Monday, October 31, 2016

Fail a Little, Fail a Lot

The last few days I have sat down to write, with various ideas. and have come up short. I lack the desire and impetus to write my thoughts out. I made a poor decision on Friday that really messed up my head. It is incredibly simple and stupid, but for my oddly wired brain, it was a serious infarction.

I had a paper due on Friday that I was having significant difficulties with and knew I was not going to get done on time, and there was not allowance for late work. Friday morning I made the decision to let it go and try to focus on other work. The next couple of days were ridiculous. My decision had made more of an internal impact than I had realized. I was riddled with guilt and my skin began to crawl every time I sat down to do school work. I have not felt an anxiety attack creeping on like that in years. It scares me.

For years I have made a habit to make crappy decisions and quit things, rather than try and fail. This is a horrible, perpetuating habit that I am now battling. Right now I am struggling with a battle between my goals, academic struggles, depression, anxiety, and old shitty habits.

I have not dealt with parallel depression and anxiety for decades and I can tell you right now that I hate it. At least when I want to die, I can try to find the motivation to get up and work. But the anxiety adds a whole new dimension that includes extra physical pain.

Too.... damn.... exciting.

Wednesday, October 26, 2016

Figure It Out

The heading for this entry is meant to reference the fact that I have figured out all of my troubles, finally... I am an idiot. Often times I think I know what is best for me. It seems to be about a 50/50 tossup as to whether I am correct. This week I was not. I have still been struggling with exhaustion and depressive thoughts, so I thought I would cold-turkey my Ability to see if it may be adding to my issues (the exhaustion part, I figured if I was still depressed that cessation couldn't hurt it). Bad idea. Abilify is an atypical antipsychotic. I decided to not take my Sunday dose, and I felt the first effects on Monday. I have not experienced many semi-serious psychotic episodes in my life, but Monday morning was amongst the worst. Part of the experience included paranoia, which I have experienced even less often than psychosis. Being behind the wall of an abnormal episode is very odd. I very much knew what I was thinking was probably wrong, but the thoughts also seemed very probably and likely.

I remember believing that I was probably the pawn of a giant game or show and that everything around me was fake. I was fully convinced that if I could grab a sledgehammer I would be able to break through the road and find that my world was floating on air, like I was on a giant inflatable balloon that supported the show set. That is insane, and I knew it, but that did not change the fact that I wanted to prove that it was correct. The fact that I have gone through the cycle of depression for so many years, flamed the belief that I am not meant to die because the show must go on, and that I am the center of a sick, sick program. As my wife pointed out, I thought I was in a combination of the Matrix and Truman Show. Very accurate.

So, that was fairly horrible, but I did not make the connection. Yesterday I woke up with a horrible, splitting headache. I hit it with various otc meds, but nothing touched it, including caffeine. Today I woke up with the same headache... and that is when the lightbulb went off. After a few minutes of research, it was obvious that abrupt cessation of Abilify could bring on major headaches, and other issues. I decided to stop being stupid this morning and take my Abilify. Four hours later, and my headache has already begun to improve.

Figure it out....idiot.

Tuesday, October 25, 2016

Every Day is Exactly the Lame

I can't even tell you how many times I get up, and throughout my day, think "this day is just so different, it's not my normal, and I do not know how to describe it." Ironically, I think every-day-being-different is my normal. Today I am not suffering from the severe mental erosion I was yesterday morning. I think this is mostly due to the fact that I woke up with a major headache and have had trouble staying awake. Pain and distraction can definitely serve a purpose.

Back to the distraction vein. I was writing the first paragraph about two hours ago and completely forgot. It is just very difficult to concentrate today with this headache. But, hey, I am definitely appreciative of the fact that I am not battling depression and dark thoughts today. All smiles.... and headaches.

