What the crap is wrong with me?! Seriously. I just don't even know. I'm so lost. I feel like I'm not connected to anything. Just floating out in the ether somewhere.
As far as writing, I'm stumped. I feel like I've lost a part of myself with my inability to write. I just haven't been able to write. I don't know how to explain it. It's not writer's block. It's not a lack of ideas or time or anything like that. It's just a plug. Like someone's put a stopper in, and my writing just won't flow.
I've barely written over the last year and a half. (Maybe before that; I don't know.) I don't know if anyone's even reading my blog anymore, except for people who happen here based on a search for a certain topic.
I don't know why I haven't been able to write. There are many possible explanations.
I've been more emotionally healthy (on the whole) for the last while. For a long time I wrote therapeutically. I wrote to work through all the horrific emotional battles I was waging. I don't have as many of those lately, so it hasn't served that purpose.
I've been exercising a lot more, becoming much more physically healthy over the last year. I wonder if that outlet has supplanted this one. Also, since my hysterectomy put me into instant menopause, I just don't have the multitasking abilities I used to have. I have trouble focusing on more than one thing at a time. So since I've been focusing on losing weight and feeling better, I struggle to focus on anything else. Like, it's tough for me to make a menu and shopping list to keep my family fed. It's tough for me to stay on top of the household money and making sure bills get paid. Forget about cleaning the house!
Besides focus, there's also the energy component. I just don't have the energy for much else. Now, it's possible that's changing. When I first started working out, just under a year ago, I was coming from a place of near inactivity. Like, almost nothing. And from a place of extremely low energy (which is related to not being active, but I'm not sure about which was the cause and which was the effect; I have lots of thoughts on that). If I worked out, I was just too tired to do anything else. Or in too much pain. Sometimes that's not the case now. I hope I'll be able to move past that soon.
But I'm afraid I'm also stuck in a pattern. For almost a year my main focus of each day has been to work out. I find I'm having to really put thought into making other things happen. Oh, there's so much more to this than you know! I feel like I'm just giving the tiniest bit of snippets to explain (because otherwise this post would be seventeen pages long). But I need to get some of this out. So even if what I've said sounds like I'm being lazy and not using my time or my life well, please know that I don't think that's the case. Perhaps I'll be able to explain it further in the future.
For now I'll just hit on one other potential cause of my writing drought. I wonder if it's been connected to my mood stabilizer. I'm a mood writer. I have to feel driven. I have to NEED to write. I have to need to get it out. Almost like throwing up, it has to be forcing its way out of me to feel right.
When I met with my psychiatrist Tuesday I asked to reduce my meds by half. That's what we chose to do. This is the second day of that dosage. Today I'm writing. I can't swear those two events are connected. Let's wait and see.
When we met, she also strongly pushed me to get back to things I love. Writing is one of those things. So I may feel driven because the meds are finally allowing it or because it's an assignment. I don't know which.
But I truly don't care right now. It just feels SO GOOD to write. Like feeling the barometric pressure rise before the storm hits, or does it drop before the storm hits? Either way, the air becomes uncomfortable, and my body aches for the rain. Today it rained!
Showing posts with label Psychiatrist. Show all posts
Showing posts with label Psychiatrist. Show all posts
Thursday, April 14, 2016
Tuesday, March 31, 2015
How Am I Doing On My New Medication?
I was diagnosed with Bipolar II on October 30, 2014. Within a week I was on a mood stabilizer. My primary reason for this post is to examine how that's working for me.
However, that's not the only major change recently, so I offer this background on my health and meds. While I have no way of knowing for sure what treatment caused what effect, my gut tells me. So I will tell you what my gut says (knowing I could be completely incorrect).
Each morning I take:
So as you can see, I have gone through many health changes over the last year. How would I compare where I am now to where I was a year ago? I am better. Much better.
I do not have the constant, intense pelvic pain I had before my hysterectomy. I have more energy on the new thyroid meds, although still subpar for sure; I can get out of bed and do things more often than before. I don't go through intense PMDD/PMS every month; my moods are more in flow with what's actually happening in my life instead of attacking me out of nowhere.
