This Is My Brain on Depression

Last week was B-A-D. Capital letters all around. I don't, DO NOT (capital letters all around on this one, too) get suicidal ideations anymore. That particular train of thought left the station after I got my Bipolar II diagnosis six years ago and started healing myself from the carnage of the psychotic break that led to said diagnosis; however, I do get intrusive thoughts and they vary from mildly annoying flies buzzing about the cranial chamber to a constantly fearsome swarm of passive-aggressive hornets agitated by cavorting Thought Monkeys. My waking hours last week primarily involved a near constant barrage of intrusive thoughts. 


I found this clinical definition of intrusive thoughts on Wikipedia: Intrusive thoughts are unwelcome involuntary thoughts, images, or unpleasant ideas that may become obsessions, are upsetting or distressing, and can be difficult to manage or eliminate.^[1] Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, usually falling into three categories: "inappropriate aggressive thoughts, inappropriate sexual thoughts, or blasphemous religious thoughts." 


My intrusive thoughts fall into the "inappropriate aggressive thoughts" category. When they are mildly annoying, I might think, "Hmmm, I wonder what would happen if I swerved into the concrete meridian? Would I survive? Would I die or just be injured?" Typically, I simply note and then shoo away a thought like this. If I have three or more in one day, then I tell Bowser. Quite often, once I bare the intrusive thoughts to Bowser they disappear; they've lost their power in the light of day. When the intrusive thoughts become a swarm of passive-aggressive belligerent hornets, they are dastardly in their delivery. I say passive-aggressive because the thoughts present themselves as musings or images rather than commands or the old voice-in-the-back-of-my-head trick. 


Last weekend Bowser and I took the boys on a little road trip. Any parent knows that when on a road trip, the grown-up in the passenger seat becomes concierge to the children in the back seat. After buckling and unbuckling a dozen times to turn and attend to the boys' every whim, I turned back into my seat at one point, grabbed the seat belt, started to pull it over me, and then let it go slack back into place. The intrusive thought accompanying this action was, "I'm not worth the effort it takes to buckle up. Let Fate decide if I should remain unharmed." I road the next 70 miles without my seat belt on quietly crying the whole way unsure what Fate thought of me.


The thoughts progressed from tempting Fate to images of cutting to release some of the pain. Not gashes, but nicks in the armor of my skin. I didn't do it. I wouldn't do it. I'm committed to my promise to never self-harm in any capacity. But, boy, are those some vivid, nasty, inappropriate aggressive thoughts. It hurts just to think them. 


The following e-mail exchange was had between my therapist and myself last week.

Sunday:

Dear Dr. Feel Good, 

The Depression is eating me alive.

I was incredibly INCREDIBLY busy last week w/ getting the car fixed, renting a car while said car got fixed, running around like a mad woman (hee hee) doing laundry and packing for a weekend away with the in-laws, grocery shopping and menu preparing,... and you get the idea. It went on and on. Our weekend away was both lovely (playing with the boys in the pool, going for an afternoon hike with Bowser) and exhausting for me (I hate family small talk, got very little sleep due to our stupid sleeping arrangements, and felt abandoned on a few occasions). To top it off, I have been the appointed chef for forever and get no help whatsoever. Folks literally sit on their asses reading while I run past them from outdoor grill to inside kitchen and then they forget to thank me for their gourmet dinner. Grrrrrr.

That's me bitching. 

All of that running around has taken a massive toll on my system and the intrusive thoughts have jumped into the fray rather assertively. On the way home from the getaway, as passenger I was in charge of attending to the boys' every need. By the time we hit the town about 70 miles from home I was stressed beyond compare. I went to put on my seatbelt and then decided not to, because I didn't think I was worth the effort. And the thoughts keep coming. Intrusive, Dr. Feel Good, not active, but passive-aggressive. But I can't stand them. They hurt. They're exhausting. They're self-defeating. I feel like I'm locked inside my head and I cannot get out. I can't find the key. I'm screaming and banging on the walls, but I'm getting nowhere, much less out.

Bowser has been very proud of how I handled the depression last week. He said I was a total pro. I'd do what needed to be done and then go have a good cry and go to bed early. I would call him during the day just to say, "I'm sad today" and he'd listen without preaching back to me. He has been very supportive. I told him about today's icky thoughts and we decided that it's time to put Mental Health above all else. So I'm clearing my to-do list for the next few days. He's putting the boys to bed tonight and dusting tomorrow. He said not to do a damn thing except try to center myself for the next little while and that will be success enough for him. Gosh, he's turned out great hasn't he?

So.... I'm on the Rozerem. I'm taking three to four anti-anxiety pills daily, Wellbutrin is up to full dose and has been for a week or so, and then my regular doses of Seroquel and Lamictal. I'm going to try the Chillaxing approach for a few days and if that isn't working, I'll call and make a fast-track appointment if that's okay. However, if you've got any ideas for now, I'm all ears and eyeballs. I'm drowning and ears and eyeballs are all that remain above water.

Thank you for listening.

Yours,

-Sophie

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Tuesday: (after not hearing from Dr. Feel Good in what I considered a fair amount of time)

Never mind. 

I'll just figure it out.

-Sophie

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Wednesday morning:

Hi Sophie,

I’m sorry if I did not respond when you needed.  How you are doing is very important to me. 

It would be helpful for me in my over-busy current circumstance if you would hit me on the head and say “I need this”.  :)

How can I help now?  What’s happening with your symptoms?  Would you like an urgent appointment?

