Monthly Archives: February 2014

Depression and Loss of Appetite

Most people who have experienced depression know that it can have a big effect on ones appetite.

Personally, I’ve always been on the end of the spectrum where depression leaves me ravenous, unable to stop eating the comfort foods I know and love. That is part of the reason I have been so shocked by how depression has effected my appetite the last week or so.

Breakfast doesn’t seem to be a problem, and I think it is mostly because I have been making these wicked good fried egg and cheese sandwiches on artesian sourdough bread.

Lunch is a bit trickier. Fewer things than normal sound delicious, the past few days I’ve been managing to get by by eating platefuls of gyoza.

After noon or so, it is just gone. No food cravings. No hunger whatsoever. No interest in food.

I’ve been trying to remedy this by making things I should go wild for for dinner. Mac n’ cheese, Swedish meatballs, slow cooked roast beef and potatoes… but the outcome is always the same. I take a few bites. My mouth isn’t interested, and I can’t eat any more.

Anyone who has spent time around me knows that this is completely absurd. Not only does my love of macaroni and cheese surpass the love I have for most people, but I am a huge foodie at heart. I watch food shows all the time, I love to cook and I simply love to eat. 

Unfortunately this love is just another thing on the list that depression has robbed me of.

This current bout of depression has been all about stealing passion. Passion for the future, passion for day to day activities, and now passion for eating.

Though I joked with Corey that some good might come out of this (I really wouldn’t mind if I lost a bit of weight) I really genuinely prefer to enjoy eating. I’d rather have something left I could look forward to every day. The sooner I can get that back, the better.

Tripolar

Tripolar

The thing about having bipolar disorder is that, for me, it rarely shows up in a straightforward manner that is easy to comprehend and keep under control. I’ve been contemplating that it is something more akin to tripolar… with mania and depression being joined by a third branch: rage.

This has always been a problem for me. Always that kid throwing raging fits, breaking everything around me one minute and regretting it the next. When I got older the rage showed itself through self harm and then exploded in a volatile relationship where we screamed at each other most of the time. Impulsive suicide attempts. Wanting to hurt others. Wanting to hurt myself to hurt others.

Over the years I’ve found some ways to curb some of this intensity. After throwing and breaking a phone one time I now only throw phones at… pillows. After entering into a relationship where we talk like civilized people, I work hard not to scream and make threats.

It isn’t always there, the rage. It comes on often very suddenly, much like depression and mania does for me, and it doesn’t always come alone. It often accompanies symptoms of depression or mania as well. There are other times where I can feel it building over the course of a few days or weeks, and this is how things went down yesterday.

Yesterday was horrible. By noon I was out of control, crying and gasping for air when it took all the strength I had not to punch holes in the drywall.

I’ve been feeling an extraordinary amount of rage since the SSDI hearing. Of course, this is a situation where I can understand it though. I’m upset. I’m very upset, and if my therapist hadn’t been on vacation for the last two weeks things might have turned out differently. Instead, I’ve vented to a couple people since then, but only barely touched the tip of the ice berg.

My depression yesterday morning was littered with hatred. Hatred of people. Hatred of my therapist for not calling me. Hatred of the breakfast I made, everything. By noon the remaining elements of depression had been replaced by rage, and the lethargy and fatigue I’ve felt for the last two weeks was replaced by a wild manic humming and shaking with rabid jolts of energy.

I punched pillows. I screamed into them (necessary when you live in an apartment building). I broke a pen. A switch in my brain turned on. Everything I walked past, my mind pushed me, smash! Smash! Smash!

Being poor makes it easier not to break everything I own. After all, I can’t just run out and buy replacement mugs or television antennas or… drywall.

I took Luna outside, and holding in the rage made me begin to choke. I couldn’t breathe, and as we walked I cried and shook to the point where the guy across the street with the leaf blower was staring. I hated him too.

By the time we got back to the apartment I was in the early stages of hyperventilation. My therapist wasn’t calling, and the only logical next step seemed to be to go to the emergency room.

