6/27/19

This week has been a rough week.

I worked Monday and Wednesday and both days were busy. I'm having a hard time keeping up the facade at work that everything is okay. It's exhausting. The days are long (and not only because I work 12 hour shifts). I've wanted to cut but I haven't. Yesterday I broke down twice which is something I try so hard not to do at work. But it happened.

On Tuesday I had my appointment with the Southern Colorado TMS clinic. I was there for 2 hours and we went over  what TMS (transcranial magnetic stimulation) is, the research behind it, and how it can help. I also had a medical intake. When Dr. H asked if I had any questions I said I only had one: when can I start? TMS is a treatment that has great success in treating depression with little to no side effects. It works by sending strong magnetic pulses to the regions of the brain identified as being responsible for depression. These magnetic pulses excite the neurons, activate them, and the repeated sessions act like muscle memory and the neurons learn how to remain activated. This is something I want to do.

Except I might not be able to.

See, insurance companies are like a bag of dicks and they obviously don't want to approve something if they can get out of it. TMS is FDA approved to treat major depression and generalized anxiety. What's my diagnosis? Bipolar disorder. So more than likely my insurance company will deny coverage for TMS based on that. Which let me tell you, sucks fucking balls. Because what is it that I deal with the most? Depression. I haven't had a hypomanic episode in about 4 years. But I deal with recurrent depression constantly. The longest period that I've been euthymic is 3 months. Then it's back to depression. But I'll probably be denied treatment based on a label. A fucking label.

So I cried. And I cried again that night at home. Dr. H said that he and his team would do what they can to get me approved and they were hopeful they could do it. Which gives me hope. Now if only I can hang onto that.

I had therapy today in which I cried also. I seem to be crying so much more lately. My depression feels as if it's getting worse day by day. My therapist could tell a difference in me compared to 2 weeks ago. That's not good. But what can you do? I'm trying.

I'm trying, I'm hanging onto hope. It's all I can do.

6/17/19

How to start . . .

I'll jump right in I guess.

I saw Dr. M today about my depression. And it went how I was fearing it would go. I should probably expand on that.

I told him how I've been feeling. Empty, depressed, hopeless. I told him it has been relentless and ongoing for the past 5 or so weeks. Before he could say anything I told him I'd prefer not to do ECT again. He looked at me for a full minute before speaking.

"You've been on practically every medication. And countless combos of those meds. All I can really recommend is ECT."

My stomach dropped. I don't know why though - that's exactly what I expected he would say. ECT. Electroconvulsive therapy. I did it for 3 years. Yes, I had improvement with it, but I also have had substantial memory issues.

"What about EsKetamine?" I asked.

"Well, there aren't any clinics in Colorado offering EsKetamine. It's too new, there's too much red tape, and it's too expensive," he replied. "You can try a regular ketamine infusion, but the cost for the 3 week treatment is around $2000 - $3000. It works for some people in the short term but it's pricey."

I felt even more defeated. Close to tears.

"You can try TMS (trans cranial magnetic stimulation). Studies have shown it to be effective, just not as much so as ECT. It's 5 days a week for 6 weeks, so you wouldn't be able to work probably. I can give you Dr. F's information if you're interested. See, it's just that you're treatment resistant and the best course of action for that is ECT. I'm sorry, I know that's not what you want to hear."

No, no that's not what I want to hear. I asked about Deplin, activated folic acid. He said I could try it but it probably wouldn't help. I asked about Rexulti. Again, it probably wouldn't help. It would replace my Vraylar and that med is the one that's helped me the most. So he would prefer not to stop it.

I'm stuck people. I don't know what to do. Do I take 6 weeks off from work and try TMS? Do I go back to ECT? Do I do nothing and wait it out, hoping the depression will lift of its own? The problem with waiting is that my depression tends not to go away on its own. It tends to hang around and get worse.

This is a bunch of bullshit, really. I don't know what to do. I cried in the parking lot, I cried while driving, I cried when I got home. I don't know what to do.

Fuck.

6/14/19

Staring at the walls . . . or off into space. It's what I do best it seems. It's all I do anymore it seems.

Why?

