by krubesch

Cocktail

“In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.”

Bessel van der Kolk, The Body Keeps The Score, p.94

I kind of feel like I have lost myself. Like all this work in therapy on dismantling negative beliefs and delving into the parts of me that feel like a dark abyss make me feel like I don’t know who I am.  I guess if I’ve dissociated or hidden parts of myself from myself for years maybe I never knew who I really was.  I was always just a shell of myself- what others dictated of me.

My time these days consists of working, spending time with my wife, and going to various medical professional appointments.  There was a 2 week (10 days M-F) period when I had 11 appointments while clocking 68 hours at work.  And yet all of these appointments were necessary.  Two of these appointments were at the Treatment Resistant Department at Emory (http://www.psychiatry.emory.edu/programs/trd.html).  Because medication and talk therapy are not significantly improving (or fast enough) my depression symptoms, my psychiatrist referred me to the TRD team.  These two appointments were two and three hours long involving a psychiatrist, a psychologist, and several computerized assessments.   After my appointments the team concluded that TMS (Transcranial magnetic stimulation) and possibly switching up my medication cocktail (yet again) were the best course of treatment for my particular situation.  Right now I am waiting on hearing back from Emory to see what my insurance benefits will cover for TMS.  If everything works out I will be going to an hour long appointment five days a week for six weeks having a coil deliver a magnet pulse on the surface of my head. (http://news.emory.edu/stories/2016/06/hspub_epstein_tms_for_depression/campus.html)

I am hoping I am able to do this and that it might deliver some results.  I am not putting all my eggs in this basket and will continue to go to therapy twice a week as I have been.

In January we added a stimulant to my medication cocktail.  This addition has been somewhat helpful, but I can’t figure out if the benefits outweigh the side effects.  The medication decisions lately seem to revolve around whether I can tolerate certain side effects and nixing other medications which have side effects I have deemed deal breakers.  Right now deal breakers for me are weight gain and lethargy (I don’t need any more help feeling tired!). Vyvanse, the stimulant I am taking, has definitely helped me to cope better with everyday life. It’s less effort to get out of bed, I’ve been actually cooking dinner, and I can manage a dog walk 1-3 times a week. I have even been to the gym once to lift weights!  This is a huge difference from the previous 4-5 months.  Headaches, an even drier mouth, more shakiness, jitteriness, and a brain fog in the afternoon are what come with the benefits.   I can’t decide if the jitteriness is increased anxiety or just extra energy I am not used to having- maybe both.

Another fun thing that’s been becoming increasingly painful and ever present is pain in my lower abdomen/pelvic region.  I have been assessed by my pcp, my gyno and will be going to the urologist this coming Monday. So far all the diagnostic testing shows that I don’t have anything wrong with me.  The gyno thinks that if I am cleared by the urologist I might be having symptoms of endometriosis and she will put me on birth control (more pills yipee!).  I have noticed that the pain gets worse when I am more emotionally dysregulated which means it could have an emotional component.  After finishing The Body Keeps The Score, by Bessel van der Kolk I understand how trauma has contributed to my chronic pain issues.  I do want to get completely checked out first before we determine that this is mostly trauma related.  The TRD clinic did comprehensive bloodwork and urinalysis tests when I was there.  The tests  concluded that I have an abnormally high blood sedimentation rate and a high C-reactive Protein level.  These tests basically just mean that I am having body inflammation.  It does not determine, why, where, or how.

Along with the pelvic pain comes increasingly more vivid and painful flashbacks. They seem to trigger each other. That’s also fabulous. Van der Kolk states, “Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies….Noticing sensations for the first time can be quite distressing, and it may precipitate flashbacks in which people curl up or assume defensive postures. These are somatic reenactments of the undigested trauma and most likely represent the postures they assumed when the trauma occurred” (p.102, 103).  I was totally weirded out in therapy last week when I curled up like a child and hid my face from my therapist. This action was involuntary and I just found myself just going along with what my body wanted me to do.

I have had friends ask me if I think all of this is necessary and if drudging up the past is just making things worse.  I have wondered the same thing, but both my therapist and van der Kolk (among many other professionals) have said that “In order to regain control over yourself, you need to revisit the trauma: Sooner or later you need to confront what has happened to you…” (van der Kolk, p.206).  It’s like the saying, “the only way out is through.”  Going through this recovery/process is probably the hardest thing I have ever done, but I know that not dealing with the trauma for more than three decades has brought me harm and strife.

The Body Keeps the Score is probably the most life changing book I have read to date.  It’s crazy how I can relate and see myself in almost every chapter of van der Kolk’s book.  It has really helped me to understand why I cannot readily identify emotions or know what I am experiencing/ feeling- there is a name for that, it’s called Alexithymia!  I need facts and information in order to make sense of myself and seeing it in written form really brings it home.

If everything falls into place, I plan to write and keep a daily journal about the TMS treatment. The psychiatrist at the TRD clinic also recommended that I use the hour during TMS to do some sort of meditation or relaxation techniques to make double use of that time.

by krubesch

                  Isolation

 

“In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.”

