Lessons Learned

I’ve struggled the last couple of days with my emotions.  I have to say, that’s the first time since early in December.  I stop short of calling it depression.  I know how my depression makes me feel so low that I have no hope.  I had hope yesterday and the day before.  I honestly think I was just stressing about circumstances.

Stress can really take it out of a person.  I got myself so worked up over a meeting that I cried…that I couldn’t stop crying.  And as you might have guessed, the meeting went off without a hitch.  I spoke my piece; I listened to all responses.  And I ultimately felt better for having done so.  So why did I let myself get all worked up to the point where I cried and felt scared?

The short answer is, “I don’t know.  I honestly have no idea.”  You’d think I’d know better by now, how to incorporate the tips and tricks Robin has taught me and use them in my everyday life.  Take a step back.  Take a deep breath or two.  Look at the big picture.  Go to my happy place if I need to.  See, feel, hear those familiar and comfortable sounds.  Center myself strong.  And pray.

But we’re talking about my job here.  It’s important to me.  Not only do I want to stay employed, I want to stay employed in the job I’m currently holding.  And I want to do it well.  I enjoy it.  But sometimes I don’t feel smart enough to do it.  I wanted everyone to know that I’m doing my best and I want to continue doing my best, knowing that my best will only get better as time goes on.  I was only concerned that maybe they weren’t willing to wait for me to get better, that maybe my best wasn’t good enough at this point in time.

But that’s not the case.  They’re happy with me.  They said as much.  So I need to NOT let my emotions get the best of me.  I need to continue to focus on what I’m doing, doing the best I can for them.  And I need to continue to take care of myself by eating right, getting enough sleep, taking my meds, and praying.

I can do my part.  I WILL do my part.  No more forgetting my morning meds over the weekends.  No more skipping lunch.  No more staying up late to watch a football game and still expecting myself to get up at 5am for work.  And it’s time to get more physical and watch what I eat.  I can effect change in my mental health.  I’m worth it.  It’s time to prove that.

National Suicide Prevention Week

In honor of National Suicide Prevention Week, September 5th - 11th, I'm dedicating a blog entry to it.  According to an article on The Mighty, suicide is the 10th leading cause of death in America.  We can do something about that.


I'm a firm believer that NO ONE commits suicide for selfish reasons.  In all instances, they do it because they think the world would be better off without them.  I honestly think that most suicides come from a place of depression, a chemical imbalance.


This may come as a surprise to you, but I've been suicidal before.  I can think of two occasions.  One was two years ago, the summer of 2014, when I was being weaned off one set of medications and increased on another set of medications.  That really messed with my brain chemistry and I was all over the place emotionally.  My anxiety was at its worst.  The second instance was May 29th, 2015.  I wasn't ready to take the action that day, but I had seriously started making a list of all the things that I needed to accomplish before I could take my own life.  During both of those times, my depression was speaking for me.


But I'm still here.  Due to medication, a great counselor, and a tight knit support group of friends and family.  Even though I didn't quite believe it, I listened to people tell me that I make a difference, that God wanted me here, that they wouldn't allow me to end this precious thing called life.


I had multiple people tell me that they wanted that phone call.  THAT phone call.  The one that says I can't do it anymore.  They wanted to be the ones to talk me down, to convince me that I mattered.  I have people in my life who wanted to do that.  That alone spoke volumes to me.  It made me think a different thought.  And even though I didn't hold a lot of hope at those times, I held on to what people were telling me... that this time was fleeting, that it was temporary.  To hold on until it passed.


And it did.  It passed.  Both times.  In fact, I tell myself that through every depression.  That it's only temporary.  There's no knowing how long it will last, but it's been temporary EVERY.SINGLE.TIME.  That's something I was able to hold on to.


And I'm still here.  And right now, I'm depression-free.  Sure, I'm medicated and I wouldn't even think about going off my meds.  And I talk to my counselor regularly.  And I know that my depression can come back at any time.  But I'm enjoying my life right now because I HAVE a life right now.  Because someone was there for me when I was at my lowest.  And I'm very thankful for that.

Feedback

I gave blood on August 4th.  It was the first time I'd given blood since I tried a year ago and my heart rate was too high.  This time, there were no pitfalls.  I was able to give blood successfully with no issues.


And then this week I get an email that says that my blood has been delivered.  It went to University Hospital in Louisville, KY, to a patient in need.


I thought that was pretty cool.  I liked the feedback.  I mean, I always assumed my blood was being used by someone somewhere.  But it's nice to know approximately when and exactly where.  Just goes to show you (and me), I matter.  I mattered to that person anyway.

From Science Experiment to Stability

Two years ago, my primary care provider came to the conclusion that he could no longer treat my depression.  He had changed my meds a couple of times over the years, but the cloud just wouldn’t lift and the tears were always at the ready.  So he referred me to a psychiatrist.

After talking for 30 minutes, I felt a real connection with the psychiatrist.  I felt she was really listening to me and could almost finish my sentences.  She determined that I should be treated for Bipolar II instead of Depression.  I was unfamiliar with Bipolar II (not-so-high highs/low lows), but trusted her judgment.  I just wanted to feel better.  I needed to find stable again.  So, she changed my meds.

I hate med changes.  You never know what you’re going to get.  I was being weaned off my old meds and geared up on my new meds at the same time.  I didn’t know what to expect.  And let me tell you, it was by far the worst I’d ever felt.  In addition to being depressed and crying due to a relatively long depressive episode, I was fighting some pretty severe anxiety.  It was a long three months.

