Wednesday, June 30, 2010

Just a Little Bit Crazy

I finally met with my psychiatrist on Friday... I made a June 15th appointment in April, when I had that little breakdown, and then it got pushed back a week due to scheduling conflicts, and then pushed back three more days because the doctor was sick.

Anyway, we talked over my medication issues, and decided to switch them out... but not both at once, we'll start with one and see how that works and then go to another. Since the side-effects of the lithium are the ones bothering me the most (the cognitive dulling and sleepiness make my work life a living hell and otherwise drive me up the wall), we went for that.

So instead of lithium, I'm taking Seroquel (Quetiapine). It has some worrisome possible side-effects, particularly weight gain and increased blood glucose levels... if I get that side-effect and it goes unchecked, I might develop hyperglycemia or even diabetes.

Well, I take that as a challenge to lose some weight... the best way to keep your glucose levels down is to reduce intake of sugars and starches, which I needed to do anyway... I gained back twenty of the pounds I lost last spring, and I really don't need them. And it also helps to burn off the sugars in your system regularly, so I'm trying to get back into the gym habit, going after work every day for forty minutes of cardio.

It's early days yet, I only started taking the Seroquel on Friday night, I just last night graduated to a whole pill from a half pill (I will eventually be on three pills if I can handle it) and so far I'm feeling pretty good... I'm not bone-weary all the time, and my mind feels a little sharper. I sleep very well, the Seroquel has a strong sedative effect and I sleep through the night without even taking Melatonin; and though I'm terribly groggy in the mornings, it passes off with the third cup of coffee.

However, my first couple of days of taking it, I noticed a rather unpleasant trend in my mood: I felt mellow and relaxed, but only up until somebody or something irritated me... at which point I would blow up like a shrapnel mine. And my sense of humor went all snarky, in fact I got in trouble for sending out a viciously sarcastic email to the entire office that I had intended to be funny but realized, moments after I clicked "send," was waaaaay over the top.

That seems to have settled down, though... maybe the reprimand snapped me back to myself or maybe the side effect passed, but I'm feeling pretty OK just now. Not depressed, not anxious, just kind of normal (or at least what I sort of remember normal feeling like).

Except that I'm also getting an inkling of another side-effect... Seroquel can make you feel hungry all the time, or just more severely hungry when you're usually just a little hungry. I'm not sure if I'm experiencing that or if it's just my body throwing a hissy fit because I took away its fats and sugars. Hopefully it's the latter, as I know from experience that those hungers go away... more of a withdrawal symptom than real hunger. I don't know if I can handle raging hunger three or four times a day.

We shall see what we shall see... it's always interesting changing drugs, you're never sure anything is really happening or if it's a new side-effect, and you're never sure if something you feel is a side-effect or is coming from something in the environment or other circumstances. It makes life a bit of a study.

In the meantime, I've been signed up for a Depression Management class. I took such a class last year, but I kept missing sessions because of scheduling conflicts, vacations and working late and such. Plus the facilitator was super-cute, and that rather distracted me from the information... I remember very little of what was said. But hopefully this new class will give me some good tools to work with when the medication lets me down (as it always does, it seems).

I am also being referred to a gay men's therapy group, for which I have high hopes. One of the things I miss about AA is the ability to air one's feelings in a safe and cooperative environment with problem-solving as the focus (of course, there's no reason I can't go back to AA, instead or as well... it's just that the last time I went to a meeting, I had a panic attack; and now every time I think about going to a meeting, I start panicking a little).

Well, anyway I'll keep you up-to-date with my progress... I know you'd hate to miss even a moment of this riveting and unfolding drama. Ciao!

Sunday, June 27, 2010

Picture Post

I have nothing to talk about right now... or things I could talk about but don't have the time or energy to write down... so to keep you entertained, I present the following paragons of pulchritude:

Hope your day is even half as lovely as the above. :-)

Sunday, June 20, 2010

Six Months of Silence

I'm not sure how to introduce a catch-up of this magnitude... in eight years, I've never neglected my blog for so long. So, since a picture is worth a thousand words, have a look at this while I do some me-my-mo-mu and warm up my typing fingers.

