TEAM up for health

"A new form of CBT, known as TEAMS (Think Effectively About Mood Swings), is being developed .... It aims to improve on previous therapies by focusing on current problems, like depression, anxiety and irritability, and helping patients to set goals for their life as a whole.

The aim of this new approach is to encourage patients to accept and manage a range of normal emotions -- like joy, anger and fear -- and a controlled trial is about to start following a successful case series of the TEAMS approach."

Sounds dumb (Teams. Whatever.) but good at the same time. A new approach: think about your moods as something that happens, not something that controls you. Think about what joy or sadness is, and let it pass. Sounds pretty much what I try to do. I try to identify them and not let them control me.

CBT (Cognitive behavioral therapy) really worked for me when I did it. It just teaches you to think differently; almost to not take everything so seriously. It's a nice prescription for how to go about life. You know, one day at a time, not taking everything so seriously. Sounds like AA, doesn't it?

Down in the dumps

Made it out of bed by 2 and out of the house to watch the elephants and circus parade into town with the 2 year-old nephew. It was a short parade, but he was really excited about it. Then off to therapy. "It sounds like general apathy," she said. "Let's call the doc. Maybe we can get you on some different meds." Yes. Perhaps it's time. I just feel - blah. I don't care about anything. Nothing is giving me pleasure. There's no reason to get up out of bed or get dressed. I just feel ick. And it's gorgeous outside; everything is blooming and the sun is out. And I don't care. I'd rather be asleep.

I called the doc on the way home and left a rambling message. "I think I feel worse. I can't get out of bed. Here's my number." I don't know if it made any sense or if she'll even know who's calling. I hope I don't have to go in again, cause it's $85 every time. I'm sick of spending all my money on face time with the doctor and nothing is coming from it. "You were such a bright spirit in October, so full of life," said Julie. And look what's happened? Now I've lost interest in everything. I'm only writing this blog post so you don't think I'm dead. I can't even be bothered to read the news and find interesting links for you. Jesus, I bore even me.

So let's hope the doc comes through with some med changes. Something that works. Apparently Celexa does not.

I'm so bored

I hate this. I'm in one of those moods where I'm not depressed, per se, but I'm just... eh. Here. I can't think of anything to do and so I'm just sitting here reading Twitter and the news channels, which are all about the disasters happening in Japan. It's starting to depress me to read about it, so I'm trying to find other news, and there's nothing.

I need a job. I need something to do during the day. I could go pick up some pictures I had framed, but I'm saving that for Thursday when I have all day to do nothing. Today I have therapy for the first time in 2 weeks. I accidentally forgot one week, and the next she was on vacation.

So what has happened in the last two weeks? Well, she'll be happy that I went out on a date and to a party. She likes when I get out of the house. I like when I get out of the house, too, but it just never seems to happen. I suppose I have been doing a lot on the weekends when other people are available. It's just times like these: 3pm on a Tuesday, when everyone else is working. What do you do with yourself?

Lessons learned in therapy

And that's another thing: I'm ok with me. Julie keeps saying, "You're the most well-adjusted person I know. What are you doing in therapy?" I honestly don't know. I think I'm just lonely and don't trust people.

Ohh, there's a biggie. I don't trust people. I don't want to let anyone in to know the real stuff going on inside. If I read the blog I'd probably realize it's not as bad as my brain makes it out to be, but I always worry people are going to judge me. I don't care if a therapist judges me. Her job is to just listen and comment, and she does it. Although Julie is a little obsessed with making good changes in my life. She's big into getting me some friends. I feel bad for her. I'm an isolating person.... I'm just bad at getting out there. I'd rather be at home.

But, I'm also an extrovert. I go out all the time, apparently. I just looked over my calender and last month I did a lot of stuff, or planned on it and couldn't find dates. Whatever. See? People suck.

It's insomnia night!

Well, this hasn't happened in a few weeks. I'm up, it's midnight, and I can't seem to go to sleep. I think a lot of it has to do with the fact that I've been trying since 9:30 and have been constantly getting texts. No one loves me unless I'm trying to sleep. Or maybe I'm always trying to sleep and so people just text when they feel like it.

Somethings I've been thinking about: Julie mentioned something about our sessions ending in April, so I think that's when her semester is over (she's a student therapist). I suppose I'll have to go without or try to convince the center to give me someone for the summer semester, if they have a person. I wonder how their process works.

