Mornings

One of the larger tasks I have had to work on during this whole mental health process is sleep. My sleep patterns have always been odd, at least that’s what I’ve always told myself. When I was younger I would tend to wake up in the middle of the night and have difficulty going back to sleep. Then I spent the better part of 25 years working night shift. Mostly 12 hour shifts but there was a good bit of that time spent working 24 hour shifts on an ambulance. This meant, of course, that any time, day or night, the pager could go off and I’d have to wake up and at least be able to pretend to be functional. I got used to it pretty quickly. I was even pretty good at it. I wouldn’t even take off my uniform, I’d get back to quarters, kick my boots off and fall asleep in the recliner. As soon as I stopped moving I would fall asleep and as soon as the pager went off I’d be awake.

The unfortunate thing is, apparently brains and sleep patterns aren’t really supposed to function like that. I’ve tried various pharmacological and non-pharmacological techniques to help regulate my sleep but what finally seems to have worked is Lunesta (eszopiclone). I’s the only thing I’ve found that will put me to sleep and not make me a total zombie the next morning. The difficulty is, it turns out I’m kind of a zombie in the morning anyway. I have probably slept more in the past year than I did for any two years I was working put together, I slept for eight hours right before I sat down to write this very post, and yet I still take literally hours to feel like my brain is fully on-line in the morning.

I have been assured, and also noted myself, that this is something of a family trait, and I come by it honestly but it’s still troublesome. I’m sure this arrangement is much healthier for my brain-meats but I do miss being able to get out of bed and start the day instead of spending two or three hours bumping into walls.

Ouch

An important lesson was learned yesterday. Yesterday was my first session of my second round of TMS, which was fine. There was a lot of talk about “dosing” and “intensities” but what it comes down to is, they’re zapping the left side of my brain a little longer this time. I think. I once again reassure both myself and my audience that there is good science behind it. The truth is, though, even the people who do it still don’t know exactly what it does or why it works. But it does.

The difficulty began when I decided I should go out shopping immediately after I got back. The shopping took considerably longer than expected and I ended up being out of the house for 4-5 hours1 which, it turns out, does not work for me. Or at least it didn’t yesterday. I’m not sure exactly what I did in between when we got home and when I went to bed, which was about 8pm, but I slept for almost 12 hours with no significant interruptions.

Okay, I can already hear people saying “WTF did you mean by ‘does not work’, sport?” so I’ll try to provide a little more detail. I have, in the past, described the situation as being like needing to go to the bathroom. You can be walking around and you’ll get that little kick from your bladder that says “start thinking about me”. This, as we all know, is not urgent and you can ignore it. If you ignore it for long enough, there comes a point when you don’t really have a lot of choice in the matter, you have to go. Many2 people will not have allowed things to get to that point, which is good, but you can imagine. So there came a point yesterday when I had to go and I kind of couldn’t. So I pushed through. I didn’t do anything awful or inappropriate3 but I really can’t remember a lot of detail about the rest of the day and it became pretty obvious that I wasn’t thinking clearly at times.

I did get home safe and sound and, as mentioned above, after sleeping for nearly 12 hours I even feel better. I am still much more physically tired than I would have expected but most of my brain is back on line.

Small steps.

  1. Which is not as long as I would have guessed. I’m basing this off when I left the house and semi-cloudy recollection of when we got back and if I had guessed I would have said it was 6-8 hours. ↩︎
  2. I worked in an emergency room for a long time. I know not everyone has lost control of their bladder at some point but the number who have may be higher than you think. ↩︎
  3. Except possibly being very disagreeable company for my wife. I’ll have to ask. ↩︎

How Am I Doing?

The short answer is, better. The long answer is, as it has been previously, it depends on how far back you look. Compared to two years ago, I am noticeably improved. Compared to ten years ago, I am still a complete wreck. There is no question that I have more energy and less brain fog than I did last year, but I still jump at sudden noises, I still have difficulty being out in public for any length of time, and I currently have a bruise on my forehead because I woke up from a dream all in a fluster, leapt out of bed because my pager had gone off, or someone called a code, or I can’t even remember what, and I went face-first into a wall. There is still work to be done.