Bessel A. Van Der Kolk, The Body Keeps the Score

I’ve been reading several books (thanks to Amazon) and scouring the internet for more information about what’s happening or happened with my brain and my body.  I’ve convinced myself that if I am able to logically understand the horrible body sensations that are happening, then maybe they will have less power over me.  That they won’t feel so all consuming and terrifying. This is what I do, I research and research in an effort to calm my anxiety, to keep my worries at bay. To make sense of the muck.

I have been having these flashbacks where my body feels like it’s re -experiencing some of my trauma and this is a new thing that started I think (these days my memory is for shit) in October.  After I got home from the hospital these flashbacks have been stronger and more disturbing. They happen at all hours of the day and they are very unpredictable. They happen at home, in the car, at work, and more intensely in therapy. Today I realized that shame might be a trigger (up until now it has felt like they happen on a whim).  I had a bad experience at a doctor’s office today and as I was driving back to work I could feel the sensations starting.  Surprisingly, at that moment, I asked myself what emotion I was feeling and I was able to tell that I was feeling really ashamed. I then thought about what I was feeling when it happened in therapy the day before and I was also feeling shame and anger.

These feelings and flashbacks have caused me to retreat back into myself and to have an increase in suicidal thoughts (that are shaming on their own). I feel constantly on edge, tired, and anxious.   Leah has noticed that when she is busy I have been isolating myself at home and not reaching out to friends when I have free time.  I feel so tired all the time that I just want to rest when I can, but I’m having trouble balancing alone time with feeling isolated and lonely.  I think I’ve almost forgotten how to have friendships.  I feel completely out of practice.

The other day I was having some dark thoughts and started scrolling through my phone and every person that I started to reach out to- I had a rebuttal about why I should not bother them and that I was honestly embarrassed and I didn’t know what to say. How do I reach out when I don’t have anything to say?  I’ve done such a good job at isolating myself that I’m not sure how tell someone I haven’t had an honest conversation with (in a while) that I am struggling and need someone to talk me down.  I don’t even know what I need to hear.  I don’t know what’s going to make me feel better when it feels like my body is torturing me.  I don’t even know how to properly explain what’s going on without getting super humiliated or how to make the words come out of my mouth. So I text and the emotion gets lost in translation. It’s always easier to write.   My therapist told me the other week that writing is going to save my life.  I’m not sure if I believe her, but I hope she’s right.

The shame around certain topics seems to envelope me whole like quicksand.  I don’t realize I need help until ¾ of my body is covered up.  When I reach out, I’m not able to even let the person on the other end know how serious my text exchange is. That the fact that I am texting at all is something.   They have no idea that I’m struggling unless I spell it out, which of course is extremely difficult because of the shame monster.  Sometimes I feel like I only reach out anymore when I am at my wits end.  I’ve forgotten what it’s like to have a regular conversation when the backdrop of my depression is not ever-present.  I’m really not that good with small talk anyways, if you couldn’t tell.   There are a lot of areas in my life right now where I feel like I’ve lost my groove. My week to week seems to be a strict schedule of going to work, eating, sleeping and going to therapy.  That right there feels like a lot to handle.  It’s a good week if I’ve been able to walk Penny one time.

Reading all this information is helping, but it also makes me feel like I’m drowning in knowledge without a life raft.  How do I put what I’m learning into action or at least cut myself a break?  There’s a disconnect between understanding that there are reasons why I act the way I do and having compassion for myself.  For instance in The Body Keeps The score, Van Der Kolk states, “Even years later traumatized people often have enormous difficulty telling other people what has happened to them. Their bodies reexperience terror, rage, and helplessness, as well as the impulse to fight or flee, but these feelings are almost impossible to articulate.  Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past” (p.43).  So I know that it’s normal I have trouble articulating myself and speaking with others about what is going on, yet I still get angry and berate myself when I am not able to do so.  I can’t find the compassion to let it be and to meet myself where I am.

by krubesch

Re-entry Part Two

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I’ve started feeling melancholy on Thursday, the first time since I’ve been home.  I have to stop myself from thinking that the “honeymoon” is over and re-frame it as this is a feeling that will come and go.  The only thing is that in my experience it’s the good feelings that fluctuate and the hard ones stick around a lot longer.  I knew that while I was in the hospital I was in a safe bubble, but I think that I expected that once I got home things would be easier than they feel at the moment.  They are a little bit easier (things, life in general), but I’m still really anxious, jumpy, and some of those feelings I don’t like are returning.

 

Today is the one year anniversary of Patrick’s death and the weather is gloomy outside and I feel gloomy inside myself.  As usual with death, my heart does not hurt quite as much as it did when he died, but I do miss him so much.  I think he was one of the safest people I have met: I could trust him without great repercussions.  If he hurt my feelings I could blame it on the Lewy Body Dementia instead of myself, I could tell that he was kind right from the beginning, and I knew that he would not reject me in the way I fear that others might.  Because of this I think I trusted him in a way I have never trusted anyone else.  We were content to spend time together in silence and it did not feel awkward, at least not for me.  I did not anxiously feel like I had to say something, anything to fill the silence, which I often feel in the company of others.  

