Monthly Archives: January 2012

The Diagnostic Discrepancy

If you’re an American who has been diagnosed with a mental disorder, chances are you are familiar with something called the DSM-IV-TR. The Diagnostic and Statistical Manual of Mental Disorders, currently in revision with the release of version 5 expected to take place in May of 2013, contains the standard diagnostic guidelines for all current mental disorders in the USA.

What you may not be aware of is that the majority of the rest of western civilization uses another set of guidelines. The International Statistical Classification of Diseases and Related Health Problems or ICD for short, contains a chapter (V) which is used primarily for diagnosing mental disorders. This information is apparently also currently being revised by the World Health Organization with a scheduled release of 2015.

The information in these two manuals is not identical.

This is just one of a few facts I learned at the Bipolar Disorder in Focus conference last week.

So, clearly there is a problem here. There isn’t a clear understanding of what bipolar disorder is across the board, and the criteria for having the diagnosis is different depending on where you live.

There has been such a large discrepancy in the information between the two manuals that, from what I’ve been told, up until 1980 if you were diagnosed in the USA with bipolar disorder, the same criteria would mean a diagnosis of schizophrenia in Europe.

That is obviously an extreme example, but there are still many discrepancies today.

I had no idea that this was an issue, but I have witnessed that the understanding many medical professionals have of bipolar disorder varies widely. It seems to me that defining the disorder in a way that everyone can agree on would be a really good place to start.

That may sound simple, but I realize there are many things standing in the way of that goal as well.

  • “Bipolar Disorder” covers a wide range of symptoms, and many different groupings of these symptoms. There are so many individual versions of this disorder that it would be impossible to create enough “types” to cover them all. The challenge I am currently facing is that what I experience doesn’t fall easily into any of those established categories, or at least not to my knowledge. I’ve been told that is increasingly common, but it makes it even more difficult to find a doctor who knows enough about the disorder that they can work with me. Likewise, when defining this sort of disorder, where do you draw the line? At what point do you fail to include those with similar symptoms?
  • The symptoms associated with bipolar disorder can be difficult to quantify. How many of you have been asked by doctors to remember situations or episodes that are hazy and hard to pinpoint? How many have related your symptoms to a doctor in a way that was skewed, either because of your current state or failure to comply (lying)? Even when charting my moods each hour I can have a difficult time discerning what I’m feeling or how long a feeling lasts.
  • With the research that is being done around the globe, there is no possible way to have everyone on the same page. Since our knowledge of this disorder is constantly evolving, we can’t have a static understanding. Yes, both manuals are being updated currently, but how long will they reflect our understanding now when “now” becomes the past? How many years will what is written be the norm, even after we’ve learned much, much more?

So we’ve established that it is impossible for all doctors to mean the same thing when they say, “bipolar disorder,” because of the simple fact of the lack of clear definition across the board on its own.

BUT on top of that, each doctor will have a varied amount of knowledge on the subject. Each will have biases, based on the patients they’ve seen or the people they’ve worked with. Each also has a different set of tools they use in regard to assessment, like which aspects of a patient’s history they look into. Family history, substance abuse, social history, screening tools (like quizzes), each doctor goes about seeking that final answer of a diagnosis in a different way.

The biggest frustration I’ve had, is that there is not only a huge discrepancy in knowledge between doctors, but also that there is a big discrepancy in knowledge between patients and doctors.

We’ll take the example of Dr. Mustafa from the conference. He has a more broad and substantial understanding of bipolar disorder than any doctor I’ve ever met. However, his understanding is entirely conceptual. He has the overview and knows which symptoms attribute the disorder, but there is obviously a distance between his own mind and the concept.

As a patient, my understanding of bipolar disorder is inherent, I only really understand the portions I have experienced. Even then, since they are part of my experience it can be hard to separate these symptoms from myself. It is confusing, I don’t know which elements to refer to as symptoms and I look at my experiences on an episode-by-episode basis. I rarely see what is going on, via some kind of overview.

I can appreciate and understand that this is why I need this kind of doctor. He sees the situation in a way that I can’t. At the same time, when I see these doctors I don’t know where they are coming from. I don’t know how much knowledge they have, or what their experiences are, or what their intentions are.

If I knew what they knew, I could better communicate. I could use the language they use, and save myself the trouble of wading around my brain in rubber boots looking for parts that either are or are not there.

