Facing COVID 19 (Coronavirus) Pandemic as a Person With Mental Illness

It's been quite a while since I last posted. I have been doing pretty well and stable for the most part for a bit. I still have my ups and downs, my bipolar cycles, but the extremes have flattened somewhat, and I feel more level. My anxiety has still been high but a little more manageable. My panic attacks have become much less frequent. My agoraphobia has gotten to a point where I can go to the grocery store regularly and some small stores and even doctor appointments unaccompanied, although larger places are still off limits, as are crowds, and new places can give me a panic attack. I finally found a sleep medication that has seemed to help somewhat, although it also has a side effect of weight gain. Ugh. I found a new therapist, also, and that seems to be starting off well.

Then this virus hit about a month or so ago. It actually started earlier than that, but really began affecting the general public's life about a month ago. It started gradually but ramped up quickly from there. Before I knew what was really happening, the virus was all that anyone was talking about. The state (Virginia) was starting to close certain types of businesses, such as gyms and movie theaters, and restricting gatherings of more than 100 people. On a national level, President Trump began his typical posturing, blaming everyone, taking no responsibility, giving no clear direction, dodging questions, extolling his own importance. Business as usual for him, except now he had a daily platform from which to proclaim his self-importance.

Some countries, such as Italy, were hit extremely hard initially, with death tolls in the tens of thousands as they tried to restrict daily activities and move into quarantine mode. In the U.S. the restrictions were mandated on a state level, and the governor of Virginia took relatively swift and decisive action in closing businesses, mandating social distancing, holding daily briefings, and working to get funding for the enormous need for PPE for front line health care workers, funding for the extreme influx of unemployment claims, and funding for small businesses who faced bankruptcy. He was one of the first governors in the nation to close schools for the remainder of the school year and order the state to be on "lock down" until June 10, 2020. The guidelines, however, are somewhat arbitrary and not entirely clear.

The number of cases worldwide and in the U.S. continue to rise every day. The death toll continues to rise every day. I find myself watching the site that tracks these numbers a few times every day. I watch it with trepidation and anxiety, hoping to see the numbers flattening or starting to drop. That is not yet happening. The scientists still do not seem to know much about this virus. There is not enough testing to go around. There is no vaccine. The incubation period is long, so it is difficult to maintain isolation for extended periods of time. Hundreds of thousands of people are without jobs, similar to the Great Depression. The economy is in tatters.

I thought I was dealing with this pandemic well as I have agoraphobia and anxiety and rarely leave my house anyway except for doctor visits, trips to the grocery store, and to pick up and take home my toddler grandson. This should not make a big difference in my lifestyle or in my mental health. Or so one would think. But one would be wrong.

While my bipolar is still relatively stable, my anxiety is through the roof. I expect that is true even for people who don't struggle with mental health issues. I do have to try hard to maintain my mood, though, through the anxiety. I don't want to slip back into either hypomania or, even worse, depression. It is a tough balancing act, and not one I have much control over.

I have to figure out what I do have control over. I have a little bit of control over my agoraphobia. I learned some coping strategies through exposure therapy, and now is a good time to use them since I am under virtual quarantine and can't really go anywhere anyway. I can go to the grocery store and to doctor appointments. That is pretty much it. So that is no real change. I should be ok with that. But for some reason, I am not. I feel unsafe. Maybe I am.

How to control the anxiety? How to determine what is "normal" anxiety from what is "abnormal" anxiety. I think most neurotypical people can control and manage their anxiety to a certain extent. I think, for me, my anxiety controls me more than I would like to admit. I do think, especially in this environment, a lot of my anxiety would be considered "normal." My response to it, however, is probably way out of proportion to the level of concern I should be experiencing. Thus my feeling that my anxiety is controlling me instead of the other way around.

For example. my daughter and her fiance are both paramedics. I have anxiety and worry about their health and exposure to the virus every day, especially now that their access to proper PPE is limited. It goes beyond just the typical worry and concern, though. I sometimes obsess about it. I tell myself that it is not something I can control, but my body and mind will not let go of it. I start to panic sometimes when thinking of them in different situations. My daughter had symptoms a few weeks ago and had to self-isolate for two weeks in quarantine at home, and I was terrified that she was infected. She turned out not to be, and I was so thankful, but I was anxious for two weeks straight. I absolutely hate it when people tell me to stop thinking about worst case scenarios or to just think positively. It is so invalidating to what I am actually experiencing. I am entitled to my thoughts, experiences, and emotions.