Mere weeks into that transition, it earned me a month off work.  I’d never been put off work before due to mental health and it scared me.  It wasn’t my idea to take time off; it was my employer’s.  I worried about whether I’d be able to go back.  First, I didn’t know if I’d even be able to.  Second, I didn’t know if they’d let me.  So on top of the depression and anxiety, I was scared.  As a single woman in her 40’s, I was the only one paying my bills and saving for my retirement.  I had to work.

It was during that month off work that I really got to know my new counselor.  He taught me several techniques for centering my mind and calming my nerves.  He was so patient with me.  Not only was he a great listener, he was completely non-judgmental.  These are things I learned to value in a counselor.  He also taught me how to talk about my emotional situation without getting upset.  This was something that I’d always struggled with.  My close friends and family could now be part of the healing process, where I’d never really been comfortable with that before.  And they were invaluable.

Over the next few months, we figured out what doses of medications I needed to be on.  I was feeling really good again, back at work, and relying on the techniques that my counselor had taught me.  I was living and surviving with my mental illness.  Things weren’t perfect and my depression would come back, but for shorter durations.  I could live with that.

Then one day I couldn’t give blood because my heart rate was too high.  I started monitoring it and realized that my heart rate was over 100 beats per minute most of the time.  It was time to go back to my primary care provider.  After discussing it with my psychiatrist, they decided it was my anti-depressant that was raising my heart rate.

So even though I was doing well emotionally, I had to go through another med change.  Again, I was scared.  I was scared that I’d have the same fits of depression and anxiety that I’d had before.  I was afraid that we wouldn’t be able to find another combination of medications that effectively treated my depression without adversely affecting my heart.  And that fear brought out the worst in my depression.

It took time and I felt like a science experiment again.  But we found it.  We found the combination of meds that kept my depression at bay.  And now, just two years after my worst bout of depression and anxiety, I’ve been seven months without a depressive episode.  This is the first time I’ve been able to say that in years.  I honestly don’t remember the last time I went seven months in a row without a depression.  And I feel blessed.  I feel healthy.  I feel good!  I know I’m not healed.  I know another bout of depression and anxiety can come about.  I know it might show itself as a manic episode or a depressive episode.  I know.  But right now, I’m enjoying the stability.

It's all about the meds...

Okay, it may NOT be all about the meds.  But I know that my meds have a lot to do with it.


I HATE having to change meds.  You just never know what's going to happen when you have to go through a med change.  But I've been taking my current meds since early December and the timing of that (and my depression-free status) doesn't elude me.


I take Latuda 60mg.  And if you follow me on Facebook, you know I spend nearly $1,000 for this every month until I hit my deductible.  (I just changed companies so I have to start over with my deductible, but at least it's only $4,000 now, instead of $6,000.)


From WebMD

This medication is used to treat certain mental/mood disorders (such as schizophrenia, depression associated with bipolar disorder). Lurasidone helps you to think more clearly, feel less nervous, and take part in everyday life. It may also help to decrease hallucinations (hearing/seeing things that are not there). In addition, this medication may improve your mood, sleep, appetite, and energy level. Lurasidone is a psychiatric medication that belongs to the class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.

I don't have hallucinations, but this drug definitely helps me to think more clearly, feel less nervous, and take part in everyday life.  It also improves my mood, sleep, and energy level.  It's expensive, but it's working.


I also take Escitalopram 10mg.  It's a generic version of Lexapro.  This one is rather inexpensive.  I like that in a medication that works.


From WebMD

Escitalopram is used to treat depression and anxiety. It works by helping to restore the balance of a certain natural substance (serotonin) in the brain. Escitalopram belongs to a class of drugs known as selective serotonin re-uptake inhibitors (SSRI). It may improve your energy level and feelings of well-being and decrease nervousness.

When I was taking the Latuda by itself, I was still weepy and moody.  When I was taking my anti-depressant by itself, I was still outright depressed sometimes.  But the two of them together, that's keeping me even keeled and positive, hopeful.


Six months in a row now.  Nearly seven.  I think they're working.  I'll continue to take them.

Six Months

I have been depression-free for more than six months.  I had to go back and read a handful of journal entries to know when I fully came out of my last funk.  The best I could tell, that was the first week of December.  That means, more than six months has gone by without me having to endure depression.

 

That's HUGE for me!

 

And it's not like the six months have been easy.

1. I made it through winter, which is particularly dreary and hard for many to deal with, let alone someone with depressive tendencies.
2. I was working on a contract with a drop-dead date.  We were losing employees regularly to lay-offs or because they simply found other employment.  The pallor at the office was sometimes depressing... and I don't use that word lightly.
3. I left that job and took another job, filled out paperwork for a security clearance (which I hate doing), and struggled getting my medical insurance turned on again.  New employer, new environment, new tasks, new boss.  New everything!
4. And probably the worst of all, I lost my dad.

 

I've had a few weepy days in there, but for the most part, I've been tear-free.

 

Today, I feel great!  I can't imagine feeling any better emotionally.  Who knew these days could last for six months?  I'm feeling so blessed.

 

In reading my journal entries from before this happy six months, I came across the following:

 

Robin, my counselor would keep reminding me that this is just temporary.  This is just temporary.  I've been here before and have gotten out of this before.  This is just temporary.  I can survive this.  Just a little bit longer.  I need something else to focus my mind on.  Then before I know it, this will be past.  This will all be in the past.  And I can live in that happy place again.  Even if for just a little while.  A little while of good is still worth it.  This is just temporary and God still loves me and apparently needs me to get through this.  I can do this.  Just for a little while.  This is just temporary.

