dressed like a punk you were too young to remember

Had a great session with Doc A on Thursday, where I rambled about my babyish fears and feelings of separation anxiety from my family, and he made the predictable, yet accurate, statements about the challenges of individuation and such. I sometimes think that my main gain from therapy is the validation, which seems so irritating because it's a basic service I shouldn't need to pay $250 an hour for, and for which Doc A needn't have studied for ten years! I could have just recorded my own voice on a tape recorder saying "you are fine, you are okay, yes you have reasons to be angry, yes it's okay to feel sad". Aaargh. I'm kidding, really, I know there's more to it and that the work I'm doing with Doc A has helped my Ego gain control over the rampaging Id and all that Jungian palaver. In the end, I can say 100% that therapy is worth the effort and the financial outlay - I'm "better" with it than without it I guess. That's what it comes down to with medication, too. If I function more effectively, and feel happier and more peaceful on fluoxetine and amisulpride, then I'll keep taking it.

In other news, I had a brief reawakening of my mojo a couple of weeks ago, brought about by a flirtatious afternoon with my 18-year-old coworker Logan. Innappropriate, who me?? It's interesting to me that I could actually FEEL myself becoming BPD-ish, and more importantly could head my obsessive fantasies off at the pass, as if they were runaway brumbies lol. He's a lovely lad, and if I was twenty (or even ten haha!) years younger I'd give it a red hot go, but really - even I know where to draw the line. Logan is the only man who works for the Foundation, and Michelle said to me maybe I'd fixated on him because I missed male company and Logan was the only male in my environment... Probably true! I'm not exactly falling over blokes in my current life. Most of the time I don't want one (a bloke that is), but sometimes it's nice to imagine. I'm relieved that my fancying Logan was a short and sweet moment in time, rather than a long drawn-out obsessive crush like that last two workmates I flirted with. Maybe I really AM becoming well??

(Belle & Sebastian provide today's song lyric - "I'm a Cuckoo")

you're an angry blade and you're brave

A small update post-conference. It's been, it's done, seemed moderately successful apart from the usual technical glitches and no-shows. Sir J has moved on to his next "gig", and I am enjoying a well-earned day off.

Tomorrow I have to go and have the MRI I've been avoiding most of the year. Dr A has often said it would be useful to see what effects, if any, my lupus has had on brain function (and, ergo, depression, headaches, mania, moods, etc). I guess it will be interesting to know if any lesions are present, not that there's much they can do about them. Maybe it will turn out that I have a cabbage in my head instead of a brain haha.

Increasing my dose of fluoxetine has not helped my OCD or binge eating at all, and Dr A is suggesting a mega-low-dose anti-psychotic be added to the mix. I would then reduce to my previous low dose of fluoxetine, as the Abilify (or whatever) will be activating enough. The meds merry-go-round is so annoying, and confusing. But it would be good to not be a slave to the trich and binge rituals... Any feedback or advice from y'all would be welcome, as I know Abilify is something lots of folks have tried. Apparently the risk of weight gain is less than with other a-p drugs?

So much going on, no wonder I find it hard to sleep through the night. I am determined to not start medicating for sleep, though, as I know it's a hard road to come back from. This may sound like a negative post, but I'm feeling well. Relieved the work situation will now wind down slowly until December, when the Foundation closes for a month.

(Angry Blade - Iron & Wine)

This Is What Today Feels Like

The last few days have been heading downhill. For a start, I'm getting closer to the dreaded luteal phase of my cycle, which triggers the PMDD symptoms. I've been thinking I should probably increase my fluoxetine dose to 20mg, especially as I have the added stressor of starting my new job next week. The timing sucks.

I wish I didn't have to wait so long before starting work. At first, I thought it was a great opportunity to get organised -- now, I remember how much of an enemy anticipation can be. With anticipation comes anxiety, uncertainty, "what if" scenarios, and an added need to practise my still fledgling CBT skills. I was supposed to start with my new psychologist MH this week. Although I waited 6 weeks for the appointment I cancelled at the last minute...I wouldn't have been able to continue with the appointments as they were all scheduled for work hours (made the appts while I was out of work), so I have re-scheduled the entire series of appointments for after work. The first one isn't until June 2nd, at least by then I will have some idea of my work circumstances and any issues that may have arisen there -- which I can work out in CBT with the new therapist. Still seeing Dr A once a week or every two weeks, he has one day per week when he works late so it can be hard to get the appointments. All in all, this says to me "Am I doing the right thing going back to work?" It's so much easier to see doctors, do homework, get prescriptions, etc, etc without having to be somewhere every day from 7:30 - 3:45pm.

I know, I know...all that is just an excuse and OF COURSE I can organise myself and get everything done even while I'm working full-time. I'm allowing practical concerns to mask the fact that I am flatout gut-twistingly terrified of going back to work. The last few days I have gone back to the safety and santuary of my bed, and back-to-back episodes of Buffy and NCIS. I've been mindlessly eating chips and bread and cookies, desperately lamenting the fact that I've given up my Diet Coke habit, and I've spent $200 on crap on Ebay. It's hardly the end of the world, or even the beginning of a breakdown, but these are warning signs.

So, I am going to take more Prozac for the next 10 days, and try to get out and exercise. I need to start this new job in a better frame of mind than the one I'm in today, and the only way that will change is if I MAKE it change. The bottom line is, my illness is never going to go away -- the only thing that is negotiable is how well I can manage it.

