Withdrawal...

I have spent the past three to four weeks experiencing the worst prescription drug withdrawal.  About three years ago I was started on lamotragine -  a mood stabilizer commonly marketed under the brand name Lamictal.  At the time I was in a bad place emotionally and participating in a five hour a day outpatient psychiatric treatment program.  The doctor with the program was trying me on a variety of new medications and I didn't know which was  helping and which was hurting, but I knew that the class of drugs known as "mood stabilizers" was causing within me some major side effects.  Instead of stabilizing my mood, I began having racing thoughts and many other symptoms characteristic of manic episodes.  I was having a great deal of trouble sleeping.  My menstrual cycle was greatly affected, and my overall sense of well-being was impacted, although I couldn't explain exactly why.  When I consulted my doctor about what I was experiencing, she reacted as if I were making these concerns up out of the blue.  I grew very frustrated with her and was deeply affected by her lack of understanding and compassion.  Though she treated me as if my complaints were out of the ordinary, further research on my own discovered similar symptoms in other patients who were new to mood stabilizers.  Not only had Lamictal affected me this way, but Depakote as well.

Fast forward three years.  My current doctor puts me on lamotragine, and I did not recognize it was Lamictal under that name.  I also was not made aware that it was a mood stabilizer.  I was on it about a week when I noticed how FAST I was suddenly thinking.  Ideas would bombard me so fast I would have notes everywhere of the thoughts that came to mind, but I could not organize the information into any useful combination. I finally had to make myself use one place for notes so I could keep track. I couldn't sleep, my mind was revved up but my motivation was so low.  I began sleepwalking, something I haven't done since I was a small child.  I felt entirely out of sorts and unlike myself.  I turned to my best friend Google and began to research lamotragine - something I usually do immediately upon receiving a new medication.  As soon as I saw that lamotragine was in fact Lamictal, it all started to click.  I saw my doctor soon after and reported my symptoms.  Although apparently very rare, she believed me and immediately started tapering me off, much to my relief. 

It was short lived. 

Little did I know I would feel even worse as I tapered off the medication.  I had only reached 100 mg before reducing.  The minimum effective dose is around 200mg I believe but one must gradually increase dosage over a prolonged period of time to avoid a serious rash reaction known as Steven Johnson's syndrome.  One must also taper back off slowly to reduce the chance of suicidal thoughts, suicide and seizures.  So about a week after I start tapering off I notice I cannot make it through the first three hours of the day without the intense need to sleep again.  I feel like I am moving through mud.  I develop a rash and call the doctor, who is pretty certain it is not from the medication reduction, although there is no other explanation.  It goes away a bit, but again Saturday when the amount reduces once more another rash appears - one I am certain is a symptom of the lamictal withdrawal.  I have not been this tired in my entire life.  Even the infection that my body fought for 4 months after gastric bypass surgery was not as exhausting as I've felt these past few weeks.  

I have to sleep several hours every day. I have to force myself to do the most basic activities.  If it's not essential it just doesn't happen right now. I am incredibly anxious most of the time and I feel completely different from "normal" tiredness that comes with depression and insomnia.  It's a fatigue I cannot adequately explain, but it makes me feel lazy and unproductive and only contributes to the anxiety I feel.  

I have no idea how long this withdrawal will last.  I am supposed to see my doctor next week and I am hoping she will have some insight.  In the meantime I am trying to listen to my body and do as it requests, even though it's not what I want to do.  I am watching the rash and noting symptoms so I can determine what is getting better and what isn't. 

It's a frustrating and frightening process.  A tiny white pill can make my life significantly better in a matter of six weeks, which another one just like it can change everything.  I feel fortunate on the one hand, and annoyed on the other.  It's such a mixed bag.  I'm sure I've said this before, but the most frustrating part of mental illness, for me, is that there is no exact science to it's treatment.  It's a constant mixing and matching of medications, amounts and waiting for a reaction - either a reduction of symptoms or an increase.  It can also mean deciding which side effects you are willing to live with to have the better mood.  At least when you have high cholesterol, you know which med will work the best (most likely) and how much you need.  You can then do bloodwork to see if it's working.  It's not that way for depression and bipolar.  The other aspect of it is that you must usually taper off one med before starting the next, meaning you can be looking at at least a ten week wait to see what the next one is going to do for you.  