Monday, October 24, 2016

Enjoy the Silence

I am not very good at working without background noise or sounds. Sometimes it is music or documentaries; sometimes shows I have watched a million times or new to me shows. Mostly, this provides 'white noise' that helps me focus. It is double edged because just as much as it can block out the distractions, it can distract. Over time I have come to a better understanding of what I can watch and when. The problem is that even at home, or in the library, there always seem to be distractions.

The real question that I cannot find an answer to is when exactly it became impossible for me to endure silence. Realistically it was probably when I was young. I used music to fall asleep and often used music while doing homework. It is just part of me. Except now I usually listen to shows or talking programs instead of music. Perhaps I should try going back to music and see if that is less distracting.

Is it bad that I cannot 'enjoy the silence,' as it were? At times I can do tasks in the silence, and at other times it is simply maddening. It's almost as if the quiet allows my brain too much opportunity to reflect and think about, well, anything. And as we all know, thinking is one of my top enemies. It is the thinking that permits the floodgates of depression to take hold.

Sunday, October 23, 2016

Cyclic Dumbass

I feel that so many times I try the same thing, with the same result. Today has been a crappy day. I don't really feel like writing, or know what I would even convey. Some days are like this, and that's just how it is. I'm going to sign off, before something erodes my last ounce of patience and I put my fist through my laptop.

Friday, October 21, 2016

Can Suicide be the Right Option? - Part 1

Obviously this is an extremely complex question that my half-asleep brain cannot fully address, right now; however, that doesn't mean it isn't on my mind. Feelings and emotions mostly drive this question. For years I tried to control these feelings by injecting logic and reasonable thoughts into the downward spiral, with the hopes of stopping it. About 99% of the time it just makes it worse. This week was odd. The new medication I started seemed to have a rather immediate effect and I decided to stop after two days. My suicidal thoughts became incredibly strong. I have lived with them for a long time and know a lot about where they are coming from and where they might lead. The more 'typical' and less severe thoughts can be mitigated with sleep or distraction. The severe and eminent thoughts are dangerous, because distraction usually doesn't work. The more severe and dangerous the ruminations, the more unpredictable they are (both in cause, onset, and duration). There have been times where I tell Lexi that "I'm not doing well," which is often my way of stating that I am close to needing hospitalization. I hate the wiring of my brain.

Let's start this. My basic questions:

  • Who does suicide affect and how?
  • Does any of this actually matter and for how long?
  • What can I do to stop/cure/etc this?
  • How will this affect me after death?

I will have to flesh out my thoughts at a later time, but this usually forms the basis of my pondering. What have I missed?

Thursday, October 20, 2016

Chase that F*cking Rabbit

Often my biggest enemy is my own mind. Once I start chasing that damn rabbit down the hole of depression and unreasonable personal analysis, the results at best are on the downside of neutral, and at worst set me up to require a heavy dose of medication or other chemical savior. I have worked with professionals on this, to talk it out and analyze it, but after years of addressing it I have no fix. The best course of action is distraction, which keeps my mind away from itself.

Last night I started ruminating on the fact that I have changed so negatively in the last decade. I used to feel alive and capable. I found things easier and was proud of the intellect that I had. I didn't necessarily feel that I had personal impetus, but I had a strong work ethic and the ability to push myself when needed. I feel as if the flesh has been melted from my bones, and all that remains is a skeleton. Now I am expected to stop being just a skeleton and grow back that flesh. As it currently stands I am unsure if this will ever be possible. There is no guarantee that I will not decide this is impossible and side with the fate of personal selfishness.

The more I work on improving and building upon myself and my life, the more I hate myself. What happens when I get to my grand end and look back upon my personal emptiness? Perhaps I torture those around me by building to that end.

Wednesday, October 19, 2016

God Damn Food and its Pull

I have struggled with food for years now. Growing up, I was required to eat extremely healthy because of diet related issues. When I became an adult and moved out on my own, I went the other way. Over the years, my eating habits only declined. For about 5 years I worked a job that allowed me to eat almost anything and maintain my weight, because I spent a good amount of time working my ass off outside and in the heat. When I quit my job to become Mr. Mom, I never improved on those horrible eating habits. As time went on, my eating actually got worse because of boredom, malaise, and depression. The shame of it lead me to a cycle nighttime binging.