 

Sometimes I found myself speaking with him in ways I was not able to speak to my therapist- we had this ease with each other.  I always looked forward to going to work and often had things I wanted to tell him or food I wanted him to try.  He always asked about the score of my soccer games from the night before and seemed proud when we won.  I know that Leah and Susan sometimes worry that taking care of him and seeing it through until his death made my depression worse, but I feel like my relationship with him helped facilitate more meaningful relationships with others.  As I was in a really bad place before I started working with Susan and being around them was the right medicine at that time.

 

Reintegrating back into my life at home has been a little hard and exhausting.  I forgot how much the daily things like making dinner, packing a lunch, making sure bills are paid, and taking care of our animals and basic things around the house seem to wear me down.  My mind is also less clear from the medications I’m on, so it feels more draining to think logistically and make sure I’m not forgetting anything.  Leah and I are working together on this by trying to build rest time into our daily or weekly schedule.  I’m finding that I really need that time.  Although sometimes slowing down makes me more aware of my feelings, which is arduous as well.

 

I’m pretty much giving up on the idea of going back to school for the near to distant future. I just don’t think it’s the best or smartest decision, which makes me want to criticize myself.  I know that by 2020 all the courses that I have taken in undergrad will no longer be valid as prerequisites because of the 15 year rule. That makes me want to just give up altogether.  Maybe i just have to realize that not everyone is cut out for higher ed and accept that.  I don’t know how women with families and jobs go back to school with all of that going on. They definitely have my respect.

 

My therapist told me on Friday that I need to stop worrying and trying to predict the future. That thinking is causing me a lot of strife right now.  It’s really hard to stop doing that when you’ve been doing it your entire life.  I am working on staying in the here and now even if that’s painful or difficult because I know that my old ways of coping saved my life at one point, but are not longer working or useful.  I am also hoping that writing this down makes me want to do it more than I really do!  

by krubesch

Re-entry

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As many of you know, I am back after three weeks at a residential facility that specializes in PTSD and DID and I am really grateful I had the resources and time off work to go.  (For more information: https://www.sidran.org/resources/for-survivors-and-loved-ones/what-is-a-dissociative-disorder/ http://www.sidran.org/resources/for-survivors-and-loved-ones/what-is-post-traumatic-stress-disorder-ptsd/ )  In a way I feel that this experience was indeed life changing, but not in the way I had initially anticipated.  During the admission process (which took 3-4 hours) I remember specifically explaining to the intake coordinator what I felt my biggest issues were and why I had flown from Atlanta to Washington DC to spend my Christmas and New Year’s in that particular hospital.  Those issues centered on flashbacks and body memories surrounding the rape I experienced as a child.  As my time there passed, we mostly focused on family and interpersonal dynamics instead.  As usual, I was a little off base and frustrated as to why we were focusing on other issues that I deemed not as important.  My social worker and individual therapist explained to me that we were working backwards in a way and that everything is connected.  This was surprising to me because I tend to compartmentalize and stuff everything into its own box within myself as though they are not connected.  I became less frustrated and went along with what the professionals were telling me and I am glad I did.  

I can tell you that there is never a dull moment when you are on a locked unit inside a psychiatric facility.  I thought about opening this post with “A born-again Christian, a non-binary queer, a lesbian, and a conservative Jew walk into a psych ward…” It took a minute for me to adjust to being around the other patients, but it was also liberating in a way.  It reminded me of the first time I stepped into a lesbian bar, that we all understood each other in a way other people can’t.  I recognized the community as “my people” even though we didn’t know a lot about each other’s specific trauma or most details about them personally.  We did get to know each other in an intimate way that even my best friends don’t know me.   We cared for each other by letting one another know when we were walking behind or nearby and we were sensitive to triggers of our peers and would often warn one another when we noticed possible triggers in the environment.  Because we were in a super raw and vulnerable place, being triggered was a heightened risk.  For example, I accidentally triggered someone by wearing a t-shirt with the Old Spice logo- the signature cologne of their abuser.  I am highly triggered by religion and learned to speak up in group therapy when the conversation got too centered on prayer.  It was actually really nice to have warnings when we were all processing heavy shit that made us more susceptible to said triggers.  We were able to go from heavy group therapy sessions to being able to joke and add comedic relief to the situation.  We often referred to our situation as “Trauma Camp.”  What happens at trauma camp stays at trauma camp.

