![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Nadezda on September 28, 2008, at 22:59:52
but instead it fluctuates all over the place and it's awfully hard to feel that I can be optimistic-- or can do things-- when from moment to moment, I fall into discouragement or anxiety pushes everything else away.
Sometimes I feel as if it's the medication-- but I think I recall that I was more or less constantly shifting and unreliable even before that. So it's probably some condition of mine, though the medication.
I was in a really good mood this afternoon-- and even though my work didn't go well in the literal sense, I felt excited and as if I was learning something. I had energy and could take more risks, rather than just following a kind of tired logic in the way I was thinking and seeing.
That doesn't happen too often. I really want it to. I was looking through an old book and found a note a wrote about thinking positive thoughts and doing things. I have no idea when I wrote it, but the other written things on the page were very old-- which made me think that I keep on having this idea and never following through with it.
It's hard to stay with a commitment, especially to be optimistic, when your moods are so up and down and you're shaky for hours, and then maybe better for a while, or vice versa.
My T is away for another week at least, which is unfortunate because I thought we were making progress before he left-- last week-- and who knows where I'll be by the time he gets back.
Nadezda
Posted by obsidian on September 28, 2008, at 23:44:14
In reply to I wish my state of mind were more stable, posted by Nadezda on September 28, 2008, at 22:59:52
yeah, me too
and I sometimes think I'd be better off without the meds
but then I remember long stretches of time when I wasn't feeling well sort of chronically, and I think how the hell did I get through that?
currently I'd like to hide under a rock, and oh, how I wish this was an option.The things I aspire to though, they don't change all that much. I find though at different times it is harder for me to cope with just the very basic things. Self care goes out the window (unless you call spacing out self care).
I hope you have more comfortable moments :-)
-sid
Posted by Sigismund on September 29, 2008, at 3:09:36
In reply to Re: I wish my state of mind were more stable » Nadezda, posted by obsidian on September 28, 2008, at 23:44:14
So procrastination and anticipatory anhedonia?
A commitment to be optimistic is out of my league.
I feel so much better when I do the things I can, certainly.I'll give you an example...
I have to do this whipper snippering.
I have the whipper snipper.
It stopped working once while I was using it.
So, instead of checking it out, I will buy a new one so I don't have to do that, except that I have put that off too.
The new one will cost most of a thousand dollars.
For *some* reason, the thought of having to work out what is wrong with the machine is terrible.
You tell me why.It's like a complete failure of optimism.
I don't feel that bad about it....I have always been a pessimistic and thoughtful person and am OK with that.
But I would feel so much better if I could still be reflective but not bogged down.
Posted by Dinah on September 29, 2008, at 7:33:35
In reply to I wish my state of mind were more stable, posted by Nadezda on September 28, 2008, at 22:59:52
I feel the same way sometimes. There are days when I get a lot done, and am confident that this will be a new way of life. Then the fog settles over my brain again, and everything grinds to a halt.
I tell my therapist that I have no sense of continuity. That I feel like a different person every day. Or maybe a rotating set of persons. :)
I wish I knew the answer. I too wonder if it's the meds, at least in part. I was way more anxious before I started them, but the leaden feeling wasn't so much a problem.
Posted by Phillipa on September 29, 2008, at 10:59:25
In reply to Re: I wish my state of mind were more stable, posted by Sigismund on September 29, 2008, at 3:09:36
Sigi yep everything is too hard so why do anything. I know what you mean I think. PJ
Posted by Nadezda on September 29, 2008, at 11:03:16
In reply to Re: I wish my state of mind were more stable » Nadezda, posted by obsidian on September 28, 2008, at 23:44:14
I don't think of being off meds, because I remember too well how I was without them. I resisted taking them for most of my life, and I wonder about so many things in the past that went wrong, now. Of course, I can't use SSRIs and I doubt I would have gotten what I have, so maybe it wouldn't have made any difference. But I wouldn't go back.
They don't work completely. And if I forget one, or take a little more of another (my pdoc has given me some leaway), it's throws me into this jittery gloominess. I'm always late, and sometimes forget ( there are so many, at different times of day)--. Then there's sleeping, or not sleeping, which is its own ordeal-- with seroquel I can sleep, but it makes me gain weight, so I don't take it every night. Yeah-- meds in themselves are a strain as well as a godsend.
