a happy face

on monday, my therapist suggested that i go into a residential program since i still haven't been able to get my suicidal thoughts out of my mind. so this week, i've been calling around to see if i can be admitted to the program and if i can get my health insurance to pay for it. the residential program isn't contracted with my health insurance carrier so i had to file an appeal. i have put in a couple of calls to schedule an assessment but still haven't gotten a call back. it's a bit frustrating, well, more than a little frustrating. i don't know what's going to happen, but i figure if it's mean to be, it will be.

i feel as if no one wants to work with me. it's hard to be positive, especially when you're depressed. and it's hard to change years of behavior you've had since you were a child. when i was an inpatient, my first psychiatrist told me that i have essentially twenty-eight years of behavior to fix. i've always had dark moods and i've always found it hard to be sunny and bright. when i'm especially worried about something, it's hard for me to remember to be positive or put on a happy face. i have to make a concentrated effort to act the opposite, as they say in dbt, to act contrary to my mood.

i get frustrated in dbt when my therapist gets frustrated with me for not learning a skill fast enough. it's hard because most of the skills require me to literally act the opposite of behaviors i adapted over twenty years. my inpatient psychiatrist told me that my illness developed between age 0 - 3. the behaviors i've learned are so deeply embedded trying to change them now is hard. how do you unlearn twenty-eight years of learned behaviors? how can you reverse those behaviors? and how long will it take? the skills in dbt are new to me, and some of them are harder for me than others.

for instance, thinking positive, putting on a happy face, practicing deep breathing, these are hard for me because my instinct is to resist them. i often feel conflicted in dbt because a lot of me is resistant to change. i'm also resistant to being pushed. i can be stubborn, especially if i'm pushed by parental or authority figures. i respond well to men, especially men whom i consider attractive or whom i'm attracted to. i'll change myself for them because i want them to like me. i'll be more likely to change if i want someone's approval.

i like my therapist a lot, and i think i'm more apt to change my behavior because i want her to like me too. i know i'm supposed to do things for me and not for anyone else, but that is the damn truth.

bipolar

i saw my psychiatrist again thursday night. she's keeping me on 3mg of risperdal and 200mg of wellbutrin. she's thinking of putting me on lithium and/or depakote and/or trileptal. she wants to get me off the antidepressant and put me on a mood stabilizer.

i asked her if she thought i was bipolar. she said that there's some indication i could be because i've been taking meds that treat bipolar disorder. she said that her initial diagnosis was major depression rule out bipolar.

i think it might be a good idea to try something other than antidepressants because they don't seem to do much of anything for me. i still get depressed and i have frequent ups and downs.

we know for sure i have a mood disorder, but i guess we're not sure if it's bipolar or unipolar. i can't wait until i'm stable on my meds. i've gone through so many medication changes since i was hospitalized last september.

i quit the part-time job i started yesterday after two hours of training. i was panicking with all the multi-tasking i had to do. so i told my supervisor that it didn't feel like a good fit for me. i was crying in therapy again because of the job, but i just couldn't tolerate it.

then my dad sends me this email about how he thinks i'll be better off moving back home and how he didn't have to ask his parents for help and he doesn't know how my mom is coming up with the money to help me out.

he also said he's skeptical about my therapy and treatment and that the reason i'm "weak" is not only because i'm not getting enough rest but also because of the medications i'm taking. i was naturally upset.

so i wrote back and told my dad that if i'm cut off from my support network and discontinue my treatment, then i could relapse. i also said that i wasn't in a good state of mind to move home anyway after reading his email.

now of course i feel guilty. my mom called me today to tell me not to worry or pay attention to what my dad wrote. and my dad said he was just concerned because he doesn't like seeing me sick like this.

well, i don't like seeing myself sick either. the good news is that i haven't self-harmed at all even with all this stress and worry. i'm trying real hard to not think suicidal thoughts and to push away my self-harm urges.