When I say that this experience was life changing I am referring to several things.  Three months ago I would have told you that I would consider death before admitting myself into an inpatient facility. I think this was due to the intense shame that I could not hold myself together anymore.  That I was failing at life and relationships. I was concerned about what other people  would think if they knew I had to go to a psychiatric hospital.  I think that shame along with all the other shame I keep hidden inside bubbled over and I realized I was about to hit rock bottom. Now I don’t feel as ashamed that I got the help I needed and I don’t want to associate with anyone who judges me anyway.  

My communication skills have drastically improved which Leah has happily noticed.  I am able to let myself feel and identify a wider range of feelings and emotions, which was not the case prior to my hospitalization.  I actually joked with my social worker that they orchestrated certain events in order for me to get in touch with my anger and man did I get in touch with some rage.  After feeling that rage I noticed that nothing catastrophic happened and that the feeling had passed once I let myself experience it.

I think this experience has greatly improved my relationship with my wife.  We have been in a rough place for a while before I left and now it feels like we have turned a corner. I know that we will still have rough patches, but the way I react to those instances will be different.  Leah seems to also view my symptoms of PTSD and dissociation differently- like we are both able to make sense of why I react in certain ways.  It has also made me realize how many friends I do have and I appreciate every card and package I received while I was in DC (thank you notes to come!).  Those cards helped make the holidays as special as they can when I am in a foreign place without my wife.  

I am somewhat of a people pleaser (ok, I know somewhat is a stretch) and doing this for myself has opened some doors, or at least chipped away some of the wall towards self acceptance and compassion (ugh I hate that word!) that otherwise was non-existent.  I still have a lot of work to do on many fronts, but I was able to lay down part of a foundation. I am very thankful that in a mere three weeks I was able to accomplish these things.

Ok, so right before I got discharged the psychiatrist kept talking about reentry into my life and how I needed to be easy with myself and take things slow.  I thought this was some bullshit, but as soon as I got into the airport from my Uber, I realized that he might have been right. I’ve noticed that I have been getting tired very easily and have to factor rest time into my day.  Loud noises and lots of people make me jumpy tired, and a little uncomfortable.  Facebook and the news are still completely overwhelming to me and I will still try to stay away from both.  Running errands drains me, where it used to invigorate me. Leah has been great about cooking me dinner while I close my eyes and rest on the couch.  I guess it’s all a learning curve and it’s forcing me to pay attention to my needs and act on them. What a concept!  
In closing, I’d like to say that I struggled with posting about this, but was encouraged by a dear friend who said I should write about what it was like “on the inside”.  I guess ultimately I wanted to share all this because although it was scary and hard at first, it was worth accepting that I needed this kind of help and reaching out for it.  If you need help, you should try to get some and not feel so scared or bad about it.  We can’t be helped if we don’t ask for help.  We can’t heal if we don’t take the necessary steps to do so.

by krubesch

The Fear

Oh, my, my, cold-hearted child, tell me how you feel just a grain in the morning air, dark shadow on the hill

Oh, my, my, cold-hearted child, tell me where it all falls

All this apathy you feel will make a fool of us all

Oh, I’ve been worryin’ that my time is a little unclear

I’ve been worryin’ that I’m losing the ones I hold dear

I’ve been worryin’ that we all live our lives in the confines of fear

I’ve been worryin’, I’ve been worryin’,

I will become what I deserve

I’ve been worryin’,

My time is a little unclear

I will become what I deserve

“The Fear”

Ben Howard

I’ve hesitated in writing this blog post for several reasons, but my ultimate goal of removing the stigma surrounding mental health and to start an honest dialog seems to have won out. After all Brené Brown states that the key to wholehearted living is vulnerability. Being vulnerable is a very uncomfortable feeling for me and I think that shame is the main culprit. I am putting my shame, guilt, and fear aside and I will be going to a PTSD inpatient program starting on 12/23. Happy Holidays! This has been a decision that I have been pondering for about a month now and my therapist and I have decided that this is the best course of action. Another reason why I am writing about this is that I decided a while back that I was done keeping secrets, keeping them has contributed to feelings of shame and isolation. Several people have been asking my wife, Leah,  how I am doing and she has no idea how to answer this question at the moment. In our culture it’s not socially acceptable for her to burst into tears and let them know that I will be spending the holidays in a rehab of sorts.

My symptoms from my PTSD are becoming increasingly unmanageable and scaring me a little bit, ok….a lot. My suicidal thoughts have gone from ideations to more concrete actions. I almost wish I could tell people that I am a drug addict and I am putting myself in rehab, that seems like it would be easier to accept and to say. I have this idea that I am just not trying hard enough to keep myself in check, but in reality I know that I am starting to feel less and less in control. I realize that I am needing more support on a daily basis.  I haven’t slept well or without medication in over a month and my stomach feels like it’s in knots everyday. My memory, which is usually a steel trap can’t remember if I have put on deodorant moments after I used it, I am asking questions several times in a row after receiving the answer several times, I am driving and realize I can’t remember where I am going or recognize where I have driven to, and I either feel like I am on the verge of tears or completely numb. It’s all I can do to get out of bed in the morning and make sure I look acceptable for work.

