Mick Jagger Bogarted My Meds

I know it’s been a while since I’ve written anything.

I may have mentioned it before but there are stretches where I’m literally incapable of writing anything. It’s not that the muse isn’t present, it’s just that the will is weak.

For me, writing used to be easy and fun. Now I have to be in the right frame of mind and physically up to do it. So it comes in spurts.

Anyway, I’m in the process of switching meds. My psych is switching out my Lexapro for Cymbalta. And it just took me two minutes to remember the name of the drug. Hell, I’m just popping pills so much I can’t even remember what I’m taking!

I’m on the one week weaning which is always a fun time when you’re taking two SSRIs at the same time. How have I been feeling? A weird kind of mellow is how I would put it.

I’m mellow but confused and forgetful. And, I’m dropping almost everything I touch.

Still, mellow like a hash buzz is better than the Midnight screaming meemies. For those of us who have been trying to find the right med combination for decades, the period between switching one to the other is partly opening the presents on Christmas morning and partly dread. You don’t know the longer lasting effects until weeks pass.

Why Cymbalta? The psych feels it will give me more energy, less lethargy, perhaps an appreciation of golf on TV, I have no idea. I remember I was on it once but I don’t remember why I got off it.

Such is life in the Wide Wide World of Psychotropic Medication.

Good points:

Occasional Zen-like moments of introspective tranquility – even at work

Better sleep

Bad points

Appearing and feeling occasionally drunk; balance issues.

Loss of extemporaneous speaking prowess.

Weird points

Zen state causes me to stare at inanimate objects and contemplate their existence. Staring at a lock on a door: “Wow, always wondered just how locks work with the keys and all that. Fascinating construction. Wonder what metal it’s made of? Beautiful man!”

Earwigs – the songs you hear or just appear in your head become mantras that last a long, long time. Currently, walking down the hall:

Laughter, joy, and loneliness and sex and sex and sex and sex
Look at me, I'm in tatters
I'm a shattered
Shattered

Cool beans bro.

No I’m just groovin’ to the morning vibes. Don’t ask me how I drive. Man alive, thrive on jive.

I’m a cool poppa, 54 going on 21; what the Hell, it beats curling up in bed hiding from the world, shaking and sweating into the sheets. God love Big Pharma.

Rats on the west side, bed bugs uptown

I’m a creative. I write. I’m in control of my brain though I’m feeling my emotions drain. It’s vanilla shit but the vanilla beans are fresh and I’m satisfied.

Spacing out at the keyboard, wondering how long this will last

My brain's been battered, splattered all over Manhattan . . .

Shadoobie, my brain's been battered

my brain's been battered;

brain's been battered;

battered;

shattered;

Shadoobie;

;

High Anxiety

The reactions to my Monday therapy experience have not gone away. This morning I was as nervous as I’ve been in many a month.

I don’t get it. Maybe a therapist could tell me. For two weeks, I unpacked some fairly traumatic experiences in my life. The first week was work, the second week was family. This may be because the entire conversation centered on trauma.

I hate that I can’t control the ‘willies’ as I like to call them through conventional means. My brain races too fast for mindfulness techniques and Ativan will only take me so far. It’s not good to either drive or try to work popping too much of that drug.

Yesterday in a meeting I got the ‘willies.’ I hoped no one saw me taking the deep breaths in through the nose and slowly out the mouth. That DID buy me time.

This week, routine meetings have become ordeals of nervousness and paranoia. Today I have to attend a noonday awards banquet which I am dreading. At least I get a free meal which is about the best I can say about the experience.

My new therapist promised to teach me some techniques (which I probably already know) for managing these issues. I wanted to unpack some more personal garbage but perhaps I should give my continuing reveal a rest. She’s already diagnosed me as PTSD (and surprised other mental health professional haven’t) and knows enough about me to get to techniques. I suppose the rest of the shit package can be unwrapped later.

The rudimentary Cognitive Behavioral Therapy hasn’t been of much use either. I KNOW I will survive the day. I KNOW I can make it through this awards luncheon. I KNOW I can somehow manage my workload. My rational brain knows these things and keeps telling me I’ll be OK. But all of that knowledge seems to be overridden by – what? I don’t know. Some part of the brain that likes to fuck with me.

It is one of the most frustrating parts of the illness – getting mad at yourself for not being in control, thereby starting a vicious circle.

Yesterday something else happened. I had an eye appointment and went to get glasses. While waiting in the mall for the glasses, I experienced phenomena that comes about every 18 months to two years.

