After All That .... Away for a week

I want to say that I was not hospitalized. From the ER, I was sent to a sort of group home for mental health patients. There really wasn't much to do there except get away from the daily stressors of life. I wanted to go straight home at first, then I got used to it, and then I almost missed the people I was living with. Of course, looking back at the last several weeks that I've been posting its like night and day. Even a friend of mine with whom I talk every day (except while I've been away for some reason), kept exclaiming how "great!" I sounded on the phone today. He said I didn't stutter or have pauses in my speach like I used to. What was written in my chart is pretty clinical, I know, and somewhat scary when you read it that way. But it does match up with what I've written here myself, so a big picture can be seen. My diagosis code, by the way, at my psychiatrist yesterday, is still "pschizoaffective bipolar type". The house wasn't planned out activities like in the hospital but they did hand out medications on timed schedules. Everyone was friendy. Even the guy that was constantly talking to his imaginary friends. And I can say that!! (Though I don't talk back to my hallucinations.) I was allowed to go out a handful times in the week that I was there, a few to dr visits, and a few out with family or friends to get coffee. Those were nice, but having to be back soon, we a little depressing. Speaking of depressing, the longer I was there, the more I could feel my depression lifting. No more dark thoughts. No more suicidal thoughts. No more thoughts to just not exist anymore. I began to look forward to seeing my kids and to cherish the short time I had with them. My pdoc wanted me to go on prozac yesterday, but decided against it which is good because I've heard some bad things about it. I have run out of covered visits for the year and my dr wants me to see her in Decemeber even so, knowing that a visit would cost over $300. Even though I said its Christmas time and that's present money. Even so, she just wanted to see me and see how I am. I understand this and agree- IF I had the money. But I think I can make it a month until my insurance turns over on January 1st and then see her again. She said she can't "make me" come but she'd like me to come. Considering that money is one of my problem areas, I think I'll try to make it to January. I'm going to go back to church choir. That's a great choir and I haven't been in years. I'll have to go back to working out, too.

FILE: From my Medical File

10/01/13 Client reports she had a wish to not wake up yesterday, but that she usually doesn't feel like dying or harming herself. She explained her current thoughts as "the angels told me that I know everything now and I can bring my cat with me. I don't feel scared or alarmed. I'm fine. But I realize that I could get hurt."

10/08/13 Pt reports having very passive suicidal ideation this week but no intent.

11/21/13 Client reports that she overdosed on Ativan last night (5 pills) and feels that she will do it again soon.

11/21/13 Client presents with flat affect, ambivalent in her decision making process, paranoid and delusional (feels and thinks that people are aliens, oriented x3, denying and current AH/VH, attention intact during interview, insightand judgment marginal.

298.9 Unspecified psychosis (Active as of 11/21/2013

296.80 Bipolar Disorder NOS (Rule out as of 11/21/2013

296.90 Mood Disorder NOS (Rule out as of 11/21/2013

Diagnostic Summary: 11/21/13 Client reports paranoid thinking along with delusions. (Thinking people are aliens and endorsing a hx of beliefs that she can fly and that she will not die for long if she kills herself.) Client reports a hx of auditory and visual hallucinations, but none at the moment. Client reports anxiety related to personal relationships. Client reports that she tried to overdose to kill herself last night with plans to do so again.

10/03/13: Pt presents as preoccupied, possibly resonding to internal stimuli, hears voices telling her to stab herself, reports some improvement in psychotic symptoms.

10/011/13: Client presents "ramped up" with thoughts of jumping into traffic or "flying off her balcony" w/o specific intent of suicide. She is calm in presentation but she reports that she has felt increasingly "ramped up" over the last two weeks. She spoke with her psychiatrist this morning and she recommended she present to PES.

Narrative:

Pre screen request was made by PES due to client experiencing anxiety, paranoia, difficulty concentrating and ongoing thoughts of killing herself. Client also reported that she overdosed on Ativan last night.

Client is a 41yo caucasian female. Client presents with flat affect, ambivalent in her decision making process, paranoid and delusional (Thinking people are aliens and endorsing a hx of beliefs that she can fly and that she will not die for long if she kills herself.) Oriented x3, denying any current ah/vh, attention intact during interview, insight and judgment arginal. Lithium levels reflect taking meds as prescribed. Negative for benzo's despite reports of overdosing on Ativan last night.Client reports paranoid thinking with delusions. (Thinking people are aliens and endorsing a hx of auditory and visual hallucinations but none at the moment. Client reports anxiety related to personal relationships. Client reports that she tried to overdose to kill herself last night with plans to do so again. Client has access to significant amounts of psychotropic medications including Ativan. Client denies any hx of substance abuse. Client receives MH services from XXXXXXX. Client was psychiatrically hospitalized in November 2012. Client was diverted from hospitalization in February 2013. Client was psychiatrically hospitalized in October 2013 for presenting manic and expressing beliefs that she could fly. Client reports to live with three children, her mother, and her mother's boyfriend. Client reports that her mother is both supportive and a stressor at the same time. Client reports that she has a friend that she feels is supportive, but also believed that he was an alien.Client reports to comply with medication tx usually, which was confirmed by labs, and reports to attend appts as scheduled.

