later that saem evening...

Deep breath.

So hard to problem-solve when I'm like this. How in the fuck is it that I can't easily lay my hands on my brothers' phone numbers? Fucktard. It's one thing to live physically distant. When did I allow our "connection" to lapse? Scratch that. We were never that close and I'm not the only guilty party here. Argh. None of this matters. Gotta find a phone number, call Marilyn. She'll tell me more than Mike or Scott anyway, little gossip-queen that she is. I think I'm perturbed that she didn't think I would care to know that Daddy is working. I'll think she'll tell me if he's doing okay, though. Plus there's mutual mother-snarking to look forward to. Maybe I have the number on my cell.


Is this helpful? Shit. Can't hurt.

fuck fuck fuck

Got an email from my mom yesterday, one of those "just checking to see if you're still alive" emails because I'd neglected my duty to call for too long. Emailed back, promised to call. Forgot.

Called tonight. Very little recrimination, which was nice. But then she tells me Daddy got a job at the new SuperfuckingWalmart in town. Full time. Graveyard shift. Doing "maintenance." He's 73 fucking years old! What the fuck? It's unreal. She acknowledged that the extra money is nice. Now there's a guilt trip. But the issue is bigger than guilt over their finances. I don't want my Daddy to work. I want him to rest. And play. And live. The cancer thing scared the crap out of me. He's older now. He's acknowledged he's weaker. WHY are they doing this? What can we do?

Gotta call brothers, find out how much of a toll it's taking on him. Jesus, I don't even know if I have their phone numbers. This makes me want to run home and take care of my dad.

I wonder if she nags him when dozes off in his chair, the way she did ALL MY FUCKING LIFE until he retired?

There's gotta be something we can do. Mike and Scott and I. If we all chipped in, maybe Daddy would quit. Hell, I don't even know what their financial situation is.

I'll never forgive her if he keels over in the SuperFuckingWalmart.

Please, please don't let that happen. He's a good man. He deserves so much more than this. Goddamnit, it hurts.

Family

... can be a bitch. Or sometimes a bastard fucktard.

Ya'll be strong. You're good people. :)

~w

of image

I guess it's all about perspective: How I see myself, how others view me, and how I would like to be perceived.

If I can't define how I would like others to see me, what hope is there of being comfortable with myself? Why is it I can readily tick off the pieces of me that I dislike, but the list of "likes" is so much shorter, and so reluctantly given?

I am who I am, and I am extremely fortunate. Intellectually, I know this. I will challenge myself to appreciate who I am and what I have, to define the gifts, to articulate the blessings, and to verbally acknowledge my appreciation.

Oh good God, I'm trying to be positive and instead I sound like a fucking self-help book. The blessings? What a crock of crap. I'll settle for doing something nice for ksm and telling her just how much I love her.

Somewhere here, I managed to detour off topic. Stream of consciousness and all that crap. But maybe there is a thread. There is no way to please everyone else - that's a premise born to fail and basically an all-around asinine concept. While I cannot "be" what others expect, however, I can demand certain standards of myself. Now the challenge, should I choose to accept this mission, will be not to set the bar so fucking high. I am so skilled at setting myself up for failure. And so quick to recognize when I fail myself. And even quicker at projecting the knowledge of failure onto those around me.

Yay, I've clearly delineated a habitual thought process that requires modification. When does all of this wonderful aesthetic knowledge lead to change?

Maelstrom

That's the word I couldn't retrieve last night. Maelstrom. I guess I got sidetracked on the wind analogy. My thoughts were a maelstrom. Prolly not going to find that in a song lyric, now am I?

Matters not; the thoughts are back in order this evening.

I'm going to go cuddle with my girl.

One Last Thing

You're very much on my mind tonight (and yes, my mind is settling down a little bit - Xanax is my friend.) Thank you for today.

It's good to know you're there. Someday, if we should meet, I owe you a really big bear hug.

not hyperactive

So, this is the third post I've started tonight. Manic, indeed. Scattered. All over the place. Gonna focus on that.

ADHD. Ugh. Actually, in my case my therapist always omits the "H" - it's just ADD. I wonder if she'd still say that if she could see how my mind is racing tonight?