One of the biggest things I felt at the conference last week was that there is a huge disconnect between what doctors know and what patients know. I realize that doctors go through medical school and everything, but I don’t think that is exactly what I mean.

Doctors know the big picture. What illnesses look like overall, and what can happen to them if they go untreated.

Most patients are much more familiar with the more intimate details of an illness, and are often blocked by looking at the past too much or the future too much because of what is going on immediately.

Maybe I just haven’t found the right doctor, but it seems like there should be a way to meet in the middle. It isn’t that I want the knowledge to self-diagnose, I just want to understand the medical process better, and utilize it better.

How can we rely on diagnoses when they are interpreted differently by each doctor we meet? That seems ridiculous. If our doctors can’t have a more standardized understanding, can we at least teach them to communicate better with patients? Or teach patients to communicate better with doctors?

Or both?

“Bipolar Disorder in Focus” Conference

On Friday a friend and I attended the Bipolar Disorder in Focus conference at the Evergreen Medical Center.

All we knew ahead of time was that the conference was being promoted to some degree by the Eastside chapter of NAMI (National Alliance on Mental Illness) and was being sponsored by the Pacific Institute of Health and Clinical Research.

I’m not sure exactly what I expected, but it wasn’t what I found.

I am a creature of habit, and though I have worked in the fashion industry I have no real desire to alter my own personal sense of fashion, despite the fact that it can come off in a slightly intimidating or gritty manner.

I wear an old leather jacket, for example, covered in different patches from my past. I find this to be the holy grail of my wardrobe, and once the weather is cold enough it is my go-to jacket. Whether I am on my way to work with millionaires or hanging out in the industrial portion of town, it means no difference to me. This jacket is also the single most complimented article of clothing that I have ever owned, and in that respect it has taken on a life of its own. It doesn’t wear me, per-se, but we do have a kind of mutual understanding and friendship.

So I can only imagine what they must have thought when I walked in on Friday to this conference, neon sneakers, black skinny jeans, and a patch-covered leather jacket beat to hell.

The response?

“Hi! Are you… therapists?”

(As if that was the immediate answer to my outwardly liberal exterior!)

As it turns out, this conference was being put on by a team of medical professionals, but it was intended to be for other medical professionals.

We were not deterred. In fact, my curiosity was merely piqued. I have really been struggling lately with trying to figure out where many therapists and medical professionals are coming from, in regards to bipolar disorder in particular. We had just had a conversation the afternoon before at the group about it because I have really been feeling stumped. This conference falling in my lap was the best possible solution to this issue, and I had found it almost entirely unintentionally.

“We’re consumers,” we replied.

I hate that word. Consumers. I understand the idea that those with mental illness are the primary consumers of things like psychiatric medications and services, but to me this title makes what we’re dealing with sound optional. I can decide when I want to be a consumer at Starbucks or over Christmas or on the internet. I suppose there is some choice involved when it comes to partaking in mental health services, but that choice is severely limited by the severity of your symptoms and income level.

Besides, consumers, to me, indicates a level of capitalism associated with this country that I’m not particularly willing to link to myself.

Anyway, we were welcomed inside a lecture hall, it was a bit on the sparse side, but that didn’t make the information any less pertinent.

There were several presentations that I personally could have done without (as they were a little on the disorganized side), but I suppose that even those, like the presentation on diagnosing bipolar disorder in children, were informative and definitely give me a larger understanding of what’s going on.

For me, the crown jewel of this conference was Dr. Syed Jamal Mustafa.

Honestly, I have never heard a health care professional describe any nuances of bipolar disorder with such detail and understanding. Seriously, brilliant, brilliant man. He practices as a psychiatrist, but also works on a lot of research regarding bipolar disorder. He was even on a team that co-discovered which chromosome the bipolar marker can be found on (number 18) before making the further discovery that the marker is in different places on the chromosome, depending on which population you look at. That is one of the reasons there has been such difficulty in pinpointing and treating bipolar disorder.

I spoke with him at the intermission and was pleasantly surprised to be greeted with a humble and attentive attitude. He was more than willing to answer our questions in a manner in which we could understand the answer (so he wasn’t stuck using medical terms alone, which can be a real pet peeve of mine) both with patience and a candid manner.

Yeah, so excuse me if I’m drooling over this man’s brain. I’ve just never met anyone like that in the 10 years I’ve been wading through the world of mental health services and professionals. That, and I love science. I’ve always been interested in it, and often longed to go into a scientific field. I love research and facts, and I feel like I’ve got a whole arsenal in the 6 pages of notes I took of current information regarding bipolar research. How could I ask for anything more?