 

I remember typing that.  I remember forcing myself to regurgitate each and every word.  This is just temporary and I can do this.  I remember repeating Robin's words in my head.  And he was right.  It was just temporary.  And now I'm in a happier place.  And that place has lasted more than six months.  I have been blessed with six months of no depression.  What did I do to deserve this?

 

The fact is, I probably DON'T deserve to be this healthy.  But I'm going to try my best to be grateful for it every day.  Thank You, Jesus!

Just Catching Up

Fitbit:  I've decided to stop wearing my Fitbit.  Actually, I decided that a couple of weeks ago.  And I'm happy to say, I'm glad I did.  I was getting so hung up on how many steps I hit in a day.  It was a little unnerving.  I'm glad to not be tied down to that little contraption any more.  If anyone wants a Fitbit, let me know.  You're welcome to mine.

VBS:  I'm teaching music at VBS at St. John's this week.  The theme is a campout.  The theme song is Kum Ba Ya.  So I've gotten to sing that song SEVERAL times this week.  The preschoolers and kindergarteners have another song... the first and second graders have another song... and the third and fourth graders have another song.  So I really only had to learn four songs.  Dealing with so many kids in such a short period of time wears on me.  I'm just not a kid lover. Looking forward to the week being over.  Only one more night to go.

Work:  My new job is going pretty well.  I'm working on the IT budget.  Not by myself, thank God.  It's enough to keep me busy though.  I'm really happy to be back on the IT contract.  I'm also spending some time studying for my Security + certification.  It's a bit overwhelming, but it gets a little more manageable with every day that goes by.

Health Insurance/401(k) - I've been trying for a couple of weeks now to enroll in both of these with my new company.  I finally got my health insurance lined out yesterday.  I've already racked up $1,200 against my new $4,000 deductible.  I'd like to see it counted.  So I need to figure that out yet.  And I need to call about managing my 401(k).  But I'm working on it.

Mental Health -  I haven't had a depressive day since early in December.  That's six months depression free.  Six months!  My meds are definitely working.  Robin has taught me several things to keep my mind focused on being more positive and dealing with stressors better.  That's definitely working too.  Here's hoping I can go another six months!

Cats -  Mom was on vacation this week so I watched her cats this week.  So I got some feline therapy each morning and afternoon.  Yea, me!  Time spent with Barnaby and Elliott is good for me.

Another Update...

I know it's been awhile.  Sorry.  I'll try to be more responsive in the future.

First of all, I feel great!  I haven't felt this good since I went four months this past summer without a depressive day.  I feel really good.  Check out my picture... clear skies!

Now tell me, based on those words, would you need to ask me half a dozen questions to determine how good I'm feeling?  Making me second guess how I'm feeling?  Making me wonder if I have any right to feel that good?  Well, my psychiatrist did.  So I fired her.

Yes, I did.  I fired her.

That wasn't my intention before I got to the appointment.  But within five to ten minutes of being there, I never wanted to see that woman again for any reason... ever.  And I won't.  Out of my life!  If I need a psychiatrist, and I think I probably do, then I'm going to have one that I'm comfortable with.  Not one that calls me twice a week and makes me cry harder than my depression.  Not one that makes me feel like every answer I give isn't good enough.  Not her.  Not even close.

And I'm done ranting about that.

I finally got out of the middle of the discussion between the cardiologist and the psychiatrist about medication.  Obviously the psychiatrist won that battle.  I was told not to take the Diltiazem anymore and to see Emily (the cardiologists nurse practitioner) in December.  I saw her.  My blood pressure and heart rate were down a little, so she doesn't want to see me again until next December.  I honestly wondered if my psychiatrist ticked them off and they were doing everything they could to get rid of me.  But seriously, my heart rate is now averaging in the high 80's.  So I think I'm out of the woods there.

Also in December, I started taking an anti-depressant.  I came off the Fetzima because it was blamed for my high heart rate.  And even though my new psychiatrist said that my heart rate should drop within 3-5 days, it's still dropping six weeks later, slowly but surely.  But I wasn't 100% emotionally on just the Latuda.  So she prescribed a low dose anti-depressant, Lexapro 5mg.  It's doing GREAT!  Really, I haven't felt this good since the summer.  I've taken Lexapro before, just not with the Latuda.

So, my heart rate is dropping.  It's taking a long time to drop after a workout, like two hours.  But on days that I don't work out, my heart rate is staying between 85 - 90bpm.  And it's been as low as 76bpm.  So all is well there.  And my depression is well at bay.  So other than looking for a new psychiatrist that will still allow me to keep my current counselor, I'm good.  I'm better than good.  I'm great!

Dueling Doctors

So not all has been serene in my world in the last week.  I've been fighting some moodiness and inability to get to sleep, but mostly I've been fighting my doctors.  Actually, I've been the go-between as they fight with each other.  They probably wouldn't call it that, but that's what it looks like from my vantage point.

The calcium blocker, Diltiazem 180mg, that the cardiologist prescribed has a bad interaction with the Latuda 60mg that the psychiatrist prescribed.  The psychiatrist would prefer that I not take the Diltiazem at all.  The cardiologist says I can take both, but I should score the Latuda.  The psychiatrist didn't appreciate the cardiologist adjusting her prescription.  I'm sure the cardiologist doesn't appreciate someone second-guessing his orders.

Apparently the Diltiazem can make the Latuda stay in my system longer, making it like I could be taking 100% greater dosage.  So the cardiologist says to just score it, take half.  But Latuda can't be scored.  Not to mention, there would be no guarantee that the 30mg of Latuda would be kept in my system twice as long, making it like 60mg.  Without a lot of blood work and testing, there's no way to know how long the Diltiazem is keeping what amount of Latuda in my system.