The trouble is that I can’t drive, which means taking the bus. If I had only been depressed and suicidal, taking the bus isn’t a big deal. But… being stuck around a bunch of strangers when I could barely breathe and was clearly agitated and wanting to lash out at anything that was around me?

It isn’t the strangers that terrify me. It is the Seattle Police Department. They have a rather extensive history of “accidentally” shooting or tazing people with mental health issues and killing them. Not just people that are threatening, either. People eating fruit. People who are frolicking naked. People who are carving little tiny animals out of wood.

Seeing as how my actions between my apartment and the hospital were in kind of a “wild card” zone I was afraid to risk it. Chances are I would have made it alright, but that would be thirty minutes of torture beyond what I was already experiencing.

So I called Corey.

This was apparently the right thing to do. He talked me down, he got me to start breathing regularly again.

Honestly there were things I could have done that would have helped too (like take an antipsychotic) but the episode was as such that I could barely reason for myself, beyond not doing the things that were terrifying to me.

After that I went for a three mile walk (to get the manic energy out) and then felt better (though still not great).

I’ve written about this third arm of emotion before, and was surprised to find it isn’t particularly common. I know there are people out there, though, that experience episodes like this, and I can’t help but wonder what exactly it is that we have in common that creates this.

And, if this isn’t exactly associated with the classic diagnosis of bipolar disorder, is there something else, or some other origin point, that better explains it?

The Onion Mocks Therapy, We’re Not Happy About It

Normally I’m a big fan of the onion, but this was a tad upsetting. When does joking about mental health go too far?

Girls Can't Resist

In an article titled “Supposed Adult Pays Man To Sit In Room And Listen To Him Talk About His Feelings,” the Onion mocks therapy and in doing so makes mental illness seem like a joke.

Here’s the piece in full:

BRIDGEPORT, CT—Reportedly going twice a week to his special safe place where he’s told he doesn’t have to be afraid, local accountant and supposedly grown adult Carl Rowley confirmed Wednesday that he pays a man to sit right next to him in a room and listen to him talk all about his feelings. “It’s really helpful to talk through my issues out loud with someone who has an objective viewpoint,” said the feeble approximation of a mature self-respecting grownup, describing the hour-long sessions in which he nestles himself on a big comfy couch with a soft pillow and tells the nice man how he’s sad and lonely and…

View original post 238 more words

Emotional vs. Unemotional Depression

This month depression moved in. Not the quick, fleeting sort of depression I generally have throughout the year, but the deep, slow-growing sort that seems to manifest itself during our bleak Seattle winters.

I’ve been trying to explain to the people around me the nature of this depression, because it isn’t the usual sort of fleeting, emotional, crying, despair sort I normally feel.

This depression is the unemotional, a bleak sense of resignation and a lack for caring about anything anymore.

In some ways, at first, I seem to prefer this. It isn’t emotionally jarring, I feel exhausted but don’t feel guilty if I lay around, and I don’t care from one moment to the next what happens to me (great when you have nothing happening to you). Something about it feels comfortable, like slipping on an old pair of sneakers. My anxiety seems to vanish, after all… how can you be worried when you don’t care about anything?

The trouble is that I know the end game when it comes to depression like this. Not caring about yourself and your life can be like a vacation for a week, but if it steadily grows (and it tends to for me) it can be very detrimental to began not caring for a month. Or two months. Longer, even. The longer I go without being able to care, the more things fall apart.

The other issue I have with unemotional depression is that by putting me at ease and alleviating my anxiety I lower my guard and turn a blind eye to the vigilance once keeping me from trusting the things depression begins whispering in my ear. My level of “comfort” with this sort of depression actually goes on to hurt me, because my guard is down.

It is almost like I’ve made a truce with it. Don’t hurt me any further, and I’ll let you (I say “let” as if I can actually get rid of this) stick around. 

Trouble is, it always cheats.

