Where the dogs of society howl

Lots going on.  Mainly feeling lost.  I’m still on FMLA per my psychiatrist.  I’ve been off all this month and won’t be going back until next month.  I’m having a hard time keeping my medications down and we’re not sure why.  My moods are cycling rapidly and I’m thinking it’s because they aren’t being absorbed properly since the surgery.  I’m worried about having all this time off, how it’s going to affect my job.  It gets more interesting: I have an interview for another job next week.

I reached out to a friend of mine regarding a possible job opportunity in a private practice setting.  I was doing some research and found that working midnights with bipolar disorder is a no-no.  Apparently most people working midnights – mainly those in the healthcare field like nurses – with bipolar disorder have circadian rhythm issues, leading to shift-work disorder (which I’ve been diagnosed with).  This triggers mania and many times, hospitalization.  Sound like anyone we know?!  

So I got freaked, reached out to a friend and asked if she knew of any job opportunities.  She reached out to her boss who reviewed my resume and offered me an interview.  I miss doing therapy.  I remember my old supervisor said to me ages ago while I was in training after graduate school and doing therapy in an underprivilaged area with substance abuse clients.  I was burning out hard, between the clients and the administration I couldn’t seem to meet anyone’s expectations of me and wanted to quit doing therapy altogether.  I told him that I wanted to work in a hospital doing intake assessments and case management to take a break.  I said that it would be “one and done” – I’d never see the people again after they left; no need to build rapport and no need to terminate; they couldn’t accuse me of abandoning them if I’ve known them for 20 minutes.  He told me that I was an excellent therapist and working in a hospital setting was “a waste of my talent.”

He burned out too and moved out of state.

I didn’t listen and got a job doing assessments.  The population I work with tend to abuse the system.  I often see the same faces – sometimes 3 times a week.  I’ve had some people discharge because they tell me they are not suicidal, turn around in the parking lot and walk directly back into the hospital stating they are suicidal and homicidal and want 3 sandwiches.  The record turnaround is 7 minutes – I actually counted.  It is rare that I assess someone that actually needs help.  I got into this profession to help people.  Will I have better luck doing so in private practice?  I think so.  I think I will because people are paying to be there.  Sounds messed up, but it’s true.  This is your “managed” care/health system at work, USA.  I have “managed” in quotes because there is nothing manageable about it and you, my dear reader, know it.  I’d be ignoring the system by leaving, but I’m not single-handedly going to overhaul the health care and mental health system – I know that.  Contrary to popular belief by many recent graduates in my field, you cannot change the world.  You can only make a dent.

Here’s where my trepidation lies.  I would have to file quarterly and withhold my own taxes.  What a pain in the ass.  I’d also have to go on the exchange for health insurance.  God please no.  Right now every doctor I work with is in network because they all work for my employer LOL.  If I go on the exchange, there’s no guarantee they take that insurance and I’d have to pay astronomical premiums.  It would take several weeks to build a caseload and get paneled with insurance companies, which means I would not be paid by the patients or insurances for those weeks.  Weeks.  Flipping WEEKS, man.  I’m torn.  Do I liquidate my house fund to pay my bills while I’m not paid for those few weeks – if I’m even offered the job?  Do I leave my awesome co-workers because I hate the population I work with?  The population, the crushing rules of administration and low wages are what keep me from wanting to stay are my job.  I know once I get a full caseload as a private practitioner I could rake in double what I’m making now, but I’m afraid.

I’m terrified.  What if I’m not good enough?  What if I fall on my face?  What if I messed up my taxes?  What if my clients don’t like me and I end up without anyone and I’m broke?  My psychiatrist told me it takes a while to build a caseload too.  How do I work both jobs to cover my butt?  Work midnights and days?  I freaking can’t.

And Mom’s going into surgery.  They said it’s going to last 8 hours and due to the definite blood loss, she had to sign a waiver permitting them to give her a blood transfusion.  So I’ve been scared about that.  Lately her voice has been irritating me for some reason and I’ve been blocking out most of what she says, but I think it’s me being irritable because of my mood cycling.  I apologized to her if I had been short or curt with her and explained I had been tuning her out.  I told her I’m scared shitless about her surgery next week.  I wish she didn’t need it.  She’s going to lose 20% functionality of her back in all directions.  She seems excited she’ll never have to load the dishwasher again.  Lucky.  Not the way I would want to avoid that chore, but still lucky.  I’m just scared – I keep telling myself not to tune her out.  Not to put this bed vibe out there in the Universe, but if her being annoying is the last thing you ever hear her say, hear it anyway.  I try to remember that and listen to her give me instructions about how to feed her fakakta fish.

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I’m meaner than my demons/I’m bigger than these bones

It’s been such a long while since I’ve written in here.  I don’t know if it’s avoidance or forgetfulness at this point.  What I do know is that I’ve backslid and I’m slithering around on my belly like a tongueless snake.