Cy (my therapist) made a couple of interesting points in her suggestion that I discuss this as a potential dx with my psychiatrist. First, she considered my inability to complete projects at work, along with inability to prioritize and inability to "pull the trigger" and get started. Then there was my hearing. In general, I hear very well in isolated situations. Hearing tests, for example. I have no problem hearing the upper register, and very little difficulty hearing the lower register. Unfortunately, life does't work like a hearing booth. My problem is a complete inability to filter background noises. Vacuum cleaners, air conditions, radios, other conversations... any noise likes that makes it an incredible struggle to follow a conversation. It's particularly noticeable if the person speaking has a lower voice - like Greg, or ksm's dad. Whatever they're saying just becomes a rumble. And sometimes, I'd rather let it go than have to say, "Repeat that please" one more time.


I associate my issues at work with hating my job, feeling like I can't get anything done because I'm compensating for so many others around me, and my damned internal need to "look" good. Can't be seen doing something I should've done months ago. God, no. God forbid I be seen for the fuck up I am.

As far as my hearing is concerned, well, I think some of it is genetic. My daddy has very poor hearing. Granted, his hearing was further compromised by years of working around heavy machinery, but I think the basic concept of background interference is true for him too.

Despite these rationales, I was excited when Cy started talking about ADHD. I was thrilled with the possibility that some pill would magically relieve me of these particular challenges. I took the medication gladly and was perhaps initially too optimistic as to its efficacy. Now, I don't know. I've backed off from 125mg to 50mg (just went from 75 to 50 today.) I have no idea what's doing what. Goddamnit, I wish I could evaluate myself more objectively.

Fodder for next week's therapy, perhaps?

warp speed

Overall, it's been a good day. Fairly productive at work, excellent conversation with a new friend *wink*, and a playful evening with ksm. My supervisor's idiosyncracies were tolerable. Interactions weren't tainted with those little blips of impatience and/or irritability that sometimes rear their ugly heads, nor was I a lump mindlessly clicking my way through the blogosphere. What I am feeling at the moment, however, is manic. Way too keyed up. And that precipitates the mental debate: Which is worse, the mania or the medication? Logically, I know I'm placing too much significance on this. Those little .25mg tabs are hardly the gateway to addiction. And yet... I have a somewhat addictive personality. I've proven it by abusing alcohol and Ritalin in the past. And there were those times when I self-treated with St. John's Wort. And all the instances when I know I've had too much caffeine, too much alcohol, too much sinus medication, etc., but fail to stop. Stop. God, I'm babbling. This is what it's like when my brain is on overdrive. Again with the logic. If I had a headache right now, I'd take a fucking aspirin. Instead, I have a head-warp right now. Ergo, take a Xanax. It's not rocket science. Don't be a lump now! Go take a pill.

Now, what is the source? Cy's on vacation. No better time to need a therapist than when she's unavailable. Anxious about NYC this weekend? Anxious that new friendship may have negative impact on other party? Rapacious need for attention? That brief interaction with my mother earlier (I'm never good enough in her eyes. Or at least, that's how I always perceive it.) My mind is just awhirl right now. Not making a lot of sense. Must maintain facade of control. (Must look up how to make little French thingy on the "c" in facade! I wonder if ksm knows what it's called.) Jesus, I just had to change that "sense" sentence because I typed "since." Not good. But still editing. Even if the sentences aren't sentences. (Mental giggle: imagining all the green underlining that would show if I were typing in Word: "fragment, consider revising.") Right about now I'm wishing I hadn't taken so long to mentally debate whether to take that pill or not.

I was trying to think of a song that would relate to my mental whirlwind right now. The first thing that came to mind was Free-falling by Tom Petty, but that doesn't quite cut it. I need to find a song about a storm. A wind storm. A zephyr of incredible intensity. Shit, I'm still babbling. Enough.

I'm Curious

Do you know?
Do you suspect?

I think you do.

I've been trying to compose a letter to explain, to clarify, to apologize... to connect.

Yeah, I'm talking to you.

