Lying

 First I want to vent about some things that pissed me off. I was scheduled to have an appointment at 2:00 with the physicians assistant who manages me psych meds. Yesterday at around 5:00, I get an email confirming my appointment at 2:00 with some other person I have never heard of. So I understand that there are reasons that I might have to change. I am reasonable, but it would also be reasonable to expect them to call me and tell me it's happening or my PA could have told me because apparently he's known for a while. That's the first thing that upset me. The second is that at 1:15 I get a text telling me that I had an appointment with this lady at 2:00 EST. I'm not in that time zone. I get all worried that they screwed it up and I missed the appointment, but I try to calm down and tell myself someone would have called if I had actually not shown for the appointment (video appointment). Then 2:00 CDT (or CST? not sure the difference) comes, and I go to log on to the appointment. Except now the appointment is listed as a past appointment, so there's no longer a link to join the video call. I get to frantically call and explain the weird situation to someone at the office, so they can send me a new link. Then of course, they're late. At 2:10 or something the medical assistant comes on and wants to update my chart and check my personal info is the same. Then at 2:20 probably, I actually see the new PA. She's rather too cheerful, but I think she was trying to make up for the whole situation with the appointment and the anxiety it caused. 

The title of the post has to do with some lies I told. I'm like 75% honest lately. I'm pretty honest about having self harmed, but I usually lie on when and how many times. I sometimes admit to suicidal thoughts, but I always lie about how bad they are. I lie about if there's a plan. In my defense, there's always a plan. I always have a backup plan, and that's really hard to explain to a mental health professional without freaking them out. I am currently debating how much I can trust the new lady, and that's going to take some time to figure out. 

I still am not sure why, but my hands are shaking so badly. It could be electrolytes because of bulimia. It could be the ridiculous amount of caffeine. It could be that I skipped my Wellbutrin for a week and then suddenly restarted the full dose. Either way.. I'm afraid my parents have noticed, and I think they will assume I have been drinking because I always had tremors when I quit drinking. I think caffeine pills would upset them slightly less, but it won't go over well. I can't tell them about the Wellbutrin because they'll be angry that I didn't take my meds. There's no way to win if they bring it up, so I'm hoping they just won't say anything because I've had tremors in my left hand for a while now. That I assume is med, but my doctor just told me to try taking benadryl to help with it. The real solution is probably not to have me on more than one antipsychotic, but like the new lady he didn't want to rock the boat by changing anything. I tried to mention several times that I'm on too many meds, but she basically said that's just how it is for some people. 

I don't know. This probably wasn't coherent, but I needed to vent. 

Glasses

 Not that anyone cares, but as proof that I am in fact getting old I now have reading  glasses. They're not very strong, and it's really just for using my computer. My parents paid for them, which was nice because I don't have vision insurance. They insisted on getting nicer lenses than I would have gotten if I had paid (I planned to). 

I am otherwise doing quite poorly. The self destructive urges are very strong. So far, it's all been minor things, but I have urges to do something much worse. I might have plans to, but I haven't committed to anything. It all has to be delayed because I am going to an Irish music festival on Saturday, and I have to be around and well and not hospitalized for that. I must be well enough for now. It isn't helping that I'm still in a vicious cycle with sleeping trouble and caffeine pills, so I am so tired. I did at least admit that part to my therapist. Things are also quite stressful at home, but I don't want to get into all that. It's stupid stuff like my parents arguing and the dog being horrible. 

Caffeine

 I swear if I have a breakdown in the near future, this is going to be why. Actually, it all may or may not be a result of skipping my Wellbutrin. I've basically gotten myself into the vicious cycle with caffeine. It started somewhat innocently with drinking an extra cup of coffee because I was tired. At some point, I decided coffee was not going to cut it. I had bought some OTC diet pills that are mostly just caffeine pills. I took them once, and they made me nauseous. I decided to not take them. Then I started feeling exhausted, and I decided those were the solution. Except taking one wasn't enough. I took them twice a day (which is actually what the bottle recommends). I was still exhausted, and I decided it was cheaper and more practical to just buy caffeine pills. Somehow, 2 pills became 4. Then of course I started sleeping poorly.. waking up a lot, trouble falling asleep. That meant I was more tired, so I kept consuming more caffeine. Now, I've reached a point where I am both physically and emotionally exhausted. I don't know how to stop the pills. I know I need to take the Wellbutrin and cut back the caffeine, but that's all easier said than done. I think this is going to end up with me inpatient.

Yet another new therapist

 I am back to being too lazy to check what I have written previously and so probably repeating myself, which is not exactly a new habit. Plus honestly, if anyone reads this they might want the recap. Anyway, at the end of December my old therapist stopped accepting my insurance. Honestly, I was ok with this because she had on more than one occasion announced that I said I didn't want to get better and therefore she couldn't help me. Only problem is that I never said that and she is misinterpreting something I did say and deciding without clarifying that I don't want to get better. Plus, she really wanted me to get a job and would not listen to any of my arguments about why I wanted to at least wait and see if disability works out since I've been waiting over a year for a decision about it. I started in December with a new physicians assistant for my meds at a new psychiatrist's office and made an appointment with a therapist there for January. 

