Crazy

I am out of my mind. I stressed out since my last session about being left without any financial means to take care of myself if I lose my insurance coverage and/or leave, my job. My thinking is like this...

• I become well.
• I lose my insurance,
• I have a choice..return to my old job (but it was contributing to my not being well), or find a job that I can manage to do and stay well
• I have another episode once I leave the job I have and it's insurance safety net (I have had so many depressive episodes...this is an inevitability)
• I end up not being able to work again, but this time I have no insurance
• I end up on the streets because I cannot support myself

Dr X. and I discussed this "catastrophizing" today. He asked me how likely it was that I would end up on the street...To me it seems completely possible...I imagine my husband leaves me, my family gives up on me, I run out of money...and there I am.

He asked me to think about Canada Disability benefits and could I live on that...I receive these now, but it is a very small amount of money and the city I live in is very expensive. Dr. X. says he has patients who live in the city and manage on a disability income. He says there is a safety net under my tightrope. I need not worry about ending up homeless. It will not happen. God, I wish I could feel safe. I wish I was not so afraid of change.

I had a dream last night that I was talking to my GP about how I was going to find happiness. In the dream I discovered I would be happy if I bought a motorcycle. I did not think much of it until I told Dr. X and he said, we associate motorcycles with a certain degree of risk (especially driving in this city)...maybe my dream was telling me happiness would be found only if I am willing to take some risks.

Coyote on the farm...telling me to act differently than I usually do. Be unafraid of change.

Prepare To Be Cut Off

I went into my session today feeling really good, despite not having slept more than a couple hours last night and not much the past week or so. I was awake all night last night with all this creative energy surging through me. I have been taking Art classes and I feel really good about this still life I just drew. I also started volunteering and had a really good time my first shift. It felt good to be useful.

Then I do not know what happened, but all sorts of negative thoughts started to creep into my session. Suddenly we were talking about my fears of being spied on by the insurance company and then Dr. X. said "Prepare to be cut off. When you are well it will be an inevitability"

Now I feel extremely stressed out. I know I will be cut off insurance if I become well, and I do not want to let my fear of being cutoff stop me from becoming well. However, my biggest fear is that I will become well for a while and then leave my job and get cut off insurance and then relapse into depression again and be both depressed and unable to take care of myself financially.

After my session today I came home and started worrying that Dr. X. is not going to give me enough time feeling well to be sure I am well enough to begin looking for work again and will be able to remain well in the long term. Argh! I hate my brain.

Why Don't You Work?

I am terrified of this question. I am starting a volunteer position this week at a very busy live theatre in the city I live in and I am so scared I am going to run into someone I used to work with. I am anxious they will judge me and think I am just "faking it" to get time off work. So My pdoc suggested I try to think of the questions that scare me and come up with responses.

I decided to come up with two types of responses. The first response to each question is based on my being very private about my mental illness. The second response is an honest, very open answer based on my experience with depression. As I wrote the "private" responses I started to think that in being secretive I was allowing myself to feel stigmatized by my illness. I would not be afraid to say "I have MS, that's why I can't work"...so I am not going to be afraid to tell the truth about being mentally ill.

Here's my list:
Why did you leave work?
- I became ill and was unable to work. or...
- I have an illness called Major Depressive Disorder. In me severe depression and anxiety make me feel very unwell. This made it exceedingly difficult for me to work in a high paced, high stress environment where the expectations and environment aggravated my illness.

You don't look sick.
- There are lots of illnesses where people look fine, but are unable to work. They are called "invisible disabilities" or...
- People with Major Depression often have okay days/moments. In particular people with atypical depression find our mood lifts when we are in situations we enjoy.

What did you become ill with? Are you okay?
- I would prefer not to discuss my illness. I am working towards recovering my health. or...
- I have a mental illness called Major Depressive Disorder. I have had difficulty with depression my whole life. This episode happens to be really bad and long-lived.

What happened at work?
- Nothing happened at work, I simply became unable to work due to an illness. or...
- Work became extremely stressful and demanding. I tried numerous therapies, I tried cutting down my hours, but ended up working more than full-time anyways, I had competing demands from several different businesses, I moved locations to a place where I knew no one. With all these factors and my depression I simply became more ill and decided that leaving work was the healthiest thing for me to do.

Why aren't you getting better?
- I am slowly becoming healthier. I have good days and bad days. or...
- Contrary to popular belief antidepressants do not always work for all people. I am working with a doctor to find a medication and therapy that will help me.

If you can work here, why can't you work at the your old workplace?
- I am a volunteer and can call in and say I am unable to commit to my shift. Also, my commitment here is for 3-5 hrs a week. At this point in time I am unable to work a work week at the bank.