What I respected the most was his attitude toward the disorder itself. He was more than willing to admit, (in his own opinion),

If there wasn’t a genetic purpose, it would have been eradicated [through natural selection] by now.

He also openly praised many of the benefits of hypomania and even mania, in regards to how these states have helped push our technology and society forward through many different kinds of advances.

What? A doctor who doesn’t necessarily wish to eradicate bipolar disorder in its entirety, but rather understands that there are potential benefits?? What a novel concept!

I’m very excited about the information I gleaned from this conference for a number of reasons, I plan on writing about several this week.

I would venture to say that any free, extra information I can get about any health problem that is affecting me is a good idea, and I would definitely recommend this experience to others. Check out your local chapter of NAMI or regional hospitals for potential conferences of this nature!

The Pacific Institute of Health and Clinical Research also gives patients the option to send a DNA sample to one of two genetic labs in the world (one in Florida and one in France) that specialize in research for bipolar disorder in particular. If you are interested in more information on studies in the Pacific Northwest, you can check them out here.

Overcompensation

Well, I definitely took things too far the other way.

Normally, when my boyfriend is gone I become a little reclusive, so the last 5 days or so I injected my schedule with all kinds of events and hangouts. The busy-wave crested yesterday, and after I am finished with work today I have nothing planned the next few days.

I am exhausted. I definitely did way too much. I suppose I didn’t initially recognize the hypomania I was in until it dissipated Saturday morning, now I’m left working on damage control. I’m hoping to curb this from becoming depression sometime here right quick.

It’s funny, don’t you think? I know all too well that this happens, and I try my darnedest to keep track of what is happening with my moods to try and curb them. Sometimes, though, I feel like no matter how conscious of things I am, I am still somehow blind to it.

I hate to point a finger, but my suspicion is that it has to do with anxiety. Last year I was diagnosed with generalized anxiety disorder (anxiety being something I’ve struggled with for my entire life), and sometimes it seems like anxiety can distract me just enough to take my focus off of what is happening with my moods -especially if my mood feels “good”, like with hypomania. I don’t always recognize hypomania because even though part of me feels great, there is often another part (the anxiety) which doesn’t. It brings the overall feeling back down a couple notches, so I often just think I feel normal.

Tricky stuff.

In general I am doing alright though, and I am grateful for everyone who has contacted me to check on how things are going, so thank you.

So just a quick update, and after work today I plan on being in my pajamas for a good 24 hours to relax. Hopefully I can convince the dog to let me sleep for a good chunk of time (she’s taking Corey’s absence pretty hard), so I can get on with writing some posts for this week that I’m really excited about!

Reappreciation of Self

Yesterday was one of those days where living feels worthwhile. Surprising to me since that isn’t something I expected this week, especially with the stress of being without Corey.

They say depression knocks all of the blocks you’ve built up in your life down. It can rip away your belief system, your career, your family, and all of the pieces that make up one’s sense of self. For me it happens gradually, but I don’t notice it that way. Usually I just wake up one morning and it is like my existential slate has been washed clean.

“Who am I?”

I don’t know.

“What do I believe in?”

I don’t know that either.

It is almost like amnesia of the self. I can’t quite remember how to be me because I can’t remember who that person is.

The moment depression begins to subside is equally as jarring, because I don’t quite know what to do. I still don’t quite feel like myself, and I need to stack all of those blocks that have been knocked down back up but I can’t do it in a single day. I’m usually looking at something more like six months to a year before I’m back to feeling “normal”, or fully human again, at least.

Then yesterday I had that moment that made me so appreciative to be alive that things clicked.

It all began when Mark asked me, “do you remember how you were six months ago?”

At first I didn’t. I don’t even remember why he said that, and it was only yesterday, so no, I don’t remember myself from six months ago. When I began to think harder though, I see someone in the throngs of incredible depression. That very state that I’m talking about, where my entire sense of self had been stripped away, that was me.

I would barely call what I was doing at that time living, it was more like surviving. I was continuing to let one day pass into another, waiting for the firestorm of misery to end so I could work on coming back again. Back into the realm of serving some kind of purpose instead of just squeaking by.

I’m lucky, in a sense, that I’ve done this a few times before. I know the routine now, so I know in those moments of depression that it will pass. The problem is that the time it takes to pass can seem like eons.