So when last we visited, I was just coming to terms with my disappointment over failing to complete the NaNoWriMo project; I intended to keep going on the novel I started, and in fact did write some more in the following month, but I got stalled... partly by lack of creative inspiration but mostly by my train-wreck of a life.

At the end of November, our Career Center admin left us for a new job... which means that I got to cover her position until it got filled again (which is in my job description, I checked). It wasn't as bad this time as the last time I covered the Career Center (Fall/Winter '08), as we had an intern for half the day so I was only spending four hours at a time down there... except on the days when the intern couldn't be there (he is paid by the City of Oakland, which observes work furlough days), or the days we keep the Center open late.

A lot of other improvements, to the policies and procedures and to the room itself, also eased the experience, but still those four hours were hard for me. I'm an introvert, and being around people sucks energy out of me; that Center holds twenty at a time, all of them sucking a little energy out of me; and seventy percent of the time, there is some one person or two people actually standing at my counter, asking questions or requiring assistance and sucking a whole lot of energy. And all this went on for six weeks.

And of course Christmas was going on, which you know always spins me out; and then on top of that I was on the committee to plan my agency's staff holiday party in January, with weekly meetings and all sorts of little tasks, a variety of massive setbacks and inconveniences, culminating in a very fun but very stressful party. I was definitely overextending myself.

I did everything I could to take care of myself, made sure I ate and didn't push myself too hard to get all my own work done in the four hours I spent at my own desk, made sure I got plenty of sleep and rest on the weekends, took advantage of any offer of help from coworkers. But even so, the sight of my own work piling up, the stacks of filing that I couldn't get to, the data-entry that I was weeks behind on, a new intake form that the staff had a lot of trouble with... it was just too much. By the time we got a new admin for the Center and got her trained, I was on the verge of a breakdown: depressed and anxious and exhausted and jittery all at once.

I was recovering, but just barely, when the next landmine blew: at the end of January, Grandmother had a stroke. I don't think I've ever been so scared in my whole life.

It happened in the middle of a Saturday afternoon, while she was asleep; she didn't notice it, except that she was extra sleepy and slept most of the afternoon. About eight o'clock, she got up and went puttering around the kitchen, got herself something to eat, and sat down to read the paper. That's when she panicked: she couldn't read the words in the paper, they didn't make sense. And when she tried to speak them out, entirely different words would come than the ones she meant to say.

I was taking a nap at the time (I was depressed and had been sleeping on and off all day), and I heard Grandmother calling the name "Alice" over and over again. In my sleep I couldn't understand who was calling or why, but the rising note of panic snapped me out of my sleep and I realized she meant me (Alice was her sister's name, by the way). I ran into the dining room and Grandmother was crying hysterically and trying to read the paper aloud.

I held on to her and tried to calm her down, and tried to figure out what was going on: was this a panic attack? Was she having a psychotic break? Was it her eyes? Was it a stroke? It didn't seem to be any of those things... in my ignorance I assumed that strokes were always accompanied by paralysis somewhere or other. So I just focused on calming her, and then called the advice nurse at Kaiser, who set me straight about the paralysis thing. I helped Grandmother get dressed and we hot-footed it down to the Emergency Room.

My uncle Junior (his family nickname, I forget sometimes he has a real name) met us there, and I was so glad of him... he's the unacknowledged head of the family, the rock to which we have all anchored ourselves, the steady one of us, the reliable one. If he was even half as scared as I was, he did a great job of hiding it; he acted like we were all down at the ER for the fun of it. And of course, I followed his lead, not wanting Grandmother to be any more scared than she already was by seeing one of her two caretakers fall apart.

It was hard, though... I was falling apart, barely holding myself together by a sheer act of will, refusing to add to the problem.

