Friday, 30 May 2014

[Vignette] Alone in a crowd

It struck again. It's been a while, but I guess that with my moving, the stress of all the conferences ahead of me and the long-ish absence from Susanne all contribute.

All of a sudden I was lonely. Apathetic. Felt abandoned. Felt excluded. Felt worthless.
Only: I was with many many friends. In a bar. For the vastly popular regular bar hangout that I have been organizing all year. And still, I just fade away. My attention drops off. My feelings of engagement, of presence, just drop away. Fade away until nothing exists but me and the pattern in the veins of the wood floor.

My friends being friends, of course, notice after a little while and want to know what they can do. What I need. What I want. How they can help.
I have nothing. I don't know. I'm already … gone. If I knew something that worked, I could have asked for it, want to think I would have asked for it earlier. But I have no idea.

Eventually I packed myself up. Bid everyone a good night. Assured them over and again that I would be fine walking home on my own. That nothing would happen to me. And walked off.

Halfway home, there was a pretty view out from campus. Rolling hills in the distance, fading into the clouds. I stopped. Pulled out my drawing kit (I have a new hobby, a new obsession…) and made a colored sketch. Meditative. Stopped the ugliness, the spiraling, the hopelessness.

Tuesday, 27 May 2014

A Depressing Reminder That I'm Doing Well

I seem to have had an energy transplant lately.   I don't know who's got mine but I hope they are enjoying it.

That's a slightly longer term thing: doing more teaching than I am used to this semester (entirely reasonable amount by anybody's standards but first year back as full time from being half time for a decade.)   It seems that it's been hard to get the energy to contribute fully and get things done in the key areas I want to outside of teaching.

More recently I had a cold a couple of weeks ago and it seems to be taking me a while to recover.

Today there was a specific thing.

I have been miserable today.  I don't know why.   But I was miserable, was highly unenthusiastic at work.  Came home early and had a nap.   Had a box of Maltesers I had been saving for a moment such as this.   Did have the sense to go for a run as it might cheer me up.   But the run had to be bailed on 4/10 of the way out and walked home.   Had a comfort food supper.  Had a bath.

I try hard to use a word like "dispiriting" when I'm not talking about the medical type of depression.  But this was literally a depressing day.  

But the reminder that I'm doing well is that this is news.   I don't feel happy all the time but I've had months, maybe the odd year, where every day has been like this.  For the last year or two a day like this has been news, so that is nice.

I still regularly say to myself I want to kill myself, but I don't really as I've covered before.  But I guess I can't stop myself saying even here that everything is not perfect even though I've been doing well.  But yes I am doing well.

Wednesday, 21 May 2014

Remembering I have medication

Over a year ago, when I started my current treatment plan, I got a scrip for oxazepam to help with the anxiety attacks that come with ramping up fluoxetin. Turns out that the anti-anxiety med work incredibly well for whacking me out of an anxiety spiral, so I kept them, and asked my psychiatrist to give me a new (small!) scrip to keep this as an emergency break option.

Today, for the first time in the 17 months I've had these pills, I remembered them while entering the spiral and took one.
Previously I've always either ridden the anxiety out (painful) or only gotten around to the pills when Susanne suggested them to me mid-crash.
Today I actually remembered myself.

I have no clue what was going on though. I was hanging out, lazily surfing the web when I got some sort of discomfort feelings. Either hunger or nausea, but can't quite tell which… And then it went off: within a few minutes I was starting large wracking heaving sobs. Somewhere along the ride I realized something was happening and first googled for anxiety self help techniques before I realized I have those damn pills right here.

Took a few minutes for them to kick in; I went for a (long overdue) shower and halfway through I went from deep sobs to … nothing … in the space of a single breath.

It is a tough ladder to climb:

  1. recognize the emotions I experience
  2. recognize the emotions when they happen
  3. realize I have tools to deal with them
  4. realize I have tools to deal with when they happen
I'm sure later stages are on the horizon, but now I'm still struggling somewhere around 3. Sometimes between 2/3 and sometimes between 3/4.

Wednesday, 14 May 2014

Medication adjustment kicks in

Today, two biggish things happened with respect to my depression.

For one thing, my therapy session seemed to penetrate … something. I shed a large load of anxiety there — we spent the session examining sources of my anxiety and discussing the need for me to recognize my own intrinsic worth instead of expecting and depending on external valuation and validation.
Something in all of that clicked (my cynical side wants to say that it was when the therapist told me I have worth: producing an external valuation to use) a little bit, and the rest of the day has been low on anxiety.

For another thing: the grass was pretty. I was walking along the nicely wooded walkway home, and the low sun was streaking across the malls at a very low angle, so that the individual leaves and leafs in the lawn gleamed with a seemingly inner glow. It was so beautiful I just walked along with a soft smile playing on my lips the entire way home.

I cannot remember the last time I just smiled away on my own because I was content and happy in the moment.

Friday, 9 May 2014

Adjusting meds, taking therapy

I have now, on advice from a psychiatrist here, and after checking with the Stockholm internet based psychiatric advice service that taking advice from other psychiatrists is not some sort of horrendous faux pas, increased my dose of fluoxetine: from 20mg to 40mg. Hopefully, this deals with the anxiety and depression issues that have gradually returned since I started medicating about 16 months ago.