Sustenance

Had a truly productive day. Worked hard. Worked long. Didn't eat a damned thing until dinner. Wtf? Usually if I don't eat by 1 or so, it becomes obvious. While neither diabetic nor hypoglaucemic, I do have blood sugar issues. Typically it takes the form of irritability, followed by a headache. But not so today. Curious. It wasn't even a conscious choice. I just figured I'd eat when I got hungry, and never really got hungry.

I commented on it while eating dinner and the immediate response was, "That is ODD." As in, "You know that's atypical and you better not even think about skipping meals."

I won't. I do know better. But it is curious.

Dinner was excellent.

Expense

Why does mental health have to be so damned expensive?

The prescriptions are one thing. Seems most of my meds fall in the most expensive tier of my suckass insurance. And of course there aren't any generic equivalents available, either. But I have to see the shrink for the scripts. And I have to see my therapist - preferably weekly. All those copays surely do add up.

The insult to injury here is that my insurance through my job just changed and my docs aren't part of the provider network. Well, not at the nice cheapo HMO rates I was accustomed to paying, anyway. Oh, no. Instead, I'm now paying out the ass for the PPO so that "80% of the approved charge" will be covered. Guess that's what I get for bitching about copays.

But I couldn't really give the alternative much consideration. Yeah, I could probably have replaced my shrink - I mean, I don't feel a rapport is required in order to obtain a prescription. But my therapist? There was just no way I wanted to "start over" with someone new. Way too much ground has been covered. My therapist may be an ADD-addled flake, but she's my ADD-addled flake - and I'm keepin' her.

Assigning Fault

I just solicited an opinion on something I do, then felt hurt when the response was not as glowing as I expected. Did I set myself up? Whether I did or not, I recognize (I think) that the error is mine. (I'm always being told it's not a matter of wrong or right, that there doesn't have to be a guilty party. In this area, it doesn't even seem to be a learned, conditioned behavior. Instead, it feels as though it has always been... it just is.)

***
At this moment, I'm obsessing over a brief interaction earlier this evening.

That's the thing about writing. Writing is far and away my preferred mode of communication. I adore the fact that I can edit endlessly if I feel the need to, and the recipient will only see the polished result. Sometimes I forget myself though, and let the errors through. Everyone makes typos. WHY do I feel that a recipient of an error-bearing missive will JUDGE me? (Thanks, Mom?)

Anyway, the thing about writing is that once presented, whether electronically or on good old-fashioned paper, it can't (usually) be retracted. It's out there. For the recipient to see. And JUDGE.

(Ugly thought - what if I'm projecting because I judge others???)

I get so scared that the facade will slip in front of those I know and love, that they'll see me fuck up and then no longer like me. Self-obsession is ugly. In more ways than one.

So is starting with one topic and ending with another. But I think I can forgive myself for that. Free association and all that jazz.

So I'm a little OCD. Oh, not technically. No diagnosis, I mean. Maybe "anal" is a better word? Well, maybe not. Anal covers little things like having the embroidered stripe on the washclothes all facing the same way or being hyper-aware that the little digital compass in my car is a shade off of True North. Obsessive means spending hours doing things that most would not find productive. Blogging, for example. But hey, I have an excuse - this is my forum for getting what's in my head out. And it's a journal of sorts. It's like, therapeutic! Hmm, maybe I need to improve on the rationalization skills.

like buttah

Kinda had a meltdown tonight. Didn't get any sleep last night, long day at work, fucking tired when I got home. Guess I was shorter than usual. Made a sharp comment that led to hurt feelings, painful discussion, and me crying. Part of me recognizes that the tiredness directly correlates to the tears. My emotions are most raw when when tired. But the other part of me is scared that it means the depression is not being controlled.

Talk to therapist about this:
When party A says something unintentionally hurtful, and party B reacts to it and then A and B try to discuss it... how is A not supposed to feel criticized when B is explaining feelings?

7-4-06b

Afterthought - could it be that anxiety is my biggest issue now, and that the depression is under control?

Maybe now I can go to sleep.

7-4-06

Scale of 1 to 10, I'm about a 7. Not too bad, eh?

Guess what? No new meds to introduce tonight. Xanax, Cymbalta, Strattera. That's it. You'd think that would be enough, wouldn't you?

"Psychotropics". Why does that word intimidate me?

