Tuesday, October 19, 2010

De Activating

Since I went down on the remeron my anxiety/ocd has been cut by 90 percent. Maybe more. It's too soon to say exactly how this will pan out, but one thing is clear: the med I took to help me sleep, to make sure my mood stayed level and perhaps counteract some of the deep seated tension I know I still hold, that med turned my ocd on like a switch at doses over 15 mg. At 15, I feel sort of caffeinated, even after nearly five months on it. Taking lunesta to sleep every night the last few weeks. Seeing the psych tomorrow and asking about going OFF. But since I dropped my dose, a few days after that, tremendous relief.

Figure that shit out.

Yes I have life stressors that happened at the same time I went up on the dose. But it is remarkable to me how agitated I felt, and how easily that agitation became obsession. I mean some obsessional thinking every day for the last six weeks, now completely gone the last few days. Crazy. To give him credit, with my history of ssri's, the psych said it could happen. Tomorrow I find am asking questions.

I don't know if I even need to be on any anti depressant med. I was in need of help last spring, six, almost seven months with trouble sleeping most nights, a deep down body fatigue, in short, a milder form of depression than in my twenties. Then some depression end of May, nothing too serious, and some free anxiety, just a few days really, and I went right on the med. I'll never know what the summer would have been like without the med; it helped me sleep like crazy the first 3 months on it or so and that WAS very helpful, but I do know it ended up making the last few weeks very hard, and probably has been effecting me all summer.

That's all I can say right now; I got nothin else.

I am working through some hard shit, and hard shit is simply always hard. Doing a lot better the last few days though! Late, I'm tired. much love.

Friday, October 08, 2010

Activation

It's been a hell of a year. Well, a helluva last 10 months or so, with the last five having some banner scary moments.

It sucks but it's true. After months last winter, like six, of not getting enough sleep, of experiencing a new kind of depression for me, not dramatic, overwhelming, but mostly insomnia, early waking (five or six nights a week unless I took ambien) and then a bone deep fatigue, a constant feeling of being stressed as I was pushed, and I mean PUSHED, at work, home. Taking on much more responsibility at work, in fact, becoming a central figure in a large scale firestorm; realizing I was not now and maybe never am going to go to seminary (son in college, at the least); panicking about money (until my wonderful wife got a very good job); knowing my son was moving away to college...maybe the hardest piece of all of it.

Oh, and a six month short sale purchase and choosing to find a renter for our other house, which we did. Right now, I type on a counter top, long granite slabs, I imagine is worth more than my truck. We got a nice house at a great price.

Anyway, after months of that, not seeing a doctor about all of it and seeing a half incompetent therapist (not seeing that person anymore, and did not see her long)...it was the last day of school, near the end of may, depression hit me, some real free flowing anxiety. I had, in the months before, short pieces, meaning a few hours, of a very old, very awful obsession, one that has not haunted me since my early twenties. That began to perk up a bit more. So this May I did what I could: I got a new and better therapist, I saw a psychiatrist to check into the latest in meds. I don't think I'd had a free flowing panic attack in over twelve years.

The first med I tried, luvox, I had only been having anxiety issues for a couple of weeks; luvox sent my panic soaring, and as with other ssri's I tried in the past, it is so insidious it takes me a couple of days of thinking I'm just going crazy to realize the med is at fault. I came off that, but spent a few days after still pretty anxious (would not take any xanax; should have) and then the old obsession really parked itself with me. How horrible that was, driving home, feeling that old de realization thing surface after more than two decades.

Anyhow, I went on a different med, remeron, and it knocked me out so hard I slept like a rock, ten or eleven hours, for the first few weeks of summer. It seemed to stabilize my mood, my anxiety. I stayed on 15 mg., a small dose, all summer (and, and there was a lot of feeling work even then I needed to do; I guess this is my "mid life crisis;" so far much easier than my young life crises.)

When my son moved out in August, I was very, very sad for a couple of days, and then the depresssion came in. Awful. Not like my twenties, but more pain than I'd felt in a long time. My psych had been encouraging me to go up on the med anyway, so i did, to 30 mg. Truth is, it was so sneaky it took me five weeks to realize I was activating, having huge panic attacks which were getting slowly worse, not better, on the higher dose. I just went back to 15 earlier this week. Yes I left a message for the psych.

Why all this? Because the fact is, "they" really don't understand how these meds work, or why they don't work for some people, not yet anyway. It seems that meds (like all ssri's and remeron) which affect serotonin make me worse, though remeron did seem okay for a couple months at the low dose I'm trying again now. And my guess is the reason ssri's help so many with ocd (and thank God they do help) is that they lower anxiety deep in the brain, just as, somehow, they manage to raise mine!

All if it, I think, driven by trauma.

It's been a helluva month.

So now what?

Well, I crafted my own set of exposure exercises for a different, I will say milder, obsession some years ago and worked them with my old therapist (who, sadly, retired). And you know, that particular thing, after doing exposure with those thoughts for a while, mixed in with conventional therapy, that thing has not returned. I feel like I closed a mental door. So I could, and maybe will have to, create exposure scenarios for my current obsessional stuff. Thing is, I'm hoping at 15 mg., or even if I come all the way off the remeron in time, maybe, maybe, that shit will blow over. Exposure is not at all fun. It's hugging Satan to get saved.

