Improvements and challenges

Now that I am on a time-released version of the new med, I am doing much better! And I am also tracking my symptoms in a log because I'm still far from stable, physically, and I need to see when and why I experience symptoms that can quickly tip into becoming severe.

Improvement: the new med and the new dosage and in the time-released form now allow me to fall asleep around 10:30 and sleep for a straight 7-8 hours. This is an incredible improvement after years of only being able to sleep 5 hours a night. I am also having vivid dreams, and experience this as a luxury.

(Jim des Riviere's Luna moth poster)

Challenge: I can't even move my body much less get out of bed in the morning until almost 8:30, no matter how long I have actually been awake and even with the cat meowing constantly for over an hour. This groggy paralysis or "sleep inertia" is annoying but OK if I have nowhere to be in the morning, but will be a serious challenge when I have to get to the airport for an early morning flight or show up anywhere earlier than 9:00.

Improvement: I am no longer so severely depressed that I have to actively work to shove away suicidal ideation on a daily basis. I am cautiously beginning to feel hopeful enough that I can imagine any future activity without experiencing a severe anxiety attack. This is, clearly, an enormous improvement.

(Yellena Jamos print)

Challenge: I am still so inhibited in function when I am up and about during the day (inability to focus, distraction, foggy brain) that doing more than a few simple things results in systems breakdown of competence of one kind or another. If I remember the appointment, I might show up with my clothes inside out or without having time to eat. If I manage to bathe and dress myself, I might forget the appointment altogether in spite of setting alarms or writing reminders. This can be OK if I have almost no outside responsibilities, but is a serious challenge if I want to arrive on time to a volunteer commitment, go to the gym, or have various other kinds of appointments with other people. When things break down in these minor ways, I have been experiencing a great sense of failure, of loss of competence.


Improvement: I haven't had an anxiety attack since I last went to the hospital several weeks ago, although I have felt myself on the slope to one several times. I am feeling more grounded and patient and less afraid on a daily basis. This is a huge improvement.

(needlework art by Cécile Dachary  here)
Challenge: Almost every day, if I am not extremely careful, I experience a stressful drop in my blood sugar levels (in a way I did not with the lithium),  that seems to be part of the roller-coaster metabolic pattern with the new meds. At around 11 and at 4, I get hit with a blood sugar crash and if I don't eat something immediately (ideally protein), I get extremely shaky and have a mood plunge. Even with carrying around nuts and protein bars, I have not been able to eliminate this spike. In spite of efforts to control my eating, I have gained a lot of weight and this is seriously bumming me out: I can't fit in my clothes; I feel really uncomfortable' I'm worried it won't stop. The overall feeling I get is that there is this is jagged and insecure edge to the day that keeps me on a leash. I don't want to go out at night, or venture far from home without the means to return quickly. This is making me wonder how I can handle travel where I am not always in a position to go hide if I can't fend off the crash in time. The blood sugar crash shares enough with the wind-up symptoms of hypo mania that it is scary to feel myself sliding in that direction.

Improvement: I have been making a big effort to shop, cook, and eat in a healthy way, not just for overall calories but with all the healthy guidelines about nutrition that I already know. I think this will pay off over time, but it has proven hard to incorporate  the need to eat small meals five times a day with a more restricted calorie intake.  At least my weight gain seems to have plateaued for the time being.

Johanna Helena Graff
A Poppy in Three Stages of Flowering, with a Caterpillar, Pupa and Butterfly
Watercolor and gouache over traces of black chalk
late 17th–early 18th century

Source: The Métropolitan Muséum Of Art

Improvements in external circumstances that have been stressful:

• After a month of skirmishes, the hospital that was overbilling me by $2100 has retracted the mistaken bill. 
• I was issued refund checks by two different medical organizations that had overbilled me for copays. 
• The prescription plan has admitted that the price I was quoted on the phone ($1300!) for a mail-order Rx was wildly inaccurate and I may actually receive my Rx for the correct price and on time before I run out. 
• The new management company for the condo association also retracted the mistaken bill for $1500 as an employee error and has slowly been getting its act together, although they literally have asked me to do everything (give them documents, passwords, budget summaries, etc) twice because just giving it to them once does not seem to make things stick.
• My neighbor still wakes me up at least once a week when she arrives home so drunk that she runs and yells at 3AM. I hope that in the years ahead she stops drinking so hard. Meanwhile, earplugs are my friend.

(needlework art by Andrea Deszo)