But anyway, it turned out not so bad after all... what Grandmother had was a "Transient Ischemic Attack" or TIA, which happens when a blood vessel in the brain gets clogged, but only for a bit, and then it unclogs. The inability to say the words she wanted and not having paralysis of any kind indicated that it was the central language part of the brain, rather than any of the motor parts of the brain, that was affected. Such attacks are almost never fatal, nor particularly debilitating; just in the time we spent in the ER, her speaking ability improved a little, she could say our names (she started off calling all of us "Alice"...I think that was the first name she ever learned) and where she was.

She stayed in the hospital for three more nights, the doctors wanted to keep her under observation... TIA strokes are often called "warning" strokes, since more than fifty percent of the time they're followed by a real stroke (just as I was starting to calm down, that piece of information freaked me out again). Lots of people came to visit, neighbors and friends of mine and people from church, so aside from being away from home and not being able to sleep very well, she had a pretty good time.

When Grandmother came home, my sister Suzie came down and stayed with her during the week while I was at work. Grandmother had lots of follow-up appointments, constant blood-tests to monitor her new blood-thinning medication (warfarin, it's serious stuff) and physical/speech therapy appointments to help her regain her nouns and fine motor skills, so Junior and Suzie were busy schlepping her back and forth. Her improvement was reassuringly rapid and the fear of another attack abated.

After a couple of weeks, things got back to more-or-less normal, Suzie went home and Junior was able to concentrate on his other caretaking duties (my aunt, his sister, is taking chemotherapy for cancer and needs a lot of assistance after an injection; and his wife is having trouble recovering from back surgery... like I said, he's our rock, all of us), and I was able to let myself relax a little and recover from the shock.

But not for long... in the middle of February, my father had a... I don't know what to call it... a spree, if you will. The first inkling I had was from Suzie, who handles his money for him (the Social Security Administration requires a payee for recipients with psychiatric and/or substance-abuse disabilities); he somehow managed to convince someone at her bank that he had the right to withdraw money from his account whenever he wanted, and cleaned out his account... before the bills that Suzie had already paid for him had come through, so she had to cover the difference out of her own pocket. She was furious and very hurt by this, rampaging and crying in turns, and it hurt me to see her in that state.

Later that same day he turned up at Suzie's house (she was at our house) demanding to have his flat-screen computer monitor back, the one that he'd given Suzie because he didn't need it. Ariel (Suzie's daughter), who was home at the time, said she thought Daddy was drunk, he smelled drunk and was talking crazy, and she felt very uncomfortable with him in the house.

I wondered if it was drugs or drink (Suzie was convinced he was getting painkillers from his roommate; and all the crap about money and possessions sounded exactly like an addict scrounging for drugs) or just a manic episode that Daddy was having; I was furious with him on Suzie's behalf, but there wasn't anything I was able and/or willing to do about it, so I shrugged it off as another one of Daddy's asshole spasms (much like he'd had a couple of years ago when he lived with us) and waited for the inevitable comedown with abject apologies and pleas for pity.

A week or so later, I got a call from him: he said he was "being held against his will" in St. Helena, and wanted me to get Junior to go up and get him, preferably with a gun (for those just joining us, my uncle was a cop for thirty-three years before retiring); he gave me the phone number and the address, which I promptly Googled and discovered that this particular address is the St. Helena Psychiatric Hospital... the Nut Hut, as it's more familiarly known. The Booby Hatch, the Funny Farm.

Well, I called Junior, but he confirmed my belief that it was best to not take him out of a psychiatric facility for any reason, and certainly not that late at night; however, Daddy called seven more times that night and three more times in the morning. God bless the inventor of Caller ID, as I didn't have to actually talk to him.

Anyway, Junior did go and visit him on Sunday afternoon, and reported back to us that he was "5150," being held for seventy-two hours on suspicion of being dangerously insane. Apparently, he had threatened to kill one of the security personnel at Yountville (the veterans' home that he finally got into after five years on the waiting list). On Tuesday, he'd be up before a judge who would decide whether to release him or commit him.

