Tuesday, January 31, 2012

Being Disabled Is Expensive

  1. I'm on a lot of meds.
  2. I owe my shrink a lot of money.
  3. I really, REALLY need to start seeing an ADD coach so I can structure my job search.
  4. But I can't quite scrape the money together.
  5. I have dyscalculia, so I really, REALLY need a checkbook with carbon duplicates.
  6. Unlike ALL THE OTHER CHECKBOOKS which my bank offers for free,
  7. Duplicate checks checks cost $20.
No, $20 isn't ton of money ... but then, I don't have a ton of money.  And it's just frustrating that I have to pay for adaptive tech that other people don't need to worry about.

Maybe I'll just give up on the duplicates and rely on my online statements ...

Sunday, January 29, 2012

Forgot to Take My Meds: The World at a Distance

This morning I was meeting a friend for brunch.  I don't normally meet people for brunch, which means that this was an alteration of my morning routine.  When my routine is altered, I forget to do things.  Such as, I forget to take the medications that help me to remember what my morning routine is.

In my case, of course, it's not just a question of forgetting my Vyvanse, which is bad enough.  It also meant forgetting to take my lamictal and my Abilify.  I didn't realize I'd done this until I'd been on the road for half an hour, when I started to wonder why I was feeling so out of it.  By the time I was done with brunch, I felt like everything was a hundred feet away.

As the day wore on, I also felt sad and anxious.  When I got home from brunch it was early afternoon.  I doled out my meds and put them in the little bowl that I use to make sure I have all of them.  Then I forgot about them for another few hours.

Then I removed the Vyvanse, since I'm sure not to sleep well if I take that at 5 pm, and took my lamictal, my Abilify, and my allergy meds.  I'm feeling better already; calmer, more stable, and less sad.  Maybe lamictal just doesn't have much of a half-life.

Friday, January 27, 2012

Side Effect #6: Lamictal and Balance Problems

Balance Problems on Lamictal


Balance problems are one of those side effects listed on that little insert that came with your drugs.  I've found it to be somewhat troublesome and very persistent.  I doubt that that this is very common, and I suspect that most people who experience it find that it goes away.  Not me.

In my case, the balance problems are almost certainly an exacerbation of preexisting inner ear problems. I have a history of childhood middle and inner ear infections that then lasted well into adulthood.  In other words, my balance is kind of hosed anyway.  But with the inner ear issues, I've learned to compensate in a way that I haven't quite managed with lamictal.  I'll be walking along and suddenly find myself heeling over like a sailboat.

Sometimes I even need to stick a leg out to correct my balance.  For whatever reason, this seems to happen when I'm going through the door from my living room to my kitchen.  I'm glad to say that when I overbalance in public, I've never needed to stick my leg in some weird direction in order to keep my balance.

Thursday, January 26, 2012

A Depressive Makes Some New Years Resolutions

I started this post in early January, but I'm only finishing it now.  What do you want?  I have ADHD, a mutant mood disorder, and some meds that mess with my memory.  Oh, and guess what?  I'm only a few days late for Chinese New Year!  So there.

I'm so glad to see the ass-end of 2011.  There were so many challenges, so much loss.  But it's a new year and I'm not going to dwell on them.

As with every year, I am making New Years' resolutions as a way of setting my intentions for the coming year.  Last year their focus was caring for myself.  I think I did a pretty good job of that, given all the problems I had.

Here are my resolutions for 2012:

  • To establish a nightly ritual in which I think of at least one good thing that happened that day.
  •   I spent much of last year in various states of crazy, deep depression, or profound anxiety about the future.  There weren't a lot of positives in my life, but nonetheless, I know they were there.  I need to pay more attention to them -- this is according to my friend's six year old, who, when we were visiting for the New Year, happened to mention that "something good happens every day, and we should be glad".  Out of the mouths of babes.
  • I'm will structure my time and create a schedule.  A few years ago, before my life went to hell in a handbasket, I had something of a schedule that I more or less stuck to.  Work out from 10 to 11 Monday, Wednesday, and Friday.  Do a certain chore from 2 to 3 every day.  Spend only three hours a day on the computer.  Spend at least two hours working on art.  I didn't always stick to it exactly, but I did sort of, and I got a lot more done as a result.
  • I will enlist an ADD coach to help me in my search for meaningful work.  Now that I'm past the Solstice, I need to get back to my job search.  In the course of my last one, I realized that I have no idea what the hell I'm doing.  I feel like everyone who has a real job knows something that I don't. 
    • My disabilities present an additional challenge here -- I wasn't able to "start at the bottom" as an admin like most people; and at this point I really need to be able to work from home most of the time to care for my mood disorder.  In other words, I need help.  I need real help.
  • I will continue to work on my marriage.  I realized last month that, in addition to whatever legitimate frustrations my partner has, he's going through his own shit right now.  It makes him difficult to live with.  But I didn't promise to love and support him only when it was easy.
  • I will work on my non-violent communication skills.  As my mood has stabilized, I've gone from the "shock and sorrow" phase of my relationship difficulties to the "really effing pissed" stage.  Thanks to our incompetent marriage counselor, and thanks to my partner's lack of emotional availability, I've spent the last several months holding space for him.  My issues have been ignored.  And this has made me angry.  Like most people, when I get angry I get reactive, and I can be sarcastic and contemptuous and say destructive things.  Since I'm the one with the capacity right now, I resolve to take on the responsibility of communicating my needs and my feelings in a non-violent way that will be easier for my partner to hear.
Happy Year of the Dragon!

