Thursday, April 9, 2015

Snap.

For the past three years, I've been able to rely on the knowledge that my darkest and most hopeless days were caused by my hormones, and there was some comfort in the knowing that the worst brain nausea and suicidal thoughts would go away.  Even when I felt like it was impossible that I could ever feel different than I felt at those moments, (and sometimes that I ever felt different than I did in those moments), someone else could tell me, "You don't feel this way all the time.  This will pass.  You will feel better."

So, at the bottom of that metaphorical well, I sat and waited; I waited for relief.  I was promised relief would come.  It was a promise made by people who loved me, and by doctors.  It was a promise that came from the tiny little shadow of me inside that knew, just knew that end wasn't it for me.

Yet, there were times where I wrecked myself, by giving myself time limits and expectations for a sparkling recovery.  Yes, I'd rise up into the sunshine, and for 12 days I'd be all the Joanna I could be.  Of course I wanted to feel that way.  That made it worse, when it didn't happen.  I learned to just accept the solace of knowing I would stop wanting to be dead for 12 days. Baby steps.  

I always wondered if anyone could really help me.  They sure as Hell tried.  They want me to want more, need more, hope more, see sunshine and light.  They want me to live, not just not be dead.  I even started to have expectations for more.  Dr. A said, "You have a right to be alive, Joanna."  I wanted to be alive.  I didn't want to just not want to disappear.  I want to be alive.  I want to be alive.

But here's the thing:  PMDD sucks bananas, and, depression is tricky business, I tell you.  So tricky, for the past week, it stealthily moved through me, weaving in and out, leaving traces of self-doubt, anxiety, sadness, then numbness, and then finally, despair.  The thing is, I'm not technically luteal, so what is this thing?  How can this be?  There is no, "you don't feel this way all the time," solace.  And so I now fell upon despondency.  If I can't rely on any kind of hope for relief; if I can't rely on a promise; if no one can even tell me, "this will pass"--with a calendar and pattern to prove it--and not just, "the doctors will figure out how to help you,"  than I am lost.

I snapped, you know?  I am fully lost.  I don't believe any of it anything anymore.  I can't believe in anything. I can't believe in anything.
I can't believe in anything.

For two days I have been thinking about every way I could die.  I believe in that.  I believe being dead would mean I wouldn't feel anything, and I wouldn't be messing up other peoples' lives.  Last night my only reservation about the best way to get the job done--Sam wrapping his hands around my neck and squeezing--was that Sam would go to jail (the authorities wouldn't believe I begged him to do it, I figure) and that's no good.  I believed in that.  Sam didn't.  He didn't believe that was a good idea.

I know I have children!  I have responsibility to them, even if I don't care about myself.  So I try to think, think, think, what could this be?  Is it expectations from other people that tipped me over?  I don't know.  I know that my medications were changed, and this would be when I would see if it helped or... not. It did not.  But I can't feel hope in that, just more defeated.  

I guess I can still write.  Look at me, I'm writing! I can write when I'm pretty fucked up.  

Go back to my old medication?  I did that today.  I was told to do that today, a higher dose.  Will that help?

I think it has been a long time coming, but I've been afraid of the idea of truly being hospitalized for mental illness.  The thing is, I know, and I should have remembered, that no one can help someone who is severely mentally ill, unless they're a doctor.  I've seen this.  I know it.  No matter how much loved ones want to help, they just can't.  And the trying, and believing they can, rips them apart.

I don't think anyone is strong enough to take someone else's health on their shoulders, when there are feelings involved.  It is human nature to protect oneself from imminent danger.  Loving someone who is crazy is painful and dangerous.  I've seen my father become a shell of himself, trying and trying...  I won't do that to anyone.  I've been on the other side!  I've tried to take care of everyone, all the problems, fix all the things, and maybe that's why I'm fucking crazy now. Who knows...  I do know doctors are trained, and paid to treat illnesses of every kind, and all levels of severity.  And depression can be terminal.  And terminal patients require constant care.