Here is another file from my medical history.

Search for "FILE" to find other files.

Anxiety Bad

The anxiety is still here.............When we leave here, we get me back to my car, then i drive home and then its night again. Me and night and my room- again....... hate this! Maybe its just going to be there forever??? I feel like my life ammounts to nothing and never will. Day after day after day.....round and round and round. People are after me. After me. Coming to get me. From every direction. They are going to get me. I must hide. I must run. But where?How? They will be tapping at my window like the aliens did that day many years ago on the windows at the balcony. Tap... tap... tap... Maybe everybody is an alien and I just can't tell. Even my friend that took me out to dinner. He's the worst of all because I can't tell.I want to go to bed but I can't stand the thought of being in my bedroom. There is nothing comforting about the night - about the dark. I hate it.

The Trio

Its dark. If I were manic, I'd relish the way the light plays off the metal objects at night. But I'm not. I don't know if I'm officially depressed or just really hating life right now. I did go out to lunch with the Friday lunch group. Then I took my eldest to his therapist. That lasted much longer than usual, since we were a bit early and he let someone else take his spot citing an "emergency". So all-in-all we were there over two hours for an hour appointment. However, we figured we'd make it up and go to Red Robin for dinner. But there, there was even more waiting. Not bad, though, about 20 minutes.

Every day I wake up and immediately want to go back to sleep. Lots of days, I do. I go to bed early, too, some nights. Like last night, I got to bed at 8-something. That was nice. The kids went to bed early, too. If I didn't have to get up and do things like appointments and picking the kids up from school, I don't know how long I would sleep.

Yes, I have thoughts of self-harm. I want to take anti-anxiety pills (Ativan), anti-allergy pills (Benedryl) and alcohol (Burbon) and fall dreamily asleep. Yup. If I can't type it here, where can I type it? So far, I have resisted the idea, mostly by the insistance of friends - both in real life and online. Why haven't I called psych ER? Its so complicated going there. And the negative feelings often happen at night, though not exclusively.

So here it is, night again. What to do, what to do? Wait out the long weekend? I do have plans tomorrow with a friend so that should keep me distracted. I can't believe it was a whole week ago that he and I ate at that Asian restaurant where my food was so spicey! OUCH! At the moment, I have laundry going and will have to wait another hour or so before that is done.

So this may be depression. I'm not sure. I at least can get out of the house. I'm not catatonic watching the wall. I'm not crying. However, ever since eating the hot Asian food last week, my eyes tend to water without provocation. People notice and point it out, asking, "Is something wrong?" Odd to have a tear or two running down your cheek and have to say no, but nope, nothing is wrong. In fact, I don't feel sad as much as I feel incredibly anxious- that bad things are going to happen. I can't distract myself enough. I suppose I could call my pdoc on Monday, but I should have called today! Darn it. There's always Psych ER to call if things get worse.Like if that trio becomes more of a good idea to me.

I'm wondering if this isn't a mixed episode now. The anxiety is awful.

Fade Away

The last several days I think I've been depressed. All I've wanted to do is stay in bed- the majority of which I'm asleep. My dreams are vivid. When I'm awake, I post about wanting to die. So much so, that I scared the people on a bipolar bulletin board I belong to. I just wanted to fade away into nothing and never wake up. Then I'd describe the various ways that I could do that- mainly with various combinations of script and non-script pills.

I don't know if this is just a low following my mania, or if its unrelated. I'd love to be in bed right now. I sleep about 18 hours a day and don't get groggy after. I think I might put my pajamas back on. I can't be bothered to do laundry or get a shower. Its only 4:30 p.m. The title to my post on the board was "Black". That's how I felt. Like there is no color, only black. I wanted to take Ativan and Benedryl at the same time and maybe some burbon. Just to check out for a bit. Nothing permanant. No, I didn't call the psych ER. No, I didn't call my psych. Dr. I just am in a funk. I think posting on that board has kept me from doing any of these things because they'd post how concerned they were for me. Telling me I should call the psych ER. But I know that the psych ER might want me to come in and I can't do that because I have kids here I have to watch. I know. Doesn't make sense. Welcome to my brain.

