Image woman relaxing in a recliner with headphones
I had first Spravato (ketamine nasal spray) treatment yesterday. The man running the clinic was nice and explained everything. You self administer the nasal spray. I felt clumsy but it worked. They gave 3 doses, 5 min apart. Checked blood pressure periodically and mostly just let me relax
It seemed to take effect pretty quickly. Things looked further away and I felt happy. Then, I felt an intense high where everything got brighter that seemed to last for about 15 min. Then I started coming down. Things looked normal. I had to be there for 2 hours until I was safe to leave. I was still wobbly but my husband picked me up and walked me out.
Some people get nauseous but I felt okay. It drips down your throat and tastes bad but it was tolerable. I brought headphones and listened to a music playlist. I got a headache today so I took some electrolytes.
Overall it was pleasant. I go back wed and go twice/week for a month and then psychiatrist decides taper. Some people stay on it long term maintenance, others feel they don’t need it and taper off.
It has been a long time since I last wrote. I got certified as a peer support specialist but full time work was too much for me. I requested fewer hours and my psychiatrist wrote a note but my employer refused. I felt like I was either working or recovering and got very depressed. I attempted sui but except for a trip to the er and a week long hospital stay, nothing happened.
I did 2 1/2 months of a PHP. It was okay. I did tms again and it helped but it seems to have worn off. I tried going back to work but nothing had changed and I got depressed again so I stopped working. I am applying for expedited reinstatement of SSDI but I don’t know if they are processing with shutdown.
I am looking into ketamine nasal spray treatment (spravato). My insurance approved it after months but I don’t have an appointment yet. It is done in psychiatrist office and you can’t drive after.
I have not been doing much. My sleep is iffy and I am tired often. I got akasithia from a medication and then had restless legs from another. I was really uncomfortable.
I have been playing with AI making pictures and memes. I find it is a way to express myself, but I know there are downsides.
3 pics: dog with big eyes rainbow background (groovy), dog painting self portrait, me with my dog starry night background
Image: cartoon of several people sitting in chairs. Group therapy.
I have several chronic conditions: mental health, type 2 diabetes, sleep apnea, hypothyroidism, hypertension. I am on 9 medications. I was wondering if there is any type of holistic treatment that could help, and searched different terms in my insurance directory. I came upon a mental health facility that is holistic and integrative. They have a nutritionist on staff. It wasn’t exactly what I was thinking but it looked helpful.
I saw the psychiatrist and he is a bit different but I like him. He changed my diagnosis from schizoaffective to major depressive disorder and anxiety. He seems sure I was misdiagnosed. He decreased my antipsychotic, I am on a baby dose that is more of an adjunct for depression, so far, so good. I
Image: Stethoscope with words Transcranial Magnetic Stimulation
They do a type of Transcranial Magnetic Stimulation called MeRT. It took a couple of months but my insurance finally approved it. I had an EEG yesterday. They use the EEG to determine how to apply magnetic therapy. I may start as soon as tomorrow morning.
The therapy helps bring your brain waves to calm, alert alpha waves. You can get there through coping tools like mindfulness and meditation but this works much faster. I have had anxiety Al, of my life and it impacts me daily. I am really hoping this will help. I use a lot of stress reduction techniques and have been trying to expose myself to things I fear.
I spent 5 weeks in Partial hospitalization all day M-F. Now I am in intensive outpatient 8:15-11:45 M-F. The next step down is 3 days/week, then I am done but will come in for MeRT. I think the routine and structure help. I am learning a lot. You can’t drink alcohol while during MeRT. It is M-F daily and 36 sessions total.
You come up with a daily schedule but I have trouble sticking with it once I get home. I was supposed to come up with a meal plan but I don’t know how. I eat, mostly low carb, but I don’t really plan my meals. I keep snacks on hand and my husband usually makes dinner.
My fasting glucose does not match my A1C. My A1C is normal. I am trying a continuous glucose monitor. I like it but it show high readings, too. My dr thinks donating blood gives me a false low A1C so I am having another blood test in a few months and not donating. I am thinking of volunteering for the Red Cross at the donor center, but I am having trouble hearing. I am getting the wax cleaned out of my ears soon and try to get on a schedule so my hearing aids can work.
My therapist decided that I am doing well enough and run out of things to say, so he will see me as needed. I was feeling down earlier this month and he was able to give me a phone appointment. I had an epiphany of sorts, maybe obvious to others but it struck me.
Image: Dragon silhouette
I was raised that you were valued for performance/achievements. So, any time I feel I did an inadequate job I think I am bad/worthless. So, little things can spiral me into depression.