There have been spats where I have gotten some control over my habits and lost some of the weight that I put on. Since we moved to San Antonio, I have struggled more and more with eating. This seems to be proportional to my level of stress. It really is ridiculous, because the binging and eating ends up adding to the depression. This struggle is second only to my suicidal thoughts. The depression is something that I feel I cannot control, only my reaction to it, but the eating frustrates me because I know it can be controlled.

I am striving to control this again. Gone are the days when I try to make grand gestures that explode in my face when I fail. Over the years I have found that trying to make small adjustments to my routine works the best. Right now I am just counting calories. I am not trying to make large changes in what I choose to eat, but I am working on staying under a certain calories count, which helps me keep from binging. The fun of ignoring the binging comes with anxiety, depression, and physical discomfort that leads to insomnia. I find it all extremely stupid.

If I could get back down to a healthy weight and get into hiking shape again, I think it would really improve my depression. Partially because there is almost nothing I enjoy in the world as much as hiking out in the beauty of nature.

Tuesday, October 18, 2016

The Sun Also.....

It is difficult to stay awake today.....

And now it is later, about 5 hours later. I met with my doctor yesterday and he understood that the Zoloft wasn't working for me. The current plan is to try me on a medication that isn't necessarily for my condition, but may be related via my ocd and difficulties concentrating. After giving that medication a couple of weeks, to see if it is helpful or to leave it behind, we will try me on Effexor. The Zoloft and Effexor, besides having antidepressant effects, is being utilized at a higher dose to combat my ocd tendencies that cause cyclical and obsessive thoughts that I struggle to cope with. Like my bipolar depression, the doctor thinks that my ocd presents in less-severe and somewhat non-typical fashion. By "less-severe" I mean in that it doesn't affect every second of my day, such as constantly having to wash my hands, but that when it does I cannot get rid of the thoughts. I agree with the bipolar depression; however, I am unsure about the ocd. I do not understand the ocd well enough to understand if I have minor ocd, or if I just have rigid habits and tendencies. I will have to read more into where the line is that divides the two. And ruminating on oppressive thoughts do not seem to be exclusive to ocd and I believe could simply be out of depression or anxiety. We may be barking up the wrong tree to try and address those thoughts this way.

I have been on Effexor in the past, but I really cannot remember when. If memory serves (and it doesn't always), I think that I was on it back in high school, along with Buspar and Xanax for anxiety. It is because of that, I do not have anything good to say about it (although I don't really have anything bad to say about it either). But that was a long time ago and the minuscule memory of that medication is tainted by my horrible experience with Xanax. When I first started having psych issues, I had horrible anxiety attacks, which I took the Xanax for. While it treated the immediate symptoms, I got addicted to it and weaning off it was a nightmare full of withdrawals and resultant anxiety meltdowns. I would take Xanax again if it was really needed, but only prn and not on a regular basis. Just not worth it.

Monday, October 17, 2016

Monday Funday

I must say that coming down from Zoloft has been enjoyable. This weekend I was far more productive than the previous couple of weekends. It is easier to get up early and stay up without extreme exhaustion.

Last night, the family and I played badminton at the park. We didn't play an official game, just had fun hitting the birdie around. In the end, the wife and boy were on the verge of asthma attacks, Melly had to lay down from being disoriented, and I had fallen over. Trina, however, was having a fantastic time and was on top of the world. I am hoping to emphasize the importance of having fun, that doubles as exercise, while Trina grows up. The older two, and myself, are very unhealthy and lack normal stamina. This morning my left knee isn't a fan of bearing weight or bending. I fell on my right knee, but only after my left knee buckled sideways, as I was moving laterally. Hope that heals up soon.

