Very anxious, but good. Tools to cope with anxiety

 Lately I've been extremely anxious, but still doing good. I'm more anxious than I've ever been in my life, but doing as good as I have since junior high/high school. I have my drive and motivation back. 

I have been working on ways to share my story in part or in whole. I also got certified in national mental health first aid. I am now looking into becoming an instructor for them, but I have to come up with $2200 first. I'm attending a webinar tomorrow to learn more and find out if it'd be worth the investment. 

The tools I've been using to cope with the anxiety are that I've been listening to music constantly. At home, in the car, in the store, Dr office, etc. literally everywhere. 

I've been deep breathing in lavender essential oil and using a diffuser for the same at night when I go to sleep.

Otherwise I've just been using the extra anxious energy to clean the house.

Still doing good with intrusive/disturbing thoughts

 Overall I'm still doing really well. I'm driving again. I'm taking care of the baby well. I'm sleeping in spurts. I'm giving my older son some if my time everyday.

However, I still have swelling in my legs, a headache/migraine I can't seem to get rid of and a full body ache often. 

I'm also starting to have some intrusive/disturbing thoughts. So far they are more of the fleeting type where I can shut them off easily which I'm thankful for, but still they're there. I was really wanting to see my psychiatric np this week, but my appointment isn't until next week. I just hope the thoughts didn't become more disturbing by then.

Feeling good

 The past couple of days I've felt good. Good as I ever remember feeling. So good past providers would consider me hypomanic. However, I know I'm not hypomanic. I'm doing good. I'm at a place where they would medicate me so I wouldn't get too high. My closest friends, family and therapists all think I'm doing ok this time. So that won't happen. Usually this good state I'm in only lasts a couple weeks at most then I'm back to being depressed. I'm a bit nervous I'm going to start sleeping too much and end up back there.

Constant pain

 Today we took our older son and his cousin to the Harlem Globetrotters game. While there I got a constant pain in the right side of my upper abs that wouldn't go away. Now the pain is worse lower. Thinking maybe I just tried to do too much which is quite sad considering our newborn is nearly a month old now. Walking is what makes the pain feel the worst.

24 days post partum

 I have an abnormal amount of edema in my lower legs, ankles and feet. I have tried 6 rounds of lasics to get rid of it. My blood pressure has also been through the roof as a result. I have had a killer headache/ migraine that doesn't seem to respond to meds therefore I need a new referral to neurology I should be getting today. I've tried ibuprofen, Tylenol, nurtec and coffee. Dutch Bros seems to work best.

I am supposed to wear compression socks and keep my legs elevated as much as possible which includes taking it easy. Believe it or not this is actually the best I've felt in years.

Nursing school

 It has been 12 years since I have worked or went to school. For several years I have wanted to either use my husband's G.I. Bill to go back to school or get a part time job. However, my son has autism and requires extra help on school work and such. Every semester I reevaluate if I should keep him in the school he's in or switch him back to traditional all day public school. So far it's always been his needs above my own.

I have major depressive disorder and tend to isolate myself a lot. Any stay at home parent knows that's easy to do. I had a wonderful friend I used to see often, but she just pcsd with her family recently. So now I really don't see anybody besides family. While I love my family, friends would be nice to have to.

My time in the NICU showed me just how much I need adult interaction. While not sleeping much is bad for my mental health, interacting with people is exactly what I need. All of the nurses were so wonderful to me it actually inspired me to become one. I plan to use my husband's G.I. bill to go back to nursing school starting either in the fall or next January. I have looked into school multiple times, but ultimately can never decide what to go back for. I feel like I have it figured out now. I will go to nursing school and use part of the G.I. Bill to pay for daycare on the days my mom can't keep my kids. I feel like I need this for me and my own well-being.

PTSD trigger and ketamine

 One night I was just sitting there in the NICU pumping when my son's oxygen started to drop. It got all the way down to 65% before the nurse ever came in. I spent the whole time just staring at my sons face. I was confused because he wasn't turning blue, didn't appear to be in distress, he looked totally fine. I wondered what I was missing or not recognizing. If I hadn't been in a trauma situation before I probably would've lost it, but I completely kept it together.

