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    living better through chemistry

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  1. My very first therapy session was many many years ago. I don't remember anything about it specifically. I was a young teenager, and it was awkward to be taken by my parents to therapy where I was supposed to talk about them... and then be okay enough to get in the car with them right after the session (where I would then have to rehash the session with my parents grilling me about it). There was no confidentiality (the therapist would share what I said with my parents), and I was unwilling to disclose much of any substance. I didn't connect with a therapist as a teenager, I always felt they were speaking down to me. I wasn't allowed to try other therapists for a better fit, I had to see the one approved by my parents. I think I saw two different therapists while I was a teenager, for periods of about 6-12 months each (separated by several years), until (both times!) my parents decided it was too expensive and also unnecessary because there was nothing "wrong" with me. That said, I have had similar experiences to yours, where the session seems to go well and then later I feel like I've been hit by a truck of emotions. I think this may be a byproduct of my difficulty opening up/emoting in front of people (especially people I don't know), so all the feelings stirred up by the session are squashed down until I relax a bit in the comfort/safety of home... and then I get flooded by them. I would imagine this could be worse after a first session, which is often a broad history touching on many painful things.
  2. Honestly, if I start getting a migraine, I go home before it gets so bad that I can't. I won't be able to work anyway, so better to get home and hide in my dark, cool room. However, I live only 12 minute drive from work so it's not like I have to muscle through a long commute or something. I don't get migraines frequently enough to be on RX meds for them, though I'm considering it. I do keep some Excedrine Migraine at my desk though, to take on spec. It's tylenol, aspirin and caffeine all in one, and can be quite effective if I catch things early enough. I'm glad that you got out of the training, given the migraine! Hope you're feeling better.
  3. Act Opposite

    I feel like there should be an app for that... you know, to help all of us out. You're right, Blahblah, that's what I'm really doing isn't it. I hadn't thought about it that way. I wonder how to do the skill without denying/hiding/shutting down my feelings. It's hard to imagine. I guess that's my black and white/all or nothing thinking. My tdoc would say it's about greys. Intellectually I get that. I just don't know how to see the grey. Ahh, that fine line. It's grey. I suck at greys. It makes me wonder, sometimes, if the ways that I'm broken are why I am good at engineering (which is all about black and white thinking), or if I would be a good engineer even without all the MI and broken thought process crap. Seems like a chicken/egg problem, you know? I appreciate you, Cheese. I feel needy often. Sometimes I can intellectually understand that I do not act needy and that, as you say, I am in fact not reaching out enough. If I even think about reaching out, though, the anxiety and depression take over.
  4. Acting opposite is a "coping" skill I have been using since before I ever started any kind of therapy. It's challenging but I manage to act opposite well enough to maintain appearances to the majority of the outside world that I'm well. But so, I don't trust myself. When is it okay to act in line with what I'm feeling and when is it indulging my depression? How do I know what feelings are real and what feelings are depression? Surely non-depressed people get overwhelmed with stuff and retreat sometimes? Surely securely attached people call someone when they're upset and it's not being needy? I need a flow chart for life.
