D3

Dismal, detached and destructive….D3

I told my counselor today that even though she hadn’t asked me how i felt, i had a new word – dismal – and i was going to use it. “How bad is dismal?” Me- “bad”.
She wants me to try a mood/distraction journal of some kind. I’m really not sure exactly what she wants but she said she would email something i can print out.

When i first started seeing this C last May, she asked me to buy some book on emotional regulation (i think). We started and i remember reading chapter one and a few words about mindfulness, but everything went to hell in a hand basket late June and that was that. We’ll see how it goes this time.

Wintertime is hard for me( decreased sunlight). I also lost my brother 2 years ago this Jan.
So, i get why i’m down.

I have been detaching/dissociating more of late – yea. I discovered about 6 hours after a sick exam with my PCP that “I” wasn’t really there. My usual, medically attuned advocate was floating around somewhere in a bubble and i left a smiling, nodding, even pleasant double in charge. No harm done as my PCP knows her shit. Still, for the past few days and with any stress, i find myself detached a bit. Just not in the front of my brain.

Destructiveness speaks for itself. According to my C – her new exercise in mood charting along with a list of “100 Healthy Coping Activities” may “help” with my urges to self-harm. Again, we’ll see. Honestly, i think the best coping activity i could do is get stoned. It’s really the only thing that reliably helps. Doc

chest pain 3/10

As a retired critical care nurse – retired in 1993 after vet school – i, like many medical types, do not often leap towards managed care with every little twinge or potential problem. It is no urban myth – we make difficult patients at times (ok, usually).

For me, giving in and deciding to ask for medical assistance is HARD. Loss of (imagined) control, a sense of vulnerability, skepticism in general, believing i “better be dying” before i can legitimately ask for help and yes, sometimes thinking i know what is going on and i only want what i think is the appropriate action has proven problematic.

Usually, if the advice/recommendations i get from the medical community is consistent with my own appraisal, i will go with the flow. I have some major issues with psych meds but let’s forget about that now.

As noted yesterday, i have started having consistent daily episodes of chest pain. New to me. I am 63 years old and other than arthritis, asthma, and , oh yeah- the crazies -i have been remarkably healthy so far. The only folks i know of in the family with significant cardiac disease have been a paternal grandmother (lived to 93), a paternal uncle (alive and in his eighties), and a great aunt on my mom’s side (late 70’s, i think). Anyway, the point being that true cardiac disease has never been high on my watch out list.

My mom died of metastatic lung cancer probably 20 years after she quit smoking, so even though i quit 5 or 6 years ago, pulmonary cells may be aberrantly dividing as i type. I still smoke and vape cannabis daily. In fact, yesterday i did some research and learned that chest pain after smoking pot is a recognized, potential side effect that may reflect cardiac, pulmonary or or muscular issues.

Last evening, my chest discomfort did increase after a couple of bong hits. FUCK. But, was the pain b/c of a physiological response to cannabis – increased heart rate +/or BP or was it due to my concern/stress that my beloved, life saving plant is trying to kill me? I DON’T KNOW.

I have an appt. with my PCP in 6 days where/when i will try to enlist her help in sorting out whether my chest discomfort is organic or not. In the meantime, i will continue smoking pot, will limit any over exertions, will check my blood pressure daily and with any increase in pain and will continue to self medicate with clonazepam(anxiety) and aspirin(angina), and TUMS(acid reflux).

I am not entertaining any ideas of going to the local ER b/c my mother taught me well that i “had better be dying” before do anything “drastic”. Doc

Forgotten/Rupture

I am a little less insane at the moment than i have been and i thought i would try to write it down so that when(if) i meet with my counselor again i can remember the salient points that exacerbated my insanity. (it’s all her fault)

I’m using the word “rupture” which is obvious psychobabble but this is the word my C uses when we have had major negative issues in our “relationship”. I am aware that many of my reactions to life straddle the reasonable/unreasonable – you crazy bitch divide.

I did not attend either of my 2x week sessions this week mainly b/c i was too sad and mad and knew i could not deal with her at the moment. If i had tried i know i would have degenerated into a sobbing, inarticulate idiot and could have, quite easily, ended our collaboration in anger.

During my self-induced cooling off period, i definitely considered quitting therapy all together, again. Got pulled in many different directions trying to sort it out.

