DBT Haiku

Tags

acceptance, DBT, mindfulness, practice, therapy, willingness

learning to accept

resistance slowly fading

I practice willingness

Bottle Me Now!

Tags

acceptance, birth control, cognitive behavioral therapy, diagnosis, dx, irritability, Lamictal, lamotrigine, meds, optimism, oral contraceptives, PMDD, seasons, therapy, Yaz

I sat down to write a post and drew a blank. The last couple of weeks have been relatively peaceful, stable, uneventful, and more or less productive. Nothing exciting to relate, and nothing much to complain about in the here and now.

This is one of several bucolic vistas on my commute. The lens flare is somehow just right.

The longer days and spring weather are a tonic; I just plain feel better when the sun comes out a little more often, when I’m not waking up in the dark, and when it’s warm enough to spend time outdoors (but not so warm that I have to retreat back indoors).

I said things in therapy today that felt amazing. Like, “I can’t do it all.” And then we both smiled (really big genuine smiles) because it has taken so long for me to say that, and not just say it, but also believe and accept it. After commenting that I seemed almost perky, Hippie Dude remarked,

I wish I could bottle you like this for when you’re just dragging.

I know exactly what he means. He asked if I was fixating on waiting for the other shoe to drop, as I usually do. I said, “What other shoe? I’m ignoring it. It’s not going away, but I don’t have to pay attention to it right now.” He seemed mighty pleased.

My moods have been fairly stable for the last month (a whole month!) aside from some irritability. The hormonal horrors have been muffled or muted or entirely absent. My system still needs a couple months to “settle in” but if this improvement sticks around, I’m going to declare it a miracle. I’m actually letting myself get my hopes up.

The Yaz seems to be stabilizing the hormonal layer of my mood issues, so we’re further reducing lamotrigine to 100mg. Three months ago I would have laughed and then cried (all day) if you’d said that I’d be titrating off Lamictal this spring. It’s terrifying, in a really complicated way, to let go of a drug that has served me well. But the idea of being free of it – well, that’s quite a carrot.

It’ll probably take the rest of the year to perfect my morning cocktail, but it suddenly seems possible. I can’t begin to express what an enormous relief that is. Seriously. It’s sort of mind-boggling.

At least for today, I’m feeling optimistic about getting my brain cooties under control. Not every detail has been accounted for as yet, and basically only time will tell, but it seems increasingly likely that the bipolar Dx could be rescinded. Although, ironically, one can argue that PMDD is a bipolar spectrum disorder – the affective symptoms sure can match – even though the cause is clearly hormonal. The DSM doesn’t rule that out, last I checked.

Springing

Tags

anxiety, baseline, birth control, career, exercise, job, job search, Lamictal, lifestyle, meds, mindfulness, outdoors, routine, seasons, sleep, wellness, winding down, Yaz, yoga

Budburst: coming soon to your neighborhood in the Northeast.

Spring is definitely here, even with wildly variable weather. The birds are migrating, the days are longer, the sun comes out a little more often.

I do better in the spring. Even better in the summer. Not as good in the fall. Really not so good in the winter.

Predictably, I’m doing better with February and March behind me. My mood isn’t fabulous, but it’s stable. I’m catching up on my work, managing myself a little more effectively, and while I’m still damn irritable, at least I’m not so gloomy.

I don’t know how much of the improvement to attribute to “seasonal effects” and how much is the most recent set of drug changes. In any case, it’s enough of a change that my supervisor commented on it last week.

I do know that almost immediately upon switching oral contraceptives from Desogen to Yaz, I started feeling better. It’s sort of hard to describe that change, except that I suddenly felt like myself. A return to baseline, if you will. However, I also reduced Lamictal to 150mg at the same time, so as usual, it’s hard to match cause and effect.

Back at baseline, I can now see how miserable and desperate I’ve been in recent history and with that retrospective clarity, it’s a bit disturbing to see how disturbed I get. Blogging throughout the good and bad leaves a trail of evidence that makes it harder for me to deny or delude myself into the “it’s not so bad” trap that I always fall into.