No more hallucinations, except I did just think I saw the cat, again. He ran up the stairs and then wasn't there. Nothing like what happened on Saturday with the photograph of the girl and the coffee beans.

They can't put me on anti-depressants because they make me hypomanic and maybe manic. So I guess the only alternative is to up my zyprexa and who needs that?

I posted here because my friend G.V. said he hadn't seen any posts on my blog in a while so here is one. Sorry its a negative one.

Starbucks & Stuttering

Met someone that shows up at Starbucks nearly every time I do. He said his name is Kenwa. Interesting name. Wonder if the three of us- me, my friend and this person- will talk more now. I feel on edge. Bored really. I don't have my earphones so videos are out of the question.The boards here are slow because its Saturday. Sometimes, I really hate myself. I hate bipolar. I hate just being. What a curse. It ate my brain. Munch.I am out with my friend but I still feel a bit weird. But this is just anxiety I think. My friend is talking about nuclear fallout. Nice. My favorite subject. He did buy me a coffee though. I wonder if we'll go out to eat later. Its only 3 right now. What do i care about nuclear fallout? A bomb could go off a mile from here and what would I care?

I was just looking at a photo on the wall of a woman. She is life-size. She's holding a basket of coffee beans. She has a fake smile on. The more I looked at her, the more she changed. Her face became a mean face. It became the face of the devil! She didn't want me looking at her! I continued, however. Her face changed from mean to happy to mean again. Her basket changed and moved too. Was she nice or was she evil? I still can't tell. Her expression changed from one to the other. Her eyes, too, changed from nice to menacing. Her lips curled up into a pucker of disdain for me.

I've also noticed, as of late, that I stutter. I can't get a word started, or if I do, it get stuck for quite a few seconds before it comes out. Its not just that I can't get the words out, but a mix between that and not knowing what word might come out! They really do get stuck! Its especially frontal consonants like "P"s and "D"s. I'm not sure if its one of my medications doing that or if its something else. I would guess that I'm trying to get words out so quickly that I'm stumbling, but it really feels more like they get stuck mid-syllable and take a few seconds to become un-stuck.I'll have to remember this for next time I talk with my psychiatrist.

Detached

I was going to copy and paste into here but my machine decided to go nuts on me when I tried so I'll just type.

At our Friday lunch with friends today, I felt odd. I felt detached from the world, and yet anxious without the negative feeling. I felt detached from the world. I felt the bathroom wall with my finger tips because it was made of stone and this is something that I only ever do if in some type of mood episode. I called my psychiatrist and she didn't think it was anything dangerous- no delusions or hallucinations, or medication mishaps- so I am left to ride it out. Someone at lunch when I was eating asked if I were okay. At this point, I still felt fine so I said yeah I don't know what's up. She commented on the fact that my eyes were watering and I was blowing my nose as if my dish were spicey- but it wasn't. I'm shaking a bit now, and just have an overwhelming want to detach from the world and float away. I don't feel bad like its anxiety, but it has halmarks of anxiety, I'll admit. I managed to drive home from the restaurant, pick up my kids from school, and get some supplements at the drug store. (One was buy-one-get-one-free!)

I will have to keep a watch on it. Last night, I was anxious and took ativan and benedryl to get to sleep. Maybe its leftover from that? But my day was fine. Lunch with friends should be a fun time! Tomorrow, I'm spending the day with one of my closest friends, so that should be a good day, too. We will probably spend part of it in Starbucks. Now to just finish the laundry I started and get a good night's rest.

Took two Benedryl and an Ativan. Nothing happening. Must need more....

Still feel the same and its an hour later. I'm wonder if I'm in a mixed episode- aggitated and depressed. Manic and depressed.hmmmmm If I can sleep! I took my usual pills for the night. I wonder if they will help.

So Much For Mania

I am sitting eating my second meal for the day: granola cereal. I took my eldest to his yearly dr checkup this morning. All is fine. We even went out to eat after. So why do I feel anxious? I have visions of not onĺy impaling myself but of downright just killing myself anyway I can. So much for mania. The music my son is playing is grating on my nerves. Where are the knives? I took a nap in Starbucks earlier. Time flew by. My eldest says he's lost weight since going off Risperdal. That's good. I'm never going off Zyprexa. Even by accident seems to create havoc.

