9 Months On Medication

It’s been a while since I checked in regarding my treatment for my mental health! The last post was in September after my dose increased.

It’s been 9 months now. Time for an update.

This last week, I requested a different formulation of the medication. Instead of the slow release, I wanted the instant release. Because the medication also works as a sedative, I take it before bed and it helps me sleep, among other things. I wanted to get a more “set” bedtime, since I can go between 2 and 4 hours after taking my medication before I pass out.

I’ve also gotten back on birth control. After a few months on the higher dose, my periods got very, very heavy and uncomfortable. My PMS also worsened. I have a blood test on April 3 to see how my levels are. There may be a chance I’m anemic or close to it, so my doctor and I are going to check that just in case I need to start taking supplements.

I’ll also be following up with counselling, since I haven’t started that and I’ve been on the waitlist for 8 months.

The antipsychotics are great. I really do like them. They don’t make my life perfect, and my moods aren’t always balanced at a nice in-between. But I feel more able to work through my highs and lows in a much more accessible and healthy way now.

The downside, and part of why I wanted to switch from slow release to instant release? My eating habits have been affected. I have EDNOS (Eating Disorder Not Otherwise Specified) and after taking my medication each day, I found myself getting into a “munchie” state of mind—one very similar to when I indulge in some marijuana or liquor, neither of which I use regularly. (This weekend, I’m actually 3 months’ sober from alcohol and 17 months’ sober from marijuana!)

On account of the binge eating, and the holiday bulge because of Christmas and New Year’s, I’ve gained some weight. I’m trying not to let it get me down. I know bodies fluctuate and I know that my healthier lifestyle choices will make an impact on my body. I didn’t exercise much through the winter—my bedroom wasn’t set up to let me comfortably do home workouts, and I like to jog outside, but the weather was always too cold or icy for me to safely go running.

Now that spring is around the corner and the snow is melting, and now that I’ve finally, after almost a year, set up my bedroom to let me do all my different activities, I’ll be exercising more regularly. And hopefully the instant release medication will help me get better control and awareness on my eating during the day, as opposed to mindless and drowsy bingeing at night.

The last 9 months haven’t been the greatest in terms of life events or reaching my goals, but the medication has helped a lot.

Therapy Diary: 10 Weeks On Medication

I started medication on June 29, so it’s been exactly 10 weeks on these antipsychotics. It’s been incredibly good. I’ve felt like I can complete goals now, without something blocking my brain or telling me I should feel worthless or like I should give up all the time. The first 6-7 weeks were probably the best, but it’s not like recently has been bad!

Today I saw my doctor about adjusting the medication, and at the end of September I’m doubling my current dose (which is really low) to one that’s a more common amount for treatment.

I’ve felt more stable the past few months than I have in years. I’m sleeping more, my brain isn’t on overdrive half the time, I don’t feel useless the other half of the time. I’m really pleased with how I’ve been progressing—to the point I think I’m better and don’t need the medication. But that’s the medication talking. I feel more normal because of it.

I’m not entirely better—I had a… crisis, I guess, on August 30 that really shook me up because I hadn’t felt like that in months. Then I remembered that the way I felt that afternoon was the way I felt weekly, on average, and I can’t fathom how I survived through it that frequently. And I can understand why something like my crisis is serious and should be taken seriously—like it should have been every other time it happened when I was unmedicated and not in counselling.

These 10 weeks have been great. I’m looking forward to the next few months, how I progress, and all that stuff. I can safely say that getting medication, even without a formal psychiatrist’s diagnosis, has helped me.

Basically, it’s been 10 weeks on medication for bipolar and my doctor said I looked happier, my brother and dad say I’ve been more consistent, and my goal completion is a testament to my emotions.

Therapy Diary: Week 1 On Medication

Blue and white paint splattered and dripping down a black wall.

At the end of June, I saw my doctor to get referrals and support systems underway for my mental health. I haven’t seen a professional for my mental health since April 2016, and my mood and motivation were all over the place. I know that I need additional help, so seeing my doctor to get a referral to counselling or psychiatric treatment was necessary.