I don’t want to leave my wife for the holidays, but I am looking at the bigger picture and really have no interest in celebrating this year anyways. I usually look forward to decorating the Christmas tree and if it had been up to me I would not have done it at all this year. I am terrified of the unknown. I am petrified of what might come my way next.  I don’t know if this program is going to make me feel better or assist me in being able to cope more effectively in everyday life. I don’t know if it will cause more damage than improvement. I don’t know what it’s going to be like or if it will be the best thing I have done for myself. I am ashamed that I have to do this, but at this point I don’t see any other options.

My boss has been amazing and I am very grateful I am able to do this. My friends and family that know what’s been  going on have also been great about checking on me,  bringing me treats, and lending support.

I have completely taken Facebook off my phone and am not on there at all at the moment. I have grounded myself from reading most news outlets because I cannot handle the state of our country at the moment (that is a whole other blog post).  I will not have access to my cell phone for about 2 weeks give or take a few days, so don’t be offended if I don’t answer texts, calls, or emails. If you run into my wife while I am gone, please give her a big hug.

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by krubesch

Out of Control

I’m getting fat and I feel completely out of control.  Things are still heavy in therapy, which is bleeding into every facet of my life at the moment.  It was extremely difficult to get out of bed this morning and I can’t figure out if this is the new normal for me or if there was a specific reason that I pressed snooze for two hours today.   Maybe it’s the weather change, the up in my medication, having therapy last night, missing Patrick, or the current antics of the republican nominee for president.  I don’t think I’ve realized until today how the election has had an impact on me.  There are news articles everyday about the minimization of sexual assault by various men, especially judges and Donald Trump and I guess I have a lot of feelings about it.

As a woman, I know that sexual assault is viewed differently than any other crime.  If Donald trump had been stealing jewelry or money instead of kisses, gropes, or God knows what else we would not even be having any of these discussions because he would be sentenced and that would be that.  To me it is plain and simple he took something that did not belong to him and that is wrong.  But then we want to know what she was wearing, if she was drinking, if she was even pretty enough, or what behavior she demonstrated that made him think that it was ok.  If you were at someone’s house and they stole your wallet- none of these questions would be asked.

Then you have the Brock Turners of our society where we excuse their behavior because they somehow can contribute to society in a way we deem worthy of looking the other way.  What is not considered is that the woman who was violated by Brock Turner has to find a way to get out of bed every morning and that her life has been forever changed.  Who gives a shit about what she can contribute!  This event will just be one day out of Brock’s life and will be something she will have to “overcome” and something she will be responsible for taking care of even though she did not have a choice.  She may spend thousands and thousands of dollars on mental health professionals in an effort to just to be able to make through each day or she may just decide it’s not worth it and end her life.  Obviously I am not specifically speaking about Turner and his victim.  This happens everyday in the US, we just know about this case because he was caught and the judge gave him such a light sentence.

Then there is the guy who was convicted of raping his 12 year old daughter repeatedly in Montana and gets 60 days in jail. This is our judicial system at it’s finest, folks.  This is what happens IF there is enough evidence to convict and if the victim even comes forward.  No wonder many survivors do not make police reports or even try that route. They end up feeling worse in most cases and he gets a slap on the wrist, literally.   Man, I am so angry right now I am shaking.

Everyday I have an experience where I get a creepy feeling or a loud noise freaks me out and my brain immediately thinks that this would be the perfect moment for someone to attack me or that maybe there is someone behind me.  I know that statistically I am more likely to be attacked because I have been sexually assaulted.  What’s funny is that I knew the guy who assaulted me and I still worry more about the guy who I don’t know that may be lurking around.  I constantly try to be aware of my surroundings when I am alone and do whatever I can to protect myself.  The house is always locked when I am home, my car doors get locked before I put on my seatbelt, I don’t walk alone at night if I can help it, and I made us get an alarm system for our house.  I tried to explain rape culture to a guy I went to high school with a couple of weeks ago on Facebook, but I don’t think he gets it at all- and why would he?  It’s not something you understand until you experience it.  Every woman I know does some of these things, even women who have never been raped or molested.  This is what I mean by rape culture.  If Donald Trump is elected (and I don’t think he will) he will be President of the United States- think about that.  The highest role model of role models for kids (and adults) in the US.  Little boys will be looking up to him and think his behavior is acceptable.  Little girls will think that his behavior is normal and will either have to tolerate the same behavior from other males or be constantly looking over their shoulders. Is this what we want for our children?

It’s hard for me to have hope lately because this is the reality.  I’m trying to hold out hope that someday (hopefully I will make it to that someday) I will have less days filled with anxiety and depression.  I will be able to look in the mirror and like the person staring back at me.  Suicidal thoughts will be a rarity instead of a frequency.  I won’t have to turn towards something (food, alcohol, perfectionism ect) to cope.  Hopefully we will look back on this time in history as that time the US lost it’s shit and did not elect a sociopath as our leader.