But, most significantly, I haven't had any episodes of severe depression since I started the mood stabilizer. I was initially put on it to control the hypomanic episodes that can come because of Bipolar II. Those were hard to give up. They were days of extra energy, lots of extra energy, when I didn't need sleep and could get lots done - all the stuff I didn't have the energy to do most days. When I first met with my psychiatrist I asked her why I would want to give those up when they're so great. She told me they cause brain damage. Oh. Okay. I'll give them up.
As I researched Lamictal I read that it can often have the side effect of also helping depression. I held a tiny spark of hope that this would happen, but not much. I've tried so many meds for depression over the years and had so much therapy, but none of it took away the depression for good. The meds didn't work at all or made me suicidal. And the therapy could sometimes get me through a tough moment if my appointment happened to hit during an episode. But usually the black dog (as depression is referred to by those who suffer) would just come out of nowhere and pin me to the ground. And I just tried to survive until he let me up again. I couldn't fight him off. I just had to wait until he was done with me and moved on.
Since I have been on the Lamictal I have not been pinned to the ground by the black dog. Not once. He's chewed on my leg on several occasions, but I haven't gone completely dark at all. There was one time when I'd say he knocked me to the ground pretty hard, but that was situational, and I recovered from it much more quickly than I normally would have.
So here's the deal. And I hate to say it for fear of jinxing it. But I believe the Lamictal is helping with my depression. For real. And it's kind of amazing.
Just as my psychiatrist said it should work, I have ups and downs, but they aren't as high or as deep as they were before.
And there's still a part of me waiting for it to come back and hit me in the head. I've sometimes gone through long periods without depression before, only to be dragged down again; what if this is just one of those? Depression has been a part of my life since I was a teenager. The idea that it could finally be under control is something that's difficult for me to wrap my brain around. I feel like it's an "I feel better so far, but we'll see how it plays out" thing.
And there's a part of me that doesn't want it to completely work. Depression is part of my self-definition. It's part of who I am. If it works, I will have to learn to be me all over again.
However, that's not the only major change recently, so I offer this background on my health and meds. While I have no way of knowing for sure what treatment caused what effect, my gut tells me. So I will tell you what my gut says (knowing I could be completely incorrect).
Each morning I take:
- A multivitamin for women over fifty - even though I am forty-five, because the complete hysterectomy and oophorectomy I had last year put me into instant menopause
- Vitamin D - because I don't get nearly enough sunshine and it can help with depression, especially during the winter (which it feels like we didn't even have here in Utah, oh well)
- Estrogen - because I am in menopause an estimated ten years early and my doctor wants to protect my bones and I don't like the idea of breaking a hip when I fall
- Gabapentin - which is often prescribed for anxiety, but that's not why I take it; sometimes my skin hurts for no reason, and gabapentin can help with neuropathic pain; I've been on it since April of 2014, I think; does it work? I'm not sure; my skin was hurting a lot over the last week; it feels like a first degree burn, but there is no discoloration and I haven't been burned; I'm going to talk to the doctor about getting off this one at my next physical
- Lamictal - the mood stabilizer I've been on since the first week of November, 2014; the reason for this post
- Gabapentin
- Vitamin D
- Omeprazole - a proton pump inhibitor that I take for gastroesophageal reflux disease (GERD); otherwise I often have stomach acid that comes up my throat and makes it so I have a chronic cough, chronic sore throat, chronic hoarse voice, and so I can't sleep; without this medication it will often wake me with a burning in my throat that can't be soothed
- Gabapentin
- Melatonin - because I don't sleep well, like at all; I need all the help I can get, but everything else I've tried leaves me super groggy the next day; and melatonin is what our bodies naturally produce to induce sleep
- Armour Thyroid - which is pig thyroid glands "dried and powdered for therapeutic use" (according to Wikipedia); I take this because I have hypothyroidism, which means my thyroid doesn't do it's job very well anymore; I used to take a synthetic thyroid medication but never felt better on it; I found out about this through a thyroid health group on facebook; I had to fight my doctor for it because it isn't as consistent a dose as synthetic, but I have felt better on it; I started this in April of 2014
So as you can see, I have gone through many health changes over the last year. How would I compare where I am now to where I was a year ago? I am better. Much better.