Most of what’s working well right now focuses on mindfulness and lifestyle:

• Yoga classes have been marvelously effective at reducing anxiety.
• Practicing mindful living has me in the here and now a lot more often.
• Trying to create and maintain daily routines smooths transitions.
• Spending less time working (or trying to) lowers overall stress.
• Unplugging from computers after dinner helps me wind down for sleep.
• I cope better when I get exercise, so I take a walk outside most days.
• Spending serious quality time with my husband always makes me feel good.

Basically, maintaining my sanity is a question of time. I have to take time for myself, for my own wellness – it’s a direct investment in longevity, health, relationships, and happiness. It’s been hard for me to admit it, but this requirement is at serious loggerheads with the career I felt I was supposed to pursue.

So I’m starting to consider looking for work outside of academia. Spending some time thinking hard about that issue has helped bring clarity (for another post) and has taken a little of the fear and panic out of the upcoming job search, despite new uncertainties. I’m poking around a little more deliberately to learn about other job options, but only time will tell.

Weekly Photo Challenge: Color

Tags

Adderall, birth control, color, fish oil, Lamictal, lamotrigine, medications, meds, photo, postaday, supplements, vitamins, weekly photo challenge, Wellbutrin, Yaz

Well, haven’t done one of these in awhile. Or much blogging at all. I’m not going to apologize, though, as I’ve been seeing to my needs as best I can.

I think this is the third (fourth?) time I have a photo of meds for a weekly challenge. Hey, what can I say? It fits the theme, every time. This week’s photo challenge theme, color, is so open, it’s overwhelming. I tend to massively overthink things, and sometimes forcing myself to take the easy route (like just posting yet another photo of meds, and calling it good as both photo selection and blogging) is the best way forward.

Here’s to mediocrity. And being adequately medicated. I rather like the blend from white into yellowy-orangey colors in my current morning cocktail.

Taste the rainbow of pharmaceutical flavors…

This mix contains: mega fish oil, calcium, Vitamin D-3, Folic Acid, Balanced B-100, Wellbutrin XL 300mg, Lamotrigine 150mg, Adderall ER 20mg, Yaz.

23andme: A Few Surprises

Tags

23andme, data, disease, genetics, health, information, lactose intolerance, risk, surprise

Since getting my genetic drug sensitivity testing results, I’ve been fascinated with what genetics can tell me about how to best manage my health. Those initial testing results just whetted my appetite, so in January, Mr. Chickadee and I sent in 23andme spit kits.

I found the results pretty interesting. Everything is reported with indicators of certainty based on research – 4 star certainty usually means that there were at least 750 cases, 750 controls, and results replicated at least once in a study of similar scale. For you non-researchers, those are pretty high standards for certainty. The reports are split into categories based on whether it’s about ancestry or health.

In terms of Ancestry, I’m even more of a mutt than I had expected. I have 2.8% Neanderthal DNA, which I had no other way of knowing. I have 99.6% European ancestry (yep, pretty white) but that .4% includes Native American, East Asian, and Sub-saharan African genes – more diverse than Mr. Chickadee, with whom I share almost 78% of my DNA.

Health is broken up into 4 subcategories: health risks, drug response, inherited conditions, and traits. Drug Response is the simplest – there are only a few that get checked, but my results showed increased sensitivity to Warfarin, which would be very valuable information if I ever needed a blood thinner (currently dosage is best guess unless you have gene data.) There is zero overlap in the drug sensitivity/response data between 23andme and GeneSightRx reports, even though 23andme’s gene chips include all the right data for the more detailed drug sensitivity analysis.

Under Health Risks, I’m actually in pretty good shape! My most substantial risks are coronary heart disease (31.4%; 1.29x normal likelihood) and rheumatoid arthritis (6.3%; 1.49x normal likelihood). Unfortunately, heart disease isn’t much surprise – both my mom and grandpa had heart attacks in their early 50′s, and my mom didn’t survive hers. But only about 34-59% of heart disease risk is due to genetics, so I really do have a lot of power to reduce the likelihood of heart problems.

RA was unexpected, but knowing that it’s a risk would make it much easier to catch early, which makes it possible to achieve full remission instead of lifelong disability. Other risks to watch out for include cancers of the stomach and esophagus, PCOS (I have every single currently known genetic marker), and a few others.

