that would be relevant, except that I HAVE BEEN IN PAIN FOR SEVEN MONTHS MAKE IT STOP!!!!

This time, when I called my dental insurance, I immediately asked to speak to someone who had the authority to make a decision regarding my treatment. I was connected to a supervisor – who couldn’t authorize treatment, but could work with me more efficiently. I was able to be specific regarding the treatment requested, state that the x-rays and periodontal chart were included, and explain that it was on a “referral” form but was a request to cover treatment. The supervisor offered to call the referrals department, find out what they had received, and call me back.

On Thursday I received a call saying that they have the information I’ve been trying to convince them they’ve had for weeks!!! and it will be sent to the claims department on Friday. The supervisor suggested waiting until Wednesday to follow up regarding the actual decision.

For now I’m calling that a success – because if I don’t I’ll go even more crazy.

… But sometimes it’s a situation that I don’t have any control over and it’s not really worth following up on. Most of the examples I can think of have to do with disagreeing with someone on the Internet.

I think I got myself blocked from someone’s Facebook post … or maybe the whole post got deleted? Someone else had made a comment (tangentially related to the original post) about “transgender men” being allowed in women’s locker rooms at Planet Fitness; I interpreted it to be derisive. I felt compelled to clarify that the person in the women’s locker room was a trans woman and that Planet Fitness had defended her right to use the locker room that corresponds with her gender, free from harassment. Perhaps some of the (additional) points I made could have been worded a bit better. Perhaps some of my anger came through. It’s kind of hard to say; I can maybe see how part of it could be misinterpreted…

(Or I could be making a big deal out of nothing.)

At first I was able to see the post and all the comments leading up to mine, but there was an “error loading” at the bottom of the page. Then the notifications I had received regarding the post disappeared. The post no longer appears in my feed or where it was originally posted. It’s as though it never existed… which might be for the better, but it’s annoying the hell out of me!

I could private message the original poster, apologize for anything that was offensive, and ask what happened… but I’m not sure it’s worth it. We’re acquaintances who haven’t been in the same physical space for years; I’ve never even met the other people who had commented.

I think the best thing to do is let it go and move on with my life. Focus on something else. Do something else. I wish I could switch off the thought patterns that keep fixating on this relatively insignificant experience – or delete them. The post doesn’t exist anymore, so why should my memory of it?

But if I had an easy time letting things go and switching my focus to something else, I wouldn’t have written this blog post. Anyone have any ideas? What works for you?

Blog for Mental Health 2015 – aka the elephant in the room

a smiling elephant walking toward the right side of the image and spraying water from its trunk: over its back and onto the words "2015 blog for mental health"

Blog For Mental Health 2015 badge by Piper Macenzie

This is my third year taking the pledge:

“I pledge my commitment to the Blog for Mental Health 2015 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”

I absolutely love that the primary image in this year’s badge is an (adorable) elephant! It just so happens to fit perfectly with where I am on my mental health journey:

I’ve spent the past 2+ years learning to accept that my “mental illness” is an inextricable part of me, while also working to unlearn the distorted beliefs and once-adaptive behaviors that keep me from fully expressing my true Self. One of these beliefs is perfectionism, particularly when it comes to playing guitar and piano in class: I believed I had to conform perfectly to academic, musical, and social expectations in order to be accepted by my peers. I have also spent my whole life trying to hide the fact that I (like anyone else, though perhaps sometimes to a greater degree) have times when I feel insecure, frustrated, angry, guilty, vulnerable, sad, anxious, confused, etc.; that there are times when I don’t know what to do and times when I make mistakes. I did this throughout my childhood and adolescence to provide some stability to a family that often felt determined to tear itself apart. But it became overwhelming as an adult.

Eventually I just couldn’t do it anymore, and I didn’t know how to function in society without doing it. So, I withdrew. At times I withdrew a bit too far, disappearing into video games. But, for the most part, I think the withdrawal was both healthy and necessary. It enabled me to prioritize my mental health above other concerns for the first time in my life. It required me to be honest with myself and those closest to me, in ways I’d never dared before.

