Friday, April 27, 2012

The Dangers of Blue Light: Careful With That iPad

Last fall, I thought I was getting away with something when I watched videos on my iPad at night.  In spite of the blue light emitted by iPads that can be so dangerous to the sleep phases of modd-disordered persons, there I was, sleeping normally.  I theorized that maybe the screen was too small to emit enough light to screw me up.

I now theorize that I was wrong.  My current theory is that I'd been watching videos, which are obviously not all emitting pure white or blue light all the time.  Much of the time, indeed, the colors on the screen can be quite dark.

The same is not true if you're using the iPad as a reading device.  Then, it's straight-up black text on a white background.  Then, you stay up until 2 am reading.  Then, you can't fall asleep before 2 am for the next two weeks; and then, the trend shows no sign of stopping.

Sunday, April 22, 2012

Alaska, ADHD, and the Hunter-Farmer Hypothesis

Lately I've been neglecting the blogs I used to read, so I wandered over to Gina Pera's ADHD Roller Coaster to see what I've been missing.  I found an interesting guest post about the prevalence of ADD traits in Alaska.  After the author was first diagnosed, she started to notice that an unusually high number of her friends and relatives also had ADHD traits.  So she checked with them, and lo and behold, many of them had been diagnosed with ADD.

She makes the point that Alaska is tailor-made for people with ADHD.  There's plenty of dangerous, adventurous work to do for those of us who loathe the thought of traditional desk jobs (and I should say here and now that I used to harbor a fantasy of moving to Alaska to become a bush pilot).  To me, though, the most interesting part is when she describes walking through the woods with her sons.

When her sons are outside, suddenly their "distractibility" turns into "noticing things":
They are attuned to every detail of their surroundings, noticing each chirping bird fluttering softly in the brush and each animal track on the ground. Given the high probability of us running across a bear during our excursions, I find their hyper-awareness to be quite a relief. In a school setting it gets them in trouble; in a wilderness setting it could save their lives.

Now, I'm generally not one of those people who feels that ADD is some sort of gift, that people with ADD are somehow "more creative" than others.  I've known too many creative people who don't have ADHD, and they're a lot better off than I am -- they can follow through on their creative projects, and actually get around to putting them out into the world.

There is, however, one area where I do feel ADD confers a gift: when I'm outside, I notice a lot of things my non-ADHD compaions don't.  Quite simply, I'm "distracted" by every bird flying overhead, every rustling in the grass, every mark I see the ground.  I notice foxes and rabbits and quail and coyotes.  I see hawks diving for their dinners.  I spot whale spouts offshore.  Sometimes, my companions luck out and I can show them what I see.  Often, though, they miss out -- the wildlife has vanished by the time I point it out to them.  When I'm outside, I'm not "disordered", I'm "observant".  In this one area, ADD means I have an advantage that others don't.

Thursday, April 19, 2012

300 mgs: Have to Be Careful Anyway

A few weeks ago I wrote about how bad I've been feeling lately.  Then, the next day, I did something to make it worse.  I went to Brian Copeland's show The Waiting Period.  It's a darkly comic one-man show about the ten-day waiting period that California requires when purchasing a handgun.  Copeland was purchasing that handgun in order to commit suicide.  The waiting period probably saved his life.

The show was great, both funny and poignantly sad.  But I shouldn't have gone to see it.

It wound up being really triggering.  Copeland's character moved between today, in real time, and the person he was when he was suicidal.  The suicidal character described so many things I felt, and am feeling.  What particularly resonated was the repetition of the phrase, "everything hurts".  In his case, the pain was felt physically: "Even my hair hurts!".  In my case, the recurring thought is "my life hurts".

Watching the show, I remembered all the times I've been at a stop sign or a crosswalk and thought, I could just step into traffic.  I remembered by recurring thoughts of cutting myself, thoughts that started when I was a teenager.  The recurring, frustrated thought, I should just shoot myself in the head.  Copeland wanted to shoot himself in the heart, because that's where his pain was.  I guess I think of shooting myself in the head because it's just been so useless to me -- the learning disabilities, the ADHD, the consequent underemployment, and of course, the crazy.

Lest you be worried, I don't have a suicide plan, and I don't even own a gun.  The point of this post is that, when you have a mood disorder, no matter how medicated you are, you still need to be really careful about what you allow yourself to listen to and see.  I thought I was doing well enough that I could enjoy the show without adverse consequences to myself.  I wasn't.

The only upside is that seeing the show made me realize how much I was in denial about how bad I was doing, and now I'm seeking help.  And that, as it happens, was Copeland's message:  if you're feeling really bad, tell someone.  Get help.  Don't suffer in silence, alone.

Tuesday, April 17, 2012

Starting Therapy (hopefully)

I've probably needed therapy for several months now.  It's not something I could have handled in the months following my psychotic episode, but I definitely could have used it when I learned that my relationship is cracked to its very foundations.

I didn't seek counseling at that time because I felt I couldn't afford it.  We needed couples counseling, and I knew I'd need to see my doctor for med checks pretty often once winter really swung into high gear.  My pdoc isn't in network, so that would ultimately cost a few thousand dollars.