A few hours later when I had a little time I laid down to close my eyes. And by laying down I really mean laying back more or less sitting up in the recliner chair. When I closed my eyes I saw the man shoot himself in the head again right in front of me. I believe they call that a flash back.

From then on whenever I would close my eyes and begin to doze off I would have a coughing fit followed by my throat feeling like it was closing in on me. I was having panic attacks. If it didn't happen right when I dozed off it would happen an hour or so later. I'd wake up in a panic and need to drink cold water and suck on a mint. Sometimes it would last 20-30 minutes, other times it would pass fairly quickly, but I never got right back to sleep.

They tried me on just about every sleeping pill possible to knock me out and have me sleep through it. Nothing worked. One night I took 10 mg Ambien and 100 mg of Seroquel at the same time. I can't remember if I when up in a panic or if I was throwing up, but regardless I only slept 2 hours 15 minutes. I woke up completely confused. I needed help walking to the bathroom step for step as if I had just given birth. My husband and I were arguing because I needed something to eat, but he wanted me to go right back to sleep. Finally I told him if he didn't wheel me over to the family room to eat something I was going to ask the nurse. He finally took me.

I ate something, came back to our son's room and was completely fine. An hour later I took 100mg more of Seroquel. Still fine. An hour after that I took a third 100 mg tablet of Seroquel. Still nothing. All in all I had taken 10mg Ambien and 300 mg Seroquel in the same night and I was up having conversations with people functioning just fine. How is that even possible?

I had at least one night with a bad nightmare. Thankfully lately I haven't had flashbacks or nightmares. Maybe it's the ketamine I restarted? The first couple ketamine sessions I felt nothing, but one did cause me to recall many events from the night of the suicide that I thought I had forgotten. I cried through nearly the whole session. Now I am going to start doing ketamine with psychotherapy at the same time so I can talk to sometime who is trained through these things rather than just the nurse, but it will be about a month before that happens.

2nd child in NICU

 After three losses I finally gave birth to my second child. After four days of labor I had him at 36 weeks 6 days which was basically 6 hours premature. We have been in the NICU for nearly 20 days now. Waiting on his car seat check here in a few hours. If he passes we'll finally be able to take him home.

I have mixed feelings about going home. I don't see the NICU as a scary place. I see it as a safe place. While not sleeping much is not good for my mental health, interacting with people is. I'm pretty sure all the night nurses know me and I've enjoyed getting to know them. If my son's oxygen drops too much there's three nurses right here to help him. I can trust that someone who knows what they're doing is taking care of my child so I can get rest. Everyone thinks I'm so anxious because I'm worried about my baby in the NICU, but really it's just my inner demons, hormones, PTSD, etc.

I've really only had two negative experiences over the course of the three weeks we've been in the NICU. The first one I walked in to the nurse practitioner trying to do her assessment on my son. He was screaming hysterically and she couldn't get him to calm down. I asked if I could hold him for a minute to calm him down, but I wasn't allowed to. Her explanation for why he was irritable was because of the medications I was on during pregnancy. I was thinking just because you can't calm my kid down doesn't mean he's irritable. I began to cry a lot. Tears were falling from my eyes to my son's blanket as I was holding him.

Shortly after the Dr came in and asked why I was upset. I told her and she said don't own that. We don't know if your meds caused any problems at all, but all the research says to stay on psych meds. She really made me feel better. She said just because you take meds doesn't mean you shouldn't have kids. You're a great mother. There are plenty of people that don't need to have kids. You're not one of them.

Good days and med changes

 The last few days have been good. I have slept 4-6 hours, not the 10-15 hours I was doing. I've been tired, but actually have energy, desire, and motivation to do things. It's been nice. I'm not worried about how I'm going to get through the day and night. I just do. I'm wondering if I'm finally starting to see more benefits of the ketamine and tms treatments. 

Seems like these most recent med changes have done wonders. I went up from 5mg to 10mg of abilify and went down from 40mg to 30mg of latuda. I only changed doses 4 or 5 days ago so time will tell. I'm still on 60mg of Cymbalta and 300mg of Lamictal. We are going to try going down on Lamictal next from what I understand. My psychiatric np thought I was on it for depression, but the only thing I know for sure is that it made me irritable last time I went down on it. She says the meds I was on before could've caused me to be irritable. So we'll see what happens. I'm hoping I can get off both the Lamictal and latuda. So we'll see what happens. 

