ugh, insomnia

In an effort to get my sleeping pattern back on track, I’ve been taking a sleeping pill almost every night before I have to wake up early – early being sometime before 9AM. This translates to taking something 5 or 6 times a week – 3 times for 3 work days, and 2 times for 2 clinic days, and MAYBE if I decided to do something stupid and schedule an appointment before 10AM.

One of the odd side effects of MDD (are you guys sick and tired of hearing about this yet?) is that you’re either exhausted and sleep all day, have insufferable insomnia, or you’re exhausted but you have insomnia. I suffer from all three, at differing times of my life. A couple of months ago, I was falling asleep at 4AM and waking up at 7 or 8AM, not really tired or sleepy, but not well-rested either. I was on summer “break” (for all of 2 weeks), so the lack of sleep didn’t bother me much. And since my work days were spread out, it wasn’t that difficult to sleep at 4AM for 3 days and then actually wake up at 4AM the next day. This was a pattern that went on for quite a number of weeks.

Last week, I discovered that past me decided to screw me over and scheduled me to work 3 days in a row. Note: I have not done this in quite some time and I try to avoid it at all costs. For those of you who work 5 days a week, I admire you. I know many of you 9-to-5-ers look at us nurses and go, “You guys are so lucky! You get 4 days off!”

The reality is, we get 4 days off, but not always in a row, and it usually takes a good 12 hours to recover from a day of work. If you work a 3-in-a-row shift, it can take you a day-and-a-half to recover, if at all. You really don’t get 4 days off. Sometimes, I think I might prefer the 5 days of work from 9-5 instead of this insane 3 days of work 7-7:30 – if you’re lucky enough to get out on time.  So, really, nothing to envy here.

So anyway, I worked 3 days in a row, and each night, I went to sleep hoping I’d get called off, and each morning, I’d wake up groaning at 4:30AM realizing that I still had to go in. The first day, I woke up and laid there in a groggy haze, wondering if this was all worth it (It was. I got up and went to work because I need the job). But I realized that having fell asleep at 1:30AM was not going to help me at all. After 12.5 hours of keeping people alive, turning patients 2 to 3x my weight, and trying to fit 300 things into one work day, I came home and just sat in my chair and decided, “I really need to fall asleep sooner.”

So I dug into my stash of sleeping pills that I haven’t taken in quite a while and I took one.

I haven’t really needed to take any sleeping pills for a while because I haven’t been as mentally exhausted as I had been for the past 2 months. Yes, I’m busy out of my mind and I feel like if I stop, I’ll panic, wondering if I forgot something. But these past 2 months have been something else entirely. The reason I don’t really take them is

1) Half of them work insanely well, but they make me loopy

2) Of the ones that make me loopy, half of them force me to sleep 8 hours, while the others let me sleep for 4~6 and I’ll feel fine

3) I’m running out of the 4~6 hour ones, and I’m too busy to go to the doctor.

But desperate times call for desperate measures. So I started taking the other half, the ones that don’t really work as well. These are called Lunesta. They make me fall asleep, but unlike my Ambiens, Lunesta takes an hour or so to work. Ambien knocks me out in 15 minutes.

The other problem with Lunesta is that it makes me groggy. I’ve tried melatonin, Zzzquil, other OTC sleep aids, and they all make me feel super lightheaded and dizzy the next morning, like I’m fighting to keep my soul in my body.

So here I am today, my third day taking Lunesta, and I feel like my head is about to fall off my shoulders. I can’t turn too fast because my head will spin. The coffee probably doesn’t help, but I need coffee because I’m tired.

See, I don’t even know why I’m telling you guys all this. That’s how loopy I am right now.

Now I’m playing gibberish peek-a-boo with a 15-month-old baby who keeps running into the office and going, “NYAH!!!!” while trying to hide behind the door jam.

Silly girl, doesn’t she realize I can see her poofy tulle skirt?

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Introversion

When you see an introverted person, you might see someone who is aloof, quiet, reserved, awkward, unresponsive – not such good stuff.

