I Survived 2007

This was another really difficult year for me. I spent much of 2007 battling severe depression and many months struggling with brutal anxiety attacks and unexplained panic attacks. I was extremely close to being hospitalized by mid-July as I was having obsessive, unrelenting suicidal thoughts and urges. For all the struggles I had in 2007 I somehow managed to get by without giving up.

I attribute my sticking around to a few things:

Firstly, I attribute my survival to myself. Despite how depressed I have been and how long I have been depressed I am one stubborn and resilient person. Some days I lay in bed, or on the couch, curl up in a ball and pray I will make it to the next day, but I make it. That's the important thing.

Secondly, my Pdoc, Dr. X. definitely played a big role in my making it through this year. He never gave up on me, always supported me and was tireless in his efforts to help me. Over the years we have been through literally hundreds of therapy sessions together, more than 30 different medication trials, plus combos of those trial and an 8 session trial of ECT. He helped me with my depression, my anxiety and the loss of my much loved Mom. This year I recognize he will not leave me unless I decide to leave. Even then he will see me anytime after that.

I learned this year that I can trust him; something I suspected before, but learned to believe this year. I was sometimes fearful or angry about what happened in our sessions, but he always made it so easy for me to talk openly about these. He showed me that dialogue about how I am feeling, no matter what those feelings are, is safe with him. I am thankful for that.

Thirdly, my friends and family stood by me. We have all had a difficult time with so recently loosing Mom, but despite my sister's own struggles they called me even if I could not return the call. They made sure I had the support I needed and I felt deeply loved by both of them. My husband and I had a hard time this year, but we made it through and I believe we are on the way to healing our relationship.

When I say my family helped me I include the support and love of my dog "Bert" here too. He is the family member that, due to his living with me, and his inability to criticize me, was the most help to me. Every time he saw me he came up to me and "hugged" me; tail wagging and pushing his head up against me. He got me out of the house everyday. He made me get outside and go for a walk at least 3 times a day and he never ever judged me, or stopped loving me. In return I loved him, and that helped me too.

My friends most of whom live far away, were there and are there to help me. For this I am eternally thankful.

Fourthly, medication has helped me. In September I began a new mood stabilizer: Carbamazepine (Tegretol). It was not immediately apparent that it was helping me, until about 2 months after I reached a dosage of 800mgs. At that point I began to notice my mood did not feel as labile. I was still severely depressed, but the negative energy was not as bad. I did not feel as angry all the time, I wasn't breaking into tears at really inopportune times. I felt like I had a bit more control over my mood cycling.

In Late November I began taking Prozac with the Carbamazepine and almost immediately I felt my mood lift. Even at a really low dose I feel my mood has lifted. I am still depressed, but I'd say many days moderately versus severely depressed.

Lastly, participating in therapeutic art classes, taking art classes at the local art college and the opportunity to co-teach printmaking and beginner's drawing with one of the occupational therapists at my city's Mental Health Art Clubhouse have all provided my life with more meaning and given me more self confidence. Through volunteering to help others with mental illnesses learn art I see how important it is to have a job that is meaningful. I always loved teaching and facilitating learning, I did this for a huge corporation before I became so ill, I was simply doing it for the wrong organization.

Today, this last day of 2007, I believe 2008 will be a much better year than than this one. Although it was only through the struggles and successes and the support and love others provided me this past year that I can make such a bold prediction.

Happy New Year everyone. I hope 2008 is better than this past year and I hope it is happier than you expect it to be.
...aqua

Destination Unknown

A linocut print I made last week to represent my dream. The raven on the bustop is a trickster figure. These westcoast First Nations symbols bring light to dark situations. They lead us in directions we may have avoided because we did not have all the knowledge needed. They make us aware that life is unpredictable, but neither good or bad, simply different.

I had a dream:

Throughout the dream an old Bauhaus song was playing in the background: "...Bela Lugosi's dead, the bats have left the bell tower, the victims have been bled red velvet lines the black box, Bela Lugosi's dead..."