And since I'm much more concerned with my depression than my heart, I've been following my psychiatrists advice of not taking the Diltiazem.  So I've had it for a week and I've taken it once.  I'm sure the cardiologist would not be pleased.  I tried to call him a couple of times last week, but they were off for the holiday.

Today I called the cardiologist's office to tell him the following:

• Latuda can't be scored, so that's not a solution I can use.
• There is no 30mg dosage of Latuda, so I can't get to half of what I need to be taking.
• I've been working too hard with my psychiatrist to manage my depression and my anti-depressants to go backwards.
• I haven't taken my Diltiazem in a week.
• The psychiatrist thinks a beta blocker would work better with the Latuda than a calcium blocker.  Can we maybe try that?
• If you have further questions about any of that, call my psychiatrist.

I'm tired of being in the middle of their little spat.  I wish they'd come up with an appropriate plan of action and just let me know what the answer is.  I don't think I should have to keep passing on messages that start with, "but the psychiatrist thinks..." or "but the cardiologist says...".  Let them have those conversations on the phone without me.

They're causing me stress... which is probably adversely affecting both my depression AND my heart rate.

We'll see if I get a call back and if they're willing to talk to each other.  I sure hope so.  The psychiatrist is calling me tonight.  And I want her to start the conversation with, "well I spoke with the cardiologist...".

The Latest

First thing's first.  I was depressed from last Wednesday (the 18th) through yesterday (the 23rd).  But I feel GREAT today.  I was depressed through lots of work, an appointment with my psychiatrist, and an appointment with the cardiologist.  Good times [sarcasm].  But I'm encouraged that my depression only lasted six days.

So my appointment with my psychiatrist didn't go great.  I must first concede, she didn't get on my nerves nearly as much as she has in the past.  Maybe I was too depressed to care.  Maybe she was treating me with kid gloves because I was so obviously down.  And I know it's her job to determine when I should be admitted.  But discussing suicide with someone who is already depressed is not uplifting, needless to say. So I didn't even remotely enjoy the time spent with her.  Nothing new there.

Before I left, I talked with my counselor, who seemed a little concerned with how I was doing.  So he wants us to get together Wednesday.  But I'm feeling MUCH, MUCH better, so that appointment will go well.  Sometimes when I'm not feeling good, I don't look forward to my appointments with my counselor.  Actually that's not true.  ALL THE TIME when I'm not feeling well, I don't look forward to appointments with my counselor.  So I'm no longer dreading this appointment.  Bring it on!  He'll remind me of things I should say to myself when I'm down.  He'll teach me another trick or two to try to get my mind out of that bad head space.  I expect it'll be productive and well-spent.

My appointment with the cardiologist went very well.  He says that my heart is in GREAT shape.  Yea, me!  He also asked me if I was working out.  I told him that my primary care provider had me scared to death to raise my heart rate any higher and suggested that I walk without breaking a sweat.  The cardiologist told me to start working out 30 minutes a day.  So I need to do that.  (This eating 350 calories right before bed to accommodate the Latuda is quickly making me gain weight.)

He was well aware that I was depressed yesterday.  I told him that my psychiatrist has been mucking with my anti-depressants in an effort to get my heart rate to drop.  He wanted to make sure I knew that he never suggested to anyone that my anti-depressants were the culprit.  I assured him that my primary care provider championed that cause and my psychiatrist was more than happy to jump on board.  To help quell the continued science experiment, he suggested that I take a calcium blocker to lower both my heart rate and blood pressure.  I started taking that last night.  I'll follow-up with his nurse practitioner in a month to see if that works.

In the interim, I need to call my primary care provider to see if he wants me to stop taking the pill he put me on a year ago, to help lower my blood pressure.  There's really no need at this point for me to be taking two.  So I need to make that call.

Work has been busier lately.  But depression or not, I've been able to keep up.  Praise the Lord!

No day is better in my world than the day after a depression passes.  "This is the day that the Lord has made; let us rejoice and be glad in it."  Psalm 118:24

Just an update...

I know it's been awhile since I've provided an update.  My picture today, chance of sunshine.

First of all, I've still heard nothing concerning my echocardiogram.  Maybe I should call them and simply ask.  But between my other appointments, I'm doctored out.  I figure if it was bad news, I would have heard about it already.  I can wait until the 23rd.  Honestly, I'm trying not to take any of this all that seriously.  It helps me to NOT stress over it.

I made an appointment with my primary care provider's office last Monday (the 2nd) to get my blood pressure and heart rate measured.  Yes, I had to make an appointment.  I'll never do that again.  I'm not going to call the office for more than an hour just to get through, wait in the lobby for 15 minutes, and pay for an appointment, just for a two minute task of getting my blood pressure and heart rate.  Not when I can do it myself.  At any rate, my blood pressure was perfectly acceptable at 117/77.  And my heart rate was still a whopping 103.

My psychiatrist called me three times last week.  One of those conversations took well over an hour.  But I'm not going to vent about that.  One thing I learned though was that I've been taking my Latuda wrong for more than a year.  It says to take it with food.  I do.  But normally medications tell you that to prevent an upset stomach.  I only need a boiled egg or a handful of crackers to avoid any upset stomach and I've never had an upset stomach with my Latuda... so I thought I was doing things perfectly fine.  But no.  When they say take it with food, they mean 350 calories!  Who eats 350 calories at bedtime?!  But at Robin's suggestion, I'm drinking an Ensure Plus with my Latuda every night.  This is going to kill my diet!

As for my moods... I found myself being both angry and weepy last weekend (the 30th - 2nd).  But I've been mostly good since then.  Who knows if it was the increase in calories with my Latuda or not.  But I feel good.  No complaints.