The Jagged Little Pill

Yesterday, I managed to drag myself out of bed in time to present my high-functionin' self to Dr A at 8:30am. It wasn't easy, not least because dealing with peak-hour public transport is enough to send the sanest soul into a decline. I HATE the train, the ones that go near my house are set up so that the seats are all along the sides, facing in - your paranoiac's basic nightmare. A friend of mine who works as a train security guard says it's due to the high level of crime and naughtiness on my train line - but I *think* she's joshin' with me. Anyway, the trains at that hour of the morning are chock-full of worker drones (um, hello, you used to be one, yes I know, now shut up, ok?) and I was paranoid I would run into someone from my old work. In a small town city like Perth that happens a lot. In fact, it happened last time I had an early appt with Dr A and I could just imagine the chatter back at the office "Hey, I thought L had a schiz-out and was in the funny farm? Well, I just saw her heading into the city and looked like she was going to work...does she have a new job?" Bummer.

Anyway. Anyway. Anyway... the appointment went pretty well, although I am mega-cynical of most of his shrinkish moves. He asked me about the job situation, saying I was "extremely well spoken and had the gift of the gab" (bless) and that I was "very skilled" (you got no idea honey). I just about managed to not roll my eyes in cynical acknowledgement of his attempt to bond my good self to him. We talked a bit about "Lost in the Mirror" a great book about BPD that was recommended by the fab Wandering Coyote . It's terrific, and one of the things the author discusses is the benefit of ritual and routine for the Borderline. I had already been planning to try and set up a daily plan for myself, getting up at a certain time, exercising, cleaning, homework etc, because I am really scared about becoming wedded to my bed hahaha. So Dr A and I gasbagged about what I might have in my ritual/routine, trying to strike that happy balance between tasks and fun.

Once I left there I was all fired up for the day and had a small shopping spree (wouldn't call it a binge per se...) and saw a movie (Duplicity - not bad. Clive Owen deliciously British). Then went out later with my friend Michelle, and we had dinner and saw another movie (Paul Blart Mall Cop - v. entertaining, Kevin James chubbily charming). Today, I managed to stick to my routine/ritual and got up at 8am (better than yesterday's 6am, ugh) and have been cleaning and writing and applying for jobs all day while listening to Taylor Swift. Even managed to get outside and sweep the patio floor and vacuum my dog's kennel (Michelle, no need to call the RSPCA now lol).

So here's the thing. And ain't there always a kicker? Yesterday I *finally* opened the Lovan box, pushed out a pill, snapped it in half and swallowed it along with my myriad other tablets and supplements. Lovan, for those not "in the know" is another name for fluoxetine, aka Prozac. Sometimes, apparently, SSRIs can start working immediately and in very small doses. But maybe I am just having a couple of great, energy-filled, productive fun days?? I am furious at the fact that it might be those god-damned chemicals that have given me the kick in the ass I needed to get out of bed and into the world again. Part of me hopes for a major slump, so I can go "hooray, the meds aren't affecting me, it's just a hypomanic state!!" It's nuts, clearly. I want to be well, but I don't want medication to help me? Where's the sense in that?? I'm just gonna have to go with it. Here's the confusing list of facts (for my own record as much as to entertain my beloved readers, so please forgive me!)

1. Finished my darn period four days ago, always a positive thing
2. Kicked my diet coke habit six days ago - traditionally a hard time, usually gives me withdrawal headaches and lethargy?
3. Could barely function four days ago, and now have energy to burn and a clear head
4. Two days ago started SSRI anti-depressant at 1/8 of the standard/highest dose

I don't know how much of this relates to my current mental and physical state!

I don't know if I'm just having a "good" week!

But I am DETERMINED to make the most of it, regardless.

Visual Cues

I'm considering doing one of these graphs each week and displaying it like a flashcard for Dr A, so he can better "assess" me. It's colourful. It occupied some of my day. I am trying hard to focus on the tiny, but brightly visible, sliver of hope still present at the top.

I keep thinking longingly of the activating qualities of fluoxetine. My memories of taking it (2000) are clouded by the intense migraine headaches I had at the time, which may or may not have been a side effect. I imagine myself lucid, energetic and focused...less "rejection-sensitive" (Peter Kramer, Listening to Prozac). My shrink was torn between prescribing an activitating SSRI or a sedating one (namely citalopram aka Celexa, Cipramil). He asked me to make the decision...ie: "would you rather turn positive behaviours ON, or turn negative behavious OFF?" How the %^$#$%^ would I know? I used to think the "right" medication (or the "right" relationship, job, pair of shoes) would do BOTH. Would make me turn away from cake and towards the gym. Would make me see beauty in the mirror instead of horror. Now... I seriously doubt the capabilities of medication. Been there, done that.

• Fluoxetine - failure.
• Sertraline - failure (admittedly after working for a couple of years)
• Mirtazapine - failure.
• Diazepam - failure.
• Venlafaxine - GROTESQUE failure.

Of course, these days I have a more accurate diagnosis and with that, the realisation that medication doesn't really help Borderline Personality Disorder the way it can help other mental illness. Basically, the way to work through BPD is therapy, continuing the CBT and DBT I have started. Dr A seems to think that the therapy might be "easier" with the help of fluoxetine, make the darkness lighter and the energy levels a bit higher.

I know I keep flogging this dead horse. It's what consumes me, when I'm not trying to decide what kind of cheese to eat lol. I'm fairly sure that once I get my disability/heathcare card (with it's associated discount on medications) I'll shuffle off to the pharmacy and fill the script. If only to deflect the questioning of the persistent Dr A. And I will take the tiny pill (or half), and try not to choke on the weight of my sliver of hope.