I was at the University. I got on the bus to go home. When I saw my stop I rang the bell, but the bus drove right past my stop. I rang again and it just kept driving by all the stops. I became super stressed out because I had two essays and an exam the next day. I did not have time to be wasting it on trying to find my way home. The bus drove and drove and soon I had no idea where I was. I began to cry. My crying turned into unconsolable sobbing. I just wanted to go home and do the work I was supposed to do. The bus finally stopped and let me off. I was hours away from home and had no idea how to get home from where I was.

• I see my dream as a "death anxiety" dream. The song is full of imagery of a coffin and death. I am terrified of wasting the little time I have on this earth. My depression feels like it is forcing me to do this.


• Death anxiety encompasses that fear that you have not completed what you are here for, that you are not living the life you are supposed to live.


• Dr. X. said he thought the bus might represent my life going in a direction I never expected, a direction different from where I thought I would be going.


• I feel he's right on many levels:

1. I am derailed by my depression. I feel it has stopped me from doing the things I wanted to do, from being as successful as I know I could have been if I had not suffered from so much anxiety and depression.


2. Had I not been depressed I would never have left a high paid, but truly unfullfilling and soul sucking career...so my depression has led me away from that, which is good on many fronts.
   
3. Had I not been depressed I would never have had the time, or the inclination to become artistic. Something about the sadness inside me and the struggle I face feeds my creativity. I'm not saying "mental illness leads to creativity"...I hate that stereotype. Mental illness made me so sick that I had to leave work and being the workaholic I am I had to fill my time with something. I've always been creative, but never really artistic...more "crafty". The time away from work, and an Art Clubhouse for mentally ill people in my city helped me nourish my artistic side...and I love it.
   
4. My crying in the dream because I wasn't going to be able to finish what I wanted to (my essays and exam) is parallel to my grief over losing my job and the life I thought I wanted. I am finding the only thing I wanted in that whole situation was financial safety. The bus is hopefully taking me to a different place where I can still feel like I contribute and feel like I won't end up mentally ill, no job, broke and living on the streets.
   
5. The dream is telling me my destination is simply different than the one I expected and maybe it will be better for me.

I'm Grateful for...

This will probably be my last post before Christmas. For the record I am an ardent Christmas hater. It is not that I hate the original meaning of Christmas. Even though I do not believe in God I think the original Christmas story and the many of the ideas behind Christianity are beautiful ideas.

For instance I believe in treating others the way Jesus is portrayed to have treated others in the bible. I believe if he existed (and I am open to him having done so) he was an ideal person: treating others with love and respect, reaching out to those in need, humble, thoughtful, caring. These are the values I hold close to me too. I have not been able to achieve them to my liking yet, but I am working on that everyday.

What I hate about Christmas is the disgusting and rampant consumerism that comes with the holiday. I'm all one for giving gifts, but I am repelled by the hoards of shoppers spending more money than they can afford on tons and tons of gifts for there kids, or there families. I would like to see every single person donate 1/2 of what they normally spend at Christmas to a charitable organization.

There are millions of people in need. Millions who will not receive a gift Christmas morning. In my city alone, in one approximately 10-15 block area, the Downtown Eastside, they estimate there are more than 2000 people living with no shelter. This saddens me. Most of these people have addiction and/or mental health problems. Not having a home complicates these problems.

For me, in my life I really need nothing more than what I have in terms of material goods. Of course I would like to become well this year. I would also give anything to have my Mom back. If I could have any gift/s those two things would be what I would want. Unfortunately, neither of these things can be bought or given to me by anyone this, or any other, Christmas.