I have only gone outside the apartment a few times to the grocery store or to doctor appointments. I went to the grocery store two days ago and had a major panic attack. The first one I have had in quite a while. And it was bad. I can differentiate between a panic attack and an anxiety attack for me because they feel entirely different. A panic attack comes out of the blue with no warning, is severe from the beginning, has symptoms of trouble breathing, extreme pain in my chest, inability to speak or even stand sometimes, shaking, usually only lasts a few minutes, lingering pain that can last for hours, and has no unknown reason I can ever figure out. As opposed to an anxiety attack for which I can usually determine a cause and has similar symptoms that can last several hours but are much less severe. So I found myself on the floor of the grocery aisle holding my chest struggling to breathe, feeling like a fool with strangers staring at me from six feet away. Me controlling my anxiety and agoraphobia or them controlling me?

Anyway, this wasn't meant to be so long, so political, or so involved. It was really just meant to be an update on the current situation and that I am handling things the best way I can and that I am proud to say  that I have not moved into a really bad place. I am holding steady even though some days it feels like I'm holding on by my fingernails. But holding on I am. I am holding on to my family and friends. We are holding on to each other and supporting. And mentally I will get through this and, I hope, be able to get through this pandemic and out the other side. My stupid anxiety is telling me to hold on till this is over and have a breakdown then. I am trying not to listen to it. I don't want to have a breakdown at all. Not now. Not then. So the anxiety is not going to win this time. Stay healthy. Stay safe. Stay strong.

Smoking Rant

For anyone who has followed me through with my goal of quitting smoking, here it is. In the last three months I have gone from 2 1/2 (50) packs of cigarettes a day for 40 years to about 5 a day. I am trying so hard, but it is really difficult, and I can't quite get there yet. I am plateaued for some reason. I have started vaping with liquid without nicotine just to help with the habit of holding/inhaling a cigarette.

I feel like I am making progress but am just stuck. I have tried so many things...medications, patches, gum, lozenges, cold turkey, hypnosis...and nothing has helped. I am told that if I "really wanted this" then I would be able to do it. It's just not that easy. I have heard some people say that quitting smoking is harder than to stop drinking alcohol.

What bothers me the most is that most people in my life do not encourage or celebrate my achievements so far. I get negativity and disapproval. Like if I go to the store to buy cigarettes and come back with two packs instead of one I get a disapproving tone and look. Even though it's because I'm sick of going all the time, plus I get a $1 discount of two packs.

And I got a new duvet and pillows for Christmas and am told that I can't actually "have them" until I quit smoking and vaping. They are put away where I can't get to them in their plastic containers. At this rate they will be my Christmas present this year, too.

People tell me things like "I didn't want to tell you before, but..." such as "I didn't want to come to your house when you were smoking because I always knew the house and you would smell like smoke, and I would have to go home and shower." Even though I never smoke outside my bedroom with the door closed and usually the window open. Thanks for sharing your opinion. I really appreciate it. You can stay home and just keep it the way it was before. Thanks for sharing your thoughts even though that is so negative and has no positive reinforcement for me. Thank you for making  me feel shitty about myself for being weak and having people not want to be around me.

I completely understand that people hate smoking. It's nasty, it stinks, and it's bad for your health. I am trying to stop not just for me but also my grandson. I don't smoke around him. First I stopped smoking in the car. Ever. Even when he isn't in there (which would be illegal) because I don't want any nicotine residue on his car seat. That was a really hard habit to break. I know it's better for my health, and I am trying to do it. I used to smoke in the living room, but now I don't even vape outside my bedroom because I don't want any chemicals to be in the rooms where he is playing, even when he is not here. I'm so sick and tired of hearing "I never told you before but..." Like it doesn't insult me or hurt my feelings now almost as much as it would have then.

Rant over. Thanks for reading if you made it this far. I'm going to keep on trying. I'm not giving up. I am determine to get over this hump if I can, when I can. And I can't let people push me into doing something I am just not ready for yet.

Rough Time But Getting Better

Hi all. Just an update. Had a rough couple of weeks. My stupid CNP psych terminated me for no good reason and left me hanging out to dry without my spravato treatments or medications. I was so fucking pissed. I wanted to get back at her in every way I could.

I took some time so I didn't act impulsively like I am prone to do. Luckily I found a new psychiatrist (a real one this time) who seems pretty cool. She is getting me back on my spravato as soon as we can get the medication approved. And she immediately sent in prescriptions to get me back on my medications that I missed. She also changed my anxiety medicine from the useless low dosage valium on back to the xanax that worked, and I am already noticing a difference.