I will write a post in Facebook or Twitter and then come back to that post in 20 minutes and the post will look foreign to me – I didn’t write it that way. I can remember I wrote a post – right there – but not using those words and phrases. It’s like someone, not me, completely rewrote it.

It’s a scary thing. I tend to panic and start looking at other posts and tweets, making sure I haven’t written anything odd or offensive. I used to joke that I think my ghostly rewrites were better than the original text.

So I did post about it, trying to explain that my posts might not be written in my normal style and that if I wrote anything people found odd or offensive to forgive me. I said I’d look at them tomorrow and correct or delete them if so.

Of course, while writing that post, I was fully aware that these words might not look the same to me 20 minutes later. So I stared at the post for about 10 minutes trying to make sure.

When this happens I feel like I’m losing my mind or possibly having some kind of weird stroke. The episode lasts about 6 hours, always comes in the late afternoon or evening and is usually gone after a night’s sleep.

By posting it, I was also hoping someone would recognize the process and maybe help me with some advice. I’ve talked to doctors and the only thing that was ever done was switch me from Xanax to Ativan. It did not help.

But it’s worrisome. The best thing to do is to sign off social media, stop writing anything, and take a walk and connect with the environment around me.

My fear is that one day I’ll get an episode that might not go away.

Psychiatry R Us

I went to see my drug pusher today.

She has a nice office, of course, in a nice building and she has a lot of pretty professional plaques on the wall and a special chair given to her by the Department of Psychiatry at the University of Pittsburgh. And she’s been listed as one of the top psychiatrists in the metro area by Pittsburgh Magazine for at least two years in a row.

And, frankly, she stinks at what she does. And I probably should find (yet) another psychiatrist, but I am so tired of it all.

Maybe she's still practicing?

Today was the day I knew I wasn’t going to get any more help from her than I already am. 

I told her about my ER visit and how, after all the tests, they could find nothing wrong with me. I also told her that since then, things have not been getting better with the reprimand still hanging over my head and a supervisor who gave me a yearly rating guaranteeing between the two personnel actions, that I will not be able to leave this job, even if we want to move.

I made it very clear that the drug regimen is not working.

I made it very clear that the work situation was untenable. 

All she wants to know is whether I’m going to kill myself. And how. And she wondered about my rusting shotgun.

Exasperated, I said, no, I’m not going to kill myself but if I did I know it wouldn’t be with a shotgun that doesn’t work. 

It was Col. Mustard in the bedroom with the bungee cord

Well, how, she asked.

I gave this a few seconds of thought. Drowning myself in the koi pond sounded romantic but I didn’t think she’d buy that.

Um, how about a bungee cord from a doorknob? Seems easy enough, and, like those exercisers you see Ronco pushing at Christmas, they fit over any doorknob anywhere – at home, at work, even in your doctor’s waiting room!

Seriously, I wouldn't kid you

Instead of seeing the humor (hell, no one ever sees the humor, I think they’d rather see you off yourself since it would demonstrate that at least you’re a serious person), she asked me if I had any bungee cords at home.

Seriously?

Yes, seriously.

Doctor, do you want to come over to my house and take all my bungee cords? Because if I ever must bring home something large in my car or move, I’ll have to buy a whole other set.

Words fail me some times. This was not one of those times.

I really think we're making progress here

“Look, while you’re there taking my greasy bungee cords, why don’t you help yourself to all the knives and forks in the kitchen too,” I said. “I mean I don’t mean to be disrespectful (but I did), but there are so, so many things you can use to off yourself, it’s only limited by your own imagination!”

See why I’ve gone through so many, many mental health professionals in my life? 

As for the drug regimen that is clearly no longer working, that seemed to panic her about as much as the phantom bungee cords (I mean seriously, have you even LOOKED at pictures of suicides doctor? I could show you a few sites. . .).

Her solution was to double down and prescribe more of the same, which we did six months ago. 

Happy happy happy happy

Yes, if it’s clearly not working, let’s do much more of the same.

With that kind of thinking, I think she has a clear shot to be the next general manager of the Cleveland Browns.

As for the job, her solution was quite novel.

“I just think you need to find a different way of thinking about your job,” she said. 

I am seriously not kidding. 

And that’s when I knew it was game over.

You see, I think my psychiatrist is probably pretty book smart. But I think judging from what I’ve seen of her credentials and FB site (yes, I spy on everyone – I was in Military Intel, it’s in my blood) that she can’t put herself in the shoes of her patients. I asked her to do that today and she said “I’m trying.”