Blogging for mental health has contributed immensely to this process. This blog gives me a safe place to share my thoughts on topics I might otherwise consider taboo. Writing helps me get a better sense of what I’m thinking and feeling, to better understand what’s really happening beneath the sudden flashes of anger or crushing guilt or hurricane of conflicting emotions. (It probably has something to do with a distorted belief.) Sometimes I receive comments from other bloggers who offer support, congratulations, advice, encouragement, and the knowledge that someone can relate to my experiences. I can see that people are reading the blog (even if they don’t respond directly); my voice is being heard. And I have the opportunity to read about the experiences of other bloggers, to connect with them through comments, to feel a sense of community.

(Sounds good, right? Join the Blog for Mental Health Project!)

So, elephants. I’ve come a long way on my mental health journey; I’m replacing my distorted beliefs (e.g. “I have to be perfect to be accepted.”) with more realistic ones (e.g. “It’s okay to let my imperfections show.”). I’m even trying out new behaviors, like telling my small group I’m not sure what to do or admitting to a classmate that I’m (also) terrified to play in front of our piano class. So far they seem not only to accept, but maybe even to like me.

I think the next step is to be honest about my mood disorder in my everyday life, with people who know my legal name. I won’t be as candid as I am on this blog, but it’s important to talk about mental health issues. I especially need to be able to do it in my music therapy classes, conferences, and (someday) my work environment. I want to help create communities of mutual support, where talking about mental health issues is the norm and it is safe to be genuine.

Not only does talking about mental health issues give others permission to do the same – which could save a life – but it has been and still is a safety issue for me. I need to be able to say things like “that was triggering for me,” “I’m not role-playing anymore; this is how I actually feel,” or even “I need a break from this, can someone come out to the hallway with me?” When I speak up and receive support from someone else, my emotions and destructive thoughts can’t overwhelm me. I feel better about, well, everything.

Blog for Mental Health FAQ | Take the Pledge! | 2015 Official Blogroll

Dismissed

I had another appointment with the APN on Friday. She took my blood pressure – which was a bit high, both for me and based on the health guidelines I’m aware of – and said it was “fine.”

Then she asked how I’ve been. I told her about being tired and unmotivated to do anything; sometimes I don’t even feel motivated to play Skyrim. I tried to put it in the context of everything that’s been going on: the stress of the holidays and then everything just stopping. I told her when I’m very depressed there’s less anxiety because I don’t want to do anything so there’s nothing to be anxious about, but when I’m less depressed and starting to want to do things I feel anxious about them. (To be honest I’m not sure that’s entirely true. I experience different kinds of anxiety. But I didn’t express this to her.) I also told her about the ominous voice twisting all the imagery in the guided meditation into things I found threatening. I told her I’m both excited and anxious about my classes starting next week: excited because I’ll have some structure in my life and anxious because of the responsibilities. (Not to mention my social anxiety.)

As I was talking about this stuff, she was making notes on the computer (facing away from me). Then she looked back through her notes from past appointments and the information I’d provided in the intake paperwork before our first meeting. She weighed me and told me I’m a candidate for sleep apnea. She told me to go get blood work done so she could see if there is a problem with my thyroid or something (past blood work has ruled that out, but I haven’t been able to show her the printout to prove it). She also called a sleep center for me and handed me the phone, basically forcing me to make an appointment for a sleep study.

Okay, I’ve been dragging my heels, I can kind of understand her being a bit heavy handed. But the next thing she did utterly terrified me.

She told me to stop taking the Lamictal/lamotrigine. She said I’m “sensitive” to it and it doesn’t seem to be helping. “There’s no point in taking medication just to take it.”

That’s it. No plan for slowly reducing my dose over time to minimize withdrawal symptoms. No concern over what effects suddenly stopping Lamictal might have on me. Granted, I’m only taking 75 mg, but we’ve worked our way up to that dose very slowly. If I’m “sensitive” to it, doesn’t that increase my chances of being “sensitive” to suddenly not taking it?

I honestly don’t know if it’s helping. Maybe it isn’t. Maybe it’s wreaking havoc on my central nervous system and I should stop taking it immediately. She didn’t explain why she thinks I’m sensitive to it, and gave a very simplistic explanation of why I should stop (which suggested she views me as medication-seeking). Her tone sounded dismissive to me, so I didn’t feel comfortable asking questions. I couldn’t think quickly enough to formulate them and felt like she wouldn’t listen anyway.

