‘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.


I don’t like labels. I’m constantly telling my patients that it’s not about their diagnosis, it’s about their recovery, yet I find myself trying to label myself all the time.

Labels serve a purpose. As humans, we tend to categorize the things around us to help in our understanding of the world and its processes. If I described something as “that living thing that hides in a tree,” you may not know to what I’m referring unless I provide a category – Animal? Plant?

The intended purpose of a diagnosis is to help clinicians identify a grouping of symptoms. Labels get dangerous when people misuse, overuse, or make assumptions regarding a diagnosis.

You see misuse all the time. “I’m so bipolar today!”

Shut the fuck up; no you aren’t. You’re moody and perpetuating the stigma of mental illness. Honestly if one could be bipolar for only 24 hours…

Overuse is just as bad. “I have bipolar manic depression.”

…No you don’t. Manic depression, as a classification, no longer exists. The correct term is “bipolar disorder.” The danger of over-using these terms is the stigma that follows along with it. Why are we over diagnosing ourselves? Isn’t being on the multi-axial system ENOUGH?! /rantoff

The reason for all of this is a recent quest I went on. You see, I’ve been studying the new DSM-5 (I’m a tad nerdy) and stumbled across something called “excoriation disorder.” Now, under DSM-IV-TR, excoriation seems to be a symptom of OCD: dermatillomania.

Why is any of this important? Because I’ve been doing this for years and didn’t know it was a fucking disorder. I didn’t think it was a problem.

Granted, my mother thought it was disgusting that I’d “picked at my nails” so much that I’d permanently damaged my nail beds, causing my nails to grow short, brittle, and very misshapen. I just thought it was a bad habit to pull my cuticles until they bleed (and sometimes after they do). I thought it was just anxiety for me to take sharp objects (safety pins, push pins) and use them to pull the nail away from the nail bed.

It’s just something I’ve done for a while. It just got worse when I started working full time.

So I spoke to my psychiatrist about my symptoms; I tried not diagnosing myself, but I know me and I know the DSM. My doctor gave me some meds for impulse control/OCD.

I painted my nails tonight; maybe if I don’t see the beds, I won’t pick at them so much.

Sometimes it’s nice to put a name to the bully that’s been shoving your face in the dirt for 20 years. Knowing your bully’s name is only a part of it – you need to know how to fight them; that comes through education, support, and inner strength.

point of balance

I’ve been trying to avoid this blog for quite sometime.  Forced introspection is not something I’ve been looking forward to.  Recently, I’ve spent days wading through streams of countertransference and I’d like for that to stop.  The idea of therapy is just that – an idea – it passes as soon as I think of going back.  I miss my old therapist, but my insurance won’t take them and their office is almost 20 miles from work.  Other therapists just didn’t seem to “get it” – or better yet, me.

My disease has taken an interesting turn.  My psychiatrist took me off my Lithium a few months back, only for me to have a meltdown 3 days later.  I called in the morning, that evening I was back on it.  Now, the doctor told me to take it in the morning – for years I’d been taking everything at night.

This makes a big difference.

You see, I’m not your average woman.  I don’t take long morning showers, followed by makeup and hair time, followed by picking out the right outfit for the day… My mornings are never that drawn out or glamorous.  I get up, usually 15 minutes late – after hitting snooze twice – and jump into the shower.  I spend a maximum of 8 minutes in the shower.  Eight minutes.  I put on socks of even length (Note: I did not say color, pattern, or style; I didn’t say they matched my outfit as they are the first thing I put on) and clothes that aren’t completely wrinkled and hopefully match when I turn on the lights (yes, they’re clean).  I brush my teeth for 2 minutes, hair for 3, no makeup, grab something from the kitchen that can be eaten while driving and I’m out the door.

…Didn’t see any Lithium in there, did ya?  Neither did I.

I told my psychiatrist – who was thrilled (remember, they wanted me off the stuff anyway).  But I was pissed at myself, pissed for my lack of “medication compliance.”  I expected better of myself than to be “too busy” to take the medication I credit as saving my life once.

So, my doctor put me on Seroquel full-time.  Now, seeing the damage it’s caused in my personal and professional life I was not thrilled, but I figured I’d give it a fair shake… Until it made my belly shake.  So, as someone who suffers with body image issues, this is not the drug for me.  Between that, the risk of tardive dyskinesia and diabetes this pill can kiss my ass.

Again, not “medication compliant.”  Now, I can understand where my clients are coming from when they just stop taking their medications because of side effects.  I’d love to believe that I know better than they, but I don’t.  I’d like to say I’m better about advocating for myself, but maybe they advocate just as much or harder; I listen but the system they’re in was not build to hear.

I’m still on my other mood stabilizer.  I’ve been on it for 15 years.  I don’t think that will change.  When I see my doctor next week, we’ll talk about more options for medications.  In the meantime, I’ll keep meditating.

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.

Danger Will Robinson

Nothing knocks you out of depression like a panic attack. My heart pumps faster, my thoughts race – everything that was slow about me begins to move at full speed. While I abhor the idea of depending on my rapid cycling to pull me through, it may have saved my ass this time. I don’t think I could have made it through the rest of the week without that bolt of anxiety-ridden lightning.

My doctor called. He put me back on one of my meds; we were trying to wean me off the major ones so my husband and I could start a family. Between the stress at work, unstable finances and other variables that affect my stability, children don’t seem to be in the cards in the near future. As much as me and my husband want them, we’re going to have to wait until we can afford for me to either work part-time or I can set my own full time hours without fear of losing my job (in other words, private practice).

Time to put my theory to the test. Shower and take the rest of my meds. And some self-care something. I’m not trying to push myself this week: a sure-fire way to screw myself over before Tuesday afternoon.