She can’t. She has never known the want, the pain and the fear inside of people she is looking to help. She can’t relate to it. There’s always a book solution, always another pill, always some, well, bullshit rationale that will keep the patient from bleeding out mentally. At least until they do. 

But for Christ’s sakes, don’t die on my watch. The paperwork is such a pain.

Often time I have caught her looking at me as if I was some sort of exotic insect. I suspect many other patients have noticed the same thing as well. We fit somewhere into the diagnosis matrix of the DSM V. Some of us are just a little harder to identify, classify and index.

So, the next time I go back to see her, everything will be fine. I won’t waste her time by whining about intractable issues of jobs and medications and she can get me in and out in enough time to protect her billable hours because her nice Lexus in the parking lot needs paid. 

No sense fighting for treatment or a solution. There is no solution and treatment, it seems, is pushing the latest drug the pharmacy rep has just given her samples of (I’ve seen all manner of trinkets on her desk with drug trade names on them). 

I should have given up on treatment a long time ago. I was stupid. I believed the advertising, the hype, the caring professionals who said, in the nicest ways, that they wanted to help you. 

It’s an industry, like everything else. As for your mental concerns, what it comes down to is this:

You’re on your own sucker. 

With apologies to Johnny Cash. . .

(sung to the tune of 'I've Been Everywhere')

I was draggin’ my ass through another bad depression,
When along came a shrink who came from a big pharma sales session.
"If you're feelin' pretty poorly, I’ve got a new pill for you to try."
And so I took her damn prescription and I got back on the ride.
She asked me if I'd ever tried what I had in my hand.
And I said, "Listen, I've tried every anti-dep in this here land!"

[Chorus:]
I've tried everything, man.
I've tried everything, man.
Some of them made me sing, man.
Some of made my brain zing, man.
Some made me feel creepy things, man.
I've tried everything.

I've tried:

Ativan , Lexapro,  Zofran,  Trazodone, Clomipramine,
Gabapentin, Valium, Xanax, Depakote,  Abilify,
Topamax , Lamactil, Sinequan, I’m real gone.

[Chorus:]

I’ve tried

Doxepin, Klonopin,  Buproprion, Buspirone,
Celexa, Cymbalta, Luvox, Zoloft, Paxil, Effexor,
Wellbutrin, Butriptyline, Nortriptyline, see what I mean, 

[Chorus:]

I’ve tried everything. . .

In case you need a sing-along, here's the Man in Black:

 

Settle Down Francis

Yes, yes, yes and.  .  . yes.

Indicative of the strain I'm under (and admittedly not handling well), 'bad Keith' came out on the blog last night and went into manic posting mode which last reared it's head around 10 years ago.

I suppose it's good that I'm better at recognizing the warning signs.

I thought about removing last night's post and decided against it. The whole point of this blog is to show the good, bad and ugly as go through the stages, reflected in my writing.

But I'd be lying this morning if I didn't say I wasn't a little worried.

Last night was a particularly lousy night sleep punctuated by a charley horse in the right calf that had me bolt upright at 3 a.m. I couldn't even walk to the bathroom for awhile. I got up at close to 8, exhausted with my calf still in pain. I felt woozy and lightheaded but gradually forced myself to get going, get off the couch.

My major accomplishments were vacuuming the pond and going to the vet with wife and cat.

The sun has come out and I feel better. Not great, better. I am definitely jumpy and short of breath. Whether this is developing in a real hypomanic stage is still a little too early to tell but all the signs are there.

Stress is cumulative. For me, it built up all week, getting a big kick on Wednesday when I got my reprimand. Yesterday was 10 hours of pain. The issue is I'm finding it harder to get back to a semblance of sanity in the three days I am home. This worries me.

Saturday's especially in the mornings, are no longer fun. I should probably stay in bed but I just can't. My pride won't let me. At least I have that left.

But I have to get control of the stress that slowly becomes anger inside me. Diversions are what I need. I hated the idea of vacuuming the pond but it needed it and once I got started, I got going. I just felt lightheaded and was a bit worried about slipping and hitting my head on a rock.

An Ativan and a Gatorade on the way to the vets seemed to help me turn the corner.

RIght now the most annoying thing is the ringing in my ears is ferocious - a whistling whine.

I did one positive thing about my situation at work - I finally went to my thrift savings plan site and re-arranged my funds to be more aggressive in my investing. It was long past time.

So I'm rolling my retirement (such as it is) dice on the upcoming election. This should be fun.

In the meantime, pet the cat, watch college football and try to relax.

And put Mr. Mania back in the closet again.