Shit I am sick of hearing

First and foremost, I am sick of people saying if stuff sucks, you can just go and change it. I can’t make my adrenal glands start working again, and the majority of my problems are caused either by this or by the medications for this. I am very sick of people saying you just need a positive attitude. If you’re in pain from the minute you wake up until you go to sleep at night, it can be somewhat challenging to be cheerful all the time.

That being said, I am also sick of people telling me I probably complain to people all the time. I can’t remember the last time I complained, out loud, to another person. I avoid human contact if I am not in a good enough mood. And then, at the same time, people tell me I should talk to people about myself and then I’d feel better. [*facepalm*] In any case, I don’t talk to people about myself much at all and have very much crawled up my own asshole and died, to paraphrase Vonnegut.

I’ve also had numerous people tell me that I can’t possibly be suffering from things like impaired cognition, poor executive functions, short term memory loss, and attention problems, despite these being listed as side effects or symptoms from my meds and health problems. I’ve done things like making lists, but writing things down is a poor substitute for being able to think clearly and remember things. My former therapist suggested maybe I would benefit from ADHD-type meds, but I have not tried this or discussed it with my regular doctor yet, and I have enough trouble as it is remembering to take the pills I’m on and dealing with the side-effects of those.

I also think about parallels with dealing with grief. People often say that it is work, that you need to do it and get through it rather than repress it and remain in denial. That tends to be how I think about negative feelings in general: that they are often valid feelings and maybe you shouldn’t repress them 100% of the time. If things kind of suck, I think it’s probably ok to acknowledge that they suck now and then.

Anyway, I don’t think my current situation is the result of mental illness alone. I think I coped with things quite well before getting seriously physically ill (adrenal crisis can kill you quit rapidly and I’ve come close more than once). If I am sometimes in a shitty mood, it is because I am sick and I do not see a way out. I only see things getting worse. I’m subscribed to various groups for adrenal and pituitary-related diseases, and am bombarded with “in memoriam” posts about people with the same and similar illnesses dropping dead before they are 45. That and the medical literature also makes it seem like I don’t have a very long life expectancy, and that all that remains of that life expectancy is going to be miserable most of the time.

Anyway, though I am sure positivity has its uses, people telling me to deny that anything is wrong with me physically or that my meds have a very negative psychological affect does make me want to say “fuck your positivity.” Unless your life is perfect, you probably can’t be positive all the time. I have seen my entire life turn to shit and all my dreams and goals in life as well as my health crumble within the past 10 years.

I used to at least enjoy things like writing or painting, but the brainfog has impaired any sort of creative urges to the point where I find myself unable to write, no matter how much I push myself. Some might consider this unimportant, but it tends to mean that there is absolutely nothing in life that I am able to enjoy or feel good about, so I consider it a great loss. I didn’t even let people see or read most of my shit, I did it for myself, but I enjoyed it, and I don’t have that anymore, either.

It is possible that someday in the distant future, I will be able to get off of the corticosteroids. The endocrinologist said it will, at the very least, take years. I’ve also read that the negative side effects of long term corticosteroid use can persist for years after stopping the meds, and it’s quite possible that 10 years of high doses of steroids has really fucked up my insides and lessened my life expectancy, and yes, that bums me out sometimes. And I feel like it’s ok to be bummed out about that sometimes, especially since I only mention it on the internet and no one is forced to read it.

Psychiatric disturbances and corticosteroids

There doesn’t seem to be all that much in the literature about psychiatric disturbances caused by corticosteroids, but here is a good overview I found:
http://williams.medicine.wisc.edu/steroid_psych_effects.pdf
In the following, I will make some short quotes from the article and respond to them based on my personal experience.

The most frequently identified symptoms include agitation, anxiety, distractibility, fear, hypomania, indifference, insomnia, irritability, lethargy, labile mood, pressured speech, restlessness, and tearfulness.

I’ve probably had all of those at some point. I’ve been on corticosteroids for about 10 years now. I tend to divide that 10 year period into two distinct portions: the first 9 years, where I was severely depressed, often unable to leave my room (causing me to drop out of college), severely indifferent, anhedonia, tearfulness (there were times I cried about things like pizza toppings), insomnia. Then a few years when by in which I was so apathetic I couldn’t cry about anything.