Today I go to see my new doctor for the second time. Now that the Zoloft is leaving my system, I feel fairly stable. Having started Abilify at the same time, I think it is doing it's job. I had good results with it years ago, until my body adapted to it and it ceased providing benefit. I have high hopes that someday I could decrease my lithium level. I do not appreciate how it makes my hands shake, and I am concerned about long term effects. Steady hands are a requirement for my future career.

It's Monday, but I feel that today is going to be a good one. I will be hitting it hard, because I have a big bioscience exam tomorrow. Let's do this!

Friday, October 14, 2016

Great Life, Depression Anyways

I cannot say that I do not have stressors and that my life is perfect, but one of the major issues with depression is that it doesn't always make sense. Sometimes a bout of depression sets in, because of a particular event or maybe the season of the year. Those have a direct cause. My direct cause doesn't seem to exist, and it can be maddening.

In 2014, when I was in the hospital, I conveyed my frustration to the doctor. I told him that I was absolutely tired of this unending cycle of major depression that really has no basis in reality. It does in fact biochemically, but not as far as life events. I consider myself lucky that I have a great wife and a good life. Why the hell am I depressed if I have 'it all'? Sometimes there is no answer. There is only the question, "what are you going to do now?"

Thursday, October 13, 2016

University = Stress

Like a job, college is stressful. I had heard many times that community college is nothing like university, and they were right. CC was like high school in many ways, but the primary way is that it was pretty laid back and simple. I had little difficulty achieving A's. The first couple weeks at UTSA were a blur. It felt like someone threw me on a treadmill at 100 miles per hour and socked me in the face. The moderate to massive stress increase literally made me feel as if my mind was going to break, snap, or whatever adjective best describes catastrophic failure. After feeling that I was getting my ass kicked and losing, because I cannot afford a low GPA to continue to medical school (and by low I mean less than 3.5-3.7... B+ = 3.5), I worked hard to increase the time I was working on material and assignments...and then the medication change came on.

It was necessary. I knew it, because the stress was continually pushing my mind into the rabbit hole of obsessing about suicide, but I was a bit unsure. Having been on Zoloft before, I was not as afraid; especially considering that I was playing with the idea of getting ECT booster sessions (which I am definitely afraid of because of the side effects on my memory that I have previously experienced). However, I was never on this dosage. Per my last post, I am staying on it for a few more days until I see my doctor, but I am cutting my dose in half and taking it at night. Yesterday I took half a dose in the morning, which means I have been without it for 24 hours. Already I have more clarity and my headache has decreased. Antidepressants have their place, but when they make things worse, it is time to find another.

Oh, and as a side note, when I started putting more time into school my grades and stress level started improving; however, over the last 3 weeks when I have struggled from brain fog, apathy, and exhaustion, I have started sliding backwards. I am strangely excited to be free of this medication. I would consider 'cold-turkeying' it but in the past I quit Wellbutrin like that and ended up in the emergency room with the symptoms of a heart attack. While I was cleared, my psychiatrist at the time read me the riot act about stopping that medication abruptly and that a cardiac event could result from my actions.

....aaaaand that is why she is the doctor with years of experience and I am just a guy with an internet connection. Knowledge, incomplete that is, can be dangerous.

Wednesday, October 12, 2016

Sometimes It Isn't Worth It

Recently, I started on an old medication to see what it could do for me, after being off it for years. My starting dose is twice as big as the largest dose I was ever on, with the intention of doubling the dose again. My doctor is hoping to not just treat my depression, but obsessive tendencies as well. These obsessive tendencies can result in dark thoughts that I cannot get rid of. But this time, at least at this dosage, it will not be worth it. Particularly not when I have to function at the university. Medications can have strong initial side effects, and it can be important to stick with the regimen to see if the benefits show up, while the negatives subside. I've given this medication about one month, but I am going to talk to my doctor about removing it.

