bitterfig

This weekend was Gay Pride in Chicago but I didn’t end up going to any of the events.  .  There weren’t any signs posted about being on the float so I didn’t get to be in the parade like last year.  I didn’t even get to go to the parade because I had work and of course I wasn’t exactly in a celebratory mood either yesterday or today.  

 

First, let me explain the situation with my medication.

 

I’ve been off Effexor entirely for over a week and am now taking just 60 mg of Cymbalta each day.  A couple of weeks ago my brother-in-law had suggested that my tendency to shut down and isolate may have as much to do with over-medication as it does with depression and I think he might have been right.  I feel much more alert and engaged in the world around me now that I’m taking less medication but I’m also much more sensitive and volatile. 

 

At the beginning of the week I did some painting for the first time in ages and actually finished up my sister Vienna’s Christmas gift which I’d sketched out back in December but never completed.  On Saturday morning I rode my bike over to her condo to give it to her.  During the course of the visit the subject of my behavior at the MBA graduation party for her sister-in-law Staci came up.  This was a small party, mainly family except for Staci’s boyfriend (who she’s only been seeing for a couple months) and a guy who works with her. 

 

I was very nervous about attending but I decided to make the effort and when I got there I ended up drinking about 4 glasses of wine (I will say in my defense that at least one of them was much less than a full glass, probably only 2 or 3 ounces).  As a result of this drinking I talked much more and much more expressively than I would have otherwise and Vienna was very much not pleased with some of the things I said—mainly allusions to my eating disorder and mental health problems and a remark that I wasn’t interested in having a relationship, I’d just like someone I could call to come over and have sex when I felt like it. 

 

Vienna sort of pointed out all the things I’d said wrong and told me that she had been embarrassed and more or less scolded me for drinking too much. 

 

It was almost something I’d expected.  I’d spent the last session with my therapist going over the exact same things Vienna mentioned but we’d ended up agreeing that I need to let myself make mistakes and that I shouldn’t obsess over what I’d done wrong or feel guilty and that these things weren’t that big a deal and that is was positive that I’d attended the party despite my anxieties and been able to interact…

 

I still got really upset.  Being told my family members that I’ve embarrassed them always cuts me right to the core.  When I was in high school my father used to bludgeon me on an almost daily basis with what an embarrassment I was to him, how my clothes and my grades and my conduct were a reflection on him and I was making him look bad and humiliating him in front of the other teachers. 

 

It just really upset me, to the point where I started crying.  My 6 year old nephew and 3 year old niece were there.  Luckily I don’t think they noticed because they were playing with their tricycles across the room but I really feel bad about losing it in front of the kids like that. 

 

Even after I left, I was still really distraught.  I kept tearing up and having crying jags for the rest of the day including at work.  Today I got through work without incident but I felt drained and very sad. 

 

I can’t blame Vienna for this; my reaction has been completely disproportionate to what she’d said to me (which was nothing I hadn’t already said to myself).  This makes me think (hope) it might have something to do with the medication because it seems like the only other possibility is that I’m just weak. 

I had my psychiatric evaluation on Thursday.  I’m pretty familiar with the structure of this sort of evaluation because I worked at a Chemical Dependencies Clinic in Upstate New York for five years and part of my job was transcribing our in house doctor’s notes.  Basically they have a checklist of questions to go through to determine if you’re oriented x3 (person, place and situation), whether or not you’re having visual or auditory hallucinations, whether or not you’re a danger to yourself or others. 

 

I know this but I still feel a little insulted when asked if I hear voices.  I’m depressed, not Drusilla from Buffy the Vampire Slayer.  Of course I suppose in all fairness they have no way of knowing that without asking (well, maybe reading the notes from the hour and a half evaluation I went through on my last visit). 

 

Anyways the psychiatrist thought that I should either bump my intake of Effexor XR from 275 to 350 mg per day or try adding a small dose of Cymbalta, an anti-depressant I’ve never heard of. 