I am an undeniable introvert. Unfortunately, people often mistake that for being shy, because the official definition of an introvert includes being shy. But that’s not necessarily true. You don’t have to be shy to be an introvert. Because I am not shy, and I am not quiet.

One time, I was over at my ex boyfriend’s place. I had been pretty tired, so I fell asleep and woke up in a daze 2 hours later to the sounds of people hanging out (a usual occurrence at his place). I could hear his rather loud, very extroverted sister chatting and singing in the kitchen.

Here’s the thing with me: sometimes, when I’m tired, I don’t want to talk. It’s like using your muscles after working out all day – they’re sore, and you kind of don’t want to move. Here’s the other problem: my voice is generally quite small. Even if I’m shouting, 5 out of 10 times, someone will need me to repeat myself. So usually, I stick with gestures when I’m tired. I’ll do my wide awkward smile or wave at people.

So when I got out to the living room, I muttered a small hello to the people around me and waved. Unfortunately, everyone was so absorbed in their phones and laptops that no one saw me.

At this point, my ex’s sister was pretty much singing at the top of her lungs while banging pots and pans around. I said hi to her as well, but I don’t know if she didn’t hear me or if she just was ignoring me or was too absorbed in her singing. I couldn’t tell. Either way, I just shrugged and slipped out the door.

So later that night, after I got home, she messaged me on Facebook, asking me why I didn’t say hi. I told her I did, but she was singing and I don’t think she heard me, and she had also been chattering away to her friend she was cooking with. I also told her that I was really tired and it’s hard to raise my voice when it feels like my chest is caving in.

Her response was, “Oh, you’re always welcome here! Don’t be a mouse!”

I just laughed and didn’t respond anymore. The thing is that I’ve fallen victim to this stereotype many many times.

Yes, I am introverted. I am probably one of the most introverted people you will ever meet. I like spending time by myself. I literally have 4 friends whom I see regularly, and for the most part I’m okay with that. It can get difficult when i’m not doing well, but that’s a completely different story. I have the classic symptom of having a limited social battery – if I’m around people for a long time, I will become physically fatigued. If I go to a party where I’m standing around and eating and chatting with people who are around, I need to go home and sleep a solid 10 hours to recuperate. After 3 full days of work in a row, I don’t want to interact with anyone because I’m so drained. Being around people is very draining

I don’t like talking any more than I should. It’s one of the reasons I hate chit-chat. I don’t understand talking mindlessly for hours. This was something I had to get over very quickly as a nurse. The majority of the population my hospital serves is the elderly white or Hispanic population, and let me tell you, old Caucasian people LOVE to talk. I had to learn quick how to make small talk, and I think that drains me more than working to keep everyone alive.

And I don’t have a need to announce myself or my intentions everywhere I go. I browse social media often (mostly FB and IG), but I rarely pose, unless it’s something abstract or if I’m doing something special with my friends. But it’s rather rare.

But I’m not quiet and I’m not shy. I’m not afraid to tell people things as they are, particularly if I think it has merit. I can be loud, crack witty (I think) jokes, and dance like a crazy person. I’ve talked down particularly aggressive patients, without raising my tone or cursing. I’m not afraid to demand a wrong be right.

There was a time when I was shy… almost painfully so. I didn’t know how to defend myself. People manipulated me, used me. They played pranks on me, bullied me, and said horrible things to me to my face. They played with my emotions, doing whatever they could to embarrass me, simply because they knew I wouldn’t defend myself. People ran me over so hard that I had permanent emotional scars that, to this day, are visible.

But these days I’m not.

People, I want you to understand one thing: being an introvert doesn’t mean being shy. I might not talk much, but I will stand up to you if you cross a line. I may not speak up often, but if I think there’s merit to it, I will talk for hours. I can stand up in front of 100 people and give a presentation, no problem. And I can dance like I don’t care.

Don’t think that just because I’m introverted that I’m shy. Those are two completely separate entities.

Now, insecurity? That’s a different story for a different time.

Today is one of those days.

I woke up in a sort of haze this morning. It was still fairly dark and kind of foggy outside. I have not had to get up this early in 4 days because I didn’t have work, so going from sleeping at 5am to waking up at 5am was probably not so great for me. But insomnia is a normal part of me when I’m in an episode.

