The Voice Inside

If you have read any of my previous posts then you know what demons i struggle with and you know the financial toll being disabled by them takes on me.  What you don’t know, at least not yet, are some of the daily activities and new experiences that inspire me.

I titled this “The Voice Inside” because that was the title of the sermon I sat in on today at my local church.  I attended this sermon not as a member of their congregation or a devout worshiper.  This church runs a food pantry, giving food to those in the community in need of assistance.  I’ve gone to this pantry before but I must have arrived after the usual sermon.

Going to a food pantry for help is a new experience for me.  I have found it to be beneficial in more ways than just getting food.  I’ve tried going to a couple of different places.  The process varies slightly but one thing each has in common is that they are packed with people, there is waiting time, and you often stand in a line, and are in close quarters with complete strangers.  Since just leaving my house or my comfort zone neighborhood is sometimes hard,  you can imagine how each one of these things is a tremendous challenge to me.  I’ve left many times unable to bear the anxiety and panic that can set in under these conditions.

I view each attempt as a therapy exercise, some I frequently fail.   I fight the voice within me telling me to leave and go home.  Thoughts flood my mind and I have to employ all the tricks and self talk to get me through the panic situation.  Sometimes I have to sit off away from everyone to calm my pounding heart, stop the cold sweats, or just to steady myself from the dizziness that accompanies my panic.  Each visit is exposure therapy, and the reward is food.  Sustenance for body and mind.

Today’s sermon was about listening to the voice inside.  The voice of reason, security, and logic.  The voice that keeps one from getting into a fight, lashing out at someone, or doing something wrong or even criminal; the voice some interpret as their gut feeling.  The Pastor’s sermon was general and the crowd of around 50 or so seemed to understand exactly what he was referring to.

I understood too, but perhaps from a different angle. I know there is more than just one inner voice.  There is the inner voice he spoke of, the gut instinct, that keeps you from harm and guides you in the right direction.  That voice is often ignored and overridden by the circumstances of the moment. Overridden by ego, want, and false righteousness.  How many times do you feel in your gut or hear your inner voice telling you the correct path to take, only to take another?  It happens to all of us multiple times a day.

The other voice I refer to is the additional internal voice of someone with anxiety, panic, and depression disorders.  Ants; anxious negative thoughts.  Ants swarm us with all kinds of thoughts and emotions, feeding upon each other until we are in a panic loop. It’s this inner voice that often trumps the normal inner voice.  It’s with these voices, we, those of us who suffer from these illnesses, must converse and argue just to get though a situation. A situation that to someone who doesn’t suffer from these conditions is ordinary.

If any of that made sense to you then you understand what I go through on a daily basis.  It’s just one of the reasons having these conditions can be so physically exhausting.  All those thoughts, conversations, physical manifestations, and struggles playing like the largest and loudest orchestra; only I’m the only one who attends this music appreciation class.

So, today I got a little food to help sustain my body, made it through a tough situation for someone with my conditions, and got an unexpected reminder of the inner voice to stimulate my mind.  A good morning indeed.

I Want a New Drug

“I want a new drug
One that won’t make me sick
One that won’t make me crash my car
Or make me feel three feet thick”……………………..

If your old enough, or into 80’s music,  you might remember the song and get the idea.  I’m going to see my PDoc on Thursday to request either a new drug or a return to my old friend Xanax.  Klonopin and I are just about at the end of our affair.

Klonopin started off with some positive results with regard to anxiety and panic.  (see prior post)  It did however, have some devastating sexual side effects.  I hoped they might improve but they did not.  In addition there are some other side effects.  A bit of apathy, irritability, and a general “I don’t care” attitude are among the most prevalent.  Taken by themselves I think I could have made this work but I can not take the sexual side effects, which may actually be contributing to the irritability, grumpiness, frustrating, and at times angry attitude I’ve developed over the last couple weeks.  These moods are also effecting the drug’s effectiveness and causing me more anxiety and even a panic attack.