  5. I rarely login here, I only access CB from my personal computer and phone. However today I logged in on my phone and ended up here: Adware (?) approx. every 10 mins coming up on screen
  6. getting over things you've said

    I do this too. The way I cope with it is pretty similar to @quietly bonkers: redirect and distract. During the day, I force myself to change my activity - get up and clean the kitchen or fold laundry or leave my desk and get a drink in the break room. I try to be very mindful of the new activity, pull my focus as much as possible onto that. At bedtime is harder, because I don't want to change the focus away from turning my mind down enough for sleep. However, I might turn on music or a guided meditation and try to sink into that. I try not to say to myself "don't think that!" but rather "yeah, sucks that I said/did that, but can't undo that now... hmm, this tea tastes really good"
  7. Cheese, I guarantee you that your doctor's offices (all of them, including the county clinic) have this information if you ask for it. They may even be willing to email it to you. If not, if you speak to them on Monday they could mail it to you and you'd have it by the end of the week. These doctors are getting paid for seeing you - it may not be cash out of your wallet, but they are sending a bill to your insurance (whether it's private insurance or medicaid/medicare) and keeping meticulous records of exactly when and for how long they saw you. It is 2018, this data is recorded electronically on computer systems that make it possible to search and sort data based on things like patient name. Even if medical charts/details are kept on paper, all billing is tracked electronically. Billing is based on appointment dates, appointment lengths and the activities the health worker performed. This information is there. Call Case Manager on Monday. She can help you get it. You can call Sleep Dr.'s office and ask the receptionist to get you this information. Same with Weight Dr. and the GP (even if the doc you saw there has retired, there were probably other doctors that work in the same office, right? The office staff at that office have access to these kinds of records, which must be kept (by law) for years). You can get a list of your medications from your pharmacy. I get all my prescriptions from Walgreens and they allow me to download my RX records from their website. It shows the med name, instructions, quantity, fill date, price and prescriber for every single prescription I have filled. I download these records each calendar year (for tax purposes), but currently I can see RX records through their online portal from the last 24 months (and a form to fill out to request older records than that). I am confident CVS has a similar option. Even small pharmacies can provide these records, though you may have to go in person or call to request them. Mail-order pharmacies have this information in their online portals (where you'd go to request refills, verify orders, etc.) also. It's going to be okay, Cheese. Really. Edited to add: if you need help navigating websites to get this information, please PM me. I'm good at this stuff and would be happy to help a friend like you.
  8. Maybe ask your docs (or, rather, their receptionists) to print out all your appointment dates for the last year and just staple those to the form? Write "see attached" in the space on the form. Your doctors, all of them, can totally provide those printouts. It is very easy, they do it all the time. Just ask nicely, they might even do it while you wait (I ask for these statements, along with statements showing my payments, every year when I do my taxes because not all my docs bill my insurance and I itemize my medical expenses). Specify to them that you want it on letterhead or another way that shows the provider's name on every page.
  9. No valid scientific trial will let you participate in receiving an experimental psych med treatment while also changing any of your psych meds (doses or cocktail). That is bad science. The data they would collect in that situation would not tell them about ketamine because there is no way to tell what changes are from it vs from other meds. The trial I was in required me to have been on the same meds/doses for 6 weeks before beginning with them. My pdoc had to clear any med changes with them before writing a prescription, and they basically wouldn’t allow any changes while I was an active participant.
  10. Since weight gain is an issue, it may be worth discussing with your pdoc about trying metformin in addition to an (A)AP. I've read some recent studies indicating Metformin can reduce or prevent AP-induced weight gain, especially Zyprexa. It appears to be most effective when started at the same time as the AP. I can't offer much insight/experiences with other AAPs. I've tried Abilify, Rexulti, and Vraylar as adjuncts to various anti-depressants (I don't have psychosis, so can't speak to that). Abilify seemed to help the best of the three but also caused akathisia. That did not happen with the Rexulti but it was a much more minor impact (if any at all) on my mood. I gained weight on Vraylar, though lost most of it without trying once I came off it. Vraylar had no impact on my mood, however.
  11. I do not normally take medication for high blood pressure. I was given a small dose of clonidine to take the night before and day of the ketamine treatments. I was told it was thought to help reduce some of the dissociative symptoms in addition to the hypotensive benefits. They also took my BP every 15 minutes for 2 hours after every IM treatment. I don't remember the frequency during the infusion, though I was hooked up to a BP monitor and an EKG monitor (I think?) for the entirety.
  12. Yeah the money part sucks. If I could drop all my other medical expenses (meds, pdoc and tdoc), I might be able to afford IV ketamine. That’s not realistic though because my depression is partly situational and I will need treatment/support for that as well. The problem with IN route is the imprecise/variability in absorbed dosage. How much mucus is covering your sinuses today? How dry/moist are your sinuses? How much of what is administered just drips down the back of your throat? Nasal steroids work by delivering the steroid to the exact site requiring treatment and even then their efficacy is impacted by those physical factors. I did have some transient dissociation and derealization from the ketamine. It lasted 90-120 minutes after an IM shot, decreasing in length and “depth” as the number of shots I’d received increased. It was pretty similar from the IV too, though onset was faster. I didn’t enjoy or look forward to it, but it wasn’t exactly unpleasant. Mostly I just spaced out. I wasn’t able to read or watch tv or carry on a conversation (I did talk/listen a bit after 60+ minutes, but it was slow and taxing). I usually kept my eyes closed and let my mind wander. Weird but not bad thoughts. Not sure how to describe them. I’ve never been high or drunk (I’m too much of a control freak) so while I imagine it’s similar I can’t compare.
