Counselor

5-Minutes

/ Robin / 1 Comment

5minutes Are you listening? Can you hear me?

I need you to hear me.

I need you to know what I mean when I say, “I just can’t!”

You really need to understand this illness before we talk about, “I just can’t” It will make so much more sense then.

I’ve written about my troubles for years in my paper journals. I’ve always imagined that when I die, one of my family, my kids perhaps, would read them and finally understand me. They would finally understand that I’m not a bad person, a lazy person, or a freeloader.

I’m sick. I’ve always been a sick person.

With technology what it is today, it’s easy to find an informative book that explains what it is to have what I have. I’ve searched YouTube for videos that explain me and have found a few that try to do it and seem to do it well. We’re all different of course so what describes one person may not completely fit me. But if the person watching will just listen, listen and hear the pain and the wrongness of it all.

Wrongness. That’s what it is.

You’d think, maybe this is the child whose rage never seemed to end, a brat that pushed and pushed…. Wouldn’t you like an explanation?

I’d think someone who claims to love me would take a few minutes to watch a 5-minute video, just a five-minute video, to learn about me. Surely, someone, anyone of you must care enough to sit for five-minutes for me? Did you hang out in line for coffee or in line at the grocery store? Is that silly? Have you “liked” any funny pictures or memes today? Did you watch ANY TV? What were you doing on commercials? Why is this so hard for you?

Did you watch the news today or read your Facebook feed? Have you texted anyone or talked on the phone?

Would you think I didn’t love you if I didn’t return your calls or texts for two or three weeks? Would you call and check on me?

How much energy does it take to watch a video?

What are you afraid of?

I’d have thought I’ve shown you enough of what this illness is that you have nothing left to fear.

And yet, you don’t hesitate. You completely stop.

“I don’t have time.”

Will you have time to visit me in the hospital?

I’m not going to try to kill myself just to get your attention. But I can’t promise to do what’s best for me all the time.

Maybe I’ll have to mourn the death of you so that I can learn to live without you. Because you see, I already live like this. You are emotionally unavailable to me. Without “my people” surrounding me in a protective layer of love to cushion me when I fall….

Adults are just like children. We all have a fair expectation of being loved. When that expectation is not met we wither and begin to slip away.

Do you have five-minutes?

I need you to listen to me today.

Just follow the link.

Then maybe we could talk.

I’ve had a thought. I’ve unwillingly learned more about inappropriate relations whether they be physical, racial, or political just watching prime time TV than you’ve learned about me on purpose.

It isn’t rocket science. But it is science. I am sick. Unlike some illnesses like some cancers where the patient may go into remission or finally be overcome by it, my sickness has not given me a moment’s rest.

Sometimes I wish I had an illness you could see so that you would mourn me when I die. But for today, I live as though I’m normal. That’s how you see me. Normal. That’s how I look. This illness is rude beyond anything I’ve ever seen. It grabs hold and never lets you go. It bombards me from within, from where you cannot see. This illness, it stays in the “ON” position from before I was diagnosed until I die.

That’s right. I have it now. You cannot see it. I will die with it.

Would you watch the video?

Or would you rather I had cancer? Then you’d have something you could see.

I’m tired of being unseen for who I am.

Please, are you listening? Can you hear me?

I’m wondering if you’ve ever felt anything like this. This is all true in my life. What about you? If you have known that, I hear you. I will listen to you. I have way more than 5-minutes to give you.

* I had my counselor read this yesterday so that he could see what’s in my brain. I told him I was going to edit it, polish it up before I posted it so it would be clearer in some places. He suggested that I not do that. He felt that letting you see where my brain was at was a place of raw emotion. He urged me to keep the “rawness” in it. So, here it is. Right from my brain and served up to you on a virtual platter.

What My Med Provider Means to Me

/ Robin / Leave a comment

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I’ve complained about my med providers and their apparent inability to comprehend the word ANXIETY for over a year now. You could assume that I don’t like med providers… that I don’t trust them, that I think they’re stupid. Well, umm, yes, that’s basically how I’ve been feeling. I’ve been living a nightmare that has been driving me downward toward my old companions: anger and rage. It makes me feel like they’re getting out of prison and are moving into the house next to mine. I’ve been really scared that I was about to lose control of my emotions again, and eventually, my mind. It has happened before.

I last week I spoke with my counselor (Lee) before my visit with my med provider (Susan) this week. He thought the Ritalin obviously wasn’t working and that my ADHD was out of control. I allowed myself to interact with him the way I do at home with Jessica. My inability to control things like how fast, how much, and how many topics I covered while speaking certainly indicated that this was true.

