Lamictal, 250 mgs: So Far, So Good

Two weeks ago, I dropped from 300 mg to 250 mg. In the past few days, I've noticed that I'm feeling a bit sharper, mentally. I've begun craving healthy food again, after several years of craving salt, fat, and sweets (normally, I'm one of those lucky people who can normally look at a plate of cookies dispassionately; not so on Lamictal). Best of all, there's been no drop in my mood whatsoever!

The downside: I've had some GI issues (constipation and gas). My muscles are stiffer. I've also been really tired, but this might be my body's way of telling me it's OK to lower my Ativan dosage as well :)

Can Haz Cat!

In a recent post, I wrote about how my husband and I were kind of stuck in a netherworld of wanting another cat, but of not feeling ready.

Last weekend we took a trip to the SPCA to test the waters.  By that point I felt I was ready, but my husband didn't.  Then, we met our cat.  It was a cat I had seen before but never visited; every time I saw her, she already had a visit tag for that day, so I needed to visit cats who hadn't been visited.  But I felt like I wanted to get to know her better.  I liked the way she looked at me -- as if she knew me.

She's still adjusting, of course, but still seems very different from our previous two cats.  She doesn't say much, for instance, even when she's hungry (our other cats would wail and complain, and when we told them they'd have to wait for dinner time, they'd start nipping our feet).  However, she's a sweet kitty and is already proving herself to be a lap cat.

I knew that cats were an important part of my self-care, but I'd forgotten how much.  Since the arrival of SC, my anxiety levels have plummeted by a factor of ten, at least.  I'm less depressed.  I'm more hopeful.  I don't just love cats, I need cats.

Overcoming My Fear of My Own Mind

The other night, as I was falling asleep, I realized that I was actually thinking about myself.  Boring stuff mostly, where I'm going, how to get there, my complete lack of confidence in my ability to do so.  The odd part is that it wasn't scary.

Since my psychotic episode, I've been terrified to delve too deeply into myself.  I've had a creative block.  My meta-cognition has sucked.  I've been put so much effort into hanging on by my fingernails that I haven't had time to think about myself ... but it's also something I've studiously avoided.  I've been afraid of my own mind.

My psychotic episode, and the subsequent mood issues, makes me feel like my mind completely betrayed me.  I'm a person who has always prided herself on being rational, on being able to think straight, of only holding well-reasoned opinions.  The belief that the universe is devouring light particles is neither rational nor well-reasoned.  The fact that I could believe such a thing, even while knowing it was false, is deeply frightening.

The belief came from such a deep part of my mind that I've been afraid to go back, so to speak.  I've been afraid to look into my own depths.  What if I'm overwhelmed again?  What if my mind starts lying to me again?

Last night, something shifted in me.  It was as if I'd been hanging on to a branch for dear life.  If I let go of the branch, I'd go over Niagra Falls.  I had to put all of my energy into hanging onto that damn branch, or else.  Then, a channel opened up in front of me, a peaceful stream, and I can start making my way toward it.

I still find myself hoping that the stream isn't too deep.  I'm afraid of what else might be in the water with me ... giant sturgeons, ichthyosaurs, anglerfish ... but at least I don't hear a thundering waterfall in the distance.

So Much for Inner Peace

In a recent post I wrote about feeling a sense of acceptance for my lot in life.  My dead cat, my troubled relationship.  That sense of acceptance has come and gone since then, but mostly gone.

I've been really moody this week.  OK, one day it was because I forgot to take my meds, but still ... someone asked how I was doing and I started crying about my cat.  They didn't even ask about my cat.  Yet, I was in tears, and could barely speak.  Yesterday I felt tearful as well.

I wasn't quite this bad after Piglet died.  I suspect it was because I still had CC there to comfort me.  I'm stuck in a crappy place where my partner and I aren't ready for another cat, but not having one is driving me crazy.  I'm afraid I'll meet the perfect cat before we're ready, and also terrified that I'll never bond with another cat as long as I live.  

Acceptance, Actually

The path to healing is supposed to involve "acceptance".  Sometimes this is called "surrender", a word which I hate for its connotations of cheesy romance novels.  So I'll talk about "acceptance".

Since my psychotic episode I have struggled mightily against my illness.  I felt like I had to; I couldn't afford to go back there, I couldn't afford for my mood to get any worse, I couldn't afford another mistake with my meds.  I've struggled against everything that's gone wrong with my life over the last two years.  The jobs I've lost.  My relationship problems.  The loss of my cats.