Supposedly the more psychiatric meds you're on the higher the risk for birth defects. Still don't know if I'll end up having another child or if I'll pursue fertility treatment again, but I've been thinking about it. Lately it hasn't been so hard to look at babies on the TV, it's more made me want another one. I'll take that as a sign of healing. 

Frustrated with providers and current situation

 Can't sleep again. Yesterday I was frustrated. When I went to bed last night I couldn't stop thinking about dieing. This morning I woke up frustrated. I'm frustrated because I'm trying to figure out which provider to go with and neither one of them are helping me out. My current provider has me diagnosed with bipolar depression. I tried to ask her why because she's known me for quite awhile to get some insight and see if I believe her, but she won't tell me why. I'm assuming it's just because her assessment told her that. I'm thoroughly frustrated with the provider over seeing my treatment. I tried to ask her if I switched over care what her approach would be and what diagnosis she thought I had. She won't answer me either. I looked for a response for over a week just to find out she's not going to respond. She doesn't want to step on my current providers toes. Well I need some clarity to make a decision. If she agrees with her former providers diagnosis she will approach it as if I have major depressive disorder. I know that is going to be a completely different approach than what I've had in the past. I'm hoping it's the right approach and I can get some relief, but I'm not sold on it yet. On top of that they have two completely different styles. My current provider is ultra conservative. If something has any potential harmful side effects she doesn't believe in prescribing it. The provider over seeing my treatments seems to more weigh benefits vs risks and will prescribe just about anything she thinks will help. One says this'll be great and could help with your depression and vomiting. The other says it can cause Mania. Like wtf.

My current provider I have the potential to get ahold of any time. She checks her email all the time so she's responded to me on a Saturday night before. She usually only takes a couple of days to get back to me and her availability is fairly open. I can often get in to see her within a couple of days if need be. I like that. But does it matter if she doesn't have me on the right medications... the over seeing provider of my treatments has much less availability and she doesn't check her email when she's not working. Sounds like it'd take at least two weeks to get in with her on a good day. I don't like that at all. I need a provider I can be in touch with, but if she's the one who will put me on the right medications it may not be a big deal. 

I had two to four days where I had relief from my mental health symptoms. It was like heaven even though I was still experiencing nausea and vomiting. I just want more days like that and I'm not sure who, if anybody, is going to be able to get me there. They say oh it's only two weeks until you see the over seeing provider then you'll know. Well right now two weeks feels like an eternity it's weighing so heavily on my mind. I don't know if that glimpse was due to the tms and ketamine or the not sleeping much for days. Nothing else changed. 

I'm frustrated because I'm still throwing up just about everyday. I have an appointment with the gi Dr. in a couple of hours to discuss my current symptoms and plan moving forward. I don't have high hopes it'll do any good. I've been waiting to get my stomach figured out before resuming my fertility treatment, but it feels like that's never going to happen so I don't know what to do. Do I just jump back in knowing if I'm pregnant they're just going to blame my nausea and vomiting on that and I'll likely never stop throwing up. I'm at a loss. I'm like if I'm throwing up everyday might as well be pregnant. At least I'll get something out of it. 

If I'm pregnant I can't continue ketamine treatment. Not sure how much good it's doing so I'm not sure if that's a big deal or not. And if I do get pregnant again will it result in a healthy child I can cherish like I do my son. There's just so much unclarity in my life right now it's taking a toll on me. 

Good days

 Yesterday was a hard day. It just felt like it was impossible to get through. Not sure why. Thankfully yesterday evening was better. I'm back to sleeping 10 or more hours the past two nights. Even though I slept a lot last night I have some energy today at least so far. 

This past week I had some good days. The first couple days were good because I felt like I had a lot of energy. It wasn't so hard to make a decision on every little thing. However, I was operating on 4 hours sleep those days. The other couple days were good just because I was calm. I actually had times where my mind was blank. Like I wasn't thinking about anything at all. It was peaceful. 

