So, I've been busy as hell...Trying to keep this train on the tracks, you know?

Gone up on some of my medications (Lamictal and Seroquel) and might have to switch antidepressants soon. I think the mood stabilisers are doing a decent job, but I don't feel better, if you know what I mean. So I think something has to give. Hopefully I can expect more, eh?

Today I went to my first DBT pre-treatment appointment. I think there will be a couple more before the program starts on the 19th. I'm not yet as freaked out as I could be, so I guess that's something. The woman whose name I can't remember was pretty cool...Even though I had to rehash everything right from the beginning up until recently, which is always a pain in the ass, but still, she was OK. It's a nice change from people who don't know their ass from their elbow or people who've never had a bad day. Urgh. Anyway, this DBT thing is a year long course of therapy...One full day a week for a year. Looking forward to it? No. Interested? A tad. I think the biggest thing is I'm quite literally at the end of my rope. I can't do this anymore, you know? I feel like this is just about all I have left in me....So, one last ditch effort, and all that.

Still not sure about admission. I'm going to wait until exams are over before anything definite happens, and I also have to (preferably) wait for two months or so until our new health cover kicks in. We've pretty much always had private health insurance, but I'm kind of at the point where I need better care (God, I even hate typing that) and if I have to pay through the nose for it, then so be it. You have to do what you have to do, right? It's like I'm haemorrhaging money over here, but still. A couple of months and then Medicare will kick in to take some of the weight off. I think everything I've spent so far can be reimbursed, so it's not so bad, but when you watch the numbers adding up it makes one's blood run cold. But yeah, so I'm going to hold off, if I can, to decided whether admission would be a decent idea...I mean, if I end up changing medications, I'd much prefer to be doing that in a decent environment because the medication I'm on (Lovan) has a really long half-life and you have to wait til it's all out of your system before moving to something else, so you have to taper down and then have a week or so free of the antidepressant so you're clear to start something else. I'm not looking especially forward to trying to work something like that out of my system, but surely I can expect more than this.

So yeah. Uni's just about done for the semester, so all of this couldn't have come at a better time. I've done my exam for Language, Brain and Mind, which did not go swimmingly, and still have a paper to write for Corpus Linguistics and a take-home exam for Modern Irish Literature. Pretty chuffed that we get that last one for a week, so that should take the heat off a bit. It's just two 1000 word essays ;) can't complain about that. The Corpus paper isn't going to be much fun, though, so I guess that kind of makes up for it.

Hope you guys are faring much better than I am xx

So, it's not "yesterday" as such (see previous entry for context), but here I am nonetheless. 

I met with my new psychiatrist (just typing that makes me feel crazy) on Wednesday and had what felt like a billion hour conversation. All of the background stuff, etc, etc...Pretty much talked about everything that has ever happened in my life. I hate that stuff. Anyway, long story short, he agrees with the diagnosis of Major Depressive Disorder (MDD, AKA Melancholic Depression), and said that he was running through a list of symptoms and behaviours in his head as we were talking and thought that Borderline Personality Disorder fit the bill also.

I'm not so sure how I feel about this new label. Not that it doesn't fit stupidly well: Chronic sense of emptiness and distance, alternating between idealising and demonising significant people in one's life i.e. unstable interpersonal relationships, treating one's body particularly badly for no real reason, unstable self-image, impulsivity....The list goes on for quite a long way and it does, objectively, make a lot of sense. I really have always felt different from other people (not that I know how other people feel, of course), and have kind of always thought that my emotions -- such as they are -- are different, or appear different from those of other people...For example, I'm not now, nor have I ever been, a terribly empathetic person...Which makes me sound awful...But over time I have managed to learn appropriate social responses and have learned how to behave empathetically. Which makes me sound like a sociopath, lol, which I'm fairly sure I'm not. I've just never felt particularly close to many people, always kind of felt like a bit of an outsider for no real reason...It's not like I've ever behaved in a peculiar way to distance myself from other people, it's just that I've never really felt like I fit in. Like I'm kind of an impostor...I can behave the right way and I can say the right things, but I don't know that they come from a genuine place. Which also makes me sound like an asshole...Which sometimes I am because I'm not always affected by things that other people do or say. Or feel. 