 

by krubesch

Triggers

“Ongoing experience convinces me that some children respond to pervasive emotional neglect and abandonment by over-identifying or even merging their identity with the inner critic and adopting an intense form of perfectionism that triggers them into painful abandonment flashbacks every time they are less than perfect or perfectly pleasing.”

Pete Walker

The only time I am in touch with my anger/rage is when I’m driving.  It always shocks me when I venomously yell out curse words or hurl insults at crazy drivers around me.  I don’t recognize my own voice. I have to stop myself from flipping people off.   It’s interesting to me that this is the one situation where I express anger. I guess it’s safe? Because I am in my car and it’s socially acceptable to have some road rage.  No one can hear me and I am in my own space.  Quiet  and calm Katie disappears when I buckle my seatbelt and put my car in drive. I’m becoming more aware of my habits, traits, and actions.

I mentioned in the my last post that I have started EMDR with my therapist and it’s been pretty intense.  I have also been attending DBT (Dialectical Behavior Therapy) class every other week.  Since I’ve begun processing events of my childhood I’ve gone from one regular therapy session and one DBT session to as many as three therapy sessions and one DBT session a week.  I’ve been gauging how I am doing by how many sessions I’ve had to go to in a week.  A four session week means that I am  not doing well and having to take each day an hour at a time.  The good thing is that I’ve been reaching out and asking for more appointments when I need them instead of “toughing” it out.

Since we started doing EMDR I am more aware of my anger and a greater presence of PTSD symptoms.  I’ve been extremely jumpy in my everyday life.  The other day Leah was driving and I literally jumped out of my seat because of brake lights ahead of us. I scared the crap out of both of us!   Today I’ve jumped when the office phone rings, when I hear a loud noise from the restaurant above our office, and when the bank teller surprised me.  I had forgotten what this feels like- always being on edge. I’m also not paying as close attention to tasks and everyday things as I normally do. I went flying over a speed bump that I did not see and took my car and myself by surprise.  Laundry, grocery shopping, and meal planning have been incomplete to my wife’s alarm.  She’s used to me being the one who gets most of this done. Sorry honey!   My therapist says that this is normal and that things are going to get worse before they can get better.  I’m just afraid of what worse means.  I’ve also been way more emotional and triggered by things that I would normally just let roll off my back.

I’ve found myself unable to cry when I feel like I need to.  I don’t know if this is because of the anti depressants or because I’m somehow not in tune enough with myself to let the tears fall.  I’ve recently started getting sad books from the library because when I really get into a book I am able to let the tears flow. I was not sure if this was going to work because I had not tried it with this round of drugs, but last night it did still work. Is this self-care? I’m not sure.   I am able to identify more with a book than with my own life. I’m not quite sure what this says about me.

Sorry if this is TMI, but my entire blog is pretty much “too much information.” I was diagnosed with a urinary tract infection yesterday and boy has this been the biggest trigger so far.  It’s all I can do to stay awake and present with the pain from my lady parts. I’d love to just retreat by going to bed and pop a trazadone to fall asleep until the pain goes away.   I’m really glad my therapist and I did not do EMDR last night during our session because I don’t think I could have handled having flashbacks along with this intense pressure in my pelvic area. It was nice to be able to go home and be with Leah and lose myself in a book after therapy last night.  I think reading has always been a welcome escape for me even as a child. I remember loving how reading could take me away from the present moment and into the lives of other people.  I felt like I had a relationship with others through stepping into their lives.  I’m still learning which of my coping skills are “effective and kosher” and which are not.  I know that in a way reading lets me dissociate from the present, but it also serves as a great distraction.  It’s a lot better than drinking, self-harming, or eating.

More info about DBT http://behavioraltech.org/resources/whatisdbt.cfm

by krubesch

Paradox

“It is an odd paradox that a society, which can now speak openly and unabashedly about topics that were once unspeakable, still remains largely silent when it comes to mental illness.”

Glenn Close

I have not written in awhile.  It feels like I’ve been riding a rollercoaster of emotions since January and sometimes writing helps and sometimes it makes it worse.   I really did not want the latter to happen.  In March I switched to a new antidepressant in the hopes that it would help my depression.  At that time I thought things were pretty bad.  Patrick had just died, I was unsure of what my employment was going to be, and I was taking two classes from Georgia Perimeter (taking classes for the first time in 10 years).  The new medication, Serzone, made things worse…much worse.  While tapering off the old and onto Serzone, I had skin sensitivity all over my body (kind of like the flu) and it made me even more tired than I was already.  I had to chose between sleeping at night by taking my sleeping pill and not being able to wake up in the morning or not taking the sleep aid and not sleeping, but being able to wake up in the morning.  I chose the latter.