I have struggled with exhaustion, lack of attention span, decreased motivation, headaches, desire to binge eat during the day, and the almighty caffeine does not work anymore. Oh, and I won't even go into its effects on my libido. It is hard to be exhausted when I get about 25% efficacy from coffee or energy shots. There seems to be no effective way to battle the fatigue. I have a hard time not stopping my medication by myself, but I know there is a proper way to do this and I am going to work with my doctor.

Unfortunately, that means waiting.....

Tuesday, October 11, 2016

Disease is as Disease Does

Someone with Type I diabetes needs medication and cannot be cured of their disease. Cancer patients seek important medical treatments to hopefully rid their bodies of the disease. Both of these afflictions, among many others, can kill you. These people are not blamed for their afflictions or chastised for needing treatments, so why are those with mental diseases? I have suffered from bipolar treatment-resistant depression, with bouts of anxiety, for more than half of my life. I have been hospitalized and undergone many types of treatments. There are fantastic times of remission, but it is my 'cancer' that continues to recur.

I am continually judging myself, an action that only helps to promote the feedback loop of depression. It is difficult for me to understand that when others look at me they cannot see into my mind and feel the hole of existence that I feel. Why am I like this? Did I do something wrong? Was there a latent genetic predisposition in my ancestry? Or is it something else? Not knowing can be difficult. That others do not have the feelings I do seems foreign to me. After a year of ECT treatments, I started to not feel that dying would be the best option. I got up and had less pervasive thoughts and felt like living for living's sake. This will sound odd, but it was an incredibly bizarre and almost uncomfortable feeling. I know that survival is an important and innate feature to any species, so where did my desire flee to?

This year, particularly the last few months, has been difficult and stressful. The reserve of emotional and mental stability I felt that I had accrued has been depleted. I am working with a new doctor and therapist,  to hopefully reinforce the dam before it breaks. For the first time in nearly a year I am considering getting ECT booster treatments. I hate the side effects that I have experienced, primarily memory effects, but it may be worth it.

Monday, October 10, 2016

Hope Between Lies

There are days that are good but peppered with moments of hectic despair. The current moment may be productive but my mind loves to throw in thoughts of failure. "Just because you are doing well doesn't mean the depression will not win in the end. You need to kill yourself now, to prevent your future failure and pain." In some ways it is a habit of mind, and in many ways it is my screwed up chemistry. There was a fairly good and stable period in my life from Spring 2015 into the beginning of 2016, but the stress of moving to Texas, kids, finances, and school have seemed to dissipate my resilience. As an example, if someone told me that if I continued to work hard for 10 years, life would be wonderful and I would get a million dollars, I don't think it would change anything. I continually struggle with how I will react over time.

In many ways, I consider myself a loose cannon. Perhaps it is the bipolar side of my depression, but in the middle of a great day I can become hopeless and suicidal, and sometimes for no reason that I can determine. There are definitely times that my thoughts or ruminations drive my descent into 'the rabbit hole' or 'spiral,' as I tend to describe them.

I feel bad for my wife. After years, I still struggle to communicate fully about what I feel. She is such a hard worker, with many of her own stressors, so I hate burdening her more. Although in the end I know that not talking only makes it worse. She has for years tried to figure out how to best help me, and for a woman so effective at helping others, I know she is frustrated at the intractability of my disease. Maybe she doesn't see it, but she has helped greatly. Some stressors she brought into my life, but she has pushed me so search for a future and to continue treatment. And she has provided my greatest impetus, being around her.

