Hard today

It's a holiday and I'm at loose ends. I can do anything I want to do -- I've given myself permission to do what I want. But I don't want to do anything. I want to go to bed, but can't do that all day. Don't seem to have the patience to read or watch TV, can't muster the energy to go to the movies.

It's a luxury I don't always have -- time to do what I want to do and the means to do it. I wish I could appreciate it more.

What are you doing?

Are you depressed, too? Suffer from borderline personality disorder?

How are you working to make yourself feel better?

What kinds of strategies work? What doesn't work?

I need all the help I can get!

Somehow they know

We were at the elementary school, an open house night where parents were invited to come to the classrooms. My kids were so excited to show me their desks and art work and teachers. Their dad showed up, too, and I was so torn between wanting to be joyful to see him and being heartbroken that he was there.

I opted for somewhere in the middle, a little neutrality, though inside my heart was churning and my head was spinning and I was so sad.

As it was time to go, he hugged the kids -- and I could have had a hug too if I'd asked but I didn't want to ask though god knows I wanted a hug, oh how I wanted a hug. He told them he'd see them soon and didn't say anything to me and my eyes betrayed me and started watering. I turned and started walking away and then my daughter came around me and peered right in my eyes. Seconds later, my son did the same thing. By then I had squeezed the tears from my eyes and turned to them smiling.

But they knew -- they always know -- that my heart is still broken.

Getting moving

I'm still concentrating on simply moving forward in the world. No, not moving forward, simply moving. Not standing still. Not vegetating.

I am loathe to admit it but it seems to be true: If I will simply do something, I feel better. I should be happy to admit it, happy to know it. But the truth is that depression is insidious in that way. It sucks the desire out of me, it sucks the marrow out of life. It leaves me an empty shell that doesn't want to do anything but sit and stare.

There is something in me that makes this impossible. If I simply sit and stare, I gradually grow more and more anxious, like I should be doing something, anything. So I run through the list of things I could be doing, ticking each off like beads on a rosary. But nothing seems to spark me, nothing sounds fabulous, nothing sounds the least bit fun.

So in the past few days, I have forced myself to do something anyway. Something. Go to the coffee shop. Walk the dog. Read my email. Write a post in this blog. It doesn't matter that it's a small accomplishment, having a shower every day is at least better than not having one. Putting my contact lenses in is a sign I want to be alive instead of in the hazy, fuzzy world of myopia. Buying a book and reading a few pages every hour or so is better than not reading it.

So I will keep moving. Forward, laterally, zig zag. Just keep moving.

Slogging along

The theory here is that by doing something -- again, anything -- I can make myself feel better. The chemical explanation is that when I do something and am successful at it (even getting up and showered and dressed), my brain rewards me with a wash of dopamine. Dopamine is the natural "feel good" chemical that our brains long for.

By hanging out in bed, by being afraid and nervous and edgy, I am denying myself the natural good feelings from dopamine. By going for a walk or reading the newspaper (or posting in my blog), my body should recognize that I've accomplished something and be happy about that.

The hard part is that the microscopic bits of dopamine generated by each individual act aren't enough themselves to get me past whatever this is that has me frozen in time. I am anxious and have a sick feeling that I'm failing at something, even when I'm not. I'm trying to ignore it and slog past. I went out yesterday evening and did manage to stay "in the world" for five or six hours without melting down or giving in to the overwhelming feeling that I needed to go home, I needed to go to bed.

It was late when I got home, and my dog was happy to see me. She was also antsy and had been cooped up most of the day so I did something highly unusual and went for a walk with her. Not a long walk -- I couldn't force myself into that -- but for 10 to 15 minutes. She was so delighted her tail wagged right up to her head. I was happy to make her happy.

I hope my brain earned a little dopamine for that.

Just do it

Just do it. That's the solution my therapist has come up with for me. Continue with life, act as if it is OK, and hopefully it will be.

Don't stay in bed. Do something. Do anything.