I see the doc next week, and I think he's going to take away my Abiify. I'm appalled at the thought. I can't imagine being without the antipsychotic. It's what got me out of a depression last year, and what got me free this time, too. If it's a crutch I don't care- I need it. But how am I supposed to have it? Well, I'm not going to worry about affording it. There are a bunch of folks who've taken up the cause d'Anne and said they would help pay for my meds. I think that sucks, but if it's the reason I can still go to interviews and function, then so be it.

Jesus, I need some sleep. Ugh.

Chaos rules the day

I gathered my strength and drove to the neighboring state for an interview today, and when I got back home my dad and my aunt had taken over my room. They moved all the furniture to the middle of the room and then painted. Everything is piled high, but luckily I had most of it in boxes in storage already.

"I want them to start in your room first," dad says. Which is good, because then they'll be out of my room first and I can re-arrange it the way I want. But they took down the curtain. So I'm sitting here exposed to the street. We're on the 6th floor, but it's pretty much at eye level with the hill in front of the apartment building. The building across the street was torn down, so I have a nice view of the office building two streets away. I bet the cleaning ladies don't care what I'm up to, but it's creepy to be so exposed. I don't even know where the curtains are, or I'd put them back up.

So I went to therapy. "My life is chaos. I want to cry. I think the meds are working, cause I'm not suicidal, but I sure as hell am depressed." And Julie gave me the speech: there are people worse off than you, you have a lot going for you, the universe is aligning to help you out, blah blah blah, go buy yourself flowers. So I did. Pretty, purple tulips.

I wandered the aisles of CVS for over an hour and bought all sorts of shit I didn't need, like new lipstick, and shit I did, like travel size contact cleaner. Then I went to the grocery store and bought 100-calorie packs of Oreos and some ice cream. I grabbed the flowers and, feeling a little better, walked home.

I get home and dad says, "Aren't you allergic to flowers? I am. Your mom is, too." No, actually, I'm cool. I can't stand the high perfumey ones, but tulips are fine. Then he tries to talk to me about moving stuff again, and how I need to put more stuff in boxes. So I ran away and took a nice hot shower. I even shaved my legs and then plucked my eyebrows. Self care. A little self-love.

And I still feel insane. I need to move out and be in control of my own life again!

Detatchment with love

Adam came over to give me a hug and see how I was doing. As he left, he told me he was "detaching with love." Ok, I've heard that before, but it is normally used as a synonym for loving you from a distance, no?

"We take responsibility for ourselves; we allow others to do the same. We detach with the understanding that life is unfolding exactly as it needs to, for others and ourselves. The way life unfolds is good, even when it hurts."

Right, so it's letting go of the other person and letting the chips fall where they may. It means he's been talking about me at therapy. He was saying how he's worried about me, but he's not going to take it on. "You can call me, you know." I know. But it's so hard to reach out to anyone. I don't know what to say; don't know what I need.

I was wary of physical contact when he said he was coming over. I feel so weird right now and I didn't think I could handle touch. It wasn't bad. I felt a little more relaxed, and he made me laugh a few times. I'm glad he didn't stay too long, though. I don't really feel up to interactions.

What the hell am I going to do on Tuesday during the interview? I hope I can pull it together by then.

Why is college so fuzzy?

Something else we talked about was my overdose at age 18 and whether or not that was my first suicide attempt. I don't know if I'll ever know, but it was out of character for me to mix meds and illegals. I just never did it. And then suddenly I do? I don't remember that morning at all, but I remember everything about that day from the moment I started to feel weird until I passed out, and then when I woke up till the moment I got home. I don't think it was an accident.

Anyway, we were talking and it occurred to me: in the five years between one suicide attempt and another, I didn't get any significant help. Imagine, your kid is bipolar, angry, and obviously has drug problems, and all you do is make her get a job? And then let her move out and in with some boy she's known for 2 days? What in the hell was my dad thinking? Why didn't he immediately get me help when I got home?

We went back to get my meds later, but what I remember was we went to get my allergy shots (and then left them in the car). But there was at least a few weeks there where I wasn't allowed on campus and so didn't get my lithium. Did I just stop taking it? Was my last day of lithium the day I overdosed? What happened next? Apparently there are no withdrawal symptoms for lithium, so there's nothing obvious I can try and think of. So what happened?

The next time I think I got in touch with the mental health community I was in college and probably 21 or 22. I could call the University and get my records. I was taking drugs from them for a while, but all of college is kinda fuzzy.

So, really, since 2003/2004 I've been on continuous meds, but have had a lot of sketchy periods in-between. What was I doing all those times? 1998 - 2003. Well, I know I was using a lot of alcohol, cigarettes, and sex with strangers to make me feel better. I was moving in with people and making really rash decisions. Those were my college years, so I know I was taking something....