What have you been up to?
- I have been exploring ways to create meaning in my life. I am volunteering and taking some art courses. I am spending more time with my family.

Why can't you work?
- My illness is unpredictable. It would not be fair to my employer to commit when I am unable to predict my ability to work on a regular basis.
What do you do for a living?
- I have the means to take care of myself...so I try to do the things that make me feel good.

Why aren't you working? Why don't you work?
- I worked from the time I was 15 and at 40 I feel it is time to reexplore my options and discover a career that speaks to me or...
- I have an illness that prevents my working right now.

What do you do?
- I garden, and draw, meet with friends, walk my dog, visit my family, spend time with my husband, go to the theatre, to the VSO, recitals, art galleries...all sorts of things

I Told the Truth

I went to therapy today and tried to say what I wrote earlier...but, just like I thought, it would not come out. I was not going to let myself leave without telling Dr. X. the truth about my hoarding meds and self-destructive and abusive behaviour...so I handed him a printed copy of what I wrote in my last post.

You would think I would feel relieved now, having got it all out of me, but I feel sick about it. Despite Dr. X's reassurances that I have not destroyed his faith and trust in me, I feel really ashamed and embarrassed by what I do and have done.

Dr. X. said my embarrassment is a huge hurdle for me in many situations. He is right. I have this intense fear of being embarrassed, or made fun of. This really informs my anxiety and makes me quash myself into something I think others will accept and want.

I went to see the Shakespeare play "A Midsummer Night's Dream" last week. In it there is a play within the play casted by some seemingly inept actors. What struck me most was the joy with which the main "cast member", Bottom ,lived his life as an actor (even if he was a BAD actor). Nothing stopped him from playing out his melodrama exactly how he wanted to play it out.

I could see Shakespeare's intention was to make him look like the Ass he gets turned into, but on another level, on an existential level, where success is measured in terms of how you lived your life according to what you desire to do....Bottom was extraordinarily colourful, successful and so full of life (even in his "dramatic" death).

That is what I want. I want to be free. I want to be the wild me again. The me who lets loose, sometimes does stupid things, but revels in my being unafraid to make mistakes. I want to be bold again. I want to sing out loud when everyone is listening. I want to be okay with not being good at things I enjoy. I want to just unselfconsciously enjoy those things.

Right now....I am going to make a decision to just let it go. Just know that I spoke up honestly to my pdoc. I let him know what I was doing. What I was doing is a symptom of my illness on some level, but on the other level...the deception level, I told him what I was doing. So from this moment on I am going to believe we are square.

Truthtelling in Therapy

I feel so ashamed and guilty about how I behave. While I believe absolute honesty in therapy is extremely important to, (and maybe the cornerstone of), successful therapy, I still hold back and find it hard to explain the bad things I do to myself.

I am going to try right here and right now to get some of those things out, then if I can't bring them up in therapy today I will show this to Dr. X.

For a couple weeks now I have been having increasingly intense and anxious suicidal ideation. I have been feeling so depressed, but also anxious to the point of panic, and irritable to the point of rage. In these rages I have been hitting my head-hard with my fists...A couple weeks ago I flew into a rage when my husband was 1.25 hrs late for dinner. Right before he came home I started hitting and kicking the wall so violently I had huge bruises on my elbows. I felt totally out of control with anger over such a stupid thing.

I feel like my brain is going to explode. I want my brain to stop. It will not STOP....it just keeps ruminating on all the negative things...flying from one bad feeling, incident, potential incident, to another.

I spent hours on Saturday counting medications I have hoarded (Epival 18500mg, Zopiclone 300mg, Gabapentin 7500mg reading about suicide online, looking up ways to commit suicide, thinking about how I could do it without hurting my family, trying to figure out where to do it. Yesterday I spent hours trying to find out if I would die from an epival overdose. I tried again today, but could not find the dose needed, only the blood levels...but I don't know how that works so not very helpful.

As my anxiety increases throughout the day I have these obsessive visualizations of stabbing myself in the chest with a really big knife. Over and over and over again, until (in my imagination) the tightness in my chest goes away, my whole upper body deflates and becomes relaxed again.

I started an Art Class (drawing) the other day and my anxiety was so acute I could barely breathe and started to have an anxiety attack where I almost had to leave the room I was so anxious. I started shaking (my hands and legs) and I could hear my vice quaking when I spoke...I just shut down and couldn't even think when I was being asked questions...like all I wanted to do was get out of there...it was so brutal. Every night I have this intense sense of rage and irritability going on inside me...there is so much energy behind it I feel like I'm going to blow up...and I do start spewing negative and angry words out towards my husband. I feel like I can't control the feeling...it gets worse as the night goes on, the t.v, or the sound of my husband chewing his food, or my cat's meowing make me feel explosive.