    Wednesday, January 25, 2012

    Working with a Couples Therapist: Warning Signs and Red Flags

    Last week I wrote about a list of questions you should ask as you're interviewing couples therapists.  This post delves into the deeper problems in the field of couples therapy: lack of training, lack of experience, and individual bias.

    This is information I wish I'd had before starting our disastrous couples therapy.  If I'd known what I know now, I would have realized as of our first session that our counselor had no idea what he was doing.  But I fell pray to the most common assumption about couples therapy: that anyone with a Marriage and Family Therapy degree has received training in couples work, and that they are therefore qualified to work with couples.

    As it turns out, having that "MFT" after their name tells you nothing about a so-called "couples therapist".  In spite of the name, "marriage and family therapy" programs usually require only superficial coursework and training in couples' issues.  As for other therapists who provide couples counseling, including psychiatrists, psychologists, social workers, and others, receive no coursework or training at all.

    Nonetheless, about 80% of therapists do some form of couples therapy.  To put it another way, an overwhelming majority of therapists work with couples, and the overwhelming majority of those do so without any real training.  



    Most therapists are trained to have an individual therapeutic orientation, not a relationship or community orientation, and they fall back on this when attempting couples therapy.  Don't get me wrong, individual therapy is great when you need to talk about your own problems.  A good therapist can help you see where you might be sabotaging your own goals.  They can help you elucidate your needs, see the places in your life where they're not being met, and support you in making the changes to your life that will ultimately help you meet these needs.

    When one of these counselors tries to do couples therapy, their instinct is to focus on each partner as an individual, what those individual's needs are, and how they're not being met in the marriage.  Even if the couple comes to them saying that both are committed to staying in the marriage, this individual may lead the therapist to give up on the relationship -- and tell the couple, sometimes after only a few sessions, that they should divorce.

    Does that sound like a viable way to save a relationship?  Didn't think so.


    Fortunately, there are ways to determine whether your therapist knows what they're doing.  Again, thanks to Dr. William Doherty, here is a list of red flags that indicate that your couples' therapist may be incompetent:

    1.  The sessions lack structure.  If you're going to therapy and having the same fights you are at home, with no interventions from your therapist, that therapist doesn't know what they're doing.  At the end of the session, after you're both worn out and emotionally bruised, the therapist might say something inane like "we've gotten some important issues out into the open here!".  Both members of the couple leave feeling hurt, drained, and pessimistic about their relationship.  Been there, done that.

    2.  The therapist fails to recommend any day-to-day changes that the couple can make.  You're in therapy because something in your relationship isn't working, right?  Which means you want to change something, right?  For instance, if Dick and Jane's therapist explains to them that they handle conflict by Jane losing her temper and Dick retreating into silence to punish her, but fails to tell them how to change this dynamic, Dick and Jane's therapist lacks the necessary experience to them.  Been there, done that.

    3.  The therapist feels overwhelmed by the couple's problems and recommends divorce.  Seriously.  In these cases, the therapist fails to realize that the overwhelm is caused by their own lack of knowledge and experience, not by the couple's "emotionality" or "irreconcilable differences".  It's not your therapist's job to recommend that you split up.  If they do, they're not competent to help you, and you should seek help elsewhere.  This is actually one mistake our therapist didn't make.


    Dr. Doherty says that there are other mistakes that are more common in more experienced therapists.  A therapist may have worked with dozens, even hundreds of couples over the years.  They know how to provide structured sessions, how to give meaningful feedback, and how to contain the difficult feelings that come up during couples therapy.

    Listen up, dear audience, because this one relates directly to you.  Even an experienced therapist may lack experience in your particular area of need.  Doherty relates several examples of this, but to me, the most important one involves a story of mental illness.  Out of the blue, Doherty's friend came home and announced to his wife that he was having an affair and that he wanted an open marriage.  The next day he was found in a confused state, wandering around in the woods.  He was diagnosed with psychotic depression (a fellow sufferer!) and spent to weeks in the hospital.