I've seen something else too... I've seen what happens when everyone thinks they can help, but in doing so, no one does anything.  I'm sorry mom.  I'm sorry.  I know I can't do nothing... because I have children... and rocking for hours with my arms wrapped around my knees whispering, "Kill me, please, kill me, please, kill me, please..." will scare the living daylights out of them.  Mommies don't do shit like that.  Mommies can go to the hospital when they are sick.  Kids can understand that.
***
Later that day...
I saw Dr. A this afternoon.  He fit me in for an emergency appointment.  He said, "You told me I've never seen you when you were really feeling terrible, but I'm seeing it now."  He told me it would go away.  I told him I was scared it wouldn't, because this psychological breakdown wasn't on my calendar.  He said I had better fix my calendar.   And, I did.  I started in January when I started Yasmin, counting the days from the first appropriate point.  I counted off 12 day increments and marked them.  I then went back and counted off 14 day increments and marked them.  I've always had a 24 day cycle, but 28 day cycles are what most OCPs force the body into.  In both scenarios, I would be luteal now.  I thought I had just snapped back to pre-pill pmdd.  Maybe I didn't go right back to that, exactly.  So... my luteal phase would have started on between April 1st and April 4th.  One of those days.  And here I am.  Is that good?  Should I believe, again?  I feel too horrible to think about it, for now.  Maybe later.



Monday, March 30, 2015

ADDEFGHIJKLMNOPMDDPTSD.

If you feel compelled to be an active participant in your healthcare and treatment, you probably want to know what the Heck doctors are prescribing you and what the Hell it will do to you.  And, you probably have done a lot of medical-related internet research.  I have.  I read message boards where patients talk to each other, and some that include medical professional in the discussion.  I have read articles, and books.  I have collected studies and trials and read the reports.  I research from every angle.  

I have found a treatment through buried archives of trials, that is just barely mentioned by national sites dedicated to the treatment of PMDD (if at all), which show 80% success rates when administered.  It's just not labeled by the FDA, so you will never hear about it unless you dig in real deep and you ask.  Now, that doesn't mean it will work for me.  I was just surprised to that I hadn't heard about it before.  I actually found it because it kept coming up as a treatment for hormonal acne, and I kept thinking that hormonal acne usually comes with PMS, so maybe they could be treated... the same?  I don't know...  But I was right...
Spironolactone.

Actually, when I asked about Spironolactone as a possibility, the resident doctor (to be referred to as doctor lady) seemed confused and said it wasn't a common treatment for PMDD, and She instead suggested that what I had was MDD, exacerbated by the menstrual cycle, and if SSRIs weren't working, I needed to be referred by to my psychiatrist.  I said, "No.  Nope."  She then said if I did have PMDD, what they would have to do is induce menopause with the medication Lupron.  (My research showed Lupron could be potentially, extremely dangerous).  I was in a luteal state, but I did calmly listen to this ridiculously drastic first line of treatment, which she also told me was very bad in many ways-- Induced menopause that is.

I stared blankly at her, at best.  Sam said as she was talking, he was thinking, "Oh, shit.  This is not going to go well for this doctor lady."  But I was tired, you know.   I just looked at her, and said, "No.  Nope.  That's not what has to be done.  Nope."  She then seemed nervous and went to get the real Doctor, not a resident Doctor (you may take offense, student doctors. I'm just saying it how it is).  The experienced, fully educated doctor knew about spironolactone as a treatment and talked about Yasmin having similar components as Spironolactone.  First, and most important, she came in with a look on her face that said, "I know you feel horrible and I want to help," which is not the look I got from "doctor lady."  She said it's difficult to treat, and we really ought to try Yasmin, if I was willing. I was willing to try a treatment suggested by an experienced doctor. She didn't look overly hopeful, and wasn't even encouraging, completely.  She did say, "I'm so sorry you are suffering from this, and I hope this first try works for us.  It has worked for some of my patients." 

Yasmin is approved as being a successful treatment option for PMDD, I hadn't tried it yet, and so that's what I was prescribed.   Yasmin is a birth control pill, and Spironolactone is actually considered a diuretic.  I don't need birth control, although I was on ortho-tricyclen in the past, which seemed to jive with my body okay.  But... it didn't stop the onset of PMDD... that pain train was already full speed on the tracks to this body.  So how does any of that make any sense?  Birth control to regulate hormones: I get that part.  BC pill similar to a diuretic?  What?  


