Sigh

I've felt off today, not depressed or blah even, just kind of blunted and quiet and unmotivated. It was an okay day. I'm taking my meds regularly. I haven't gotten much sleep this weekend and I haven't eaten the best, but other than that things have gone pretty well. A coworker rubbed my shoulders earlier and she said I was really tense, but that's not unusual. My stomach and head hurt a bit and I'm one of those people who carry a lot tension in the body a lot, so that's telling. I don't know what's going on. I'm going to go to bed early and see if tomorrow is any better. I've been pretty happy and relaxed lately, but who knows what's going on with my neurotransmitters. This is why I keep a mood diary and try to stay aware of how I feel. Today I knew things were off but I can't figure how or why. It's frustrating living in my head sometimes.

In the past week

 I have:

1. Made an appointment with a local therapist.
2. Had a telehealth appointment with my psychiatrist.
3. Had my meds adjusted by 50 mg twice a day.
4. Entered a telephonic behavioural programme through my insurance that allows for therapy and coaching with two different people each week for seven weeks [the same programme where the screener ran me through the DASS-21, which said I was severely depressed]. I have my appointment on Tuesday evening and the second on Thursday evening.
5. Had an in-person appointment with my new therapist to establish care.
6. Taken the DASS-21 again and came out mild on depression, anxiety, and stress, with anxiety the greatest. (It's just for the past week at a time; because I have Bipolar II, my mood can vary quite a bit from one to another.  In fact, last night I couldn't sleep, and I don't know if it was too much caffeine or swinging towards hypomania).

Having taken steps to deal with my mood issues, I feel better this week.  Also, my boss has been very understanding of how difficult it has been to get up and barely make it under the wire when clocking in or even being slightly late.  She even wrote me an encouraging note.  She lost her husband last year, so I think she gets depression.

The telehealth with my psychiatrist was early in the morning. The therapist is on Saturdays; the telephonic programme calls are in the evening, so they won't impact work that much.  Instead of three months, my doctor will see me in six weeks, and I have that appointment set up.

My goal this week is to get up on time and shower at least every other day.  At one point I was having so much trouble with it that I went six days without one. Let that sink in.

So, considering the week before last I was being given the suicide hotline number and the location of the nearest hospital that could deal with a mental health crisis, I think I'm doing better. I took my first dose of the increased lamotrigine last night (it's also called Lamictal; it's a seizure medicine also used as a mood stabiliser).

Since I came out with a lower depression score and my anxiety fuels a lot of my depression, we're going to start with dealing with frustration and anxiety in local therapy.  She suggested The Anxiety & Phobia Workbook by Edmund J Bourne as a beginning, and it turns out I already had it, so we're going to start with chapter one.  I told her that I did well with cognitive behaviour therapy and homework, which made her very excited, I think.  She also knew my former therapist (we think he retired or moved), who had helped me with my hoarding issues.

So I think I've started to go in the right direction.

Update on my mood issues

In the last couple of days I have:

1. Called and made an appointment with my psychiatrist.
2. Received a phone number for a therapist a friend goes to that he thought would help me.
3. Received a phone call from the lady I spoke with the other day who said that despite my severe depression, they were willing to have me participate, so I'll meet with her on Tuesdays (she's a behavioural therapist) and with a behavioural coach on Thursdays.

It can't hurt to have too much intervention, I don't think. I meant to call my friend's therapist yesterday when I was off from work, but was too loopy to remember after the MRI.

I've known for awhile that I needed to get into therapy and that I was feeling down, I just didn't really realise how bad it had gotten till I'd spoken with the woman from Able To, which partnered with UnitedHealthcare. Being given the 988 number plus the closest hospital for mental health crises was kind of a wake up call. Her first appointment was in March, but she decided she wanted to start things this month, in a couple of weeks. I think she was afraid to let it go longer. So that's that. I'll have a whole team to help.