I have had many gifts this year that I am grateful for:

• The love of my two sisters and my nieces. This has made the loss of our Mom at least bearable. Without them I do not think I would have survived the last two years. I love them more than anything in this world.
• My husband who, and this is hard for anyone, has stayed with me most days this year. We have had so much sadness in this house for years due to my depression, losing my mom, our dog being sick etc. While he does not support my psychiatric treatment, he does help me in other ways. We have had many, many really hard days, but he loves me through all I have gone through and all I have taken him through. I know it is not easy being around someone as depressed as I am.
• My friends "D.M" and "H.H". Even though we do not see each other a lot because they live so far away. I always feel a connection to them that I feel with no one outside my family.
• The constant and unflagging support of Dr. X. I feel blessed for having met him and for being a patient in his care. Without him I know I would not be here today.
• My online friend and fellow blogger Jcat of "Jcat and the Big Bad Wolf". She has been so supportive of me. I only hope I can be as supportive towards her. Thanks Jcat.
• My dog. He really is a miracle. He has 4 types of cancer, boxer cardiomyopathy, tumours growing everywhere and pancreatitis. He costs me a fortune in pain medication, two kinds of heart medication, special (really expensive) food and vet bills, but every single day he wakes up, wags his tail, cuddles with me, bounces around and shows me more respect and love anyone in the world could muster. I love him so much.
• Other bloggers who have been so supportive of me this year...including James at "Letters from the Sanitarium", Polar Bear at "The Polar Blog" and Dr Shock at "Dr Shock MD PhD"
• The members at the Art Clubhouse I attend. All of them have been so helpful, kind and caring. The members at this clubhouse really did make my year a better one.

Thank you all and Merry Christmas and a Happy New Year!

Not Sustainable

I had a pdoc session on Tuesday. My mood dropped dramatically this past week. I'd say much of the time it is flat/apathetic which is still higher than severely depressed so for that I am grateful. Dr. X. did not seem surprised by my lower mood. He said while he loved to see me feeling so happy last week the energy behind my mood simply was not sustainable. Funny that was not what I HEARD last week. I thought he thought I could be that happy. Hmmm. Wishful thinking I guess. I must have misheard him.

I know what he means though. Looking back to last Tuesday I had so much energy behind my mood that in his office I was almost bouncing off the walls.

I cried much of this week's session. I was okay until he asked me how my exercising was going. It's not. When he asked me this wave of shame flushed over my body. How can I know exercising would be good for me and not be able to get doing it? I have so much resistance in this area.

First Dr. X. is at a disadvantage because I know I am projecting my father onto him. My Dad used to berate me and belittle me into exercising. I was skinny as a rail and he would tell me I was fat. He would make fun of my butt, my hips, my whole body after I went through puberty. I'm 5'9" and in high school I weighed 125lbs...that's NOT fat. HE would cajole me into going bike riding or exercising any opportunity he had. Maybe his intent was to keep me healthy and skinny, but all it really did was make me feel bad about my body. His methods led to me being extremely resistant to wanting to exercise. SO when Dr. X asks me...I think all those feelings come up unconsciously.

Also...and this will sound stupid...I am obsessed with the passing of time and I am afraid if I take the time to exercise I will not have the time or energy to keep up with my other things...like the volunteering I do at the Studio, or the art I do myself. This type of thinking is so entrenched in me that when I begin thinking of exercising I think..."if I exercise at 9:00am, how am I going to keep exercising when I begin working again. I can't work and exercise, so why even start exercising" I begin stressing out that I won't be able to keep up with my volunteering, and working and exercising...so why bother trying.

Dr. X. says there is a paradox in this thinking. What I may find if I begin exercising is that rather than the exercise sapping me of energy, it may provide me with more energy. Rather than it taking up time, it may make me feel like I have more time and energy for other things.

I understand what he is saying on an intellectual level, but on an emotional level I have a hard time believing it. I don't know why I think this way. It is as though when I do things I need be 100% sure I will always be able to keep doing those things or why start. If I can't get that assurance I get so stressed out. Stupid I know, but unfortunately that is the way I think and I cannot seem to change that thinking no matter how hard I try.