Then, the day before my cat CC died, I was overcome with a sense of calm.  The universe is kicking my ass right now, for whatever reason.  There's nothing I can do about my illness except what I'm already doing -- taking care of myself as best I can.  The job stuff, my cats -- those situations are both out of my control.  My relationship -- well, that needs work, no question, but we're finally ready to start that work after healing from the trauma of our previous, fraudulent couples counselor.  So there, at least, there is something I can do, and I am damn well going to do it.

I don't know why or how I attained my sudden sense of calm.  I just know that for the first time in two years I feel like I know what I can and can't control, and I feel deeply that things will get better.  It's a damn good place to be.

The Other Shoe Drops: RIP CC the Cat

Ever since I lost my first kitty in March, I've been terrified that my other cat was soon to follow.  I felt like she was the one thing I had left to lose, and I keep experiencing horrible loss.  It didn't help that she went and developed hyperthyroidism.  But then the meds seemed to help her for a good few months.  And then last week she started seriously throwing up again.

They vet ran her blood work, which had been normal the week before, and found some pretty bad liver numbers.  They were, the vet said, consistent with a liver tumor or lymphoma.  I guess hyperthyroidism can mask these conditions.

Given that CC was 18, I was not going to put her through chemo or surgery.  I elected for palliative care.  That was Thursday.  On Saturday I had to put her to sleep.

I'm coping with this better than I coped with Piglet's death.  I think it's because it's not the same roller-coaster, where she was at death's door several times and then bounced back.  CC had a normal life right up until her last hours.

But damn, how I miss her, and how quiet and empty the house feels without cats.

Getting Out of the House Helps

I haven't been blogging a lot lately.  It's because I decided to take my shrink's advice and get out of the house.

His theory was that moping around the house wasn't good for me.  It wouldn't be good for anyone, but in my case I'd been housebound for months while taking care of my late lamented kitty.  Being here all the time, he thought, was probably retraumatizing.

So I pledged to get out of the house three days a week.  I have to go to physical therapy anyway, and PT is close to my volunteer gig at the animal shelter, so I'm spending more time thinking about cats than my own misery.  When you're depressed, this can't help but be a good thing.

CBT for Depression: Mood and Thought Diary

Last week I started therapy for my depression and ADD.  If therapy for ADD sounds strange, allow me to say that it's always been a huge factor in my depression.  When you grow up with any sort of neurological difference, your self-esteem is systematically crushed into a pulp; you're told that you're not "really" trying, that you don't care enough to learn, that you could do so much better if you just "worked up to your full potential".

It's that last one that really got to me.  I was told repeatedly by my parents and teachers that I was "too smart" to be sucking in school as much as I was.  I didn't feel like I was smart at all.  If I was so damn smart, why was school so hard?  Why couldn't I remember a word the teacher said?  Why couldn't I finish my assignments?  Why wouldn't they all realize that I was just plain dumb and leave me alone?

Growing up like that plants a lot of negative thoughts in your head.  The thought and mood diary that my therapist assigned me to do last week has really brought that out into the light.  I learned that sometimes my thoughts precede my mood, and sometimes my mood precedes my thoughts, but that whatever the situation holy crap am I a negative person!

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.

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.

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.

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.

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.

Losing a Pet

Yesterday afternoon we had to say goodbye to Piglet, our loving and faithful kitty of 17 years.  She was a real sweetheart.  She was always there for me when I needed comforting.  If she were here now she'd be on my lap purring and letting me cry into my fur.

Losing a pet just sucks.  Part of it is the lack of understanding on the part of non-pet-owners; they may be sympathetic, but in a lot of cases you can see that in the back of their minds they're thinking, "it's just an animal".  It's their loss.

It also sucks that animals can't tell us how they're feeling.  I don't know if Piglet was in pain in her last days.  For that matter, I don't know why she wasn't eating for the last two months.  I couldn't ask her what was going on, whether there was a food she wanted or could tolerate, or where the discomfort was.

The biggest part of the suckage, though, is the foreknowledge of the loss.  I wished so much that Piglet would just stop breathing and peacefully slip away.  I hated calling and making an appointment for her death.  Knowing that we had until 3 pm to spend time with our cat was a hard thing.  On the other hand, her last few hours were clearly hard, so it was also a relief when the vet showed up.  That also sucked.