And really, I’m sure now that Mark was pointing out what was (and is) now so readily apparent.

I’ve built it back. My sense of self and my confidence is here, and it is very likely that it has been here for a little while now, I just didn’t wholly recognize it until Mark brought it to my attention. The difference is plain as day.

What I’m left with is an overwhelming appreciation for today. Right now. This second, this minute, this year.

And when I’m standing right next to some version of myself from six months ago, that version of me completely incapacitated by depression, it made me realize that I need to take advantage of the sense of self I have right now.

I need to live life to the fullest in those lucid times when I’m able to really appreciate both what I can do, and what life can give back to me. There are so many times were I’m not able to take charge or accomplish things, part of me feels the need to make up for it double when I’m able.

For me, living life to the fullest when I’m stable or even on the manic end of the scale isn’t about partying and catching up on the general self-destructive behaviors I’ve missed out on while being depressed though. It is about making a difference in my own life, with the hope of possibly making the difference in someone else’s life.

After all, that’s what I’ve wanted all along. Growing up wanting to be a doctor or a scientist or even a comedian, really all I want to do is effect people in a positive way. In the past I’ve tried to force it, but what I’m finding out right now in my life is that if I just try to focus on making a difference in my own life and work on self improvement, it somehow bounces back ten-fold.

(I guess I can see where the concept of karma may have originated.)

Anyway, I can neither confirm nor deny if what I’m feeling is linked to hypomania, but my epiphanies are almost exclusively accompanied by some form of mania. In all fairness, though, that doesn’t seem to make them any less true or real, so even if that is the case today I don’t discount what I’ve concluded.

Periods of lucidity and stability are extremely precious to me, especially when compared to the harsh backdrop of depression. I ought to do a better job appreciating them while I have the ability to do so.

Saying It Out Loud

So I’m a little nervous, I’m going to be hosting a group this afternoon.

The first one was actually supposed to be last week, but I had to cancel because of both my health and the snow.

It’s sort of a bipolar peer support group (so there are no medical professionals) and I’ve been going to a Monday night version on and off for a couple years now.

Obviously, these sorts of groups can be difficult, both to attend and to host -I do believe I mentioned something about it here.

Most people are afraid to share anything about mental illness to anyone, thanks to our old friend stigma. I’m a firm believer, though, that learning to talk about it out loud can be both a huge tool and help lift a lot of the burden we carry from being silent.

The biggest trouble seems to be: where do I begin? Believe it or not, most folks with a diagnosis would rather chew off a limb than willingly talk about mental illness, so it is ok to take baby steps with this process.

  • The first step I took (or was forced to take, rather, as a teenager) was to talk to a therapist. I think this is the simplest and least frightening step one can take for many reasons. Your privacy must be respected by law, so unlike talking with a friend or relative you know for certain anything you say will be confidential (though keep in mind there are one or two exceptions to the rule). Many therapists are also trained specifically in the realm of mental health, so they are people who can usually readily identify what you’re trying to say, even if you don’t really know how to say it. Practicing talking with this type of professional can begin building the skills to talk to other types of people. You know, the ones you aren’t paying to listen.

After a time, I was encouraged by my therapist to join a support group. This was (and can be) a terrifying prospect for many reasons. You may not be someone who is comfortable talking to strangers in general, or you might have an anxiety or panic disorder. Then, of course, there is also the fact that you will likely be talking about that big, scary topic again: mental health.

  • The second step was to reach out to others with mental illness. This could be talking one-on-one (my usual preference) with someone with a similar diagnosis, attending a group run by a medical professional, or attending a peer-run group. I was really lucky as a teenager because there was even a summer camp in my area for creative teens struggling with many of the same things I was. The platform here doesn’t really matter, as long as you can begin a conversation with someone else with a mental illness. Many of us have very similar experiences, so we find very quickly that we almost “speak the same language” if you will. Even though some people consider strangers to be scary, I don’t! They’re people I have no relationship with yet, so really I can say whatever I want and I might never see that person again. Just try it once, I promise it is incredibly freeing!

I would say about a year ago I reached the point where I began to feel a little stagnant in regards to the pool of people I usually talked with about my mental health. I really began to feel tension between the times I could be open with a group of people and when I seemingly “couldn’t”. I wanted to bridge the gap a little bit so I could feel like I was able to just “be myself” around a larger group of people.