dosing

yesterday in therapy, we went over my chain analysis and talked about having my mom come to therapy for one session to go over money matters. my money worries are a constant problem. i end up doing things i'm not supposed to do, like cut or drink or contemplate overdosing. the problem is that i don't know where the money will come from week to week.

my therapist talked to my mom at the start of dbt about how important it was that my parents commit to my treatment, because i don't need additional pressure from worrying about money. i was doing good until i started working again. after a month of temping at fast-paced silicon valley companies, i ended up back in the er.

on friday, i start a permanent part-time job as an administrative assistant at a non-profit organization. the pace seems slower there and the hours are great, 8:30 - 1:00. being able to work part-time relieves the conflict i felt about having to choose between making money and attending therapy. now i can do both.

still, i don't think the money is going to be enough, so i'm thinking of picking up another part-time job doing shift work at target. i don't like borrowing money from my parents. i feel guilty and worry about them not being able to afford it. and it forces me into a relationship with them that isn't exactly easy.

last night i had an appointment with my psychiatrist. she wanted to know how she could help me. i told her my main problems were depression, anxiety, and sleep. she didn't want to increase my antidepressant because she's concerned about me becoming too manic. but she did suggest some solutions to my sleep problem. one was a new sleeping medication that worked on melatonin, something that started with an "r."

another possible solution was going on seroquel, which i had taken twice when i was at s. i'm still a bit scared of seroquel and wasn't ready to try it. the solution we settled on was increasing my risperdal from 2mg to 3 or 4. last night i went up to 3. i slept but still kept waking up and was still paranoid about people hurting me and had to sleep with my light on again.

i'm thinking of going up to 4mg of risperdal tonight just to see if i sleep better on 4 than 3. i want to make sure i get my sleep stabilized before i start work on friday. i know i probably won't have all the answers by then, but at least i might be able to settle on a good dose. i'm still having pretty vivid dreams, and they aren't all good.

eps

yesterday morning, instead of taking my meds, i drank an 8 oz. cup of merlot and started on a second cup before calling my therapist. i had promised to call her at 9am to check in. because i wouldn't dump the wine and had told her the night before that i wanted to take all my sleeping pills at once, my therapist called welfare to check up on me. the sheriff was at my apartment in less than 15 minutes. sheriff called amr (american medical response) who bussed me to eps (emergency psychiatric services) at valley med.

everything seemed to happen so fast. probably because i was a bit buzzed. i only had one drink. my blood alcohol was under the legal limit at .029 but because i'm on psych meds it seemed as if i'd been drinking more. let me tell you, eps is no fun. since most of the patients in there don't have health insurance, the environment can really put you on the edge. my patience all about wore out after six hours. i was freaking out, crying and laughing like crazy from anxiety i had to request an ativan to calm me down. they ordered me a 1mg tab. thank god.

i had heard stories about eps from other mental health patients who had been taken there and then hospitalized at valley med. one patient said he came out worse after his hospitalization. one mental health professional, a nurse at s., called valley med a zoo. eps is like an emergency room exclusively for psych patients. you get evaluated by a psychiatrist and you're put on a seventy-two hour hold. in my case, i was discharged after nine hours because i suppose they didn't believe that i was a further threat to myself and i was stable enough on my meds.

all i wanted to do was sleep and relax because i've been so tired lately. i wasn't really trying to kill myself. it's been hard going back to work, even if i'm just temping. it's taken a lot out of me to function in the real world. it feels as if i've been relapsing again. but i think in reality if i just had more friends, if i weren't so lonely and isolated, if i felt like i was around people who cared about me, a social network, people who could catch me when i fall, then i wouldn't be so depressed.

tonight i talked to my aunt and realized i miss being around people who love me and like to hug me and tell me how wonderful i am. my aunts are usually always happy to see me. maybe i should talk to them more. maybe it would help me to feel a part of a family. things have been different since my grandmother died. and since i moved up here to the bay area, i haven't been able to spend time with my relatives as much. it helped tonight to talk to my aunt.

i still miss my doc at s. a lot. writing the novel is hard work. but i hope someday i can make my place in the world again. i hope someday i'll get published. someday. someday soon.