So, I have the counselling scheduled! Sort of. They need to do an intake appointment, which is on July 31 (far away, I know, but it’s pretty speedy for where I live), and that isn’t even like… the start of counselling. My doctor started getting referrals processed for me to see a psychiatrist for a formal diagnosis of my situation, and gave me a prescription for a low dose of medication to help me out. It has a sedative property to it, which is partly why this specific drug was prescribed: I have awful sleep problems.

It’s been 1 week since I’ve been on the meds and… I’ll be honest, I’m not sure if they’re doing much. I’ve kept a journal to record when I finish eating for the day, when I take the pill, when I feel sleepy, and when I fall asleep. I’ve discovered that the sedation effect comes into play when I take the pill on an empty stomach, or 60 – 90 minutes after eating my last meal. I’m still not getting a balanced amount of sleep—it ranges from 5 hours to 12 hours—but it’s still only the first week.

I’ll admit, I like having the routine of taking a pill at the same time every day. That’s something I liked when I had the birth control pill. Having the routine of taking my medicine, then brushing my teeth and washing my face, helps set me up for bed rather than waiting until it’s bedtime to do those things.

My period started the second day of the medication, and with how my hormones affect me, I’m unsure what’s from the medication and what’s from hormones. I normally have a very good day when my period starts (which is really weird, I know; I’m all happy-go-lucky, then oops, menses!) and am either dissociated or lethargic during my period. I have been a bit lethargic some days—as in, I’ve been sleeping more—so it probably was a combination of the medication and hormones.

Since I’m on literally the lowest dose possible of this medication, there’s also the possibility that it’s not doing anything or I’m not feeling it. I definitely felt it the first day I took it, but it’s hard to know if it’s doing anything if I’m not also experiencing side effects.

There are a lot of side effects, as there are with… anything.

One of the less common ones is experiencing symptoms of infection, such as fever, sore throat, coughing, and I started experiencing that on the 3rd. However, my brother was sick, so I could actually be sick (again!)—in any case, it’s basically gone today.

I’m hopeful that medication will help me, though, even if this one doesn’t. I’d prefer if it did, since I wouldn’t have to switch and try new ones. But I know one of the other side effects is weight gain, and I don’t know what I’ll do if that happens to me. I’ve been trying to lose weight for 4 years. I was weighed when I saw my doctor, and I was back at my highest fucking weight again. Granted, I don’t think I’m carrying as much fat as I was 4 years ago—but I’m still unhappy with my body, and how it looks and feels. I’ve managed some workouts this first week (cardio, strength training), but it’s hard to exercise when the temperature is high. I’m susceptible to heat exhaustion and need to be careful doing any exertion in the summer.

Anyway! This first week has been… okay, I guess? It’s still really early on, and I need to be aware of patterns moreso than immediate changes. I’ve also been reading a lot of forums where people talk about their experiences on this medication, and it feels like I’m in the minority. I don’t feel like a zombie, I don’t have a lot of side effects, and my mood seems fine. But I go through periods of “fine” moods, and then experience highs and lows (AKA bipolar, which is what my doctor and I suspect)—which is why I saw my doctor. I need more balance in my life, and all the yoga, jogging, meditating, journalling, and healthy eating isn’t doing enough. There’s something wrong with my brain, and the medication is for my sick head.

My PTSD

I first started seeking help for my mental health in 2011 when I said to my parents, “I think I have depression.” My father then revealed to me that he has depression (something he has been successfully managing since 2013!) and mental illness is frequent in our family.

A year ago, in February of 2016, I saw my third therapist: a trauma counsellor with a focus on spirituality, psychosomatic medicine, and cognitive behaviour therapy. She was a fantastic fit. I can’t stress enough how therapy is most successful if you have a therapist who actually helps you.

I had seen two other therapists who specialised in treating depression, and though I could have gone on antidepressants (I fully support them!), I didn’t feel right. I didn’t feel like I was being treated the way I should have. I didn’t feel like depression was the end of my mental health struggles. I felt like there was more that I needed to figure out.

During the standard first meeting with my most recent therapist, she instructed me to get comfortable. In retrospect, when she saw me assume the Lotus Position in my socked feet, she knew exactly how to approach my treatment. I remember having doubts about how successful our work would be, and she challenged that. While sitting on the couch, I told her in detail about my life and the experiences that mattered to me. She told me I have posttraumatic stress disorder (PTSD) and that it might be complex posttraumatic stress disorder (C-PTSD). She told me how a traumatic life, specifically childhood, can lead to PTSD in adulthood.