Tonight I'm going to go out and work on a hobby I like. I am not supposed to leave for over an hour and I've been dreading it -- seriously dreading it -- all day. I don't know how I'll get through an evening of "fun" without being exhausted. I feel like I could go to bed now -- before 5 p.m. -- and sleep through until morning. In fact, I know I could. But instead I'll be out in the world. Sweating every second of it, but being there.

Wish me luck.

No help, no hope?

I can't seem to get out of this feeling that I'm slogging through life. I can't force myself to do anything, even things I theoretically love to do. It feels like I'm underwater most of the time and I don't know what to do.

I don't know where to turn for help -- I'm seeing a psychiatrist about medication, but it seems this is a long, slow process that doesn't have any real relief. I'm struggling most with the depression, not borderline personality disorder, but the anxiety overlay of all of this makes it really hard on a day to day basis. I'm on disability leave from work but don't think I have the wherewithal to go back, to do a good job, to even want to work at all. I have to work, of course, and am suffering financially from being off. I just don't know how to be better. I desperately want to feel better, but every single thing I do is a struggle -- every task is like a mountain I need to climb and the thought of it is just exhausting. Even the thought of getting through a day.

My Head Exploded

So I've been up and down -- roller coaster city -- for the past month. Not sure if I'm much better. I have been suffering major depression for so damn long -- I wish there was something that could instantly fix it.

Here are the highlights of the past few weeks.


Saw my psychiatrist on 3/2. I had run out of some of my meds and had tapered off taking them. (For the interested, they were Topomax, Lamictal, Trazadone and Adderall --yeah, I was taking them all for this bone crushing chronic depression I have suffered for SO LONG. I figured it out and I've been on an SSRI since Granger was 2 -- so nearly 15 years ...) I was still taking Cymbalta (too) but had tapered it down because I was running out. I was still also taking Wellbutrin every day.

I stopped taking them because I ran out and didn't make/take time to go get an appointment. But nothing had really been working to stop my depression anyway so I was not feeling much different when I was down to 1/2 dose of Cymbalta + regular dose of Wellbutrin.

He said this was a golden opportunity to try a relatively new drug, Emsam. It is an MAO inhibitor (a type of anti depressant used for a very long time). It isn't used much because dietary restrictions go with it -- nothing aged (cheese, wine, salami, etc.) and many overthecounter drugs interact with it badly. But Emsam had a new transdermal delivery system and so it doesn't come with the dietary restrictions (but is still sensitive with OTC drugs).

I went on Emsam and off everything else cold turkey. WHAT A MISTAKE. By 3/8 I was a gigantic puddle of slobber on the floor. Couldn't stop crying couldn't stop SCREAMING at my kids, couldn't concentrate at work ... cried cried cried. The best therapist in the world (he IS) told me to go back to the psychiatrist so I saw him again that night and he said it was just the withdrawal effects and give it another week. The next day it was so much worse that I went to the psychiatrist again and insisted on getting off the Emsam and back on the other stuff. He convinced me not to, and added Xanax (sweet xanax) to help me sleep/reduce anxiety.

I worked that Friday, then slept until 9 a.m. Monday (sweet xanax). (That's an exaggeration but not much -- I slept as much as possible because I couldn't bear to be awake). However, Saturday night I had a GIGANTIC fight with my kids' dad and got into a conversation with my therapist by phone from 10 p.m. to 2 a.m. (Told you he was the best therapist in the world.) He convinced me to go home finally and sleep. I did. Sunday I slept and on Monday I called in sick to work.

By Sunday late afternoon I knew the jig was up and I went to the ER. They admitted me with blood pressure 194/125 (OH MY GOD!) and blood sugar near 800 (Double OH MY GOD but I hadn't taken any insulin since Friday because I was sleeping, not eating ...).

