Med Check

 So it’s been awhile since I listed my meds, I wanted to do it so I have a record to look back upon. Here’s my daily cocktail prescribed for my Bipolar Type 1 with psychotic features:

1. Mood stabilizer: Depakote ER, 625 mg/day

(Note: I’ve been on Depakote for 22 years, started out at 2,500 mg/day. I have not had another depressive episode for as long as I’ve been on this med, instead I had manic psychosis occurring about every two years, until I finally got to Dr. Levy in June, 2017. He had me on 1,500 mg Depakote, which was slashed in half when I was hospitalized in November of 2022 with Depakote toxicity. Dr. Levy would go on to lower me further to 625 mg, where I am today.)

2. Antipsychotic: Risperdone, 4 mg/day

(Note: When in florid psychosis, I’ve been put on as much as 6 mg Risperdone, which put a dent in it, but basically with me my psychotic episodes have to just run their course before they “click” off. This can take anywhere from 3-6 months, start to finish. Dr. Levy did lower my Risperdone dose all the way down to 1.5 mg/day, but after my 2022 hospitalization, he has kept my daily dosage at 4 mg., and intends to leave it here. I dread the side effects, yet fear another psychotic episode, so I’m not pushing for a reduction. I wonder if I’ll be at 4 mg. for the rest of my life? Who knows.)

3. Anti-anxiety: Gabapentin (generic Neurontin), dosage varies

(Note: US psychiatrists have been reaching for Gabapentin in lieu of habit-forming benzodiazepines to treat anxiety disorders. Gabapentin has worked well for me to control obsessive, anxiety-producing “thought loops” by stopping rumination in its tracks. My dosage has ranged from 2,400 mg/day, taken throughout the day, to my current dose of 4,000 mg/day, taken to help me get through a particularly stressful period in my life. The only side effect I’ve experienced is a slight sedation during the day. That’s ok, it’s worth it not to be trapped in worry all the time.)

***

So that’s all that I take for my bipolar, and I’m actually relieved I’m not on that hefty cocktail of five or six different meds from years long ago. Dr. Levy got it all straightened out right off the bat of first meeting with me in 2017. It’s just all been the question of getting the dosages right, and I think, for now, everything is fine-tuned just right. Sure, there are side effects, but I’m wise to all that now. No more fighting and demanding med changes. 

I take my meds religiously, using a pill tray and setting alarms on my iPhone to remind me when to take them. Years ago I wasn’t this organized and it caused nothing but chaos. Thank God I have a routine now! I’m a firm believer in med compliance for those with bipolar disorder, and this view is borne out of personal experience spent tinkering with meds and using substances like marijuana to self-medicate in lieu of taking prescribed medication. All that got me was constant trips to the nut hut. Not something I want to repeat.

Meds are just a part of my life and I accept that. That makes it easier. Acceptance is the key to all my difficulties. I’m grateful for the sanity they give me. 

An Early Valentine’s Day

 So Michael and I are celebrating Valentine’s Day a day early, and going out for dinner at our favorite restaurant located in our neighborhood. I’m excited to get dressed up, and enjoy an excellent meal served in a place with romantic ambiance. I’m setting my worries aside for today, tonight is for lovers celebrating each other. Michael and I have over 23 years together, that’s a lot of Valentine’s Days we have experienced. Normally I cook a special meal for us, something like Steak Diane, but this year I wanted a meal out. I think I’ll have lamb chops tonight.

My bipolar is completely under control, if anything I’m slightly on the flat side but that’s ok. The issue still of concern, my anxiety disorder, seems to be better controlled now, though this morning I was a little uncomfortable. Now it’s past lunchtime and the Gabapentin has fully kicked in so I’m doing much better. I did some cleaning of the bathrooms and I think I’m going to do some reading before taking Lily on her afternoon walk. Then I’ll shower and get dressed for dinner, probably braiding Michael’s long hair if he wants me to.