Everything clicked for me. It made sense: I wasn’t just depressed. I was traumatised over decades. I developed PTSD.

Often, I feel like saying I have PTSD is a sham. I’m not a military vet, I didn’t grow up in a war-torn country, and I haven’t experienced sexual assault. There are so many “poster child” representations of PTSD that feel more valid to me than my own—hence why complex-posttraumatic stress disorder (C-PTSD) has been proposed. I grew up and experienced more frequent trauma, on average, than people my age.

But I still have PTSD. I say PTSD for simplicity’s sake, though it’s really C-PTSD. I haven’t found much difference between the two for me personally, but I know others have a different experience with PTSD and C-PTSD.

So that’s why I’m writing this post: to share my experiences with my mental illness.

My PTSD and experience with it mean that I am…

  • prone to violent anger.
  • prone to psychotic episodes, where I can’t discern reality from imagination, dreams, hallucinations, or delusions.
  • unable to regulate emotions, particularly strong emotions.
  • afraid of developing dependency on substances like alcohol and strong painkillers.
  • terrible at sleeping normally.
  • terrible at remembering things without having a record of them.
  • dissociating frequently from my body, to the point where I can wake up, go through an entire day, and not remember what happened by the time I’m in bed again.
  • triggered when events, sounds, and images are similar to the traumas I’ve experienced.
  • unpredictable and a lot to handle emotionally and mentally, especially for myself.
  • comorbidly suffering from depression and anxiety.
  • struggling with grief.
  • suicidal and ideating suicide more often than not.
  • controlling, with very specific preferences.

Like all mental disorders and illnesses, it’s impossible for me to separate myself from mine. I have PTSD, and I expect the rest of my life will be a journey of coping, surviving, and managing my mental illness. I have lots of resources and good methods for working through it, but I’m always struggling.

Therapy Diary: Mindfulness

Blue and white paint splattered and dripping down a black wall.

When I was in therapy last year, my counsellor told me that the goal for our sessions would be creating mindfulness. There were a number of ways we worked through being aware of my body and my emotions. Because my PTSD is very dissociative, it means there’s a mind-emotion-body disconnect. I often feel “outside” of myself in varying ways. Sometimes I am a floating balloon being held by my body. Sometimes I am a suitcase being dragged. Dissociation is a beast in itself and I wrote a short blog post on it a few months ago. This post acts as a bit of a follow-up.

Along with the exercises we did, such as identifying where an emotion existed in the body and describing it (anger being in my throat, or despair being in my belly—that kind of thing), I use or have used these tools to become more aware and mindful of my entire existence:

  • journalling
  • yoga
  • meditation
  • tarot reading

I don’t journal as much as I used to while I was in therapy. I think this is because I’ve gotten better at being mindful/aware/in-tune/etc. Journalling was a very explicit way of creating awareness of my emotions and my body, and the relationship between the two.

These days, I lean toward yoga, meditation, and tarot reading. The yoga helps with my mind-body connection, with a focus on my body and how it connects within itself. The meditation points me toward the relationship between my mind and body while emphasising my emotions, feelings, and thoughts.

Tarot reading is a new one, though. I grasp onto symbols and metaphors, and that’s all tarot is. I don’t use a classic tarot deck, with Major Arcana and whatnot. Instead, I use regular 52-card playing cards with numbers and suits. There’s an additional layer of abstraction with these cards. The symbols and metaphors come from interpretation of the numbers and the suits. Instead of seeing a moon or a sun, I have to consider my own intuition and understanding for the numbers and suits.

When it comes to the tarot reading, I do a combination of reading cards for in-depth interpretation of a single card, or I do a self-reading with a 3- or 4-card spread. Some spreads require a question to answer, and others are assessment or guidance spreads. I don’t read the cards for prophecy or fortune-telling. I read them so there’s somewhere I can project my worries, concerns, desires, and intuitions.

On the whole, creating mindfulness has been the key to lessening my dissociative states—whether by frequency or intensity. I have been plagued by a constant disconnect between my mind and body because connecting the two was dangerous during my traumatic childhood. There’s been a lot of learning, trial and error, and patience involved. I have to constantly work in order to hinder the PTSD from dictating my life, but I’m finding ways that let me progress.