I plan on asking about Xanax XR.  It says it’s a once a day pill but I’m reading a lot that says it isn’t.  I have a hard time understanding half-life, plasma level, and therapeutic dose level information so I will leave that to my doctor, who I respect and trust.  It should be an interesting conversation.  I will update in a later post.

 

Loss of Identity

I am sure I am not alone when I say one of the biggest parts of dealing with the effects of PTSD, Panic Disorder, Anxiety and Depression is the loss of one’s identity.  It is multifaceted with so many levels of loss sometimes I lose count.

Being unable to work and provide for myself is a constant nagging and regurgitating loss that never stops giving negative feelings and emotions.  I can’t work in my current condition.  I was not a top earning, highly educated professional, but I had a career in automobile dealership management that provided a decent living.  A highly stressful job with long hours, it had many drawbacks; yet many rewards.  I haven’t worked in my former career for two years.  In a vain effort to maintain control over myself I continued to suppress, deny, and distract from my conditions.  I bounced from job to job attempting to find something I could sustain.  My illnesses interfered with each and every one of the them until finally I became so agoraphobic and panic stricken that I would leave in the middle of the day and couldn’t return.  I couldn’t hold a job.   Finally, my doctors advised against working and had me file for disability and concentrate on healing myself.

I understand the logic of this approach and it is very slowly working.  Each day is different.  A good day gives me hope that I will be soon be ready to return to my former life.  Conversely, a bad day simply reminds me that I have tons of work to do on myself.

I’ve yet to accept the reality of my situation.  I cling to my desire to be a fully functioning member of working society, providing for myself and my partner.  Instead I am reliant on others to provide for me.  I have no income.  My self worth ebbs and flows.  I need money and don’t know what I can do to in my condition to get any.

Social Security Disability is a system with so many flaws I don’t have the time or patience to list them.  It’s a long and arduous process that someone with a disability, any disability, should not have to endure.  For someone with mental health issues its even harder because the disability is not cut and dry like blindness or loss of limb.  The process is beyond frustrating.

I add the loss of my professional identity to the long list of losses I’ve endured over the past five years.  Unfortunately this loss keeps repeating itself in a never ending loop every time I need a dollar to pay a bill, shop for food and every time I have to seek assistance and rely on someone else for my sustenance.

 

New Drug, New Adventures

I had been treated for Anxiety, PTSD, and Panic Disorder with a healthy dose of Xanax throughout the day.  I am also treated  for depression with Wellbrutin. I also participated in a Transcranial Magnetic Stimulation program for depression several weeks ago. I had hoped that TMS would help anxiety too.

Post TMS (you can read my previous posts) I felt a boost in mood but no benefit to anxiety. Then one day, like the switching off of a light, that mood boost was gone.  The cause is unknown to me and my doctors; but they have told me I didn’t respond as well as they would have liked or as much as the average patient to TMS treatments.  My mood decline also coincided with the anniversary of the death of my former partner from suicide and his birthday, so multiple issues are involved.

For three weeks my anxiety increased and my world began to shrink again.  My mood also dipped; I was reliving trauma and grieving.  Neither was near my worst ever experiences.  However, I did feel as though each day I regressed further and further downward.  When you make progress it is a wonderful feeling, when you regress it simply adds to the anxiety and negative feelings.

At the same time I began to suspect Xanax wasn’t quite working as well as it had been for the many years I have been taking it. I’ve always kept myself at minimum dosage, only increasing (PRN with doctor’s permission)  during times of extreme panic or stress and I dosed throughout the day to maintain a minimum steady state level.  Suddenly it seemed, more and more I began to feel the ups and downs of the drugs short acting character.  My anxiety levels were high and I began having more frequent panic attacks.  Strangely, upon taking a dose of Xanax instead of feeling its quick calming effects, which I still somewhat felt,  I was instead acutely feeling its cognitive side effects.  Dizziness, and mind fog being the most prevalent.  Those two effects exacerbated my already high anxiety, temporarily negating the calming effects of the drug.  It wasn’t until those side effects subsided that I was able to feel the calming effects of the drug.  Then the drug acted as it is designed to; but being short acting the effects dissipated and the pattern repeated.