I do not have the constant, intense pelvic pain I had before my hysterectomy. I have more energy on the new thyroid meds, although still subpar for sure; I can get out of bed and do things more often than before. I don't go through intense PMDD/PMS every month; my moods are more in flow with what's actually happening in my life instead of attacking me out of nowhere.
But, most significantly, I haven't had any episodes of severe depression since I started the mood stabilizer. I was initially put on it to control the hypomanic episodes that can come because of Bipolar II. Those were hard to give up. They were days of extra energy, lots of extra energy, when I didn't need sleep and could get lots done - all the stuff I didn't have the energy to do most days. When I first met with my psychiatrist I asked her why I would want to give those up when they're so great. She told me they cause brain damage. Oh. Okay. I'll give them up.
As I researched Lamictal I read that it can often have the side effect of also helping depression. I held a tiny spark of hope that this would happen, but not much. I've tried so many meds for depression over the years and had so much therapy, but none of it took away the depression for good. The meds didn't work at all or made me suicidal. And the therapy could sometimes get me through a tough moment if my appointment happened to hit during an episode. But usually the black dog (as depression is referred to by those who suffer) would just come out of nowhere and pin me to the ground. And I just tried to survive until he let me up again. I couldn't fight him off. I just had to wait until he was done with me and moved on.
Since I have been on the Lamictal I have not been pinned to the ground by the black dog. Not once. He's chewed on my leg on several occasions, but I haven't gone completely dark at all. There was one time when I'd say he knocked me to the ground pretty hard, but that was situational, and I recovered from it much more quickly than I normally would have.
So here's the deal. And I hate to say it for fear of jinxing it. But I believe the Lamictal is helping with my depression. For real. And it's kind of amazing.
Just as my psychiatrist said it should work, I have ups and downs, but they aren't as high or as deep as they were before.
And there's still a part of me waiting for it to come back and hit me in the head. I've sometimes gone through long periods without depression before, only to be dragged down again; what if this is just one of those? Depression has been a part of my life since I was a teenager. The idea that it could finally be under control is something that's difficult for me to wrap my brain around. I feel like it's an "I feel better so far, but we'll see how it plays out" thing.
And there's a part of me that doesn't want it to completely work. Depression is part of my self-definition. It's part of who I am. If it works, I will have to learn to be me all over again.
Labels:
Darkness,
Depression,
Health,
Hysterectomy,
Mental Health,
Oophorectomy,
PMDD,
PMS,
Psychiatrist,
Therapy
Wednesday, March 6, 2013
Taking Stock of My Progress
It's a good idea to take stock of life every now and then. I tend to get so focused on the mountain ahead I still have to climb that I forget to look back at how far I've come. I don't take that moment to look out over the view I've already got because I'm so fixated on getting to the top. And then I just get frustrated and down on myself. Plus, if I don't take stock, I don't realize I've left the trail entirely and wandered.
So tonight I'm taking stock. It's been almost a year since I went to the psychiatrist and she basically told me to change my entire life. Okay, not really, but it felt like that. I took it seriously. I worked really hard at it. Where am I now?
Let's break it down to the different areas she wanted me to work on:
Sleep: I am getting more sleep. I am going to bed earlier (not consistently at the same time, but consistently earlier). I used to be up until 1 or 2 almost every night, frequently 3 or 4. I then got up to get the kids off to school and crawled back into bed for a nap -- every day. Now I shut down for the night around 11:30 or 12 (earlier many nights) and am up at seven. I get the kids up and off. Sometimes I go back to bed for a nap, but not every day. And the waking at seven is consistent. Even on weekends I wake about that time, without an alarm. My body is becoming conditioned to it. It even lasted through the summer last year. Instead of seeing how well I'm doing, I've been noticing the occasional naps and the inconsistent bedtimes and feeling ashamed of myself. I really am getting much more sleep and have made great progress toward undoing a lifetime of bad habits. To the point where my family is feeling the effects. Most nights our house is completely shut down (lights off, most of us asleep) by 9:30 or 10. On the weekends it might be 11 or 11:30. For a house full of teenagers who used to routinely stay up until 11 or later on school nights and whenever during the summer, it's incredible progress. We are night owls by nature, but we've fought that nature and tamed it enough to be healthy.