<OMG! Alexa is playing music from the 1950’s for me. I LOVE THIS MUSIC!>

I was stunned. ADHD? If he was right, this could change everything about the way I approached my brain. I was told I had ADHD just a few years ago and had never taken the time to learn anything about it. Wow, that wasn’t like me at all. I love research! Following rabbit holes is my favorite pastime!

Anyway, I assumed Susan would look at my chart to see what notes Lee would have put in it before she saw me. Doing that would give her knowledge she should have used to help her understand where I was at and she would have seen what Lee was concerned about. It was an assumption I shouldn’t have made. Apparently, things don’t actually work that way.

Every time I see Susan 12 times a year. Yikes! So many times. One of the first things she asks me is if I feel like… if I FEEL like the Ritalin {1} is helping me focus? Focus? What does that mean? How can I tell it’s working? I can pay attention in class. Is that what she means? My attention is crap at home. I can’t ever do just one thing at a time. I have to leave the commercials in when I watch from the DVR (DISH) so that I can read or research stuff online that they just talked about. Is it working? I suppose so? I always replied that I guessed it did. I guess that was silly of me. I would say that because I had no idea what else to say. If I was a little boy, I could probably mean that I’d slow down and stop bouncing off the walls and maybe stay in my seat. But as an adult… I had no idea what that looked like. If I said the wrong thing, she might mess with my meds and right then, they were treating me okay. I wasn’t raging at anyone that day and I didn’t feel depressed.

After I mentioned what Lee and I had talked about and that he was very concerned she took a minute to read his notes. Suddenly she made a whole new treatment plan. I had been on Lithium when I was first diagnosed with Bipolar Disorder (BD). The first book I read on it was: “An Unquiet Mind: A Memoir of Moods and Madness” by Kay Redfield Jamison. I was deeply touched. I felt like I understood what she was talking about, like we were kindred spirits, linked through the ether by BD. Jamison was very sick when she was diagnosed.

Let me attempt to generally get right to the point for once. Jamison was placed on Lithium to treat her BD and it worked. So, that’s what I asked to be given. My personal doctor (MD), was the one who initially treated me. He said that Lithium has been around for many years and there is a lot of evidence that it works.

The Lithium worked.

Susan felt that since the Ritalin was obviously not helping me focus. I guess that made her rethink her strategy. She finally agreed that my brain was hopping along on two of four legs. She told me that does think I have ADHD she now believes that I’m far more manic, which was making me act like that bouncy ball they teach kids to sing songs with. Do you know what I mean? It might be too old for some of you. They wanted to teach kids songs so a character on a film or on TV would get you to sing along as it had a bouncing ball hop around on the lyrics so we could see the lyrics while we sang. It was great fun! than anything else. Sure I talk incessantly to Jessica, but my brain was exploding with ideas. It was time to help me continue to be creative, but to control my mania so that I could be productive.

The plan: no more Clonazepam, no more Ritalin. Start Lithium.
*The reason I went off Lithium was that my PC (Primary Care) had been highlighting the dangers of being on Lithium more than he was the benefits of it. It was because of these side effects, that I requested I be put on something else that didn’t have the same drawbacks. Lithium toxicity can occur even at a low dose. While on Lithium, the user has to be closely monitored so that the dose can be adjusted as needed. The symptoms of Lithium toxicity are numerous and I already have several of them for other random reasons. This website lists the long lists of side effects. In addition to these potential problems the user (remember this is me) has to carefully watch their intake of salt, caffeine, and alcohol. And get this… some of the other medications that may interfere with Lithium and increase the risk of toxicity are ibuprofen (Motrin, Advil) and naproxen (Aleve). Oh, and I can’t leave out this one: acetaminophen (Tylenol). So… yeah. I had a lot of scary reasons to ask to be taken off the drug that was helping me but was also kind of terrifying too. 

Susan believes that this change in medications should make my extreme moods in control much better.

Excuse me? As long as I’ve been seeing the professionals in this clinic, I’ve never had anyone decide to try Lithium again. All this time… lost. Years of feeling my little grey cells melting, running out of my ears. But then again, Lithium toxicity…

I want to be a writer when I grow up. I once heard that writers go through life with their head cocked a bit to the side. I showed Susan a piece of paper that was covered with writing on both sides. It was filled with websites, blogs, and email addresses that I’d created. She studied it for a while. I asked her if I was stupid and delusional to think that I could do all these things and believe that they were not just good ideas, they were great ideas. They were creative ideas. Is my mind actually existing in a consistent state of delusions of grandeur?

