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The Circle Is Complete

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Kintsugi

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Well, the circle is complete.

I probably disappeared from here early this year, during my last semester of graduate school. My cycle has been to resurface 2-4 weeks after a semester is over, stay till 6 weeks into the semester, then bob in and out of the forum until the final 4 weeks or so when I completely go MIA.

Last semester was different. Last Fall I was so strung out from working and going to school full time, my boss stayed an intervention with me after my last day of school, and that final night of turning in work had brought on a fullblown flashback the likes of which I hadn’t experienced in years. I burned myself with a cigarette that night to ground—still have the scars on my wrist. I’d been drinking A LOT that semester and eating very little. I lost one pound every week of that semester. The clothes I bought in September were hanging off of my bones by November. My boss felt like I might have a total breakdown if I continued to go to work and school every day of the week. I think she was right.

I checked out that winter break. Totally checked out. I was self-medicating with a variety of pills—benzos, neuropathy pills, opiates. Yep. There it is. I did not give a f*ck.

My first week of school last semester, I knew something was terribly wrong with me. I felt hypomanic, which I’ve only ever actually been once. My adrenaline and cortisol were at their ceiling constantly. I describe this to my therapist as constantly being in a room with a tiger. Things that would startle a normal person, like a near-miss accident, had no effect on me as my CNS already felt topped out on stress. It didn’t make any sense to me for about a week. Normally I feel pretty good at the beginning of the semester. I get an initial adrenaline rush that usually lasts the first four weeks, but it’s generally a helpful rush. It makes me super productive. I typically run out of steam 6 weeks in, then the real stress starts killing me at 8-10 weeks. I get depressed, suicidal, then I emerge like a psychotic phoenix from the depressed ashes to manically finish my school work while feeling like I’m going to actually drop dead at any moment.

I began desperately clawing for help. I’ve been trying to get assistance from the disabilities people at the university since I began school in 2016, but going back and forth between them and my T was frustrating and expensive and extremely time consuming due to my work and school schedules being so tightly packed. I reached out to a psychiatrist. I couldn’t pay for therapy; I finally paid off my therapy bills from spring 2017 early this summer. It was kind of a shit show.

I finally realized I was withdrawing from gabapentin. I didn’t realize I’d been taking it so regularly until that first week of school, when my symptoms were seriously kicking my ass. Let me tell you, never again.

So I stopped indiscriminately self-medicating. My system went back to normal levels (for me) of stress after a couple weeks. I also made the decision not to graduate last semester as I’m just a few classes away from snagging a second certification to complement my MA. That took a ton of stress off of me.

Last semester was absolutely fraught. I took a class that probably taught me more than any class I’ve ever taken, but it also about killed me. I experienced a weird head change, where no matter what, I felt completely apathetic towards school. That apathy caused me to go through these peaks of panic over my lack of panic. Professional opinions abound about this reaction. You’re clearly self-sabotaging, Simon. You think you’re worthless and scared of gaining value, Simon. You’re scared to graduate, Simon. You’re manufacturing stress because that’s your homeostasis, Simon. I think all of these things are probably accurate at once.

Anyway, this summer I just kind of got reacquainted with what it feels like to have the time and space to mentally collapse. Aside from someone attempting to ruin my reputation at work, and all the crazy emotions and fallout that accompanied that, I basically gave myself permission to stop running my mental engines at 7000rpm. I decided, finally, that I wasn’t going back to school this semester. I’m taking a break to try and get all of my shit in order so my last semester doesn’t kill me, and I’m optimistic that by waiting I’ll be able to get another full scholarship to complete my degrees this Spring.

But, on the other hand, taking a break has meant that I have the space to process loads of shit I’ve only marginally had the time to reflect on while I’ve been in this program. For those of you who know me, you may remember that I moved back in with my ex, started graduate school, did one year, broke up with him, moved out again, started a new relationship, and then I went back to school—all the while working full time and often volunteering here pretty intensely.

So this summer, I’ve processed quite the load of crap since I haven’t had any major life shake ups (aside from almost losing my f*cking job recently, of course).