Calm, but down

 I don't really feel like writing tonight, but I am so I can better track my mood. Night before last I slept about 7 hours. I was kind of amped up in the morning until we went to look at mattresses. I laid down on a base that massages and I completely calmed down. I'm still calm. I don't think a few minutes of a bed massage could relax me for that long. 

Last night I slept 4 hours again. This time I couldn't sleep because my knee and ankle were killing me. I don't know if it's our old mattress or the weather or what. Today has been a lot different. Usually when I don't get much sleep I feel amped up the next day and have quite a bit of energy despite being tired and I have to work to not let my thoughts race in my head. Also, I'm usually in a better mood. Today was the complete opposite. I didn't get much sleep, but I've been completely calm today and feeling down most of the day. I don't think a few minutes on a vibrating mattress yesterday would cause me to feel this way. 

I've been down most of the day, but my mind was very calm. I feel flat almost emotionless though tears did come to my eyes when my brother told me he got to stay here. It was touching I guess. The past few days at tms I had been pretty animated and very talkative. Today I hardly said anything, just answered questions pretty much. I watched family matters and didn't laugh, I thought the episode was dumb. Tonight I'm having a hard time focusing on anything, but it's like my mind is more blank than usual. I'm not distracted by having too much on my mind, I just am kind of here having a hard time focusing on anything even thoughts. I haven't felt off tonight. At least not so far. 

Better sleep, provider response

 After having such a good day yesterday I took about a 20 minute nap and woke up feeling depressed again, having passive suicidal thoughts and feeling like getting through the night was nearly impossible. So much for the all up from here hope. 

All in all last night I slept much better. I went upstairs about 9:30 to lay down. I ended up having really bad stomach pains until 11. I was able to mostly resolve those and get back to bed about 11. I probably fell asleep about 11:30 and woke up at 5:30. Laid in bed until about 7 and got up. Not really sure how I'm doing yet today. Not amped up, not too tired, no desire or motivation to do much, but I feel like that could possibly change soon. It doesn't feel impossible like it usually does.  

The provider over seeing my tms and ketamine treatments emailed me back. I was thoroughly impressed because it was very thorough and thought out. I was totally expecting a few lines followed by we'll discuss further at your follow up next month. She said it was absolutely common to experience an emotional "purging" during tms as well as ketamine. It is common to experience very rapid and INTENSE mood shifts, tearfulness, and disruptions in sleep. Sure would of been nice to have been told this prior to treatment so i could've thoroughly thought out if i wanted to go through with it or not or at least be more prepared of things to expect beforehand. She said something important to note- ketamine can enhance the mood state you are in when you receive the infusion- positive or negative. She said you absolutely do not have to focus on anything intensive during the infusion. Ketamine targets glutamate receptors which helps ptsd, depression and anxiety. It also is one of the only medications that's creates growth of neurons and synapses. Ketamine will do that whether or not you are journaling/thinking/etc.

She also mentioned she thought I could really get improved symptom management with a medication adjustment. She said she wonders if the extremely high doses of welbutrin and latuda could be causing akathisia or restless leg syndrome. My current provider has mentioned this too. It could be the reason for the "off" feeling I get. However the medicine given to combat that doesn't seem to help. 

My "off" feeling has actually gotten better. I used to feel like I just had to escape and try to sleep through it and wait for it to pass. The past week or so I still have times where my legs and arms won't stop shaking which is annoying but I have been able to function through it and stay awake. This makes me think maybe it's being triggered by anxiety. The tms and ketamine are both supposed to help with anxiety. So maybe they're helping with that and that's why the "off" feeling doesn't affect me so much mentally anymore.

Diagnoses can really suck so much and it's amazing how they can affect you and make you over think so much. Yesterday i was over thinking everything. It's like even when I'm feeling good I question if I'm "allowed" to feel that way or if it's hypomania and a red flag I need to watch out before I become manic. When I'm sleep deprived I actually have more energy and feel kind of amped up. Is that hypomania or am I just not feeling depressed? I recently spent a lot more on a mattress and base than I anticipated. I went out not even intending to buy a base. I researched for days, visited multiple stores and spent countless hours trying to make a decision. I didn't just walk by a store and say yep I want that one and buy it. Was I hypomanic over spending and I need to watch out before it leads to Mania or am I just fed up with feeling like shit and want to be comfortable so I can sleep well so I'm willing to spend more? Why can't I just live without over thinking every little thing I do... 