Delusions of grandeur. I’ve always been afraid that people would remember that part of the list of symptoms for BD and dismiss me as a kook. Am I brilliant? Or am I bonkers and deluded? I’ve always believed my ideas were great. Yeah. Delusions of grandeur?

She said no. It wasn’t that. Yes, my thoughts are crazy fast, but I am very creative and smart.

Me – creative and smart. OMG!

Of course, now I respect her. She believes in me. She agrees with me that I’m smart and creative. No one has really said that to me. No one has said, “Robin, you’re not delusional. You’re smart. You’re creative. You have good ideas… cleaver… innovative. Don’t worry about being crazy. We just need to slow you down so you can get things done.

Since then, I’ve discovered additional information that indicates that one aspect of BD is the tendency to be super goal oriented. Yep, that’s me. Why haven’t I’ve seen that before?

Watch out! Corner coming!

What are the good things about having BD? I’ll have to think on that for a while.

Go ahead, get mad when the medical professionals don’t seem to be listening. Pester them until they hear you. Then, you listen to them. Work together. Hope that things will finally start to workout. Now that Susan and I are communicating, now that she hears me, we have a new plan. Maybe my mind won’t keep leaving the scene without me.

Yes, it really has done that. We’ve called professional trackers to find it a few times now. It-is-very-embarrassing when your mind is so exposed, so naked.

New plan. New hope.

Bring it! I’m ready.

I’m more than ready –

{1 – Concerta and Ritalin are stimulant medications used to treat attention deficit hyperactivity disorder (ADHD). They’re both different brand-name versions of the same drug, called methylphenidate hydrochloride.  https://www.healthline.com/health/adhd/concerta-ritalin}

Bipolar – Med Provider Day

/ Robin / Leave a comment

I’m unstoppable.

I’ve been trying to sleep, but it eludes me like a chicken running for its life.

I’m going to see my med provider at 10 in the morning today. I hope she listens this time. If she doesn’t I’ll be requesting someone else and informing them of why I’m choosing to under go all the stress that comes with a decision like that. I’ve had enough.

I’m going to confront her with the facts. I’ve been keeping a list of my symptoms since I saw her 30 days ago. It has grown quite long. It looks even worse than before I was being medicated.

I’m unstoppable.

My pain management guy and I had to ween me off one of the long acting pain killers I’ve been taking for a couple of years because of supply issues. I went from 100 mg twice a day to 50 mg over night because there wasn’t anymore to be found anywhere. No one knew it was going to happen so there was no helping it. It didn’t feel so great. Then we kind of gradually weened me off the rest. Now my pain level is constantly higher. Also, the torn fascia in my foot still isn’t healed. It’s painful. I got special shoes for it today. But as the compassionate woman said while I walked around and around testing shoes, my foot was going to feel soar and tired. It still is. It wasn’t fun.

All this has added to my overall stress level, as you can imagine. Withdrawal is never a good time, nor is added pain.

I’m unstoppable.

I will be thankful if my counselor, Arthur, can make it to my appointment. He said he’d try. He feels it is important for her to understand my mental state from his side of the equation. He’s been with me two previous visits.

It hasn’t helped.

I’m still choosing to be unstoppable.

I may stumble, and I may fall over and over, but this damn illness is not going to continue to run my life. I’m very ill. I’m too exhausted not to fight anymore. I feel like my life has been a waste.

I’ve had enough.

I’m unstoppable.

Help me. Or, stay out of my way.

I refuse to stop!

I’m Bipolar 1-How Much Further Must I Go?

/ Robin / Leave a comment

I’m dang angry. I’ve worked my agitated ass off for three years, stumbling under the nightmares of depression and raging as anxiety unleashed tries to undo all that I’ve endured. So close. One more quarter and I’ll graduate from UWT. One more quarter and I’ll have to get a job and support myself.

Listen to me dear Reader, if you have a medical professional who won’t listen to you or thinks your complaint is in your head (duh) or is in some way not treating you with the dignity and respect that your insurance dollars demand of them… stand up and say something! You do not always need to be nice. Trust me on this one.

I learned long ago to hide much of my mental crappiness that was going on in my skull. I was super high functioning. I had kids to raise. I can play the “I’m fine, I’m a great” parent game.

But you know what? Turns out that didn’t help the “me” of today. The “me” of today STILL needs something for anxiety. Go ahead moron. Yes, you Jamie, you have ignored my pleas for something to do for me what all the hundreds of hours of counseling have been unable to do… relieve my over the top anxiety.

I’ve asked this woman for something for anxiety since the first time I saw her. You know what she did? She started lowering my Clonazapam (spelling). Every time I’ve seen her, she reduces it. “It is just one less pill. You’ll be okay.” [bitch]

I went home with 10 pills for 30 days.