I was hoping for commitment. Junior found out from Daddy that he had stopped taking his psych meds right after Christmas, because he felt "tied down" by them and by the staff at Yountville. Essentially what he was saying is that, after years of carefully displayed helplessness and maneuvering his friends and relatives into taking care of him so that he wouldn't have any responsibilities at all, turning over all of the work of living to my sister and my uncle and the Veterans' Administration, he decided that he was being stifled.

This is the point where any hope of sympathy from me went right out the window. I could forgive a manic episode, I mean I have manic episodes, I know what they're like. But to purposely go off your meds in order to invoke a manic episode for the excitement of it, to use your mental illness as a drug, that's simply unforgivable. I mean, here I am struggling to control and cope with a mental illness that I inherited from him, and he's off playing Russian roulette with his own. That just made me so angry I couldn't think straight.

Before he wound up in St. Helena's, he had been driving around in a drugged daze (we later found out), had been in a car accident bad enough to end up in the emergency room at UC Davis, had his license suspended and his car confiscated because of it all, had called up all of Grandmother's nieces and nephews trying to borrow money, and stolen his oldest friend's purse off her kitchen counter. The man was off the hook, completely running wild.

However, the judge didn't commit him, I guess he presented well enough at the hearing that he seemed to pose no danger to himself or others. Of course, Yountville was going to evict him anyway, threatening the employees being one of those things that will get you kicked out of places. But during the next week, he skillfully maneuvered around the complex so that no officials saw him long enough to talk to him about it... they could tell he'd been sleeping in his bed, but hadn't been able to lay hands on him.

Then he took a car... stole, borrowed, it's a matter of interpretation, but he took it... and drove up to Sonora. His intent, apparently, was to go and make amends to my mother for the way he treated her when they were married... forty years ago. Of course, he couldn't find her, as she's moved since the last time he was up there (I don't even know where the bitch lives), so he ended up at our half-sister Becky's place. He talked wildly for a while, then took off somewhere else; Becky called Suzie and Suzie called the Highway Patrol with the license number and all, then called me to tell me about it.

The Highway Patrol didn't catch up with him... who knows if they even tried... and Daddy decided to go down to Riverside to visit his half-sister (you may remember that Grandmother is not his biological mother; his biological mother had three daughters a good bit younger than Daddy who live in the LA area). He only made it about halfway when he ran out of gas. He'd already blown through all his money, so he called his half-sister to come and bring him the rest of the way (a four-hour drive). She called Junior, after calling us to get his number (our relationship with Daddy's birth mother was purposely nonexistent and her later children are largely unknown to me), wondering if she should go to him; Junior told her everything we knew about the situation, and let her decide; I guess she decided not to go.

Then Daddy called Junior and wanted him to come pick him up. He wouldn't; he'd finally had enough of rescuing his brother, which he'd been doing over and over again for years. So Daddy somehow, in the following twenty-four hours, managed to find enough gas to get him to Visalia, the town where Grandmother's family all used to live, about twenty miles from where he'd stalled.

Once there, or rather after spending most of the day in a Denny's with wi-fi, he called Grandmother, wanting numbers and addresses for her two nephews and two nieces who still live in the area, in hopes that he could crash with one of them. She refused to give him those numbers, still humiliated from his calling around to her other relatives for money; he started telling her how he was cold and hungry and scared, until he got her crying. I fortunately came in right then and took the phone from her.

I wanted to tell him off something fierce. Nobody makes Grandmother cry and gets away with it... I've never even forgiven myself for doing it. But comforting Grandmother came first, so I just told him we couldn't help him right now, waited for him to acknowledge what I'd said, added a good-bye and hung up. I haven't spoken to him since.

So anyway, to shorten things... he ended up in a homeless shelter for the night; later he was arrested for driving on a suspended license in a stolen car; but then the guy whose car he took declined to press charges and he was let off; my step-sister took Daddy in and he's living with her now in Modesto or somesuch, with her as his payee, and the rest of us are shot of him.

