The past six months have been busy, frustrating and painful. My physical issues have included a knee replacement, a gallbladder removal and multiple treatment programs for lymphoedema. Mentally and emotionally I’ve been through two bouts of hypomania, a brain exploding mixed state and ongoing depression with suicide ideation. Not what I’d call fun and I’m still not over these things but I’m trying.
When I had my knee operation I “lost” four days. I have no memory of anything that happened during that time. Family and friends say I sent them nonsensical text messages yet I can’t remember having my phone with me. My first recollection was of being moved to a physical rehabilitation hospital for a month. I was aware of my new surroundings, but my cognitive processes were still affected. I couldn’t read nor write, not even sign my name. I couldn’t concentrate on anything and found it difficult to follow directions in my exercise classes. Then, wham, the depression hit really badly.
I struggled through each day trying not to cry, often failing and sobbing during times spent in my room. The pain of the depression was far worse than the pain in my knee, but it was easier to let everyone think that I was just being weak about coping with the rehab exercises. I was very thankful that my psychiatrist kept in touch with me by phone as he was the one person with whom I could be truthful.
After being discharged, I attended more physio classes for my knee and it slowly started to improve. I wish I could say the same about the depression that still has a strangle hold on me. I see my psychiatrist weekly, which helps to control the urge to kill myself, but those thoughts are always just under the surface. I’ve tried to distract myself and to self-soothe by doing things I’ve always enjoyed yet nothing has helped. All my life I’ve read a lot but I still can’t get involved in a book. Similarly, I love (or did love) listening to music but that doesn’t interest me either. I don’t want to see friends or family even though I know that I’m becoming dangerously housebound. I hate that it has taken so long for the temporary cognitive impairment to ease and I’m reluctant to even think about having surgery on my other knee. I hate it that I’m so depressed. I feel physically and mentally paralysed.
A couple of months ago my psychiatrist suggested I try a very low dose of Lexapro (escitalopram) to see if it would ease the depression. I don’t do well on antidepressants; they always flip me into mania, but we hoped that such a small dose would help while not having any undesired effect. Fail! I started on 1mg then after 10 days it was increased to 2mg and two days later I was in hypomania. So that’s it for me and antidepressants. My psychiatrist has now suggested that I go into hospital and undergo TMS treatment. I’ve had Transcranial Magnetic Stimulation before with no success, but he tells me the process has been refined and improved so it is worth revisiting it. For the past two weeks I’ve seen another psychiatrist while mine has been on holiday and he also agrees TMS is worth a second go. I’m thinking about it. It’d be great to feel stable again and not to hide away crying under the bedclothes, but I’m not feeling good about a month in a hospital. It’s not so much hospital itself, it’s being away from home for so long. Away from my husband and my dog, away from familiar surroundings where I can cry when I need to (I hate crying around others) and hide away when I don’t want to see anyone.
I don’t know what I’ll do yet. Maybe my depression will miraculously lift and I won’t have to make a decision.
I’m frustrated, really bloody frustrated!
Firstly because I’ve been horribly depressed since my flying-so-high-I’m-fantastic mania. Damn medication is not working and I’m so sick of trying to drag myself out of bed each day just to do nothing because my motivation level is at zero. My concentration is crap and my memory is stuffed; all I want to do is cry and hide away. I’m on auto-pilot when I have to do anything and my smiley face facade is in place so that I don’t drag others down. Feeling useless, hopeless and helpless. Whinge, whinge, moan, moan.
My second reason for being frustrated and even more depressed is that I weighed-in with my GP this morning (after a cry because she asked me how I am) and I have put on two kilos in two weeks :( I had been losing a steady two kilos at each weigh-in which was great after the massive weight gain on the evil (to me) Zyprexa but my psych re-prescibed Zyprexa after my manic episode and my fat cells obviously love the stuff. What a vicious circle I’m stuck in.
I can’t write more today. I know I should be exercising but I’m going to crawl back into bed and close my eyes to the despair I’m feeling. Psych appointment tomorrow.
There is a new poem on poetry two
Today I had my first post-manic, post-scheduling session with my psychiatrist. I was very apprehensive as my behaviour last week had been so bad and I really thought he might say that it would be better if he referred me to someone else. I’m also terribly depressed after my experience at the hospital and also because I’ve “crashed” badly after being so manic. Read More »
The past few weeks I’ve felt unable to write. Too much anxiety, too black and depressed. I’ve been exploring with my pdoc the dual feelings of depression and emptiness, looking at where they exist simultaneously and whether or not they are separate conditions. The emptiness I feel is a physical feeling. To demostrate it physically I’d take a large knife and carve out a hole in my abdomen so you could see through to the other side. There is nothing that can fill that hole, or so it seems.
Is this just due to being depressed? I’m not sure. I’ve always felt the emptiness even when antidepressants have worked for me in the past. During mania I am not aware of it, but does that mean it goes away or am I simply not attending to it while in a manic state? Even as I child I felt like I had a dark hole inside me and I had no understanding of what it was — I thought everyone felt that way. As I grew older and was able to express my feelings to my peers I realised that most people don’t feel this way constantly.