    While his own therapist cautioned him not to make any major decisions in his current state, his wife's therapist urged her to divorce.  Remember that "sickness-and-health" promise that's part of the standard wedding vows in this country?  Yeah.  Her therapist wanted her to up and abandon it.  She, however, was not ready to give up on a long-term relationship when her husband was clearly not himself, and found another therapist.

    This was yet another area in which our therapist couldn't help us.  He gave me half of one session to talk about my issues with disability.  He provided no insight, let alone concrete suggestions, as to how my partner could come to a more empathetic understanding.  He didn't deal with my mental illness at all.  These issues are fundamental to our marital problems.  Yet we barely even mentioned them.  I suppose I should be grateful that he didn't recommend divorce because this was clearly a problem that would never go away.

    For Doherty's full article on the hazards of marriage therapy, click here.  For a more compact list of what to look for in a therapist, and what warning signs you should heed, click here.


    individual therapy hazardous

    Friday, January 20, 2012

    Side Effect #5: Increased Skin Sensitivity

    Lamictal and Skin Sensitivity


    Welcome to Post #5 in my series of the most troublesome or persistent side effects of lamictal.  I've written 10 posts about skin reactions.  Nothing serious happened to me -- I've avoided Steven's-Johnson Syndrome, a.k.a. the Deadly Rash -- but my skin has been more sensitive, especially when I first started titrating up.

    That being said, I'm spending a bit more time on this post; we've all been warned about the Dread Rash of Doom, and because of that a lot of people stop taking this med unnecessarily the first minute *anything* strange happens to their skin.  Most of the time it's not SJS.  However, I am not a doctor, so don't go construing this as medical advice, people!

    The skin effects I noticed were as follows:

    1. Something like heat rash on my second day of lamictal (at 25 mgs).  This continued for the first two weeks I was on the med, and was particularly noticeable after exercising.
    2. "Combination skin", or simultaneous dry skin and acne.  
    3. Sensitivity to heat (like when I open the oven door).
    4. Tactile sensitivity in general; for instance, it would hurt noticeably more when my cat scrapes her tongue across my face.  
    5. Returning rash when titrating up to 50 mgs.
    6. Sunburn happens faster than usual and is more severe.  Since I'm pretty damn white, "usual" happens pretty quickly anyway.
    7. Sensitivity to chemicals, such as Advantage flea control.
    8. Niacin rash, which turns out to be a sunburn-like reaction to niacin, also known as vitamin B3.  It's in a lot of grains.  It happened to me after drinking too much electrolyte replacement drink and eating multi-grain waffles. This has never happened to me before (and I know I've OD'd on gatorade before this), but since cutting down on the electrolyte beverage, it hasn't happened since.
    There you have it.  Several skin reactions to lamictal that ARE NOT Steven's-Johnson.  For the rest of my series, check out #1: Delayed Sleep Phase#2: Loss of Appetite#3: Digestive Issues, and #4: Weird Food Cravings.

    Thursday, January 19, 2012

    Couples Therapy: Questions to Ask Before Making that First Appointment

    As I've ranted before, my marriage is going through a rough patch.  My husband is frustrated by my crappy employment history as well as my current unemployment.  This makes me feel that he's not taking my illness and disabilities seriously.  And in fact, he once said in counseling that he thinks I use them as "an excuse to not work".

    Because it's not bad enough that I have to hear that crap from ignorant neurotypicals on the internet, the breakroom at work (when I work), or even on the bus.  I get to hear it from my partner.

    In other words, we got issues.

    We also had severe problems with our marriage counselor.  At this point, we're not sure whether we'll go with another Gottman counselor or not.  Whoever we choose, it will need to be someone who knows what they're doing. 

    I'm guessing that if you read this blog, you're either mentally ill or you have ADD, which pretty much means that you've also dealt with relationship problems.  ADHD and mental illness can both put an incredible strain on any relationship, and you may need help to negotiate this treacherous terrain.  A competent couples counselor can be the guide you need to save your relationship.

    But how can you tell your couples therapist is competent?



    Going through the mill has led me to do some research I wish I'd done before seeking couples therapy.  I've learned that there were questions I could have asked our counselor that might have indicated his lack of experience.  I've also learned that during our sessions he gave clear signs that he had no idea what he was doing.  I've decided to share that research with you in the form of a short series on couples therapy.  Part One will be how to choose a counselor.  Part Two will be signs to watch for when you're actually in the therapists office.  Part Three will be about relationships in general, and staying in them when things get hard.  


    So let's begin with Part One.  Your relationship has problems -- whether they're big or small doesn't matter -- and you've decided to seek counseling.  You've looked online, talked to friends about recommendations,  and you've made a list of people who seem like they could work with you.  What next?