Right now, I'm 3-4 days into the switchover: I have started noticing effects, but not stabilized yet.

I also have started seeing a psychologist for therapy. It's painful, but aspects of it are helpful as well. My worldview is intrinsically pretty horrifying, and once the basic assumptions my emotional circuits work with show up, the size of my emotional responses no longer are quite as outlandish as I am used to considering them to be.

My worldview, on the other hand, is pretty unreasonable. But this is hard to change, and won't happen in an instance.

I have an appointment with my main psychiatrist in Stockholm already scheduled. My plan for that is to

  1. validate the medication adjustments, possibly talk about further adjustments - depending on how much the fluoxetine increase dulls me off
  2. ask if we can add psychotherapy to my treatment plans. I've done only medication for over a year now, and it helped a lot in the beginning, a little in the middle, and not so much towards the end of the year. It would be ... very nice if I could get to use therapy to help me reshape my worldview so that it is not quite as terrifying.
    Even if it turns out to be difficult to add psychotherapy in my health care plan, I think we will do it. If we have to pay for the therapy sessions ourselves, we can afford to do so, and I'm likely to get some support from my employer's healthcare plans as well.
But right now? Kinda difficult. 
I feel useless. I cannot concentrate. I beat myself up for not doing anything enough. I feel ugly.
Then again, I got rejections on a journal submission and a job application today. So maybe feeling a little bit shitty is not ... entirely unreasonable.

I really should write here more.

Wednesday, 7 May 2014

My new skill

If anyone read my posts last May or whenever I began writing for Depressed Academics, you would know I was having a really hard time emotionally. Here I am a year later and I have to congratulate myself on something in particular: my new skill of sitting with uncomfortable feelings without being destructive or resorting to some form of escapism.

Truth be told, I am having a pretty hard day today. I've been experiencing mixed states-- a combination of an elevated/anxious mood and symptoms of depression: crying, isolation, etc. Mixed states are probably my least favorite mood state(s) because they can be so unpredictable. The last several days, I was in a hypomanic state-- which was pleasant initially. However, underlying the pleasantness was the knowledge that at any time, I could tip into a more severe manic form. I had been monitoring my moods carefully, ensuring not to get too overstimulated either by drinking too much caffeine or being around too many people as these things can definitely heighten my mood. Making sure I got my sleep, doing my deep breathing. The basics.

I noticed my mood shifting earlier today, however, due to family stuff, I had to keep myself composed. Be strong. Be the rock. After all, some members of my family are having their own issues-- whether its financial or emotional. So I was there for them as they had been for me when I was going through my breakdown last spring and summer. The problem with "being strong" when you feel like crumbling is that at some point, you have to release those feelings. Alternately, you can avoid them or overeat or oversleep or drink a beer or a lot of beer and forget. These things are what constitute escapism.

I released my mania last spring when I went crazy in the city of 2. I was in a similar situation I as I am now. Living at home with family and in a hypomanic state. I have a tendency to "let loose" emotionally in environments and people I'm most familiar with. So when I was invited to visit my friends in the city of 2-- a place I had lived for several years before moving in with family -- I decided to go even though I had a feeling it might disrupt my moods. In fact, I went because it would disrupt my mood. Let me explain. Physically, I felt I had to release all the built up energy and neglected emotions. This wasn't my cognitive process- but rather something like muscle memory. In other words, I knew (somewhere inside of me) I was about to go crazy and I needed a safe space to do so. So I chose my safe space to be with my two closest friends at the time. However, since this wasn't a cognitive process, I didn't think that they might not be equipped to handle my emotional state. And that's when things got complicated.

Back to my new skill. I am feeling really shaky in the sense that at any moment I could teeter on over to mania's side or worse, a severe mixed episode. But instead of indulging in that drink or another destructive behavior, I've been sitting with my feelings. Figuratively and literally. For instance, I've been communicating with my family and being assertive about my needs. Earlier I told them I needed to stay home to unwind, relax. When I was back at the house, I ended up calling a friend and talking out what's been bothering me. But instead of completely "letting loose" with my friend, I kept the conversation to a specified length and told her that if she had to go at any time, to let me know. By establishing those boundaries, I didn't overwhelm my friend. Additionally, I have been invited to visit the city of 2 recently--invitations I've rejected for the simple reason that I actually do not want to disrupt my moods this time, intentionally or not.

The good news in all of this is that I see my psych doctor later today. The other day I wrote out a list of all my questions relating to my my anxiety, irritability and elevated mood. I do have some speculation as to what triggered this emotional state so I'll be bringing up those concerns and issues as well. Just knowing I see my psych doc is comforting and reassuring. Because I've gone through this before, I know the drill and I'm prepared. Despite this difficult and painful state to deal with, at least I know that I do have resources here to help.

Before signing off, there's an adage that just seems too fitting not to reiterate. I feel like people with a mood disorder know this one best: this too shall pass. If I had a penny for every time I heard someone say that in response to a difficult situation! But what I'm trying to say is that if I could sum up all my lessons into one remark about the malleable nature of moods, that adage would be it.

I'll keep you updated.