Tms, ketamine, sleep, diagnosis

 I haven't been sleeping well the past few nights. Well really I never sleep well. I usually wake up about every hour or so. I was sleeping 10-15 hours every night. However the past few nights I haven't slept more than 4-5 hours. I've basically been going to bed about 10 and waking up about 2 with no naps. The first night I couldn't get back to sleep was because I couldn't get comfortable. I need a new mattress. Easily explained. The next night pretty much the same thing. The third night I couldn't fall back asleep because I couldn't stop crying. Tonight a combination of things. Can only breathe out of one nostril when I lay down, but I'm not sick. Not sure if my apap machine is making it worse. Couldn't get my mask to stay sealed correctly. Not very comfortable. I thought I'd be upset about not being able to sleep and be super tired. I'm tired, but functioning and just hanging out. Not too upset as long as this doesn't lead to Mania. 

I'm just over half way through tms treatment. I'd been going everyday the place was open for what seemed like forever. Now I'm finally in what they call the tapering phase where you go 4 days a week, then 3 days, 2 days and finally 1 day. I also had my first maintenance treatment of ketamine the other day. 

Two nights ago I think I had reached my breaking point with all my stomach issues. I've been battling nausea everyday and vomiting most days as well as constipation. Long story short maybe I'll add it later but basically my husband and I got in a fight about a burger. I was so pissed. That led to my break down. I just started crying and told him I hate life. Life right now just really sucks. 

I pulled it together for the rest of the night. Fell asleep about 10, woke up at 2 then at since point fell asleep and woke back up about 4, but this time I couldn't sleep because I couldn't stop crying. I laid in bed for probably a good hour crying softly. My son was sleeping next to me and woke up and said mom are you sweating. I said no I'm crying. Why are you crying? I'm sad. Why are you sad? It's hard to explain. Why? Because I'm tired of throwing up. Then he was awake so we went downstairs about 5:30. I usually don't let him get out of bed until at least 6, but we went down early because my stomach hurt. I felt like I was starving so I ate some crackers and took some ibuprofen because I'm pretty sure I had a headache. The crying never stopped. I cried probably two more hours. My son said mom stop crying it's so annoying. Please don't cry all day. 

I was crying about everything good or bad. It was like a movie of my life was playing in my head. One thing led to another and it was just constant. The whole time I never even thought about all the pregnancies I'd lost. It was like it was all the little things I'd never really cried about before. I was told about halfway through tms people tend to experience unexplained emotions that are just all of a sudden. Like they'll cry and not know why they're crying. The week prior I had a day or two where I was irrationally angry. I couldn't fall back asleep. It pissed me off and it ruined my whole day. I was angry all day. Now with the crying. I knew exactly why I was crying, but why now and why so much. 

I sent my psychiatric nurse practitioner an email and the provider over seeing the tms and ketamine an email explaining what happened, but I haven't heard back from either one of them. I'm assuming this is just a turning point in my treatment and everything will be up from here. But I've thought that before and obviously I was wrong because I've fallen back down. 

The provider that told me about the tms and ketamine told me about all the benefits of these treatments, but not really anything about the difficulties. Living with depression, anxiety and ptsd is hard. Going through this treatment is just as hard. I just hope it turns out to be worth it. 

After the 3 or so hours of crying I was able to talk to my counselor. She helped a lot. I was able to process what ketamine brought up for me. I was told if I brought something with me I wanted to work on to ketamine it would take me there. I was working with a new nurse who didn't really know me so we were talking a bit during my session. I mentioned witnessing the suicide so then I started thinking about it and I decided well let me focus on this to work on it, but it only made it worse. I started thinking maybe he did the right thing and I should do it too. I didn't really feel like I should tell the nurse because I didn't really know her and she's not a counselor. I started trying to watch family matters because it tends to make me laugh so I thought maybe it'd help distract me and put my mind on something else. Somehow I managed to put it on the only episode with a gun in it. Steve had invented a machine that would transport anything he put on it to Paris. By accident they discovered it would send not only objects, but people to Paris too. So the whole family decided to take a trip to Paris. Anyway the lady on the receiving end of this machine boyfriend decided he was going to still Steve's invention and then kill him. So I'm on ketamine like is Steve going to die. No it's family matters no one is going to die. There in Paris. Can I go to Paris? No you can't do that, that's not real. Am I in Paris? Then I started feeling like I was floating and I got really confused battling with this internal dialog with myself. I eventually got done with ketamine and settled back into reality. 