Although still somewhat effective, I began to feel that it was letting me down and creating too much of a constant state of rebound flux.  I don’t know how long this was truly happening since when my anxiety was lower these rebound states may have been less noticeable and easier to handle.

At my next doctors visit I discussed this matter and my desire to try something else.  I was interested in trying Xanax Extended Release.  I was once encouraged to try Klonopin so I was also open to considering that too.  My doctor recommended Klonopin over Xanax XR because he felt it would put me on a more even keel throughout the day.  I agreed to Klonopin 1mg twice a day. (the dose had to be slightly increased to add .25 to .5 midday)

It’s been two weeks now and I am still deliberating.  I have noticed some advantages and some disadvantages with side effects.  Although I was told they were very much the same with Klonoin just being longer acting, I found them to be quite different.  Different is the word I have most often used in my comparison.  At times I can’t even articulate exactly how they are different, they just are.

There is always more at play than just drug interactions.  I also got past the trauma anniversary dates at the same time I began trying Klonopin so what is attributed to what is hard to say.  I can say that I had no adverse reaction switching from one to the other.  No Xanax withdrawal.  I will also credit Klonopin for providing a more longer acting calm throughout the day.  I don’t experience the rebound flux I had been experiencing with Xanax.  Klonopin seems to keep my anxiety just below the surface.  Sometimes it rises and  I use my CBT methods to quench it. I have had only one full blown panic attack during this time.  Those are the good effects I’ve noticed and been able to verbalize so far.

On to the side effects;  of which Klonopin has its own set of unique side effects.  Again,  different from Xanax.  So far it’s the most descriptive way I can say what I am feeling and experiencing.  First and foremost it has sexual side effects I did not anticipate, especially after being told it is in the same class and essentially a longer acting Xanax.  I never had any sexual side effects on Xanax.  I don’t feel as interested in sex and when I do its more difficult to maintain and nearly impossible to, without getting to graphic, reach completion.  This has been extremely difficult for me to manage.  I’m a very sexual person so this is obviously at the top of list of concerns.  I’m hoping it will improve, if not to my previous level of function, then at least to a livable level.  The other side effects are cognitive in nature.  Not as dizzy like Xanax, but more of a lightheadedness. A lack of focus and concentration, and a general spaciness.  Also, transient fatigue, which I find puzzling.  Some days I feel more energy and others less.

Some of these side effects have slightly improved over the two weeks.  Some I feel are more manageable than the constant rebound flux of Xanax. That is why I have not yet made the decision to either remain on Klonopin or request to try the extended release Xanax.  A part of me thinks I owe it to myself to at least try Xanax XR but I really hate changing medications. Therefore I am giving Klonopin more time.  My main concern is the sexual side effects.  Again without getting to graphic or personal, I was able to function twice.  I think both were at a time when one dose was wearing off and it was time for the next dose.  It’s something I am continuing to experiment with and monitor in order to help me make the decision on this medication.

I tried not to read too much on the internet because its full of horror stories and I know everyone reacts to drugs differently.  I also know that I have a proven track record of being extra sensitive to medications and can not take most of what is offered to me.  The fact that I can tolerate Klonopin at all is a plus.

I would be interested in hearing from anyone with any experiences with Klonopin or Xanax XR and welcome any questions since I know I’ve had a difficult time putting into words my experiences.

 

 

A Personal Letter…In The Wake of a Suicide.

What follows is a therapeutic exercise in the form of a personal letter.  It is the most personal post on my blog.  It’s my hope that by putting word to paper and digitally scattering those words in the winds of the internet,  I will release pain and perhaps someone else will benefit in some way.