Sunday, October 9, 2016

Addition by Subtraction

At first blush, the title of this entry sounds ridiculous, but it doesn't have to be. The demon of depression has been hitchhiking on my back for years. My life is a spring, compressed by a rock; and if the rock was removed, perhaps all that potential power could be released. There are days and periods where I feel free of the restraints, but they are fleeting. No, I will never be completely free, but what degree of freedom is possible? How will I know when I have achieved maximum freedom? If I am able to improve to the point that I only have one major relapse a year, should I assume that is the apex of freedom and not hope for more? Too many questions. I do not want to focus on a sense of false hope. I will always want more freedom, but when I search for it and relapse earlier than expected, the relapse compounds and I fall deeper into depression and the thoughts of suicide blossom even larger. I need a balance of reasonable expectations, with a sustainable interim of actionable suicidal thoughts.

My new doctor in Texas has reintroduced two medications into my daily routine. Both of these medications worked well for me about a decade ago, but after a while they lost their efficacy and I had to move on. Hopefully after being off them for years it will bring me a new level of stability. The ECT, for all its own troubles, had a very beneficial effect on my thoughts. If I can get to the point that I only have one major relapse every 6 months, I would be happy. Then I can focus on "forcing," to some degree, for the meltdowns to happen on my schedule and not at any given moment.

Saturday, October 8, 2016

Behind the Name

Unfortunately, if there were to be an overarching theme to my life, it would have to be the quest to find peace, purpose, and freedom. Recession from troubles in another theme. I suppose we all are like this to some extent. For me, I am running from the troubles of my mind and searching for a cure. There is none. There likely never will be. At this point, I have begun to accept this and hope to finally see my life as a journey with ups and downs, rather than absolutes.

Through the years I have been hospitalized, found varying degrees of help in dozens of medications, undergone ECT, and suffered with the anguish of pervasive suicidal thoughts way too often. I've talked things out, tried natural everything, prayed, and researched the cause; but in the end, there is no quantifiable answer and it can be maddening. This demon has now been on my back for over half my life and will never truly go away. Despite all of that, here I am. For this I have much thanks and hate to share with my friends, family, and wife. I don't mean to sound disingenuous. I know that suicide is a selfish action, but to that same degree I believe that keeping someone alive that doesn't want to be can be it's own torture. There is a constant equation in my head that tries to work out the balance between enjoying life and hating it. I do truly enjoy spending time with my wife and she one of the only things that anchors me to this world. Someday I will crawl down the rabbit hole of my thoughts and write more about it.

Despite the ups and downs, somehow I still move forward. Time has me by the wrist and is pulling me along like an angry child. Truth be told, in my mind's eye, time to me looks like the grim reaper, scythe in hand, heading toward an inevitable destiny. Gravity and time; you cannot stop them but you can try to figure out how to use them to your advantage. I, myself, have not achieved this yet.

Friday, October 7, 2016

The Trouble with Time

I have been listening to an excellent audio book on my commute, Designing Your Life. The Stanford professors that wrote this book, based on a course they offer, were on NPR and it sounded very interesting. Truth be told, I would love to read it, but it just isn't going to happen with my schedule. Back to the book. The concept that grabbed me was that people tend to be on an unending search for passion and purpose. To this end, people make life decisions based on desires or false beliefs that don't pan out. This resonates with me because I decided at a young age that I wanted to be an Architect, and I pursued that until my second year of college when I had the opportunity to work in an architecture firm. Dream destroyed.

Yadda, yadda, yadda, a decade and a half later, and life is very different. I am on a path that I had never seen myself going towards. I feel now that I am doing something out of choice, and less based in passion or desire without foundation. The authors make a good point about something called "gravity problems." What the hell is that? Ok, if you are fed up with gravity because it keeps you down, makes you feel heavy, and walking up a mountain is difficult; it doesn't matter. Complaining, worrying, or wasting thoughts about it do nothing. You cannot change gravity, but at times we all try to fight "it." We have plenty of "gravity" in our lives. Most of all, I think I worry about time. Do I have enough time to do something? There is too much time left until something else happens! Time, time, time! It is something that I cannot change; but I still wish I could. Change in perspective is needed to properly adjust my actions, but I haven't achieved that state of zen yet. I will choose to be happy with just pondering on this thought for a while.