I was thinking about how dependent I am on my husband, and I’m hoping to gain more strength and ability to manage some things myself. For instance, I really have no clue how the TV remote works, I’m mystified by a lot of things on my iPhone, I always need assistance navigating the internet, just stuff like that. For years and years when I was on that really high dose of Depakote (2,500 mg) I was seriously, seriously cognitively impaired. Don’t get me started, I’ll start raging against all those psychiatrists of the past who kept me drugged out. I don’t want to go down that rabbit hole.

Let’s switch gears. What’s going on positively today?

I have a new therapist, Matt, who I see tomorrow. I’m meeting Shawn on Thursday to continue my work on the AA Steps. I have my Creative Writing Group on Saturday afternoon. I have a FaceTime with Dr. Levy next Tuesday and my report for him is good. The anxiety is now under much better control. After that I have a massage, then I’m going to mom’s for a dinner out and a sleepover. Should be fun. Let’s face it, my life is manageable, there are moments of peace and joy. I’m sober, I’m med compliant. My overall health is very good. Not such a bad life.

So that’s it for today, off I go to new experiences. Happy Valentine’s Day!

Good Days, Bad Days

 I need to remember that like everyone else, I have good days and bad days. Like yesterday morning, I was gripped by paralyzing fear but this morning I awoke feeling like everything was going to be ok, that Michael and I would handle whatever came our way with his mother’s dementia or our current car situation. I’m wondering if what happens is I have anxiety dreams I cannot remember, and if I wake up from one that impacts how I feel in the morning? Or maybe it’s just what Dr. Levy said about the Gabapentin wearing off from the night before, that’s why I can have rough mornings.

But this morning I feel ok, which is saying a lot because it’s a Monday and those have been hard on me in the past. I don’t have much planned for today, I guess I’ll do some reading of a romance novel, a welcome distraction. I don’t read online news stuff, no newspapers, I actually work hard to keep myself in an stress-free bubble of sorts. Perhaps I will work with Matt on how to open myself up to the outside world more?

Mom continues to be plagued by IBS, she’s hell bent on scouring Google for some answer on how to treat it through food modifications instead of working on how to rein in her anxiety. Our cross to bear has been this anxiety disorder, I’m grateful that my bipolar is under control, yet saddened that the anxiety has been so much more difficult to coral. Fingers crossed that Matt can assist here, along with Levy tweaking the Gabapentin as needed. 

So I have a beautiful chuck roast in the fridge, I’m going to make the Sicilian Beef Ragout with olives and leeks and fennel, it’s a favorite. I feel like cooking today, cooking and reading, I’m blessed to be able to lead this kind of life in my 50s. Michael is joking with me that he wants me to write a smash hit screenplay for a series about a bipolar woman who gets famous, sorry I don’t think that’s my calling, I’ll just keep my little blog here that nobody reads except myself. 

Let’s rejoice that I’m not in manic psychosis today, it’s been almost a year now that I’ve been back in sanity. I’m really, really glad that I kept detailed entries here all throughout the episode from December 2022 until April 2023; now I have something to look back upon to see the workings of my manic mind (which maybe wasn’t as disturbing as I thought it was). One thing that’s definitely clear is when I’m off my rocker I definitely write every day, whereas now the entries here are much more sporadic. I guess no news is good news and all that.

Ok that’s all for now, off I go to enjoy this sunny day. One foot in front of the other, I can do this. Til next time.

Writing Prompt: A Serious Tent

 Prompt: Describe an experience in a storm.

A Serious Tent

One of our more adventurous road trips out West involved a two-week excursion out to Colorado to camp and hike at various spots up and down the entire state. Before leaving on this trip, I had cast our cheap, nylon Coleman tent aside and threw down $400 on a large, beige canvas Kodiak tent from Alaska, which is a bitch to set up but once inside you feel like you can survive any kind of inclement weather. 

The tent easily stood up to a stiff wind storm in Rocky Mountain National Park early on in our trip, but the true test would come at the back end of our journey, when we arrived at a campground adjacent to beautiful Pike’s Peak Mountain. It was sunny when we arrived and we took our time unfolding the tent, getting the aluminum poles, then erecting the structure and filling it with our air mattresses, sleeping bags and pillows. We scoffed at the warnings about August being monsoon season in Colorado, feeling like we had dodged all that and chalked it up to good luck.