I try to remain grateful for the pharmaceutical interventions that make my life manageable, but I can't always ignore the negative.  It's part of my life, and even though I don't like it, it's the way it is.  Addressing it with honesty is the only way I can deal with all the feelings it brings up. 

Some Days...

I still feel like doing this...

Me - 3 days old

Navigating the Expanse of Mental Illness...

Depression has been part of my life for about 20 years, but there are some aspects of it that I never grow accustomed to.  Most of the time I have been a pretty high-functioning person with depression, meaning that I did well in school, worked, got along socially as well as possible, etc.  For most of my life my depression didn't lay me low - until I got to college.  I had completed my first year of community college achieving a 4.0 GPA both semesters, but at the start of the second year I lost my drive.  I dropped out of school before the end of September.  I wasn't accustomed to "quitting" anything I started, so it was difficult to give myself a mental break and be okay with the fact that I needed a break.

I transferred to a state college and loved living in a new town and attending classes at a college that was the perfect size and setting for me.  My excitement and pleasure with the education I was getting was not enough to push the depression away for long, and soon I was attending counseling and a few months after that I was on fluoxetine (generic Prozac).  That year was difficult for many reasons, but the added fact that I could never seem to rest only worsened every aspect of my illness.  For the first time in my life I began missing a large number of classes.  This was so difficult for me, because in so many ways I felt that my education and my love of the academic atmosphere was the only thing that kept me going.  Yet, I couldn't get to classes because sleep was erratic and social interaction proved to be excruciatingly painful for me.   I was hard on myself for not showing up, which did nothing but exacerbate the depressive symptoms, further limiting the quality of sleep and rest I was getting. 

When I attempted suicide in 2004, it was partly due to the depression and the bleakness I experienced daily.  But it was mostly due to the deep longing I had to just simply sleep.  I wanted to sleep forever, so to speak.  I was so exhausted.  It's nothing I can explain.  It's a tiredness of the soul, of the body and of the spirit.  I could never rest peacefully and I never felt rested.  I also was constantly on edge from the little noises, events and daily aspects of life.  Without appropriate rest, life becomes unmanageable very quickly.  Sleep has continued to be impossible for me to completely manage, but I'm learning to accept the unmanageability and do as much as possible when I'm awake and then allow myself to sleep as I can.  Sometimes that means a four hour nap in the afternoon, or a period of no rest that stretches past 40 hours.  It's still tough to deal with, but I'm leaning to "go with the flow". 

I left my job almost two years ago to focus on the issues that have plagued me for years.  In that time my diagnosis changed from clinical depression to bipolar disorder, as well as the conditions of social anxiety disorder, generalized anxiety disorder, complex PTSD and obsessive compulsive personality.  In some ways I've hated the labels of these various illnesses, yet at the same time I appreciate them because they give me some peace in knowing that this is beyond simple effort and trying to be okay.  It's an illness that is partly under my control, but mostly impossible to figure out.  I can do my part and go to therapy and support groups and take my medications as directed and see my physician, but there is a part of the illness that is in and of itself and is beyond what I can control. 

In small ways I try to recognize what I can control and what I can't.  It's very hard for me to let myself off the hook and put the blame on the illness.  I want to be accountable for the poor decisions I make, or the choices that affect me and my life.  It's a balance I constantly struggle to maintain. 

It's been very stressful to not work.  I feel that I don't contribute enough to the family.  The days when the illness lays me low and I have no motivation leave me feeling worthless and empty.  Sometimes a sink full of dishes is insurmountable.  Who can't do a simple sink of dishes???  I don't like to complain about my illnesses, because in all honesty, the gifts that have come of being depressed/bipolar are great and I am grateful for them.  