You say you'd like to hide under a rock. It's pretty dark and cramped there-- I can say from my hiding place. And lonely. And boring and unstimulating. Although nothing devastating ever happens. Sometimes I don't see the sun, or breathe fresh air for days or even weeks. It's not agoraphobia, just loss of desire.
I've been struggling to go to a class-- for the last four months, I sign up every month and don't go. (Luckily they're very inexpensive.) I keep obsessing about it, and talk about it with my T, who is angry that I never have the courage or commitment-- and work myself into a hopeful state, only to freeze at the last minute. The irony is, I have a good locker in the hall (the prime lockers are in the hall) and I think I'm almost signing up not to lose the locker, and to bring the equipment home, and then have to admit failure. I want to be the kind of person who can do this. It would be really awful if I just never could be.
There are the bad months and years, and and better days and times, but what does it add up to? A lot of failures, it seems. I can't figure it out. Is it just to keep my spirits, in my own private fantasy world, up-- to help me pretend that I'm doing something and not just totally worthless?
But I haven't taken all my meds, and maybe those they'll have some effect on this mood.
So, Sid, how are you today? any better than yesterday? or it this sense of self-hatred persisting lately? I know you've mentioned it before-- but I don't know if it's every day now, or only sometimes.
Nadezda
Posted by Nadezda on September 29, 2008, at 11:23:04
In reply to Re: I wish my state of mind were more stable, posted by Sigismund on September 29, 2008, at 3:09:36
You know, it's a mystery why things are so hard, so implacable and overwhelming, in prospect-- when, in the doing, they suddenly reveal themselves as so amenable to one's efforts.
I can't make phone calls for example. I don't have a clue why. I just dread making them. When I think of picking up the phone and hearing a voice, my mind just goes haywire. But when I do, after months of stalling and making up excuses, or just going: " no-- no, I can't do it now"-- I phone a store, or a person's phonemail, it's so easy. So quick and painless. Nothing happens. My voice makes sounds, it isn't quavering and hoarse as I'd imagined-- the sentences rise and fall in normal rhythms. I sound like a regular person.
No one ever explains this discontinuity. Why a dark mountain chasm stands between me and the phone, or why fixing a whipper snipper (what a great thing to have, by the way, we just have lawnmowers, or shears, or some such things) seems so gnarled and tangled and why the frozen metallic parts so repel one's attention.
I face things with the grim belief that they're going to go badly. That they'll prove yet again that I can't do it right, or well, or even okay. I don't know why. I guess painting is very hard for me-- because it's so important to me-- and doesn't go well. But if it's that important, why can't I do it anyway? That's why my T says. I have no answer for it, other than that I'm lazy and cowardly.
But unlike you, I don't accept my state. I guess that's that radical acceptance thing-- it's worse when you can't, say "it is as it is" and live with that.
Nadezda
PS I should try to be more terse and to the point. Another thing I don't like in myself.
Posted by Nadezda on September 29, 2008, at 11:32:21
In reply to Re: I wish my state of mind were more stable » Nadezda, posted by Dinah on September 29, 2008, at 7:33:35
You put your finger on it, Dinah. Continuity.
I feel as if life is a constantly turning lazy susan-- or one of those wheels of fortune, where, as the wheel slows, the pointer never quite makes it to the good part, and gets stuck in one or another versions of bad fortune. It seems as if it's going to get there-- but it doesn't.
You never know-- will today be okay, or will I be a case of nerves, will my mood last for another few hours, or will I fall into disillusionment and dread; if take a break for a few minutes, will I recover, or sink even more into anomie.
Maybe I am a rotating set of persons-- every once and a while, this brighter, freer spirit emerges and reproves every other spirit and mood-- and maybe it's that, more than anything, that makes the disability so unfair and the good present so elusive.
Nadezda
Posted by muffled on September 29, 2008, at 13:13:00
In reply to I wish my state of mind were more stable, posted by Nadezda on September 28, 2008, at 22:59:52
Sigh, I SO hate my changeabiliy.
You dissociative at all?
Hopefully with time and T things will improve some.
Best wishes to you, and hope you T is back soon.