Water: I'm drinking more. For a long time I was hitting that 96 ounces a day religiously. I've slipped a bit. I'm working on this one. Seriously, the hardest part is to remember to take my water bottle to the kitchen with me and fill it up. If I get back to my room and realize I didn't, I'll usually just put it off. That means I don't hit my total for the day. And, no, my kitchen isn't that far from my room. It's a very poor excuse. But I am drinking more than I used to and I am working on it. I have made progress.
Exercise: She wanted me to walk 20 minutes a day 4-5 times a week. I suck at this one. I worked hard at it for a while, but it was making my shins hurt. I looked it up and realized that my lengthened stride (which I remember training into myself in high school when I spent a lot of time walking with a much taller friend) had to be adjusted back to a natural stride. This helped. But I have another problem with exercise (other than the tired and lazy part). Whenever I do anything physical for more than a few minutes, my face and chest flush. I go bright red and hot. Not the traditional exercise overheating. This can come from simply sweeping. Even singing does it. Almost like clockwork, at 20 minutes in I flush. It's very uncomfortable (the doctor has no idea what this is). The psychiatrist suggest that I do 2 ten-minute sessions instead. Yeah, use your logic on me. Some days I do. Most days I don't. Walking outside is less likely (which is too bad because I'm sure the vitamin D from the sun would help). A bit of dancing with Just Dance 4 on the Wii is more likely. Even though I'm not where I should be, I am still doing it more than I used to. Tiny progress, but progress nonetheless.
No soda after 3:00pm, because it interferes with sleep: Yeah, I kind of completely forgot about this one until I just reread my post from a year ago. Once I started sleeping better I quit worrying about this. I may or may not take another look at it.
Food: I still suck at this. In a big way. It's still way too easy for me to not eat. To forget to eat. Or to decide it's not worth the work of preparing food. I'm supposed to eat three meals and three snacks a day. For months after my visit with her I did this meticulously. I tracked everything I ate, making sure I was eating every two and a half hours. Tracking how many servings of vegetables and how many of protein and how many of dairy and so on. I did fabulously! Seriously, my therapist and the psychiatrist were pretty much speechless at how well I did and how hard I was working. And I remember when it fell apart. My best friend got really sick. I spent a lot of time in the hospital by her bedside. I was careful even then. I packed things to take with me so I wasn't dependent on finding something in the cafeteria. I was still about 90% compliant with what the psychiatrist wanted. And after my friend went home and I was no longer spending 8 hours a day taking care of her, I felt like I deserved a break. I felt like it was okay to relax a bit. I felt like I had earned a week of not tracking, of not being so careful. And that week turned into another and another. I tracked here and there but never really got back on it. While I work to make healthier choices, I'm not doing fabulously. There is progress. I usually eat 2 or 3 meals a day and 1 or 2 snacks. It used to be 1 meal a day and a snack or two on a good day. And when I eat junk, I eat less of it. Usually much less.
But the thing that made me slip up on the food is the same thing that makes me slip in the other areas. There is still a part of me that says I've earned a break. When I've worked hard or my life is heavy, I feel like I can stop taking care of myself. Where does that come from? When you spell it out like that it doesn't even make sense. When I've worked hard or my life is heavy, I deserve to take better care of myself. I deserve more of my attention. I deserve to feel better.
Because those months when I worked my fanny off on this program, I felt better. Not healed. Not healthy. But better. I keep forgetting I deserve that. But now that I've taken stock I remember.
So tonight I'm taking stock. It's been almost a year since I went to the psychiatrist and she basically told me to change my entire life. Okay, not really, but it felt like that. I took it seriously. I worked really hard at it. Where am I now?