But sometimes it's damn hard.  

The never knowing when the next low (or high) will hit is frustrating.  The lack of energy and motivation is crippling.  The effect that the meds have on my creativity and my ability to find the words I want is enough to, at times, make me reconsider whether I want the meds at all.  The need to get blood work routinely to make sure the meds aren't harming my liver or other organs is anxiety provoking.  The dizziness and nausea that I get when I miss a dose is scary. The hopelessness and dread is paralyzing.  The side effects of the meds which include shakiness, twitching, lack of focus, and on and on are annoying.  It never gets easier to deal with the ups and downs.  It's just a matter of being able to manage it all differently.

I have new coping skills that I use, but sometimes I revert to older, less healthy coping methods.  Like in any recovery, sometimes there is relapse and setbacks.  It's all about getting back up in the saddle and trying again.  Some days I feel that it is pointless and I don't want to even try.  But the next day a little hope shines through and I do what I have to do.  

My life will probably never be completely free of depression or bipolar disorder, but I can be free of the hold it has had on me by doing what I can to make the episodes shorter, less traumatic, and ensure they make as minimal impact on my life as possible.  It's come down to realizing what I can control, and surrendering the rest.  That's where the real struggle is. 

Supplies for Sale...

Hey gang!

I am going to have a yard sale to raise money for Depression and Bipolar Support Cheyenne, but I thought I would list some of my craft supplies on Etsy before putting them in the yard sale pile.  Check out my site at http://www.etsy.com/shop/Roxann17.  100% of the proceeds go to DBSA.  Thanks!

Love is All There Is...

Isn't it interesting how women view the "practice" of love and how men view it?  For example, I feel that Kyle loves me when he does some random act of kindness - he cleans the kitchen when he knows I'm really exhausted, or when he moves all of his old junk out of the laundry room that has been messy since we met.  For him, he feels loved when he has my time- undivided attention watching a movie together or sitting together for a meal at a favorite place.  Not that I don't enjoy the time together; not in the least.  I am merely referring to the fact that our cup gets refilled through different acts of love. 

Thus the importance of communication, understanding, and compassion.  Yesterday was one of THOSE days.  The kind where no matter what I did, I ended up making more of a mess than I started with.  Cleaning the kitchen I knocked over a can of just opened pop, which of course spewed across the floor leaving a sticky mess in every conceivable direction.  The cheap trash bag split on the way to the dumpster so I enjoyed frantically picking it all up before the wind blew it into the neighbors' yards.  I had to deal with an issue by phone that I have been trying to get resolved since September 7th.  By the end of the day I had accomplished practically nothing yet felt as if I'd run the New York Marathon and then promptly been forced to trek to the top of Mt. Everest.  Thanks to medications, motivation has been an issue for me lately.  I was tired, cranky and pretty much just fed up in general. 

Slumped on the couch in the late evening I said to Kyle, "Remind me in 10 minutes to go put the sheets in the dryer".  I was almost done washing our bedding, and I was looking forward to crawling into a freshly washed batch of sheets and quilts.  Kyle, ever-loving, seeing how tired I was, went to put the sheets in the dryer, and while he was there he thought he would "help" (i.e. practice his love for me) by washing the quilts (that I had already washed) together (when one is all that should be done at one time).  So here I was thinking that all I had to do was wait for those sheets to dry and then I could go make my bed.  Kyle went downstairs a little while later - I didn't think twice about why.

Forty five minutes after that I went downstairs to make the bed.  But I couldn't find the quilts.  The dryer was on even though the dried sheets were in the laundry basket, so I open the door and see both quilts knotted together and nowhere near dry.  I was surprised (and now ashamed) to admit how quickly my ire surfaced.  Instead of seeing that my loving husband was trying to help me by washing the quilts, all I could see is how it was making more work for me.  More work when I couldn't even accomplish the work I already needed to do.  I crabbily barked that we couldn't go to bed yet as the quilts weren't dry (as if there weren't anymore blankets to be found in the house).  I jerked the quilts apart, threw one damp one in the basket and the other back in the dryer, slammed the dryer shut and turned it back on.  I proceeded to fume silently as I jerked the sheets over the corners of the mattress. 