I am Flying High

I went to see my pdoc this a.m. and this is how I described myself: "I feel like I am vibrating". "You ARE vibrating" is Dr. X's response. It's true. I "danced" in my car the whole 45 minute drive to my appointment. Red Hot Chili Peppers, "Stadium Arcadium" cranked as loud as my stereo can manage, tapping my fingers, bopping my head, rocking to the music.

A symptom of feeling better: I want to dance. I am singing all the time. I LOVE loud music. I love people. People LOVE me. There was a girl at the gas station yesterday. I could tell she was hitting on me. She couldn't stop talking to me. Even though I had no intention of following through I led her on because she was captivating and I loved the attention. The pharmascist was the same today. Usually he says a salutary, "Hello". Today he spoke with me about my pdoc, about the drive out to the University, about other Dr's and their handwriting. He joked with me the whole time like he was my friend. I liked him.

This is not me when I am depressed. When I am depressed I shrink. I hide. I pretend no one sees me. No one likes me. When happy I am BIG: big voice, big smile, take big risks, big wide open arms to everyone.

In my appointment I had some concerns that I might be switching into mania. This "vibrating" for instance. I am literally wired for sound. I have constant snippets of piano music (Schumann in particular) running through my head. Imagine them in real time...mine are racing through my head at mach speed. I tried to hum it to my sister the other day and she said it was incomprehensibly fast. The music will not stop. It is going on even when I am talking to others, when I am sleeping it wakes me up. It's been like this for almost 2 weeks now.

Which brings me to another worry about getting manic. I am not sleeping. I sleep for 2-3 hours and then at 2-2:30 I wake up and am awake until 5-5:30, then fall asleep for 1 or 2 hours if I'm lucky. I don't miss the sleep at all. I have tons of energy.

I asked Dr. X. if I should be concerned and he pointed to the fact that I have never been manic. (Although he has told me there is a bipolarity in my mood disorder and that my highs look very much like hypomania). I asked him if I would have insight that I was manic if I was. He said that's the problem with mania. People do not have insight. I am going to trust him that this is just a high mood. I am sure he will let me know if I am too high.

I thought about it in my appointment today and I thought maybe this mood is just so foreign to me that it seems too high. Maybe it is really just a good mood and I'm not used to that. I've been so depressed for so long that I forgot what good feels like.

I do remember that my good mood always seemed to display itself more intensely than other people's good mood. I was always the one who couldn't stop dancing, singing, swearing (blush!), talking loud, getting excited and excitable. Even as an adult I was like a delighted and ebullient child when happy. Right now I am thrilled to be alive, I see my potential, and I feel so happy, even with the annoying music in my head.

Me and ECT

Today's post was inspired by a blog posted today on the Dr. Shock MD PhD blog. Dr. Shock has a very interesting blog on which he addresses Treatment Resistant Depression and Electroconvulsive Therapy (ECT), among other fascinating things. Today on his blog he has posted videos by people who have first hand knowledge of ECT, because they have received ECT treatments.

I did not create a video when I went through my ECT treatments, but I did the next best thing; I wrote about my experiences with ECT on a Bipolar/Depression Discussion Board as I was going through the 8 treatments I received.

After viewing the videos on Dr. Shock's website I went and found those old posts and I thought I'd share them with you:

written 1/18/2004

I will be in the hospital all this week (voluntarily) to receive the ECT treatments Mon, Wed and Friday, then I will go home for the weekend and, if all is working well, will go back to the hospital the next week. I am able to leave the hospital on non-treatment days so I will update the group if I can on those days. If not I will do so on the weekend.

My 1st treatment was Friday. As my brain is super important to me I had all sort of concerns about the procedure and its effect on my intellectual abilities. I read tons. The document on this website: http://www.mheccu.ubc.ca/ has lots of info. The Drs told me that I may have some short term memory loss for around the time of the treatments, but that most of those would come back within a few weeks of the treatments ending. The literature and studies I have read say the same thing.