I was there hoping to get relief from the withdrawal, but they treated the BP and diabetes aggressively as if the was my main complaint. I was in the ER from 9 p.m. to 6 a.m. and then around 10 a.m. this resident (I swear she was14 years old) came in to see how I was. I was no better -- hadn't even had a xanax by then for so long! She said they were going to put me back on the Emsam and keep the xanax going. Something in me snapped and I was pissed -- I said "I didn't need to come HERE to do that, why don't you re-examine the whole case and see what is really best in the big picture vs. the immediate situation." I didn't say it that nicely.

She said she'd take it back to 'the team' and talk about it. She then asked if I wanted to hurt myself (I didn't). Then she asked if I wanted to hurt anyone else. And I said "Only you. I want you to go put your highly educated brain to work and figure out how to help me. And give me something to sleep."

She said they were going to "hold off" on any medication, and then I stupidly said "Well that's stupid and it makes me want to hurt someone -- you. If you don't get out of here now I'll kick your ass." And then I decided I'd leave because at least my own psychiatrist would give me sleeping pills!!!!!!

She was back in 10 minutes with a form that put me on involuntary admission for 72 hours and I was PROMPTLY escorted to the locked ward. There are crazy people in there. OH MY GOD. The 72 hours passed v.e.r.y. s.l.o.w.l.y . and with no decision by 'the team' on what to do. First they decided on more MAO, but then changed t heir mind because they didn't think I'd comply with the dietary restrictions because of my track record with diabetes and failure to monitor the diet (true enough, but really -- I don't like gefeltefish and tofu and fava beans and rotted meat -- that was ACTUALLY on the restricted list -- so didn't think that would have been a big deal)

By the time my hold wore off I was better in general and was taking Abilify, an antianxiety drug (comfortingly called an "antipsychotic" though they assure me I am not psychotic ... who knows). It has made me somewhat manic and at the time in the hospital I couldn't sleep.

Did I mention the toothache? A back molar had an abscess, so they put me on antibiotics and said I couldn't go to the dentist because, well, I was locked up. I made a huge stink on Thursday about it and a dentist came to examine me that night said "I need to see her in my office tomorrow to drain that abscess." Friday? No appointment. A merry mixup I guess, no one coordinated a visit, guards to escort me, etc. I literally asked about it ever 15 minutes and kept track of what they said (Mostly "we're checking on it.")

That meant no appt Friday, and of course not Saturday and Sunday. When the 72 hour hold was up I was still SO PISSED about it all and then my tooth was KILLING ME. So guess what? A new hold! 14 days this time.

I asked for a hearing (my right) and contacted an attorney. The hearing was at 3 p.m. on Monday but at 11 a.m. they said t hey thought it was safe for me to go home. No new anti-depressants, I should see my psychiatrist. OH MY GOD. What I spent in the hospital for a week could have taken me to Hawaii for a week or two ... that may have been better in the long run. Who knows.

Oh, unless I want to do electroshock therapy. They offered to keep me and do that ... sheesh. No thanks, thanks very much but no thanks. I was in the hospital a total of 7 days.

Out on Monday, to the dentist immediately, he extracted the tooth (now I need a $2500 implant ...) and I instantly felt much better. Had to go buy a refrigerator since mine had been out for two weeks by then, so Granger and I went to the Great Mall and did that and I got home around 9 p.m. EXHAUSTED but had only xanax to sleep. Bad night.

Tuesday I was up at FIVE A.M. and cleaning out my kitchen s helves (the last thing I need to do -- the pile on the table is six feet high and I decide to clean INSIDE the cupboards?). Got it started, then took the kids to school, then to the coffee shop to check email. I cannot sit still, so decide to blow off the Abilify. My blood sugar and blood pressure are under control now that I am checking both and taking Lisinopril (however you spell it) for my BP. I hate being old.

Saw my psychiatrist Tuesday and he was happy to prescribe Ambien (sweet Ambien). He is a drug pusher. Really. Anyway, at least I can sleep. Still so jumpy when I saw my therapist on Wednesday he insisted I go BACK and ask for something to counter the effects of the Abilify or go off the Abilify. SO back to the psych and yeah, sure, there's a good drug (Cogentin?) that counters Abilify's manic side effects. So nice of him to offer it 24 hours earlier, eh?)