My psychiatrist is going to call me again tonight.  Hopefully we don't have another marathon call.  I'll tell her I've been taking my Latuda with food and that I've been feeling well, and that my heart rate is still averaging over 100bpm.  My guess is that she'll take me off the Fetzima completely.  The only thing I don't know is whether or not she'll increase my Latuda to 60mg.  My guess is that she won't until next week.

Bottom line, I still feel like a science experiment, and I'm still scared of my next crash.  I've credited the medication for making my depressive episodes farther apart and shorter in duration.  But I'm trying to enjoy the current feelings of being good.  No sign of depression today.

But I have been thinking... what if I come completely off the Fetzima and my heart rate STILL doesn't come down?  The assumptions that were made about my medications will be wrong and we still won't know where the actual problem is.  Ugh!

After the echo and a counseling session...

A couple of days have gone by since my echo and counseling session.  Just know that I'm not nearly as upset as I was on Tuesday.  Really, truly.  So you're going to get a watered down version of events.

First of all, the echocardiogram.  I'd never done that before and didn't really know what to expect.  I had to get undressed from the waist up and lay on a bed while covered with a towel.  All the while the radiology technician pressed a hand-held wand against my chest looking at various angles of my heart.

My responsibilities were fairly easy.  Once I had to move my left arm.  Once I had to move from lying on my left side to lying flat on my back.  Otherwise, I just kept up my end of the conversation.

I got to hear the blood flow through my heart.  I got to hear my heart beat... and I can verify that it is fast.  I also got to see the occasional picture of my heart... though I couldn't have told you it was my heart.  But if there was ever any question as to whether or not I actually HAVE a heart, the verdict is, I do.

My primary question was when I might expect to hear the results.  The tech said that it might not be until my follow-up appointment, which in this case is four weeks away.  I guess if I have to wait that long, it's only good news.  If there's bad news, I'm sure I'll hear from them sooner.  I've heard nothing as of this blog.

As for my counseling session.  I didn't request the appointment, my counselor did.  I simply agreed to show up.  I assumed that he knew this process of changing my meds this quickly would be stressful and he wanted to offer emotional support.  The appointment didn't really go that way though.

So I started off with telling him that I'm going to miss the warm fuzzy I felt with Dr. Callaghan, because I didn't feel that with Dr. Woodward, that she was much more clinical, much more mechanical than I'm used to.  Whereas I fell in love with Dr. Callaghan the first time I met her, the same wasn't true of Dr. Woodward.  (Between you and me, I don't care if I never see Dr. Woodward again and I'm truly going to miss Dr. Callaghan.  Just sayin'.)

I told him that I was nervous about changing my meds twice in ten days.  I told him I felt like a science experiment last year, trying to figure out what dosage of medicine I should be taking.  And here we are doing it again this year.  And since my meds just got upped to 120mg in March, I felt like that's probably the dosage I needed in order to avoid emotional crashes.

Ultimately, Robin told me that all patients are science experiments, that this is nothing new.  He told me that every doctor is going to treat the physical symptoms before the emotional ones.  He didn't seem to understand my real fear.  I also think that everyone is concerned about my heart and NO ONE (but me apparently) is concerned about my depression.  I'm paying a lot of money and spending a lot of time and energy on mental health care... yet I don't feel like I have an advocate for my depression, for my fear of the next crash.  I feel like they're okay with me just crashing again.  And I can't get anyone to hear that I'm NOT okay with that plan.

By the time I left, I realized that it doesn't matter what I think.  It doesn't matter what I feel.  It doesn't matter what I expect.  It just doesn't matter.  Even though I'm the patient and I have concerns.  Even though I'm the one spending the money.  Even though I feel like I'm screaming at the top of my lungs that this process scares me.  It doesn't matter.

And so what?  What difference does it make if they 'hear' me or not?  What difference does it make if they don't care?  I should just keep doing what they say and let the chips fall where they may.  I should trust the process, trust the professionals... even if they don't listen to their patients, which I don't find all that professional.  What's the worst that can happen?  A crash.  I've survived them EVERY.TIME.BEFORE.  I'm not looking forward to it.  But what difference does it make what I am and what I am not looking forward to.  None of my doctors are all that concerned.  So maybe I shouldn't be either.

So my Fetzima, which is assumed to be the culprit of my high heart rate, was reduced by 40mg on October 16th, nearly two weeks ago.  It was reduced by an additional 40mg again on Tuesday the 27th, only two days ago.  So far, there is no change in my heart rate.  When I took my blood pressure and heart rate last night, my heart rate was at 100bpm.

The next action item is for me to stop by my doctor's office on Monday to have my heart rate officially done by a professional and report it back to my psychiatrist.  If my heart rate is still high, I'm pretty sure I can count on buying yet another smaller dosage of Fetzima.  Yea.  [sarcasm]

After seeing my new psychiatrist...

I don't think I like her.  And I hate that because she obviously wants to be much more involved in my treatment plan than my previous psychiatrist was.  After spending a grueling two hours with her yesterday...two hours that I didn't even remotely enjoy, she insisted on calling and talking to me for the first 20 minutes of the Colts game today.

She's already given me bad news.  She wants to change my meds again.  That will be the second time in ten days that my anti-depressants have been adjusted.

I spent the better part of last year being a science experiment for Dr. Callaghan, changing medications regularly, trying different combinations to try to get me to an even keel.  And at times it was painful.  I even spent a month on short-term disability due to the affects.  Obviously Dr. Woodward wants to do that same thing this year.  Not only is it expensive, it's scary as hell.