 

I don’t want to take a higher dose of Effexor because I already feel foggy sometimes at the dose I’m on.  I looked up Cymbalta on-line and it doesn’t seem too much different than any of the other anti-depressants so far as side effects are concerned so I’m going to give it a try.  To be perfectly honest I was hoping for Wellbutrin but it turns out Wellbutrin is not recommended for people with a history of eating disorders which is probably smart as I only wanted it because I’ve heard most people lose weight on it. 

 

I haven’t started taking Cymbalta yet; my brother-in-law is rounding up some samples for me, that way I won’t have to spend a lot of money on something that might not work. 

 

I have a tendency to peep at doctors notes when I can.  I noticed that I was given a 40 under Axis V, which rates level of functioning.  I looked it up and according to psyweb.com a rating of 31-40 means—

 

Some impairment in reality testing or communication ( e.g., speech is at times illogical, obscure, or irrelevant ) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood ( e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school ).

 

I think (I hope) I fall under the impairment in several areas rather than the impairment in reality.  Impaired reality seems much more serious. 

Yesterday I broke out my bike and went riding for the first time since November.  I went over to my sister’s place in Ukrainian Village and though I took mainly side streets I did a little riding on busier roads and it’s going to take me a while to get used to traffic.  It gets sort of daunting when you’ve got parked cars on one side and cars and trucks zooming by on the other.  I do wish my bike had narrower handlebars.  When my bike was in the shop after my accident last summer (for those of you who missed it: Deathly Hallows release + 3 way intersection + city bus + turn of questionable legality + me= smashed bike and spectacular bruising) but they still seem too wide.

 

After numerous false starts it seems like spring is finally here.  Several successive days of fine weather have done wonders for my mindset.  I feel like I’ve finally pulled out of the period of low mood I’ve been in since the end of March.  Yesterday when I was at my sisters I felt pretty content and enjoyed myself whereas a week or two ago I felt quite bad about how we were relating and everything.  I think when I get in these moods everything is off. 

 

Because I’m feeling so much better I’m almost tempted to cancel my psychiatrist appointment next week because frankly the clinic in Pilsen is seedy and depressing and I’d really rather not go there.  Unfortunately it’s what I can afford and I have to make myself follow through on the appointment.  I’m all right at the moment but if I don’t address the problems with my medication the sort of depression I’ve had to go through this winter is going to continue to be a problem. 

I was off both my jobs on Tuesday and hoped to get together with my sister or go to the movies but after running some errands in the morning I ended up sleeping most of the afternoon. I think recent events at work (plus a couple of eight hour bagging shifts) have left me kind of exhausted.

Tomorrow morning I have my much-anticipated mental health evaluation. I’d put in a request to have the morning off back in February when I first made the appointment. It was ignored as scheduling requests generally are but I was able to trade for a closing shift so I’ll be able to make it. After the evaluation I’ll hopefully be referred to a psychiatrist and can start the process of adjusting/modifying my medication.

I have been better since the time change but I’m still having difficulties—the episodes of cutting I mentioned last week as well as periods of listlessness and fatigue and times when I feel totally overwhelmed and worthless. I’ve made a conscious effort not to do any more cutting and I’ve been able to hold to it but there have been a couple times in the past weeks where I honestly thought I ought to just go to the emergency room for suicidal ideation.

Yesterday I was at work and having sort of a hard time and ending up opening up maybe a bit too much to Tycho Brahe, a co-worker I feel pretty comfortable around (I’d actually asked out in January, probably not the best idea given that he’s 24 and I’m 36. Still, he was very gracious in turning me down. Poor boy, he must wonder exactly what he did to catch the eye of a mentally unstable older woman).

He’s finishing up a Master’s degree in mathematics next month and planning to go into a program in the fall for a Master’s in humanities with a focus on literature and eventually teach in that field which sounds wonderful. I would love to do something like that but right now it seems so out of my range. Because of my depression bagging groceries for eight hours seems like too much for me to handle most days.

I talked about this to him and it honestly felt good to get it out, I just worry about imposing myself and my problems on others. On the other hand I do feel like it was part of a conversation. It wasn’t just me talking at him. The boundaries of social interactions are so confusing to me. I always worry about going too far though I suspect that most people find me very restrained and unwilling to share any of myself.

