...where I feel like I have to continue taking a medication for as long as possible to give it a chance to work. I do it with all my psych drugs, I won't let myself quit or hit reverse. Well, I hit reverse this time.
On Sunday night I had my first real full-blown akathisia. That basically means inner restlessness, but I was pacing, frantic, couldn't lay down, couldn't breathe deeply...just a mess. I tried to just breathe through it and relax. I tried all my little DBT techniques. NOTHING worked. So then I doped myself up with everything I could find--Vistaril, clonidine, Xanax, Restoril--ANYTHING that could calm me down. I had a hot shower, hoping it would relax me as the benzos (et al) kicked in. Luckily all that worked, but not before I tearfully announced I needed to go to the ER. Thankfully I problem-solved (someone on the web forums linked me to a study where they used Restoril for akathisia, so I did exactly the right thing) and didn't end up at the hospital. Thank goodness.
So, instead of trying my hardest to take 160mg of Geodon nightly, I'm back down to 80mg. 80mg feels DANDY compared to 160...minimal sedation, some speedy days where I am motivated to get things done, etc. But it's also just not quite enough...I'm having crying fits, and intense anxiety, and general lability in my moods. In a lot of ways Geodon feels exactly like taking an antidepressant. Its D2 action is less than Seroquel's, and is both a seratonin and norepinephrine reuptake inhibitor. It also of course has the same 5HT2A antagonism that makes Abilify, et. al., good drugs to augment antidepressants. It's a jack of all trades (and maybe the master of none?).
But, due to the aforementioned "stick it out" complex, I plan on asking the doctor to write me a script for 20mg so that I can try taking 100mg a day. With Geodon, it's very much a "sweet spot" kind of drug, where everyone is different and the wrong doses are all VERY wrong, but once you get to the right dose it is oh-so-right. At least, that's the sense I'm getting.
A couple of other developments. I started applying for jobs other than my current position. I applied to be the patient access/financial person in the admitting areas of both local hospitals. What that means is that I will be helping people understand insurance benefits as well as apply for Medicaid and hospital charity care. It's basically a dream job for me. I also got off my butt and asked the university to let me back in as a student. They said yes. I have to have academic advising and I have a hold on my account for outstanding tuition from the last semester I attended (about $300), but I'm back in for fall 2012. I have some GE credits to finish, hopefully I can finish those all online, and then I am aiming for my BSW - bachelor's in social work. After the BSW, I can get my masters (MSW) in one year, or I can pass the exam (I think there's an exam?) and start practicing immediately. So probably, if I have my shit together and can make things work with my schedule, I can have my degree in hand by spring 2015. I hope. I did my FAFSA, and I'm eligible for Pell grants (YAY) and the usual Stafford loans. So once I get my shit ironed out, I can be a student again...and hopefully not fuck up this time. I'm hoping that since I have Lisa to keep me accountable in therapy, that I'll do much better this go around.
In our last session, when I mentioned the above (applying for jobs and going back to school), Lisa was PUMPED. She loves that I'm doing social work (she's an LCSW, of course), and has offered to write me letters of recommendation to get into the BSW program once my GE's are complete. (This is good, she is clinical faculty at the same university, and knows all the social work program staff.) She also thinks it will be better for me to be working in the hospital doing something I love than working from home doing something I hate. Can't argue with her there...staying home all day to do a job that is tedious and moronic breeds depression. It makes me less mentally healthy. But waking up early, putting on scrubs, riding the bus to work, interacting with people who are respectful of the work I do...that's rewarding. That will give me a sense of self-worth.
Granted, I am still mired in fears that this is all for naught. That I'll flunk out, again. That all my smarts won't translate to grades once my bipolar and ADD get in the way. I'm petrified that I'll be doing too much, piling too much on my plate, and end up in more debt with some more incompletes on my college transcripts. I'm terrified. So afraid. So, what I'm going to do is be no more than half time, taking two classes. Hopefully at least one class will be online. I need to set a schedule for myself and stick to it. Kristina will be going to community college in the fall as well, and if we are BOTH "scheduled" to do schoolwork then we won't distract each other. We have to make it work. We are both too fucking smart not to have our degrees in hand, and I'm sick of feeling like a failure compared to all my former classmates and peers who are now doctors and lawyers and whatnot.
Back to the psych meds. At my last visit, Dr. Yasar gave me an anti-hypertensive called clonidine and an antihistamine called Vistaril for anxiety. Vistaril is mostly just useless, I don't like it, it makes me drowsy but doesn't relieve anxiety. Clonidine is something he's been pushing on me for months now. I should have listened sooner, because clonidine brings down my anxiety by a couple notches right away. It's not overly sleepy, and it makes me a little more focused. That one is staying. I take it in the afternoons and it brings me right down to the chill zone and stops the anxiety from escalating. Geodon does shit for anxiety. If anything it makes it worse. But clonidine and the occasional Xanax are helping.
I also got me a new sleep med! My longed-for, oft-suggested but never selected temazepam. Lisa is not thrilled about temazepam because it's going to permanently change my sleep architecture, but last night Geodon zombified me and I fell asleep fine without having to take any temazepam. When I do take it though...man is it good. Such beautiful, restful sleep. I should have been on temazepam LONG AGO.
One note - if I've already taken my Geodon for the night, forget about Xanax. It makes me...drunk almost. Sedated and stumbling. I've now had three instances where I take Xanax after the Geodon and become the walking dead. It's no good. So.....note to self on that. (Another note to self, if I took ONE .5mg tab maybe it would be fine. But I take them two or three at a time, sometimes more if I'm going to be around someone unbearable...so no wonder. This is of my own making, I just need to realize the correlation and STOP.)
I think that's about it for my updates. I'm trying to put myself in a better position in my life, but am struggling right now with anxiety and battling with Geodon to get to the perfect dosage. I can no longer eat full meals with Geodon, my stomach doesn't feel right, so it's been with peanut butter sandwiches (for fat/protein) and that's been working out better than full meals. I also figured out, with Geodon, to take it AFTER I've eaten. Not before. Not during. Not after but then I go get dessert....just completely after I am finished eating. Then the sedation (when it comes, which sometimes it doesn't), is less severe. I've also been trying (really) to walk more and get some weight off, but the scale and I aren't friends right now, and there are some days where the motivation to just hoof it around the neighborhood is slim to none.
In any event, now I need to do my nails so they look cute for group (no one ever notices, but I feel like SOMEDAY they will) and then take care of shit around the house, like watering the yards and picking up after the animals. I will try to post more later, as now the desktop computer is up and running without making crazy noises. I spent several hours removing programs and defragging and disk cleanup-ing yesterday, and it seems to have helped. My brother may also be able to fix our many broken laptops, so more posts forthcoming.
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