priorities and anxieties

It seems like I’ve been neglecting things here, but I’ve been too busy obsessing about things to write or think or breathe. I’m working on tasks to improve our retirement investments, and we are cleaning up our current finances a little. I’m procrastinating on a bunch of small tasks that will move us closer to likely selling our current house; those small tasks add up to a large effort, but I think it’s will ultimately help us. I’ve been scavenging used parts to build a new computer, but I decided to put that on hold due to time and cost. I have been extremely busy at work, putting in lots of overtime in the past two months to move along a few important projects (I’m sure the shareholders appreciate my hard work). So writing has taken a back seat lately, which I’m sure has disappointed my faithful readers’ need for fresh content.

Of course, mental health always occupies a lot of my time. I saw my psychiatrist last week to discuss the tardive dyskinesia and the medication I’ve been taking for it. I explained how is seems like the involuntary movements have mostly subsided due to the medication I’ve been taking, but I still have the semi-voluntary tics that have been present my whole life. Those tics and movements (see this old post) have been more obtrusive in the past few years, increasing during manic episodes, periods of high stress, or in relation to medication changes that didn’t work well. After our discussion, my doctor is not sure I still have the TD symptoms, but the Ingrezza will help act on the tics as well (although I’m not convinced on that). He wrote “chronic motor tic disorder” in my chart, and said that the first treatment for that is typically Abilify. Yes, my old nemesis Abilify, which has made me fatter and basically ruined my daughter’s life. I told him it was a hard negative on that, so at the moment we’re simply not addressing the tics. He also said cognitive behavioral therapy has been used to help with tic disorders, but he was as skeptical as me about the effectiveness of thinking your way out of a tic disorder.

Another thing consuming my brain cycles has been my relationship with my wife. Sometimes we seem to be thinking and working well together, and sometimes it feels like we don’t even like each other. She has a lot of stress right now, and it is affecting things between us. Her anxiety level is very high sometimes, but to my knowledge she doesn’t really have an outlet for talking things out with someone, and she won’t consider taking medication to help.

I’ll end with words of wisdom which I should trademark and sell to makers of motivational calendars:

Smart people make mistakes all the time. Stupid people make the same mistakes repeatedly.

between two poles

Darling, I don’t know why I go to extremes
Too high or too low, there ain’t no in-betweens.
– Billy Joel

I’m in a strange place at the moment. At first glance, my bipolar symptoms seem to be relatively stable. I’m not having depressive spirals, and I haven’t had any hypomanic or manic episodes.

Emotionally however, I’ve been all over the place. It’s too easy for daily events to push me one way or the other, between mildly erratic behavior and sudden sadness. I’ll put myself into a hopeless mood when I listen to a melancholy song or ponder the future of our society. But a small bit of humor or irony at work will raise my mood a little too much.

I’ve been especially vulnerable when I perceive rejection, disappointment, or anger directed towards me. It’s like I stop trusting the people I care about because of a sentence or two of conversation which might be critical. I seem to be looking for reasons to throw relationships away, discarding people and memories like I’ve done multiple times in the past. At my most dramatic, I wish I could run away and disappear from life.

Then again, some days I feel like I’m vibrating with energy. I’ll be overly energetic, working on tasks that aren’t really productive, and putting on the mask to be somewhat social if I feel like it. I’ll be oblivious to this until something triggers the realization that I am being fake-social, and then I’ll immediately withdraw, feeling embarrassed and sometimes angry with myself.

I don’t know if I’m characterizing this correctly, but it seems like I’ve always been able to separate the physical effects of brain chemistry from the lingering emotional damage from childhood abuse. It’s as if I can feel the physical changes coming and prepare for the ocean swell, but my emotional lability sometimes hits me like a sneaker wave crashing on me.

My other issues are still causing some discomfort. I still get episodes of anxiety where I’m terrified of social situations, and I cancel plans or modify my routine to avoid people. My ADHD symptoms seem to be slowly getting worse over time, but I was able to increase the dosage on that pill.

The tardive dyskinesia is also still present; the medication seems to give some relief, but I’m still noticeably shaky and twitchy. I told my psychiatrist more about the mental part of the twitchiness: how I often feel like I need to do these movements, that I get only fleeting satisfaction from doing them, and that when I don’t do it “the right way” I have to do it again. The doctor said he would do some psychological testing next time, so we’ll see where that leads.

Maybe my next post here will be written in crayon from the rubber room.

what’s on my mind

It looks like my blog has been abandoned, but that’s not the case. I have been very busy and mentally exhausted most of the past three to four weeks, and I have not had time or energy to sit and write something coherent. I never seem to find the intersection between solitude, motivation, and creativity. That doesn’t mean I don’t have thoughts; oh yeah, I’ve got thoughts on many topics. I’m great at overthinking, obsessing, and hyper-fixating on things that don’t really matter while important things collect dust on my desk and in my brain.

Having said that, here are some things that have occupied my mind lately:

I’ve been obsessing about growing grass. After replacing our septic system in August, a large portion of our backyard was left a muddy and rocky wasteland. I rented a small tractor and an attachment to groom the soil, then planted seed and covered the seed with straw mulch. Currently there are little green seedlings reaching for the sky, and I think it will look pretty good before the cold weather sets in.

I visited the Air Force museum in Dayton. It was very impressive, but also thought provoking. I was looking at planes and talking to a few guides, but then I found the “missile room”. The missiles stand tall, witness to the possibility of destroying nations in a nuclear war, with millions of people dead as a result of collateral damage. This led to deep thoughts and the possibility of a short story. Hopefully I can expand on that in the future.