But wait – here are a few of my reduced risk categories:

• Diabetes, both types
• Breast cancer
• Alzheimer’s
• Melanoma
• Multiple sclerosis
• Lupus
• Migraines

Isn’t that awesome? It doesn’t mean I won’t become diabetic and won’t get skin cancer, but it’s just not as likely as the average person, and I’ll take those odds! I have average risk for many other conditions, including bipolar disorder and ADHD, so obviously we only know so much about genetics, and again, environment matters.

In the Inherited Conditions category (I think the category refers specifically to heritable genetic mutations rather than standard variations), I’m only a carrier for one mutation for a kidney disease. Since kids aren’t in the plans, that’s of little concern.

Traits was actually a more interesting category than I had expected. OK, so mostly just novel – it was accurate in predicting straight hair, brown eyes, ability to taste bitterness, blood type, smoking behavior, and several other details.

Whole cow’s milk versus fresh homemade almond milk

The big surprise? The Traits report showed that I’m probably lactose intolerant. I had no idea! It turns out that you can be lactose intolerant but still have a relatively high tolerance before your body rebels. And you can also be totally ignorant that your symptoms aren’t run-of-the-mill digestive variability.

Compared to everything else on 23andme’s extensive and fascinating reports, lactose intolerance seems, well, average. But unlike many other conditions, this condition is pretty much diagnosable from the results: genetics are entirely responsible for lactase enzyme production into adulthood.

It’s also something I can act on, today, right now. And so I shall. I’ve been cutting my dairy consumption and while I haven’t been strict enough about it to be certain, it does seem to make a positive difference. So despite my deep love of cheese and yogurt and ice cream, it seems worth continuing to limit dairy consumption (fortunately butter has so little milk protein that it’s safe to consume as much as I please. Well, aside from the coronary heart disease thing…)

All of this is from 23andme’s standard reports – interesting, entertaining, and potentially life-saving information. One of these days, however, I want to download all of my data and run it through Promethease so I can really dig into it.

Irritability, Triggered

Tags

crankypants, hypomania, insurance, irritability, mood swings, overcommitted, triggers, vacation

I’m experiencing a lot of irritability lately. Like way more than usual, more than I expect, more than is reasonable. I’ve been working pretty hard to manage my reactions so that I don’t make things worse. It requires constant vigilance and mindfulness of my emotional state, stopping myself when I’m unsure of my judgment (and how do you judge that, anyway?)

It’s damn exhausting.

Usually the trigger is something utterly trivial, inconsequential in the bigger picture, and the reaction is way out of proportion. For example, the other morning I thought about summer “vacation” and was derailed for…an hour or so?

Here’s a sample of what’s setting me off:

• Yoga instructors not giving enough detail about poses in beginner classes.
• Traffic. Commuting. ‘Nuff said.
• Being broke, all the time. My budget is tighter than it’s been in years, thanks to student loans. I have almost exactly enough coming in to pay bills, if nothing unexpected comes up. There is no spending money, which becomes demoralizing fairly quickly.
• Barbecue sauce on my beef brisket that was too mustardy and sweet.
• Home improvement projects that move at a snail’s pace because I don’t actually work on them and it’s unfair of me to expect Mr. Chickadee to carry out my plans. But we really do need to finish the bathroom.
• Dealing with health insurance and insurance plan administration and medical billing.
• Doctors. All of them.
• Myself, a lot.

Is this an early warning of hypomania? I dunno. My docs and therapist would probably say no, but I suspect they underestimate subsyndromal symptoms. I’m considering the facts that in addition to irritability, I’m in improved spirits, constantly making things, agreeing to new commitments, and recurrently distracted by the notion of expanding my tattoos, among other semi-obsessive fixations. All behaviors that tend to surface when I’m running a little hot. All in the last couple weeks. On the plus side, I’m getting a lot more work done, when I can be bothered to actually work instead of being distracted by the latest irritation.

It’s nothing serious right now, but I’m working really hard at avoiding the usual pitfalls. I just have to keep a watchful eye out and avoid over-committing, starting a million new projects, and forcing myself into a guilt-shame spiral when the winds change and I can’t keep up anymore. Again.