From March to June I was not sleeping very well at night and finding it very difficult to propel myself out of bed in the morning.  The problem with depression is trying to figure out what is side effects from the medicine and what is happening because I am depressed.  My psychiatrist encouraged me to stick with Serzone because the exhaustion should wane over time or I would get used to it.  Along with the exhaustion I was very bitchy.  I was increasingly irritable and difficult to be around.  That’s great….feeling like crap and distancing yourself from everyone because you know you are being impossible.  Another fun thing was that suicide was sounding better and better.  I found myself eliminating possible routes of suicide while I was laying in bed trying to fall asleep at night.  I began to think that maybe this was as good as it was going to get.  I figured that this heavy depression was going to be a regular part of my life and that maybe it was resistant to medication. I tend to think in realistic terms instead of hopeful ones and this was the conclusion I was coming to.  Thankfully I reached out to my psychiatrist for the third time and let her know how serious the situation was.  At the beginning of June she switched me from Serzone to Pristiq along with my regular dose of Wellbutrin.

Normally I would keep my thoughts and feelings about suicide to myself or disclose them to a minute number of people, but I feel like the silence is almost as bad as the thoughts.  September is suicide awareness month and I feel like if we are more open as a society about these topics there might be less suicides.  Or at least less suffering in silence, because that obviously is not working.  I don’t want any sympathy, I just want to start a dialog.

Anyways, back to the topic at hand. OMG. Pristiq helped me to climb out of the dark hole I thought had become my home.  Almost immediately Leah noticed a change and said that “her wife was back.”  I jokingly said to her on our road trip, “Aren’t you glad that bitch Serzone did not come on vacation with you?”  This became a running joke.  I was able to actually enjoy our vacations this summer and to manage a low grade depression.  Pristiq does have some drawbacks, like any antidepressant.  I have to stay on top of checking my blood pressure because it’s in the same family as Cymbalta, which made my blood pressure to sky rocket to stroke level numbers over two years ago. So far it’s only been slightly elevated.

During my three week follow up with my psychiatrist I noticed that I had only one suicidal thought in the past three weeks and how different that felt.  It felt pretty amazing.  I was beginning to feel good!  After our trip to Seattle in July (another vacation where I came back feeling rested instead of triggered) I decided that I would keep steadily taking classes towards my goal of eventually getting my Master’s in Occupational Therapy. I cannot take any of my classes consecutively, so I could only take Chemistry for the fall semester. Because of my class load (and the need for more income) Leah and I decided that I would also start interviewing for ¾ time to full time jobs.  I found an awesome job that I love that also gives me some freedom to continue therapy and taking classes.

With my meds situated, a new job, and a renewed goal of working on my masters degree I was feeling pretty good.  I felt like things were falling into place.  Fast forward to almost a month at my new job and three weeks into taking Chemistry.  I was going to work 5 days a week and spending 6 hours at school every Saturday.  My free time consisted of homework, studying and relearning algebra, laundry and fitting in time with my wife.  Leah was helping out a lot with stuff around the house, which I really appreciated.  I’ve noticed that school brings out my perfectionist side in a real and problematic way. As therapy has become more intensive with the start of EMDR (Eye movement Desentization and reprocessing) and delving more into my past I’ve been struggling again. Last week was a rough week and Leah and I came to the decision that it would be best for me to drop chemistry and try again at a later date.  It was a hard decision for me to come to because my critical voice tells me that I’m quitting and a disappointment.  At another time in my life I probably would have pushed myself to continue with school, a new job, and intensive therapy.  Now I am able to realize that pushing myself to continue to do all these things together will not end well and may ultimately be catastrophic.

Sometimes self care means putting things on hold and making hard decisions. I’m starting to learn that and hopefully it will get easier to make these decisions and not be so hard on myself.

For more information about EMDR go to http://www.emdr.com/what-is-emdr/

Project Semicolon http://www.projectsemicolon.org/our-history.html

by krubesch

I Miss Your Face

 

Rivers And Roads
The Head and The Heart

A year from now we’ll all be gone
All our friends will move away
And they’re goin’ to better places
But our friends will be gone away

Nothin’ is as it has been
And I miss your face like hell
And I guess it’s just as well
But I miss your face like hell

Been talkin’ ’bout the way things change
And my family lives in a different state
If you don’t know what to make of this
Then we will not relate
So if you don’t know what to make of this
Then we will not relate

Rivers and roads
Rivers and roads
Rivers ’til I reach you

The 22nd marks a year since my grandmother passed and a month since Patrick’s death. Two people who meant a lot to me.  I tried to write about Patrick several times before his death (I have three unpublished drafts), but I was unable to let myself go there.  Thinking about the situation too much made it difficult for me to do what was needed and to not be a blubbering mess around him.  Now I’m just a blubbering mess without him.

I spent so much time with him and thinking about him on an everyday basis that I feel lost now, without a purpose. I have this nagging feeling that something is missing. It feels like I don’t know what I’m supposed to be doing at any given time.   I find myself feeling like I should be getting Patrick’s pills ready to go into his pudding at 2:30pm everyday, but then I remember.  I don’t need to look at the camera on my phone when I’m not with him.  When I’m cooking at home I wonder if Patrick would eat what I am cooking and then I remember.  I find myself crying at the weirdest times, usually when I’m driving in the car.  I know it’s better this way, I know he is no longer suffering and Susan can start to regain her freedom to come and go as she pleases.  She no longer has to worry about getting up early in the morning to get him taken care of.  She does not have to watch her husband slip away from her anymore. He is at peace.