The second portion began in August 2015 with what seemed to be a rather severe psychotic manic episode. The first thing I did was stop seeing my therapist. This episode wound down after about a week and a half, but continues to this day. It would probably fall under the category of a “mixed episode” now, with symptoms of mania and depression at the same time. Overall though, I am much more energetic, I have trouble sleeping, I have a disturbing and constant desire for drugs and alcohol, suicidal ideations, irritability, I cry all the time, I spend too much money (spending money makes me feel good for 10 minutes or so). The major differences are the energy and the ability to enjoy things, though. I am now more or less able to enjoy some things some of the time.

The most commonly reported corticosteroid-induced psychiatric disturbances are affective, including mania, depression, or mixed states.
Most often, patients receiving short-term corticosteroid therapy present with euphoria or hypomania, whereas longterm therapy tends to engender depressive symptoms.

This fits with my experience.

An overly stimulating environment can exacerbate a patient’s condition.

This is why I am largely avoiding Facebook. It’s a constant, overstimulating, unpredictable stream of unrelated nonsense. There is too much going on. Everyone uses it for a different reason. It’s complete chaos. On a related note, this is probably why I can’t stand going to bars anymore. Too noisy, too many people, chaotic.

Among patients with corticosteroid-induced psychosis, as many as 33% experience suicidal ideation.

I am not surprised, and I fall within that 33%, without a doubt. I have spent many, many hours thinking about killing myself. There was only one time I think that I really intended to do it right at that moment, but certainly I’ve done a lot of things that could have killed me, also, and spent a lot of time thinking about how much I want to die. On wikipedia’s page on suicidal ideation, there is also mention of role-playing: I actually purchased an air gun that looks reasonably similar to a real gun, and I keep it in my desk so I can take it out periodically, point it at my head, and pull the trigger. It’s never been loaded with anything and only takes plastic BBs anyway, but that’s not the point; the point is that I like to point a fake gun at my head and pull the trigger. It’s worth mentioning that, before being on steroids, I never had a suicidal thought in my entire life.

While the article says that some people respond to antipsychotics and antidepressants, it also notes that treatment success can be unpredictable. I have not had any success with various mood stabilizers and antidepressants. Due to adrenal insufficiency, my steroids cannot be stopped. At this point, I am not seeing any options other than learning to deal with it on my own, since drugs and therapy haven’t helped, and I can’t afford to just keep throwing hundreds of dollars at the problem anymore.

On motivational quotes and mental illnesses

control1
While there is nothing inherently wrong with attempting to be positive, I do have a big problem with the way a lot of “motivational” images seem to imply that all you need to do is think positive thoughts and your life will be hunky-dory. Maybe it could help someone who is simply having a bad day to focus on being grateful for things or think happy thoughts, but it becomes a problem when you figure in mental illness. It seems to be blaming people for things like depression or anxiety. My mom used to be this way about my anxiety, she acted like my panic attacks were some kind of attention-seeking behavior and I should just chill and snap out of it. You can’t just “snap out of” mental illnesses though, and having a crappy day isn’t the same as being clinically depressed. So when I see things telling me to “focus on the positive” and that I am only as happy as I allow myself to be, sometimes I get irritated.
nature
The same goes for the ones saying pets and nature are better than any therapist. I don’t dispute that spending time with animals or outdoors can be great and even therapeutic; but I do dispute the implication that these things are a replacement for therapy or better than therapy. No reason you can’t have both, but some people are helped by therapy, and talking to your dog is not quite the same as talking to a licensed professional in the mental health field. It minimizes the struggles of the mentally ill and says they’d be ok if they just took their dogs for more walks in the woods. While I can understand the idea that many people are stressed out from their jobs and perhaps being stuck indoors a lot, not all problems are solved by a little sunshine and fresh air.