Let's break it down to the different areas she wanted me to work on:
Sleep: I am getting more sleep. I am going to bed earlier (not consistently at the same time, but consistently earlier). I used to be up until 1 or 2 almost every night, frequently 3 or 4. I then got up to get the kids off to school and crawled back into bed for a nap -- every day. Now I shut down for the night around 11:30 or 12 (earlier many nights) and am up at seven. I get the kids up and off. Sometimes I go back to bed for a nap, but not every day. And the waking at seven is consistent. Even on weekends I wake about that time, without an alarm. My body is becoming conditioned to it. It even lasted through the summer last year. Instead of seeing how well I'm doing, I've been noticing the occasional naps and the inconsistent bedtimes and feeling ashamed of myself. I really am getting much more sleep and have made great progress toward undoing a lifetime of bad habits. To the point where my family is feeling the effects. Most nights our house is completely shut down (lights off, most of us asleep) by 9:30 or 10. On the weekends it might be 11 or 11:30. For a house full of teenagers who used to routinely stay up until 11 or later on school nights and whenever during the summer, it's incredible progress. We are night owls by nature, but we've fought that nature and tamed it enough to be healthy.
Water: I'm drinking more. For a long time I was hitting that 96 ounces a day religiously. I've slipped a bit. I'm working on this one. Seriously, the hardest part is to remember to take my water bottle to the kitchen with me and fill it up. If I get back to my room and realize I didn't, I'll usually just put it off. That means I don't hit my total for the day. And, no, my kitchen isn't that far from my room. It's a very poor excuse. But I am drinking more than I used to and I am working on it. I have made progress.
Exercise: She wanted me to walk 20 minutes a day 4-5 times a week. I suck at this one. I worked hard at it for a while, but it was making my shins hurt. I looked it up and realized that my lengthened stride (which I remember training into myself in high school when I spent a lot of time walking with a much taller friend) had to be adjusted back to a natural stride. This helped. But I have another problem with exercise (other than the tired and lazy part). Whenever I do anything physical for more than a few minutes, my face and chest flush. I go bright red and hot. Not the traditional exercise overheating. This can come from simply sweeping. Even singing does it. Almost like clockwork, at 20 minutes in I flush. It's very uncomfortable (the doctor has no idea what this is). The psychiatrist suggest that I do 2 ten-minute sessions instead. Yeah, use your logic on me. Some days I do. Most days I don't. Walking outside is less likely (which is too bad because I'm sure the vitamin D from the sun would help). A bit of dancing with Just Dance 4 on the Wii is more likely. Even though I'm not where I should be, I am still doing it more than I used to. Tiny progress, but progress nonetheless.
No soda after 3:00pm, because it interferes with sleep: Yeah, I kind of completely forgot about this one until I just reread my post from a year ago. Once I started sleeping better I quit worrying about this. I may or may not take another look at it.
Food: I still suck at this. In a big way. It's still way too easy for me to not eat. To forget to eat. Or to decide it's not worth the work of preparing food. I'm supposed to eat three meals and three snacks a day. For months after my visit with her I did this meticulously. I tracked everything I ate, making sure I was eating every two and a half hours. Tracking how many servings of vegetables and how many of protein and how many of dairy and so on. I did fabulously! Seriously, my therapist and the psychiatrist were pretty much speechless at how well I did and how hard I was working. And I remember when it fell apart. My best friend got really sick. I spent a lot of time in the hospital by her bedside. I was careful even then. I packed things to take with me so I wasn't dependent on finding something in the cafeteria. I was still about 90% compliant with what the psychiatrist wanted. And after my friend went home and I was no longer spending 8 hours a day taking care of her, I felt like I deserved a break. I felt like it was okay to relax a bit. I felt like I had earned a week of not tracking, of not being so careful. And that week turned into another and another. I tracked here and there but never really got back on it. While I work to make healthier choices, I'm not doing fabulously. There is progress. I usually eat 2 or 3 meals a day and 1 or 2 snacks. It used to be 1 meal a day and a snack or two on a good day. And when I eat junk, I eat less of it. Usually much less.
But the thing that made me slip up on the food is the same thing that makes me slip in the other areas. There is still a part of me that says I've earned a break. When I've worked hard or my life is heavy, I feel like I can stop taking care of myself. Where does that come from? When you spell it out like that it doesn't even make sense. When I've worked hard or my life is heavy, I deserve to take better care of myself. I deserve more of my attention. I deserve to feel better.