Lately, I feel like I am no good at anything. That I'm lost in a loop of unproductivity. Look at how wonderful my sister's life is! And look at me. I suck. For as nice as I am to people, I still suck. Nobody seems to want me. Sometimes people say that I'm great, but I want to hear that more and from more people, I guess.

I'd like to publish what I've written here, but it seems such a long-shot.

I feel like my left-over migraine is part of this. I should take a pill for it just in case. I've tried a nap, coffee and food, now drugs. I should've gotten my blood drawn today, too, and I forgot again!

I want to hide away somewhere. There are too many things going on. I can't filter them out. Too much guitar. Too much YouTube. Too much someone on the phone. Too many complaining people. I must get out of here. But how? Fly? Fun? Or just walk? Noise overload!!!

It's now six hours later and I'm feeling like taking Benedryl and ativan at the same time. I can't stand this feeling scratching and knawing at my insides. Earlier, I heard a helecoptor go very close over the the house and I thought they were landing for me! It doesn't help that in amongst all this, the "Cylandrical Sex Seconds" person finally ended our relationship. That sounds so final, but I've said that how many times and its never over. I'm more "meh" about the relationship being over, but then I think about it and it has been whiddling down to almost nothing for over a year now. Back to the feeling, it just won't go away. A friend suggested that I call the psych ER but eh, I don't feel like it. So much for mania. Which it were back. This sucks.

I broke down and took ativan. I hope it helps me calm down. The knawing feeling sucks. Its like a creature is trying to knaw its way out of my body. If it doesn't work, I will try Benedryl. Few minutes later: tried Benedryl. Feeling better. Don't care if its not pollitically correct.

New Diagnosis? Schizoaffective Bipolar type

I saw my pdoc today. I didn't think I had much to say, since the zyprexa seems to be doing its job. I'm improved over last time I saw her two weeks ago. I'm still having hallucinations of cats, though. One moment they are there and the next they are gone. So when I checked out, I got the printout that reminds me of when my next appointment is. Printed in amongst my info was "Diagnoses associated with this visit: Schizoaffective disorder, bipolar type. Anxiety disorder". Never has she mentioned this before! And the anxiety? Yes I've had a lot lately but I don't remember telling her about it? So odd... So now I'm BP1 with schizoaffective? Or is this just for this one visit? I'm confused. Schizoaffective is when you hallucinate outside of a mood episode, I think. I wish they'd be something more entertaining than cats. Zyprexa is doing its job, that's for sure. Puh. Still miss my hallucinations. EDIT: Here on May 18, 2014, my diagnosis is still Schizoaffective, bipolar type. (There is also depressive type.)

Schizoaffective Disorder

From the link: Schizoaffective disorder (abbreviated as SZA or SAD ) is a mental disorder characterized by abnormal thought processes and deregulated emotions.[1][2] The diagnosis is made when the patient has features of both schizophrenia and a mood disorder—either bipolar or depression—but does not strictly meet diagnostic criteria for either alone.[1][2] The bipolar type is distinguished by symptoms ofmania, hypomania, or mixed episodes; the type by symptoms of depression is exclusive.[1][2] Common signs of the disorder include hallucinations, paranoid delusions, and disorganized speech and thinking.[3] The onset of symptoms usually begins in young adulthood, currently with an uncertain lifetime prevalence because the disorder was redefined, but DSM-IV prevalence estimates were less than 1 percent of the population, in the range of 0.5 to 0.8 percent.[4] Diagnosis is based on observed behavior and the patient's reported experiences.

Schizoaffective disorder is defined by mood disorder-free psychosis in the context of a long-term psychotic and mood disorder.[2] Psychosis must meet criterion A for schizophrenia which may include delusions, hallucinations, disorganized speech, thinking or behavior and negative symptoms.[2] Both delusions and hallucinations are classic symptoms of psychosis.[9] Delusions are false beliefs which are strongly held despite evidence to the contrary.[9] Beliefs should not be considered delusional if they are in keeping with cultural beliefs. Delusional beliefs may or may not reflect mood symptoms (for example, someone experiencing depression may or may not experience delusions of guilt). Hallucinations are disturbances in perception involving any of the five senses, although auditory hallucinations (or "hearing voices") are the most common.[9] A lack of responsiveness or negative symptoms include alogia (lack of spontaneous speech), blunted affect (reduced intensity of outward emotional expression), avolition (loss of motivation), and anhedonia (inability to experience pleasure).[9] Negative symptoms can be more lasting and more debilitating than positive symptoms of psychosis.