But Mother Nature had something in store for us, which we would see in the distance the next afternoon forming in the dark clouds encircling Pike’s Peak. Those clouds looked angry, and soon we could hear claps of thunder signaling something menacing was heading our way. Michael and I looked at each other, then scrambled toward the tent, not the car, and zipped ourselves inside.

Next thing I knew came the sound of large bits of particles hitting the roof of the tent, we soon figured out it was hail, pieces of ice raining down all around us. We laughed, and not really knowing what else to do, we climbed into our sleeping bags and lay our heads on our pillows, staring upwards. I’m not sure how it was possible but right in the middle of a raging hail storm we both fell sound asleep. It was a deep, peaceful slumber, one of the best naps I’ve ever had.

Eventually we both woke up and it was silent outside. We slipped out of our sleeping bags and Michael carefully unzipped the tent and we both stepped outside. The sun was out, and piles of ice pellets surrounded our tent. We laughed, marveling at what a superb job our canvas tent had done, lulling us into sleep in the midst of a raging storm. 

“It’s a serious tent in the old-school style,” Michael said when I asked him about it recently. Serious tent indeed. Today it rests bagged up in our attic, it hasn’t been out in the elements in a long time. But she served us well, that Kodiak tent. I wouldn’t do another Colorado monsoon without her. Best hail storm I’ve ever experienced. Thanks for the memories.

Angst Then, Some Improvement Now, And Some Struggles

A month earlier:

 My husband is productive, while I sit paralyzed with fear in my chair.

There is clutter everywhere upstairs, yet I do nothing to straighten things up.

I’m plagued by flashbacks to traumatic events, they keep reoccurring with little relief.

I’m a mess.

It’s been 7 years crippled by anxiety with no headway made in therapy to improve things.

Is my anxiety caused by my surroundings or do I have miswiring in my brain?

How can I break this inertia and institute change? 

Why do I catastrophize about the worst things that never come to pass?

Why don’t I trust that good things will come to pass?

I think my biggest problem is my current inertia and paralysis when confronted with stress; stress of any sort sends me into a tailspin, I become immobile and trapped in panic and worry. I am meeting with a new therapist on Wednesday in two days and I hope he can help me overcome this anxiety, either through tools he gives me, or maybe we might try certain therapeutic techniques to break whatever block is causing my inertia.

I’m stressed and my feet are freezing, I’m miserable with my current situation, I so desperately want change and improvement. Maybe I need to reach out to sponsor Shawn, but what good can he really do right now? Michael is all business today, he doesn’t want to deal with any meltdown from me. I’m angsting over things I cannot control and I need to just let go and let outcomes happen.

***

Today:

The increase in Gabapentin and switch to new therapist Matt is doing wonders. The obsessive, anxious thought loops have been stopped in their tracks; my mornings are calmer, no more break through anxiety plaguing me throughout the day! I actually walked to Matt’s office this week, and we spent time talking about the trauma of my ECT back in 2016. We will begin ART eye movement therapy on it in two weeks.

Matt is challenging my negative thoughts about myself, prompting me to look at things in a positive light. He is encouraging me that I have made a lot of positive growth since I got sober and med compliant in 2017. We are still getting to know one another but I feel good about working with him. We are meeting Wednesdays at 1:00 pm. 

Michael and I are getting into little tiffs mostly having to do with trying to control one another. It never works, I should know from my AA experience to let go trying to orchestrate outcomes. We are both under stress with his mom’s dementia. Being a caregiver is mentally draining, no one prepared me for this. But I’ll try to keep my head above water as best I can.

 My interest in cooking is waning, I don’t know if this is permanent or something that’s just temporary. I’m scared if I don’t have my cooking to lean back on for stress relief, routine and a sense of purpose. It really feels like a chore, I jump at the chance when Michael suggests a dinner out. I suspect side effects from meds are causing my troubles in the kitchen. Why, why, why?! 