I have decided to just let things go with my previous CNP. It just isn't worth it to me, although it just kills me that she is getting away with all of this. But it isn't worth my mental health to fight this battle. I just want to move on to a better place.

And speaking of a better place, had a great Christmas (belated) with Mom, Kassi, Martin, and Logan. Went out for breakfast then back to our place for gifts and such. So nice. Mom and I babysat Logan that afternoon, and Kassi and Martin left for a few hours. They came home with a BRAND NEW CAR for Mom and me. Ours has been broken down for a while and is always on the verge of not running so they decided to do this for us. No words can express our gratitude and love for this incredibly generous gift.

So all around things are pretty good. I know I will feel better once I get back on the spravato, but until then I am just holding things together and trying to be positive. Hope all is well for everyone.

Update on Spravato

Some of you have been following my journey with the new treatment Spravato (esketamine) for my medication resistant bipolar depression. I just thought I would give an update now that I have had 16 or 17 treatments and am going every other week after starting with twice a week.

If you haven't read my other blogs, a quick update on what it is. It's a nasal spray for medication resistant depression. It is administered in a certified doctor's office, and you stay there for a two hour monitoring period afterwards. It is derived from a form of medical ketamine.

The side effects are weird but not unpleasant. Yesterday was, for some reason, my most intense experience yet. I had serious dissociation (where you can feel disconnected from your body, thoughts, and feelings) and hallucinations, which are the two primary side effects that I feel. It's pretty weird, though, which is why you have to be monitored for two hours (and also it can increase your blood pressure but not mine). Plus, you can't drive for the rest of the day.

It has given me my life back. I can actually laugh and smile and play with my grandson and interact with people and leave my house more (although that is still hard). I am not "cured" because there is no cure for bipolar disorder, but I feel better than I have in years.

My hope is to be able to go to a once a month cycle at some point, but I am still having a bit of a struggle a couple of days before my treatment which tells me that I still need to stay at this frequency. I'm not ready to stretch it out yet.

So that's where I am. If anyone has any questions about Spravato, the experience, the side effects, or the outcomes, please feel free to message me. Hope this helps some people. Good luck.

Depressive Episode or Bad Day?

Since starting my blog I realized that I mostly post when I am in a depressive episode. I find that on the rare occasions that I feel more positive I am less likely to post. I am changing that with this post.

As anyone who follows my blog knows, I have Bipolar II and have been in a medication resistant depressive episode for almost three years. This is compounded by Generalized Anxiety Disorder, Panic Disorder, Agoraphobia, a Severe Sleep Disorder, and a few physical problems. I didn't know what happy felt like. It had been too long.

Since starting my Spravato medication treatments I have noticed a big change. Previously, whenever I felt down, I knew my depressive episode was crashing even further. One of the big differences I have realized now is that I can tell the difference between a depressive episode and just a bad day or two. That is huge for me.

For the first time in a long while I can smile and laugh with my mom, my daughter, and my baby grandson. I can leave the house for short periods of time. I can interact more. Hell, I even got my driver's license. What a change a simple medication can make in my life. I felt that I had tried everything, every medication, every treatment. Then I found Spravato. It is not a magic cure, but it is starting to make a profound difference in my life.

I owe this to my daughter and son-in-law who make it possible for me to receive my treatments by paying for them and making sure I have transportation since I am not allowed to drive myself due to the after effects. Without their help, I wouldn't be able to do this. People around me started noticing a difference even before I did. They pointed out to me how I was acting and the changes that had occurred.

So I just wanted to share with people that there is hope. I'm not saying my way is the only or even the best way. Just an alternative. I had almost lost hope. I had lost my way. I may not have found it yet, but I think I am on the right path, finally.

Just an update on rambling thoughts

So I'm continuing my spravato and getting good results. I feel better, would have more energy if not for my sleep disorder, and have stopped feeling suicidal thoughts. Even with my agoraphobia, I went to the grocery store briefly by myself for the first time in years. And I got my driver's license after six years! I start once a week next week and hope I continue to feel better with fewer treatments.

I have to give a shout out to my daughter and son-in-law. They pay for my copays for all of my psych appointments to get the spravato, along with providing me with transportation since I can't drive, and it's a long trip each way. If they aren't able to take me, then they pay for an Uber which is also expensive. They are so supportive.