  13. I have had both IV ketamine and IM ketamine (shots). I did not have the infusion schedule that is typically followed in commercial clinics because I was in a medical study. However, I had enough to know for sure that for me, IV ketamine is a game changer. Also and despite that, I did not feel better immediately or even within 48 hours. From what I've read and conversations with psychiatrists studying ketamine, you really need about 6 commercial sessions over 2 weeks to know for sure if it will help. Some people feel better quite quickly and some just take longer to respond. I described my experience in response to a post in the depression forum. I'm not currently receiving any ketamine. When the IM ketamine didn't improve/maintain my mood I dropped out of the study. IV ketamine is out of reach, financially. I've already done ECT, so it's back to the drawing board for me. I have discussed IN ketamine and ketamine lozenges with my pdoc but we decided that since the bio-availability is so much less than IM and even that wasn't enough for me, there is little point in pursuing those options for me. Good luck with ketamine. Let me know if you have any questions.
  14. Thanks for your concern, Cheese. I'm not doing well. I'm exhausted, physically and emotionally. I'm trying to limit some of the self-harm or at least the severity of it. Sometimes I'm successful... sometimes not so much. I saw pdoc on Thursday. She didn't ask about self harm, so it still hasn't come up. I know I should mention it, and yet it feels like among the less important things to talk to her/them about. Pdoc did say she will be talking to my tdoc and arranging for the three of us to have a 1hr meeting together at some point this week "to brainstorm" together, I guess. She said she'll talk to tdoc about it before my 1.30 appointment with tdoc on Monday (tdoc isn't in the office on Thursdays and pdoc was off on Friday). I'm supposed to be taking Xanax at bedtime (in addition to Trazodone) because I've not been sleeping well. Pdoc increased the dose from 0.25mg to 0.5mg. Maybe I should try taking it more than just at bedtime, maybe it would help with the feeling of drowning that tends to precede self harm? Though I should bring it up with pdoc so I don't run out, and... *sigh* I don't like telling her how much I suck. You have my vote! And yeah... I expect I will be a more active presence seeking support here for a while (assuming I keep living). I appreciate all of you guys.
  15. I want to share with you my experience of IV and IM ketamine. In the fall of 2017 I participated in a medical study where I received both. While my diagnosis is MDD, the study was open to participants with BP in a depressive state. I described it in a post here in the depression forum. Most notably, with IV ketamine I found the dissociative effects started to ramp up within about 10-15 minutes. When I received IM ketamine, the dissociative effects ramped up at a similar pace and initially lasted 90+ minutes but after repeated treatments those side effects were less intense and didn't last as long. For me, it took at least a week to notice much impact on my mood. I did not notice instant or near-instant lifting of the fog or anything. However, my depression doesn't prevent me from smiling, laughing at jokes, and so on, it's just that those are fleeting. Regardless, if I were in your shoes, I would give the first 2 weeks worth of treatment a shot, and about 1-2 weeks after that decide if you want to continue. The beneficial effects of IV ketamine, at least at the dose I received (I'm not sure what it was, sorry), lasted about 4ish weeks. IM ketamine did not improve my mood. I am prone to nausea/motion sickness/post-operative nausea & vomiting, etc. and had a horrible time initially with ketamine. I threw up for hours even after maxing out IV Zofran and wearing a scopolamine patch. Taking 8mg zofran orally 1hr before the IM ketamine treatment was much more effective than IV zofran after getting ketamine. My understanding is this is an unusual reaction (in severity especially), as my doctor's weren't sure what to do initially. I have not tried IN or oral lozenge ketamine. My pdoc suggested those recently, but given my lack of response to IM ketamine I/we decided it wasn't worth it. I hope it helps you!