  • The third step was to open up this topic with close friends that may not have been wholly aware of it before. At first I was a little scared to go there, but these were all people that I’ve known for a long time and who I have great relationships with. I couldn’t imagine any of them suddenly “dumping” me for talking about my mental health, and they didn’t. When you finally feel comfortable and are able to explain your diagnosis to a fair degree (and to someone who might not know what any of that medical jargon even means), it might be time to talk to some close friends of family about it. With my own experience I have tried to add this topic to conversation casually (while stable), instead of building it up as this huge, “deep dark secret,” I need to tell someone (even if it often feels that way). If I spew what I want to say out in a big awkward lump, yes, it’ll be awkward. But, if I act casual about it, it is more likely that the person I’m talking to will act casually about it too. After all, stigma might say that this topic is a “big deal” but it doesn’t have to be if we don’t make it!

After the ball got rolling and I was triumphant with talking to my friends, I had a lot more confidence in myself when it came to my ability to explain bipolar disorder, what it is, and how it affects me.

  • The fourth step, in a perfect world, would be to be open with everyone about mental health. There have been one or two moments in the last few months, I admit, where I’ve really stumbled on this one, but for the most part I’ve been very open. For me, this is the step where some resistance occurs, and I don’t think it is because people are hateful or malicious, just that they are ignorant. Obviously the more open and casual people can be in normal conversation about mental health, the more ignorance we can eradicate.

Some people reach this last step somewhere in the middle, and are comfortable with that. Personally, I wasn’t. I needed to feel empowered enough to get there.

  • The final step is advocacy. Representing those who aren’t feeling strong enough to speak up yet, representing the community in which we are a part of, and helping out our peers. This is what I’m going to do today, and I am nervous, but very excited. It took a little pushing for me to get here, but that’s ok, I must’ve needed it.

I realize, too, that just because I’m hosting this group today doesn’t mean I’ve finished learning how to talk about mental illness and I can move on to something else. On the contrary, I’m constantly learning about how to express what I’m feeling out loud, and it is something I have to work at on a regular basis.

Could Magic Mushrooms Ease Depression?

There was an article published yesterday on the HealthGrades website that caught my attention, “Could ‘Magic’ Mushrooms Ease Depression?”

Really? I thought, I’m sure this’ll be bizarre.

What I didn’t know is that psilocybin (the active ‘ingredient’ in these mushrooms) was used extensively in psychotherapy in the 1950s, but the biological effects haven’t been thoroughly researched until recently.

When injected with psilocybin and scanned with an MRI, the psilocybin caused decreased activity (the exact opposite of what you’d expect from a mind “expanding” drug) in the “hub” regions of the brain.

A second study found that psilocybin helped patients recall personal memories and increased their emotional well being for up to two weeks after the dose was given.

Finally, a third study suggested that people with anxiety who received one treatment with psilocybin had decreased amounts of depression six months later.

Obviously there is more research to be done, and I would recommend reading the whole article for more details, it’s pretty interesting!

The reason this article caught my attention in particular was because it reminded me of something I recently read in  Welcome to the Jungle, by Hilary Smith. The book is supposed to be a guide about bipolar disorder, but is said to contain, “everything you ever wanted to know about bipolar but were too freaked out to ask.”

I wasn’t thrilled with the book, and for an “alternative” source on bipolar disorder I’d highly recommend another source, one I’m planning on writing about in the next week or so.

The only thing in the book I thought was surprising was that it addresses the concept of psychedelics. Mind you, it is basically two pages of, “these might screw you up for good, or they might not,” but I was shocked to even find that a chapter. It is the only book I’ve stumbled on that had a blurb about medical marijuana as well, even if it was just a few lines of the same wishy-washy non-information.

Personally I’ve opted to avoid psychedelics, a feeling that was certainly confirmed when I unwittingly began having Ambien hallucinations a couple months ago. It isn’t that I experience hallucinations on my own, per-se, but I feel like I am on the brink of having them at all times. Why would I induce something I experience naturally, especially when it is something that can become so unnerving so quickly?

I have, however, babysat folks who were experiencing the effects of psilocybin, and from what I can tell (and have read) it seems like the setting is what really defines the experience. Maybe that is something that makes a huge difference in these medical trials, but I guess we’ll have to wait to find out more.

Imagine those therapy sessions though!

Accusations of a Breakdown

My boyfriend is going to be gone for 9 days, he leaves tomorrow.