Since the death of my cat, I've felt overwhelmed by feelings of sadness and hopelessness.  I've lost a lot of motivation.  Though I know I don't really want to die, at times I felt ... well, kind of like I wanted to die.  It's clear that I need help.  But I can't afford to spend a few hundred dollars a month.  Not after spending a few thousand on vet bills last month.

Finally it occurred to me that my clinic at UCSF, which takes my health insurance, has one of the best mental health outfits in the country.  They probably also take my insurance.  I called them, and while they themselves are booked up, they could recommend a few people who had the knowledge to deal with my problems and who also take my health insurance.  

I think I've found someone I can work with (*fingers crossed*) and I hope to start late this week or early next week, depending on availability.  He's knowledgeable about both depression and ADHD, which I think will help me a great deal.  I've always wondered how depressed I would be if my ADHD weren't such a problem.  I underachieved in elementary school, and was constantly shamed by my teachers.  I came to believe that I was actually stupid and wished to hell everyone else would catch on and stop expecting so damn much of me.  When things got better in junior high and high school, I sort of felt like a fraud; when I got to college I hit a brick wall and was finally diagnosed with ADHD and learning disabilities; as an adult I've been chronically unemployed and underemployed.  Under these circumstances it's hard to have much self-confidence.  It's easy to get depressed.  

So I'm pretty glad to have a therapist who understands both mood disorders and AHHD.  One lesson I've learned is that if a therapist doesn't really understand ADHD, all sorts of problems can arise -- for instance, if you're chronically late, it's time to explore why you might be resistant to therapy.  Oh, of course you have ADHD, but what's really going on?  What's "really" going on, dammit, is that people with ADHD are chronically late.  That particular therapist was excellent in all other respects, so I kept working with her.  I guess the only good thing I can say is that I damn well learned to be on time to appointments.

Last week I was feeling pretty hopeless.  Just knowing that I'll be getting help has made a big difference.

Friday, April 13, 2012

Nothing Like Ativan In the Morning

I'm pretty depressed right now.  My life has been a bit like a bad country song lately: my cat died, my marriage is in trouble, I'm unemployed ... all I need is a midnight train out of town and the narrative would be complete.

Earlier in the week I was damn miserable.  I'm not suicidal or anything; I don't have "a plan", and I really don't want to die ... except that I felt like I wanted to die.  I didn't say this to my pdoc, but described my mood and motivation, and how they had suffered incredibly since the death of my dear kitty.

I figured that he'd up my abilify because it seems to be a very effective antidepressant for me.  Instead he recommended that I try taking .5 mgs of ativan during the day as needed.  At that dosage, he said, it shouldn't make me sleepy.

So yesterday I tried it.  Within half an hour I needed a nap -- pretty amazing, given that I'm also on 70 mgs of amphetamine for my ADHD.

So much for that idea.

Wednesday, April 11, 2012

Self-Esteem and the Confidence of Others

It's important for others to have confidence in us.  If those closest to us don't believe in us, in our ability to reach our goals, in our ability to heal, in our ability to overcome our difficulties ... well, it's damn hard for us to believe we can accomplish those things.  

I'm depressed right now, and maybe that's coloring my memories, but I feel like nobody's ever believed in me.  My parents always told me I was smart, but they won't acknowledge the disabilities that hold me back.  Without doing that, I can't go to them for advice the way some other people can go to their own parents.  Then there's my husband, who thinks I make excuses to avoid working.  Yeah.  Three learning disabilities and psychotic depression is an "excuse".

Right now, I'm trying to believe that I can overcome what happened to me last year.  And, for that matter, my entire adult life of underemployment.  But it's a damn difficult thing.  Here I am, depressed, feeling bad about myself, needing to view myself positively ... and having to get to that place without help from anyone.

Tuesday, April 10, 2012

Lamictal 300 mgs, Abilify 5 mgs: Sunlight, Heat, and Exercis

Brain meds can mess up your body in all kinds of ways you might never think of.  For instance, both lamictal and abilify can screw with your body's ability to handle sunlight and overheating.  The side-effect warnings on abilfy even caution you against heavy exercise.

And yet, when you have a mood disorder, your pdoc is always pestering you about exercise.  Exercise improves mood -- it's a proven fact.  I know that if I don't engage in regular heavy exercise, my mood, my energy level, and my attention span all suffer.

So here I am, on lamictal.  The little drug sheet warns you about susceptibility to sunburn, and some people find they're prone to heat stroke when taking it; and indeed, when I first started on it, I found that I could get a non-trivial sunburn even while wearing my 60 SPF sunblock (n.b.: I'm of Irish descent, living in Northern California, and can get a mild sunburn in 15 minutes even on a cloudy day).  But I had no problem exercising on lamictal whatsoever.

Enter abilify.  Right away I notice that I'm more easily fatigued while exercising.  Then I notice that my skin gets hot much sooner than it should, given my activity level.  Then I notice that I'm not sweating anywhere near as much as I should be.  So I'm basically overheating, which explains the fatigue.