On Thursday, I was given a physical, blood work, chest x-rays (I had a cold) and they checked my heart with a heart monitor. I met with an anaesthesiologist to discuss the process. She said I would be under anaesthetic for approx. 10 mins and would be given a muscle relaxant so my body would remain still through the process. The Dr who does the actual ECT then visited me and I asked him tons of questions. He calmed my fears about my brain and the process.

On Friday morning at 9:30 I went into the treatment room. I panicked when I saw the Dr and nurses...thoughts like, "I think I've made a mistake, I don't think I want to do this, I'm scared", were going through my mind. The anaesthesiologist held my hand and said, "it's okay [Aqua] we are all here to make sure you are safe". I was still terrified, but that made me feel better.

The next thing I knew I woke up to the sound of myself crying (I had been crying as I went under the anaesthetic. The doctor said this sometimes happens during the first treatment). For a few moments (seconds) I was pretty scared. It felt like I was in a nightmare crying and trying to get up, but my body was still asleep. Within a few seconds I opened my eyes. I felt really drowsy and it took maybe 3-4 minutes for me to fully come to. I was in the recovery room, it was approx 10 minutes after I went in for the treatment. They took me back to my room and I rested for about an hour. I then got up, had breakfast and woke up a bit more.

At 1pm my husband came and took me out for a walk and some lunch for a couple hours. I really enjoyed the walk. The rest of the day I had a bit of a small headache and some muscle tension. All in all I felt pretty good. In fact by the evening my mood had lifted considerably. Dr said this might be a placebo effect as the treatments generally take 3-4 treatments to start working.

I haven't had any memory impairment from the 1st treatment and I feel much more confident about tomorrow's treatment.

written 1/20/2004

I had my 2nd ECT treatment yesterday. I was quite a bit calmer as I knew what to expect. I will find out the name of the muscle relaxant for next time I write here. Yesterday I did not have the crying when I woke out of the treatment. It took a bit longer to come out of the anesthetic, so they may have given me a bit more relaxant than the time before.

I was a bit more confused yesterday while I was coming out of the anesthesia. For instance forgot the nurse had given me my medicine, forgot when I had come back to my room. Every once in a while I can't find the word I need to complete a sentence. All in all though it hasn't been that bad and I don't think someone who didn't know me would even notice.

My mood feels quite a bit up today. I visited with my regular psychiatrist today and he said it is probably too soon for this to be the result of the ECT treatments. Generally it takes 6-8 treatments to feel better. It may be that I feel much better on the mood disorders ward than I ever expected to feel. I feel safe. I thought I would feel bad about being here [in the hospital] (i.e. like I'd failed, I was never going to get better etc.). In fact, I feel like I can be me for the first time in a long time.

[At this point in my posts on the BP Discussion Board a member posed a question]
1/24/2004

"Dear Aquamarine,
You don't give all that much of your history - 2 1/2 years of trying various antidepressants doesn't seem all that long - personally, I would rather keep trying other treatment options. Have you tried cognitive therapy, or some of the older antidepressants?
You must be in a lot of pain to risk permanent brain damage. Hope it works out for you.
Best Wishes
V"

written 1/24/2004
[My Response]
Hi V,

I have been struggling with my depression for at least 20 years. I have been through so much, and so many kinds of therapy and nothing has worked. I do not believe I am risking any kind of "permanent brain injury". I did not take this step lightly. I read tons about the procedure. I asked lots of questions, I spoke with others who had gone through it.

[Also, in my city the Mood Disorders Ward/Clinic is at the forefront of research on depression and bipolar disorder...this, along with the fact that they treat so many people with depression and bipolar disorder, and the fact that I trust my own pdoc's opinion 100% made me confident I made a sound choice]

I have been in the...hospital for a little over a week now and it has been a great experience. I cannot believe how much better I feel. The ECT has given me back my hope. I can see that there is something to live for. I was getting pretty desperate before I went into the hospital. I couldn't keep going the way I was.