Therapy Diary: Dissociation

Blue and white paint splattered and dripping down a black wall.

My dissociation manifests in a few different ways and feelings, and I can compare it with a bunch of metaphors. But it all boils down to a single feeling—of rather, lack of feeling.

My dissociation means I’m not part of reality. I’m not fully in the world I’m interacting in. My body is doing one thing, but my consciousness is distanced.

Sometimes my dissociation is heavy and sometimes it’s light. I’ve described it as half of my existence floating behind me like a helium balloon; or half of my existence being dragged like a suitcase with a broken wheel.

You’d think that being dissociated is easy to notice. But I only notice the way it feels—the heaviness or lightness or distance or closeness—once I know I’m dissociated.

So the disconnect is something that shows up as irritation or lethargy. It’s only after a bit of wondering, “Why am I reacting like this?” that it dawns on me: “Oh… I’m not all here.”

And then what? What do I do once I realise my consciousness isn’t within me?

I try meditating for a few minutes. I try doing a vinyasa or two. I try lighting a scented candle. I try taking a warm shower or a cold shower. I try reading a book. I try playing a video game.

But none of those are fool-proof, sure-fire ways to reassociate with the world. They’re only baby steps.

It’s almost impossible to eliminate the dissociation the day it happens, or even the day after. Sometimes it lasts for a few days. I’ll power through it, but there are days I just can’t. I need to sleep and let myself succumb to another reality (the surreal of dreams).

My therapist told me that it takes time to feel safe enough to “come back” after being dissociated. So I don’t push progress or obligation on it.

Therapy Diary: Day 7

Blue and white paint splattered and dripping down a black wall.

My first short-term therapy session was on January 15 and the last was on March 18. It’s been two months since I last saw my counsellor and I can definitively say that even this short amount of counselling was helpful.

What’s Changed?

I’m doing more yoga and I’ve been approaching it differently than I did last year. There’s something more to it now. Before, it was focus on shape and form and getting a pose correct. Now, I focus on how it feels: how I can feel my strength or my weakness; my inhales and exhales. In particular, I can feel a connection between all of my body parts. Yoga has been one of the best practises I could have chosen, since it drastically lowers my dissociation—though I still struggle with it.

I’m also more aware of what sets me off/what triggers me. In particular, what triggers my anger and my panic attacks. I can’t even describe how this has helped me be able to even deal with life. From talking to people to running errands to sitting alone, I’m aware of my emotions and understand how to express or disperse them.

What’s The Same?

My depression is still fairly the same. I’m not that happy and barely anything gives me joy. But I’m trying not to dwell on that, on how I should be, or how I want to be. I know my friends have noticed it, and I’m trying not to talk about it because it’s a cyclical conversation. I’ll start talking about being depressed and it increases. This isn’t something I’ve learned to resource/cope with/deal with/etc. Pick a synonym.

I’m also still struggling with my dissociation. It isn’t as intense as it was in January, but it’s still around. I feel like the film on top of a stew left to cool on the stove. Like, I’m still part of the stew—or my Self—but it isn’t the same. I can’t simply stir the film back into the stew to have a whole stew—a whole Self.

What Next?

I’m going to be completely honest here: I don’t know.

I do not know what to do next.

I know I still have a lot of work ahead of me, but I’m not ready to take on more. I’m just going to continue doing what I’m doing and hope that, little by little, something else will change. I guess there won’t be anything new to do: simply practising what I’ve learned in the hopes it’ll become habit or second-nature instead of a conscious effort.

Therapy Diary Day 7

Therapy Diary: Day 6

Blue and white paint splattered and dripping down a black wall.

Pre-Session

I woke up at 6:45am because someone was being loud outside the house, on the street level below my window. I take too long to get back to sleep, but I wake up to my alarm and snooze it—not because I want to keep sleeping, but because I want to do some light yoga to help get my body awake. And not as stiff.

My morning prep is routine and a bit of a blur. I make a cup of coffee—instant, hazelnut flavour. Measured meticulously so I don’t fuck it up and make it overly sweet or bitter or watery or milky. It’s divine. Cheerios for breakfast, along with a banana.