In January, I saw this new therapist, but then she couldn't see me again for almost a month because her schedule is so full. I saw her in February, and while I had appointments scheduled for the rest of February, she couldn't see me the first 3 weeks of March. While I'm relatively stable, I don't think I'm doing well enough to be going 3 weeks to a month between appointments. The PA agreed with me, so he asked the office staff to schedule me with another therapist. I am trying to see if I can see someone out of that same office because then I think the PA and therapist can communicate more easily than if I go elsewhere. I actually didn't like the first therapist there anyways (besides the schedule issue) because she seemed like a robot. She'd just keep saying "tell me about that" instead of giving any sort of feedback. Then she decided I should do EMDR because that's what she does, and I agreed because I am non confrontational. However, I don't really have a history of trauma, which is the main thing they use EMDR for. 

Today, I saw the new therapist, and I got a better feeling about her. I hate first therapy appointments because I don't know what to talk about. I basically said the main problems right now are depression and self harm. I obviously mentioned the alcohol and the bulimia, but I'm doing pretty ok with those things. We talked about why I'm cutting and if I want to change.. I said it's pretty much 50/50. I want to change, but I also know that self harm works and I don't have anything to replace it with. We talked about other things I can try like exercise or journalling, and I did say that I had started writing on my blog again. She asked if I would share something I wrote, and I awkwardly said no.. mostly I was unprepared, but I also like having some privacy. I'm sometimes more honest on here than I would be with my therapist. Anyway, she seems nice and very goal oriented, which is good for me. I lied when she asked if there's any thoughts of suicide. I'm.. not sure what the answer even is. I'm not really suicidal, but I have these urges to do certain behaviors that might be seen as suicidal. To me it's more wanting to hurt myself severely enough to need to be hospitalized, but I am assuming I won't die. Anyway, I didn't mention that. I don't know if she would push me to go inpatient, and I'm not really interested in going inpatient. I don't really have a plan, so I don't think it's necessary at this point. I see the therapist again next week, so I'll see how I'm feeling about things then. 

Speaking of secrets and lies.. I have gotten good at ordering innocent items and less innocent items from Amazon in the same orders, so that if my parents ask I can say I bought some normal thing without mentioning the other item. Today's innocent purchases were a shirt, a bra, and an eyeshadow pencil. The less innocent purchases were caffeine pills and first aid supplies. I have gotten very dependent on caffeine, and I only bought a small number of diet pills a few weeks ago. I also honestly think it's self care to buy first aid supplies since I am going to self harm one way or another. This lessens the risk of infection or serious scarring. Still, I can't explain either of those purchases to my parents. The bra is actually so that if I end up going inpatient, I have another bra without an underwire because I refuse to go without a bra in the hospital, and I only have a couple of bras without underwires (which aren't allowed in hospitals here). The shirt is a green shirt to wear to the North Texas Irish Festival.. assuming I don't get myself hospitalized between now and then. Can you see that I have decided the hospitalization is inevitable? I just don't want it to happen yet. My brain is a strange place these days. 

Awkward appointment

 So I saw the physicians assistant who does my psych meds today. I actually like this guy, which is a lot more than I could say for the last person I was seeing. He asked how I was doing, and I said I'm ok in what I thought was a pretty convincing voice. He said I seemed down, so I guess not so convincing. I explained how I had stopped taking my Wellbutrin for a few days, and obviously he asked why. I tried to awkwardly explain the logic that I was having a lot of self destructive thoughts, but that my mood didn't match. So you know.. logically.. I should make my mood worse to make it match my thoughts. Then I quickly add that this is something I have done frequently in the past, which is true. Thankfully, he didn't try to argue with my logic, and I said I did take it today. I took it mostly because despite having 2 cups of coffee and 2 cans of diet soda and a diet pill, I am still so tired I could cry. Oh and I slept like 10 hours last night. 

I also explained how I don't think it is going to work with the therapist I am seeing. I didn't get into my issues with her style because that's not really the issue. The issue is that sometimes her schedule is so full that I would go 3 weeks to a month without therapy, and I said that I'm not exactly doing well enough to be going without therapy. He totally agreed with me, and he sent a message to someone to see if I could start seeing someone else who he thinks is more available. She also does EMDR, which I am not totally sold on but was willing to try. He asked if things had been going ok with the other therapist, and I basically said it was too early to tell. I'm afraid to sound critical of therapists because in the past my parents have acted like it's my fault that therapy wasn't working because I was either lying or not trying. I'm afraid if I say that it's not working that he'll assume I just wasn't willing to try. So now my appointments with the current therapist have been cancelled, and I see someone new next week. I am seriously hoping this person will do more than say "tell me more about that."