Again, though, I do feel like I’m starting to come back to life a little bit. Nothing much has been showing up here, I’m afraid, because I’ve been spending a great deal of time playing No Man’s Sky, and working on an unnecessarily complicated and overly detailed setting for a Dungeons and Dragons game I hope to start running next week.

I’m going back to see the TMS1 people next week to see if I might benefit from some supplemental brain-zapping, and I continue to take my meds and see my therapist. I have been assured there isn’t much more I could be doing to help myself along the road to recovery. The speed of recovery wouldn’t be as much of an issue if we currently had a functional federal government. I have been waiting for a final decision on social security disability benefits for some time now and I can’t really foresee much progress coming in the next 3-4 years. This is something of a disadvantage.

At this point, all I can do is try not to worry about it. I have to get better and find something economically viable to do with myself, sooner rather than later, but there really isn’t much else I can do to speed the process along. Things will work out or they won’t.

——————————–

  1. Transcranial magnetic stimulation, for those who may not recall ↩︎

Click?

I have been intending to post about this for several days now and here I am, finally getting to it. I referred previously to getting trans-cranial magnetic stimulation, or TMS, therapy. If you had asked me how I thought it was going a few weeks ago, I would have said I thought it was helping with my anxiety symptoms, especially the hyper-alertness. Not game-changing but certainly worth pursuing. Two weeks ago, something clicked. Let me preface this by saying in the intervening time things have settled back down closer to, but still above, my previous baseline but for a few days there, my brain was working, possibly better than it ever has.

When I say something clicked, I really do mean the change was almost instantaneous. I was walking along in my usual depressive funk then, as best I can describe it, an instrument panel got plugged in. I could monitor and regulate things I hadn’t even been aware of that affected my mood. “What kinds of things?”, I hear my excited audience ask. Therein lies the problem. I’ve referenced the original Star Trek episode Spock’s Brain before, the relevant part being Dr. McCoy using the alien hair-dryer to learn how to put Spock’s brain back in and his amazement at how simple the procedure is, once he already knows how to do it1. Of course, as time goes on, the effects of the magic hair-dryer start wearing off and McCoy, mid-procedure, realizes how complex it is and that he no longer has any idea what he’s doing. Très dramatique. All this is to say, I feel like I’ve lost that level of admin access and I’m not sure how I was making it all work.

For those few days though, I felt invulnerable. I bumbled through life feeling vaguely cheerful. I had fun doing things I enjoyed2. The closest I’ve ever come to that before was the first time I started taking antidepressants3. While things have pulled back somewhat, I still feel considerably better than I have for quite some time

As long as I stay in the house, don’t go anywhere, or do anything. Baby steps, I suppose.

  1. If you prefer a more high-brow reference, you can think of this as being my Person on business from Porlock ↩︎
  2. I told my therapist I wanted to go back and revise every PHQ-9 I’d done for the last three years. I have a much better understanding of the “Little interest or pleasure in doing things” question now. ↩︎
  3. For the curious, it was sertraline and I think it was somewhere in the early 2000s? Maybe? That I’m not so sure about. ↩︎

Habitual

Insert Scumbag Steve meme here – states intention to post more frequently; disappears for a month. That is a thing that happened and I don’t really have a good explanation for why. Nothing much seemed post-worthy.

Since the last update, the major piece of news is that the extreme house cleaners came through and extremely cleaned the place. This is not to say that the place is extremely clean, but it is extremely cleaner than it was. Functional, even, which has made living somewhat less complicated.

With the theme of un-complicating things in mind, I am working on developing some self-care habits. I’m sure I have lamented previously in these e-pages about my lack of skill in the self-care department. This is, of course, the result of running myself ragged for twenty years or so while trying to behave as if I was an unlimited resource. Which is, more or less, how I ended up where I am now.