It’s February in Columbus, a dreary time, I’ve got problems but so does everyone else. At least the anxiety has died down, hooray for that. I just shed some tears, something very hard for me to do, and it feels cathartic. I got handed a bunch of lemons, and I guess I’m doing my best to make Strawberry-Lemonade. Some days are good, some are bad. Such is life. 

That’s it for now. 

Writing Prompt: Only In My Dreams

 Prompt: Write about a dream(s).

Only In My Dreams

Out of the blue I had a drinking dream this week and it was really unsettling. In the dream, I was at some tony bar/restaurant with some friends, and I started drinking red wine. I felt myself getting drunk in the dream, and I was filled with remorse for blowing my long-term sobriety. But I kept on drinking, proof of course that I am indeed an alcoholic.

Upon waking, I was obviously filled with relief that I was indeed sober, no real red wine had passed my lips and my sober date was intact. I wondered why I had happened to have a drinking dream, and realized before falling asleep I had been reading a book where some characters were raiding a wine cellar in their holiday home. So everything started to make sense, though I was still somewhat unsettled.

Normally, I don’t remember any of my dreams, that’s what happens when you take the medication I’m on for my bipolar disorder. But occasionally, I’ll awake with crystal clear memory of something that tormented me when I was asleep. Like the really bad dream I had a few years back where I was in a car that had gone off the road and started filling up with water. I somehow got out and was frantically trying to keep my head above water whilst simultaneously locate my purse which had my ID and credit cards.

 I still remember that nightmare to this day. I can read all kinds of things into it, like fear of dying and the search for an identity. I imagine I have a pretty active dream world, and I wonder if it’s a blessing or a curse that my meds block my memory of most of it. I know my mother is deeply tormented by anxiety fueled dreams every night, and she’s got an anxiety disorder just like me. Thankfully I don’t contend with that misery, as I said, I only remember a handful of dreams, albeit bad ones.

Sometimes I long for the days of my youth, when I’d often have flying dreams and other pleasant experiences. It’s been a long, long time since I experienced the exhilarating feeling of flying, perfecting my takeoffs and landings with ease. Perhaps when you age into your 50s you just naturally worry more, and that carries over into your dream world where pleasant experiences don’t take place. At least that’s been the case with me. Will I ever dream of flying again? I certainly hope so.

So I guess I’m tempted to say all my dreams I can remember today are filled with angst, driven by anxiety that has plagued me most markedly since I got sober almost seven years ago. I’m working on it though, with medication and talk therapy and activities to distract my mind from fear and worry. But thankfully, I don’t remember most of my dreams, which I guess is a blessing. Though when it comes to the drinking dreams, I do want to at least always remember how relieving it is to wake up knowing your sobriety is intact. That drinking was only in my dreams. Let’s keep it that way, shall we?

Big Changes

 So here we are in February 2024, and I’ve made some really big changes this year. Biggest on the list is I’ve switched talk therapists, leaving Fetter for younger Matt McTeague who has a background in both mood disorders and substance abuse disorders. I went to Matt specifically for assistance in dealing with this crippling anxiety that has plagued me for a good seven years now. Matt uses Cognitive Behavioral Therapy techniques and also does this eye movement stuff for trauma—I’ve thought for years that the trauma from all my hospitalizations, the ECT, and being in psychosis has fueled my anxiety. 

Leaving Fetter was extremely difficult to do though, even though I’d been thinking about it for awhile. Fetter was excellent when it came to talking about psychosis, he helped make it less scary, it’s just that I was always left with unmanageable anxiety to contend with in between sessions. I just couldn’t take it anymore, and I’d heard about how successful CBT was for treating anxiety. So when I found out about Matt, I jumped at the chance to get his help. We will see how this goes.

My psychiatrist Alan Levy has also increased my Gabapentin morning and noon doses to help me feel less anxious and stop the obsessive catastrophic thought loops. I’m feeling relief, though I am arguably more sedate. I had begged him for help, what with all the worrying I’ve been doing over my mother in law’s worsening dementia. Thankfully, Dr. Levy did the Gabapentin tweaking just right and I’m feeling better.