On a semi-related note, I also dislike seeing the ones saying all you need is love and companionship, or that those things are the only things that matter in life. I sure hope those aren’t the only things that matter in life, or nothing much matters in my life, because I seem to be unable to form close relationships with people as a result of my mental illnesses. I’m not denying that many people have reason to enjoy these memes saying love is what matters in life; I’m just saying that these ideas make me feel very alienated.

rupaul

Additionally, as much as adore RuPaul, I also feel alienated when she closes her shows saying “if you can’t love yourself, how in the hell are you gonna love somebody else?” Maybe the answer really is, “you’re not,” but it isn’t very motivational for those of us who don’t have relationships and have trouble loving ourselves. I’m not saying people should be expected to never say or post something like this or the other love-related ones, I am just stating how I feel when I look at them.

Thoughts on relationships and my mental illnesses

Mental illnesses report:
My last post got me thinking about marginally-related things. I had a “best friend,” OC people will know who I mean, who constantly put me down and insulted me since the early 90s. But I didn’t tell her to piss off until 2011 because I always figured if I got rid of her, I wouldn’t be able to make new friends. And I suppose I made a couple, but not many I have been very close to.

Regarding boyfriends, there was the guy I met in the mental hospital when I was in high school, but, in addition to the fact that, the more I got to know him, the less I liked him, and that I only saw him a couple times a year, and that he was an alcoholic, he was cheating on me the entire time. In fact, I was so aware of this I’m hesitant to call it “cheating,” more like an unspoken open relationship, but only open on one side. But I stayed with him for several years because (as a parallel to the “best friend” situation) I figured if I got rid of him, I’d never find another boyfriend. [And I was right.] He occasionally re-friends me on Facebook and then unfriends me if I don’t reply to his messages immediately. One time his wife started sending me nasty messages, apparently thinking I was the one who friended him.

Eventually though, I figured that if I didn’t have a bf/gf and didn’t have friends, I could deal with that, and that it would be better than having the BF and [some of] the friends I had. There were times back then that I wished I had people to talk to about things but then I started writing a journal again and that helped and I more or less got over the emotional need to have other people around and to talk to people (most of the time when I tried to talk to people about anything emotionally-related in the past, I felt ignored or was quite blatantly ignored anyway, so talking to people never seemed to help). I got new hobbies, exercised compulsively, learned some new languages, etc. And I suppose some people have offered to listen, but I think I am so emotionally closed off that I am unable to have a dialogue about myself, I can only make posts which are written as a monologue. Possibly also why I’ve never really been able to open up to therapists; they are another person in the room who might potentially say something and that scares the shit out of me and I go mute.

Eventually I was on enough medication that my emotional state was completely numbed to the extent that nothing bothered me, so it was quite traumatic for me when that numbness disappeared recently and I am still working through that. Posting on FB helps. If my posts bother you, though, I ask that you unfriend me rather than just hiding my posts from your timeline (assuming anyone who wants to hide my posts from their timeline would actually be reading this, of course). I really don’t mind it when people unfriend me here. I think it is possible that, with a change of medication or a reduction of medication, my problematic emotional states will resolve or become more stable. In the meantime, I will probably continue the posts because, as stated before, this helps me to organize my thoughts.

I wish I didn’t have a sex drive

[Forum post plus some discussion from other people]

I’m not sure where I am at. I’m comfortable for now not talking to people in real life. I no longer get the urge to. There was a time when, if I felt bad or whatever, I would have an urge to talk to people in real life and have a conversation. That’s gone now.

Mainly these days I just wish my sex drive would go away. It’s especially upsetting because, due to medications, I thought it had gone away forever and I was very disappointed and disturbed when it came back (common symptom of bipolar mania: “hypersexuality”).

Here’s your TMI for the day:

Despite, after many years, getting over the Catholic guilt concerning masturbation, it doesn’t really help me much because (1) it seems a bit second-rate, and (2) it occasionally makes me cry, which makes it especially unpleasant and unhelpful. It’s not that I’m not good at it, I think I’m pretty good at it, it just seems like I’m lacking something I guess. It has diminished slightly since the psychotic episode last summer, though, but it’s still there.

So, not really sure where to go with that. If you’re horny and haven’t had any success having sex with other people, masturbation would be the obvious way to go, but it doesn’t seem to help me much. I guess I’m just waiting for menopause now because it’s my understanding that that can help to diminish sex drive.

I used to abuse drugs and alcohol very heavily to reduce or eliminate my sex drive, but it’s my understanding that that isn’t necessarily a healthy thing to do, either.