I had been waiting for this aspect of my depression to manifest for weeks now. Usually, in an episode, I’ll first experience some kind of overwhelming sleepiness and fatigue that doesn’t go away no matter how much or little I sleep. All I want to do is stay in bed and not move. Showering becomes overrated, and I only shower because it’s probably not great for me to get close to patients and reek of BO and stale sweat. Even then, I push it to as late as I can, usually 11:30 at night.

With the fatigue comes the inevitable thoughts. Since my body can’t move, my mind moves for it. Once they start, it’s so hard to stop. It starts a mental cycle of self-loathing and sadness that consumes all of my thoughts.

As the thoughts make their way to the forefront of my mind, I begin to suffer from insomnia because, really, how do you fall asleep when the voices in your head are telling you what a shitty, insignificant, miserable little thing you are. It’s sad because this isn’t even from other people; this is my own mind telling me this. You can run away from others or shut them down, but how do you shut down your own head?

After enough self-destroying, I lose my motivation. During a “typical” episode, I can usually keep a smile slapped on my face or adopt a cheery attitude that dampens the sadness. It’s there, but just out of sight enough for me to keep  smiling. Sometimes, I even forget about it until I’m alone, during which time the facade falls apart. You know in movies or shows when someone is smiling, but then their smile fades as they turn away? I always thought that was so corny until I realized how often I did that.

But after prolonged self-bashing, things are different. I become physically incapable of smiling. Instead, my face turns dark and stormy. I already have pretty bad RBF, but when I can’t spontaneously make a smile when someone looks at me, people start wondering what’s wrong with me, if I don’t like them, or maybe I’m just really rude. When someone talks to me, my replies are short and curt, not because I’m angry (at them, anyway) but because I know that if I open my mouth, there’s a good chance I’ll start crying out screaming.

The worst part of it all is that I’m fully aware. What does that mean? Of course I’m aware, I’m a very with-it person.

What I mean is that while my body has gone under the control of my own toxic thoughts, another part of me is screaming at… well, me. This screaming voice is saying, “What are you doing? Why are you being like this? Everyone is going to think something is wrong. You have to snap out of it! Come on, you know it’s just your depression, for God’s sake, don’t let it win! Stop being so weak! Everyone’s staring at you! You’ve officially become a freak show, good job. You’re so fucking disappointing, you know that? God, you’re worthless.”

Well. That escalated quickly.

The point is that I’m constantly trying to snap myself out of it, but I can just no longer smile. I can’t be happy or friendly. That person is trapped deep into the corner of my mind. All the while, my mind is also going crazy trying to logic myself out of it.

Today is one of those days. My smiles, if I have any, are strained into a small grimace. I know that people are looking when they think I’m not. I can’t fake any joy or happiness. I look angry and upset and I hate it.

Why can’t I just smile? Why can’t I just say something nice? It’s not that hard to smile, right? I don’t want people to think badly of me. I know I’m not a rude person. This is never

But it is. It’s hard to smile when I’m in this state. It becomes almost impossible.

I’m aware that this is something I need to work on. I have been, I swear. The only thing I can do is remind myself over and over to smile, to push down those terrible thoughts that keep me from being able to separate the internal from the external.

All I ask is that you know and don’t take it personally. That while I’m snapping at you, I’m hating myself for not being able to control myself. That while I’m quiet and sullen in the corner, I want more than anything to be enjoying the situation like you are. That while I look at you with fire in my eyes, I do really love you and want to be around you and God, do I wish I could be normal and part of the group and with you. I wish I didn’t snap at you, that I could greet you with an easy smile. The fire in my eyes isn’t directed at you, it’s meant for me.

I wish I were different.

But I’m not. This is who I am. Always broken, always misunderstood, too depressed and withdrawn to even apologize because I hate myself so much.

This is who I am. And I’m sorry if you catch me on one of those days.

 

Grummy, Parp, Whimble

Let me tell you a story about Grummy, Parp, and Whimble.