I have had 4 treatments now. I am having some short term memory difficulties. For instance when I came out of the anaesthetic yesterday I had no idea where I was, or who the nurse was. Once they told me it came back to me. I have taken to writing my plans in a daytimer because I cannot keep everything straight in my head like I did before.

This is a small price to pay when the reward is feeling like living again. Over the past few days all my suicidal thoughts have disappeared. I feel hopeful again. I feel like I have been given back my life. This has been an incredible experience for me...and I hope others might consider this path when they see how it has helped me.

written 2/17/2004

It has been two weeks since my last ECT treatment. (I had 8). I have had very little memory loss. Maybe just a bit of confusion about things that happened around the treatment times, but even then I do not feel I lost much, and nothing that important. When I came home my Pdoc started me on some lorazepam to help me sleep(because I have been so anxious and wired for so long) and lamotrogine to stabilize my mood.

Before I came home I had a bit of a hypomanic episode for 8 days in the hospital (1/2 way through my treatments). I thought it was the ECT, but the Pdoc said no way, not so soon. Anyways, the day of my last treatment my mood crashed ...This is usual for me as I have been rapid cycling for a couple years now.

I went through one week of really bad depressive symptoms, then voila, my mood lifted and I feel AWESOME!!! Maybe verging on hypomanic, but that feeling you get when everything is perfect. I have tons of energy. Tore my house apart, from top to bottom and cleaned it like crazy. I've been going out with friends and generally feeling like life is so good. It has been 5 days of this incredible feeling. Everyday I have been waking up and thinking, "Am I okay still?" Each day I breathe a huge sigh of relief when I realize I still feel WELL...Please, please, please, let this last!!!

written 3/16/2004

[In response to a later question]:
I had 8 ECT treatments..(each Mon, Wed and Fri for 2.5 weeks). Since my last ECT treatment approx 2 mos ago 2 things have happened:

1. It appears the ECT helped medicine finally work. The medication I am taking (Lamotrigine, Lorazepam and Trazadone) seems to be working. I had tried the lamotrigine before and it had not worked. ...(I have tried so many meds. without success...it would make your head spin if you saw the list!!!)
2. I have had more GREAT or GOOD days in the past 2 mos. than I have had in the past 2 years. There has been a lot of really rapid cycling with my mood since the ECT, however:

• My "downs" are not quite as low as they were before..3 or 4 on a scale of 10 vs. my lows (before 1 or 2 out of 10)...10 being manic/1 being suicidal
• My downs are definately not lasting as long as they were before...usually 3-4 days then I go up again. (my ups have been high, but not TOO high!)
  

My theory:

• I may be cycling because my meds are trying to lift me out of a very long-lived and very awful depression.
• I get up, but my brains natural tendency is to take me back to what I am used to (i.e. Major Depression).
• I've used the learning to ride a bike analogy before(cycling...ha, ha): Each time I get on the bike and try to ride I get a bit better, and go a little farther, but I fall down a bit before I take off and KNOW how to ride!
  
  One really important thing for me is the fact that I do not feel like I have lost any of my intellectual or cognitive capabilities at all. I have had some memory loss, but nothing that I have felt was important. In fact I think when I am depressed I have a much harder time remembering things. For me, ECT was a godsend. I cannot believe my progress since I left the hospital.
  
  written 4/14/2004
  
  Couple things about my experience following the procedure:
  
• I was having many good/great days following the ECT...for approx. 1.5 months.
• I did however rapidly cycle up and down. I tend to cycle, but in the past my cycles had been tons of depression, with a day or 2 a month being okay.
• After ECT I had more okay/good days than bad for approx. 1.5 mos, but cycled up 4-8 days, down 2-4 days over and over.
• For the month or so following the treatment I did not see much memory impairment...
  I am now having a bit of difficulty in that area (remembering words sometimes, or someone telling me something and two seconds later it is gone...