Wow. This is turning into a weird, windy and polluted stream of thought. Let's end that, shall we?

Anyway, my new doctor (whose first name is Clayton, believe it or not) has suggested that I do a year course of Dialectical Behavioural Therapy (DBT) in both individual and group settings. Again, makes me feel crazier than I am. Fuck, I hate group therapy...I always have. I never know what to do or say. There's no manual for how one should behave in those situations. Anyway, I may be mistaken, but to me, judging by what I've read recently, DBT sounds like an emotional shock-collar. No, you can't do or say this or that because it's not how other people behave. I'm not a child and I don't really need to be treated like one. But, I guess if this thing is going to be at all useful, it's going to help with how I conduct myself in relationships (I have a stunningly bad track record here...They're going to leave you anyway so take control and make them hate you. Healthy) because at this rate I'm never going to be emotionally equipped to be someone's partner and/or, eventually, someone's parent. And I can't stand the thought of destroying my own family.

As I'm sure you can see that I'm vacillating between this being a decent diagnosis and it being a misguided one. I don't really know how to feel or what to think about the whole thing...I don't know what I should do or should be doing. I don't know much about much right now.

Also I started on a new medication called Lamictal. It's primarily used as an anticonvulsant to treat epileptics, but it's off-label use is as a mood stabiliser. The off-label thing means it's not covered by the PBS and therefore it's stupidly expensive. Anyway, not much in the way of side effects right now save for stunning headaches and the weirdest, most vivid dreams I think I've ever had. The doctor said it should help me sleep, too, but no evidence of that so far. As the dose increases there will probably be cognitive difficulties like memory problems, slowed thinking (good for the racing thoughts, but not good for productivity), lack of focus etc etc. This is lovingly known as "The Stupids". I'm not looking forward to that. Anyway, I'm going to give this whole thing one good, proper try. I guess I owe myself that much.

Hope you all are well xox

Holy crap, I've been busy, lol.

Finished that 1000 word assignment and managed to hand it in (only a day late) and I handed in my 2000 word paper for Modern Irish Literature today. So busy. And so exhausted.

Really haven't had much time to sit lately, just so busy with uni and appointments here and there.

Got an appointment tomorrow morning with a private psychiatrist. Oh, what a treat *sarcasm*. He comes highly recommended by my doctor who referred me, so I feel alright about that, but the whole thing is so expensive. Seriously, I might as well become a shrink myself...This guy is $350 per hour. Thanks God for medicare, which should take care of about 2/3 of the cost. Eventually. I'm not happy about how this is going to eat into my savings, either, but I guess that's what that money is there for. Urgh. One session with this guy costs more than my stupidly expensive new coat...Which I haven't even been able to wear yet...OK, no more talking about the money. It's starting to make me feel nauseous.

I really haven't been up to much else...

I saw Henry Rollins talk on stage for three hours on Friday :) He's too good, really. Extremely intelligent and hilarious. I can't believe I don't have a single one of his books...Should rectify this ASAP. And Saturday, even though I should have been working on my essay/studying, my brother and I went with our dad on a ghost tour. Hurrah. Much walking, interesting stories, weird as hell tour guide, but all in all, not that bad.

Anyway, just a quick update to let you all know I'm still here, lol, and I'll probably let you know how everything goes tomorrow...Woo.

Good thing I never expected my life to be easy or straight-forward.

Going back to my doctor today for a referral to a private psychiatrist (so I don't have to keep going back and forth from GP to shrink) and/or for a referral to a private hospital. 