The difference between Yasmin and the other birth control pills on the market is that drospirenone is unlike other progestins that have been available in bc pills. Drospirenone is a close chemical cousin of spironolactone (ALDACTONE),  that causes the body to retain potassium. Spironolactone is known as a potassium sparing diuretic, and because of its diuretic properties Drospirenone can increase potassium to a dangerous level if not properly monitored.   Dangerous means it can kill ya and stuff.  I didn't know that.  

Yasmin.
But I didn't have many options.  I wanted something to work.  I saw doctors who were focusing in on PMDD and not the whole shitshow that is my brain, and I wanted them to help me.  I took the Yasmin.  It wasn't good.  It just didn't go well.  As I've written in the past, PMDD for me was clockwork.  Here's a clear picture of the first day, through texts to Sam:   
3:45
Hi
"Hey, what's up?"

Nothing.  Just saying hi.  Trying not to crash.

"I feel ya
You have not been able to sleep well"

That's true.

4:15
I am crashing.  Brain nausea. 

Body temp seems to rise.  My head and face feel hot. 

I start to detach, go numb, I feel sick to my stomach, then...

... I feel agitated, like I've lost something very important, or missed a critical deadline...
Shaky.  

 It is so drastic.  So intense it doesn't seem real.  I feel like I should be able to wipe it off my skin, like it's just on the surface.

But it's inside me.  And I know that, too. 

Just putting sour cream into a bowl feels like a struggle.  When the kids ask me for something, I feel like I'm going to cry, throw up.  I feel numb, like my hands aren't attached to my body.
I put all the clothes on the bed, to put away.  Now I want to scream at my earlier-today-self, "what were you thinking!?  You never finish anything and now you're trapped. It's everywhere, stuff is everywhere, and I can't make it go away.  

I could open the door, throw them out onto the deck and not care.  I could pretend they never existed.  

Then I want to not exist.  Now I'm staring at this phone, not seeing words I'm typing, and just knowing when I put it down, I'll go even more blank and numb.  Stare at nothing.  See nothing.  I don't feel anything.  But I know I'm scared. 

The "change" always started around 3:30-4:00 pm.  It was marked and disturbing.  It even got worse at the evening progressed.  I might have "hallucinations," a panic attack, or crazy brain nausea that left me laying on the floor crying... But I knew what was coming.  My crazy was a scheduled crazy.  It was reliable. When I started Yamin, I went from at least knowing what was coming at me, to a fluky freak show.  Yes, I'm used to feeling terrible--being in a bad way, still trying to function--so I could handle it.  I've been doing it for five years.  And, the Yasmin didn't cause a new feeling of depression, it was just the same...  It just bothered me more because it was not happening on a schedule that I could rely on.  I then began to realize I was feeling pretty damn bad most days of the entire months, with no relief.  I did some crazy things while taking that pill that I don't want to write about in detail.  I'll just say, The Night of Scissors and Fire.

Despite all that, I stayed on Yasmin, to give it the time the doctors said it might take to start "working." Then I had to stop it.  I had to.  It felt worse than ever.  I was scared it would make me stuck that way if I took it too long.  

It didn't stick.  After being off Yasmin for about 10 days, now, I'm so back on track--the crazy track, but I know where it's taking me, and when.  I have a little itinerary.  9:00 am:  Wake up groggy and body aches.  10:00-3:30:  Get stuff done, or your entire day is toast!  3:30-9:00 pm:  See above.  And all that lasts for twelve days, and then I feel more like myself again.  

You know, I have been diagnosed with ADD, PMDD, MDD (Major Depressive Disorder)--some people tell me I have PTSD--but I can handle all of it, if I know what to expect.  I research the heck out of everything I can find related to my special-psycho-alphabet.  I want to know.  I want to know as much as I can.  

So, this was a boring post, but sometimes I feel like I'm so damn smart, I ought to tell you actual stuff, and not just my feelings.  If you have PMDD, I really wouldn't recommend Yasmin unless you are married to a firefighter and live in a padded house with no sharp objects... anywhere...