Then later that day I ended up having the break down followed by all the crying. I'm assuming it was all due to the lack of sleep combined with the stomach issues, combined with tms and ketamine and that's all it was and it's behind me. I guess time will tell. 

Talking to my counselor helped a lot because she just had surgery on her foot so she's stuck at home and can't do much. She's sarcastic so she makes me laugh. She was saying she is so bored she takes like 3 naps a day and goes to bed at 7:30. She can't figure out if it's physical or mental at this point. She said it so light heartedly I was laughing so hard because that's the way I feel everyday. I kept thinking there was something really wrong with me, but maybe I'm just having a hard time because I'm bored. She said I have too much time on my hands. Life is so much easier when you're busy all the time. 

The new psychiatric nurse practitioner I saw that put in for the referral for tms and ketamine left the practice. She told me when I met with her the one time that she couldn't diagnose me after only seeing me for an hour. She said she wondered if I really had bipolar disorder because major depression can cause psychosis. Mania is very similar to psychosis. The lack of sleep in the past led to the Mania, with bipolar the Mania usually causes the not sleeping. So maybe what led me to the hospital wasn't Mania it was psychosis. I don't have bipolar 1 disorder. I have major depression with a psychotic episode. After asking I finally found out she did diagnose me. She diagnosed me with major depressive disorder, generalized anxiety and ptsd, chronic. She is the first one not to jump to a bipolar diagnosis. 

Since she left a different provider is over seeing my tms and ketamine treatments. I have a follow up with her next month. I'm interested to see what she finds to be my diagnosis after going through all of this. 

I talked to my counselor and she said she agrees with the major depression, not the bipolar. She said she's never seen a bipolar person that has the perfect cocktail of meds to keep them from getting some kind of Mania at some point. Mine was a single episode many years ago and the post partum psychosis I experienced could've been linked to major depression as well. 

All in all it really doesn't matter what I have. They are all just labels. Whatever it is I just hope it gets better. I feel much better after the breakdown, all the crying and talking to my counselor despite the lack of sleep. Hopefully it just continues to get better from here on out. 

Next tattoo

 It's 3:43 in the morning and I've been awake for about the past hour thinking about my next tattoo. I'm supposed to have a consultation tomorrow to talk about it with an artist. I guess that's why I can't sleep. I'm still trying to decide if it's the artist I want to go with, for sure what tattoo I want to get next, and if I should wait until after the holidays and after our next trip. My husband is very supportive so he said I could get it now if I want to. Tattoos are always so healing for me.

I'm looking to get a tattoo of three butterflies to represent the three pregnancies I've lost. I want them to look like 3D like they're sitting on my skin. I'm thinking I'll get one purple, one light blue, and one lime green. The guy I'm going to see tomorrow is one of the cheaper ones in town, but his work looks nice. So I'm leaning towards going with him.

I was originally going to get the butterflies on my foot. I think they'd be cute there and symbolic because what happened was painful and the foot is said to be very painful. However, now I'm thinking if I get it on my foot I'll see it more than I'd like to. I don't really wear sandals. Only really when I dress up and when I'm at the beach, but I'd see them every time getting in and out of the shower too. And I'm nervous about how they'd heal in my shoe. Will it get infected? Will it hurt to the point where I want him to stop?