M
Posted by onceupon on September 29, 2008, at 13:34:55
In reply to I wish my state of mind were more stable, posted by Nadezda on September 28, 2008, at 22:59:52
> but instead it fluctuates all over the place and it's awfully hard to feel that I can be optimistic-- or can do things-- when from moment to moment, I fall into discouragement or anxiety pushes everything else away.
I hear you on this one.> Sometimes I feel as if it's the medication-- but I think I recall that I was more or less constantly shifting and unreliable even before that. So it's probably some condition of mine, though the medication.
Could be a little of both? The medication is perhaps amplifying or tweaking a response pattern that used to be more manageable?
> I was in a really good mood this afternoon-- and even though my work didn't go well in the literal sense, I felt excited and as if I was learning something. I had energy and could take more risks, rather than just following a kind of tired logic in the way I was thinking and seeing.
It feels really good to have that experience, doesn't it? And good for you for being able to notice it.> That doesn't happen too often. I really want it to. I was looking through an old book and found a note a wrote about thinking positive thoughts and doing things. I have no idea when I wrote it, but the other written things on the page were very old-- which made me think that I keep on having this idea and never following through with it.
>
> It's hard to stay with a commitment, especially to be optimistic, when your moods are so up and down and you're shaky for hours, and then maybe better for a while, or vice versa.I get this two steps forward, one back, or on bad days, one step forward, two back pattern. And I see how it can get so caught up with identity too. At least for me. When I'm depressed, I think that's all I'll ever be. I think I read something awhile ago too that said that people who are depressed have a negative memory bias, that is, they tend to remember events that confirm their negative feelings. I wonder if you (we) could keep a sort of positive events list or journal, as a counterbalance to the often negative stream of thoughts.
I know that this is probably not quite what you're talking about, since it sounds like physically, it's hard to maintain a sense of yourself as capable when you just feel out of it or shaky or whatever. But I've always been interested in how we construct our identities.
> My T is away for another week at least, which is unfortunate because I thought we were making progress before he left-- last week-- and who knows where I'll be by the time he gets back.
>
> NadezdaWhatever happens now does not negate any progress made previously. You have the capacity to make that same progress, and more, again. Where would you like to be by the time your therapist returns?
Posted by llurpsienoodle on September 29, 2008, at 17:14:06
In reply to Re: I wish my state of mind were more stable, posted by onceupon on September 29, 2008, at 13:34:55
Hey nad,
Sometimes I wonder whether it's US or our environments.You may be more sensitive to the transpersonal vibes around you, whereas others are less permeable. I'm not sure that being sensitive (porous) is such a bad thing, though. Us humans need all kinds of folks.
The best way to get over fears is to realize that they are well-worn ruts. They don't necessarily make sense, so there's no point rationalizing a rut. It just is. Maybe there was a reason for them at one time; maybe they were part of some solution for a problem in your past. Well, you've practiced your fears for a long time, and it will be VERY uncomfortable to ride your bike out of the rut, on the fresh lawn.
Whether you use therapy, coping skills, coffee, meds, friends, love, scented oils, welding, etc., you will still feel uncomfortable. I guess you just have to lean into the pain and trust that you won't expire. My T refers to "surfing the wave of bad feelings". At first they feel like you're going to drown, then you get pulled into them, but then you pop up, and ride them until they disappear into an inconsequential wavelet on the beach. Or something like that.
For what it's worth-- I like your verbosity. I look forward to reading your posts :)
-Ll
Posted by lucie lu on September 29, 2008, at 18:11:53
In reply to I wish my state of mind were more stable, posted by Nadezda on September 28, 2008, at 22:59:52
Nadezda,
You know, what you describe is how I get when I am under-medicated or not taking the right mix. Like you I have always had a tendency toward mood fluctuations, which often cycle rapidly. I have frequently felt like a succession of people too. I hated to make social commitments because I never knew "who" I was going to be when the time came. At work, I would take on projects when I was feeling good and then hate myself when the mood swung down and I was stuck with the project. My kids would get confused because they never knew quite how I was going to respond. My DH complained that he never knew which woman he was dealing with. Maybe worst of all, I didn't feel that I had a single skin to live in, but put on different ones every day like I was changing clothes.