Before long it whispers to me, you know, you really are doing more harm being alive than you would if you were dead.

I sip my orange juice and think, “you have a point…”

WAIT! WHAT?!? NO!

Sneaky little snake!

But after months of those situations I’ve had a lot of trouble in the past not believing and agreeing. Then, you know. Hospitalization time again.

The fact of the matter is, I would like to avoid another hospitalization at all costs, and that is part of the reason for this post today. I need to remind myself who the enemy is, get to know it, and stay on guard.

Olfactory Hallucinations

For the past week or so, I’ve been smelling a smell and I can’t find the origin of the scent in my apartment.

It smells like perfume worn by an older woman, that kind of sickeningly floral smell with almost an herbal quality to it.

I have extremely sensitive sinuses, I generally can’t be around perfumes of any kind (soaps, detergents, deodorants, colognes, even actual flowers sometimes) without them triggering sinus pain and headaches. Naturally, when I began to be overpowered by the perfume smell in my apartment, I began taking steps to find the scent.

I sniffed blankets and pillows touched by my guests, I took out the garbage, I smelled the laundry my boyfriend just did (in case someone else’s dryer sheet had been left in the community machine), and I smelled all of my own clothes as well.

The verdict?

I can’t find it. I can’t find the smell coming from anywhere in the apartment… yet sitting on the couch it smells very much like I’m sitting next to a 70 year old woman, and the scent is overpowering.

At this point Corey is joking that I am psychic and perhaps these phantom smells are coming from the ghost of our apartment’s previous tenant.

I’ve reached the conclusion that the phenomenon is most likely (as I’m the only one that can smell it) phantosmia, or olfactory hallucinations. After all, we can experience hallucinations through the feeling of touch or through sight, is it really any different to experience them through smell?

This is not the first time this has happened to me. Usually I smell garbage though, a funky odor I can’t seem to find or get rid of even after I’ve taken out the trash. I don’t know at this point if the odor of perfume is really any better.

These sorts of hallucinations are probably most likely known for occurring with brain tumors, but they are also fairly common with schizophrenia and other mood disorders.

For the record, phantosmia refers to the hallucination of a smell in the absence of any other odors. There are other types of olfactory hallucinations called parosmia that is the misinterpretation of a smell into another smell. Pretty much the equivalent of when your dishwasher is running but your brain believes people are whispering in the other room (but with smells).

In any case, I hope this goes away soon. I’ve been under an intense amount of stress the last couple weeks, so I imagine that might have been what triggered it. It is just extremely inconvenient to be sitting on the couch dreaming about wearing a gas mask (HA! but I’d probably still smell it…) because, well, this stinks!

The Tegretol Verdict

Next up on my (short) list of medications left to try was tegretol (carbamazepine). I started taking it about two months ago, starting at 50 mg and moving up gradually to 250 mg last week.

I want to take a minute to make my normal note that I have treatment-resistant bipolar disorder, and I don’t react the way most people do to medications. I wouldn’t consider this the average response to tegretol, if you tried it things would probably quite different for you. This is simply an account of how I reacted to it, and why (spoiler alert) it isn’t for me.

At a very low dosage, my side effects were minimal. Diziness and nausea in the evening after taking Tegretol with food, but nothing more. You can believe there was much rejoicing at that fact!

Moving up to around 200 mg was a bigger issue. I began having headaches lasting  75-100% of the day. My nausea would creep in between meals, and was especially bad in the afternoon. Despite loading up on things like tums (and slices of pizza) the nausea would go away for about ten minutes and then return with a vengeance (I had better luck with about a 30 minute relief after each slice of pizza, though the pizza does have the added side effect of weight gain). The dizziness in the evenings (after taking the medication) became overwhelming, to the point where I could barely stand within three hours after taking the tegretol. The dizziness was on par with a night of binge drinking as a 21 year old (without the fun), so much swirling and whirling upon closing one’s eyes that vomiting was almost inevitable.