When an episode begins, my mind usually splits into three entities: Grummy, Parp, and Whimble. Without fail, these three characters form very distinct personas of each aspect of my depression.

Parp is the child you might see in the foster care system – beaten down one too many times. Parp feels worthless. No one loves or cares for him. He doesn’t understand why no one wants him. He thinks he’s a good boy, and he tries not to hurt anyone, but it doesn’t seem to matter. Parp doesn’t matter.

Grummy is the school bully. He’s big and strong, both brawn and brains. He knows that he can beat Parp down and say the things that will hurt him the most. It doesn’t matter whether they’re true or not. Grummy knows that Parp will accept them without a fight.

Whimble is the voice of reason, my residual logic that most becomes overrun when I’m in an episode. Whimble is almost an out-of-body entity, who is able to step away and see things from the outside.

When I fall into an episode, my mind forms these three distinct characters, and it’s always the same. Parp begins to remember how useless and worthless he is. He curls up in the corner and cries as he remembers that no one wants him and that he’s so small, he barely makes an impression. No one really knows he exists.

Then Grummy comes along and sees Parp in the corner, and he begins to do his thing. He kicks and beats Parp, affirming that Parp is worthless, a waste of space, useless, and unloved. Grummy tells Parp that he’s better off dead, no one would miss him, and everyone would be better off without him. The more Grummy beats him down, the smaller Parp feels.

Whimble always makes an appearance, and to be honest, she always makes it worse. Whimble comes to Parp when Grummy is taking a break and tries to tell Parp to snap out of it. Whimble knows that Parp is worth so much more, that Grummy is lying, and seriously, you’re making us look bad! You’re coming off as rude to these people! Everyone thinks you’re mad at them! Come on, snap out of it, you know just as well as I do that this is just your emotions getting the best of you! Please!

Unfortunately, this just makes Parp feel worse. He begins to loathe himself for being unable to fight off Grummy. He hates himself for being so weak, for being unable to control himself. He hates himself for not being able to pull on a smile. He hates himself for being on the verge of tears no matter what happens.

It’s hard to break out of. Eventually, Parp and Whimble will work together to overpower Grummy, and peace is temporarily restored. But just like any person who has been bullied, the scars are still there. Parp still remembers those feelings of worthlessness at the peripheries of his emotions and Grummy knows it.

Grummy is just waiting for the right moment with Whimble’s defenses are down.

And when that happens… Well… then a new episode beings.

there are no words

When I’m not feeling well, my symptoms usually manifest in one of two ways – my stomach and my heart. My heart usually begins to overwork, as though it needs to pump harder to get blood to the rest of my body. In fact, it pumps so hard, I can feel my entire body pulsating along with it.

My stomach – or rather the processes associated with my stomach – go completely out of control. Everything I eat becomes a trigger for nausea that can only be relieved with vomiting. I usually force myself to throw up because if I don’t, I’ll be in bed, so dizzy and nauseous that I’m unable to move. Food feels like it’s stuck in my throat and no matter how much water I drink, the feeling doesn’t go away.

So when I don’t feel well, one of the first things that happen is I stop eating. Part of it is that I’m simply too nauseated to keep anything in and at that point, why even bother trying since I’m just going to throw it up after an hour of misery anyway. The other part is fear because I know how miserable I’m going to be.

Unfortunately.

This also means I stop taking any of my pills because 1) I only get enough for exactly one dose a day and 2) if I throw that up, either I’m going to be short or I’m going to pay more for lopsided pills/month.

Okay, I know how bad that is. Considering that the stuff I take is very relevant to my well-being, I realize the implications of being non-compliant. I’ve written three entire research papers (and read way too many related studies and articles), so I’m competently-versed in the forthcoming issues. I don’t need a lecture on that.

So where am I going with this?

A few weeks ago, after one particular night of no sleep (I just couldn’t sleep, I don’t know why), I went to school in a complete haze. I could feel my heart pounding so I knew my body was spiraling downward. And then, of course, the nausea hit. The thing with being nauseous and vomiting is your body needs food to get better. But when you’re throwing up everything you eat, you can’t get that nutrition, so you simply get worse. It’s a terrible cycle.