And then I told myself to just rethink the situation.  Kyle had merely picked up on my tiredness and tried to help out by starting another load of laundry.  He wasn't down there evilly plotting to annoy me by a) washing clean quilts and b) washing them in a manner in which I would not (i.e. too much soap, too much load, etc.).  He simply was showing me he loved me in his own way.  I tried to swallow my pride and looked at the hangdog expression on his face as he helped me put the sheets on.  

And so I said, "I'm sorry.  I know you were just trying to help me out.  I'm just having a bad day.  I love you."  We finished making the bed with another blanket on top and the world continued to turn.  

Why is it that I can take a minor situation and put all the blame on someone else, when it's really myself I am mad at and displeased with?  Why do I take out my frustration on the one person in the world who not only says he loves me, but practices loving actions on a daily basis? 

It's a great lesson to me about the importance of demonstrating love, not just saying it; and then accepting it, in whatever form it shows up in.  Maybe my life was robbed of an extra 10 minutes of time over this minor issue, but the fact is, I was fortunate to sleep beside the love of my life last night, when many people spent the night alone or apart from the people they love best.  It was a humbling moment of realization that I am a very fortunate person, and not to take that for granted.

Household Binder Linkup

I showed you my home management binder a few weeks ago, but when Jen at IHeartOrganizing posted the March challenge, "Project Household Binder", I knew I couldn't resist joining in the fun, seeing other people's suggestions and then relishing in looking at photos of all the binders that are linked up.  For a month I've been touching up, reorganizing, re-evaluating, searching the garage for file boxes that were moved out there after the great basement flood of 2010.  Now I have a delicious Home Management Binder that I am proud of and use everyday.

Now, I warn you, this post will be long.  However, there is so much to keep track of in our lives, there is no "easy" way to do it, so I decided I would get super organized to make life a little easier to manage. Let's get started.

I began with a lovely plum colored binder - I believe 1 inch and a half.  I also grabbed page protectors and dividers with pockets.  I also used my DYMO label maker that I LOVE.  

I slipped in a coversheet I made with Microsoft Word beneath the clear plastic on the outside of the binder.

In the pocket on the backside of the cover I slipped in any papers or notes that need immediate attention.  It's my reminder to me every time I open the binder that I've got to get to those tasks first.

First in my binder I inserted a pocket folder that has a flap that velcros shut.  Inside this pocket I keep a few post-its, a checkbook, and my notepad for random lists, etc.

With reflection about what categories were already in my binder, along with suggestion on Jen's site, I made lists of categories that I needed.  I rethought it out about ten times, scribbling and scratching.  Then I listed them in the order I wanted them.  The sheets of each section are contained in page protectors.  Finally I pulled out my shiny new pocket folders and DYMO labelmaker and got to work on the 16 categories I would use:

• Planning and Schedule
• Brainstorming
• Contacts
• Menu Planning
• Household
• Cleaning Lists
• Maintenance
• Health - Kyle
• Health - Roxann
• Pets
• Auto
• For Fun
• Celebrations
• Finances
• Check Register
• Important Documents

 Planning and Schedule

The first page in this section is my personal daily schedule.  I can't say that I stick to this every day, but it's important for people with mental illness, and especially bipolar disorder, to maintain a daily routine.  This schedule I made with Word and it includes the task, the time frame and the day of the week.

Next is a 2011 calendar from Anny.

And then a monthly calendar for each month in the rest of 2011 that I downloaded from IHeartOrganizing.  I color coded the appointments that I entered on it.  I highlighted Kyle's appointments in yellow, mine in purple, and the appointments we go to together with pink.  I lurve it!

Then for reoccurring events (birthdays, anniversaries) or special events (graduations) I have a two page spread with categories for each month:

At the end of that section is the 2012 calender, also from Anny's site.