Because those months when I worked my fanny off on this program, I felt better. Not healed. Not healthy. But better. I keep forgetting I deserve that. But now that I've taken stock I remember.
Labels:
Change,
Exercise,
Food,
Frustration,
Health,
Motivation,
Psychiatrist,
Self-care,
Sleep
Saturday, March 17, 2012
My Visit to the Psychiatrist
Some of you may remember that at my last physical my doctor suggested I get back into therapy and see a psychiatrist. I am back in therapy, making progress, and this past Monday I finally met with a psychiatrist.
I've been both eager and anxious about going. I was eager to feel better and had hopes that she could help me. And I was very anxious about the medicinal roller coaster of trying new meds until we find something that works or give up in failure. But I trust my doctor and had a good recommendation for this psychiatrist. So, off I went.
It was kind of like going to therapy with a doctor. Lots of psychological and medical questions. She took an extensive history and asked follow up questions about my life and behaviors. The history part took about forty-five minutes. I'm telling you, she asked questions I've never been asked. And considering my therapeutic and medical history, that's saying something. Some of these questions sparked thoughts I hadn't had before. They changed my perception.
She asked about my sleeping habits. I don't sleep well. I haven't for years. I gave a description of my typical bedtime, rising, and nap habits. She asked me to quantify it. In a twenty-four hour period, how many hours do you sleep? I'd never quantified it before. I knew my habits were bad. I knew I should be getting more sleep. But until she had me add it up I had no idea that I was sleeping only 4-6 hours on a regular basis, including naps.
She asked about my eating habits. Ugh! I hate this topic. I described my general aversion to food and my typical eating patterns. I knew I didn't eat well. I had no idea how bad until she asked me to quantify it. Do you eat enough to sustain life? Calorically, probably. Nutritionally, not even close.
Having someone ask that and having to admit how badly I was failing was eye opening. But not as much as her next statement. Earlier in the interview, we'd discussed my history with self-harm. I'd explained that I hadn't purposely hurt myself for over a year, except for once after a particularly difficult therapy session.
She said that sleep deprivation and starvation are forms of self-injury (common with a history like mine).
Now, I don't know if that hit you hard, but it hit me hard. I had never thought of those behaviors as self-harm. But after considering it for a few moments I realized that she was absolutely right. It didn't mean I was converted and ready to change in that instant, but it made an impact.
She also said that sleeping during the day is a self-soothing strategy. An unhealthy one.
Again, not something I'd thought of. (After thinking of that and the other bomb shell I spent a lot of time over the next few days wondering why I am self-injuring and self-soothing my way through my life. I guess I still have lots of work to do.)
She said she wouldn't think of trying meds until I start sleeping. So many of my symptoms could be sleep related. Also, she'd like to build on success rather than failure. In other words, let's try something we know will help instead of working our way through things that might not. Once we fix the sleep problems we can see if we still have things to work on.
Of course, she doesn't simply want to work on the sleep problem. That's just the beginning. Basically, my life is in complete overhaul. She wants me to change several of my behavior patterns. She was very direct and specific. She said I am well on my way to an eating disorder (something I'd actually considered before). And then she gave me the following goals.
* I am to eat three meals and three snacks a day, on schedule.
* I am to sleep 7-8 hours a night, going to bed and getting up at the same time each day -- zero naps! (Melatonin is allowed)
* I am to drink 96 oz. of water a day.
* I am to walk at least 20 minutes a day 4-5 times a week.
* No soda after 3:00pm, as the carbonation interferes with sleep.
Having her spell it out so definitively is helpful. No thinking on my part, just follow through. She set standards. It's my job to do my best to meet them. It was also helpful when she told me that changing patterns like this can take 3-6 weeks. You see, I've done it for a month at a time before and seen no change. It helped to have a time frame.
I agreed to do my best. I will go back and see her in two months. She also ordered a sleep study; I meet with that doctor next week.