I’ll do the dishes when I’m back. I’ll probably be five minutes late for my 11:00am appointment, but that’s okay. Better late than never.

Session

I feel like I’m relaying everything I’ve learned. I still haven’t mentioned to her the various hallucinations that have started cropping back up. I’m not ready. But she remarks on the differences I’ve told her, and encourages me. She gives me some more advice, as she normally does, and all I can think about is my pride.

I say, “I don’t know,” a lot, and don’t feel bad about it.

We talk about the past, the future, and my memory. I get more advice on a technique to deal with my childhood trauma—and the things that trigger it—in order to help with my thought process. That kinda cognitive behavioural stuff, y’know.

I’ve been being kinder to myself and it shows. My dissociation is still strong, but I said it was more like I was attached to my body as a balloon on a string, instead of my body dragging along a suitcase. She enjoys my analogies. She’s big on them.

Since I’ve been doing yoga daily this week, I think I’ve been more mindful and present in my body. Starting off, she said we would be working on mindfulness. At first, I thought it was that mumbo-jumbo about “being present” and “being here” and “being aware” that doesn’t have a specific recipient. Present where? Where is “here”? What am I aware of?

But that was the point. I’ve learned how to be more all-encompassingly mindful. I’m more aware of others and I’m more aware of myself. I’m not so much in a fog as I once was.

I talk about my former room mate (who she later said was “Satan room mate” and I laughed), my boyfriend, and my bunny. I know that having my rabbit with me has helped me put to practice what I’ve been taught.

Everything goes back to the same system of roots. The same seedling that grew into a tree, strengthened by the many events and situations that developed its foundation and how deep it planted itself. I’m encouraged to sow new seeds and nurture them.

I haven’t made as much progress on my psychosomatic connection, but that’s okay. There’s no rush to an “end” since this is all stuff I need to continually practice and refine. The sparkly feeling in my shoulders is back. I’m more aware of where my emotions sit in my body—the physical reaction to my feelings, to put it simply. I just don’t know what to do with it.

This session progresses really quickly.

Post-Session

I have another cup of coffee because holy crap this instant coffee tastes so good. I’m less disoriented today than from previous sessions. We didn’t reschedule immediately, so I’ll have to make an appointment at a later date. I’m not sure when I’ll schedule it for, but I don’t want to simply not reschedule.

This has been too helpful to neglect. I don’t think I’ll “regress” or anything like that. I’ve learned too much and grown and changed so much that doing so—going back to how I was—would be literally impossible.

The rest of my day is incredibly productive. Work work and school work get done. I even make some progress on taxes.

Starting this therapy was an act of self-love.

Therapy Diary: Day 6

Therapy Diary: Day 5

Blue and white paint splattered and dripping down a black wall.

Pre-Session

I’ve had a gruelling morning. My co-worker and I were attempting to make some changes on our employer’s website—something that should be easy for me—but ran into obstacle after obstacle after obstacle. All I’m gonna say: if you hire a third party to register and set up your website, make sure you save the credentials for logins to your registrar and host. Fuck. We had hoped to relax after an assumed quick fix by watching a movie, but didn’t have time to do so.

I’ve been plagued by migraines all week, but today has been alright. Some slight discomfort, but nothing as terrible as Monday or Tuesday. Last night I didn’t sleep very well, unfortunately. The initial stages of falling asleep seem to be the most difficult for me, all the getting comfortable and feeling restful. On top of that, my sleep was broken up a bunch.

Initially, my session was scheduled for last Friday, but the headcold I had came first and I prioritised sleep above therapy. It was a good decision. The offices then bumped my appointment up an hour—a small scheduling error on their part—and I’m glad for that. Means there’s less time for me to build up any nervousness.

Today, I plan on telling my therapist that I’m not sure where to go from here. That I feel like I’m talking in circles. A few of the exercises she gave me have helped immensely, so I want to get more of those. They’re concrete. I can work with them more easily than with abstract thought mechanisms.

In my class yesterday, my professor gave me the best definition of Freud’s id, ego, and super ego theories. I think I’m going to mention it to my therapist. I think my super ego is overdeveloped, in a sense, and has suffocated both my id and ego. Like an iceberg turned upside down.