I had the surgery and I’ve lost about 50 pounds.  I honestly think, for once, I’m returning to my baseline physical self.  I never saw myself as this fat, huge overweight thing. Body dysmorphia is quite common for people after the surgery; my mother struggles with it daily.  I wasn’t always fat – I was a skinny kid.  I see myself losing weight and – don’t tell anyone – but I feel fucking awesome.  I think I look fucking hot.  Aside from the loose skin I’ve acquired, I feel my confidence going up.  People at work keep commenting on how great I look, and while I don’t particularly enjoy that, I do like the looks I give myself.  Pretty narcissistic sounding, huh?  It’s not like that, though.  I used to look at myself and glare.  I’d give myself a once-over in the mirror, gazing at each body part with hatred and disgust.  Each body part was subject to ridicule and hazing by me, every day.  There were some days I couldn’t bear to look at myself at all.  I’m fucking done with that.  I look at myself – loose skin and all – and see someone who struggled with a lot of shit, but won’t give up.  I see a woman who is not just a fighter, but gorgeous inside and out.  Not just because she has a sexy husband that wants to fuck her every minute of every day (God he’s seriously relentless), but because she believes it now.  She doesn’t need his validation or anyone else’s.  Who knew it would only take a $40,000 surgery to get to this point?  Oy vey.

So I just got out of the psych ward.  Ha!  Didn’t see that coming, did you?  Alice: always full of surprises.  It had been over a decade since I last graced their halls with my presence.  The staff remembered me.  I’m still trying to decide if that’s good or bad.  My schedule affected my medication schedule and then I stopped taking it all together.  Then I slipped into a manic phase.  I told my family that I wasn’t taking that “poison” anymore, I was “normal” without it.  I was also unable to concentrate on anything, I was the best at everything ever in life, I was getting 4 hours of sleep at night, and couldn’t sit still worth a damn.

Then I fell.  Hard.

I couldn’t get out of bed.  I wouldn’t shower for days.  I would cry at nothing.  Or something, anything.  I’d get frustrated at little things.  I just couldn’t function worth shit.  So I called my psychiatrist.  He told me he was having me admitted to the psych ward.  I was there for a week.  He put me on FMLA and here I sit, at home, taking my meds… ish.

I told him I’m fucking trained.  I know better than to not take them.  I know that the incidence of bipolar patients not taking their meds is higher than any other mental illness because we think we’re getting better, stop taking them and fall on our faces.  I said I know the stats, I’ve read the studies, I know this shit and did it anyway.

He said, “That’s how you know it’s the disease, Alice.  Not you.”

Being in the psych ward as a mental health professional was a nightmare.  You think they treat you any better?  Nope.  Still just a fucking nut in a ward full o’ nuts.  I didn’t expect to be treated better than anyone else but I think I’ve become more aware of the stigma than I had in years past. I never remember the staff being so dismissive and cold. Even the social workers, who claim to help even the playing field between the professionals and the patients were at times condescending and patronizing.  I reminded them that we shared the same credentials, same degree and performed the same functions in our profession as a way of humanizing myself however I doubt it did much good as I was still cast aside when asking for simple things like respect.  During a group session, one social worker stated part of their job is to educate the other staff members, including the doctors, about mental health.  I actually fell out laughing.  I said that, as noble as that may be, the worst stigma against mental illness I have ever seen has been in the medical community.  I explained that I am terrified my co-workers will find out that I am in the psych ward, as I was in my own employer’s medical system and in our computer system it will show that I was there.  I further explained that none of the doctors I work with have any interest or desire to work with psych patients; they actually express disdain for the entire population.   The nurses at my hospital are mostly impatient and rude when treating a psych patient and want nothing more than for my department to hurry up and get them out of the hospital.  I have social workers who actually said to me they hate working with “bipolars” because they are constantly going off their meds and have wild mood swings.  So, excuse my skepticism when discussing “educating” the medical staff – I’m sure it’s going well.

The nurses and nurse’s aides were a fucking nightmare.  It didn’t help that they’d rather surf Facebook and Instagram than do their fucking jobs. Aside for a select few, they treated me like I didn’t know my own body.  And, not to sound like a dick, but like they knew more about psych than I did.  As someone who’s been on both sides – a patient and a professional – I can safely say that’s bullshit.  And as an employee at that hospital I knew corporate policy, so they couldn’t fuck me around when it came to that either.  Plus, this isn’t my first rodeo.  I’ve been hospitalized about 7 times.  Go fuck yourself; I know how this goes.  I wasn’t in the mood to be fucked with.  Not to mention the fact that my psychiatrist is on staff and we’ve been working together for over a decade.  I know that he always has my best interests at heart and will go to bat for me (and did) when I need him to.

So.  You’re caught up.  Time for my meds.

Release me from this curse I’m in

My meds are off. Like off

I’m laughing.
Crying.

At the same time.

Thinking about the election.
Thinking about work.
Thinking about nothing.
Thinking about suicide.
Thinking about my dog’s exercise plan.
And back to suicide.
And now on to my DVRed episodes of People’s Court.
I’m hungry.
Did you hear that?
I fucking heard something.
It’s dark over there, I’m not going over there. Fuck that. This house is full of stuff I don’t want to see at night. 

Why can’t I fucking sit still?  I want to throw myself against a wall. Maybe I’ll slow down. 