Dr. Callaghan reduced my Fetzima from 120mg to 80mg and increased my Latuda from 20mg to 40mg last week.  That happened a week ago Thursday.  I've been on those meds for less than ten days.  My new psychiatrist says that I should have already seen a change in my heart rate.  And obviously I haven't.  So she wants to change my meds again, lowering the Fetzima to 40mg.  So even though I already spent money on Latuda once this month and Fetzima twice this month, I get to spend more on Fetzima yet again.

Last year, I was on every dosage that Fetzima offers along with Latuda.  So I have absolutely no faith that taking 80mg less of the Fetzima will maintain any emotional stability for me.  But by Tuesday, we'll be trying it again.  She says that I should see a difference in my heart rate by the weekend.  She's going to call me next Monday to find out.  I can't wait. [sarcasm]

Also, she keeps telling me to let her know if I have any signs of 'discontinuation syndrome', which will feel like flu symptoms and last 3-5 days.  I'm not the least bit worried about freakin' flu symptoms that will last a few days.  I'm much more concerned about hitting another long depressive episode.  I can live with the damn flu!

She already told me to calm down and not take this as bad news, that I'd be bringing on a depressive episode with just my thoughts.  Great to know that my next depressive episode is already my fault.

I know this is blunt, but I'm going to say it anyway because this is how I feel today.  Being dead sounds much more appealing than being depressed.  Depression sucks more than any other feeling I've ever known EVER.

After seeing the cardiologist...

So I saw a cardiologist for the first time in my life on Monday.  His name is Dr. Leonard and he's treated my dad before.  I really liked him.  He was kind and answered all of my questions.  And in return I was able to answer all of his questions.

He listened to my heart and my lungs.  We talked about my blood pressure being up to 142/100 that day, as well as my heart rate being 100bpm.  He didn't like either of those numbers.

We talked about what Dr. Potts (my primary care provider) said and what Dr. Callaghan (my old psychiatrist) said.  We talked about the fact that my anti-depressant medications have already been adjusted and how that might be enough to make a difference in my heart rate... though not yet.

He wants to see if any damage has already been done to my heart, so he ordered an echocardiogram for next Tuesday.  Otherwise, he's okay with waiting another four weeks to see if this medication change is enough to bring down my heart rate to something more reasonable.  If not, he mentioned adding a beta blocker to my regimen.  Dr. Potts had negative things to say about that option, as apparently they don't mix well with other medications.  But we'll see how everything turns out.

Ultimately, if the echo doesn't show any heart damage, we're pretty much just looking for anti-depressant meds that will allow my heart rate to be lower and I won't likely have my own cardiologist.  If the echo DOES show heart damage, I'll have a couple/few more appointments with my new cardiologist.  Dr. Leonard doesn't think there's much chance in there being any damage though.  I found that to be a positive outcome to that appointment.

So let's all pray together that the adjustment in my anti-depressants brings my heart rate down to something more reasonable while still managing any depressive tendencies.  Amen.

After seeing the psychiatrist...

I met with Dr. Callaghan yesterday afternoon.  She too is convinced that my Fetzima in particular is causing the high heart rate.  She too was surprised to hear that my heart rate is averaging over 100bpm.  She said that Dr. Potts (my primary care provider) was adamant with her that she see me right away.

So she got me in.  It was great seeing her.  She supports patients at Transitions through the Daviess Community Hospital.  The good news for me is that she knows my new psychiatrist, Dr. Tracy Woodward and even introduced her to my counselor, Robin Maglinger.  So she's going to ensure that a copy of our record gets to both Dr. Potts and Dr. Woodward.  (I was a little concerned about meeting with Dr. Callaghan when I'm supposed to meet with Dr. Woodward any time now.  I kind of felt like I was cheating on Maglinger Behavior Health Services.  But there was no need for that concern.)

So, Dr. Callaghan completely agreed with Dr. Potts that we need to make a change to the medications controlling my bipolar II.  Thankfully she didn't suggest changing the meds.  That was NOT pleasant the last time I had to go through that kind of transition.  But she did suggest decreasing the Fetzima from 120mg to 80mg and increasing the Latuda from 20mg to 40mg.  Hopefully that allows my heart rate to come down to something more reasonable, while still managing my depressive episodes.

I'm a little nervous.  But I've got good doctors who care.  So I keep reminding myself to trust the process.

I wonder if my heart rate could drop as fast as three days.  I see the cardiologist on Monday.  Wouldn't it be great if he sees marked improvement and doesn't require me to visit with him regularly.  One can only hope.

The fact is, I don't deal with stressors all that well and I'd just as soon not have this one.  But I'll know more after meeting with him on Monday.  I'll let you know!

The Old Ticker

So I know I talk/write about my challenges with depression regularly.  But it's not the only health concern I have.

I've been taking medication for high blood pressure for a couple of years now.  And its done it's job perfectly.  But lately I've had issues with an elevated heart rate.

It was brought to my attention on August 13th when my heart rate was too high to donate blood.  It was up to 118 that day.

So I started recording my blood pressure and heart rate shortly thereafter.  I have a cuff that fits around my left wrist and makes it easy for me to use.  My heart rate for the last (nearly) two months has averaged 102.6.

Do you know what they call a heart rate that's hit 100bpm?  Tachycardia.  I'm pretty sure I've only heard that word on shows like "ER" and "Grey's Anatomy".  Well I guess it could be used to describe my heart rate.

I'm sure it's related to my bad fitness level and the fact that I'm grossly overweight.  And I'm sure that's where my doctor will start my treatment plan... as well he should.  That doesn't mean I'm looking forward to it.  It's definitely not something I can fix overnight.