Overheating while exercising is a pretty bad thing, but I can't afford to give up heavy exercise.  I need it to keep my mood, energy levels, and attention span stable.  Right now I have a shoulder injury that's kept me from lifting weights, and believe me I can feel its impact.

What to do?

I've tried to fill in the gaps by running, but when I overheat I get tired and can't exercise like I want to.  Then I had a revelation.  If the problem is that I don't sweat, the effect is that I don't get the evaporative cooling that sweat provides.  If I replace the evaporative cooling, I can get the benefits of sweat without actually sweating.

So I run on a treadmill and always have a water bottle nearby.  When I need to, I splash water on my face.  It helps enormously.  I cool off and don't tire as quickly.  A spray bottle would work even better, if I could remember to bring one.

Friday, April 6, 2012

What's My Motivation?

Lately I've been feeling horribly unmotivated.

I was motivated when my cat was still alive; motivated to find foods she would eat, motivated to feed her with the feeding tube when we thought it would save her life and return her to health (as it does in nearly 90% of cases like hers).  But that's all.  I was motivated to care for my cat, whom I loved and who loved me.

Now that she's gone, so's my motivation.  Primarily, I'm not motivated to take care of myself.  Two years ago I was doing everything right -- I was eating well, exercising, avoiding caffeine and sugar, drinking moderately.  Two years ago I was not depressed.  I was in a good, healthy place mentally.  I knew how to talk myself up when I had a mood swing, I'd left my traumatic childhood behind me, I'd even gotten past a lot of internalized ableism that whispered poison in my ear: You'll never be good enough, you'll always screw up, any company that would hire you has something deeply wrong with it ... your fourth grade teacher was right, you'll never amount to anything.  But when I had these thoughts, I could laugh them off.  I only needed 12.5 mg of Zoloft to keep me stable.  I thought I'd licked depression for good.

Then I landed a job, and lost it within two weeks because the company was really screwed up.  They left me with a work-related injury and no workers comp insurance.  My job-hunting efforts for the rest of the year came to nothing.  My husband criticized me for not finding work.  The past year had been dark and gloomy, and was beginning to bring my mood down.  I started to get paranoid.  By December I was putting foil on things.

In other words, even though I was doing everything right, I went from not depressed at all to bat-shit crazy within a year.

So when it comes to self care, what's my motivation?  Self care is hard.  I have to give up things I enjoy, like coffee and wine and beer.  I have to exercise regularly (and, to add to my happy happy joyous situation, I'm prevented from working out by a bad shoulder injury).  I have to eat healthy.  I have to get enough sleep -- though this last part isn't a problem, as I've been averaging 10 hours a night lately.

I guess I've gotten depressed again, in spite of the lengthening days.  Dysthymically depressed.  The kind of depressed where nothing is fun anymore and everything seems too hard.  The kind where you're bored and nothing seems interesting.

Of course, this could be an effect of bereavement, but when you've got a mood disorder, even "normal" depressions can lead to very bad places.  I hope I can pull myself out of this before it gets really bad.

Wednesday, April 4, 2012

The Twists and Turns of Bereavement

Since my cat died last week, her absence has been a palpable presence.  I could feel that she was gone every minute of every day.  I knew she was nowhere in the house, not upstairs on the bed, not downstairs on one of the couches, not out in the yard doing whatever it is cats do outside.

I talked to my mother recently, and she said something along the lines of "It's hard, because I bet you keep waiting for her to walk into the room, keep seeing her out of the corner of your eye."  "No", I thought, because of that absence.

Now it's been almost a week, and suddenly I'm right where my mom thought I was.  I don't see Piglet anywhere -- she must be upstairs.  But wait, no she isn't; she'll never be upstairs again.  Wait a minute, she's not lounging on the couch; she'll never be lounging on the couch again.  She must be outside -- no, she's not.  She'll never again be outside, doing whatever it is cats do there.

Funny how grief works.  When I lost my grandparents (3 out of 4 now) I would be at their house and expect them to come in from the kitchen, to come down the hall, to come down the stairs.  I didn't feel their absence because I hadn't processed it yet.  Maybe this is because the lived far away from me and I couldn't process it.  Maybe it was different for those that lived with them.

I'm in a slightly different place with my grief right now, but mostly the same place -- I miss my cat awfully and I wish I could haev her back, alive and healthy and purring in my lap.

Monday, April 2, 2012

Squidoo Article About Dental and Mental Health

Since one of my most popular posts deals with the dental problems that can result from medications, I decided to write a Squidoo article (or "lens", as they call them over there) on the subject.  It's called "Effects of Depression: Taking Care of Your Teeth While Taking Your Medications."

In the article I recommend some products that have really helped my teeth over the years.  In the interests of full disclosure, I'm an Amazon affiliate, so I will earn a small commission on anything anyone buys through my article.

Shameless pitch:  I'm unemployed and broke.  If you're thinking about buying xylitol gum or high-fluoride toothpaste, you'd help me out a lot by buying it through my Squidoo lens.