I have been diagnosed with a lot of nutty things over the years, so before I go on about this, I will tell you that I am generally a medical mystery and take any diagnosis I get with a grain of salt. But years and years and years ago I was diagnosed with PTSD, and once I was diagnosed with depression...and then I was also diagnoses with post-partum depression in which I was on paxil for almost a year. (Post partum depression is the very definition of a neurochemical imbalance. You can almost hear the neurons misfiring in your head with that specific brand of crazy.) Since then, all has been well.
However, along with my physical health, my mental health has never been something that has just been self-evident, it has been something that I have had to consistently work on and manage. It is a little, um unpleasant to talk about, but I think more people need to talk about it. Or risk something like coping like my mother, who denied that she ever had any sort of problem ever with anything. And then vacillated between depression, cold-hearted numbness, and occasionally irrational hysterics. So, in general, I will talk about it, but I don't like to make it into a big, dramatic thingamahoo. Again, all this is with a grain of salt.
Both D and I have done the cognitive therapy counseling. And both of us have had difficulty with the fact that most counselors seem to want to jump out of a nine-story window after hearing about our lives. We have trouble finding someone who doesn't blame it all on disability, or who requires so much instruction about disability 101 that really, we should be charging them rather than vice versa. We've gotten cynical about therapy. Besides, who has the time? We are way more into drugs, these days. (Don't email me about this, I kid, okay? I kid.)
The last time I saw a counselor it was with D. A hospital counselor when he was going through the foot thing. So, thankfully, disability wasn't a overriding issue. But both of us had the "he's going to jump out the window" feeling about this guy. Yes, D is a quadriplegic whose been in the hospital for months on end because of a life threatening foot injury. Yes, we have twin babies. No, D is not the biological father. No, his family is generally not supportive of our lifestyle. My family barely tolerates mine. Oh, and my mother died a horrible death, ten months diagnosis to death of brain cancer. Oh, and I am losing my vision and hearing. Oh, and I have kidney disease. Oh, and we live in different residences. Yes, we have constant health insurance, health care woes. No, I don't own my house and could get kicked out at any time. No, I don't have a break from the kids and the care-giving. Yes, we both try to work as much as we can. It went on like that. The act of talking to him and dealing with his little tsk, tsk, tsk expressions as he jotted things down was more depressing than when we just went on our happy, merry way with our lives. I think he invoked mental illness by his mere presence.
He diagnosed--both of us--with PTSD. A chronic version that actually changes the neurochemistry of the brain and the actual size of the hippocampus. This guy was so overwhelmed by our lives that I was skeptical of anything he said. Sometimes, I think people are intimidated by how much and how well we handle things (although not perfectly, of course, we are not depressed from day to day. We aren't planning on jumping out the window any time soon.) I think diagnosing us with something helps them not feel so intimidated. We saw him because obviously there was a breakdown in the level of D's health care management and we had to make good by the hospitals rules and do everything they said, i.e. see a counselor. A breakdown which I put squarely on the shoulders of D as being 100% responsible for. That being said, I think the mistake on D's part was just that, a mistake. Probably made because he was not paying close enough attention in light of the new babies and such. A mistake that manifests itself in able-bodied people as in things like forgetting to pay the electric bill or chronically misplacing one's keys. In D, it manifested itself rather quickly into a life-threatening health issue. We have very little margin for error with some things. In any case, we didn't feel like there was some underlying cause like killing ourselves softly with depression or PTSD, we mostly felt like we just needed to get a better day-planner. So, that whole diagnosis of 'severe, chronic PTSD' was kind of shrugged off.
Interestingly, though, in most of my routine pee tests I do to monitor my kidney disease, I show extremely low levels of cortisol. Which this guy says is a tell-tale sign of PTSD and its neurochemical permanent damage. Having discussed this with Dr. Google, I find that this cortisol issue is controversial. It seems like although most people with long-term PTSD have low levels of cortisol, they can't decide of the PTSD causes the cortisol issue or if the cortisol predisposes one to the PTSD. In any case, D and I went on with our lives. (As far as I know, D does not have (or has never been tested for) abnormal cortisol levels.)
Of course, I am the one who peed on an ovulation test stick that indicated that I ovulate every single day of the year, so I always question the accuracy of anything my pee has to say about me. My pee has been known to lie. This is why it took me two weeks to find out I was pregnant. But speaking of pregnancy, one unhappy bit of research states that you can actually pass on a predisposition to PTSD to your offspring through the womb due to cortisol levels. The children of Holocaust survivors, for example, have a tendency to have low cortisol levels and PTSD at higher rates than the general population. My mother was significantly abused as a child, and so it would not surprise me if she did suffer PTSD and passed some kind of predisposition to mental illness on to us. (Oh noes! Does this explain Naim's irrational fear of toilets?!) But again, too much thought into it will make you crazy. It is all speculation.