All about suicide

I love trivia. I learned some interesting things from Julie today:

-April and December are the months with the highest suicide rates.
-The older you get the more likely you are to commit suicide (and succeed).
-Older men are more likely to commit suicide.
-Single, celibate people are at most risk.

Julie says she always worries when she hears about depressed older men, dads especially. They've got the highest risk. You would think it would be teenagers, but it's not. Teens have built in networks of family and friends to watch out for them, unlike older, single people.

We talked a bit about my last suicide attempt tonight, and she went through a questionnaire the center gives her about risk. She had to, for my file. I aced that thing! "Yep, definitely suicidal, as if we didn't know, but what do you really think your risk is? I think it's low. You're so practical about it." I think it's low, too. I'm not having impulse control issues, yet. I'm able to talk to myself and turn away from the bad things.

I went to the grocery store after therapy because I was thirsty. I was walking down the aisle and saw the bleach. For a quick moment I thought, "I could just open the bottle and chug," but I quickly reminded myself of the consequences: that would burn like hell. What a painful way to mess yourself up. We're awful close to a hospital, so there's a likelihood it wouldn't kill me - only severely disable me from breathing on my own. Sounds pretty horrible to me. I don't want to be incapacitated, I just want to hurt myself.

And that's where I am, I think. I get the thoughts of suicide like that one, but I don't really want to die. It's just my illness talking for me. Luckily, I can still talk back.

Look deep into my eyes

Insight into the cause of your problems is a good starting place for feeling better, but it's not going to change your life. Action is.

The New York Times had a neat op-ed this morning saying basically that, which I've been thinking forever, now. I am therapy and meds' number one fan, but you've gotta take those as tools and run with them. The op-ed talks about a young man who had been through therapy and understood the basic causes of his troubles with life; his early problems with his parents were to blame. But, "When he became depressed, though, this insight added to his pain as he berated himself for failing to stand up to his father and follow his own path." Exactly! It doesn't help you to just know the background, you've got to do something with that knowledge.

Julie and my old therapist have both asked me what my plans are for therapy. I had no idea. I mean, I've spent 15 years in therapy, and I'm pretty sure I'm angry and know why, but what good is talking about it all the time? I've forgiven my mom for a lot of things, and my dad, too. A fourth step was, I'm sure, easier because of all the work I'd already done. But the past few years I've been using therapy as a tool to deal with the day-to-day. Is that the right use of it? Where should therapy take me now?

There are some basic goals for therapy: crisis management (which we're kinda in right now), coping strategies (check), long-term pattern changes (good idea), symptom-reduction (check), self-examination (check), and prevention of relapse (which goes with the crisis for me).

Right now, I'm definitely in crisis management and prevention of relapse. But once I've got a job, meds, and a sponsor, where should we go from there? I suppose it's just taking those character defects from step 4 and working through them. Does that make any sense?

Match?

My therapist thinks it's about time for me to stop pining, and start dating. Apparently it's unhealthy to think about your ex so much and "wait" for him to make a move. Sure, he kissed me, and we sleep in the same bed sometimes, but he's also the one who tells me not to overthink it, wonders why we have to talk about it, tells me he's dating. So whatever. I need to get over it and move on, right? He's had almost 5 months to say something besides "I don't know how I feel about you."

She suggested I do something like Match.com. Even if I don't meet "the one," maybe I can make some new friends from it. I did eHarmony last year on a bet from my aunt, and met a new friend (and some creeps). It was a fascinating experiment, but maybe if I took it seriously I could get something out of it. Only problem is, you have to sign up and pay for that stuff.

Other options? Well, there's always Meetup. I can join groups who do stuff, which would get me out of the house and meeting people. I need to make friends too, she says. That's one of her goals for me for the new year: make more friends. She's a smart cookie, that one.

Therapy saves my life

"He who thinks much is not suited to be a party member: too soon, he thinks himself through and beyond the party."

I'm following this guy on Twitter who does Nietzsche quotes all day. I liked this one. I have trouble being in any sort of group, or with group-think. I don't belong to a political party, even. And I think that's where my trouble with AA comes from. I'm able to think myself through and beyond the party. I can see where it has amazing benefits, and it really is a program that was ahead of it's time - something that is transformational. It's worked for millions of people, and failed millions more.

My therapist is behind me on this. "I have you, what do I need a sponsor for?" She agreed, "Many people work the steps with the help of a therapist instead of a sponsor. However you want to do it, or even if you just want to continue with therapy, is fine by me. If it works for you, keep doing it." When I moved back here the first thing I did was find a therapist. I've been in and out of therapy since 1995, and when I'm out of it I'm crazy. Therapy keeps me sane; it's something I can rely on to help me reach inside myself and find the truth.