HOWEVER... I'm not sure if these were caused by ECT because:

1. Could be side effects of the meds I have been taking for my depression / anxiety (one of the side effects of ativan can be confusion/attention difficulties).
   
2. I also broke both elbows in the interim, so that stress and all the pain meds I have been on may be contributing to these difficulties.
   
3. I have had to withdraw from all sorts of pain meds and I am withdrawing from my ativan right now...this is/has been hard.
   
4. As well, I am depressed again...so that can cause memory/attention dificulties.
   

Sorry I cannot be more definitive about the ECT and how it affected me...
All in all...I think it was worthwhile and I am hoping that once the pain, frustration and limited mobility caused by my toasted elbows disappears, that my meds will work again. I do believe the ECT helped the Lamotrigine work for me...a miracle given I have tried 20 different medications with no success.

Written today:

The Lamotrigine did not work again, and was causing balance problems, so I stopped it. I would definately try ECT again if I needed to. This time I would ask for maintenance ECT, where they give ECT once a week, then once a month and maybe even less frequently, in order to keep the depression at bay, or the medications working. I am confident it was, and is, a good treatment option for me.

Why Do Doctors Say these Things?

I do not know if it is me, or if everyone has stories like this, but here is an example of what NOT to say to a patient:

I decided to go to the walk in clinic two days ago because I was unable to get in to see my GP until mid-January. I went because about a 10 mos to a year ago I got this small bump on my right eyebrow. I had no idea what it was, but it did nothing until about 4-5 weeks ago when it began growing rapidly. It had also become very itchy. I looked at it the other day and wondered if it was ring worm, although it didn't quite look like that because it wasn't exactly round like ringworm is. It was more uneven around the edges. Anyways, I had ringworm from my cats years ago and I didn't want it again, so relatively unworried, (because it's completely curable), I went to the clinic.

The doctor looked at it and said it definitely wasn't ringworm and that she wanted to get a second opinion; so she asked another doctor to come look at it. He looked closely at it and said: "There is a type of skin cancer that is very deadly, and it kills a person very quickly". He then paused for what seemed like an eternity.

During that pause I think, "Great, I have found medication to stop my depression and suicidal thoughts, only to find out I am going to die in the next few months". The irony of this situation is not lost on me.

As my panic begins to build he pipes in, "...but this isn't that type of cancer". I think: "WTF?" He leaves and I cannot remember what he said after he said it isn't the deadly cancer. All I still hear is "deadly cancer" and "kills very quickly". This phenomenon, not hearing things after devastating news, happened when my Mom was diagnosed with pancreatic cancer. I used to carry a notebook to my Mom's Dr's appointments, because I'd leave the appointment and not have a clue what had been discussed.

I asked the initial Dr. what the consulting Dr. said. She said, "it is either Basal Cell Carcinoma (BCC) or it is a wart (although it does not really look like a wart)". She said it does not matter because BCC is a very slow growing cancer and the treatment for both is the same...freeze off with liquid nitrogen over a period of 4-5 weeks. I let her freeze it and booked another appointment, but when I got home I felt really angry at myself.

Why had I not insisted on a biopsy? What if it was cancer, how am I going to know if it is gone? She seemed really unsure about what to do if it was cancer. She even asked the other doctor if she should refer me to a dermatologist. I do not feel confident about the projected treatment.

I also have read that BCC can be really disfiguring if it is not dealt with in a timely manner and can metastasize if not treated properly. The growth is on my face, on the far right of my right eyebrow. I do not want a huge scar on my face. Something happens when I am faced with an authority figure. I shut down and do not have the ability to stand up for what I want.

I got home and decided I needed to see my Family Doctor. I phoned and told them what had happened and I have an appointment late next week. I am going to ask for a biopsy and a referral to a dermatologist. Even though I really trust and like my Family Doctor this request will be so hard for me, because it means questioning the original Doctor's authority. A task I dread.