She increased my Ritalin dosage and made it extended length. I didn’t ask for that. What? You want me to calm down so we can finish our 20 minutes on time? Have you dosed me so that I’ll be a good woman and let you get done with me?

Well guess what? The shits hitting this fan.

Can any of you relate? Have you felt unheard and improperly treated? Guess what? You are NOT ALONE. Not by a screaming momma long shot.

I have IBSd. I had to talk to my counselor from home. Since I was in my own I felt FREE to explain again about my anxiety and graduation and jobs and money and acting out in class because I simply cannot contain the mountain of anxiety spilling … over into my phone call.

For an hour I yelled about Jamie to my poor counselor. I accused her of having her own agenda and it didn’t include my mental health. I’m done. She either treats my anxiety when I see her next week or –

Or I will hand deliver a letter I’ve been writing about our times together to the facility director. I’m done.

I’ve worked my hardest, trying to keep hold of myself while my wild mood swings tried to prevent me from my goal – getting a college degree at 55.

This, this Jamie, she can’t seem to hear, see, understand, empathize or give a rats ass whether I self-destruct because my anxiety has paralyzed me again. I sit on the sofa and I cry because I’m terrified I’ll fail. So I don’t start. Then the panick sets in as I realize I can’t write the paper.

In the name of the oath that we have been lead to believe that those in the medical profession must swear to, treat me for my illness.

I cannot imagine going through the graduation ceremony in the Tacoma Dome with my freaking anxiety not treated.

I cannot imagine the day after graduation when I need to be looking for a job, but because Jamie didn’t treat my well documented illness I am instead sitting in the back yard vegetable garden pretending to being weeding. The problem with this scenario is that I have arthritis, and if I have sat in the garden without anyone home to help me up… I’m not going to getup. It would mean that I’d given up. It would mean that I’d be punishing myself for continuing to be the Bipolar failure that I’ve always been. (How I feel.)

And Jamie? Still with me? You could have prevented me from losing all the ground I’d worked so damn hard all these years to reach. And why? For what? From here it just seems you’re stupid. Some medical “professionals” are stupid you know. I’ve even taken my counselor with me on two occasions to verify what I tell her.

I’m done.

I’m saying Hell No! That’s enough of this irresponsible crap. You expect those of us with mental health issues to behave? Then treat us right. Hear us when we call for help. If we bring backup pay special attention. I’m trying to get my son to go with me. He’s a psychology major.

To all of you struggling to work with your own Jamie’s, you stand fast. Do not let them push you around. They’re there to serve your medical needs. Document what you talk about and when. Keep a clear record so if you need a new med provider you can state your case and prove that they aren’t listening.

One reminder though. If you’re really messed up you may not be thinking straight. No worries. You just take a family member or someone who you can trust with you.

You’re not alone.

Oh, and if you happen to be a Jamie, what’s your damn excuse?

Insidious Black Box

/ Robin / Leave a comment

I apologize for the length of this post. Please consider reading the entire post. It’s very important. Your life could depend upon it. (Robin)

Emotionmasks insane faces

I take two medications that I considered to have a Black Box warning. They both depress breathing. Together they can stop my breathing altogether… There are other dangers.

I have chronic pain with Bipolar Disorder and Generalized Anxiety. I am prescribed both Oxycodone and Clonazepam by two different providers. They both know that I take both medications.

I see a pain management specialist for my pain. I have for some time now. To be treated there, I have had to sign a contract that governs my behavior with regards to taking pain medications, I have to take a pee test every time I go in and they count my pills every time as well.

My med provider handles my Clonazepam prescription for anxiety. I suffer from extreme anxiety. Sometimes I feel like my brain is going to explode. Recently, this woman, who is the 4th or 5th provider I’ve had since I started going to this clinic, told me that I’m more likely to kill myself because of anxiety rather than depression. I was always told that a depressed person was more likely to commit suicide when they started to feel better. When they started feeling better, they finally would have the energy to follow through with their suicidal inclinations. Apparently, there is more to it than that.

My counselor and every med provider I’ve had is intimately aware of my massive anxiety and my inability to get it under control. We’ve tried all the counseling type of solutions including Cognitive Behavioral Therapy (talk therapy), mindfulness and other techniques. I’ve not had success with any of them.

My med provider is content for me to only take Lamotrigine, which is primarily to treat my Bipolar Disorder depression symptoms, and not to take anything other than Clonazepam for anxiety. From talking to her, it appears that this is primarily to treat the depressive symptoms that I experience. I have not been able to get any of the med providers who have treated me to give me anything for anxiety other than Clonazepam.