I don’t have any real hopes of ever being in a real relationship (I assume that would potentially be helpful with the sex drive), because, after 17 years or so, I have gotten discouraged by being rejected by everyone I ever attempted to initiate a relationship with and either (1) I am just not attractive to people in that way, or (2) I am doing something very wrong and I can’t fix it because I don’t know what I’ve been doing wrong.

There has never been a time where someone wanted to start something up with you, where they initiated the potential relationship?

No. I mean, not since like 1996, and he was cheating on me since the very beginning. So I always figured it was up to me to make the first move, but that always ended up leading to rejection and/or losing friends. I don’t think I’m creepy or anything, and the most I ever did was suggest that me and another person hang out (alone, without other friends), and I never even got that far* with people I normally hung out with (around other people), I would either be told they weren’t interested or they’d agree to hang out or go somewhere and then never show up, and then never talk to me again because apparently that made it weird. I also never considered myself anything worse than average looking, so I don’t think that’s it, and I had great tits in college.

*Not counting some drunken messing around with some women when i was 18 or 19, but that was more in the realm of 1 night stands and not potential relationships.

On involuntary celibacy

[This was a discussion of a post on Facebook which I can’t find to quote right not]

It’s interesting to read people’s thoughts on this; this guy is obviously angry. The culture in general is often judgmental toward people who don’t have sex, though, which probably doesn’t help and just causes more hatred and lashing out.

I disagree that it’s a male problem, though. I mean, I tried during the entirely of my 20s to have sex and relationships without any success at all (haven’t even kissed anyone since I was a teenager, probably wouldn’t remember how; by the time I was in my 30s I’d given up), and I do get resentful when people suggest that any woman can just go out and get all the sex she wants, whenever she wants, just because she has a vagina.

I do think discussion is helpful though. People can get really uncomfortable if you start talking about anything other than a normal sex life. I think there is some overlap with the way people respond to people talking about mental illness, many people don’t know how to deal with the discussion and try to avoid it, but I think talking about it helps people understand each other and should be encouraged. I also refuse to censor what I say regarding things like mental illness and sex to make the people around me comfortable, because (1) no one has the right to never be upset, and (2) if other people can talk about sex and relationships and that’s socially ok, I feel like I should be able to talk about what it’s like to not have those things.

I got irrationally upset one time when I was talking about a back tattoo I considered getting and some guy said guys would appreciate it. I said no guys other than my dermatologist ever see my naked back! (I have several tattoos no one has ever seen, for that matter.) And I realize now I was just lashing out because he just assumed I had sex with people because most people do and I shouldn’t have gotten angry with him.
Also probably why it bothers me if people ask if I have children. I never had a chance to make a decision to have children or not. As a kid, I always said I didn’t want any, but that’s not the same thing and thinking it over and being able to decide on the matter.

The worst thing about being bipolar and having severe mania at times is having a sex drive, for me, anyway. It’s the most unpleasant and unwanted symptom, and harder to deal with even than suicidal thoughts, which I also have a lot of while manic. The only good thing about the medication induced depression I was in for several years there, IMO, was complete lack of a sex drive. I thought maybe it would stay that way forever.

Mental illnesses report, Jan 25

It has been several months now since the bad chemicals in my head have changed their configuration. It might be not quite perfect to refer to things as only mania and depression, but that’s the best vocabulary I have at the moment. Sometimes I’m on, sometimes I’m off. I’ve been on nonstop since last August, and it’s beginning to wear on me.
I find it kind of funny, though; I spent the whole time I was depressed wishing I was manic, and now that I am, I’ve actually found myself longing for the depression. I know I don’t really want that, either, though.

This is greatly complicated by the medications I am on. I am convinced that there is little hope of psych drugs stabilizing my moods. I have tried that, and with fucking disastrous results (nearly hospitalized once) and no psychological changes. I don’t like therapy and I don’t feel like it helps me or has ever helped me or ever will. And it was costing me hundreds of dollars a month. I feel like my problem, other than the obvious bipolar disorder, is that it is complicated by the medications (corticosteroids), which exascerbate it and make it sort of unbearable, except for short periods of time when I am falling down drunk or engaging in ebay/amazon “retail therapy” (lol), which is to say, obsessively buying shit and then obsessively organizing and reorganizing the same shit. Books are nice, too. Started writing again and have been drawing more. If I can’t sleep, I have about 50 books of classical sheet music, and I do enjoy just kind of zoning out and playing some Beethoven on the piano. It is almost relaxing.