She works in the same office as my therapist. I saw him a couple of days later. I am not exaggerating to say that he was tickled pink with how well it went and that I was taking it seriously. He said only about 30% of patients follow through with a plan like this. They both also agreed that whether these changes take away all my symptoms or not, they will help my therapy to be more successful. I know that's true. Therapy always goes better when I feel better, especially when I have the energy needed to maintain boundaries.
I expected sleep to be the toughest one. It's not. Not by a long shot.
Walking is tough because I have a bit of a social phobia thing happening right now. The idea of going out and walking through my neighborhood makes me anxious. It doesn't mean I won't do it, but it's tough.
The water has been relatively easy. A lemon Propel Zero packet in my water bottle and I'm good to go. It's also cut way down on my Diet Coke consumption. I am making a lot of trips to the bathroom, but that is supposed to level out over time.
The biggest difficulty for me has been food. I really had no idea it could possibly be so hard to eat. I eat every two and a half hours now. Meal, snack, meal, snack, meal, snack. I have to set an alarm on my phone to keep myself on schedule. I try to make healthy choices, but I'm not working super hard on balance throughout the day yet. Right now the goal is to teach myself to be hungry and respond to it.
I did okay for the first few days. I ate on schedule. I made healthy choices. But it got harder yesterday.
It was time to eat lunch. I went to the kitchen and tried to find something that looked good. Nothing. So then I looked for something that would meet the basic needs of a meal. I ended up choosing a peanut butter on wheat sandwich and yogurt. As I took my first bite I started crying. I desperately didn't want to eat this food. It didn't taste bad, I just didn't want to eat it. I forced my way through. It was hard just to open my mouth and put the food in. I sometimes gagged as I swallowed. And I cried the whole time, but I did it. Then I was super nauseous afterward. For several hours.
The high and determination I felt those first few days seems to be gone. Now it's just a chore. It's so hard to find food that I like. It always has been. I prefer somewhat bland food with few ingredients. Today, as I make up the grocery list, I find myself struggling to think of things to put on it that I will eat.
It sucks. It seems like I spend my whole day thinking about food. What am I going to eat next? With all these changes I'm working on, I'm struggling to even think about anything else. I'm not taking on anything new or making any other plans for a while. I just don't have the time and mental energy to do one more thing.
But I am doing my best. I have always been one to do my homework. I just hope it's worth it.
**********
To see how it was all going a year later read this.
I've been both eager and anxious about going. I was eager to feel better and had hopes that she could help me. And I was very anxious about the medicinal roller coaster of trying new meds until we find something that works or give up in failure. But I trust my doctor and had a good recommendation for this psychiatrist. So, off I went.
It was kind of like going to therapy with a doctor. Lots of psychological and medical questions. She took an extensive history and asked follow up questions about my life and behaviors. The history part took about forty-five minutes. I'm telling you, she asked questions I've never been asked. And considering my therapeutic and medical history, that's saying something. Some of these questions sparked thoughts I hadn't had before. They changed my perception.
She asked about my sleeping habits. I don't sleep well. I haven't for years. I gave a description of my typical bedtime, rising, and nap habits. She asked me to quantify it. In a twenty-four hour period, how many hours do you sleep? I'd never quantified it before. I knew my habits were bad. I knew I should be getting more sleep. But until she had me add it up I had no idea that I was sleeping only 4-6 hours on a regular basis, including naps.
She asked about my eating habits. Ugh! I hate this topic. I described my general aversion to food and my typical eating patterns. I knew I didn't eat well. I had no idea how bad until she asked me to quantify it. Do you eat enough to sustain life? Calorically, probably. Nutritionally, not even close.
Having someone ask that and having to admit how badly I was failing was eye opening. But not as much as her next statement. Earlier in the interview, we'd discussed my history with self-harm. I'd explained that I hadn't purposely hurt myself for over a year, except for once after a particularly difficult therapy session.
She said that sleep deprivation and starvation are forms of self-injury (common with a history like mine).
Now, I don't know if that hit you hard, but it hit me hard. I had never thought of those behaviors as self-harm. But after considering it for a few moments I realized that she was absolutely right. It didn't mean I was converted and ready to change in that instant, but it made an impact.