I've been dealing with these really rapid, stupidly intense mood swings. I go from feeling crap but functional and stable to feeling desperately bad in minutes. All day is like this. I don't have any mania, which is good, but it would be nice to break up the picture a bit, lol. It's becoming increasingly clear that my medication isn't working and shit's been all fucked up since I had to take the five day course of Zyprexa. I've never had mood swings like this before and I'm struggling.

I have assignments due this week which I haven't done. I have readings to do which I can't sit still long enough to do. It's all of a sudden so hard to focus on a thought or a conversation...It takes so much effort to connect thoughts together to make them seem logical when they come out of my mouth...Which makes me seem like a crazy person, lol. 

I know I don't have to sort everything out right this minute and things will be fine once I have a proper plan in place, but I feel like I'm at a loose end and I don't know what to do. I keep sitting with this assignment and it's making me crazy, knowing that if I was feeling alright I'd have had it done, from scratch, yesterday, ready to hand in today. It's only 1000 words, for fuck's sake.

I wish I didn't feel so erratic and disorganised. I'm not used to that. I don't like how unpredictable this whole thing has become. I wish I could just get something done. It's going to be a long and interesting day.

I'll keep you guys updated as to what happens next xx

Ladies and gents, it's been a rough couple of weeks. And an even worse few days. Everything's OK(ish), though, so don't worry too much.

My mood has taken a pretty serious downward turn over the past fortnight or so and over the last week or so it's gotten much worse. The day before yesterday was not a highlight for me. Long story short, without going into all of the crazy details, my mum made an emergency doctor's appointment and I've been prescribed a five day course of Zyprexa. My dose of SSRIs has been upped again from 40 mg to 60. According to my doctor, that's quite high. According to the doctor I saw at the Black Dog Institute, 40-60 mg is fairly common. I'm not super worried about it.

Hilariously enough, I'm not super worried about anything right now.

Yesterday morning was rough as hell. Or early afternoon, rather, because I slept all the way through the morning, lol. I got up and shambled around the place like a zombie and when I spoke it felt and sounded like I drunk person trying to appear sober. Very precise and slow. That all went back to normal a little later with the application of time, sugar and caffeine. This morning the effects weren't so bad, though I did fall over once. 

Thos couldn't happen at a worse time, though. I have so much stuff due for uni, it's not even funny. Group work, readings, essays, the whole nine. I feel like I'm not learning or achieving anything. I was so sure that I was going to wind up in a hospital a couple of days ago...I just couldn't keep it together. All I could think about was maybe having to defer this semester and wind up doing something part time. I hate thinking like that, but I hate even more that the longer this goes on and the worse it gets, the more that this full-on stuff -- these "solutions" -- are on the horizon...Hospitalisation, more/different drugs, more therapy, EC, etc etc etc...This is not fun for me.

And the longer it goes on, the less I feel inclined to continue. I don't want my whole life to be like this. I mean, I don't want it to be dead easy and cruisy, of course, I don't have that expectation, but it surely can't be like this forever. I don't want to end up being some horribly damaged person who's unable to live independently or have any semblance of a proper, adult life. I feel like I'm going to be trapped inside this illness forever.

Anyway. I'm glad I'm not going to be on the Zyprexa forever because it has some fucked up side effects; inability to regulate and maintain body temperature, sensitivity to sunlight, massive weight gain, etc, etc, etc. I'm just not interested. I mean, I know that my meds may have to be augmented with an antipsychotic at some point, but I have no interest in something that's going to make me stack on weight. I know it sounds shallow in the face of everything else I'm dealing with right now, but I'd rather be crazy than fat.

Urgh, whatever. Hope you guys are doing better than I am xox

So, because I'm lucky, I've been having a few blood tests done alongside taking medication and going through therapy so the doctors can be sure that what I'm dealing with is indeed a mood disorder and not something that looks like a mood disorder but isn't.