So now, here I am, five months stretched out between me and the completion of graduate school, experiencing depression, avoidance, terrible nightmares, suicidal ideation... I stopped dissociating around this time last year, which frankly made everything worse for me because I was learning how to live life in the driver’s seat without that comfortable numb cushion between me and reality. But dissociation is even making a small comeback. Disordered sleep patterns of every type are crushing me: trouble falling asleep, extreme difficulty waking up, difficulty staying asleep. In cycles. The oversleeping more than anything has been worsening my depression and anxiety.

My P put me on trazedone. It worsened my nightmares, but it stabilizes my overall mood. Well, f*ck me, I’m hooked on them even though I hate them because of the nightmares and the dependency. He tried another medication to get me off of it—nope. All it did was make my libido super high before they started making me vomit. I have propranolol for anxiety, and I like them, but I can easily eat them like Skittles. The effect just isn’t enough for any real relief. Mostly, I f*cking hate these meds. The next time I see my P, I’m dropping the hammer. He asked me which drugs I wanted. I told him. He said let’s try mine for a few sessions. We did. Now it’s time to try mine, IMO—prazosin, ambien, and benzos. I resent the fact that I could buy a bottle of these pills off the street for the same cost as going to a psychiatrist, but after my little adventure with withdrawal, I’m trying to appreciate having a doctor who can oversee me. I don’t know. Gabapentin honest to god relieved all of my symptoms for those two weeks, so that’s an option I’m willing to try under close supervision. The point is, something’s gotta give, and I refuse to be on SSRIs or similar drugs because of the long term effects and potential side effects etc. Finding something that works has been a bitch. And my depression only seems to be getting worse. Not to mention I’m in an either/or situation with having a P or T; I can’t afford both. And therapy has been more helpful. But I also don’t want to resort to buying drugs on the street just in case I have a terrible episode and need to extinguish my suicidality super fast. Sigh.

Well, anyway, this turned into a super long post. Not sure if General or Education is appropriate, but there you have it: my update. I’m very glad I finally found the courage to reach out here again. This forum has been an invaluable resource that I so believe in.
 
Not sure if General or Education is appropriate
Look at you, thinking like a staff member :) This made me smile.

I'm really glad you came to check in. There's a lot you've been going through. Sometimes, just having a place to park some of it can help, a little.

You know me and meds, just wanted to give some thoughts on this...
My P put me on trazedone. It worsened my nightmares, but it stabilizes my overall mood.
That nightmare effect with traz is such a bitch. If you haven't tried already, you might want to look at seroquel before going to the ambien/pazosin/benzo combo. A relatively low-dose of immediate release will knock you out pretty fast. Can't also try and function on it, as you could with a clonazepam or loazepam, but also doesn't have the drawbacks of those. Extended release seroquel (low dose) can also be used for sleep and mood stuff.
Gabapentin honest to god relieved all of my symptoms for those two weeks, so that’s an option I’m willing to try under close supervision.
Also worth considering, even if just as an as-needed.
The point is, something’s gotta give, and I refuse to be on SSRIs or similar drugs because of the long term effects and potential side effects etc. Finding something that works has been a bitch. And my depression only seems to be getting worse.
Last one I'll mention, promise :) . I think this drug is the devil because it works incredibly well, but can f*ck with metabolism: abilify. It's generally well tolerated (both getting on and off), no-where near as difficult to discontinue as trazadone (IME), and is also not an SSRI. You may have tried all these suggestions already, I just wanted to offer them up in case no.
Not to mention I’m in an either/or situation with having a P or T; I can’t afford both. And therapy has been more helpful. But I also don’t want to resort to buying drugs on the street just in case I have a terrible episode and need to extinguish my suicidality super fast. Sigh.
It sounds smart to prioritize a P, just for right now. Getting a working solution in place will make therapy possible again, and (maybe) once you've got that solution, you can drop the P down to every 3-4 months, and get some T in?