This is something I’ve always had trouble with, for a number of reasons. I guess I may as well just lay them out for you,

  1. Things become skewed when I am alone, particularly at night. Corey is an incredibly grounding individual, and he usually gets home from work right around the time I start to get a little antsy. Unfortunately, his calming presence is something I’ve come to rely on at times, so I tend to get a little haywire without him.
  2. My ex was constantly running out the door at the drop of a hat to have adventures he told me I couldn’t be part of because I was a girl. It’s even more complicated than that, the sort of torture those actions provided me, and it is genuinely difficult to trust anyone in a relationship after someone previous has cheated on you (even if they’re entirely different people). I’ve made good headway in this department, but when Corey is out of town it brings me back, even if just for an instant, to a place and a feeling I never want to re-live again.
  3. It is a lot of responsibility. Let’s face it, I’ve gotten lazy, because I’ve reached the point where I’m used to only completing about 50% of the household tasks. He does the rest! Without him I’ve miraculously inherited the entire apartment, and everything from preparing the meals to walking the dog is suddenly my sole responsibility. That is a lot of pressure for someone who is otherwise terrible at being under pressure.

To be fair, there are a lot of great reasons why he should go out of town, which totally trumps any wussiness I have about it. He’s an extremely talented person and I try whenever possible to encourage working on projects that mean something to him, and I work very hard to try and make sure my particular maladies don’t get in the way of his dreams and opportunities.

He has become increasingly familiar with my patterns over the last four years and over the last year his grasp on what it means for me to be bipolar has really tightened, especially after my fairly-recent hospitalization.

That said, when he walked in the door last night he froze dead in his tracks and said,

“I’m a little worried that you’re listening to System of a Down right now…”

I laughed, it wasn’t what he thought.

 

Let’s back things up.

Every year around the end of December since 2006 I’ve compiled a mix cd that relates to the goings-on of the year that is being completed. I didn’t realize it when I started doing this that what I’ve made is a musical mood-chart time capsule.

Listening to 2007, for instance, brings me right back to graduating college and the wild ride that came after, and I’m transported back to how I felt at that time.

These songs can represent moods, seasons, events, moments, the overall feeling of the year, whatever you want it to be. I would highly recommend it, if for no other reason than to be amused by having musical mood charts.

Anyway, I’m a little late this year getting 2011 off the ground. I’ve collected most of the music, I just haven’t figured out the order. I have chosen to include one song on the mix by System of a Down.

If you aren’t familiar with them, SOAD is a little unique because of some of the political messages they put in their music, but there’s screaming and yelling and singing, they’re a little loud and intense. When I was in my middle teens somebody turned me on to “Toxicity” and “Steal This Album!” and I was smitten, they were unlike anything I’d ever heard before (note, I grew up on an island) and all of that fun screaming really seemed to jive with the overwhelming teenage angst that was running around slapping bipolar disorder in the face trying to get its attention.

I remember when I went to the hospital the very first time I had left my stereo alarm clock on by mistake, and at 6am every morning my mom had to listen to “Chic ‘N’ ‘Stu” (a song about pizza toppings) shaking the house because she couldn’t figure out how to turn the alarm off.

Needless to say, this music was very much a part of me when I was younger. It helped usher in the beginning of something, namely the era of, “maybe I’ll just do whatever the hell I want.”

I have a SOAD patch on my jacket (I put it there when I was 17) but we’ve definitely drifted apart. I’m not a huge fan of the band’s later work, but I always regretted not getting a chance to see them in concert.

In 2011 though, I had that chance though a total random fluke. Someone I don’t even know very well was giving away a ticket, and somehow it was given to me.

Now, I’m sure the concert I saw doesn’t compare to the shows they put on 10 years ago, but it was a good reminder of the journey I’ve taken. Almost like a bookend, it felt like closure.

That is why I was listening to System of a Down last night. I put one song on my 2011 mix to commemorate the moment, and the feeling of peace it gave me. Of course, as it played in the apartment my feelings of peace looked suspiciously like intense anger and sorrow directed at “the man” so I can imagine what kind of mental and emotional upheaval Corey thought was taking place.

Thus the beauty of the annual mix. Everything on it will be interpreted by others much differently than how it is interpreted by individual that made it.

So, in a brief conclusion, yes, Corey is leaving tomorrow and I am nervous, but I guess I’m not quite as nervous as I have been in the past. Even if I appear nervous at this point, I’m channeling an inner peace that I can ride until he returns.

Pepperonis and green peppers, mushrooms, olives, chives.