I’m also going to try and set goals for myself to move more and execute more tasks at home. I’m resigned to the fact that the 4 mg Risperdal dose is not going to change and I must push back against the fatigue as best I can. I am tempted to beat myself up for being lazy yet I know I have to fight against powerful med side effects that would set anyone back. I’ll always try to be a fighter, I just get frustrated a lot. I wish I had a support group of people who had to be on antipsychotics—but maybe it would just dissolve into one big bitch session. 

As always, I’m so grateful that I’m sane and sober here in 2024. No wandering, no hospitals, no delusions. I’m continuing on with my Creative Writing Group, it really means a lot to me to keep practicing my writing skills. The guys in the group are very supportive and it helps strengthen my sobriety. So things are somewhat good right now. I’ll take that.

Writing Prompt: Simple, Yet Satisfying

 Prompt: Write about your evening routine in sobriety.

Simple, Yet Satisfying 

Sobriety has ushered in more order and a routine to my evening life, something that was sorely lacking when I was in the grip of addiction. For instance, my husband and I sit down to dinner every night at 6:00 pm, and then I spend time doing the dishes, loading the dishwasher, and cleaning up the kitchen. I like my kitchen tidy when I come down in the morning to make my coffee, so I make sure everything is orderly the night before.

At 7:00 pm every night an alarm on my phone goes off, letting me know it is time to take my evening dose of my important bipolar medication. I am extremely regimented about taking my meds faithfully at 7:00, with an exception only made if I have a dinner out planned, or we have a hockey game or some activity to go to. In that case, I will take my meds as soon as I get home, making sure these evening activities don’t happen too frequently. 

I learned my lesson about keeping a rigid evening 7:00 pm med schedule from years in active addiction whereby I would take pills at random times, or not at all, only to ultimately end up in another psych ward in florid psychosis. Funny how things straighten out if one just follows instructions, namely in my case, take your meds at the same time every night, and never, ever, mix with alcohol or marijuana.

So back to my typical evening, I’ll often enjoy a cup of herbal tea after dinner, and catch an evening AA zoom on some nights. If it’s cold outside, my husband may build a fire in the fireplace and I’ll spend time watching the logs burn, soothed by the sight and sounds of the fire. Or perhaps I’ll join my husband in the den, and we will watch whatever random sporting event is on, be it football or hockey, baseball or basketball. Perhaps my husband has gotten some DVDs from the library, we just watched a documentary about the Civil War that was very good. Basically, I let my husband control the evening viewing selection, I’m really not picky, preferring instead that someone else make the decision of what we watch.

Since last summer, I’ve been spending a good deal of nights reading books I get from the library. These are not intellectually challenging works, rather, feel-good, happy-ending fluff romance novels. I’m plowing through these books at a rapid pace; I think that’s how they are intended to be read, one book after another. That’s why I get them at the library, why spend money on something you will devour in one sitting and not need afterward? I’m wondering when this romance novel phase will end, but it’s keeping me occupied for the time being.

Between 10 to 11 pm, I start getting tired, my evening meds have kicked in and it’s time to head upstairs to bed. In sobriety, I’m definitely not a night owl anymore, and I’ve learned good sleep is key to my overall stability. Sometimes when I’m in bed, before I go to sleep, I might get anxious from some catastrophic thinking; but I’m learning to practice deep breathing and I say the Serenity Prayer to calm myself. Gone are the nights when I drank myself into black outs and I’m so very grateful for that. For the most part, my slumber is peaceful. 

So I guess I would say my sober evening routine is for the most part simple and repetitive, yet still satisfying. The older I get, the more simplistic I want things. No more alcoholic late night drama for me. Keep the fire burning in the fireplace and I’m a happy camper. When I lay me down to sleep, it’s with deep gratitude for my simple, sober, sane and stable life. And I guess you can’t ask for more than that.