I'm going to be honest for a second, so I guess trigger warning. My head is totally fucked up. I have this stockpile of pills that I have gathered for various reasons (like I didn't take my meds because I was nauseous but didn't want anyone to know so I hid them). I keep thinking about ODing, but I come up with reasons not to do it yet. Like I don't want to do it before we're supposed to have dinner with my brother because I don't want to screw up those plans.. or I'm supposed to have an optometrist appointment on Monday.. or now I have this new therapist appointment. I still think about it though... a lot. The thoughts have been going on for weeks now, which is what prompted me to mess with my meds and sabotage things more. I honestly can't tell if I'm suicidal or just self destructive or if it really matters which it is. Today I am too tired to do anything. I am just going through the motions until I can collapse into bed at 10. 

So I get points for being more honest than not during my appointment today. I admitted to cutting as well. I lied about how bad the thoughts are. In my defense, I do not have an actual plan to do anything, so I didn't really lie. All I can really do is go through the motions and take things one day at a time. The PA did increase my lithium, so maybe that will make some difference.. and maybe I'll start taking the Wellbutrin again. That could help with the exhaustion. I can't handle the exhaustion. Caffeine is hardly making a dent in it. I'm rambling now... so I'll stop. 

Still managing

 I haven't known what to write the past few days. I'm not doing so well. I haven't been taking my Wellbutrin in my continued attempt at self sabotage, and I'm starting to feel the difference. I'm consuming a ridiculous amount of caffeine to keep functioning, which is fun because it makes me nauseous. I haven't done anything more self destructive than usual, so I suppose that's good. It doesn't mean my thoughts are any better. 

I see my psych this week, and I think I will bring up with him that I don't think the therapist is going to work out. There's a few reasons. The main one is that her schedule is so full that I end up having several weeks in a row with no appointment. It happened for the majority of January, and she can't see me during the first 3 weeks of March. Clearly, I am not well enough to be without therapy for almost a month. I also just don't think her style will work.. she's very much the "How does that make you feel?" style. I will talk, and she'll just keep saying "Tell me about that." Now she wants to work on EMDR, and my issue with it is the same as when my therapist in residential brought it up. EMDR deals mainly with the past, and I'm having far too much trouble in the present to try to deal with the past. I need help with my current thoughts and feelings and behaviors more than the origin of my core beliefs and whatever else I'm supposed to be dealing with. Does that seem reasonable? Maybe it's just an excuse, but I currently expect to end up inpatient in the next couple weeks. I'm hanging on by a thread. Anyway, the first reason is probably enough to justify changing. My hope is that there's someone within the same practice that can see me regularly, and it's a bonus if that person has a different style. I need feedback and not to just ramble endlessly. I am well aware that my thoughts aren't logical, so I need them challenged. I haven't been entirely honest with her, so that might be a problem. I'm just trying to delay the inevitable hospitalization. 

It might be good.. or pointless, but I am sort of attending online AA meetings. I don't know if I mentioned this, but it was discussed with my case manager for the disability attorney that it might look good if I can show I am working on maintaining my recovery. I say sort of because at least once I have logged on to the website and then stayed logged in without actually listening to the meeting, but the topic was on how our higher power shows up in our lives. I don't do the higher power thing at the moment (which is a whole other post). Several meetings I have at least listened in on. I honestly don't have a lot of thoughts are feeling about it because I don't feel connected to much of anything or anyone anymore. I'm just going through the motions. I am so tired. I've been going to sleep around 10:30 and sleeping until 8:30, so I'm sleeping 9-10 hours a night. That's after at least 2 cups of coffee, 3-4 diet sodas, and a diet pill. If I end up inpatient, I am going to crash so hard. 

I think I should write something else, but I don't know what. The lack of medication is fucking with my head. I'm just going through the motions and caffeinating enough to keep up appearances. I see my psych tomorrow, and maybe I'll at least be honest about not taking the medication. 

Self sabotage

 I am really struggling at the moment. My mood is slightly better.. I laugh more, I smile more, and I don't feel like I'm going to cry at any moment. However, my thoughts are still absolute shit. Actually, it's not just thoughts. It's behaviors too. I'm having a lot of suicidal thoughts and thoughts about self harm.. actually what I have in my head is less an actual suicide attempt and more a massive form of self harm. I am cutting. I am hoarding pills (although I've had a stash for months now). What I'm really struggling with is the difference between my thoughts and my feelings. I think my mood should be sad if I'm having all these thoughts.

So the only rational thing is to start messing with my meds, right? I decided to cut back on my Lithium and Wellbutrin for the week and see what happens. This is the sabotage the title is referring to. I know nothing good will come of this. Either it will make no difference or more likely it will make things worse. Obviously, I haven't told anyone. I have therapy tomorrow and am debating in my head how much I can tell her before she decides I need to go inpatient (she's already asked me if I think I need it). I am ok with her suggesting it but not if she decides she needs to call my parents or the police or something. That's what I'm avoiding because I don't want to go until I decide I want to go. I know it's likely to happen, but I'm just not ready to admit that. 

Wow, I really intended to have a more coherent post, but it didn't end up that way. I am safe. My head is just in a horrible place, and I don't know what to do about it. If I went inpatient now and I smile or laugh, they'll think I'm fine or I'm lying. I may decide to go back on all of my meds. I didn't throw the pills out. I just put them somewhere. Rationally, I know I need help, but I'm not exactly rational most of the time.