I could function more or less like a human before the prednisone. With the prednisone, I am barely holding my shit together. The depression sounds nice just because it seems like a very stable, calm, Vulcan-like state, but while depressed, I really I am just completely numb, apathetic, can’t enjoy anything, and am vaguely sick of being alive. While manic, I can be irritable, I can start raging or crying at any time, for any reason, or for no reason at all, I alternate between extreme egomania and something like a post-Catholicism super-masochistic martyrdom complex, but I am very productive and when I enjoy shit, I enjoy shit a lot. So there are good and bad points.

I have tried probably dozens of drugs over the years (talking about psych meds here) and nothing ever had any positive impact on me. Most of the time there was no change at all, and if there was, it was something unpleasant like an allergic rash (depakote) or constant diarrhea for months on end (prozac), or the zombie-like state I was in when they had me on anti-psychotics in the late ’90s.

I have given up on being stable. Part of me enjoys being unstable, just not *this* fucking unstable. So I am just hoping I can reduce the corticosteroids, maybe find something else that works, and at least get to the point where, if necessary, I can more or less pass as a human for short periods of time. I’m not there at this point, I’m more like a very volatile walking pharmacy/toxic waste dump.

Obsessiveness and language learning, etc.

I think the reason I stopped therapy was mostly that (1) I considered hypomania much better than the state I was in before a couple months ago, and (2) I am afraid that any treatment to “stabilize my moods” is going to put me closer to the aforementioned state, which is my worst fear at the moment. As for things like coping strategies or whatever, I feel like if any coping strategies were going to work with me, they would have worked at some time in the past 25 years. I’d been contemplating quitting therapy for at least 6 months before I actually did.

That being said, I’m still very far from stable and I just feel like I need to regain some self-discipline. I will, on occasion, get very, very fucking angry over some stupid shit. Today it was because someone claimed a translation project I wanted, and I screamed a long string of profanity (not even muttered under my breath, I mean I fucking screamed “fuck” about 20 times) and nearly put my hand through my wooden desk. Glad I work from home, haha. On a serious note, though, I need to not do anything that could potentially injure my hands, because they’re sort of important to me considering they’re what I use to work. But that’s where the desired self-control comes in, I suppose. It feels good to be angry though; it’s much nicer than the sort of void I was in before. People could have pissed me off in any conceivable way then, and I wouldn’t care, because I didn’t give a shit if I was alive or dead. Now I just sort of randomly rage about stupid shit. That’s one of the things that drove me to compulsive exercising when I was in college though, in addition to projects like a video game thing that I spend untold hours/months/years coding. It gave me something to do with the extra energy. Same with when I’d buy German grammar books 15 years ago when I didn’t know any German, never took any classes, and I was like goddamnit I am going to do every exercise in these books until I understand German. And so I did, 8 hours a day sometimes. That’s why I bought the piano. I’ve completely forgotten how to read bass clef, which is really weird because I can still read treble clef and the last time I actually had to read music when when I played trombone, which was bass clef. So my right hand knows what to do and my left hand just hovers stupidly in mid-air. I’m sure it’ll come back to me. I also cut up a bunch of pieces of watercolor paper (I have a gigantic roll of it) to do some paintings to try to sell. I had some bad BDD-related moments because if I was going to work a self-portrait in there, I had to take pictures of myself (the angles are too weird for a mirror), but it didn’t bother me that bad. I don’t even have a state ID, I haven’t since 2007, because I don’t want to have to have my photo taken. The Cushing’s syndrome is a big part of that, but it existed long before the Cushing’s. Will probably do a couple more serial killer paintings just because people buy them on there, but I’m bored to death of doing them.