It's been no better from the jumpiness/can't sit still perspective since then, not sure what to do .... I have been up and down 15 times since starting this email. Today we had T-ball opening ceremonies, was there from 10 a.m. to 1:30, then my kiddo's sixth bday party from 2-4. What a day. Slept a little when I got home but just can't seem to get the napping science back down -- I used to be a champion napper. Can't say I feel BETTER or less depressed but at least I am functioning somewhat.

Did I mention I'm coach of the T-ball team? At a parent meeting Tuesday they said we can't have a team unless we have a coach. No one raised their hand so I stupidly did. I bought a book "How to Coach T-Ball," so we'll see how that goes. The first practice was good, I was up most of last night making the team flag for today's opening day and we had opening day activities in the hot hot sun today.

I've decided to take a month's leave of absence at work. I will get 66% of my salary, not bad and I think it will be OK. I need to get my chemicals in balance. I am so not optimistic about this, but have two new mantras: One moment at a time -- I can always count to five to get through something, even if I count my breath to five five million times.

And "One thing at a time." I can't drive and talk on the cell phone and drink a diet coke and supervise kids. I can't do this email plus a bath for Walter plus making zucchini bread and trying to do 1,000,000 loads of laundry. One thing at a time. Right?

*See the sculpture's page. Isn't it great?

Hello, EmSam

I've been depressed as long as I can remember. It's not just like "Oh this is so depressing" kind of depressed. It's the insidious kind, the kind that steals moments of my life and never gives them back. It's the kind that makes me want to close my eyes and sleep, all the time. The kind that makes it hard to give a damn about anything.

They call it "major depression," and in my case it's chronic -- which means it is there, always. My particular type is treatment resistant, which means that even if I'm lucky enough to find a drug or combination of drugs that help me for a time, they eventually poop out.

I visualize it as a cloudy figure, surrounding me with silvery fog. It's deceptively soothing, but really is much more like numbing. I care about things and people, but not about life. I'd rather just have a nap, thanks.

I don't realize how depressed I am until I get a flash of it lifting, when I see a color I haven't seen in a while or have an inspiration to actually pursue a hobby again. I take it as a good sign when I wander around inside a craft store, for example, and imagine all the things I'd like to make. If only. If only I had the energy, or the desire for more than a flash or two.

I have tried all the SSRIs, one by one, for the past 15 years. It started with Prozac, which was described after an especially acute episode of public rage. I was scared into taking a drug I knew would alter my brain chemistry in the bizarre and somewhat frightening ways that anti depressants do.

I've been on a rollercoaster ride of various drugs since then -- when a new SSRI comes out I was switched from Prozac to Paxil to Effexor to Zoloft to Cymbalta. Probably a few others in there, too. I tried Wellbutrin and had one notably frightening experience with lithium.

Nothing lifts my moods. I am somewhat resigned to living a life that is not worth living (considering the alternative is too costly). I have researched vagal nerve stimulation and transcranial magnets. I read Kitty Dukakis' book about electric shock therapy and have seriously considered it. Am seriously considering it. Would do it if given the chance without the red tape involved.

Instead, today, I'm on Emasam. It's a new antidepressant, named for the daughter Emily and son Sam of a marketing person somewhere. Well, hello there.

Some people out there say it works wonders. Others aren't so sure.

Right now I'm in the second category. I'm experiencing withdrawal from the Cymbalta and Wellbutrin (yeah, was taking both) and am off sleeping pills and anti-anxiety drugs as well. From being on all of it a few weeks ago to being on only this.

This morning I thought it was going to be the end of me. I was so light headed, so frightened, so frazzled. It's minuscule improvement in the past few hours, but probably because I succumbed to taking a Cymbalta I found rolling around in the bottom of my purse. I felt like someone had given me a gift or a sign so I popped it and I think that's relieving some of the pain of the withdrawal. Or I'm imagining it. Or something.

Anyone else taking Emsam? How does it work for you?