OK. Basically – at the end of our last session as i was headed out the door, with her next client waiting in a nearby chair, i remembered we did not set our meeting times for next week. Times vary week to week. I said ‘oh, what about next week ?” and she told me she would text me with the times. Cool, no problem.

This was on a friday. I did not expect her to text me right away. But….when i heard nothing by the following monday (our usual schedule was weds. and fri.) doubt started creeping in. I could feel myself getting depressed all day monday, it got worse and worse tuesday and by weds. morning i was in bad shape.

Unfortunately, for everyone involved, about a week earlier i had agreed to donate blood at a Red Cross event. I should have cancelled but they basically begged donors to give due to shortages. At the VFW tuesday evening i could barely contain my sadness which morphed into anger b/c (as usual) they were running majorly behind schedule. The intake interviewer noted my “mood” and they kept asking me if i was ok throughout the donation in that “are you OK?” kind of voice that screams “lunatic in attendance, watch yourself”. But i did stay and donated a double red but i have a feeling this will be my last donation.

By weds morning with no word from M, i reached a LOW low and knew i could not face her yet and i decided (since i did not have an appt.) to just not show up or text my intention. I wanted her to wonder. I also knew from past experience that she could not EP me simply b/c i failed to turn up. HA! Fear is gone.

She called and texted me around 12:30pm stating “I was expecting you for a 12 noon appt., please respond and tell me where you are.” Ah, no. Fat chance. On thursday i texted her that i would not be in and did she have anything for the following week? She has offered an appt next weds. but i have not replied yet. Trying to spread the fear and uncertainty around.

I am very conflicted and ambivalent at the moment. Logically (ha!) i believe she simply forgot. But, in my twisted, forever damaged brain I FELT forgotten and unimportant. I decided i did not feel abandoned by her b/c that is an active process and this isn’t. Just not important.

I entertained the idea (and still do) that this is/was intentional on her part as some kind of therapeutic lesson and that pissed me off. Another reason not to engage and try to “address this rupture in our relationship” is b/c that’s what she wants me to do. At the same time, i am not quite ready to turn her loose and quit therapy b/c despite all the negative things that have happened between us, she is someone who i believed might be different from past t’s and might actually help me.

Today, friday, i need to text back and tell her if next weds at 1p is ok or not. I think i will go. I think i may be able to have a civilized conversation with her by then that does not end with me uncommunicative and crying. But i am making her wait b/c i am a bitch and she hurt me very badly. Such an emotionally dysregulated baby.

Another contributing factor is over a year ago after an appt with my psych NP the receptionist told me she would check with my NP to see when she wanted me to return and she would call me. Never happened, i felt ignored and forgotten, and it was about 8 months before i could go back. So, no meds for over 8 months – supposedly not a good idea with bipolar.

Another issue- i have been having chest pain/discomfort about a month along with accompanying shortness of breath. I told my psych NP about it last week b/c i believe the Wellbutrin i am taking is the reason i am newly hypertensive and this may be contributing to my chest pain. It can last several hours. Yesterday, i tried aspirin and clonazepam b/c i don’t know if my chest pain is a somatic symptom of my depression and anxiety(clonazepam) or angina(aspirin’s anti-platelet effects). I have an appt. with my PCP NP next thursday to discuss.

Life is fun. Doc

BP depression

I am so depressed right now. I can’t stop crying.
I (reluctantly) agreed to start taking Wellbutrin again b/c i do believe that i have SAD.
Not unexpectedly, i have been self-sabotageing by skipping every third dose. This is also a strategy to manage my Wellbutrin-induced hypertension. Wellbutrin metabilizes to a variety of amphetamine and in addition to daily mausea it has caused my BP to rise above 140/90 at times.

Tried to burn myself earlier with my lighter and the metal bowl from the bong. Did a half-assed job, will try again later. I feel like i should be hurt, punished. Being sad is not enough.

I want ( a little, but strong part of me) to text Mary but i will not as she and her people are on winter holiday and i will NOT interfere. I made that promise to myself long ago. Off is off.

One of the last things she told me was to text her if i felt like killing myself. So, obviously i can only text her if i am willing to admit to this and of course it would end with me being ep’ed. So, no.

Blue is limping (left front) b/c of a broken toenail.. Last night she was whimpering..luckily i had given her half an aspirin with dinner. After an hour, she was able to rest and eventually sleep. I felt so inadequate and useless. No access to rads. or other pain meds. Ultimately my fault b/c i have let her nails get too long. Doc