Now I go back to a life where I'm not spending half my time and energy feeding my cat.  I have to adjust to not having her in the house.  If she were her right now, she'd be in my lap, purring, letting me dry my tears in her fur.  My other cat, CC, has a shit-ton of personality, but sweetness and comfort aren't really in it.  I lost the most comforting thing in my life yesterday.  And there are no two ways about it.  It just sucks.

FML: More Impending Loss

A few weeks ago I rejoiced to learn that Piglet, my feline companion of nearly seventeen years, does not, in fact, have cancer.  She has IBS, which caused fatty liver disease.  If a feeding tube were put in, and she could tolerate the food, she could make a full recovery.

Well, she can't tolerate the food.  Even though it's food she tolerated a few weeks ago.  Even though it's bland as hell.

Obviously, a cat who can't eat isn't going to make it.  I've decided to stop all procedures, like the feedings and the subcutaneous fluids, because they're only making her miserable (she's actually started hiding from me for the first time in her long life).  I don't want our last days together to be filled with me doing things to her.  The only meds I'm continuing are the anti-nausea and anti-inflammatory drugs that are likely to make her more comfortable.

This was a tough decision, but it helps that I have the strong sense that Piglet is just Over It.  She's ready to go.  That makes it only slightly less devastating.  This cat has been a loyal and loving companion for nearly 17 years.  She's the sweetest and most easygoing cat I've ever met; if you wanted her on your lap, you just put her there and she'd settle in.  But chances were she was on someone's lap anyway.

I could always count on Piglet to support me when I was sad or upset.  She'd bump her head on my arm or my leg, rub against me, and generally carry on cute until I at least had to smile.  Then she'd crawl into my arms and purr until I felt better.

She's no longer well enough to do that, and I think the feeding tube makes it difficult for her to purr.  But she's still nestled nest to me on the couch, providing what comfort she can.  I can't imagine my life without that love.

I've lost so much in the past two years.  I lost what I thought was a promising job.  I lost my mind and my mental health, and therefore the sense of efficacy I'd worked so hard to build throughout my adult life.  But hey, I thought to myself, at least my relationship is strong.  Then, last fall, my marriage crashed onto the rocks.  I thought to myself at least I've got my cats.  I also thought, but they're old ... and the way things have been going lately ... they're two of the few things I have left to lose.  And now I'm losing one of them.

FML.

Worn Out, OR: Gotta Have Heart

I am officially sick of taking care of myself.

Why bother to limit my alcohol intake?  Why should I avoid sugar and caffeine?  Why make the effort to exercise?  I worked so hard to instill these habits four years ago because I wanted to get healthy.  And where has it gotten me?

Fuck-all nowhere.

OK, it worked for awhile.  I lost 60 lbs.  I got in shape.  I got organized.  Let me say that again: I, that is to say, Addy Bell, got organized.  If you'd seen my report cards from elementary school you'd know what a miraculous feat that is.  Anyway, as a result of working my ass off, my depression lessened, my ADHD symptoms improved, and I felt better than I had in years.  For the first time in my life, I was in control.

That is, until I wasn't.  Until I went nuts.  Until I had to spend an entire year rebuilding my brain from the ground up.  So much for control.

Lately, I haven't been moody, and I haven't felt sad.  I just feel tired and pointless.  Why put in the effort when past experience tells me that no matter how hard I work, I will fail?  And not just fail, but burn down, fall over, and sink into the swamp?

It would be easier to get off my ass and do something, anything, if I felt like I had any efficacy at all.  But I can't even remember what it feels like to feel a sense of control, to feel like what I do matters, to feel like I can effect the outcome of my own life.  Sure, I can put in the effort, I can work my ass off, but that won't make the Universe take down the "kick me" sign it's had on my back for the last two years.

Maybe if I just lie low, life won't notice me and will leave me alone.

But I can't think like that.  I know I can't.  Because I know that I have to take care of myself, or things will get even worse, and thinking so negatively is bad self care, and is practically a guarantee that things will get worse.  So I need to keep my chin up, stiff upper lip, put on my game face, and all that.  I gotta have heart, right?  Lots and lots and lots of heart!  Gotta keep singing Damn Yankees in my head.