I was encouraged to make an appointment with my family doctor by my gynecologist who I saw Monday morning.  My blood pressure and heart rate were high at that appointment.  He asked what my primary care provider was doing about it.  I told him that I hadn't yet told him about the racing heart rate.  He suggested that I do so... and soon.

So I had an appointment this morning.  I ended up being there for two hours.  His primary concern was that it might be my anti-depressants.  And sure enough, after doing a bit of research, he was convinced.  But just to be on the safe side, we did blood work and an EKG.

He didn't like the T-waves on my EKG, saying that they could lead to an arrhythmia.  I've already received my initial blood work results.  I had six indicators that were out of normal range.  But I don't know how concerning they are.  All I really know is I have an appointment with the psychiatrist tomorrow to discuss possibly changing or adjusting my meds.  And I have an appointment on Monday with a cardiologist.

So I'll know more in a week.  I'm looking forward to seeing Dr. Callaghan tomorrow.  She's a great psychiatrist.  But I'm a little nervous about mucking with my meds.  Right now, my depressive episodes are farther apart and don't last as long.  And transitioning from one set of meds to another was fairly painful the last time I had to do it.  But my primary care provider is convinced that my problem is being caused by my meds.  He just wants the psychiatrist and cardiologist to weigh in with any concerns.  So like I said, we'll know more in a week.

The Sun Is Rising

First of all, I'm feeling much better than I was last weekend.  I am once again depression-free.  Let's see how long I go this time.

I met with my counselor last weekend and he reminded me of all the things we've talked about in the last year, things I should be doing regularly to increase my chances of staying depression-free.  But I get complacent and stop doing them.  So I've created a schedule and put it on my refrigerator to remind me daily.  I need to be moving my body, challenging my mind, and focusing on taking better care of myself EVERY DAY.  So...

What I'm Reading
Fiction:  Suzanne's Diary for Nicholas (James Patterson)
Non-Fiction:  The Catholic Guide to Depression (Aaron Kheriaty, MD) How the Saints, the Sacraments, and Psychiatry Can Help You Break Its Grip and Find Happiness Again
Bible:  The New Testament from the Gospel of Matthew to Revelation.

I've read Suzanne's Diary for Nicholas before, but it was years ago.  It's an easy read and a sweet story.  As for the non-fiction... I have SEVERAL books that I've purchased in the last year or so and haven't taken the time to read them.  Now the time is scheduled on my calendar.  I'm also reading three chapters of the New Testament each day between now and the end of the calendar year.  I should be able to finish it by then.  Then I'll start on the Old Testament.  That'll take me a whole year!

How I'm Moving
Workout - Les Mills Combat 60-day schedule
Walking - three times per week

I love Les Mills Combat.  It's all punching and kicking.  Just over and over again, punching and kicking.  It makes me feel powerful.  But walking is probably the best workout for me right now as I'm so out of shape.  So three times a week, I'm going to get a significant walk in, at least two miles.

There are other things I've scheduled just because I've been slacking on doing them and it's affecting me negatively.

• My journal - I want to journal daily, just vent the good and bad so I can mentally and emotionally move on.
• A clean, organized, comfortable environment - I want to spend 15 - 30 minutes each day focusing on one room in my home, just to maintain a healthy environment without having to spend my entire weekend cleaning.
• A Budget - I want to get back to a strict budget.  I read Dave Ramsey's "The Total Money Makeover" last December and want to get back to his suggestions for saving money and getting out of debt.
• Writing - I want to write more often.  I used to write all the time, whether it was just a blog entry or the next chapter in my latest novel.  I miss the writing process and want to spend time on that again.  It'll be mentally challenging as well as creative.

I just want to be a better version of myself.  I want to follow my counselor's suggestions to focus on more positive things, healthier things.  And by doing these things -- moving my body, challenging my mind, and focusing on taking better care of myself -- I'll have a much better chance of fighting off depression before it takes over my life.  And if I do happen to slip into a depression, I'll have several positive options for distracting my mind.

That's my plan.  And I started yesterday.  (I usually wait until the first of something to start anything new.)  Yesterday, I successfully read three chapters of the Gospel of Matthew, read The Catholic Guide to Depression for 30 minutes, straightened my bedroom, and did Combat 30 (which kicked my butt).  Today, I'll take a walk after work, balance my budget, read three more chapters of the Gospel of Matthew, do the laundry, and get a Les Mills Combat workout in... all before having dinner with the girls tonight.  It's all good!

Now my next challenge is sticking with the plan even when I don't feel like it.

Overcast - Chance of Rain

So I was on vacation last week.  I didn't necessarily have anything specific to do or anywhere exciting to go.  I just knew I'd been working long days and thought a break would do me good.  I felt I'd earned it.

And I thoroughly enjoyed myself.  I slept in a lot.  I read a whole book in five days.  I did some housework that I'd been wanting to get done.  I spent a couple of days in Evansville with a few family members.  I even ate an amazing Italian lunch at Biaggi's.  I wouldn't have changed a thing.  It was lovely!

But I was truly hoping to completely refresh and renew my frame of mind in coming back to the office.  My plan was to have a whole new outlook and attitude with respect to work.

The fact is, I'm not at all dealing well with the dichotomy between what I hoped for and reality.  I've been so frustrated and angry these last two days that I could cry.  I've seriously been on the brink of tears several times.

It's not that anything at work is any worse than it's ever been.  I'm more saddened by my inability to deal with things better.  Moreover, I was hoping to OVERCOME the feelings of frustration.  I mean, I'd just come off vacation for heaven's sake.  I should have a whole new energy to side step the petty little things (and not so petty things) that bothered me before.  But I don't have that energy.  I'm not overcoming anything.  I'm obviously worked up.