She, my med provider, told me at our second meeting, that people with anxiety are more likely to commit suicide than people with depression. Since I suffer primarily from anxiety, you would think someone would have warned me of this. I understand now why I feel so self-destructive while I’m exploding with anxiety.

She has told me that her goal is to get me off the Clonazepam completely. Now that I’m taking my runaway anxiety and the real chance I will kill myself because of it more seriously, I’m also taking the mix of these two medications seriously. I always have, but my frantic response to my anxiety has created a situation where I’m so afraid of what might happen if I stop taking the drug for anxiety.

I’ve always felt like I’m most insane when my anxiety is at its peak.

I understand that long-term opioid use for chronic pain is not the most effective way to treat it. I’ve wanted to find a different solution for a long time. My pain management provider doesn’t offer other alternatives than pain medications.

I normally don’t want to die. I’ve always had urges that are normally short in duration towards it, but I haven’t had times when I sit there with my bottle of Oxycodone ready to take it all. But, I could.

I’ve never told any of my mental health caregivers that I have suicidal thoughts. I know that my community does not have good facilities to treat acute mental health emergencies. I don’t want to become one of those people who is shuffled into a hospital emergency room with a guard sitting outside my little room. That’s what they do. I have first-hand knowledge of this.

So what’s the answer? Do I chance dying in my sleep? Or do I chance ending my life while I’m awake? Both are real dangers.

I’ve decided to deal with my feelings of self-destruction now. With the danger of the two medications and my new understanding the relationship between anxiety and suicide, I have promised my family that I will talk to my counselor on Wednesday when I see him. I will admit that I think about suicide. That’s a huge step for me.

I’m afraid. Admitting how I’ve been feeling for years is like admitting that I can’t control the one area of dealing with my mental health that I always felt I could say I didn’t have a problem with. I’ll finally be admitting I have no control over my depression or my anxiety in relationship to staying alive.

As I say, I don’t want to die. When my anxiety runs away I cannot always control myself. I can become violent and destructive. I break down and cannot function. I become paralyzed yet also hysterical.

Yesterday I talked to my mother and all three of my kids and admitted the truth to them. My youngest who is a psych major at the same university that I attend (so is her partner) said she had been wondering if that was a problem for me. They all agree that they would rather I call them than I call a suicide line. I’ll talk to my therapist about that.

I have tried to learn to practice mindfulness several times in the past. I never fully committed to it. Mindfulness was just part of the learning experience in one of my classes I just finished. It’s time for me to review the materials I have about it, I have lots. I need to try to learn how to harness it’s potential in earnest this time. My life depends upon it.

I have a particular fear: I’m terrified of my anxiety. I know what it does to me. I sometimes feel the insidious devil of insanity creeping through my mind trying to take over, and it literally shreds my mind.

If you have any Black Box warnings for medication yourself, please take it seriously. Now that I am self-aware of my true situation I’m ready to find a way to deal with my symptoms.

 

My main medications:

Chronic Pain – Oxycodone / Nucynta

Anxiety / PTSD – Clonazepam / Benzodiazepines

Bipolar Disorder / Depression – Lamotrigine

 

Oxycodone – Warnings

“To make sure this medicine is safe for you, tell your doctor if you have:

  • a history of drug abuse, alcohol addiction, or mental illness
  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others)”

https://www.drugs.com/oxycodone.html

Clonazepam – Warnings

Risks from Concomitant Use with Opioids
Use of benzodiazepines, including Clonazepam, and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of benzodiazepines and opioids for use in patients for whom alternative treatment options are inadequate.

Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone. If a decision is made to prescribe Clonazepam concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation.
(The above Warning is taken from: https://www.drugs.com/pro/clonazepam.html)
Concomitant: (synonyms: attendant, accompanying, associated, related, connected)

Lamotrigine – Warnings

To make sure lamotrigine is safe for you, tell your doctor if you have:

  • A history of depression or suicidal thoughts or actions
  • Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

https://www.drugs.com/mtm/lamotrigine.html

Nucynta – Side Effects for Health Care Professionals

Psychiatric – Common (1% to 10%): Insomnia, confusion, abnormal dreams, anxiety, depression, irritability, nervousness, drug withdrawal syndrome, restlessness, sleep disorder, hallucination, depressed mood.
https://www.drugs.com/sfx/nucynta-side-effects.html

 

Benzodiazepines

Benzodiazepines may be used in the treatment of anxiety, panic disorder, seizures, or sleep disorders.
https://www.drugs.com/drug-class/benzodiazepines.html