Dr. Feel Good

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Early Wednesday afternoon:

Dr. Feel Good,

I need the following:

A way to stop the intrusive thoughts. Wouldn't wear my seat belt again yesterday just to tempt fate and see whether or not my life matters. I don't think it matters right now. I'm NOT suicidal; I just don't give a shit.

To stop crying. Thank Goddess (Sophia, in my case), for Cover Girl waterproof Lash Blast. Best waterproof mascara on the market.

To stop thinking that the weight of the world is on my shoulders and putting myself in the position of being the sole (in one case) or main go-to person for friends' problems. I want to be there, but the "sole" case is becoming toxic for me and I don't know how to say "STOP! TMI and I can't handle you calling me every day." Enter the Not Enough Thought Monkey.

To stop being a snarky turtle. Nobody likes a snarky depressed turtle. I'm sorry for my last email and for not being clearer in my first email. 

I feel very alone right now. Last week's haiku explains it VERY succinctly (one stanza - promise); Icarus and Me ( a bit longer prose) is pretty good, too. but I know you're busy and can't read all of my posts. I don't expect you to do so. But the haiku is worth the jump.

So, do I need an urgent appointment? I don't know. I don't know what to do anymore and I've no decision making capabilities. If you can think of something I can do from here, then I remain all ears and eyeballs. If you think I need to come in, then I will.

Whatever you think best, I will do.

Yours,

-Sophie

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Late Wednesday afternoon:

Sophie,

Appointment – YES – 1 hour ASAP next week.

Have a protector step in and shield you –and say STOP.  You are ill (very ill).  You are unable to take phone calls (except mine of course) – NURSE PRACTITIONER’S ORDERS!!!!!!!  (I’m sorry the world is too heavy for anyone (except maybe Hercules))

RESCUE DRUGS – The drug you hate to love – time for Zyprexa – one or 2 nights, also a couple of doses of Lithium.

Email me in a day or two if you are not a bit better.  Call if you feel worse.

Breathe

EBB – Earth, Body, Breath

Dr. Feel Good

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See why I call her Dr. Feel Good? She's good. Good-hearted, kind-spirited, and very intelligent in the way she deals with the Snarky Depressed Turtle I can be. 

We call Zyprexa the drug I hate to love because it is a fantastic short-term rescue med for the sort of depression that I'm in - that would be severe rather than mild to moderate. It takes the edges off the depressive thought process, takes the stingers off the hornets. They still swarm, but they aren't quite as intimidating. I hate it because it makes me gain weight. 10 lbs. in one week. Great. Now I can move fat housewife up a few spots in the Why I Hate Myself list. Bowser and I joke that he can have a fat sane wife or a crazy skinny wife. Good thing he likes me cuddly. And sane. Sort of. More very real reasons to hate Zyprexa can be found in this staggering Rolling Stone article called "Bitter Pill". (If you think 10 lbs. is bad, the article reveals that those taking Zyprexa daily and long-term gained an average 65 lbs. a year. Holy Shit. Diabetes, heart problems, cholesterol issues, anyone?) If you or anyone you know is on or is thinking about taking Zyprexa on a long-term basis I insist you take the jump and read that article. It is also a mind-opening play-by-play description of how the pharmaceutical companies use and monitor your doctor's prescribing practices to make sure he or she is shilling the drugs the companies want them to shill. Creepy.

I hate to like lithium, too. Karita over at If Narky, Feed Profusely is my Lithium BFF. We started around the same time last week and are enjoying lithium side effects. She's a great read by the way, particularly for those interested in what life with bipolar is like. Lithium is considered the anti-suicide drug. For some crazy reason ;) lithium reduces the rate of suicide among the bipolar population taking it by seven-fold. Lithium nearly eradicates the intrusive thoughts, at the very least downsizing the swarm of hornets to the occasional annoying fly. Lithium is an effective mood-stabilizer because it solidifies one's mental floor and reinforces the ceiling. Can't float up too far or fall too low if the mental parameters are strong. Lithium does work.


Then there's the side effects. The part of lithium I really really hate and the reason I balk at having to go on it even for a 6-8 week stint.  Karita has the tremors and forgetfulness right now. I have forgetfulness, a bit of hair loss - knots of it come out in my hands when I shampoo, vertigo, and the feeling that my brain has been dissembled. I cannot figure out how to do anything that involves a seek and find aspect, my thoughts are disjointed, I can't remember why I am doing some task I find myself doing. It's like someone took out all the parts of my brain and laid them side by side on a tarp intending to come back later to put it all together again. I think this dissembling of the brain is why Lithium is so effective against intrusive thoughts - I can't put a thought together, much less an aggressive one.


This is what my brain looks like on depression. More specifically, this is what the brain of someone who works very friggin hard to manage her mental illness looks like as I slog my way through depression towards a light at the end of the tunnel that I cannot see through the blinders of my tears, but trust will be there because it has always been there in the past.


I slog on to find my Normal. Let's just see if Lithium lets me recognize my Normal when I find it. Shit, I'll probably walk right by it, turn around at some point and go, "Why did I come up here? I can't remember." I hope something resembling Normal comes along soon. I'm getting sick and tired of being with myself. I'm done with Depression. I've had it. I'm Done.


Do you hear me, Depression? I'm DONE! Leave me the fuck alone!!!

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creativity credit for Chemical Angels, unblocked by alexcateye on flickr