You want to know something else?  (I'm assuming you said yes to that question.)  I've had an issue lately with my heart rate being really high.  When I went to give blood on the 13th of August, I was turned away because my initial heart rate was at 118 beats per minute and it only went down to 104 beats per minute after a ten minute focus on relaxing.  I've since been keeping track of my blood pressure and heart rate.  The lowest my heart rate has been in the last two weeks is 88, but it's averaged 102.

Since my depression has been so much better, I'm wondering if my mind, body, and soul are simply dealing with stress in a different way.  No more depressive episodes, but an over-worked heart.

I should also add that I take a medication for high blood pressure.  I've had an elevated BP a few times, but mostly it's good.  Strangely, the higher my BP is, the better my heart rate is.  (Or maybe that's not strange to someone who knows what that means.  But it was strange to me.  I expected them both to be bad equally.)

Anyway, so my weather/mood today is overcast with a chance of rain.  But I'm pretty sure I'm causing my own adverse weather (see picture above).  Here's hoping for sunshinier days ahead.

By the way, I was able to successfully give blood this past Friday, the 28th.  My heart rate was only 96 beats per minute.  So I got that in for the quarter.

New Month, New Challenge

So I'm reading "Do Over" by Jon Acuff.  But as I walked three miles this morning, I listened to another Jon Acuff book, "Start".  I love the subtitles of this book... "Punch fear in the face.  Escape average.  Do work that matters."  I only walked for an hour, but I listened to the first two chapters of the book.  I'm already looking forward to listening to another chapter or so when I do this same walk tomorrow morning.

I find myself wanting to start new things on the first.  The first of the month is ideal, but the first day of the week works sometimes too.  I'm really not any good at starting something on a Thursday unless that happens to be the first day of the month.  But today is Saturday, the first of August.  It was a perfect day for starting something new.  Today, I started walking again.

I walked the SummerFest 5k route, though my FitBit insists that I only did 2.63 miles.  Still, it was a good walk and I feel great.  Like I said, I'll do it again tomorrow.  That's the plan!

I'm also going to make sure I spend time reading.  I want to do that every day. I'm in the middle of reading two different books.  And every week or so, I find another book I want to read.  I'll never get through all of those books if I don't spend some time reading every day.

This is what I'm reading right now...

1. Do Over - Jon Acuff
2. Total Forgiveness - R. T. Kendall

This is what I have on deck...

1. The Catholic Guide to Depression: How the Saints, the Sacraments, and Psychiatry Can Help You Break Its Grip and Find Happiness Again - Aaron Kheriarty, MD with Fr. John Cihak, STD
2. WordPress Web Design for Dummies
3. Platform: Get Noticed in a Noisy World - Michael Hyatt
4. The Yahoo! Style Guide: The Ultimate Sourcebook for Writing, Editing, and Creating Content for the Digital World

A couple of those are more for reference than for reading.  But I'll skim through them nonetheless.  I want to get my professional blog up and running and start pitching for freelance jobs.  So I bought a couple/few books to help out with that hustle. And I have another James Patterson book in the mail.  And I love me some fiction, so that one will likely jump to the top of the list.

I love to read.  I just need to make more time for it.  I need to make it a priority.  I'll learn a lot more from reading that I will from watching reruns of "The Waltons", regardless of how relaxing it might feel.  I've gotten into the habit of coming home from work, getting comfortable, and sitting in front of that wholesome family for a couple of hours decompressing from my day.  But it's not very productive.  I need to be/want to be a little more productive.  So I've challenged myself to spending that time walking and then reading.  It'll be good for me.  Just maybe not at the same time.

Blue Skies

A couple of months ago, I started using weather pictures to describe the way I felt.  Check out this post, and this one, and this one, and this one, and this one.  So today... lately, that is... would be sunshiny blue skies... with flowers!

I haven't had a depressive episode since May 19th.  And I feel GREAT!  Even though we've had inches of rain lately, wind, lightning, flash flooding, and power outages due to nasty weather, my mental and emotional health has been full of sunshine.

I wish I could take credit for it, but I'm not completely convinced that I can.  In addition to taking my anti-depressants, I've been saying daily prayers that speak specifically to my depression and feelings of total darkness.  And I've gone back to taking my doTerra supplements.  I've recommitted to hitting 10,000 steps every day.  And I'm reading my bible most days; my plan is to read the New Testament this summer.  I'm also reading Jon Acuff's "Do Over", which is all about getting a do over in life, possibly changing careers and such.  It's very positive and offers hope.  Maybe those things are working.  Maybe I'm just lucky right now and my brain chemicals are behaving themselves.

I've also taken on an old hobby.  Writing.  And I think it's doing me good.

I used to write all the time.  I'd write journal entries or blog entries, or I'd start writing a novel... that I'd never finish.  I've started several novels that I never finished.  Mostly I did it because I enjoyed it, not necessarily to make money off of it.

But lately, I've been drawn to writing of a different sort... freelance writing.  I've found a couple of free online courses.  I've found a supportive Facebook group.  And I'm learning how to go about writing for money.  Not only is it keeping my mind sharp... and busy... and distracted.  But I figure I can knock out Dave Ramsey's Baby Steps 2 (paying off all debt except the mortgage) & 3 (saving 3-6 months of living expenses) with the money I make.

I don't know exactly what's keeping me on the sunny side of emotional health right now.  But I'm here to tell you, with a smile on my face, that you couldn't PAY ME to stop the prayers, the supplements, and the research and exercises in writing.  Pray with me that this season lasts for quite some time.