Originally, my doctor got me to have a regular blood test, nothing fancy, just to check if there were any deficiencies I had that could have caused or played a part in my depression (I'm sure I've said this already, so I'll condense as much as I can), so got the results back and found that there was something off about my thyroid function. Now, they measure three things and one is the hormone that the brain produces which tells the thyroid what to do and the lowest level in the normal range is 0.35. For this test, mine was 0.01. The other two things on the test were perfectly fine. Naturally Dr Moppet wanted me to have another test done, the results of which I got back today, and this number rose a tiny bot to 0.09, but it's still too low to be completely fine. Again, everything else is in the normal range. So, tomorrow morning I'm having another (!!!) test done that will measure, among other things, the levels of cortisol in my system. Now, unbeknownst to me until today, cortisol levels fluctuate during the day and naturally they want to get the best reading for the test, right? So, I have to have this blood test done BEFORE 9 am! My eyes are just opening between 10 and 11 ack-emma, and tomorrow I have to be out of bed, with clothes on and be heading out the door at about 8:30 or so, so I'm at the path lab as early as is possible (not as early as is convenient, lol) so everything will be right for the test. At least I'll get some coffee.

Now, the reason I'm having this test done is because they think it might not necessarily be my thyroid after all. Judging by the results of the last two tests, and because everything else was perfectly fine, the doctor has reason to believe that the problem may be autoimmune, not hormonal, so tomorrow I'm being tested for a slew of autoimmune diseases including, but not limited to, Lupus and Hashimoto's. I immediately thought of House, "It's never Lupus." Both of these diseases can affect a person neurologically, that is, can cause problems like mood or (sometimes) personality disorders. My depression may actually be caused by something other than bodgy brain chemistry...It might not be, lol, of course, and everything might be the same, just with a new illness to deal with, but this might be fixable. I'm not counting my chickens, but who knows? I don't know how I'd feel if the depression could be explained away, either...I'm not sure who I really am without it, I've been dealing with it on and off for so long (episodic...Like Lupus ;)).

Anyway, that's about that. Not much else has been happening, more than anything else I've just been making and keeping appointments, lol. The Dr Moppet suggested that this could be my new hobby. I told him the tests are just a ruse, I'm actually planning to open my own pathology lab and I just like to steal the vacutainers ;)

Hope you're all well xox

So, I had that assessment this morning...At 8:45. I was awake at 7 am. Now, I know to a lot of perfectly civilised people out there, that's actually not that early, but for someone who often isn't awake until 11 and certainly isn't out of bed at that time, seven o'clock might as well have been 4 am or something.

We left in plenty of time, had Macca's for breakfast (a rare treat) and headed over  to Randwick (in peak hour...gawd) to the Prince of Wales hospital where the Black Dog Institute is and waited around a bit to be brought upstairs by a disturbingly chirpy research assistant. It struck me as odd to see a chipper person in a mood disorders clinic, lol. Anyway, she asked me a bunch of questions regarding the last two weeks or so of this episode and then the same questions regarding my depression since it began. Tedium. We finished up fairly promptly, I went back out to the waiting room and then was called in shortly after that to meet with the doctor whose name is...Wait for it...Dr Friend. Yep. He asked me about an hour and a half's worth of questions about pretty much everything from my childhood and where I grew up to allergies and family history, from suicidal ideation and self-harm to anxieties and phobic behaviours. He quite literally asked me about everything to do with my depression and even some other things I'd never thought of (such as exactly why I don't like public speaking...Not just because I find it vaguely terrifying, but also because I blush easily when I'm embarrassed or stressed and that is, in itself, embarrassing). The doctor went over the online component I did previously as well as the assistant's questions and the paperwork I'd completed beforehand, along with his own notes and the diagnosis from my doctor, and went on to deliver the not-too-bad-news.