It works a lot like AA, I think. Therapy is a program of self-knowledge and change, if you do it right. And it addresses the underlying emotional wreckage more deeply. As you can tell, I really love therapy. I rely on it. It's one party I can get behind.

The limbo elves

There is something afoot. My therapist says it's the limbo elves. Like normal elves who come in and cobble your shoes at night, the limbo elves come in and make sure you're on the right path. They distract you from things or point you in the right direction. They say, "No, no, no!" when you're heading off in the wrong direction.

Limbo elves. It's like mini higher powers at work. They come in and invade my dreams, keep me from getting a job until it's the right one; they know what they're doing. Damn elves.

I'm feeling a bit better. My therapist thinks I'm a little manic, even though I've been sleeping during the day and up at night (which I usually equate with depression), and I'm bitchy. Huh, ok, that is more manic. I guess I've been writing about being a little manic for a while, and a little crazy, but I haven't really felt it. I do know that being this optimistic all the time is weird. We agreed the drug cocktail I'm on is probably the only thing keeping me from a breakdown at this point. Everything is crazy in my life, and I'm fine. I don't even want to drink or smoke. Normally I would be treating unemployment with booze and drugs. It's just what you do, right? As an addict, it's just what you do.

I don't know what I'm talking about. I'm just post-therapy rambling.

Travel on a dime

Therapy is one of those nice inventions. Thanks Dr. Freud for making it cool to go to therapy and spreading the love to us peasants. It's also really great that the place I go for therapy has poor people rates. My new (old from when I used to live here) psychiatrist on the other hand, does not. He's really expensive without insurance, but he's worth it. I really like him, and he totally remembered me.

My therapist is really proud of me for using my "limbo" time well. I'm making progress in changing my life for the better and finding out what I really want in life. I'm moving towards a better life.

So what do I want for myself? Well, I wish I had enough money to travel for a few years. Maybe I should join the Peace Corps. I didn't before because of my dog and my car, but I've proven that my mom can take care of those things. I would just need about $600 a month to pay my bills. I don't know where I would get that, unless I took out some money from my IRA, which tax-wise would be stupid, but it could work.

Then again, I just want to travel, not work. I wish I were rich. Where would I go? Well, I haven't done Asia or South America or Africa. I know! That's a lot. I think I would start with Chile and Peru. Then I would go to Vietnam and Thailand. Then maybe Japan, Morocco, South Africa, New Zealand. That's a lot of places, and a lot of money. If I'm not employed by March (when my benefits run out) I'm taking the rest of the money from my money market (about $4k) and running away with it. I think half that will get me a plane ticket somewhere far away, and the rest will be an apartment in some beautiful town like Santiago or Marrakesh.

Of course, it's all wishful thinking. I need a job, even a job in retail. I need some income. If it's a retail job, then I can afford to take the time to leave for a little bit and still have some money saved up. I need to stop spending all my money on clothes and tattoos. Alright, I'm calling a moratorium on spending. After this tattoo I'm buying nothing. No more plane tickets, no more clothes, no more tattoos. I'm saving my money for another trip or to pay bills while I'm on a trip.

Lessons from the therapist

I got homework from the therapist: a)get your sleep back on schedule, b) make a vision list, c) pull away from the bad things in your life slowly, d) think about dating.

My sleep has been funky, as you can tell by the times on all the posts. I've been up into the wee hours of the morning just sitting here on the computer being prolific. Go me. So I've got to find another way to have time alone, rather than waiting to stay up all night just so it seems like I have my own apartment. Tonight I've got to go to bed early because we're getting up at 5 tomorrow and hitting the road to head up north. Traffic should be awesome.

A vision list is something you do that's kind of like a fourth step: what are my characteristics now, and then what do I want them to be. So if now I'm obsessive about stuff, and I want that to change, what does that look like? Also, the simple things like how do I want to dress in the future, and what will my career path look like? It's like making a five year plan, but looser.

I told her I quit smoking and she commended me, but also warned me about the difficulty of doing that while I'm trying to find a job and do a million other things. She thinks I can do it, but I need to change those habits slowly and realize that if I slip it's not the end of the world; I just need to get back on that horse.

Oh, dating. She talked about how I have the obvious capacity for intimacy, since I've shown it with Adam, and how a lot of people just aren't capable of that. She thinks I have the potential to find a really fulfilling relationship one day. She suggested I look into the possibility of dating, but not having sex. Just taking it one day at a time - maybe just going to dinner or a movie. I think it's a nice idea, because I don't really want to be in a relationship right now, but I do need the practice, and it's good to meet people. We'll see what the sponsor has to say.