All this is to lead up to this conclusion I've slowly been coming to. I don't feel depressed, I don't feel all that anxiety ridden. Except for the usual trials and tribulations of double toddler motherhood, I don't feel like my life is out of control. I had an incident this summer that involved a childhood friend getting in touch with me with a problem that was a bit traumatic and flashback-y, (sorry, not something I can talk about since it is more her story than mine), but that is over now and I feel like it has been appropriately handled and dealt with. I feel like I'm doing more or less what I am supposed to be doing for my overall health, eating wise, exercising, etc. Or at least I have been most of the year. The kids and the big boy beds and the tornado that is Aaron has been challenging, but really, that just can't be that big of deal. So, despite all this...
Something is wrong.
Something neurochemistry-ish. Something not related to what is going on in my life or my adaptation skills. Something not related to some kind of acute or even chronic depression. Because I don't feel depressed, honestly. But, I don't sleep. Ever. Well, I do, for 45 minute cracks at a time. And then I wake up for some unknown reason and I'm wide awake. For hours. For days. For weeks. Sure, every so often I crash for about 14 hours straight, or go over to D's and sink into the couch and crash for a few hours. I'm tired all the time. I can be exhausted and sit there wide awake. For hours on end. After a while it makes me not think straight. It makes me ramble on about nothing. It makes me lose things and have serious mom brain. It makes me a boring mom who can't get simple things done.
So, I hate medication. But I've tried everything else. (Except doing that CPAP thing, which might be an option to try, but my MD doesn't think I have sleep apnea) But I've now gone to the doctor, this time my GP, and guess what? Chronic PTSD. She thinks. Extremely low cortisol levels. Just to clarify, I'm not going around having flashbacks or nightmares, but I am constantly in a state of sorta hyper-vigilance. I'm hyper-alert all the time, even when I'm so tired it doesn't matter because I would be ineffectual anyway.
So, I'm trying Ambien for two weeks. And if that doesn't work, I guess I am going to try some type of beta blocker like propranolol, or possibly a SSRI type of drug. Also, this is putting off my goal of finding menstruation-ending birth control, but I'll get there at some point here. I just need to work with one drug at a time. I hate psychological meds. It isn't because of the stigma, I know they help a ton of people and I'm fine with that. I just don't like putting eeeevil pharmaceuticals in my system. I don't like the fact that this all feels so neurochemical, like a disease that is totally out of my control. I'd rather have to just cut out caffeine or something easy like that. But it feels like exactly that. When I wake up all night long, it feels like I'm jacked up on some kind of hyper-vigilant high. And I'm not ON anything. I actually have cut out my caffeine. Didn't do a damned bit of good.
Anyway, this is probably boring to read, but I just want to sort of document where I'm at so I can see where I end up. I have a feeling this is going to be a bit of trial and error. So, I'd like to keep track of my variables. Also, I'm interested in researching naturo/homeopathic solutions to this, so if anyone knows anything like that, I'd be interested in hearing about it. I'd rather not be supporting the eeeevil pharm companies for the rest of my life.
But, Crazy? Buddy? Welcome! Enjoy your stay here all up at Camp Lisa's Hippus-thalmus. But don't get to comfy, cuz you'll be having to leave, soon, now y'hear? Oh, and be sure to tell your cousin, Batshit Insane, that he has quite overstayed his welcome at the Brain of Britney and he needs to move right along now and get back home where he belongs...Huckabee is missing him.
WOw, you have my sympathies. The few run-ins I have had with insomnia made me feel very off. I have a bad habit of letting my bedtime slip later and later, so I don't feel sleepy until lik 2 or 3 am. A tablet of melatonin usually takes the edge off so I can sleep even when I don't feel sleepy. It is no ambian, but it also isn't addictive. I hope you get it sorted out and have some long, lovely sleep.
Posted by: AmericanFamily | January 06, 2008 at 05:34 AM
Your symptoms sound very similar to mine after my boys were born. I was diagnosed with PTSD too. Every sound would wake me all the way up, and I was constantly hyper-awake. the only way I could sleep is if J took the monitor into the living room and I turned a fan all the way up. That, and Ambien. Things are much better, but I still take Ambien on and off, and I'm so grateful to have that option instead of going through the cycle you describe every few months. You know, as far as drugs go, it's not so bad, except that you need to take a break every few days or it will stop working eventually. It has a very short half-life, so you're not groggy in the morning,and it has few side effects (n one at all for me). PTSD can continue on a long time if the trauma is followed by chronic stress, even ordinary daily stress. My therapist called that situation a recipe for disaster. If you can find something to break that cycle, whether it be therapy, respite or help sleeping, or a reduction in your daily stress level, you will gain some resilience back and your symptoms will get better. Easier said than done, I know, but the Ambien is a good, very logical start. For me, I find that an extended period of solitude also does wonders. I know that this probably isn't possible for you right now, but maybe someday. I hope the Ambien helps. I really, really wish you lived closer so we could swap childcare sometimes and give each other a break. I'd totally trust you with my boys.