The diagnosis I'd received earlier is correct -- melancholic depression -- and the absolute best way to treat it is with medication (physical illness, physical treatment), but my dose isn't high enough, which I'd been beginning to wonder about myself since I'm pretty much only contained, rather than improving, and I feel like I'm hanging on by the absolute skin of my teeth. So, starting tomorrow, I'll be taking two of my antidepressants instead of one and, if there's little or no improvement over the next 3-4 weeks, then I have to go up to three. I also have to be taking 1000 mg of fish oil every day to make sure I'm getting enough Omega-3 which is supposed to affect one's moods. We shall see. The aim is to get me through this episode and to maintain a higher dose of the medication to prevent another one, though I have to tell you, I'm not 100% sure that's entirely possible, but what would I know? I have to give this a proper go, you know? The depression is really interfering with my life, as it does every time it comes around, and I don't feel like I'm as productive or as complete as I ought to be, so before I do anything super drastic, I have to give it a shot. 

Interestingly, along with the depression, the results of this thorough questioning (see: interrogation) heaved up another diagnosis or two; Generalised anxiety disorder (which doesn't tell anyone anything useful, just that I'm a fucking worry-wart) and a panic disorder. The latter is far more pressing when I'm dealing with a depressive episode.

I don't know if I should be glad that there's a proper, sturdy, obvious diagnosis and an appropriate method of treatment, along with future plans, should it all go awry, or confronted and weird because I'm going to be on this medication indefinitely...I mean, sure, I guess it's a decent thing that I'll be able to have a better quality of life, and a longer life, with this kind of treatment, but is that really what I want? Is this more for the benefit of the people around me than for myself? I only went to see Dr Mossop in the first place at my mother's insistence, not of my own volition. To be perfectly frank, and maybe it's the depression talking, so feel free to ignore this, but I'm tired, you know? I'm tired of going through this again and again, and I'm tired of always worrying that the black dog (heh) is going to come back up and drag me arse-first down the abyss. I have hardly any friends; my relationships are pretty much all tenuous for one reason or another and mostly superficial. If I never had to leave the house, I never would, and I have no long term goals or desires. I'm tired of constantly having to fight back the ideation and the hurt and the anger all the time to simply just get through an ordinary day...Something that it appears most other people have almost no trouble with. I don't especially want to live like this. And I'm sure you don't blame me. I doubt that anyone would blame me. But, before I get ahead of myself, and before I let myself spin out of control, I have to keep trying with this. Maybe it'll be alright? 

Anyway, sorry for the long ramble. I think I got away from myself a bit there, lol. And sorry for the drama, too. Totally not my intention to freak anyone out or to draw undue attention to myself, it's just the way I'm feeling right now. And lately. Meh.

Hope you are all doing better than I am x

So, poppets, I'm housesitting for the next few days (because I'm lucky). M and V are going to visit M's parents and they needed, as usual, someone to watch the remaining pup (LuDog) and the cats. So, as I say, here I am until about midmorning on Sunday. No worries.

The medication has settled down to the point where I don't really have to worry about side-effects and things like that (the tremors have settled down, mostly), but now everything's kind of moving into the maintenance phase where it all just falls into place and I'd kind of forgotten about this bit...The real effect of the medication...I have no emotions. My affect is almost completely flat. Sure, there's respite from the crippling depression -- in the fetal position, marinading in my own pain -- and I'm grateful for that, really, but there's just something that's strange about not really feeling anything. I mean, my emotions have never really been up and down, there's not a lot of fluctuation, but there's some movement, you know? For a decent example, I went and saw David Sedaris (got tickets for Christmas) on Monday night, and he was pretty good, told some interesting jokes, cool anecdotes, and I was surrounded by people who were laughing and enjoying themselves, and I had nothing. I understood the jokes, of course, and intellectually I found them amusing, but emotionally I really didn't have a huge connection to his act and I found that more distracting than worrying. Because worry would be an emotion ;)

Had the worst morning...I got a call from my shrink's office telling me my 1:30 appointment got pushed back to 2:30, and they felt that they had to call me to tell me this at some stupid hour of the morning. Before 9, lol. I went back to sleep for an hour or so and I got another call from the Black Dog Institute during which a lady whose name escapes me informed me of what I had to do and what the process was going to be. I have an appointment to go to the institute at 8:45 ack-emma *gags* on February first to meet with another shrink whence I'll complete a total assessment. Urgh. Tiring, time consuming, irritating. There was an online component, too, which I did today before I forgot about it, and there's some paperwork that I had to print out and fill in, which I did too, lest I forget. I'm going to review it when I get home and see if I should redo it, but so far so good. 