A/Ds helped with the lows but the feelings of discontinuity persisted. SSRIs really intensified the cycling so I couldn't take them, but did OK on wellbutrin. Started therapy, but didn't begin to make any real progress until I started going more frequently and was able to generate some continuity. I learned in therapy about identity problems and self-instability that I grew up with but which was the chicken and which the egg? Was my identity unstable because of my mood or vice versa? Whatever the cause, the variability was the constant. I tried mood stabilizers but didn't tolerate them well until lamictal. That has really worked well for me when added to wellbutrin. In therapy, my T and I worked hard on generating internal continuity, so that I wouldnt feel so much like a Raggedy-Ann, a patchwork person made up of discontinuous experiences and moods. Slowly, eventually, the pieces all started growing together and I continue to work on this in therapy. I also have to stay on the meds or the problems return. The stability I got from the meds helped me work in therapy to develop psychological stability, which then reduced (but didnt eliminate) the need for meds. I raise the dosages again when the need arises. I stay on these meds because others make me nuts or fat or both.
So the point of this long-winded post, Nadezda, is that I think I know what you are going through and its a b*tch. I can really empathize. At least for me, if I found myself experiencing what you describe, I would know I need to change my dosages or med combo or whatever. It sounds like whatever youre on just isnt stabilizing your mood enough. It is hard to go through your days like that. Life is tricky enough to negotiate without constantly feeling like the rug is being pulled out from under you.
Hope you are feeling better soon.
Best, Lucie
Posted by Sigismund on September 29, 2008, at 21:15:48
In reply to Re: I wish my state of mind were more stable » Sigismund, posted by Nadezda on September 29, 2008, at 11:23:04
Thank you for that.
It is some relief to know that other people have terrible trouble doing ordinary things.
Many years ago I took some Methedrine before I went to work and, when I was there, took apart a mower and put it back together out of sheer interest and optimism.
Posted by TherapyGirl on September 29, 2008, at 21:29:31
In reply to I wish my state of mind were more stable, posted by Nadezda on September 28, 2008, at 22:59:52
I hear ya' and I'm right there with you. I will tell you that my moods have calmed down a fair amount in the last 10-15 years. Not sure if that's brain chemistry related or age related (I'm 45 now). I guess it could also be the work I've done in therapy.
But I'm also freaked out by my T's continued absence, so I clearly understand all of what you said. I don't think it will ever completely calm down for me. But maybe we both can come up with additional skills for dealing with it.
Sorry you're having such a hard time right now.
(((((((Nadezda))))))))
Posted by obsidian on September 29, 2008, at 22:20:38
In reply to Re: I wish my state of mind were more stable, posted by Nadezda on September 29, 2008, at 11:03:16
> I don't think of being off meds, because I remember too well how I was without them. I resisted taking them for most of my life, and I wonder about so many things in the past that went wrong, now. Of course, I can't use SSRIs and I doubt I would have gotten what I have, so maybe it wouldn't have made any difference. But I wouldn't go back.
I was just taking the darn pills and I heard one drop to the floor, and then I couldn't find it. I think it was the lamictal, so I got another and took that...hope I got it right.
> They don't work completely. And if I forget one, or take a little more of another (my pdoc has given me some leaway), it's throws me into this jittery gloominess. I'm always late, and sometimes forget ( there are so many, at different times of day)--. Then there's sleeping, or not sleeping, which is its own ordeal-- with seroquel I can sleep, but it makes me gain weight, so I don't take it every night. Yeah-- meds in themselves are a strain as well as a godsend.I take seroquel, and it has made me gain weight. It also stops the ruminating at night, which is why I think it helps with anxiety. I just don't have the chance to get keyed up.
I hate being a chemistry experiment.