Maybe it is helping and my depression would be a lot worse without it. I feel like she’s not taking my life circumstances into account. I was doing great up to the wedding, then suddenly all my loved ones had gone back to their own lives, nothing meaningful had changed, and I no longer had something important to work on. I couldn’t sleep for a week or so while Mom was having work done on the roof. Then the holidays were a blur of excitement, socializing, not getting enough sleep, and thinking my godmother was going to die. Then, once more, everyone left and everything stopped – except worrying about my godmother. The floor dropped out from under me – and my pending courses for the Spring semester are looming over me.

The courses are the thing that has me the most concerned about stopping my medication. I’d like to have a bit of stability going into such a big lifestyle change; the last thing I need is unpredictable changes in my body chemistry and mood at the same time I’m going into a frightening and challenging situation. The last time I took these courses I had to drop them because they were triggering self harm and suicidal urges. I don’t feel safe trying to take them again without some kind of safety net. (I should probably talk to my instructors about this.) At least taking medication is something I’ve been able to do with some consistency; I feel like I’m doing something to help myself!

I suppose I could possibly enjoy the same effect from continuing to take my supplements (omega-3, vitamin d, and a vitamin b complex with folic acid and vitamin c), but I really don’t want to give up on the Lamictal just yet. Wakana has been urging me to take medication for so long (since before I started this blog), I hate the idea of finding that yet another one doesn’t work. I don’t want to start from scratch again…

During the meeting with the APN, my mood went from 1) low energy, depressed and a bit anxious, to 2) slightly higher energy and a bit irritable, to 3) more depressed, frustrated, and wanting to cut myself. She ended the appointment after telling me to stop taking the Lamictal; she didn’t even ask if I had any questions or concerns or anything else I wanted to talk about. I feel like she thinks I’m not really depressed or only mildly depressed and that I’m being lazy.

(Much of our conversation was her giving me advice: to make healthier food choices, move around more, make a schedule for myself, and give myself a to-do list with simple tasks that help me feel good. Some of these are lifestyle changes I want to make anyway and think would be helpful, but in general it sounds like stuff laypeople say to people with depression because they don’t understand it.)

I left and made sure I have future appointments pre-booked, but thought about not coming back. In an ideal world I would find a better psychiatrist, but with my insurance that would be a nightmare. And I’d have to start the whole medication dance all over again! When I was halfway across the parking lot I thought about going back to ask about reducing my dose slowly, but decided I wanted to consult with someone before trying to advocate for myself. I had just utterly failed at advocating for myself and was in no state to do so successfully.

I talked to someone I know who works with adult psych patients and has bipolar himself, and with his wife who has a good amount of medical knowledge – including potential effects of different drugs and what various symptoms might indicate. Together they helped me decide to continue taking my current dose of the Lamictal until I’m able to talk to the APN again. They encouraged me to talk to Wakana about it and have her talk to the APN as well. My friend with bipolar also made an important point: my insurance might not approve the sleep study right away, or in time for our next appointment, or ever. I can’t wait, untreated, while they bathe in red tape (as I have been for my tooth – brief update: I have an appointment for a periodontal consultation and another to get a root canal).

At the very least, I want a better understanding of her thought process. I want her to sit down and look me in the eye and answer my questions until I feel confident in whatever course of action she prescribes. Is that so much to ask? If I have to go off Lamictal, I feel much safer reducing my dose slowly with a plan we’ve come up with together. If possible, I intend to have Fox there with me. He’ll be there for my future scheduled appointments, at least!

Intro – read this first

I discovered this amazing blog today and believe everyone should read it.

What is therapy like?

Intro

Hopefully this explains why I started recording my therapy. I wanted a way to remember all the important work that was happening. It also became a great way to communicate to my therapist some difficult thoughts, feelings and experiences, and for me to chart my progress. So it was meant initially as a way to express things going on for me. My hope by putting it ‘out there’ on the ‘tinterweb is that it may help someone is some small way as it has helped me. Therapy is not easy. I wish I had known some of the things I know now when I started out! I’m not an artist, nor am I very good at spelling – but well, they are not the important things.

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