It’s taken me a while to find a place I could afford but yesterday I set up an appointment for evaluation at the Pilsen-Little Village Community Mental Health Center.  It’s funded by the state so they do sliding scale fees for people such as myself who don’t have insurance coverage for mental health. 

I think this is a step in the right direction, but it’s only a first step.  They couldn’t get me an appointment until March 28 so I have a couple more weeks of being depressed to get through.  And of course I have to go through the evaluation process before I can actually see anyone qualified to mess around with my medication. 

In general however I’m feeling a bit better.  Yesterday I got through the first day with the new register system at work and it wasn’t too bad.  It’s different and will take a while to get used to but no one got mad at me for being too slow which I was afraid would happen.  I really lucked out as far as scheduling.  Tuesday nights are always fairly slow so it was probably the best time to get used to the new system. 

I’d sort of been hoping that after my unpaid sick time I had to take earlier this month I could get myself back on stable ground financially before I dealt with getting my medication sorted out.  However over the past couple of days I’ve come to realize that if I don’t do something about my depression I’m just going to get sick. 

Getting through work is just so damned difficult.  I get so irritated with the customers then I just hate myself for being such a nasty, intolerant cunt then I wonder how I’m going to get through the next six hours and just want to cry. 

I feel like I’m basically leading a joyless existence at this point- going to work, holding on by my fingernails to get through it, being to drained afterwards to do anything as far as finding another job or going back to school..  I never go out or anywhere new, I don’t see my sister’s family at all, I just feel like the world is getting smaller and smaller for me and it would be worth it to see if I can do something to get better, even if it means dipping into my savings.

I went to the doctor’s yesterday. I was a year overdue on my annual physical (on account of not having insurance last year) so it was probably good to get that taken care of. However I was a bit disappointed in that no solution for my recent problems was forthcoming. While my doctor suggested the possibility of adding wellbutrain to my medication because I’m close to maximum dosage of Effexor RX there’s a chance of side effects and she felt I ought to see a psychiatrist before any medication changes were made. I called the psychiatrist she recommended but they didn’t have any openings till February, which frankly doesn’t do me a whole hell of a lot of good.

In the meantime I’m put in a call to my therapist asking if she might know of a psychiatrist, maybe affiliated with the clinic I go to. Beyond that I was advised to go to the emergency room if it gets too bad. Elizabeth Wurtzel does it all the time in her books, but I’m a bit lower key than her. Showing up at an emergency room seems like an awfully grand gesture, which of course is followed by about four hours of mind-numbing boredom waiting to be seen. If I’m going to sit around doing nothing I’d rather be home watching movies.

As part of my physical I was weighted and I was rather distressed at the results. My weight has gone up, I’m at about 150 pounds, 10 pounds higher than what I deem acceptable. I’d known I was over, but I thought it was closer to 5 pounds. The question is what to do about it—start restricting and take it off or just accept it and be heavier. 150 pounds at 5’8 sounds awfully high in a world where the ideal seems to be 5’ll and 110 pounds but I’m actually still fairly thin even at this high weight. I think a lot of it is from muscle mass, and I do like being strong. I take a secret delight in the fact that at the market I’m the only girl who carries the bales of paper bags by myself instead of using a cart.

Still, I think I could do with eating a little less. I sort of upped my food intake when I was recovering from my bike accident but I’d spent the whole month prior to that riding nearly 10 miles a day. I’m not doing that anymore so really I don’t need as many calories. Of course I don’t want to mess up my metabolism by cutting back to dramatically. I think that’s what I did when I cut back by several hundred calories a day in February. That might actually be the reason I’ve gone out of my “safe” weight range (140 thru 145 pounds) to begin with, I’m not eating any more calories per day than I was a year ago.

I’ll have to figure it out. In the meantime as the whole psychiatrist situation doesn’t look like it’s going to be resolving itself in the near future I’ve taken the step of replacing the light bulbs in my apartment with broad-spectrum “natural light” bulbs. Maybe that will help and I doubt it will hurt.