I want to tell my pdoc, but I feel so childish and immature, unbalanced, unworthy, labile...so embarrassed, that I have these thoughts, that I behave this way, that I treat others this way, that I have been deceptive (by hoarding medications)...especially the zopiclone, because I keep asking for more.

I am using the new zopiclone I get...(though it is not helping me sleep anymore). I keep asking for more instead of using the stuff I have hoarded from months ago...so I can save my stashed sleeping meds...so I have a way out or a means of relief if I cannot take it anymore. On Saturday I even thought I should just take 10 or 20 zopiclone....just to get some rest and some relief...not to die, but to calm down and let go.

In my last post I spoke of fearing abandonment by my pdoc. At the time he asked me if I had had thoughts of abandoning him. I took it to mean was I thinking of leaving therapy. Given how suicidal I felt last Saturday ,now that I think about it it maybe he meant "leaving"...as in permanently, as in suicide. I do talk to him sometimes about my suicidal thoughts, but I sense an uncomfortable avoidance of the topic when I bring it up, so I've been trying to let it go and not talk so much about it.

I recognize the counterproductivity of having all these medications around. They seem to entice me to use them. If they were gone I would have no reason to obsess about whether they would help me die or not, or whether they would relax me or not...they simply would not be here, so I could not use them.

I am going to print this off and try to talk honestly and openly with Dr. X about this. I will bring these meds to my session and if I feel safe I will give them to him.

Judge and Jury

I felt so stressed out and scared in my therapy session today. I have been severely depressed (even more so than usual)and have been feeling really paranoid about being abandoned...both physically and emotionally, by Dr. X, by my family, by my friends, basically by everyone.

In regards to Dr. X. I am both scared he thinks I cannot be helped (I am starting to wonder myself) and afraid he is giving up on me. I spoke with Dr. X about my having difficulties with our therapeutic relationship because I see him so much like an authority figure. My Dad(authority figure) was a policeman(extreme example of an authority figure). I think my reaction to authority is very much related to my interactions with my Dad while growing up. I was gardening just now and I had an "ah ha" moment while thinking about what went on in my session this morning.

I have a great deal of anxiety when I am around authority figures, especially if I feel I am being judged in any way, or if I feel I might disappoint them. I will go out of my way to please and placate any authority figure, because I am afraid of the consequences of not doing so.

Therein lies the problem. The nature of a Dr's position is such that they are always judging, categorizing etc. your health...so I am intensely fearful of being misjudged and thereby being abandoned because I am seen as not needing help. I am also deeply ashamed of my inability to "snap out of it", or make some progress in my therapy. This shame and fear are intensified by my feelings of guilt for remaining so depressed for so long and my self blame for believing I made myself this way...that I somehow did this to myself, made myself sick.

Dr X. made it clear today he will not abandon me. Not now, not in the future, not even if I decide to see someone else for therapy. He said, I will always be free to see him as well if I decide to see someone else too.

He asked me if he was doing anything that was making me think he would abandon me? The only things I could think of were his taking me off the medication I was on and then readily agreeing with my not wanting to be on medication. I felt like "...well if he is so laissez-faire about the medicine, then he must think I do not need it, or it will not work for me, which MUST mean I am not sick, which must mean he thinks I am fake. Also, I sometimes sense a change in tone when I am having a really hard time...like he is frustrated with me. He says I do not frustrate him...

In the garden this morning I realized I am projecting my frustration and ambivalence about my treatment, my medication and my depression's resistance to treatment, onto him. It is me that is trying to abandon me.

I have set it up so if Dr. X. is too much an authority figure (tells me I need to do more, sleep less, take meds, set up a schedule, drink less, try doing the things I like to do, etc) I freak out with anxiety and panic because I feel pushed and fearful I will be unable to complete what is expected of me (and will be punished for not doing so).

If he does not act like an authority figure (ie. gives me no feedback, or does not react positively towards me) I feel like he must not care about me, or thinks I am beyond help, or do not need help...or I go to the opposite extreme and think he thinks I am a completely lost cause and there IS NOTHING he can do to help me.

It is a no win situation...unless I can stop seeing him as an authority figure, or learn to not react to that aspect of the relationship, or learn to "feel the fear and do it anyways". Dr. X. said to me today to try to do the things I am afraid of despite feeling fearful I will be judged. Do the things I am afraid of in spite of my anxiety. Acknowledge the anxiety in the moment and forge ahead like no one was watching.

I will try.