I'm still angry, though. The thing is, I was already depressed when all this was going on, and these shenanigans made it worse. And while it was getting worse, and I was pondering over my anger, I started remembering other little things he'd done and said, times when he'd blamed my childhood troubles on my stepmother and my mother without taking any responsibility for himself; worse, as I looked back over my life with him, I tried to find good, and I couldn't... every little thing he'd ever done was self-serving, he'd never done anything for any of us that he didn't absolutely have to, and if he did anything remotely generous it was in full view of people he wanted to impress.

I came to the conclusion that my father is an asshole. And that was even more depressing than thinking of him as useless but well-meaning. What's more, I came to the conclusion that I deserved better parents than I'd got. I finished with my mother a few years ago, now I'm finished with my father; as far as I'm concerned, I'm an orphan. Grandmother is all the parents I've ever really had, and all the parents I need going forward.

That sounded very bitter and melodramatic. Let's cleanse our palates, shall we?

While all this was going on with Grandmother, and then with Daddy, Caroline (my best friend, you know... my only close friend, really) was having a lot of difficulties as well. About three weeks after Grandmother's stroke, I spent a night with Caroline in that same damned emergency room: she'd had a panic attack so severe that the doctor thought she'd had a light coronary. Caroline has never been especially good at processing stress, and has a tendency to get more emotional than one would expect; some issues built up in her office and she hit a breaking-point, freaking out right there at her desk. Fortunately she works in the hospital, so it wasn't much of a trip to get help.

About a week after that, her routine mammogram revealed a lump in the upper-central portion of her left breast... her situation at work was stressful enough, but the lump just about drove her nuts: she was more than half convinced that it was cancer and that she was going to have a mastectomy and would shortly thereafter die. And I, in the role of best friend, found myself giving her a lot of moral support and advice, ferrying her to and from procedures, as well as just listening and holding her hand as she processed through it all.

Under normal circumstances, I would have found that rather draining, but these were no longer normal circumstances. I was feeling like a squeezed-out lemon, but I needed to be there for her, so I just soldiered up.

The lump turned out to be a benign tissue sclerosis that was easily removed and left the tiniest unnoticeable scar, but the damage to her peace of mind was deep and severe... ever since then, she's been emotionally on edge. On the other hand, it and the panic-attack have given her new drive to get a handle on her mental health, on her coping mechanisms for stress and for personal interaction at work, and other problems that she's been looking at (but not too closely) for years. It was a wake-up call, and while wake-up calls are always unpleasant, they can lead to a productive day.

And while all this was going on, I was still working, still trying (and more importantly failing) to catch up with my backlog of work... I was behindhand before the Career Center admin left, and the six weeks of covering the Center put me so far behind I couldn't even see the front anymore. And then to add a nice little soup├žon of unbearable pressure, we converted our file room from drawers to shelves at the end of March. This entailed a complete update of all files, spending all of March not just catching up, not just resolving all our "mystery files" and usually-too-irrelevant-to-bother tasks, but also getting ahead of ourselves as best we could, jumping ahead to purges and overhauls we usually do in July.

Fortunately, I had help from the intern (though honestly he wasn't very good at it) and from my supervisor; nevertheless, the pressure to get it done by the end of March was overwhelming. And then the pressure was exacerbating my depression, which made me tired, which in turn made it harder for me to work, which put me further behind, which put more pressure on, which made the depression worse...

Well, it's no surprise that I would have a breakdown... but just a little one. I woke up one Thursday morning in early April crying. And I couldn't stop crying. I called in sick to work (or rather emailed, I couldn't have made a phone call in the state I was in), and stayed in bed as long as I could... I wasn't wailing or anything, I was barely even weeping, it was just a feeling of profound sadness and a steady stream of tears.