All of this I took with a grain of salt, despite the nausea and headaches becoming quite intense this week.

What finally made me pull the plug on tegretol was a painful swelling in my neck that started around 100 mg. It started on one side, and was so painful I had trouble sleeping (I actually thought, at first, I might be having some kind of trouble with the firmness of my pillow!). After showing my psychiatrist I went to my general doctor who made sure I had no reason for my lymph-nodes to be swelling. He wanted to wait and see if the swelling would go away before trying to take me off any medication.

Well, that was a week ago, and yesterday I woke up with the swelling on both sides of my neck instead of on just one side. My neck is covered in painful swollen lumps, not unlike the Cardassians on Star Trek. Apart from not looking particularly attractive, it definitely doesn’t feel good.

So, uh… no more tegretol for me. I’m tapering off it as fast as I possibly can.

I find this to be a bit of a sad story, because (though I don’t have any proof) I was beginning to think it might be helping my moods. There were several situations where I expected to feel overwhelmed or depressed, but the feelings didn’t seem to show up or last as long as they might normally. Mind you, this is really speculation (and I’ve been so anxious lately I can’t expect my observations to be spot on) but I wasn’t willing to let the other lymph nodes on my body start to swell up painfully while I waited to find out if I was right.

The Initial Aftermath

Yesterday was the SSDI hearing. Turns out I was dealt the most difficult judge, and despite my intense anxiety I went in feeling more confident than I expected to be going in (which is slightly laughable, considering I was on the verge of a panic attack at any given moment).

I couldn’t tell for certain, as the man was straight-faced and tight-lipped, but I’m about 98% certain he didn’t like what I had to say. I laid everything bare, even things I haven’t told my therapist at this point… all of these horrible questions making me say things I didn’t want to say (but needed to). I answered the questions as best as I could, and despite the anxiety felt a stillness of emotion for the hour I was engaged.

I’d be lying if I said it was anything less than traumatizing. The sense of relief I felt when I walked out the door (feeling as if I’d done and said everything I possibly could have) lasted about an hour. As soon as Corey and I got on the bus, it began. My mind started replaying every little detail, every moment that made me cringe. Every instant I have suddenly began second-guessing. All of this has made up some horrible loop in my mind, giving me only a 15-60 second window of being able to think about anything before my thoughts automatically cycle back to the hearing. The hearing. The hearing. The hearing.

“Alan Tudyk will be at comic con this year… what about when you said you’d only posted your blog once last week? It looks suspiciously like three posts. But I did technically only post once! One was a re-blog and the other two I wrote at once and scheduled to be posted on the same day. That’s one day’s work, it just looks like three!”

Gahhhhhhhhhhhhhhhhhhh.

I got in bed early last night and took an Ambien to silence this obsessive inner monologue. I felt sneaky, like maybe I had beaten it, when it started up again at 4 o’clock this morning.

I’ve been trying very hard to look at this hearing like I might look at a job interview. The way I feel about most jobs is that I am not particularly interested at first, I’ve even been wary about the amount of stress the job would put on me. Then, after thinking about it a little, I become interested. As time begins to pass, my enthusiasm begins to grow, and I move from being interested, to wanting the job, to passionately wanting the job, to feeling like I need the job and ultimately feeling like I can’t live without it.

In the last year, my mind has moved from a place where “it would be nice” to have SSDI benefits to, “there is no point in living if you don’t have them,” (which I understand is untrue, just the way my brain tends to exaggerate sometimes). Undoing this thought is difficult, and doesn’t really lend itself well to helping me not frantically obsess over this for eons.

The truth is that I’ve been obsessing over this for a year. I am ready, really ready, to obsess over something else. Wrestling with this situation has been extremely difficult, so please refrain from calling/texting me right now in an attempt to find out more detail about how things went. That’s why I’m writing this post.

Luck was not on my side. I will find out “for certain” in a few weeks, but I can say with some assurance I really don’t believe I won.