Back at work

I went back to work on Monday. It was hell. On that first day, I cried six times. The stress and pressure I feel have caused a massive flare-up of my IBS, which doesn't help. Each workday is an ongoing series of mini-breakdowns. I'm struggling with feelings of worthlessness and futility. I can honestly say that this is one of the worst depressive episodes I've faced.

Therapy with Lisa is fine, I guess. I typically leave feeling drained and exhausted from revisiting old memes - my parents never loved me, I disappointed the only people who ever believed in me, I'll never get back on track with my education and am permanently inferior to my peers... all of that fun stuff. I like Lisa, I just dread trudging through all this old crap that I've since (attempted) to accept and make peace with. I mostly avoid my parents because of their feelings towards mental illness... my mother doesn't get it and seems vaguely glad that at least I'm not addicted to hard drugs/in jail, and my father likes to think that mental illness doesn't really exist or that I'm not really as challenged as I feel I am. In any event, it's exhausting reliving and re-feeling all that old trauma.

Group therapy is a whole different story. It's small at least, just five of us and Lisa, but I'm petrified. We did a mindfulness exercise and I couldn't stop my racing, anxious thoughts long enough to breathe or focus. I'm the biggest person in the group by far, and all I can think about is how offensively fat I look, and how the other women must be looking at me with judgement. I strategically chose a seat so that no one could sit next to me, but I was right across from Lisa so I felt pressured to say the right things because she was looking straight at me. It was horrible, but I'm committed to it, so...

I have an appointment with Dr Yasar on Tuesday, after my visit with Lisa. I had some bloodwork done and my lithium level is a pathetic 0.4, so I'm predicting a dose increase there to 900mg/day, maybe more. I'm also officially NOT a fan of methylphenidate, it makes me a basket case on the comedown. I've heard Dexedrine is smoother, so I'll aim to try that. Aside from that...I'm thinking we'll keep everything else the same. I'm on track with my Lamictal titration, bumped it up to 50mg/day on Wednesday and no rash. Next dose increase is to 100mg/day on 3/28, so I'd imagine that he'll write me that prescription on my next visit. Dr Yasar has been telling me that he doesn't want me on Seroquel long-term, but I'm not sure I want to give it up. I am sleeping a solid 7-9 hours a night, and it's the most restful, wonderful sleep I've ever had. I fear that without that sleep, I'll rapidly fall apart. I'll be glad when I can switch to generic immediate-release but I am really digging the Seroquel. The only drug that I could be readily persuaded to switch to is Zyprexa, which I loved...such a sense of calm when I was on it for that one week.

I wish there was something that could help with my depressed mood. I'm hoping that once I'm at 200mg/day, the Lamictal will help with that. If not, then I'll want to at least explore the idea of incorporating Prozac, which is the antidepressant that has been most studied for BPII in conjunction with a mood stabilizer. I'm going to give it some time though, maybe Prozac will be an option come summer.

Today, with the aid of Ritalin (HATE this drug, seriously, it isn't worth how it makes me feel on the back end!), I did about 5 loads of laundry and cleaned up after the cats, took out loads of trash, tidied up the kitchen, and cooked dinner.