Left the house today

Managed to leave the house socially for the first time in .. I dunno… maybe the first time this entire year. It was really nice to hang out with two friends I’ve known since high school or earlier, they are now dating each other and have moved into a new house. We talked a lot, drank a lot, smoked an entire pack of Marlboros in >12 hours (I only smoke blu e-cigs and not real cigs anymore, so that is uncharacteristic). I thought my bad habits were finally catching up to me a while ago, tired and shaky and headache, but then I realized it was just low blood sugar and could be correctly easily with a bit of candy or sugary beverages.

Because discussion of mental illness tends to eventually lead to discussion of sex, the one asked me to clarify what my sexual orientation actually is. I think the only constant is that while in a depressive episode, I don’t think I have one; and while manic, it changes every five minutes and I’m not sure it’s actually relevant anyways since various issues prevent me from actually acting on it. I answered the question anyway, because it’s easy to understand why people might have no idea and/or be confused about what my orientation might be. They kept offering food despite the fact I had been telling them I’m having huge troubles eating most food. I ended up eating a bit of garlic bread.

Other than that, I have not taken any recreational drugs at all today. Whoo. I also ate a whole grilled chicken breast and half a yogurt today.

Worrying about not being in a depressed episode anymore

For the past 8 years or so, I had an incredible fear that, if I ever were to *not* be in a depressive episode again, that is, if I were to either be manic or in some vaguely normal state, that everything I ever refused to deal with would sort of hit me over the head at once. All sorts of denial, repression, and just refusal to think about shit, and that all of this would sort of incapacitate me in some way. I feel like I’ve failed as a human being. But as it is, it sorts of trickles into my consciousness slowly, here and there. Life still seems nightmarish but in a very different way. I sort of went from a tendency toward being apathetic and sober to being very energetic and volatile and that clashes so much with my self-image that I still am unable to integrate into human society in any sort of meaningful way that doesn’t seem nightmarish to me. And it’s probably true to an extent that I avoid people because I don’t like seeing happy, well-adjusted people because that hurts me, and I am not exactly sure how to improve my situation. Also, because I take a stupid amount of pride in attempting to be an island and to withdraw from all human contact.

I don’t think there is much chance of me enjoying being around people, not as long as I live in this place, no. I have given up on that.

Anyway, I was not prepared for a huge personality shift at this time and it will take me a while to adjust, that’s all.

I’m just not good with people. And any time I am around people I can’t quite shake the feeling that I am wasting my time. I just had a brief moment of weakness and cried myself to sleep last night.

Now that I have some energy I would like to paint more, get some more decent portfolio pieces together, apply for other types of jobs.

When I was still in therapy, I sometimes complained about not having emotions, and I’d say that certain things are objectively shitty in my life and I should feel sad. He told me I shouldn’t complain about NOT feeling bad. I still completely fucking disagree. Feeling awful and going to bed crying every night is 100x better than how I was before. It was just complete emptiness and not caring about anything, not caring if I was alive or dead, and that fucking terrified me because it bore absolutely no resemblance to being alive.

Still having trouble sleeping and eating and spend most of my waking hours (and there a lot of them) struggling in one way or another. And because I have this bottle of 151 I started drinking before 8:00 this morning, which I think counts as an ill-advised attempt at self-medication. But as I said, it’s better than before. At least I feel like I’m alive. I’m sure my old self-discipline will come back to me eventually and I’ll level off a bit.

Mostly it just seems like I am in hell. Part of this hell is of my own making, and the rest is due to circumstances beyond my control. And part of it is I was in such a severe depression for 8 years that I accomplished pretty much nothing at all. I don’t see many good things in my future, certainly not in the near future. Also, fuck my life.

Someone assumed I was depressed and I had to tell him I am not; I am most definitely extremely manic. I’m just not in the mildly psychotic euphoric mania state that I was in when this all began. But as I said, bipolar depression can apparently have a lot of differences from regular depression. Personally anyway, when in a legitimate depressed state, I do not and cannot feel sad, I do not cry, etc.; I’m just very apathetic and rather grim. In a dysphoric manic state (which, so far as I can recall, is the state in which I’ve lived most of my life) everything just seems rather sad and nightmarish, but in kind of a beautiful way. Also obvious signs I’m still manic: still can barely eat or sleep, still have headphones on 20 hours a day, still making idiotic purchases on ebay, crying myself to sleep for no particular reason, obsessively exercising to get rid of excess energy, racing thoughts, and so on.