>
> You say you'd like to hide under a rock. It's pretty dark and cramped there-- I can say from my hiding place. And lonely. And boring and unstimulating. Although nothing devastating ever happens. Sometimes I don't see the sun, or breathe fresh air for days or even weeks. It's not agoraphobia, just loss of desire.Boring would be nice for a while. I'd be ok with just not being bombarded by stimuli. I'm not meant for it. Perhaps a nice cave then? We could paint the walls, maybe install a screen door, get a lava lamp...it could be alright
> I've been struggling to go to a class-- for the last four months, I sign up every month and don't go. (Luckily they're very inexpensive.) I keep obsessing about it, and talk about it with my T, who is angry that I never have the courage or commitment-- and work myself into a hopeful state, only to freeze at the last minute. The irony is, I have a good locker in the hall (the prime lockers are in the hall) and I think I'm almost signing up not to lose the locker, and to bring the equipment home, and then have to admit failure. I want to be the kind of person who can do this. It would be really awful if I just never could be.
A locker is a good thing. Can you say what type of class it is? Is it lack of desire, anxiety or both?
I have done that before. I've signed up for classes and then didn't finish. I just didn't have the interest or energy to see it through.
I took a modern dance class once...I got tired of leaping across a gymnasium floor at the local high school....but it was nice for a while ;-)
> There are the bad months and years, and and better days and times, but what does it add up to? A lot of failures, it seems. I can't figure it out. Is it just to keep my spirits, in my own private fantasy world, up-- to help me pretend that I'm doing something and not just totally worthless?I wish I could remember this thing I read today...something about keeping up with yourself and not with anyone else. mmm..but I know about the failures thing. It takes a lot of energy to keep going. What is the "something" that you have to be doing?
> So, Sid, how are you today? any better than yesterday? or it this sense of self-hatred persisting lately? I know you've mentioned it before-- but I don't know if it's every day now, or only sometimes.
It's a fairly consistent thing now...seems to have gotten worse - but I think its been brewing for a while, but I made it to work today. I'm just trying to go through the motions. I feel too raw otherwise.
thanks for asking :-)
-sid
Posted by Nadezda on September 29, 2008, at 23:21:52
In reply to Re: I wish my state of mind were more stable, posted by muffled on September 29, 2008, at 13:13:00
Thanks so much for your good wishes, muffled. I don't think I dissociate-- except in a kind of subtle way--
My T will be back in about a week-- I'm hoping tomorrow will be a better day.
Nadezda
Posted by Nadezda on September 30, 2008, at 10:31:54
In reply to Re: I wish my state of mind were more stable, posted by onceupon on September 29, 2008, at 13:34:55
Thanks for your response, Onceupon.
I do get what you're saying about two steps forward, one step back. My T says I do that all the time-- I'll seem to be making progress and understanding things better, and then suddenly, my mood will deteriorate and I'll slip into being hopeless or overwhelmed, and everything we've just done vanishes. When the mood lifts, I'm somewhere else entirely and it's as if our conversations never took place.
I hadn't really noticed that until he pointed it out and I'm just dimly coming to see that he's right.
I like the idea of a journal with positive thoughts, though. I'm trying to collect phrases and sayings, in order to remind myself about feeling better when the anxiety takes over. One idea that I particularly liked, if I don't forget it, is that the feeling of fear or loss of my footing is only a feeling, it isn't all of who I am. I've been trying to remember that-- but strangely, I find that these things also vanish from my mind. I'd really like to remember this one.
Nadezda
Posted by Nadezda on September 30, 2008, at 11:03:17
In reply to Re: I wish my state of mind were more stable, posted by llurpsienoodle on September 29, 2008, at 17:14:06
Hi, Llurpsie.
Thanks for the reassurance about my verbosity. Maybe there is no good way to say it. But thanks-- I really do appreciate that.
You're right about the rut. I'm one of those cars that keeps steering to the left, and no matter what I do, I find yourself heading into oncoming traffic. My T says, though, that I often think a little knick on my fender is some sort of major catastrophe. I guess he thinks I imagine things, or construct things, in a bad way-- that he says is part of my destructiveness. Maybe he's exaggerating in order to get through to me that it's serious-- but I think, too, that he sees it as destructive, so it's not that much of an overstatement.
The rut, I guess, is my imagining that that's what's going to happen and feeling that the fleeting, meaningless looks on people's faces or words used signify something rejecting or uncaring, or that they would just as soon I wasn't there. Seeing that, I almost do a doubtle-take, in which everything is suddenly dislocated. I see too that it could be different, but my mind always steers into that place, against my will-- or according to some unconscious will that my T keeps trying to show me.