Hmm. Now I'm feeling more like a 6.

Must be time to go to sleep. ;p

Of Tweaking

These days I'm taking Cymbalta for the depression. Talked it over with my shrink, told him I was tired of the libido issues with the SSRIs. He picked Cymbalta, a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). Verdict's not in yet on how well it works, but I'm not liking the libido hit with it either. It's been about two months on a 90mg dose. That's another thing. If one is a bit obsessive and looks up Cymbalta.com, one will see that in clinical trials, "There is no evidence that doses greater than 60mg/day confer any additional benefit". So why did he work me all the way up to 90mg?

My therapist, who frequently talks about her own ADHD diagnosis and is a bit flakey, also talked my shrink and I into an ADD diagnosis for me. Introduction: Strattera. Went as high as 125mg, told the shrink I felt like a lump of inaction, now down to 75mg. Still a bit "lumpy". Thing is, how am I supposed to know what my body is reacting to when all my meds are constantly being adjusted?

Maybe

Today... was a better day. Or maybe the reality was that the last few days have been "worse" days. I was pmsing so maybe the chemicals were more imbalanced than the other days of the month. Maybe. I don't know.

Maybe it doesn't matter. I had a good day. 'Nuff said.

Doubt

Is this "public" forum really helpful? Is it good to put my fucked-up thoughts to text? Or am I simply increasing the instances of "living in my head"?

I find I feel doubtful at this moment. Anonymity was the idea. Coupled with expressiveness. And journaling my fucked-up thoughts. But right now I'm not so sure it's a good idea. Seems it's sort of releasing the beast. Why should I give my brain more liberty to dwell (for lack of a better word) on everything it's not doing right?

Have I mentioned how much I hate over-analyzing everything I feel and think and do? And how fucking scared I am that I will destroy what would otherwise be a pretty damned nice life?

Maybe I should make a deal with myself: I'll post something positive next time around. Nah, that probably won't work. I'm really skilled at not keeping promises to myself.

Jeez, how's that for a positive thought?

Of Personal Integrity

Why is it that, day after day, I make contracts with myself and then routinely break them?

Whether something as simple as "I will go to bed by xx," or "I will make that phone call," or "I will..." hell, fill in the blanks. Whatever it is, I say "Today's the day" and then don't follow through. Sure, sometimes other issues take precedence - particularly at work. Priorities and such. But, Jesus, why the fuck do I routinely lie to myself? Why can I not just pull the trigger and take action?

All that my inaction does is create more anxiety. Is it really just the fear of being "found out" that I'm such a fuckup? Is it some overblown fear of failure? Am I really so self-destructive? I'm constantly waiting for "the other shoe to drop." Anticipating it. Losing sleep over it. Taking Xanax for it. Why doesn't my crystal-clear ability to recognize this lead to some sort of change?

To do lists don't work. Asking for increased accountability has not worked. And besides, I get SO damned irritated about that. Why do I need someone else to make me accountable? Where is my own personal integrity? Where is the woman that does what needs to be doing without waiting until it's a crisis? God, I miss her.

And why is it, when I know not one single person reads this, that I'm SO bothered by changing tenses in the middle of the previous paragraph? God, I'm neurotic. The weight, the burden, of others' supposed opinions of me is obviously contributing to my inability to "do" things. Did I say obviously? Again, since I recognize it, WHY can't I DO anything about it? "Adjustment disorder," my ass. That just sounds so damned simple. What I need is some way to get outside of my head!

I've told my shrink and my therapist that I am SO SICK of feeling like this. My therapist had an interesting response: It's the healthiest people that seek help. Hmm. In my immediate family, it might actually be true that I'm the healthiest one. But, when one looks at the general population, I hope to hell I'm not indicative of the "healthier" populace.

It's a truly scary thought. But of course, I won't "do" anything about that either.

of depression, therapy, and insight

I see a psychiatrist for medication management and a therapist (Ph.D.) for psyche management.

I've been on anti-depressants for years. It's a fairly straightforward diagnosis: major depressive disorder, chronic. "Chronic" meaning everytime I ever try to stop taking meds, I crash. No initiative, no affect except irritability and crying, and feeling quite content to do nothing but lay in bed and read all day. For the most part, I feel apathetic. And like a failure. Hence the tears.