So now, here I am, five months stretched out between me and the completion of graduate school, experiencing depression, avoidance, terrible nightmares, suicidal ideation... I stopped dissociating around this time last year, which frankly made everything worse for me because I was learning how to live life in the driver’s seat without that comfortable numb cushion between me and reality. But dissociation is even making a small comeback. Disordered sleep patterns of every type are crushing me: trouble falling asleep, extreme difficulty waking up, difficulty staying asleep. In cycles. The oversleeping more than anything has been worsening my depression and anxiety.
I think we are going though some of the same stuff right now. My T is adamant that getting my sleep to be more regulated is is priority, and I think I agree with him. I don't have great words of advice about it, just that yes - when you've been pushing and pushing to stay above water, and then hit that kind of enforced break - even though the break is fundamentally good, it's got it's own shit within it to navigate, which is very f*cking annoying. Well, annoying when one can try and laugh at it, and just incredibly demoralizing all the other times. Hearing you.
 
Oh my f*cking god @joeylittle I have missed you so. So, would you be able to sit in on an appointment on the tenth? No? I’ll get you a cabin? :bag:

Seriously, though, thank you. Why the F*CK did he prescribe me something with that side effect? Don’t get me started on the puke-inducing one: buspar. I also experienced worsening anxiety, restlessness, and some other side effects that made me go wtf was he thinking with this nonsense.

I actually have seroquel on hand. Maybe I’ll text him and ask his opinion about a test run. One of the reasons we like each other is because I’m completely honest about how stupidly accessible pills are for me and what I’ve experimented with alone. He thought the buspar would have an immediate effect on me because I’m “so sensitive.” Apparently he was surprised I was getting mood stabilizing effects from trazedone. :bored: Well, he was wrong. Buspar did nothing for my anxiety except give me frankly an uncomfortably high libido.

I would be willing to give abilify a shot if it really is fairly easy to get off of. The thing is, I lost all this weight from stress and it’s come to my attention within the past couple of weeks that, well, I’m pretty sure I’m just flat out back to having an eating disorder. I’m not quite clinically anorexic (<400 calories/day)... yet. Some days I eat around 4-500 calories. Some days I probably hit 1200+. But I never have two good days in a row, and it’s less and less by accident. Pretty much anything these days convinced me I’m not worthy of eating when I’m hungry. f*ck me. It’s hard to admit that. I haven’t mentioned it to anyone. Everyone got used to me chronically under eating from stress, so no one really bats an eye anymore. All that to say, I’m phobic of weight gain. That scares me re: gabapentin (or lyricas, which holy f*ck, are incredible and I probably liked too much, honestly), because that cured my low appetite immediately. I started eating normally, and whatever it did to my body also completely cleared up all of the digestive problems I started having thanks to grad school.

What the kicker about all of this fiddling with meds crap is is that at the end of the day, I still take benzos whenever I can, a la carte, and that’s going to be the focus of my next appointment. Idgaf to try different things, but I want a PRN script for klonopin or Xanax. Because I will take those anyway. I’d rather not be going off the grid with that, but when the stuff I’m prescribed either doesn’t work or makes me worse, yeah, I’ll blow $20 on pills I know work wherever I can find them. It’s not ideal. It’s reality. And I’ve been upfront about that with my T and P. I want a PRN script because I damn well know I’ll get them anyway. And I know I can handle them responsibly, because they’re always available and I don’t fiend after them. I really just want real help. But it’s been since April, and I’m not getting anywhere.

Also, y’know... I’ll always think like a staff member in my heart. It’s like going to a restaurant you used to work at and marrying the ketchup bottles out of habit. :roflmao:
 
It’s good to see you back again.