Mood symptoms are of mania, hypomania, mixed episode, or depression, and tend to be episodic rather than continuous. A mixed episode represents a combination of symptoms of mania and depression at the same time. Symptoms of mania include elevated or irritable mood, grandiosity (inflated self-esteem), agitation, risk-taking behavior, decreased need for sleep, poor concentration, rapid speech, and racing thoughts.[9] Symptoms of depression include low mood, apathy, changes in appetite or weight, disturbances in sleep, changes in motor activity, fatigue, guilt or worthlessness, and suicidal thinking.

You can see how this is very similar to bipolar 1, but at the same time, it is different, especially when it comes to hallucinations. I still believe this is my true diagnosis, even though my new psychiatrist just has me down for a psychotic disorder not otherwise specified.

Stretched-out Moments

Looking at a photo of an old toy called the "Fisher Price Activity Center", I am taken way back. Back to a time which I am not supposed to be able to remember. To a time of big linoleum floors, floral aprons, and towering table and chairs. There is a dial to turn - like a rotary dial that goes nowhere. A spinning pinwheel that goes on forever. A stripe that turns and turns indefinitely. A mirror. I was sucked into this world for hours upon hours. Every little bit was its own little universe.

As I got older, something as simple as a tuft of grass could be its own world and I could stare at it for stretched-out moments on end. Now that I have kids, I see some of this in them:They can stare and take in the world indefinitely.

How much of this is bipolar? I don't know. But I always felt like I was special for the way I saw the world. As a teen, I would write poetry, some of which was noteworthy. Now, I still see the world differently- especially when manic. I'm not sure that I ever was what you'd call manic as a kid, but I know that my perception of the world was very different. I know that I was distraught a lot of times and was told I maybe depressed- or maybe "just a teenager". Yet I know that I was different. Always had been. I was "an alien castrato" (an earlier post here). I was different than most people and always had been.

I still feel like I see little things- little things to make up the big things. I can get lost in the little things for ages, just like the Fisher Price toy. My mother always told me that I could play for hours in my playpen as a baby. I believe it. I would just get facinated by objects. Anything. As a child, I'd stare at a glass ball, for example, and become fixated at the reflextions of light and of me. My paternal grandmother always yelled at me to stop touching things. I had to! I had to know what everything was about! When I get more manic now, its in how things feel- the details of the mortar between bricks, or how smooth a table-top feels. Its how cold the air is blowing across my face, or how the voices in a restaurant irritate me to no end. Its all about how turned-up the volume is. The older I get, the more this happens. I just think its always been there.

Police & EMT

A few years ago, I was at home looking through photos with my mother and sister one late afternoon. We got into a disagreement over whose they were: Were the ones of me mine or the ones of my mother's children hers? I got so upset that I got up and left the room and left the house.

I had tried to call my therapist because I really felt bad, but she didn't answer or call back. I got in the car. Driving, I got even more upset. I called my sister. What I said, I don't know; I just needed a friendly voice; she asked me where I was. "Walgreens", I said, and I was "going to kill myself", as I was driving past, and I pulled in. There I sat in the car, on the phone, oblivious to everything around me. My psychiatrist had called me back. We were talking about how I was feeling and thinking. I don't remember what the consensus was, only that my sister kept calling while I was talking with my doctor. I didn't answer, as I thought this was a more important conversation. Very soon after, I got out of the car, and was surrounded by two police cars and two police officers! They had parked me in. They asked me to get out of my car and took a cursory look with flashlights around my car. There I stood outside in the parking lot with two police officers, each standing sideways to me, guns in their belts and all. They asked me questions, most of which I've forgotten, but they did want to see my big, yellow purse. They asked to see inside it and proceeded to rifle through it, laughing the whole time. One asked if it were part of my camping equipment and I answered back, "Yes, that's my tent," referring to the size of my purse. No handcuffs for the smart remark, but I was locked in the back of the cruiser for a while; through the thick-glassed window, I watched them rifle through my purse some more. I had an extension cord in there - I think it was to charge my phone- which they found particularly odd.

It turns out that if you say you're going to kill yourself to your sister and then don't answer the phone, people get nervous.

Soon, an ambulance showed up. The EMT asked me if I had a mental illness diagnosis. I said that I have bipolar. I was allowed to have my purse back. I was looked over in the ambulance. My sister turned up not long after the ambulance did. She wanted to call the whole thing off- as if she'd never called 911. It was too late, the EMT said. So, off to the hospital we went. My sister said she'd pick me up later. The psych ER just talked with me and I don't remember what was said, but they didn't think that I needed to be admitted. So I was released and called my sister to come pick me up. She seemed to think it was a serious situation and was very loving toward me. We had a lovely conversation on the way home.