Yet it is also common to feel empty, to feel a nothingness, when severely depressed. So it is not clear if there is separation between the two or not.
My last couple of sessions with my pdoc have been good ones, productive. My current thinking is that it may be possible to fill my empty hole through therapy in such a way that it heals slowly from the outside edges much like an ulcer heals. Time will tell.
The only medication changes I’ve had is an increase in Pristiq to 300mg per day and an increase in Zyprexa to 7.5 mg PRN.
I’ve also added a new poem to my poetry page.
If it isn’t enough having bipolar depression, along comes another thing to send me spiralling further down. I’ve been having lymphoedema treatment for my legs (massaging, laser and daily heavy bandaging). After four weeks of treatment I now have compression stockings that I will have to wear forever. They are very thick and you need to be some sort of iron-woman, which I’m not, to get the damn things on.
Not only that but they severely limit the type of shoes I can wear. For a start, I always have to have shoes or thick socks on — no going barefoot. Summer shoes are out because they won’t fit over the stockings. “Slide” type shoes are out because they cause too much wear on the stockings.
I’m imagining summer and having to wear big clumpy trainers all the time and not being able to wear light summer clothes and shoes. For someone who absolutely loathes the heat this is bothering me a lot.
So today I hit rock-bottom yet again. The whole deal is costing a small fortune (which I don’t have), and all I can see is a dismal future. This coming on top of already being so depressed is making me feel like I can’t go on.
Today someone said to me “well think of the others who are worse off than you”. Telling someone in the depths of depression something like that does NOT help! I know there are others worse off but that doesn’t help me.
My pdoc comes back next week and I know he is cutting back his hours, so if he tells me he is retiring soon, I won’t just be at rock-bottom, I’ll be tunnelling through it.
GIVE ME MORE MEDS!!
Something I hate about this horrible bipolar depression is that it robs me of enjoying the former pleasures in my life. I love reading, or I did. I used to read a book every one or two weeks, yet since the depression has been at its worse I haven’t been able to read. I start a book and find myself reading the same page over and over with no comprehension. I have a stack of books waiting to be read and no ability or motivation to read them. For me that is sad.
Music is something else I’m missing out on. In good times I have music around me most of the time. I listen to the radio or my iPod in the car and my iPod at home. But at the moment music is just too triggering for my emotions.
As anyone who has experienced major depression knows, it is a destroyer of motivation. Everything becomes an effort and interest in even the simple things in life just disappears. Getting up and ready for the day is a huge effort when all you want to do is hide in bed and let the world go by. Then at night sleep is hard to come by as you sit blankly in the dark wondering when this feeling will end. Either tears, or sometimes the loss of the ability to cry, become your constant companions. A sense of nothingness overcomes you. All you want is your life back.
Today I started a lymphoedema treatment program as a day patient. I have to do this for 6 days a week for a month (how come everything is a month-long?) I have had lymphoedema of the legs for about a year and it hasn’t got better, hence the full-on treatment consisting of having my legs bandaged, a massage, laser treatment, the gym and the hydrotherapy pool. Not exactly fun but necessary. I was told it is a condition I have probably inherited (lucky me) and it has also been suggested that my bipolar is also inherited, so some ancestors have a lot to answer for!
Not sure how all this is going to affect my bipolar treatment and my depression. I feel it is one thing after another and I still have the possibility of ECT looming over me. I wish I could laugh about it all but life is not too funny right now.
Today my pdoc started me on Pristiq. He explained how Effexor is changed into Pristiq (desvenlafaxine) by the liver, so it is essentially the same med by the time it goes through the rest of the body. However, some people get fewer side-effects with Pristiq than with Effexor. Apparently the same happens with Cipramil and Lexapro. It will be interesting to see if it works to lift my depression. That way I may not have to have ECT.
My poor husband has been copping heaps from me. I feel so down, tired and grumpy, especially in the mornings. He is learning not to talk to me for a while!! I hate being like this. I hate feeling grumpy as well as the depression. It is hard to ensure no one else suffers because of my depression. I wonder if others feel this way when the medication for depression is not working. I doubt I’m alone in this.
My symptoms of dizziness, blurred vision, stomach cramps etc are, apparently, being caused by taking Solian. I’m told they are common side-effects due to the rapid increase in dosage. Today I have to have an ECG (yet another one) to see if this increase is affecting the QTC interval in my heart as many meds have done this in the past. The QTC interval is to do with electrical impulses in the heart.
I am in such a black hole that I feel I will never get out of it. Maybe the psych at the hospital was right — “just learn to live with it”. I’m at the stage where I feel like quitting all meds and therapy because nothing is working. My motivation to do anything in daily life is non-existant.
I can’t share how I’m feeling with those around me. Hearing that I have no motivation and that I want to quit is not what others want to hear. I can understand why they feel this way. Being around a depressed person is not a lot of fun.