Had a long lesson in mindfulness today with my shrink. I've had some experience with mindfulness before, but I've never been too successful with it. Partly because of lack of effort on my part and also because my thoughts sometimes come through really fast and it's hard to stay on top of it all, so it's just easier -- though not smarter -- to just let them take over. So, I'm committing myself to the process and am going to get the hang of this cognition therapy if it kills me. It just might, if all sessions are as irritating as today's, lol. I don't know...I still feel that it's all a bit 'crunchy-granola,' as my mum would say, but the techniques work and there's plenty of evidence to prove it, I just need to accept it and commit to it. Good luck, what?

By and large, I'm doing alright. Not perfect, but I don't need an intervention or anything like that, lol. As I said, I feel flat, but OK. I'm just going to hang in there and see how it all plays out over the next few days. It'll be fine. Surely.

Hoping you all are well xox

So, second appointment with Dr. Moppet was at 3 pm today. He ran late. I was annoyed.

He asked about how I was doing. I hate that question...How are you ever supposed to respond without sounding like a drama queen?! I told him the truth; I feel more composed than I did last week (no tears today, thankfully), but my mood is really, really flat and low overall, and the anxiety is still present all the time. No panic attacks over this week, but being able to feel it all the time really puts the kibosh on one's plans for eating, sleeping and/or going outside, all of which I have to do but currently loathe. But, so far, so good. I am not yet swinging from the rafters, so I'll call it successful for the mo'. 

I saw the shrink last week, too, and will again tomorrow. We talked for a therapist's hour (the irritating and always insufficient 45-55 minutes) about my history with depression (pretty much my whole life) and anxiety (ditto), about previous medications and hospitalisation. Really a fun conversation to be having all at once. Really. I understand that tomorrow we'll be talking about my family. Oh, Lord. This is all groundwork, of course, because the real work will be done with DBT (Dialectical Behaviour Therapy), about which I know almost nothing (djcliche, I'm looking at you for help on this one ;)), but I've got some experience with Cognitive Behaviour Therapy, so hopefully that'll put me in good stead. I will, apparently, need a notebook (purchased) for 'homework'. Now, I don't like doing homework for things I really have to do, like uni, but, I'll do my darndest and try not to get my back up about it all. Rani (the shrink) wanted me to get a referral for an assessment at The Black Dog Institute (http://www.blackdoginstitute.org.au/), an Australian institute that studies and helps to treat and provide support for people who deal with depression and bipolar disorder. I think the whole idea about this assessment is to get some more information for Rani, but also to provide a second opinion and to recommend further treatment. I don't like doing those assessment things (I've done one or two in the past ;)) because I find it hard to name my emotions...Or have many, lol. I hate but can name extreme emotions, but not your more average, everyday ones; to me they're 'fine' and 'flat' and 'OK', but none of that really tells anyone anything.

So for now, that's about it. I really haven't been doing much else. I'm grateful that I feel less completely shattered than I did because that's almost impossible to deal with long term, but I'm still trying to figure out what I have to do about this thing in the longer term because melancholic depression (my diagnonsense) is more biologically based and so needs a biological treatment -- like medication -- rather than therapy. So I kind of feel like the therapy is a bit pointless, but I guess that's more to do with my previous experience with it when I was in high school...I pretty much just played along because I wanted the treatment to end. I endeavour to make a more concerted effort this time, but my hopes still aren't radically high because I don't really feel like there's much to be spoken about...Addictions and control issues aside, of course. 

I hope this all made sense, lol. Turned into a bit of a vent there, I think. I hope you guys are all doing well and thanks to those of you who sent me kind words and words of advice xx