Currently I’m working on some very complex habits, like remembering to eat, take my meds, and brush my teeth. I’m hoping to move on to more advanced topics soon, so if anyone has any good tips for taking care of oneself, please feel free to share. Or don’t. Either way.

Since I Have a Moment

It is currently stormy AF outside and the power keeps blinking. I usually1 sleep with two white noise machines going, and music playing in order to keep me from hearing things at night and waking up. The difficulty is, of course, that the white noise machines shutting off wakes me up, so I turn them back on and go back to sleep. Then the power blinks again. You get the idea.

Anyway, through the miracle of battery technology, I might as well take advantage of this unexpected up-time instead of just lying in bed and seething2. So what has been going on in my head?

The most confusing bit for me is that I feel both better and worse than I did, say, six months ago. I feel better because my mood is generally more stable (for the last few weeks anyway) thanks to getting a combination of meds that seems so work, having a therapist who is good at his job, and transcranial magnetic stimulation treatments3. On the other hand, the world in general, and the United States in particular, have managed to engineer a set of circumstances that are similar enough to the winter of 20204 that my PTSD is on Extra-Jumpy mode. I think I’m coping with the increased symptoms better than I would have if I didn’t have a few things working in my favor but it still isn’t much fun.

The coping methods include, picking up writing again5, and aggressively ignoring as much of the outside world as I can for the time being. I assume someone will let me know if any of the four or five things swirling around that could cause another pandemic actually does.

  1. This is a habit left over from working night shift. I have needed to continue doing it because I tend to be jumpy enough that nearly anything will wake me up. ↩︎
  2. I’m still seething but I’m not doing while lying in bed and I’m also doing something else, which makes the seething better somehow? I don’t know how these things work. ↩︎
  3. More on this when it isn’t 0330 during a windstorm. ↩︎
  4. I’m not going to go into a detailed list of the similarities between today and 2020 and today because it would likely cause my brain to spiral. It’s all the things you would think would be on the list and a few things that might be a bit more obscure. ↩︎
  5. No “I told you so”s from the peanut gallery, please ↩︎

Well Then

Where even to begin? It was pointed out to me, by more than one person, much to my surprise, that this site, whatever it is, was down. I kind of knew it was coming up, as the host service had an expired card for billing purposes, but I also didn’t think it was really worth doing anything about. More important things to worry about and all that. I was encouraged to pick it up again so I will make an attempt to post somewhat more frequently.

The difficulty with posting updates more often is the same as it has been for some time; there really isn’t that much going on. I remain in bureaucratic limbo with disability. I would say my overall level of functioning has improved somewhat. That said, compared to where I was 12 months ago, I have made definite improvement but compared to, say, five or six years ago I am still a giant mass of quivering dysfunction.

We’ll see how it goes.

Optimism?

Talking about feeling better and making progress is more difficult for me than bitching about being miserable, which makes a little bit of sense considering I don’t trust not feeling gloomy and on edge. It just isn’t normal. Hopefully this is something I will have the opportunity to get over.

From the above, astute readers may guess that I have been feeling a bit better. Why? Who f@#*ing knows. Again, this is my frustration with brains. There is really no way to determine why they do anything. I can come up with a dozen plausible theories but there isn’t any way to find out which, if any, are even remotely related to what is going on. That said, my baseline mood has been better this month and, over the last few days, I would even say I’m approaching what I think “normal” might be.

One of the contributing factor to this improved mood is almost certainly that we finally got some assistance from the social safety net in the form of SNAP1 benefits. They’re giving us kind of a ridiculous amount of money for food every month, for a household with only two people2. It does carry over month to month, which is nice, and having a dedicated (and more than adequate) food budget has expanded our options somewhat. I’m certainly not going to complain.

Getting SNAP money does not cure all the financial uncertainty going on right now. It has, however, been enough of a relief that if I ever manage to get disability benefits, I’m actually pretty optimistic about what that would do for my mental state. I’m not holding my breath.