Posted by: Emmie (Better Make It A Double) | January 06, 2008 at 12:19 PM
When I started to lose my vision everyone seemed to think I was suicidal, because of course death is better than blindness NOT
Crazy doctors.
I don’t know what to say but I hope something works for you and you get some much needed rest and feel awake for a change.
Posted by: Angela | January 06, 2008 at 12:44 PM
Well, join in with the rest of us. We all feel like we are losing it this winter. It has never been this bad before and trust me, I have been around for a long time! Our disabilities greatly add to the crushing seasonal depression, true, and no one ever get's used to being "not quite like everyone else". But we are still expected to go with the flow, and celebrate every single holiday as tho it might be our last!
Posted by: [email protected] | January 06, 2008 at 09:05 PM
The "black dog" showed up in my life a few months ago, after a nearly 4 year absence. I, too, have been told that I have PTSD and I'm not buying it. (Actually our family histories sound pretty similar!) Anyways, it wasn't really debilitating depression this time, but I didn't want it to get there. It was mostly the numbed out feeling. So I started taking St. John's Wort capsules (just the Trader Joe's version, nothing exotic) and damned if it doesn't seem to be working, without the side-effects of SSRIs.
Posted by: Molly | January 06, 2008 at 09:08 PM
Oh my god, you are funny. That last paragraph is amazing, and how do you do that on no sleep?
I have some PTSD, and my husband does too. We do fine, we have good lives, although we do both take antidepressants. I had a massive attack of insomnia in my twenties, and Ambien really helped. I'd recommend taking a small does to start, because it was pretty strong for me.
It makes sense to me that you'd be hyper vigilant in any case, because you are the only parent home with the kids at night.
I have a funny insomnia story. We just got cable, and I watched about ten minutes of Hannah Montanna with my daughter. It's the show with Billy Ray Cyrus and his real life daughter. I *hated* the show. Then, that night, when I couldn't sleep because I'm 8 months pregnant and uncomfortable, I couldn't get the image of Billy Ray out of my head. It was awful. I almost had to get up and watch infomercials to clear my brain!
I really hope you feel better soon.
Posted by: cherylc | January 07, 2008 at 10:34 AM
OMG! Cheryl,
Billy Ray Cyrus nightmares would have to be worse than any PTSD nightmare I've ever had! : )
I had very weird dreams when pregnant. Dreams I will not mention here! I am thinking of you and hope your pg and birth all go smoothly. It is getting close, isn't it?
Posted by: Lisa | January 07, 2008 at 10:50 AM
First of all, I am sorry that I didn't get in touch when I was out your way. I was really overwhelmed the first week and really busy the second week. We'll be back in August, and I hope we can work it out then.
As for the sleeplessness, ugh. I hope the Ambien helps. I'm like you, though, about hating to take meds.
You articulated something that's been on my mind about therapy that I have not been able to put into words. I have a lot on my plate, and I mostly hold my shit together. I worry that if I go see a therapist, that he or she will want me to do things that aren't realistic for me to do or want to diagnose me with *something*. I'm not ready for the tsk-ing and the jotting of notes.
Posted by: snickollet | January 07, 2008 at 11:39 AM
Hi Lisa,
Yeah the Billy Ray Cyrus thing was bad. I think I'm just sort of amazed that he's still around, and it stuck with in an unconscious state.
I'm due 3/14. I delivered two weeks early last time due to preeclampsia, and I have several risk factors this time, but so far I'm okay. But in theory, I have 9 weeks to go, which seem very short and very long at the same time.
Cheryl
Posted by: cherylc | January 09, 2008 at 07:37 PM
hmm... this is interesting and timely. Someone I know is up in the air but leaning towards a PTSD diagnosis. I am going to go read that link.
I hope you're feeling better soon!
Posted by: shannon | January 10, 2008 at 09:34 PM
"Twinkle" we can "hear you". We are available to work alongside of you,to satisfy whatever you wish. But first, you must respond to our emails to you. You have to trust us.
'Long time worker with the deaf/blind, etc. etc. Knows the ropes and the turmoil to avoid!
Lantana
Posted by: [email protected] | January 15, 2008 at 06:55 PM