While in Dayton, I started feeling sick, and by the time I was home I felt pretty poor. The next morning I felt like I was hit by a bus. The sudden onset of typical symptoms made me think I had finally caught Covid. I contacted my doctor’s office and got a lab test, then just out of curiosity I took an at-home test; it was negative. The next morning, the lab contacted me and said I was negative for Covid, Flu A, and Flu B. Regardless, I had to work from home for the entire week because I felt like I was contagious with whatever I had. When I finally went to the office a week later. it turned out that several people had missed time due to Covid. Based on that, I’m assuming I am no longer Covid-free in ‘23.

Another issue was the anxiety and twitchiness I had previous to the Dayton trip. I saw my psychiatrist, and he thinks I have Tardive Dyskinesia. After getting samples from the doctor, I had to jump through several hoops with my insurance, the manufacturer, and a rare-medicine mail-order pharmacy. It’s an expensive drug, but the manufacturer has a copay discount program. After taking the drug for about three weeks, I’m still a little twitchy and I’m still having movement problems. I’m unsure about the TD diagnosis, but I’ll ask the doctor about it. I’m wondering if it is autistic stimming that has become more bothersome as I become less able to mask and control it. I think my biggest source of anxiety is not from mood swings, but from the struggle to hide my issues from everyone.

I’m switching cubicles at work for several reasons – distractions and loud conversations near my current cube, and a desire to just be quieter and less social in the office. I’m really tired of switching on and off depending on who is at my desk trying to talk to me. I’m at the limit of my ability to concentrate on my job because of ADHD and depression and moving all the time. I am moving to a quiet corner with tall walls, and I am hoping it will make a big difference. All I want to do is go to the office, concentrate on improving the quality of my work, avoid conversation as much as possible, then go home and relax.

The company had a remote seminar about hidden disabilities, and I listened in to see if I could learn anything. I struggle with this because I feel like I have multiple issues, and I need accommodations, but I’m not disabled enough to be disabled. I’m wondering about what would happen if I was diagnosed with autism and I disclosed that at work. They talked about using the anonymous employing assistance program to determine what accommodations the company might be able to provide. The risk for me is that the company would argue that I’m a safety hazard in my job description. That makes no sense for an office employee, but it’s the reality I face.

I’m also thinking about the realization I am neurodivergent (as is my daughter and maybe my son (more about that in a future post). My therapist (who I have not seen for two months since she is on maternity leave) says I need to accept who I am and learn to work with it. The problem is that I still want to hide it from everyone, including myself. Is that unhealthy, or maybe is it internally directed ableism? When I reach my limitations, I feel angry, guilty, and ashamed when I can’t manage everything. As long as I feel that way, I’m never going to be able to deal with my issues in a constructive way.

I also have physical aches and pains as I get older. I have to face the fact that there are some things I will never be able to do, and that is frustrating. I feel like I’m getting less healthy every day, and I’m not doing anything about it. I care, but I don’t seem to care enough. Will I get old and feeble, will I have a debilitating illness, or will I make an exit how and when I choose?

There are always financial concerns, and I think a lot about getting things set up for my family for when I am no longer alive. I feel like I won’t make it towards retirement unless I make changes, and maybe not even then. My son is basically independent now, but he needs investment advice so he is prepared for his future.

Finally, I had a dream about some high school friends. We might not be friends today, but if we were it would be uncomfortable for me. I am such a different person than I was in high school – I’m more bitter and weary, more neurotic, more aware of my problems and my mental health, and more aware of autism and everything that brings with it. I don’t know if my old friends would recognize me or want to be around me. My friend Lena, who was always kind and forgiving, would probably be the exception – she would have lost the immature behaviors and kept the grace and beauty she always had.

Well then. That’s a lot of words, but I have a lot on my mind. I’ve got work and office distractions, the music always present in my head, the movement disorder, dealing with autism, worrying about my daughter’s problems, paying attention to the baseball playoffs, going to concerts and museums, trying to make sure my new grass gets watered, and obsessive thinking about everything going on.

Hopefully things calm down a little and I’ll get more chances to write something, even if I don’t post it.

still twitching, still struggling

I’ve been struggling with the anxiety and twitchy symptoms and the jumbled thinking for about three weeks now, and I thought it was simply a reaction from trying a new antidepressant drug. Yes, I’m aware that antidepressants sometimes don’t mix well with bipolar disorder, and this was one of those times. In addition, I had stopped taking an antipsychotic drug at the same time I started the antidepressant.

I finally made it to my psychiatrist appointment yesterday. My doctor believes that I have tardive dyskinesia which was caused by withdrawal from the antipsychotic and made worse by starting the new antidepressant. He doesn’t really think it’s a manic episode; I’m not sure, but I guess it doesn’t really matter. Whatever has happened, it appears my brain is more susceptible to TD than in the past. Looking back, I know I have had these symptoms in the past but not as bad. We now know that I can never take an antipsychotic again, and antidepressants are probably off the table as well.

He gave me a new drug to treat the TD, which continues to be disruptive. The severity matches the amount of stress I am feeling, which tells me there is an anxiety component to this. It’s possible that the anxiety is in part caused by my uncertainty of being able to work due to the TD, which creates a worsening feedback loop.

I will take this new drug for two to three weeks in the hope that it will prevent the TD symptoms or at least reduce them as much as possible. In the meantime I am still having trouble concentrating enough to read or write or work or even watch a baseball game. It was difficult to make it through work today without needing to hide in the bathroom or an empty conference room. Fortunately I work from home tomorrow and Monday. I hope the TD medicine has some effect before I need to face the world again.

Sorry if this post is disjointed or rambling, but I’m not well right now.