  1. Supplemental nutrition assistance program? I think? Something like that. It’s the new and improved version of food stamps. ↩︎
  2. SNAP does not cover pet food which is an understandable but unfortunate gap. With two animals on special diets, the amount per month we spend on their food gets pretty close to what we spend for human food. ↩︎

Clever Title

November kicked my ass all month and then it kicked it some more. Now we’re in to December and the ass-kickings continue. I was denied disability benefits for the second time. Again, I haven’t seen any indication of why. I assume it would be the same reason I was denied last time, which was The Powers That Be not seeing any reason I couldn’t just go back to work.

This was going to be a much more cheerful post about a couple of times I had managed to talk myself out of having a panic attack but then I found out I was denied benefits and I’ve had all the stuffing knocked out of me again1. This is the beginning of my third year of sitting on my thumbs and I can’t seem to even get started without the carpet being pulled out from underneath me.

I am incredibly lucky that I continue to get support from my family but I shouldn’t have to be. I don’t know what The Powers That Be see that gives them such confidence in my ability to just go back to work but whatever it is, I definitely don’t see it. Or feel it. Its hard to not return to my personal favorite explanation, the “Lazy Piece of Shit Theorem” but I have been assured by many people that doesn’t hold up2. I still have a long list of appeals available to me, and the process continues but I don’t see much reason for optimism3.

Edited to add – A while ago, as part of the disability application process, I finally got all the dates of where and when I worked sorted out. It isn’t really relevant to anything right now but here it is:

February 2013 – Start at Swedish CVICU

July 2019 – Leave Swedish Cherry Hill for staff RN position at Swedish Issaquah

October 2020 – Leave Swedish Issaquah for staff RN position at Overlake

March 2021 – Leave Overlake for staff RN position at Virginia Mason

January 2022 – Leave Virginia Mason for RN Supervisor Swedish Issaquah

March 2022 – Leave Issaquah for UWMC

November 2022 – Last worked

So after spending close to seven years at one job I suddenly changed jobs 4 times in the space of two years. That has to mean something?

  1. Please don’t bother pointing out the significance of small victories like this. I’m aware that this is progress, of a sort, but being able to occasionally self-regulate my emotions (a skill most people learn as small children) pales in comparison to the disaster that is this country’s social safety net. I also realize I’m somehow supposed to remember that failures in one area don’t invalidate successes in another but, again, I have a hard time seeing how having a delicious dinner on the Hindenburg is supposed to make up for being horribly burned to death ten minutes later. Call me cynical. ↩︎
  2. Expert opinion is definitely against me on the Lazy Piece of Shit Theorem but all the evidence I’ve seen is, at best, Grade V (things you believe that I don’t) so I remain unconvinced. ↩︎
  3. I have a great deal of difficulty maintaining any sense of optimism about anything but, as a wise person once told me, that’s depression for you. ↩︎

Bad Brain

(Please note: this post has nothing to do with either the seminal 80’s punk/reggae band or the song by The Ramones from their 1978 album Road to Ruin. If that’s what you’re looking for you can stop here)

Anyone with an internal monologue1 will likely be familiar with this phenomenon. My brain will occasionally go into this mode where everything is broken and nothing can ever be fixed. It exists, in my case, solely to shit all over anything and everything I do. Progress is meaningless because you’re never going to finish, no matter how much you do it isn’t enough because you didn’t do everything, that sort of thing.

Bad brain has been rampant recently and I don’t have much explanation for why. If nothing else, November/December marks the beginning of the third year of me hiding inside playing video games, with no end in sight. That by itself may be enough but who knows? That’s the real frustration for me. There is no way to figure out what is going wrong or why with any certainty. I can construct a coherent narrative to explain my symptoms, but is it correct? no way to tell!

Brains are a waste of time.

  1. Something like 5-10 percent of the population have no internal monologue whatsoever, which blows my mind. How does that even work? ↩︎