I miss him anyways. I start to wonder what I miss because he has not been the man I met for awhile now. I miss the simple things like watching tv with him, or cutting his hair, even wiping his mouth.  It’s weird to go from hoping that Patrick will be at peace (essentially die) to wanting him back.  Wanting life to remain the same, I hate change.  I lost a very good friend and my job in same day. This sadness, or grief feels so selfish, which then makes me critical of myself and my feelings.  He was not my father or my husband.  When I let myself feel my emotions, I worry about the backlash of depression.  Sadness and depression feel so similar that I’m afraid I can’t feel one without the other consuming me.

I feel like our jobs define who we are (at least in the USA).  What is the first question you ask someone when you meet them? What do you do? It’s not how we make a living, it’s who we are.  My past several jobs have defined who I am or at least were the center of my life. For a year and a half I spent more time with Patrick than my wife. I knew the subtleties of his expressions, if our day was going to be difficult from the shakiness of his hands, I knew if he was with me by looking in his eyes. I learned to anticipate his and Susan’s needs (at least those that I could meet).  I knew I ran the risk of being heart broken by connecting with Patrick instead of treating this like just a job.   I understand now why hospice aid’s and nurses seem a bit detached, they have to be or they’d have their hearts broken over and over.  I did not know how hard his death would hit me.  Logically I knew what the deal was: I was going to help Susan care for Patrick until his death.  I wholeheartedly agreed to having my heart broken.

Now I have to figure out where I go from here and how to get there.  When people ask me what I want to do now the answer is still the same: take care of Patrick.  Maybe at this point I have to be ok with not knowing and not wanting.  I am grateful for the relationships I have made because of Patrick (Susan and ALL the Doc’s), that and Leah are what keeps propelling me forward and out of bed in the morning. I have to believe that I will find my purpose again otherwise the darkness wins.

 

by krubesch

Dark Companion

My November Guest

My Sorrow, when she’s here with me,
Thinks these dark days of autumn rain
Are beautiful as days can be;
She loves the bare, the withered tree;
She walked the sodden pasture lane.

Her pleasure will not let me stay.
She talks and I am fain to list;
She’s glad the birds are gone away.
She’s glad her worsted simple gray
Is silver now with clinging mist.

The desolate, deserted trees.
The faded earth, the heavy sky.
The beauties she so truly sees.
She thinks I have no eye for these.
And vexes me for reason why.

Not yesterday I learned to know
The love of bare November days
Before the coming of the snow.
But it were vain to tell her so.
And they are better for her praise.

Robert Frost

A friend recently gave me a copy of this poem as a different way of thinking about my depression.  I’ve been struggling with my dark companion since August (this most recent bout of depression) and maybe thinking about depression as something to be managed, something that is always going to be there, that embracing it instead of fighting it is a better way.   After all, it’s obviously going to be a regular part of my life as it has been the past 33 years.  Trying to push it away just tires me out and the depression has a way of pushing back even harder.

My therapist recently suggested that I find someone who has experience with EMDR because I’ve been having a lot of difficulty talking in therapy and that maybe switching tracts will help me find some relief.  Unlike me (have I ever been described as enthusiastic?!), I was enthusiastic about this suggestion and have spent many hours looking up therapists who have EMDR experience and cross checking them with my insurance company. Also doing my research with finding reviews, websites, and general information about each one.  I thought the hardest part of this search would be getting the nerve to contact strangers I’ve never met with the goal of exposing myself in the most vulnerable way, but I was wrong.  Apparently finding someone  who takes insurance and is currently accepting new patients is the biggest obstacle.  That’s if they even return my phone call.

 Most therapists seem to not accept insurance at all or are completely full. My psychiatrist even slipped up by informing me that most of the good ones do not take insurance.  That would be fine and dandy if we had any disposable income- I’d even get over my guilt of spending large amounts of money on myself, but it’s just not there.  One friend suggested I just get a credit card and go into debt- I should be willing to do this for myself.  The thing is my anxiety is triggered by being financially irresponsible and spending money I simply don’t have.  The idea makes me feel ill and brings up a lot of what ifs?  I understand that insurance companies can be a pain in the ass, but most people who need these services cannot afford to pay for them out of pocket.  There is research that supports the idea that those with mental health issues make less money and have trouble maintaining a steady job or a high stress job (which usually pay more) because of those issues.  I’m wondering who are these people who can afford $100-$400 a session? Usually these sessions have to be weekly.  That would be an extra $400-$1,600 a month.

It’s really frustrating because I feel like I’m at the point where something has to give.  I’m trying to tread water here and my arms are getting tired.