I emailed that to my therapist and this is what he wrote back:
” do two things:
first, list the values you would choose to measure your life by then how you see yourself adhering to it…..
second, would you use the same standards that you grew up with to measure your children’s worth or value…..
write this out…..
lastly keep the things you have written out to re read anytime you begin to experience these thoughts….. and shame that comes with it”
There is no time limit since I don’t have another appointment set, but I have started thinking about it.
I went to a journaling group on zoom last night. Everyone has some kind of illness so I can talk about mental health and it is not weird,
They have different prompts and you choose one and write for 10 minutes, then you can share. I usually share,
The prompt I chose was fighting your metaphorical dragon.
This is it, It is really rough but I like the imagery.
The dragon in my life is negative core beliefs. I was raised to believe that how you performed was related to your worth. Whenever I think I did an inadequate job, I think I am a failure and worthless, I fall into a pit rapidly.
To fight my dragon, I would face him head on at first. I would yell and stab at him to get my anger out.
Then I would turn away in disbelief. The dragon is not real, but I am keeping his image alive. When I stop believing he will get smaller and smaller until he disappears.
What do you do when all your coping skills only help a little?
Image view of blue sky from hole in ground
I am in a pit. I know it will pass, but it feels agonizing. My dog and husband try to comfort me, it helps some. I had thoughts of not existing but I have decided against that. I am here to stay, even if I am miserable. I want to quit things that cause me stress. My husband wants me to wait a month to make Important decisions.
I am not sure what I would do with more free time. My therapist moved my appointments further and further out because I was doing well and had trouble coming up with things to talk about. So, he moved me to “as needed”. Now, I need it but I have to wait for a time he can fit me in. I see my third psychiatrist this year next week. My insurance has been denying claims.
If you have any tips on how to ride this out please comment
I saw my therapist today telehealth. One thing he asked me was what do I do for fun or to relax. My knee jerk reaction was that I don’t know how, but I corrected myself. I am a couch potato but I enjoy computer games. I am happy on my couch with my dog typing right now. He asked what is one thing I have always wanted to do, for example, travel, and would I be disappointed if I never do it. I rarely travel, and would like to, but I don’t have a dream destination that I would be upset about not going. I can vacation in my backyard. We go on short overnight trips about an hour away that I enjoy.
It did get me thinking, though, I want to visit my sister in Boston when the weather is nicer. She suggested summer or fall, I have been there once when she first moved but it was a different house. She has a lake she likes to go to that I want to see. I can start planning that trip. My nephew is getting married out of the country but I don’t think I will go. I would like to but it won’t upset me not to be there. Just the coat is too much.
I have new health insurance and took a survey and the result said I am depressed but I feel fine. I am going to ignore that result.
I joined this zoom journaling group through the Mighty. I know everyone has a health condition, not sure if it is all mental health. They list prompts, give 10 minutes to write, share and then repeat. It goes for 3 hours but I leave early because I have another zoom, DBSA later. I feel like my writing is rainbows and puppy dogs and other people go deep. They are nice to me, I can’t go this week but I think I will continue. I know I have other emotions they just aren’t being prompted.
i zoomed with endocrinologist after therapist.My labs were good. I told her I stopped keto in dec and don’t want to go back to where I started but I don’t like logging food and counting carbs. She said I can visually see if my meals are less than 1/4 starchy carbs. I fill myself up with veggies. Beans are my main starchy food. I can do that.
I got a call from an old co worker. we worked at an activity center for adults with mental health issues. we have both moved on. he is now working at a new peer advocacy non profit, I don’t know if it is the grass looking greener. I am content where I am but get antsy when I am not busy I have a lot of down time that should change once I can get trained on some more tasks.
Image of insulin and glucagon levels over time source Digbi Health
I saw the image above of how insulin drops between meals and while fasting. While insulin is low, glucagon can burn body fat. I was intrigued. I am 10 lbs away from a healthy BMI, but still have abdominal fat. I am type 2 diabetic and asked my doctor if fasting would be safe. My glucose is pretty well controlled and I don’t have hypoglycemic episodes. She said it is fine, but recommended 12-14 hour fasts. Which is mainly cutting out the nighttime snacking and eating breakfast later.
So far, no change. My weight has been stalled for awhile. My diabetes medication was reduced in June and my biometrics went south. Glucose up, ketones down, weight up. Thankfully, that stabilized but I can’t get my weight to go down. I log my food on an app (Cronometer) but sometimes I estimate weights. I am going to have to get better at calorie counting to start losing again.