And again a shout out to them both for my teeth situation. I used to have beautiful teeth, but years of medication, dry mouth, no dental insurance, no money for treatment, physical conditions that cause a lot of nausea/vomiting, my teeth have gotten horrible to the point that I can't eat much, and I never open my mouth around people. I can't even smile now that I feel like it sometimes because my jagged front teeth cut my lip. I only smile with my grandson.

My daughter and son-in-law are paying for me to get all the work done to have better teeth. It's going to cost between $2,500 and $3,000. I told them I will try to pay them back a little at a time as I can, but money is so tight. It will take about 2 1/2 months and eight appointments. The first one will be really painful as I'm getting my top four teeth pulled. Ugh. Just the shots in the roof of the mouth will hurt so much, but it will be worth it. I'm also getting six fillings, bone grinding, and upper and lower partial dentures. It's overwhelming, but I hope by Christmas I will be able to smile and eat. Going to be hard to eat without top front teeth for two months as I also don't have any molars right now. I'm not worried about how they look since they look so bad right now. This could be a life changing experience for me, and I am so grateful to them.

I'm also a little anxious about my babysitting my 10 month old grandson. I have been babysitting him since he was born, but mainly from 4:00 a.m. till about 11:00 a.m. most days which works great with my sleep disorder. But now I will be babysitting about 3-4 days a week during the day for about 10-12 hours at a time Now that he is mobile, I am worried about keeping him occupied and entertained. My mom will be helping on some days when she can. And I get so tired late in the afternoon, but being with him helps keep me alert and happy so I am glad to do it. Especially since my daughter and son-in-law do so much for me. They, along with my mom, are pretty much my entire support system.

So, that's where I am. Usually I post these blogs to pages, but I don't think I will this one so nobody may read it, but I just wanted to get my thoughts down. So many of posts have been down that it is nice to post something positive. Keeping my thoughts up about continuing to improve.

Thanks for reading.

Ongoing Treatment With Spravato (Ketamine) Update

So it's been a few treatments, and I'm feeling like I should update on how things are going. I actually talked to a journalist who reached out to me and asked me about my experiences for an article she may be writing, and it was pretty cathartic to tell the entire story to someone who really wanted to listen. Usually I just tell people the basics because that's all they want to know, and I don't want to be a burden with details.

My treatment resistant bipolar depression has been going on for about three years. Because I also have generalized anxiety disorder, panic disorder, severe agoraphobia, a serious sleep disorder, and a few physical health problems, it can be hard to isolate just what is happening and what is cause and effect. For example, I know my sleep disorder which causes me to get 2-3 hours of sleep a day most days exacerbates all of my mental and physical issues. If that were gone, it would probably help my other problems. And my anxiety exacerbates my sleep disorder and my agoraphobia, etc.

But in just trying to isolate my reaction to the spravato specifically aimed at my depressive episode, I can say that I am cautiously optimistic that I am starting to see some results. I actually don't hate every single day or minute that I am awake. I smile sometimes. I can talk to my family and friends more easily. I'm no longer filled with daily suicidal ideations. And a big thing, after six years, I finally got my driver's license.

This has not been a fast and simple "cure all." But I do feel a little bit after each treatment which is more than I can say for any traditional medication that I have taken for 2-3 months. And I do find myself somewhat pressuring myself to feel better as this might be my last hope for improvement. But I'm trying not to go there. I'm just trying to feel what is real.

The treatments have gotten less intense with each one. The first nuisance (and previously undocumented side effect) is a burning in the back of the sinuses and top of the throat upon inhalation of the nasal spray. That lasts about 15 minutes. The dissociation isn't nearly as bad if I lie down with a blanket and a book, even if I read the same paragraph ten times. I just go with it now instead of fighting it, knowing that it will be gone in about two hours. It does leave me feeling kind of groggy and drowsy for a while, but that's ok.

At my next appointment they are increasing my dosage. There are only two dosages. The first dosage, then the higher, stronger dosage. I expect that my side effects may increase again for a little while, but that's ok. And while there are no longitudinal studies past about six months, the plan is to go down to once a week in another few weeks then maybe once every other week if that still maintains the progress. We will constantly evaluate.

So to my daughter and son-in-law who are paying for the doctor appointments and providing the transportation (you can't drive after), I thank them very much. This wouldn't be possible without them. I'm moving forward with a little bit of optimism, which is more than I've had in a long time. Just that little bit is showing improvement, and considering where I have been, a little improvement goes a long way.