Every once in a while (couple of years, maybe) my meds have to be tweaked. Seems whichever SSRI I'm on just isn't as effective anymore. In the past, I had obtained my meds from my general practitioner. I explained to her that it was a maintenance med, gave her the litany of what I've had and what works, and she wrote me a prescription. Good girl. 'Bout a year ago, when it seemed the trazodone wasn't working anymore, she changed me to Wellbutrin. When I told her I didn't think the dose was high enough, she obligingly wrote a new scrip. And when I decided I was ready to quit smoking, I went to her again because Wellbutrin = Zyban. She agreed to go up on the dose again in order to help curtail the nicotine cravings. It worked, I did quit smoking.

Thing is, for the next many, many months, I was an irritable bitch. God, that's such an understatement. I was awful. Irritable. Impatient. Snappy. Quick to find fault and quick to feel that I was being criticized. I saw the negative in everything. I didn't want to do anything. I don't know how people put up with me. I was aware of it, sometimes, but powerless to stop it. I didn't feel depressed per se - no thoughts of driving over a cliff or anything. But just so damned bitchy - all the time.

After a particularly ugly argument at home one night, I made an appointment with my GP. Obviously it was med-tweaking time again. So, I went to see her. This time, however, she didn't complacently write me a new scrip. Instead, she said she did not feel comfortable managing my depression any longer and referred me to a psychiatrist.

Whoa, Nelly. Stop the boat. A shrink? Don't get me wrong here, I don't have any particular biases against psychiatrists. But it was a hassle. And an expense. And it meant that nothing would be changing quickly. "Four to six weeks for therapeutic level" is bad enough without having to wait a month or so just to get the prescription. And it was at least a month. First couple of people I called off of my insurance plan never bothered to call back. Of course, eventually one did and I made an appointment.

I went in, explained my history and current behaviors. His first real question after my lengthy recitation was, "And have you never heard that irritability is an extremely common side effect of Wellbutrin when taken at high dosages?"

I was floored. Usually I educate myself on whatever med I'm taking, but I'd certainly missed that little tidbit re: Wellbutrin. Oh, for the record - the dosage in question was 450mg daily - the extended release type. Needless to say, he started bringing me down from the Wellbutrin immediately. To compensate for the chemical inbalance in my fucked up brain, he started me on Celexa. When that didn't work (um, hello, libido? Anyone?) we changed to Zoloft. Still not so nice to the libido, but better than that damned Celexa. The irritability dropped off almost immediately. I became a much less horrible person with whom to spend time.

Whew. End of story, right? Selph got her meds tweaked and it was all good. Or not.

See, my shrink said something else that really threw me for a loop. Some asinine bs about how the ultimate goal of "treatment" would be to address the "underlying issues" via therapy so that medication could be discontinued.

Did I say I was floored before? This time I damned near had a panic attack. I immediately told him that me without drugs = bad. I told him I had tried several times over the years to discontinue whichever drug I was on, and I always got depressed again. Still, he was persistent. He acknowledged that "a small percentage" of people really do seem to need maintenance medications for life, but he really believed I needed to address whatever my "issues" were.

So I made an appointment with a therapist. And I have to admit, I'm a convert. I'm still absolutely terrified of not being on an antidepressant, but my sessions with my therapist have been extremely revealing. Turns out, I'm a neurotic mess. I care so fucking much about what other people think of me. And I'm so inclined to assume they think the worst. I've spent most of my life "anticipating" others' thoughts and reactions to me, always with a negative context. And my mind is a mess of contradictory desires. I HATE to be the center of attention, yet I crave positive reinforcement. I do want attention, but not "spotlight" attention. I guess it's attention on my terms. I feel like I'm always striving to please or impress, and always failing. Failing others, failing myself. I'm so damned self-critical. I always feel like others are judging me, and I come up short. And it was such a habit, such a familiar state, that I didn't even realize it until I started seeing a therapist. God, it seems so narcissistic. Why the fuck do I think other people think about me at all? But I do. And the frustrating thing is, so far, awareness has not led to change.