 

Brainstorming

In this section the pages are all the same format, just the headings are different.

Agenda - Every week Kyle and I have a family meeting.  This agenda sheet helps me keep track of items we need to discuss - groceries, the menu, whether to renew the car warranty, etc.  That way our meetings are more productive.

To Do List - At our weekly meeting we each get a to-do list that is blank. Anything we talk about that requires action on my part or his we put on our own sheet.  So if I need Kyle to fix a pipe under the sink, he puts it on his list.  If he needs me to reschedule an appointment for him, I put it on my list.  That way I know what responsibilities I need to get to in the upcoming week. (And he can't say I didn't ask him to do something he didn't get done!  I'm tricky that way).

Ideas - This is a list for any brilliant ideas I get.  It might be something I want to do to the house (paint, add a shelf, etc).  Or, it could be an activity or and idea for my support group.  This gives me a place to brainstorm supplies, timing, etc.  It may be a list of fundraising activities for the support group, or blogs I want to write.  It's wide open!

Projects - Here I can keep track of various projects around the house, support group, etc.  If I'm preparing for a yard sale, it might include items such as "clean garage out, donate leftover items to charity, buy price tags and signs", etc.  This is different from event planning - that will come later.

Contacts

This section holds the contact information for anyone whom I may need to reach.  The first list is a quick reference list that I typed up in Word.  I am only showing you a bit of it for privacy reasons, but it has one section for personal numbers - family & friends, and then a business section for doctors, the plumber, etc.

Next I typed, also in Word, a list of names, addresses and phone numbers for the "Personal Contacts" page and also a "Business Contacts" page.  Same format for both.

Then I slipped in a business card holder sleeve I had.

Menu Planning

Our food/menu planning is pretty simple since it's just the two of us.  This section holds the grocery list.  I highlight items according to the store where I'll buy it.  For example, Splenda at Sam's Club (yellow), soda pop at King Soopers (orange) and laundry soap at Target or Walmart (green).  This way I don't have to have three different lists.

We actually do our and then the grocery list together at our family meeting.  Since we've both had gastric bypass, we *should* be eating three meals and three snacks a day, so my menu accommodates those needs.

When we're stumped for what to put down on any given day, we keep a "Favorite Recipes" list and a  "Recipes to Try" list.  As I'm going through magazines I slip any recipes I might want to try into divider pocket and write them on the list.

Household 

The heart of the binder - the household!  First up, a list of passwords and user IDs for the websites I use.  I print it off in an excel spreadsheet.  That way I can slip in a freshly updated, alphabetically ordered list anytime something is added or changed.  It's blurry on purpose, but you get the idea.

A list of our magazine subscriptions is next, which includes the magazine name, the end date of the subscription, the new amount due and whether or not we wish to cancel the subscription.

A list of insurance policies follows with a place to write the type of insurance (auto, home, mortgage life, life), the name of the insurer, the policy number and the amount.  

A sheet for the house-sitter (should we ever actually go on vacation) follows:

Then comes the home inventory sheet.  This can be extremely useful if you ever need to make a renter's or homeowner's insurance claim.  Along with the inventory, I suggest taking a digital photo of each item listed, saving a hard copy on CD and sliding it in the pocket for this section.

The last page in this section is a household wishlist.  This is where Kyle and I keep a list of any items we want for the house that are not essential nor necessary, i.e. a snowblower. 

Cleaning Lists

Although my daily cleaning list is on my personal schedule, I also keep a list of daily, weekly, monthly and seasonal lists.  The seasonal list includes two sections:  inside household and outside household.

Maintenance

Two pages make up this section:  Household Maintenance and Maintenance and Repairs.  The household maintenance gives me a place to list all the important maintenance that has been done, especially if it includes a warranty (for example the garage door opener).

The other sheet just gives me a checklist to note any items that need our attention around the home - paint touch ups, drains run, etc.  This list also includes major items that need repairs or replaced such as the furnace or water heater.

Health - Kyle

The health sections are separate for each person in the family  In our house, we have two sections total.