I like your T's idea of surfing the bad feelings-- I've found that such a unique sensation, when I remember to do it--.which I only have a few times. But surprisingly, it works.
I love your metaphor about surfing the waves-- I remember doing that as a kid and always being so exceedingly delighted when the green energy of the wave would swallow me--and I would be afraid that I could hardly breathe-- only to bob up suddenly into the fresh air of the other side.
I'll have to put that into my about-to-be-begun notebook.
Nadezda
Posted by Nadezda on September 30, 2008, at 11:06:17
In reply to Re: I wish my state of mind were more stable, posted by Nadezda on September 30, 2008, at 11:03:17
Posted by Nadezda on September 30, 2008, at 11:35:35
In reply to Re: I wish my state of mind were more stable » Nadezda, posted by lucie lu on September 29, 2008, at 18:11:53
Thanks, Lucie lu.
I can see what you're saying about the medications. I guess I wish there were some better combination, and maybe there is. I'm always asking my pdoc if something new has come out, and also asking about possible additions. Last time I went, we tried something new that's made things a lot better and given me more continuity than I've had.
Maybe it's hard for me to know what's possible, because I've been so depressed and in such an incoherent state for so long that even the peace of mind and hopefulness that I've achieved, however unstable it is, seems miraculous to me. I know that there aren't many ADs that I can take. Like you, I can't tolerate the SSRI's. I've settled on Emsam, which is an Maoi. I did try wellbutrin, but this seems to work best for me. I've tried pretty much everything else, too, and am on a pretty complicated mix as it is.
But I think you may be right, too, that the meds aren't doing everything they could. I'll try to talk to my pdoc about it next time I go. I know there isn't much he can do to make it completely right-- but maybe timing things better, or sequencing them in some different way would add to the balance.
You're so right though-- I agree or plan to do things in one mood-- and when the time arrives, I'm in a different place and somehow the person who has to do the thing seems like someone else. I guess my T thinks it's more motivated than accidental, these shifts in perspective, and maybe I can work more on them with him. I try to remind him of the medication and how much of a difference that makes-- but he really is pretty clear that he just wants to focus on what we can do. I understand why he says that-- and won't cut me any slack--
But talking to my pdoc is something I don't need him for-- and trying to be more aware of how the meds affect me might be a place to start.
Posted by Nadezda on October 4, 2008, at 23:25:31
In reply to Re: I wish my state of mind were more stable » Nadezda, posted by lucie lu on September 29, 2008, at 18:11:53
I think you were right, Lucie lu. I've been taking a rather high dose of Emsam for half a day, to deal with the insomnia (I take the patch off at night). I think I need to reduce the dose for a while, because too much emsam makes me very agitated, which reminds me strongly of the sensation I've had the last few days.
I didn't use a patch at all today, and I've been gradually feeling more myself. So I'm thinking that the recent agitation, which does seem fairly atypical (at least lately), was caused by over- medication.
Thanks for your suggestion.
Nadezda
Posted by lucie lu on October 5, 2008, at 18:05:15
In reply to Re: I wish my state of mind were more stable » lucie lu, posted by Nadezda on October 4, 2008, at 23:25:31
> I think you were right, Lucie lu. I've been taking a rather high dose of Emsam for half a day, to deal with the insomnia (I take the patch off at night). I think I need to reduce the dose for a while, because too much emsam makes me very agitated, which reminds me strongly of the sensation I've had the last few days.
>
> I didn't use a patch at all today, and I've been gradually feeling more myself. So I'm thinking that the recent agitation, which does seem fairly atypical (at least lately), was caused by over- medication.
>
> Thanks for your suggestion.
>
> NadezdaNadeza, I'm glad to hear that you have identified what might be causing your recent mood instability. It never ceases to amaze me how profoundly biochemistry (endogenous or exogenous factors) affects our mood, cognition, and behavior. I have learned to be on the lookout for unusual moods or behavior in myself. Unless there's an obvious external cause, I have found that it usually can be addressed by rethinking whatever meds I am taking. It is such a drag to have those inexplicable and destabilizing mood swings, so I'm very glad to hear you are feeling more like yourself. Understanding what is happening helps make you feel that you've regained control, which is important.
Best,
Lucie
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.