Nothing’s right. Nothing’s right. It’s all wrong. It’s all wrong. Everything is all wrong. I don’t understand why everything isn’t right. 

‘Cause life is just a dream here

I saw my doctor this week. I told them the SSRI they prescribed isn’t doing squat – I’m still depressed and picking.

Doc said that picking is near impossible to cure, so not to focus on that more than the depression. So I guess I’m back to nail polish and hand lotions to prevent cuticles and seeing my nails in the first place. Great.

I mentioned that I’ve been getting angry and irritable more often – Doc reminded me that that’s indicative of either mania or depression, in this case Doc believes it to be depression. Doc has me back on anti-anxiety meds to prevent me from stressing out, causing the anger and irritability, Doc also suggested I go back to therapy.

I told Doc about my drinking more often. Doc wasn’t pleased; they told me not to mix my meds and they’d rather see me take meds than drink at all. I don’t know how I feel about that – it’s really about which is the lesser of two evils, but I do see the point. I’m going to try and increase my usage of coping skills to prevent the use of either.

I spoke with my mother yesterday to inform her of the doctor’s appointment. She said she hasn’t seen me manic in a while – she didn’t understand what I meant when I ran away during dinner earlier this week in tears, ashamed of my behavior. My mother, who’s known me longer than I have, and also suffers from the same illness (technically untreated, however is medication resistant), said “that wasn’t you being manic and I’ve seen you manic. That was you being happy for once.” I froze.

I haven’t been “happy” in months. I forgot what it looked and felt like. Holy shit. It took someone else to point it out; I’m so out of touch with myself – I think that may be on purpose.

I want to scream at the top of my lungs; maybe I’ll wake myself up.

Stille Nächte

Since I was a kid, I’ve hated the holidays. I have no idea why, really. I remember Thanksgiving as a real clusterfuck of a holiday. Food was great, but the family structure was not what my mother (and in turn, I) had signed up for.

I don’t remember a Thanksgiving dinner with my father. My parents were married for 12 years – I don’t remember him being there for ONE. Hmm.

My grandparents were always there with us – Grandpa watching his westerns or “war pictures” and Grandma helping my mother cook and clean. I stayed in my room, watching Nick At Nite marathons, complaining that Christmahanukwanzaa was around the corner and we’d have to put on the “happy holiday family” façade again. Yay.

And we did, this time my father would make an appearance on Christmas Day. He’d always play with my newly unwrapped presents before I’d been given a chance to, adding a layer of sourness to my morning.

“I’ll be done in a minute, Alice!”

When that minute was up, my father would leave. It would be weeks before we’d see him again. My mother and I would get dressed and go to my grandparents house, where Santa had also made a visit; I now believe this extra Santa’s visit was to ease the blow of the real missing piece from my holiday celebrations.

I’d get everything and more than I asked for; I would leave my toys and clothes under the tree, lock myself in my room, and watch Nick At Nite until dinnertime. My depression and sadness raged on, not soothed by Santa’s elves.

Now that I’m married, I’m not able to disappear into the mists of Nickelodeon’s nighttime programming during holidays. My in-laws come over and I find myself still wanting to crawl into a ball in my bed and hide until dinner and disappear when it’s over. My grandparents are no longer here, making me wish I’d stayed out of my room as a child and enjoyed their company while they were alive. G-d, I miss them so very much. (Notice my regret to have spent more time with my grandparents is not akin to spending more time with my in-laws. Nope nope nope.)

So what are my plans today? Stay in my room for as long as I can get away with it at my age and knit. Or sleep. Do my laundry. Meditate. Pray. Anything but prepare food and socialize. I’ve found that I don’t talk much unless I’m manic or at work.

I hope I didn’t scare you

I see you’ve met her. She was here only a minute ago per my husband.

Yelling at the television. Yelling at him; yelling at Mom. Laughing, yelling “nonsense.”

You see, if she took the time – if I took the time to explain why she I was yelling in the first place, maybe this wouldn’t be a problem.

I still feel like my emotions aren’t regulated. Since I’ve stopped hurting myself, I still find it hard to express my feelings aloud. When I do, I still don’t feel like I’ve done them justice – like there’s more in there.

All I want to do is crawl into a ball until New Year.

what’s done in the dark

I’m cycling pretty hard and fast these past few days.

Yesterday morning, I found my sense of humor was on point; it became finer as the hours passed. By the time I came home from work, I was a hot poker. I was performing in my own Mystery Science Theater episode: everyone was the subject of my criticism and sardonic sense of humor.

Watching movies with my husband and mother was fun… for me. My cackling between the repetition of each punchline made me cringe inside; I couldn’t reel myself in. I finally blurted, “I’m hypomanic, sorry guys. Maybe I should’ve taken my Lithium this week. Oops.” Then I cackled even louder.

I don’t think my husband has ever cut his eyes at me the way he did last night. It was only for a second; I don’t think he even knew he did it.

This morning was a different story. I rolled over onto the chilly, yet sharp spikes with which I’d whipped everybody yesterday. I vacillated between irritated yet frank, depressed yet demure. My husband actually chose to work today. It’s fucking Saturday.

I better be right by Monday.