So I am gung ho on intermittent fasting. Watching Dr Fung YouTube videos. Then, I saw this study. https://pubmed.ncbi.nlm.nih.gov/34135111/ A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults
All I can see is the abstract and I heard a review but this is what I got out of it. There were 3 groups. One calorie restricted, one calorie restricted (same as group 1) but alternate day Fasting and a third group with no calorie restriction. The calorie restricted groups both lost the same amount of weight but the non fasting group lost more fat.
It was a short study 4 weeks, I think, and these were lean adults. Also, they were doing longer fasts than I am. But, I don’t know what to make of it. I would have expected the fat loss to either be similar or more for the fasting group since they have lowered insulin during the fasting period. if anyone has any insights let me know in the comments. I will stay with 12-14 hr fasts and keto diet for now.
I tried donating plasma at a donation center. I tried calling ahead to ask about restrictions but they do not give that information over the phone. And, they don’t take appointments for first time donors so I had to walk in and wait. For what it was it was not too bad. First someone checked my veins, which are fine. Then I had to fill out a bunch of paperwork. Then, I watched a video on plasma donation and read through a manual for first time donors.
Then, a woman, I don’t know her title, took me to an office to go over my paperwork. She got to the medications and asked what each was for and looked them up in a huge book. I take 7 medications for various conditions. After she goes through the medications she goes over them with me.
Most were fine. I take antidepressants but as long as anxiety and depression are under control it is fine. But, I take metformin for diabetes. She said that is a temporary deferral. If I was off it for a year I could come back. I don’t know what the likelihood of me maintaining my diabetes by diet alone is, my husband is able to, so possibly. Then she got to abilify which is an antipsychotic although it is sometimes used along with an antidepressant for depression. But, I told her I take it for schizoaffective disorder. That is a permanent deferral.
Bone marrow donation has the same policy. It is not the safety of the product. They consider me a safety hazard. I have been stable for 15 years but still people are afraid of me because of a diagnosis. They should have a sign out front: schizophrenics need not apply. So, I would not have had to waste my time.
I had therapy, virtual, on Wednesday. I went over what was going on in the present. Then my therapist started asking questions about when I was school age. Jr high and high school were not the best years of my life. I had a friend drop me in 8th grade to hang out with more popular friends. I had a boyfriend in high school who was very critical and was sometimes mean.
Creative Commons girlshealth.gov
My home life was horrific. My father had an undiagnosed, but quite obvious in hindsight, mental illness and my brother had a severe psychotic disorder. He was nice, just a bit scary to me. Everything was unpredictable. My dad would be fine one day and raging the next. I could not deal with being there so I spent most of my time out, with friends, drinking alcohol or smoking weed. I was very sad, and quiet.
After answering her questions she asked for my thoughts and I said they are discombobulated. I don’t know what to think. So, she told me to write down my discombobulated thoughts when they come to me. She used my own words but I don’t what she wants. I am going to email mon.
She gave me other homework. To write what you can gain from AA, without spirituality. That is easier for me. I belong to a secular AA Facebook group. I tried one meeting but I felt out of place and have not looked at others. I did think the accountability and recognition for time sober helped me. I have not gone to meetings lately but I am staying sober,
I noticed it in the tone of my texts. I am insignificant I told a friend. Another friend asked me to be on a podcast. At first I said yes, but now I am having second thoughts. No one would be interested in anything I have to say
My husband held me, the dog licked me and my son texted he loves me. I can’t feel it. I just feel sad
I have schizoaffective disorder and take antidepressants and an antipsychotic.
Maybe it is a response to sobriety? I am not going to drink I will probably try to get sleep instead
I was not sure what to choose for an “S” word, but this disorder affects my whole life. Also, most people have never heard of it.
Schizoaffective is basically a combination of a thought disorder, like schizophrenia and a mood disorder, like bipolar. There is controversy about the diagnosis. It can resemble bipolar with psychotic features except you have weeks of psychotic symptoms while not in a mood state (manic or depressed). Or, it can seem like schizophrenia with depression. There are 2 types, bipolar type and depressive type. I have the bipolar type and have had mania.
I had years of psychotic symptoms, it was either a long episode with periods of insight and lucidity, or a number of relapses. It all is rolled together in my mind. But, once I got on a good medication cocktail (I take several types), I have not had the severe symptoms. Now, I am more troubled by fatigue, anxiety and milder depressions.
Prognosis varies. I am married, have children, work part time. I had a psychotic break at 39. I know nothing about dating with a diagnosis or pregnancy and psych meds. Mental illnesses can be hard on marriages. We were married for 7 years before I was diagnosed. Fortunately, my husband is supportive and understanding.
I see a psychiatrist, a therapist, and go to a support group for mood disorders. Some good resources can be found through the National Alliance for Mental Illness NAMI.org and depression and bipolar support alliance dbsa.org.
Stronger Than You Think 