But I may have to do it. It's so hard to know, because I've been activating (that's what they call it) for over a month. Even the psych missed it, because I went up on my dose at the same time my son left. I figured his leaving was the sole trigger. It was surely some of it! However, since I've gone back down on dose (Monday) my panic has diminished notably. Notably.

Underneath all of this, I know, so, so, so much emotion. That is what drives it all: fear, maybe over all; and sadness and anger, horror even, at having my son leave; the great, thick, emptiness my childhood left that he and my wife filled so poignantly almost 15 years ago now; my need to take even better care of myself, put some more stuff into that void!; adjustments, likely to be ongoing, as I continue in visible leadership at work. The empty nest, which is different but I think we'll survive. That is still a lot of shit. God I wish we had had more kids. We tried for a number of years. I wish it had worked.

I've been coasting for several years, just living, enjoying food, drink, simply living. It's been years and years since I "had" to go to the gym; I'm having to go now, two and reaching for 3 times a week, each time very helpful. Years since I felt gut wrenching panic, or the movement of very deep, powerful feelings, depression mixed into all of it. Or I might have had a day or two like that. But this, like driving on snow and breaking free...

But as my wife put so well: this is a different level of hell. And it is. I guess I haven't been "here" for more than a decade, maybe, really, since I met her, or very rarely only in those early days. But this is easier, even with the activiation!, than what I lived 15-20 years ago. Oh, those were dark years. Or the anxieties of my late teens, early twenties, longer ago than that! This is not that, at all. And I am functioning at a very high level, even with this, at work and (I hope) home.

For that, I'm grateful.

But it's hard. I don't have meetings like I did before we moved years ago. I realize, with my son leaving, I don't even have the the number or depth of friendships I need. I am, in short, often very lonely. It is why I moved out of the freaking mountains; closer to work, to humanity in all its absolute wonder. The mountains were gorgeous, but not good for that part of me that needs company, and that is a big part of me. (Thought they brought me in touch with a very wonderful family I plan to never leave).

I'm at work more days a week now. Do have a couple very "real" friendships, but when I come home to an empty house now, even for a couple of hours, it is very hard to separate that from the absolute EMPTY vacuum I grew up in. Empty. Separation anxiety my oldest, oldest, oldest fear. All the rest of my anxieties, including ocd, grew out of that childhood terror of being left alone. 19 months old, arm broken, in traction, and often alone for 20 fucking days. Then a home where neither parent was home much, or awake, or able to connect psychologically/emotionally when they were. My parents never touched me in a loving, nurturing, way.

You know, I forget who used to read this anonymous blog. Now, I am sure almost no one ever reads it or remembers it, but I wonder who will stumble across this new part? It's for the good. Mental health issues are real shit, man. Even for gifted, sensitive people like me.

I know how together I appear at work. Truth is, like Mr. Monk, I can zoom into the meeting, say just the right thing, impress everyone, and be anxious the rest of the time. But just for now. This too shall pass...it will indeed pass, and I will grow.

It's unfortunate, truly, that the meds I have tried that help many (so far, prozac, lexapro, paxil, luvox, remeron) have not been the magic bullet for me at all, in fact the opposite!! On the plus side, xanax works like an angel...a slightly tipsy angel, maybe, but it really, really works. I have taken hardly any all year (cept when I fly, when I load up on a milligram). I mean, apart from flying, I bet I've taken five or six milligrams in all these months, total; needed a lot more. But it works, and fast. Yes, I wish for, and may someday find, a better med; and surely, now that the medical community FUCKING ADMITS activation happens in some anxiety/ocd patients (who are not necessarily bipolar and don't have personality disorders) it may be in time they'll tailor meds for people like me. Shit that would rock.

But meds, at least the current crop, aren't a real cure for many or even most. It still takes cognitive tools and exposure work; it still takes, imho, lots and lots of feeling work, getting underneath to what is driving the ocd loop in the first place; ocd, if nothing else, must have energy to push it, and that energy is fear/feeling. And you know what, I'm doing the work. I'm good at that. I spent years in the gym doing cardio just for that reason (and hell I was in shape from 29 to 34). I'm going back to the gym now. Going to try some emdr when I get up to it with my new person. She keeps emphasizing attachment, opening up in my marriage, to friends, and that may be the greatest gold of all that we have on this earth. It's also more "advanced" than the gym, in a way. A new and blessed level for me to grow into.

There's a lot more treatment and understanding than twenty, thirty, forty years ago. Exposure therapy alone: powerful as hell, maybe the single most powerful thing I know for obsession. There's fucking parity laws, so I can see my therapist and psych for the same as any other co pay (in my twenties, first half of thirties, I paid out of pocket).

But of course, I've had depression too, and that's all about feeling work. Deep anger and sadness, coming out around the edges of depression, or in good hours, taking center stage completely, lots and lots of feeling. Even if that's hard, that's good. I would say more feeling than depression through all of it; pretty cool. I thank God for it.

***

You know, I'm a decent writer when I take the time to craft/edit, but that is not this time. This was one long, much needed share. It's surprising to me how very few people know what I've been going through. Like, I need to tell my brother for example. It's odd how private I became when the shit got hard in May. Becoming little. Little. Young where I don't talk about feelings because with my parents I could not, ever, do that thing. So, I'm doing it now.

Been writing poems again; has felt very soothing, very satisfying.

love to all, including me!