The Mood Whose Name Cannot Be Spoken

I'm afraid to say it, because everytime I do it seems to jinx how I am feeling. I am feeling that mood that begins with "W" and ends in "L"; otherwise known as feeling that word that begins in "G" and ends in "D".

This feeling has come about very quickly, like my switches in mood from severely depressed to almost hypomanic. According to my pdoc though it is a medication induced switch. I have been taking Tegretol (carbamazepine) for the last few months to stabilize my mood. It is so great in that it has had no negative side effects and had been helping me sleep without feeling at all drowsy. That great sleep you get where you , fall asleep easily, dream and upon wakening often remember your dreams. I love that.

The Tegretol helped stabilize my mood a bit, but I still felt severely depressed, so two weeks ago my pdoc added prozac at my request. I had tried all the other SSRI's, but not this one. I never had any luck with the other SSRI's and they made me so fatigued/tired I could hardly move (although that could have been the continued depression).

Within a week and a half on the Tegretol/Prozac combination I began feeling a change; more energy, elevation in mood, more interest in life and those around me and I felt more attractive, even magnetic. God I even asked my husband for sex. Sex has been really lacking in the past year. I am usually highly sexual, so this was a good sign.

There were a few problems with this mood switch. I have developed what my pdoc called a "tic". I have relentless snippets of music; four or five bars, playing over and over and over inside my head. Attached to this is a constant "clicking" or "tapping" of my teeth to the music. It is not a conscious thing. If I try to stop my teeth from clicking to the beat they stop while I am thinking "stop", but I quickly lose focus and they begin again. The music is even less responsive to my will. It simply will not stop.

I also find myself having way too much internal energy. A sensation that I am racing. Not neccesarily my thoughts, but a physical sensation that I am really speedy inside. I find myself unconsciously tapping my fingers, my leg is shaking like I have to much energy or am restless or agitated and I have an increase in my heart rate. My regular resting rate is 60 bpm. When I have measured my resting pulse rate while I feel like I am racing inside my pulse rate has been 70, 75 and 78 bpm.

This change quickly led to my craving alcohol again to slow myself down...(why do I do this)...so I began to drink again; drink, take valium and take muscle relaxants to try to calm down and slow down. This should be so predictible to me. Every single time my mood starts to go high I begin to drink/take benzodiazepines. I cannot manage the intensity, anxiety, agitation and speed of this mood state.

I told Dr X. about my self medication (thank god I trust him enough to be honest). I also expressed to him that I am afraid this mood that cannot be spoken is temporary, and, like my mood switches before, will disappear, or is precarious. He said it may be precarious, and may become lower, but he does not think it is like my switches before. He said the quickness of the switch; the fact that my mood responded to the antidepressant so rapidly, points to a bipolarity in my mood disorder.

I asked him if maybe the rapid switch was a placebo effect, in the same way that I think maybe my rapid response to ECT was, or how I seemed to respond to Lithium for 5 weeks after I was on 1200 mg and then lost my good mood entirely. He said no it wasn't a palcebo effect. That a placebo effect would not come with the particular neurological effects I am having (the tic). Maybe he is just saying this to keep me hopeful...but if so it worked. I do feel hopeful. Another sign that I am feeling w**l.

Yesterday Dr. X. prescribed Clonidine to me to try to help me sleep and to stop the music and teeth clicking tic. He mentioned it was used for helping people with heroin and smoking addictions come off those drugs...so I think maybe he is hoping it will help me stop drinking and taking valium. As I left yesterday he did quietly suggested that maybe this medication will help me slow down and sleep so I do not feel the urge to slow down in other ways.

I took the Clonidine last night, and I became sleepy about an hour later and soon fell into a deep and restful sleep. I woke up this morning and the music and teeth clicking was gone. Unfortunately it returned shortly thereafter, but I am hopeful it will go away over the week.

I had a great pdoc appointment yesterday. I felt cared for and listened to and it is always an incredible experience to spend an hour with Dr. X when I feel that word that cannot be spoken. Here's hoping we have hit upon the right combination of medications.