I'm still really bad at wanting to listen to my sponsor. For starters, she's 26. What the hell did I know at 26? Nothing. I'm sure she knows a lot more about AA than I do, but when it comes to life, I think I've got a leg up on her. So it's hard for me to want to tell her things and then listen. I mean, if I think of her like a friend and she's giving suggestions, then that's cool, but it seems like in AA they expect you to do exactly what you're told. I think I'm going to be a rebel. I hope that doesn't hurt me in the end.

It's rally time!

I'm ready to go restore sanity/and or fear! Should be an interesting rally.

My therapist has given me an assignment to bring a little fun into my life, instead of just focusing on the job hunt and other stuff that stresses me out. She says I don't have enough fun. I used to have fun. I used to throw parties and hang out with friends, watch my show with the girls, go wine tasting. I used to have fun. It's hard here, with everyone watching babies or having their own stress.

Adam is crazy busy at work. He's got so much going on that I haven't seen him all week. I've reached out twice, but I think I'll let him come to me when he's ready. I, of course, had a paranoid feeling that he was avoiding me. There's a girl who likes him that he's hoping to pull away from, but I think really, with me, he is just busy.

I'm going to the Day of the Dead festival after, and I'm thinking of just leaving my credit card at home. I've got to save my money for the tattoo finishing. I can't keep spending money at the rate I've been going. I have been pretty good the last few weeks, spending most of my money at Safeway or Starbucks. I think that's pretty minimal! No new shoes or shirts.

I am not the DSM

My therapist also told me to stop defining myself by the DSM. The way I talk about myself is in therapy terms, like I'm bipolar, have some psychosis, am a cutter, etc. I always look at myself through the eyes of the DSM, putting my feelings in the descriptions of illnesses. Instead, I need to focus on who I am, not what I am. So who am I?

I'm a good person. I'm smart and capable. I'm loving. I'm open to change and willing to listen to others. I'm a recovering cutter and a recovering alcoholic. I may have bipolar, but it doesn't define me. I am not my illness.

I am a person with feelings, not illnesses. It's ok to feel a little down and not be depressed. It's ok to have weird thoughts and not be psychotic. I need to work on identifying my feelings and just feeling them.

What am I feeling? Scared. A little worthless and useless. Excited for the future. Really.

Focus on the future

My therapist said I need to stop focusing on the future, and look at what I have today. Make a gratitude list. So here's my list for today.

Rain
Dad letting me stay here
Interviews
Adam
Mom taking the dog
Halloween
New clothes
Boots
Good friends

I need to stop making myself crazy by focusing on what might happen; what might happen when I get a job, when I reach my year, when this and when that. I need to let this time be this time. Put myself where my feet are.

New shoes for me!

OMG new shoes. I love it! I got three pair and a new purse in the mail yesterday and today. I love it. I have a bright red purse now, which I've never had. I've got to wear my red lipstick to match tomorrow. And my new black boots.

I love shoes. I used to wear Chucks, Birks, and Docs, and that was it. Or I would be barefoot. I was a little hippie chick with flowy skirts and bells on my ankles. I even had dreadlocks at one point. I would walk around with jeans that were too big with holes in them.

Now, I've got more of an Ann Taylor/Punk look. I love studded boots and big purses, but I dress up wherever I go. I hate wearing jeans and t-shirts now, and my docs are only worn in the snow. But I still wear them, of course.

Move your eyes

I'm writing some copy for a local nonprofit which does a neat little treatment called EMDR. It is: "Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that was developed to resolve symptoms resulting from disturbing and unresolved life experiences."

They use it on soldiers with PTSD and rape victims. It uses rapid eye movement with cognitive behavioral therapy type practices where you think about the bad stuff and reframe it in your head to think about better thoughts. They also use it for people who have suffered all sorts of other traumas like abuse.

I wonder if it would work with depression. Cognitive behavioral therapy is commonly used in depressive people, so adding EMDR might help even more. People in Alanon might also benefit from EMDR. "During her single EMDR (Eye Movement Desensitization and Reprocessing) treatment session, I witnessed a remarkable transformation as she resolved her grief over being abandoned, her fear of dying and came to a decision that she would be OK."

Fear of abandonment is a common problem in people traumatized by things like having to grow up in scary environments. EMDR apparently works well for that. I know some people believe that outside therapies and drugs are like not being sober, but those people are ridiculously wrong. So says me. And I'm always right.