But when Grandmother got up, she got after me for still being in bed. I told her I was sick, and she wanted to know what I was sick with and kept after me until I admitted I was too depressed to work; she acted like I was doing something wrong (and to her credit, she doesn't just act like that when I'm depressed, she gets after me for having allergies, too, like they're my fault) and kept nagging me about why was I depressed and what was I going to do about it. She nagged me into calling the advice nurse at Kaiser, and I did it just to make her leave me alone.

Suzie was over, too, but she left early in the morning; she did, however, try to keep Grandmother off my back. Grandmother doesn't really understand depression... most people who don't have it don't understand it... so Suzie (to whom depression is no stranger... we're all of us nuts) explained to her that nagging me was just making me worse and to let me alone. And she told me to not worry that I'd never be able to stop crying (which was my chief fear... if I let it go, what if I can't stop?) because it always runs out eventually.

Well, I called the advice nurse, and her advice was useless as I expected: if I felt like I was going to harm myself or others, go to the emergency room; if I felt I needed to see someone, I could come down for the drop-in clinic, which she said would probably entail at least two hours but as many as six hours of waiting (I was so weary that I could barely sit up to make that phone call, so driving to Kaiser and sitting around a waiting room with a lot of other depressed people was simply not going to happen); or I could email my psychiatrist and see what she had to say. Basically nothing I didn't already know.

She did at least listen to me, which was soothing, and asked questions that helped me frame the situation for a medical perspective; but I certainly didn't come away with a solution or even feeling substantially better. I emailed my shrink, having some difficulty squeezing all the pertinent information into 1000 characters, and waited. I spent all day in bed, and the next day, mostly just laying there, sometimes reading, sometimes weeping a little, and trying to sleep. I got a call back from the doctor who was covering my shrink's caseload while she's on vacation, asking me questions about my medications and whether or not I was likely to commit suicide and telling me to make an appointment for when my shrink got back from vacation.

The thing is, I guess I'd simply lost faith by then that anything could be done with medication... I needed something more, and I needed a lot of it. But what? Group therapy? One-on-one therapy? Diet, exercise, vitamins? Whatever I needed, I didn't have the wherewithal to go get it, I was too sunk in the symptoms.

Of course, it lightened up eventually. Depression always does, though it did linger, is in fact still lingering, but it cannot sustain that kind of lay-your-ass-out intensity. I do have an appointment with my shrink, though I had to wait two months for the earliest available appointment; and I started taking vitamins, fish oil in particular (GNC makes a fish oil chew that is quite tasty, if a bit expensive), and made some attempts to get into group therapy (though half-hearted and so of course unsuccessful); and work simmered down, the file conversion was completed in mid-April and is a joy to behold; we got another intern on top of the one we already had, so I have help in the filing, and though my data entry load has more than doubled and also kicked into high gear at the end of May (when we have to get our annual figures in to our funders), I haven't felt completely overwhelmed.

So here we are in June... halfway through June, and I should tell you that I started this entry on May 26th, when I started feeling like I could write again. It's taken me almost a month to actually finish it.

But I am feeling very inspired to write, even though I'm doing so little of it. I have decided to scrap what I have of The Math Teacher's Dead and plan to start it over again for the next NaNoWriMo, but with better planning and forethought, even an outline. And, during a talk with a friend at work, I came up with a fabulous ending for Worst Luck (though I have to work out the possible variations). I also asked some people at work to read it, and though they didn't read much of it, I got some good ideas (from where they stopped and why) to rethink the beginning. So now I'm going to restart the project from the beginning and aim it directly at the's time for the second draft!

Of course I'm talking big today... I had a lot of time on my hands today, Grandmother didn't want to go to church and Caroline didn't want to come over and I had no other commitments, and I feel pretty good. That's not always going to be the case. But I feel good about this, I feel like it's going to happen... maybe slowly, maybe in widely spaced fits and starts, but it will happen.

And in the meantime, I'm going to be here more often as well. If only to share pretty pictures. That's a promise (and if you know me at all well, you know I don't make promises lightly). So until we meet again, no later than one week from now, I wish you joy.