I’ve also been dwelling in a lot of dissatisfaction and discouragement. And I want to mention how terrible I am with setting goals and my whole attitude toward them in general.

We’ll see what happens. I have about an hour to kill until I need to go to the building. I chose the 3pm slot instead of the 2pm slot, since I figured I wouldn’t face the dilemma of “Do I knock on the door? Should I wait elsewhere?” if the 2pm slot remains free—which it might not.

Maybe I should do some yoga. Or take a shower. I definitely need to eat lunch. I’m still nervous, but this time because I’m not sure where or how to continue. But I know that the best method to resolve this is not to just stop going—it’s to mention it to my therapist. The key is communication, after all.

I’ve been craving junk food all week. Maybe I’ll get something tonight. But maybe I won’t.

Session

I arrive a little late and the door is propped open. A gentle knock. The standard routine—she signs me in and I remove my coat and boots. Lotus position.

Head nodding. Some resources to reference back to. I feel very good about myself.

I’m understanding more this time around. My nerves have dissipated. I don’t think I’m ready yet to dive into one of the techniques she’s had me go through each session, but it’s in my mind and I’m aware of it. That’s already a step in the direction of utilising it. It’s like a habit I have to pick up.

A good analogy. Praise. A sparkly movement in my shoulders.

She sits beside me to explain the resources and it’s the closest we’ve ever been to each other. Her winged eyeliner is on fleek omg. All of our interactions have been in this dim room, her a few feet away in one chair or the other. I’ll re-type these sheets when I have some spare time this weekend. One of them looks especially helpful, but I want to change the format. I’ll give the current column set-up a try, since there’s no harm in trying it that way. But I get the feeling a mind-map layout would work better for me.

Nebulous thoughts.

She moves my awareness elsewhere and it confuses me. I realise how comfortably out of my body I’ve been this week. My emotional reactions have been stunted somatically. I think that’s the next journey to take.

2 weeks until the next one. I think the time to process and experiment and put in effort by myself will help me.

Post-Session

I think I’ll treat myself to some greasy, carb-filled food today—simply because I want to and don’t feel bad about wanting it. Maybe a buffalo chicken poutine from a small restaurant around the corner.

Since I didn’t cry this time, and I don’t feel shaken up or moved around, I can dive right into some schoolwork I have.

Progress. Onward.

Therapy Diary Day 5

Therapy Diary: Day 4

Blue and white paint splattered and dripping down a black wall.

Pre-Session

I woke up late. I had a meeting with my employer and co-workers beforehand. My appointment is earlier in the day, which is alright. I don’t have a chance to feel anxious for the session. But I also don’t have much time to get ready for it, either. I eat breakfast and shower late, and then arrive 5 minutes after my appointment is supposed to start. At least this time around, the door is open and I don’t feel awkward approaching it.

Session

I have trouble focusing and being present. Some of what I say feels like verbatim repetition of earlier sessions, but again: patterns. The time flies by quickly, despite the long bouts of silence from me. In a way, my counsellor helps guide me through a meditative exercise. I tell her often that it is difficult, and that having difficulties learning something new makes me feel frustrated. My crying this session is less violent. Just tears and a head-filled sadness and emotional release.

I talk about my body image issues and receive tools for combating my hyper-critical thoughts and judgements about myself. She emphasises balance over removal of the thoughts.

A bridge analogy. Fluidity between extremes. A flow and an ebb between deep sea and shallow shore, rather than a metronome tick between left and right. I think of the moon and its cycles from full visibility to full shadow. Something in me feels peace, but I don’t know where and have trouble accessing it.

Post-Session

I feel like I learned the most in this session. It will be three weeks until I’m in here again, the dimmed light and green walls making me feel almost safe. Instead of leaving and feeling a little disoriented, unsure, and emotionally shuffled, I have taken away knowledge. I am more aware of how to be mindful.

I return to my journal, left closed after the page from the first session. I want to make lists and find the thoughts I need to balance out the ones I currently have. There is effort needed. Pure effort. A desire to make a change. Learning how to try has been one of the hardest lessons for me to start, let alone master.

I can think of a future.

I am motivated to look forward to something.

This is definitely progress.

The fourth session in my therapy experience.