Well, because I'm so empty. I'm not sure I've ever felt this empty. Seriously. I've felt more depressed, but not more empty. There is truly nothing there. I can't believe how devoid of emotion I am. I'm a robot, going through the motions. Trying to pass as normal. I laugh but there's nothing behind it. It's fake. Forced. I can't even cry because there's nothing there. There's no emotion.

I hate this. I can't stand it. I want to curl up in a ball and not exist. I'm trying so hard to stay positive but I'm getting worse.

I'm getting worse.

Three more days and I see Dr. M. I don't even know what to tell him. Well, I do, but I'm worried I won't get it out properly. I'm worried that I'll minimize what I'm going through. I'm worried that I won't get the help I need. I'm worried that he'll be so focused on ECT that he won't hear me. That last sentence is what scares me. I will not do ECT again. No. Not going to happen.

I feel like I have so much to write but I can't focus and get it out. My mind is blank and I fell like I'm beating a dead horse.

So yeah.

Why can't I be euphorically hypomanic? Just mildly. Come on brain, work with me here. We all know you do depression well. How 'bout some hypomania?

Fuck. 

6/10/19

Well. I had therapy today. And I talked about my depression and my light headedness and tremors and work. And maybe it helped a little? I'm not sure. The fact still remains though that I'm depressed.

I have no motivation to do anything. I got home from therapy and wanted to go to bed. I didn't. I went downstairs and did a couple of sketches. I drew a sparrow and some flowers. Go me. All trying to not go to bed. I had lunch. I put dinner in the crockpot.

I want to go to bed. Just sleep. Sleep for eternity.

So I'm writing. I'm trying to distract myself, kill time. Not sleep.

But we all know what's going to happen, don't we? When I'm done with this I'm going to go lay down. Because I can't. I just can't. I can't deal with this unrelenting emptiness. I wish I could cry. I think I'd feel better if I could cry. But I can't. There's no emotion there. It's gone. I'm just so empty. Void. Blank. Numb. There's nothing there.

I can't fucking FEEL.

And it makes me so tired. It's hard to keep up the facade that I'm okay. Even that I'm marginally okay witch is what I've been doing.

I can't do this.

I see Dr. M on the 17th. I know he's going to suggest ECT, which I can't do. I can't. My memory is jacked enough. Maybe ketamine. I don't know. I'll find out I guess.

Anyway, it's time to go lay down. /end rant 

6/7/19

It doesn't matter why. That's what I've decided. Did you read my last post? Maybe you should. See, I've been depressed since then (May 17th). And it doesn't really matter why. I don't think there's a reason anyway except my bipolar. No trigger, no cause. Just my brain being a bag of dicks.

I'm depressed. I'm empty. I'm hollow. I'm fake. I'm down, defeated, hopeless, and overwhelmed. I'm nothing.

All of the things and none of the things.

I feel I'm getting worse. Slowly but surely getting worse.

I went to the doctor on Wednesday (the 5th). On top of the depression I've been having dizzy/lightheaded spells and tremors in my hands and right leg. Fun right? Fucking laugh riot, let me tell ya. She truly believes that it is my lithium. That I'm having withdrawal symptoms (I'm subtherapeutic right now) and that I need to increase my dose. But to be safe I had an EKG, orthostatic blood pressures, a ton of blood work, and I get to wear a heart monitor for a month (no, not something like a FitBit - I have electrodes that attach to my chest and connect to a box with a button I push every time I have symptoms). And she wanted me to see my Pdoc ASAP. I already had an appointment with him on the 27th, but she wants me in sooner. Earliest I could get in is the 17th. That way we can discuss my depression and lithium.

I'm so tired right now. Not physically tired. Mentally. Emotionally tired. All I want to do is sleep to escape reality. See, sleep is like death but without the commitment. I don't have to deal with my feelings (or lack there of) while I'm asleep. And I've been sleeping more. Napping. Trying to stay in bed as late as I can in the mornings.

Withdrawing. I'm not interacting as much as I normally do. Some coworkers have noticed.

I'm trying. Fake it till ya make it, right? But it's getting hard anymore. It drains me so much. But still I try because what else am I going to do?