She also said that sleeping during the day is a self-soothing strategy. An unhealthy one.
Again, not something I'd thought of. (After thinking of that and the other bomb shell I spent a lot of time over the next few days wondering why I am self-injuring and self-soothing my way through my life. I guess I still have lots of work to do.)
She said she wouldn't think of trying meds until I start sleeping. So many of my symptoms could be sleep related. Also, she'd like to build on success rather than failure. In other words, let's try something we know will help instead of working our way through things that might not. Once we fix the sleep problems we can see if we still have things to work on.
Of course, she doesn't simply want to work on the sleep problem. That's just the beginning. Basically, my life is in complete overhaul. She wants me to change several of my behavior patterns. She was very direct and specific. She said I am well on my way to an eating disorder (something I'd actually considered before). And then she gave me the following goals.
* I am to eat three meals and three snacks a day, on schedule.
* I am to sleep 7-8 hours a night, going to bed and getting up at the same time each day -- zero naps! (Melatonin is allowed)
* I am to drink 96 oz. of water a day.
* I am to walk at least 20 minutes a day 4-5 times a week.
* No soda after 3:00pm, as the carbonation interferes with sleep.
Having her spell it out so definitively is helpful. No thinking on my part, just follow through. She set standards. It's my job to do my best to meet them. It was also helpful when she told me that changing patterns like this can take 3-6 weeks. You see, I've done it for a month at a time before and seen no change. It helped to have a time frame.
I agreed to do my best. I will go back and see her in two months. She also ordered a sleep study; I meet with that doctor next week.
She works in the same office as my therapist. I saw him a couple of days later. I am not exaggerating to say that he was tickled pink with how well it went and that I was taking it seriously. He said only about 30% of patients follow through with a plan like this. They both also agreed that whether these changes take away all my symptoms or not, they will help my therapy to be more successful. I know that's true. Therapy always goes better when I feel better, especially when I have the energy needed to maintain boundaries.
I expected sleep to be the toughest one. It's not. Not by a long shot.
Walking is tough because I have a bit of a social phobia thing happening right now. The idea of going out and walking through my neighborhood makes me anxious. It doesn't mean I won't do it, but it's tough.
The water has been relatively easy. A lemon Propel Zero packet in my water bottle and I'm good to go. It's also cut way down on my Diet Coke consumption. I am making a lot of trips to the bathroom, but that is supposed to level out over time.
The biggest difficulty for me has been food. I really had no idea it could possibly be so hard to eat. I eat every two and a half hours now. Meal, snack, meal, snack, meal, snack. I have to set an alarm on my phone to keep myself on schedule. I try to make healthy choices, but I'm not working super hard on balance throughout the day yet. Right now the goal is to teach myself to be hungry and respond to it.
I did okay for the first few days. I ate on schedule. I made healthy choices. But it got harder yesterday.
It was time to eat lunch. I went to the kitchen and tried to find something that looked good. Nothing. So then I looked for something that would meet the basic needs of a meal. I ended up choosing a peanut butter on wheat sandwich and yogurt. As I took my first bite I started crying. I desperately didn't want to eat this food. It didn't taste bad, I just didn't want to eat it. I forced my way through. It was hard just to open my mouth and put the food in. I sometimes gagged as I swallowed. And I cried the whole time, but I did it. Then I was super nauseous afterward. For several hours.
The high and determination I felt those first few days seems to be gone. Now it's just a chore. It's so hard to find food that I like. It always has been. I prefer somewhat bland food with few ingredients. Today, as I make up the grocery list, I find myself struggling to think of things to put on it that I will eat.
It sucks. It seems like I spend my whole day thinking about food. What am I going to eat next? With all these changes I'm working on, I'm struggling to even think about anything else. I'm not taking on anything new or making any other plans for a while. I just don't have the time and mental energy to do one more thing.
But I am doing my best. I have always been one to do my homework. I just hope it's worth it.
**********
To see how it was all going a year later read this.
Labels:
Choices,
Food,
Frustration,
Healing,
Mental Health,
Psychiatrist,
Therapy
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