Heads up: you have a lot of stuff going on here. You’re allowed to work through these things slowly, rather than at a million miles an hour;)

I have no advice. Just really glad someone staged an intervention - that one’s a keeper:)
 
Seriously, though, thank you. Why the F*CK did he prescribe me something with that side effect?
Well, to be fair, it's a go-to for the specific combination of PTSD, mood disorder, and sleep problems. Then, it's just roll the dice on who ends up with the super-trippy vivid as hell nightmares, and who doesn't. It's preferred over seroquel b/c it doesn't make one quite as soporific as seroquel can (so said my P-doc). Honestly, tho, I would strongly urge you to do anything for sleep before getting onto ambien.
I would be willing to give abilify a shot if it really is fairly easy to get off of.
It is, at least, both statistically and in my own anecdata. Of course, everyone can always have problems with something. But it's not as reliably difficult as the SNRIs, for example.
Idgaf to try different things, but I want a PRN script for klonopin or Xanax.
Consider Ativan? Sort of depends on exactly what you need it to do, but it peaks faster and leaves the body more quickly than I think any of the others, which just means that you can get back to life sooner. Ultimately, your doc should be able to have an opinion about which benzo would be the best PRN for you.

As far as worrying about weight gain goes...I hear you, most certainly. Abilify will or won't, and there's (as far as I'm aware) still no grasp of why. If I'm remembering right, with Gabapentin it's more of a 'you feel better, and you eat - slash - carb cravings' thing.

Seconding @Sideways about no need to tackle all the things all at once. It's really great that you've opened up some space/time for yourself to take care of you.
 
Honestly, tho, I would strongly urge you to do anything for sleep before getting onto ambien.
Well, see, I took 10mg of Ambien nightly for awhile, maybe 8 months, obviously not my own script. My T knew, and my P was also informed (seriously, I WISH you or anyone who knows—I’m lookin at you, @Friday—me could’ve been a fly on the wall for that first appointment. There was a student observing, and in 50 minutes I laid out my entire trauma AND substance use history. The student was white as a sheet of paper afterwards :roflmao:). I stopped cold turkey when my supply stopped with no problems. It put me straight to sleep, and I could easily wake up with no hangover. My only weird side effect was getting the munchies, cooking an elaborate meal, and having zero memory of it in the morning.

I piloted seroquel (100mg) last night because why not. Worked fabulously and no nightmares. I actually had a great semi lucid dream. So tomorrow I’m going to text the P and ask about it. He pitched atypical antipsychotics to me my first visit, but I had no knowledge of them.

He agrees with me re: klonopin, although I’ve now developed a distinct preference for Xanax (who wouldn’t? It works fast, hits harder). My worry with benzos is that long term use is correlated with higher incidences of dementia, and I’m young. Of course, benzos are contraindicative for PTSD, but if I’m only using it maybe 1-2X a week it doesn’t worry me in terms of failing to cope with stress/anxiety off the medication. Addiction doesn’t scare me; I’m doing just fine not getting addicted to the ones available now.

That said, I need some kind of daily medication just to level me out, especially while I continue to sort out my shit now that dissociation has pretty much left the building. The whole world is different without dissociation, and that’s been good and bad. But I’ve been having more incidents of compulsive self-harm, and it turns out other symptoms (anxiety, sadness/depression, nightmares that haunt me well into my day, intrusive thoughts, and even re-emerging memories I’ve blocked out) kick my ass way harder sans dissociative symptoms. I know I can’t pop benzos daily. I have got to get away from trazedone (I sometimes take 25-50mg during the day just to chill me out, and I hate it). I need something I can lean on.

Admitting I’m having conscious issues with food restriction is helpful. Gabapentin did bring back my appetite, and I’m trying to see that as a plus.
 
Well hello and welcome back @Simply Simon :hug: I was wondering about you the other day and here you are. My powers truly do amaze me :wtf: am I saying??? Idk.

Take it gently on Seroquel. It can work wonders and then bite you. Depends what dose you are on.

I hope you can get back to therapy soon and sort this out so you can stop mixing and matching the chemicals to get the fast relief you need.

Well done with you studies btw! :)
 
Well done with you studies btw!
Thank you for the welcome and thanks for this. I’m a Chicken Little with school. Last semester I broke my A streak with a B+ in the class that kicked my ass; the sky didn’t fall. This semester began last week, and I’m not going, and the sky didn’t fall. Funny, I thought it really might. :rolleyes: Perspective is something every student needs.
 
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