During that time, a span of 3 or 4 days, I stopped taking my medication. Now, some of my meds are not very important. My allergies have very specific triggers (peaches, anyone?) so as long as I avoid them, I’m pretty good. Others are preventative (ovarian cysts, anyone?) and really, it’s my choice to take them. But then there are the essentials. Unlike my allergy meds – which I really take very sporadically, maybe once a week – my depression meds are not supposed to be stopped cold turkey. Especially with the dose I’m taking. There’s all these warnings and teachings and blah blah blah that says to not stop abruptly because you’ll suffer from withdrawal. This stuff is no joke.

At the time, though, I was too miserable being sick, hungry, nauseous and dizzy to notice whether or not my body was suffering from withdrawal. I didn’t seem any more moody because, let’s face it, I was sick! Who doesn’t get a little miserable when she’s sick?

But even after I got better, I refrained from starting my meds again.

Why? Why, why, why would I not take them again since without them, I not only get very “low”, I also run the risk of spontaneous suicidal actions? (Erm, side note, I don’t have my gun anymore. I gave it to someone for safe-keeping because I wasn’t sure how safe I was around it.)

Well, that’s not true. Once I felt better enough to eat regularly (i.e. once and a half a day), I took half my regular dose. I didn’t want to take the full dose because I didn’t want to turn into the poor wild animals in Over the Hedge after they had their first taste of Doritos.

But, oh my God. One of the particularly difficult side effects of my anti-depressants is that they make me extremely sleepy. I am already very sleep-deprived. For as far back as I can remember, I can count the number of times I’ve gotten restful sleep on my fingers. My first all-nighter was in the first grade. That’s how bad my sleep is.

So with my first half-dose since getting better, I was so tired that even with a solid 8 hours of sleep, I could barely focus on the road as I drove to school. I felt like I was sitting in a room filled with steam. I felt like everything was cloudy. I felt like someone had hit me with horse tranquilizers. I’m lucky to be alive.

Add to that that I was entering the final three weeks of school. I had six major exams, four papers, three presentations and 10 kids that I saw regularly on a weekly basis. I couldn’t afford to sleep 12 hours a day and expect to pass my classes and keep my job. So I made a choice. I would power through without my meds and once all this was over, start up on it like a good kid.

It took me another week to get over the side effects of the half dose. All I did that weekend was sleep. I slept for hours because I couldn’t stay awake. Because it began to get dangerous for me to drive when I had narcoleptic tendencies.

I have another week of school left. Three more exams, one more paper. But already, I feel my mood hitting an all-time low. I’ve become a ticking time bomb, exploding at the tiniest things. I’ve become lethargic. Everything is boring or pointless. Things that I breezed over before now frustrate me greatly. I’ve become enthralled by the new cuts and bruises that have appeared on my body from not paying attention to where I’m walking or what I’m carrying.

And then there are the thoughts. Those thoughts. I hate those thoughts. But I like them, too. They’re an evil sort of comfort, evil because it’s obviously about dying, but comforting because it’s a familiar entity.

Yesterday, I thought to myself that I couldn’t wait for this week to be over so that I could start on my meds again and become happy. But I spent a lot of time thinking today and I wondered which me was the true me. Is it the smiley, happy, giggly, joking girl with the support of medication? Or is it the silent, stone-faced, frustrated, lonely girl who lives in the shadows?

I know that darker version of me is difficult to love and to be around. But what if that’s the real me? What if the happy version is just a facade? Am I asking people to love a version of me that isn’t real? If so, then what? Should I be looking for someone who loves me even as the dark, terrible monster that I am? Or do I continue to hide behind drugs and be the girl that people can love easily?

People stray away from me when I revert back to my darker version. Even the ones who know about my disease simply disappear when they start seeing the signs. Should I still consider them as friends and loved ones? Or should I say, “Fuck you, I’m going to find someone who loves me for me, even at my darkest moments”? Is that even plausible?

