So Scholar Owl’s meds came in the mail yesterday. He brought them in today after taking out the garbage. This is the one thing I greatly appreciate about having Martin’s Point for insurance. Not only have they covered in full all our meds without question, but they mail them to us – a 90 day supply each shot. I never have to deal with a pharmacy in person, or rather specifically I never have to deal with the local WalMart pharmacy that always seem to mess up our meds in one way or another for whatever reason every order. Anyway, I’m grateful that the mishap was not only corrected but they rushed the shipment for him. They could have been pissy about it and required all kinds of paperwork but they weren’t and they didn’t. So I’m happy and relieved. Now to just keep an eye out for the books I’ve ordered. I’ve gotten his Astronomy set already.

Speaking of medications, I was reading up on treatment options for PTSD the other day and I found an “interesting” webpage. It’s kind of boring until you get to their table that breaks it down by symptoms and the medications that have been proven to be most effective so far in addressing those symptoms. So I will go ahead and link you directly to that, here. This isn’t to say you can’t read the entire page of course.

I found this table helpful because in the past reading about PTSD has always been… how shall we say a “not me” kind of thing. Like what does flashbacks and re-experiencing mean exactly? It’s been really easy for me to dismiss this. Honestly a part of me still wants to. A part of me wants to say, “Hey look they found a med that finally works for my Bipolar and see how well I’m doing now?”

Well about that… look at that table real close. I use my med’s brand name but it’s generic name is on there. And to really top it off the number one symptom I use to complain about, the one I used to go to great lengths to avoid like the plague is completely gone now. It’s like a non-issue. Topamax is listed for treating sleep disturbance and nightmares. Yea that’s right, there was a time in my life I would go to great lengths to avoid sleeping just so I wouldn’t have to have my nightmares. Does this mean I do in fact have PTSD? My sister sees it. The people at the hospital see it. They see it even now. At this point I am starting to think it doesn’t matter given the fact I am doing so much better. I guess my issue here is all they did was screen me heavily, give me the diagnosis, and left it at that. I didn’t understand why. Until now. I was already taking the medication I could be on when I came in.

I can’t touch anti-anxiety meds (thank you Bipolar). Anti-psychotics scare me to death – the side effects list on most of these are unacceptable to me for a hit or miss, especially after trying Abilify. Lamictal was already tried but didn’t do all that well. It was an almost but not quite for me. PTSD is largely an anxiety based disorder, thus the front line for medications are still the anti-anxiety class. It’s a shame these meds trigger mania in me, which in turn triggers anxiety. I don’t know about anyone else, but there is nothing thrilling or relaxing in having a chaotic mind. Yes, the energy levels that come with it is AWESOME but I can’t think the same way as I normally do when I get like that. If I could have that energy without the noise, clutter, and chaos in my head then yea I’d love to be manic. But it never works that way does it?

So sleep disturbance and nightmares are taken care of, and quite well. Once again thanks to Topamax. No wonder the staff at this hospital have been promising me they won’t be taking me off this med. I’m assuming they mean as long as I want to be on it. They even said they won’t push me to add anything because I’ve been doing so well. This is the part that blows my mind because I’m so used to having doctors that just want to keep adding meds. “But you still have pressured speech so let’s try this to the mix.” These people told me nothing truly fixes that because it’s partly personality/habit and partly due to episodes. So we got the episodes under control. Yup I still talk a lot, only difference now is they say I’m speaking clearly and I stay on topic better. Apparently I was a mess somewhat when I first came in. Imagine that. I think they’re being kind.

Anyhow intrusive recall is a thing, but not like before. I’m guessing this is because even though Lamictal and Topamax are not the same med they are in the same class. As for the last one listed in re-experiencing… well yea it happens. I get angry about shit. And honestly a part of me is strongly in the camp of “you don’t get to medicate this away, so fuck you.” I have the right to be angry about what’s wrong with the world.

This kind of goes back to where my therapist accused me of holding grudges. Like I’m not allowed to have feelings. I’m not allowed to have any place to express them. By nature of my primary disorder, Bipolar, I’m constantly told to reign that shit in. Doesn’t matter what it is I’m feeling. It’s always too much. Ladies and gentlemen, with emotions it’s all or nothing. Either you feel it or don’t. You simply don’t feel an emotion halfway. And what really bothers me with all of that is I was trying to talk about something still very recent with my husband. She is making it very clear with me at every appointment now what is and isn’t allowed for discussion. I’m getting really tired of being told what I’m not allowed to talk about. I think I do a pretty damn good job reigning this emotional shit in every day so I think I have the right to walk in and expect to be able to say “I feel…” and not be told that’s not allowed. Especially when said person I’m talking to is being paid to listen.

