Depression

Bipolar Mixing Ahead

/ Robin

I’m feeling manic and depressed and distressed and full of anxiety. I hate these feelings. I’m coasting along, knowing these are the better days and I should not waste them. The plan… I have a plan. I have part of a plan.

And my cat is kneading the edge of my blanket that’s sticking out from under my head. OMG! He purrs SO LOUD! – I digress…

I haven’t looked at Facebook for weeks. I want to connect with old friends, but I’m afraid. (This bit is what triggered me) A while back I finally found a friend I’d lost long ago. This friend is doing well. In fact, when I ask how things are going I’m always told that things are perfect. Couldn’t be better. Married the love of their life. I guess I’m happy that things are so perfect for this friend. But I’m not, and it has nothing to do with this stinking sudden mixed episode I’m currently enjoying.

I watched the whole speech given by the student about all the loss and pain that murder by gun has brought us recently. Emma González speech

Then I read about a friend’s dad that went scary nuts at the hospital, and about another friend (about 25 years old) whose grandfather just molested her. You know how family members are often in denial? Grandma denied it and she ended up in jail. I don’t have the details and I don’t care about them because details are not what I’m so freaked out about.

Another friend is excited to not have needed pain meds today and is looking forward to doing chores and growing her eyebrows back in. Then I saw an honestly beautiful painting a dear friend just finished of three burrows… I think it was the burrows that got me.

My mixed state is just like our worlds today. I say “worlds” because we each live in our own little spheres, our worlds. None of them are like another.

There is nothing I can do to influence any of these people’s lives right now. But I’ve been working on influencing mine. I’ve been expressing to you what I’m thinking and feeling right now.

I feel my emotions smoothing out, the peaks aren’t so drastic.

Have you ever tried to listen to music or waterfalls or rain and soft music at night to help you get sleepy? I have. I’ve tried dozens of sounds. I’ve found something that I didn’t even know existed while chasing rabbits on YouTube. It’s a train going down tracks, at a constant speed, with no whistles, no horns, just the steady and almost hypnotic sound of a traveling train.

Wow, thanks for walking with me through that. If the circumstances had been different, well, I’d rather not go there.

I’d like to get my perfect friend to more than tell me we all have our own journeys
we must live. That’s crap. If you have a friend you know is in pain, and you have training in that field and you don’t reach out…. shame….

Shame on me.

Things to do ASAP: call Karen, email Marcella, email School the email, get pic of Bailey, myself and my daughter Jessica with the Easter bunny, clean hardwood floors, throw ball for Bailey on obstacle course, use elliptical, write, do class time in online classes on mindfulness and short story writing… today. If I can get my butt out of bed when the alarm goes off and don’t watch TV I have a good chance of getting it all done. If not, some will roll over into Monday.

And yes, I do sometimes do exactly what I say not to do. I set my bar too bloody high. Yep. I do that… sometimes.

(Written last night at midnight)

Insidious Black Box

/ Robin

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

 

Anxiety Storm

/ Robin

They always ask me if I’m depressed.

I’ve got Bipolar Type 1 and I cycle super rapidly, what do you think?

No, really, are you depressed?

Let me tell you the truth, I hope you hear me say it this one time because I’ve had enough.

Go ahead.

My anxiety, my stress – if that’s what you need to call it – is at 7 of 10. 10 is call the morgue. My adrenaline has been full on since I can first remember. Fight or flight…. or both.

Yes, that fight or flight reflex can be triggered.

Listen to me. All the time. It’s all the time. Stop asking me if I’m depressed because the answer will always be yes. What you should be concerned about is my anxiety. I’m more likely to have the top of my head exploded from that than I am from depression.

You know, you’d be surprised at how often that’s the case.

Shit.

Checking-In

/ Robin
pargola eclipse

Under my pergola during the eclipse, 2017.

I didn’t realize today was Sunday until my dear mother texted me and reminded me that the Seahawks were playing. Sunday. How did we get from the horrors of Thursday, past the delightful day hiking on Mt. Rainier on Friday… to Sunday?

(Thursday I spent 4 hours in the Denturist’s chair. It was terrible. The worst was when he oozed goo down my throat and didn’t know it. I hurled and hurled until up came a wad of latex looking stuff. Then, another large piece… then, a third. The teaching Professor said it sounded like I was being given the heimlich. I was. Only I was giving it to myself. It was a nightmare. I haven’t been able to sleep because I keep feeling the goo going down my throat and sitting just beyond the reach of my fingers… I keep eating to try to make the feeling go away. It isn’t working.)

Now Sunday is ending. I got up early and walked my dog before the fall rains started. Literally, today was the first rain in days and days. It has ushered in the fall. The temperature has lowered in one week and the air is crisp.

I enjoy the cool clean air, but I will miss the sun. The sun helped me fight my depression. I’m hoping to spend time outside during the cloudy months under my covered pergola nestled in a warm coat.

Right now, I’m feeling sad, as though I’ve wasted my day. I spent quite a lot of time getting to know how to use Dish and Alexa. Dish doesn’t display the time like the Xfinity box did so I had no idea how long I’d been fussing around. I’ll need to get a little digital clock.

I’m feeling sad, fearful and anxious. One and a half weeks and my classes at the University of Washington will resume. I can’t control my emotions regarding it.

At this moment, Alexa is playing me some relaxing classical music. I’m thankful for that.

Bipolar depression: Sad or mad?

/ Robin

When you’re watching for emerging symptoms of bipolar depression, make sure “irritability” is on the list. You’re just as likely to be unusually crabby, intolerant, and easily annoyed during a depressive episode as to be apathetic or despondent.

More research has been done on irritability in major depressive disorder than in bipolar disorder, but results from both groups indicate that from 40 percent to 60 percent report depressive episodes marked by irritability.

“Irritable depression” (that’s a description, not a diagnostic term) is associated with more severe depressive episodes, more frequently recurring episodes, and co-existing anxiety.

A study published in the International Journal of Bipolar Disorders in December 2016 found that participants with irritable depression also tend to take longer to recover from an episode and had more “unfavorable illness characteristics,” such as higher rates of substance use and more suicidality.

All of which means it’s even more important to take preventive measures when your irritability meter ticks upward.

bp Magazine’s columnist and blogger, Julie Fast uses the terms “weepy depression” and “angry depression” to describe the different ways she can experience bipolar downshifts. Weepy depression comes with what you might call stereotypical symptoms: feeling sad and hopeless, crying a lot, shutting down socially, becoming physically lethargic and

having trouble concentrating.

With angry depression, she writes, you feel “pissed off at everyone and everything. Kittens and puppies make you mad.” You focus on the negative, finding “garbage in the gutter when there is a rainbow in the sky.”

[THIS WAS THE CONTENT OF bp’s NEWSLETTER DATED 2/16/17. You can find bp magazine’s presence at: http://www.bphope.com/ ]

I’ve passed this along to you because I suffer from angry depression and have since I was very young. It defined me for most of my life. Today, it is one of the leading indicators that alerts me to how I’m doing. For example, if I’ve been doing reasonably well and suddenly I’m bitchy with my mom for no reason, I’d better take a look at myself and see if I’m sliding down the sheer walls of the well of depression. For me, it might also indicate that I’m manic. I don’t think it only happens to me when I’m depressed. If I’m unreasonably angry and I’m aware of it, I can examine myself and see where things are going wrong. When I’m in the midst of an episode it can be hard to recognize that things are going badly. Sometimes the anger is a wake-up call alerting me that something is amiss. Sometimes I become aware of that anger by seeing what it does to those I love.