And I guess, for me, for now, that's what success is.  Other people get to feel successful when they land a job, or a promotion, or a raise.  Or when they watch their children sharing a toy on the playground and they think to themselves, hey, I taught them that.  Me?  My success is measured in my ability to talk myself up from the depths of bitter despair, a place where I've landed because, well, my success is measured in my ability to talk myself up from the depths of bitter despair.

Only I can't think like that.  Gotta have heart.  Gotta have heart.  Gotta have heart.

P.S.: Damn Yankees.

My kitty is going to be OK!

I wrote a few days ago that my cat was very very sick, and I was expecting the worst.  Turns out it's only IBS.  She's on prednisone, an anti-inflammatory that will also make her hungrier, and I need to get her to eat bland food like simply-prepared chicken.

This is such a load off my mind.  Of course, a lot of my time is still spent trying to entice my cat to eat, which is time consuming and frustrating, but now that I know she's improving it doesn't make me as incredibly sad as I was a few days ago.  My mood has improved by a factor of a hundred.  So has my motivation.

Big sigh of relief!

Motivational Problems: (Or: My Life Keeps Getting Worse)

My cat is probably dying.

A few weeks back she lost her appetite, then seemed to regain it.  Since returning home from my trip, however, she's no longer eating.  Within 24 hours I was in the vet's office.  My cat, who's been 16 lbs most of her life, is now 8 lbs.

The vet recommended an x-ray, but the results, like the results of the blood panel and the urinalysis, showed nothing wrong.

Great news, right?  Not so much.  When you've got a cat who's obviously as sick as mine -- all that loss of weight and apetite -- you're probably looking at cancer.  The next step is to get a second opinion from an internal medicine specialist.  They would probably do an ultrasound, which would cost about $600, and be one more traumatic experience for my poor kitty.  Since I have yet to talk to anyone who's had a good experience giving their cat chemo, I would probably opt for palliative care.  I'll be talking to the specialist about this.

In the mean time, I've felt really unmotivated.  I need to clean the house, because it looks like a tornado threw up on it.  I need to sell some crap on Craigslist.  I need to work on my stained glass project.

I wondered if my meds needed adjusting, if somehow they'd started to fight with each other ... and then I realized: I am motivated to do one thing, and just one.  I am motivated to spend quality time with my cat.  I will sit on the couch for as long as she wants me to.  That's my motivation right now.

Lamictal 300: Why am I "depressed"?

Hotbrain wrote me a nice supportive note the other day about my mood problems (apparently my comment form is evil, which isn't surprising, since Blogger is run by Google).

I don't know whether my mood problems are caused by some sort of medication poop-out or not.  They may be.  I think it's more likely that my stress is situational.  This is still a problem when you have a clinical mental illness.  Situational stress drags down your mood, obviously, and unlike the mentally boring, we lack the resources to pull our mood up when the situation resolves itself.

I feel like my meds are working.  I feel stable, I'm not normal one minute and then sobbing the next.  But my life is depressing me.  I'm not meeting my goals for this year.  My cat isn't eating (but maybe she's getting better ... or maybe that's just what I want to see), which has led to a lot of unexpected expenses.  I find myself ruminating on these things.  It's hard for me to remember all that MCBT I learned ... and I'm not meditating like I should be.

I've stopped boozing.  I'm back to drinking one drink a few nights a week.  As when you throw away any sort of mental crutch, a painful realization followed: drinking had been one of the few things I enjoyed doing.  Painting seems like too much work.  Music?  Need to tune the instrument first, and harpsichords have A LOT of strings.

In all honesty, the prep for these activities are not that bad, but when you have ADD and depression, they seem overwhelming.  The thing I really want to do is work with stained glass.  But I don't have the tools, and doing it in your house is a great way to spread shards of glass all over it.  I'm thinking seriously of setting up outside on my deck and buying the damn tools.

Not having a part of your day that you really enjoy is ... well, it's depressing.

Lamictal 300 mgs: Down and Depressed

OK, partly it's because it's been gray and cloudy and gloomy.  But mostly, I've been slipping back into feelings of helplessness and hopelessness.  I feel like there's no part of my day that I enjoy.  I feel like I'll never get out of the hole I'm in career-wise.  I'll turn 37 this year, and in spite of all the hard work I've done -- and I mean really hard work, I'm still cripped by mental illness by learning disability.

And RSI.  Did I mention I have RSI?  Yeah.