The feelings though in the end really aren’t my primary issue or even my concern. What I don’t get is what exactly is setting them off. Sometimes I know, sometimes in retrospect I can figure it out, but there are times I don’t understand at all what caused them at all. It matters more to me to understand the why. If you understand the why then you can make it stop. Like the topic of rape and sexual assault. To discuss it in the general, abstract sense is fine but the moment you start giving names and faces – the moment you make it a real life case is the moment I start getting angry. I know this about me but I don’t think I avoid the topic. Not really. But I don’t seek it out either. What I find odd though is I find more often than not is my interactions with other women are triggering than my interactions with men. So something else is going on but I know it has nothing to do with gender. Not for me anyway. But how can you tease out the triggering process if you don’t talk about how you feel? If you aren’t allowed to even sort out how you feel? Nope instead I get shut down and I’m asked what are the facts or I’m just simply told what to do. I can get that for free from my dad every single day – whether I want it or not. I don’t particularly want to see someone get paid to do something for a service I already get for free on a daily basis. Anyway, she is leaving soon so hopefully I will get someone more empathetic.

Avoidance is its own category and this is something I lament all the time. I don’t experience restricted affect far as I know – my husband has accused me of being distant but no one else ever has. If anything I’m guilty of the exact opposite. I’m all about emotional intensity. But the other two symptoms I identify with. During my intake I told them I felt disconnected from the world around me. You know that whole glass wall effect? Or being on the outside looking in. Or even just feeling alien like you don’t belong here. I assume this is the feelings of detachment or estrangement from others. It might also be why my husband feels I’m distant. Who knows? At the time he was complaining about the lack of sex so it’s hard to say what the hell he really meant. Probably best that I don’t read too much into that. The act of avoidance in of itself should be self explanatory. Of the non anti-anxiety meds listed, it seems like Lamictal is a good choice. Sad that the side effects proved to be too much for me.

Looking in the list for hyperarousal, I can see now why they asked me about lithium – aside from being the historical med for Bipolar. We opted out of that one due to my dependence on Ibuprophen for pain management. Apparently these two meds mixed together causes lethal levels in the blood. I forget which one will cause the other to rise but that’s not the point. I’m not giving up the one pain med that works without blacking me out. I continue to feel this way. The only other med that caught my attention here is Clonidine. It should be listed for anger and aggression as well since I know that’s what it’s used for with other disorders but okay.

Aside from the SSRIs, the only med listed in every category is Risperidone. It’s an anti-psychotic though and that class of med makes me very uncomfortable.

I know I’ve talked about anger and irritability before. In previous posts in was in context of being a smoker and being Bipolar. I’ve always wondered if there was an option other than smoking if I was smoking as a means to self-medicate this particular set of symptoms. Like when I was put on the Chantix – that med that block the nicotine receptors – I became a rage machine. I was on that med for 3 months. I remember them saying nicotine stays in your system for only 2 weeks. I have no idea how addiction works in the body or the brain. I don’t, but in my mind I would think that once it’s completely purged from you system and you’re past the withdrawals it’s all psych at that point. You know the habit and behavior based stuff. So if nicotine only stays in the system for two weeks, then why is it 3 months later I was still raging like a blind Hulk on rabies? More importantly why was it that bad? And I’ve tried to quit by other means, not just the Chantix, and it’s always this bad. I’ve tried cold turkey and the gum too. I have never tried the patch because I react to some types of tape. Heck one I tried to quit while working at a nursing home and the staff there gave me a pack and told me to never quit again. I worked in the kitchen, usually far away from nursing staff. So does this tell you how bad I get? What people don’t realize is this is how bad I was before I started smoking in the first place, but why? Does it matter? Does it need to be addressed? Does anything really need to change?

Little Bear doesn’t come out of no where. I see a lot of myself in him. My sister says she sees herself in him. My mother says the same – she sees both of us in him all over again in many ways. So I’m really glad I finally got him on the waiting list for a neuropsych eval. If nothing else it should help with the fight for an IEP. He can’t keep repeating Kindergarten forever. That’s just bullshit. But I see what he’s dealing with, what’s working, what’s not working and I find myself looking at what hasn’t been addressed in my corner. Am I still a rage machine or do I finally have this under control? I want to have the freedom to feel and express but I don’t want to be a tsunami that drowns out and wrecks the world around me.

Maybe I’m fussing too much over nothing? That would be nothing new.