Peace

 

A personal Letter… in the wake of a suicide.

 

Dear R,

Not many people get to know me completely. It’s difficult for me, so I reserve it for those I consider genuine, kind, trustworthy, and with who I form a deep connection; whether it’s family, friends or a love. You and I bonded quickly and came to know each-other very well. Even though our temperaments were different we complimented one another.

You always underestimated yourself and your abilities. Had you been more confident you could have put your education to work for you and been a success in your field. I know your insecurities were deeply rooted in your upbringing and they carried over into your adulthood. That is why I encouraged you stand up for yourself, have faith in your abilities, and in your own uniqueness.

I learned many things from you over the years, but most of all I learned the value of patience, self-control, and how to be more creative and carefree. I think we took from each-other those traits we needed to amplify in ourselves. I became more patient, calm and understanding. You became more forthright, confident, and proud to be who you were. We developed a symbiotic relationship that worked for many years, each of us compromising for what we needed.

Ultimately, we became the best of friends and the one person that the other could always rely upon; or so I thought, until the day you decided you’d had enough. On that day you ended your life and forever scared mine with trauma. Your decision became my damnation.

You knew my personality; how I analyzed things, searched for meaning, and had to have answers. I would need to know why; yet you left me with only more questions and no ability to ever have them answered.

Without clear meaning and without answers my mind leapt between reasons, suppositions, and self examination. The Universe has yet to reveal its, or your, secrets to me. I can now accept that it never will. Through the hurt, anguish, and grief, I’ve journeyed within myself and learned more about the core of who I am in the three years since your death than I had in the decades before. Spiritually I blossomed while mentally I withered.

I don’t know if you gave conscious thought to the fact that I would be the one to find you. I like to think you didn’t plan to inflict the trauma of that experience on me as it wasn’t in your nature to be cruel. However, the fact remains that I am haunted by the vision of what my eyes saw and I hate that it is my last visual memory of you. I look at your picture sometimes to ease that pain, replace that vision,  and to remind me of the smiling, caring, and thoughtful man you were.

As time passed I was like a prize fighter rising up from the mat only to be knocked out by one final blow. My mother’s death was that knock out punch for me. I’ve been trying to get up again ever since.

This year, your birthday and the anniversary of your death weigh heavily on me. I think it’s because last year I was so focused on attending to my mom’s affairs, running on adrenaline just to survive, that I did not properly grieve.

I think of you and the many fond memories from our years together. You are in my heart and in my very being, for I am forever changed by our time together. I miss you R, but yes, I still wonder why, and I am still haunted by that night.

Every day is now a battle for me; a battle to manage the illnesses that manifested from the trauma, loss, and events of the last four or five years of my life. Some of the traits you admired in me like determination, persistence, and even stubbornness, have been the back bone of my survival. When I feel low or sorry for myself, I remember that I am a surviver. Your struggle is over but mine is still on-going. Sometimes, when things are bad, I have to scream, cry, and shout, often with anger, that your solution will never be my solution.

I have family and friends to help me through, even if its long distance and even if it’s simply just by knowing they are there if I need them. Most of all I have T, who’s gone above and beyond to support me in every way. You would have liked each-other. You have a few things in common. It’s too bad circumstance will prevent you ever meeting.

I write these passages as part of my therapy. I have forgiven you for a while now, but as you can see there remains part of me that is still mad at you; not only for the trauma you caused, but for leaving me alone.

I am sorry you felt your only course of action was to end your life and that you couldn’t reach out to someone. I guess you didn’t realize how much you were loved by so many, or maybe it just wasn’t enough. Most of all, even after three years of therapy, I am sorry I could not save you. Intellectually I know I am not at fault and wouldn’t have been able to save you, but my heart still cries that I couldn’t.

I hope you at least found the escape to peace that you sought and needed. You are, and will always be, in my heart surrounded by love.

M