I want people to love me for me. I think I’ve always wanted that, but when the two versions of me are so drastically different, when one is so much easier to be around than the other, it’s similarly easy to see why people choose one over the other.

Somehow, though, I feel like I’m lying to myself when I think someone cares for me when I’m happy and lovable. Somehow, that seems like an ironic lie because that still means no one loves me for me.

Or do they?

Why is this even important? Who cares?

Because everyone just wants to be accepted. Everyone just wants to know that the important things aren’t lies. Because I’m human and that’s important to me, too. And, hey, aren’t we all told that we need to be loved for who we really are? Or is that not realistic for someone like me?

apologies

I’ve said this before, but something that I feel a lot of people do not understand about depressed people is that there is an enormous amount of guilt.

The idea that seems most prevalent is that people with depression are selfish or self-serving. They only care about themselves. When they start drowning in addiction, drugs and alcohol, we only see people concerned with their own feelings. They don’t care about how much they’re hurting the people around them. They don’t care that their excesses and vices are destroying everyone around them.

Can I make a clarification?

We feel extremely guilty. We feel guilty because we know we’re hurting you. We feel guilty because we wish we could snap out of it. We’re ashamed because we can’t even control our own bodies. We wonder if we’re doing something wrong.

We feel guilty because we want to die. We want all the pain to stop, but we know we’d be hurting those close to us. We feel guilty for having to leave those loved ones behind, the grief that they’d feel and the pain that we’d cause. We feel guilty because we know we’re using these temporary substitutes to dull a pain that won’t go away and we know that’s hurting our loved ones. But we can’t stop turning to it because it just hurts too much. We feel guilty because we lose our tempers when people try to intervene… and because we know they’re right. We feel guilty because we’re too scared to admit that we’re only making it worse.

We feel guilty because we know we’re messing up our lives and yet we lack the motivation or drive to fix it. Not because we don’t want to. We just can’t. We feel guilty because if we had that drive to do anything, the first thing we’d probably do is kill ourselves, not get better. We feel guilty because at this age, with these many years to mess up, we’re honestly afraid to get better because then we have to deal with the however many years of a mess we’ve made. Really, how do you fix a 27-year-old mess? It’s scary. We know it can only get better, but it’s so scary to look at.

Sometimes, it’s that guilt that drives us to that desperate final act. The emotional pain from our heads and the emotional pain from our hearts just become too much to bear.

Are we selfish? Is it selfish for us to want to stop that pain? If you knew the desperation in my body, would you think I was selfish for keeping myself alive this long? Or would you tell me that it’s okay to let go, that you understand? Is it selfish of you to want me to stay alive, to keep me close and to try to convince me about the value of my life?

I don’t know. I don’t know the answer to that one. I wish I did. It wouldn’t make things any easier, but at least I’d understand better.

But one thing is certain –

We do feel guilty. We feel so guilty for hurting you. We feel so guilty for having these thoughts, for being unable to control our emotions. We feel guilty that every cut, every desperate act hurts you, too. We feel so guilty whenever you stand there, wanting to help but being unable to help.

And we’re sorry. We’re sorry that we make you feel helpless. We don’t mean for our pain to become your burden. We’re sorry.

I’m sorry.

today

Today, I learned what it feels like to have a gun in my mouth.

Have you ever wanted something so badly that you could feel your heart aching?

That’s how I felt. There I was, on the floor, this piece of metal sticking to the roof of my mouth, and my heart was aching. Because death was so close. I knew that all I needed was just one twitch of a finger… and all this pain would go away.

But I didn’t. Because my sense of duty wouldn’t let me. My sense of duty that tells me I have taken too much from my parents and this was no way to repay them.

Just a few days ago, I felt like I still had things in life to look forward to. Now, I feel a disconnect. I feel disengaged. I’m going through life and yet, I’m not really living it.

Today, I wondered why I was still living.

Today, I wondered what the point was.

Today, I wanted the pain to stop.

Today, I made a plan.

Today, I put a loaded gun in my mouth.

And cried as my pain warred with my sense of duty.

Today, my sense of duty won.

And that’s the only reason I’m still alive right now.

All of this happened today.