I think even people who have a background in psychiatry tend to think of the manic phase of bipolar disorder more than the depressive one. I spent most of my childhood, in retrospect, fairly depressed, and was very depressed when I was a teen and young adult. Since then I've cycled between both occasionally, with hypomania less than depression [I've never had a true manic episode--I think--but plenty of hypomanic ones, so I'm considered Bipolar II in terms of classification. Also, I used to have (before medication) these emotional storms that were so overwhelming. often lasting about 20 or 30 minutes, coming on like a seizure. I'm not sure if they're related to that, or not. They were the closest I ever got to actually killing myself that I've really gotten to, especially if driving (I have driving anxiety, which I think contributed, as anxiety seems to fuel my depression and vice versa). If I were home I could get into bed and ride it out. But they were draining. Once I was given mood-stabilisers, it helped so much, and I haven't had one in years. I never have done cutting, but I have ruminated over self-harm and/or dwelt on the idea that the world would be better off without me. And that scares me. And I've been thinking on and off that way since about November, so it's lasted several weeks. I'm hoping my psychiatrist can help in the short term and getting therapy will help in the long run. Just taking those steps have helped a little, I guess. I'm not feeling quite so overwhelmed. So here's helping all this helps.

Back to normal--

or at least, back to normal for me. The medication kicked in and I got some rest. I had a little trouble getting up this morning, but I felt better than I have in days and got a lot accomplished. Today and tomorrow are my catch up day for the library and all those little tasks I have for the revenue cycle aspect of my job.

Earlier I took a friend to our family doctor and went to the allergist myself (which was, fortunately, across the street from his appointment). I got a good report from the allergist and was able to start my allergy shots back up, only having to take a few steps down to a lower phial. But I'll build my way back up fairly quickly, she said. I'm going to try to go tomorrow and get another shot, as there's no harm in doing them one day after the other, but I have to go to the pharmacy, too, so we'll see if I have time for both. I think I will, anyway. Afterwards we got some food at Taco Bell (a much better experience than last time), went over to his house, and we watched an episode of 'Scream Queens' on Hulu and ate. Later, we watched 'Heroes Reborn'. Then I came home right before the UK-Auburn football game let out, yay, and got home just in time to see the final score (a close game overall, but Auburn won). UK has not had a Thursday night game since 1939, and they had much to do to make it run smoothly as far as traffic is involved, especially after the Luke Bryan Farm Tour concert that left Tates Creek road a virtual parking lot for hours on end, just a bit ago.

Okay, I'm sleepy, and it's time for bed--my phone application has told me so. I'm going to sign off. Good night.

Feeling not quite real tonight

It's called depersonalisation, and it is something that you see in Bipolar II. I think I'm reacting to the stress of working three jobs at work, and also I realised that in addition to being off my ADD medicine for a few days while I found the prescription and the pharmacy ordered it, I also missed my Abilify, which is used to treat my bipolar disorder. Apparently when I filled my medicine reminder box last, I ran out of those, and forgot to replace them. I think I've missed 3-4 days. Not good. I still have had my other medicine, but still, the Abilify really helps keep me on an even keel, and I feel a bit depressed, and not quite with it. Moreover, I feel just disengaged from my surroundings, like I'm viewing myself from the outside. Inside I feel numb tonight. I went ahead and took my medicine a little while ago, and I'll be back on track tomorrow, so hopefully this feeling will go away. Tomorrow will be a busy day (catching up in the library, and I have several things to work on for the revenue cycle, plus taking a friend to the doctor and going to my own allergist across the street from one another in the late afternoon). But it shouldn't be as bad as the last three days have been in terms of patient volume, and I won't be in scheduling itself, although I have to followup on some scheduling issues. The last three days, when I've left work, my brain has felt nearly like mush, I've had headaches, and I just had so much trouble switching gears to my other tasks. That might be a lack of medicine, too, especially the Strattera, the ADD medication. But I think a lot of it is trying to figure out where I am and what I'm doing at any given moment: I have two desks, three long distance codes, three greetings for answering the phones, three bosses, etc., etc., and I do a pretty decent job of wearing all the hats and doing my job, but I'm feeling increasingly overwhelmed by it all, and I don't know how long this arrangement will be going on. Don't get me wrong--it's not terrible. The phones weren't even that busy today, given how busy we were in clinic, and most of my responsibility over there is rescheduling and scheduling appointments over the phone. But I can tell, after about a month, it's taking a toll. I'm terribly behind on my referrals and the library stuff this week. I don't feel like I'm keeping all the balls in the air as I juggle. Maybe I can catch up before the end of day Friday. But I feel a bit like a hamster in a wheel at the moment, and it's maybe more stress than I'm comfortable with. I'm not saying I can't handle it, I'm just not very comfortable with it.