The first sheet is a medical information sheet that we can grab when there is a medical emergency. 

In the page protector I slip a copy of Kyle's insurance card.  

Following the insurance card is a copy of Kyle's Advanced Directive - also nice to have in an emergency.  Lastly, I put a copy of any recent bloodwork or test results that he might need to share with various providers. 

My health section is identical but also includes my Mental Health Advanced Directive, my immunization record, blood-work and doctors brochure for the allergy clinic describing their services. 

In the pocket of the divider for that section is blank copies of a claims form for our insurance company, since one of my providers does not directly bill insurance and I have to submit the claim myself. 

Pets

My furry friend gets his own section - though he shares it with Hedgie.  

First up a Pet Info sheet much like the medical information sheet in the last section.

There's one for Hedge and one for Pip.  In the next sleeve protector is a copy of his rabies vaccination record, and behind that is a copy of receipt from his last check-up and shots.  In the last page protector is a handout from the Vet's office listing hours, services, etc.  I would leave this form with the pet info form if we had to have someone care for Pip while we were out of town.

I also suggest slipping a current photo of each pet in the pocket divider in case your pet goes missing.

Auto

Auto maintenance list noting any major repairs or recall information.

Behind that is a copy of the receipts for any important work.

And lastly, a copy of the last inspection report.

In the divider pocket I place items that need reviewed such as renewed warranty, etc.

Fun Stuff


This section includes only two items at present. Date Night Ideas and Travel Info.  Hopefully more will be added, such as theme park guides, zoo brochure and other recreational activities.

Celebrations

This section is for items related to events and parties and holidays. First up, the event planning page:

And of course, a guest list:

Holiday Card List

And a Holiday Gift List:

And a Birthday Gift List that is identical to the Holiday Gift List but with it's own heading.

I keep cards in the divider pocket for the next 2 months of the upcoming birthdays/anniversaries/celebrations.

Stay with me, we're almost there!!!

Finances

Probably one of the most important sections, I gave this one a lot of thought.  First up is a Bill Tacker list. This is a quick reference if we want to know our balance or pay off a bill, as well as easy to access info if we need to contact someone we owe.

An Easy Budget form:

Charitable Contributions:

In the pocket on the divider I keep paper-clipped together any paper bills I just paid, and then also clipped together any paper bills I need to pay.  Most of our bills come via email, so I don't have too many in this binder.

Check Register

Instead of keeping a little register in my wallet, I keep track of checking on this sheet.  I highlight each item when it clears the bank, making balancing much easier.

Important Documents

I've long debated where to store our most important documents.  I finally decided to put them in this binder, because along with Pip and Hedgie, this binder is what I grab as our house burns down.  This section includes page protectors that hold our college transcripts, my copy of the GRE exam results, etc.  I use a label on the outside of the protector to easily note whether it's mine or Kyle's document.  Finally, I used a clear plastic zip sleeve to hold my original immunization record, passports, birth certificates, social security cards, marriage license, and any other information I deem essential.

Lurve having it all in one place, and can even see it all!

At the very end is another business card holder into which I slid the credit cards we don't carry with us and don't use unless it's an emergency or rare occasion.  I use a little piece of tape to hold these in just to reassure myself that they won't fall out and get lost.

Whew!  That's a lot of accomplishment for one month!  But it's actually been a work in progress for some time.  I can't concentrate well, so I do a little at a time, and my OCD/perfectionist nature makes it very hard for me to let go until it's - well, perfect.  

Most of these forms are available on my Etsy site.  I will update it, hopefully in the next week or two, with some customizable forms.  The Etsy collection also includes child information sheets that cover school, daycare, etc.  Since I don't have kiddos, they obviously aren't included in my binder. 

So that's it!  This is how I keep track of everything and preserve (some) of my sanity.  I can't remember anything for longer than a second at present, so this book is also known as MY BRAIN.  

If only I could improve my picture taking skills!  

Enjoy making your own binder, and thanks for stopping by!