So I'm thinking I'll get them on top but towards the back of my shoulder, under the mountains on my neck, or the back side of my arm I can't really see unless I twist it. I thought about getting it on the inside of my ankle or my calf too but I think I'd see those too much as well. I overthink everything. So I'm thinking if I get it on top towards the back of my shoulder what will I wear while getting it. A bathing suit top then pull my arm out. However, then I'd have to cover up my stomach with a shirt in order to feel somewhat comfortable. And how would it heal with my bra strap right on top of it. I think it'll be cute so I'd like someone to be able to see it, just not all the time myself. I'm afraid every time I look at it it'll bring back the pain of losing the pregnancies rather I'm already thinking about them or not. 

I'm also hesitant to get them right now too because it's right before Christmas and we have a trip planned at the end of March. Wondering if I should wait until after then, but tattoos are so healing for me. I'm wondering if getting it now would be best.

I also want a tattoo of two dolphins swimming side by side. One big, one small to represent my son and I. I kind of want to get that one first, but I'm thinking the butterflies will help me heal so maybe that's the one I get next. Plus then I could see if I like the artist before getting the dolphins. I think the Dolphins might be harder, possibly cost more, and they'd be on my arm in a spot where I'd see them a lot so I'd want them to look really good and realistic. 

TMS therapy 2nd week

 I'm currently in my second week of TMS. The positive I've noticed is that I have more motivation and energy to do things particularly in the morning around the house. I'm not sure if that's due to the ketamine, the TMS or that I went up on Lamictal from 250 to 300. I really don't think it was the Lamictal. So it was either the ketamine, the TMS or a combination of both. However, that's about all the positive I've noticed. Overall I'm not doing very well. I don't want to die which is good, but I don't really want to live either. I hope things get better very soon. I've tried talking to my psychiatric nurse practitioner and she told me to talk to the provider in charge of my TMS. I tried to talk to that provider, but I can't talk to her since I'm doing TMS. The way billing works it has to be one or the other. So I spoke to her nurse who relayed a message to her who relayed it back to me. Basically they told me that with TMS things get worse before they get better. I could wake up one day crying and not know why I'm crying. I could become pretty irritable. Mood tends to get worse before it gets better. However she assured me if I stick with it there is a light at the end of the tunnel. I'm not supposed to change any of my medications while going through TMS. Mainly because they don't want to over treat. Why I can't talk to the provider in charge of TMS about my feelings while going through it is beyond me. You're messing with my brain and I can't talk to you.

I've been having a hard time getting through the day, especially the evening. I feel overwhelmed with how much time there is. My counselor mentioned maybe it's like a restless feeling. I'm trying to figure out what to do with my time now that I have a little more energy and I'm not just sleeping for 12- 15 hours a day. I try to sleep to get through the night which sometimes works. However my son told me he feels alone and sad when I sleep. That made me feel really bad. 

Last night I tried to figure out how to stay awake through the evening. I was pretty successful and didn't fall asleep until about 8:30. I don't understand how in the past sometimes I can literally just take life moment to moment and not even think about the rest of the day. So why now am I getting overwhelmed with having so much time. To me that tells me life isn't going too well. When you feel like you have too much time you're not doing well. When you feel like there's not enough time in a day I feel like life is going pretty good.

My husband and I recently spent a lot of time exploring the option of getting a new insurance through his work to cover IVF. In the end we opted to stay with our current insurance which does not cover IVF at all. Therefore if we decide to do IVF it'll be all out of pocket. We don't know if we'll ever do it. Hopefully things work out where we never have to. I've been trying not to think too much about having another child and just take the time to focus on my mental health for now. However I did talk to maternal Fetal Medicine and the provider told me that all my medications are fine to take during pregnancy. If I need to go back on lithium it's not as harmful as they once thought. If I took it after 12 weeks there would really be no chance of harm to the child. Before then would be very minimal. The main thing is I wouldn't be able to breastfeed on lithium. I'm really hoping I don't have to depend on lithium, but at least I know it's an option. However I would want to breastfeed so that would be a big problem. I won't worry about that unless the issue arises. 

I have an appointment next week to talk to a different doctor about the possibility of mini IVF. My current fertility Dr. does not believe in it. I kind of want to cancel the appointment because I don't want to think about it right now. However, right now I don't have to pay a copay for it so I'm thinking I might as well at least talk to her.

Ketamine #5 and #6

 I finished my acute phase of ketamine infusion therapy. Overall I'm not feeling life and I've still been pretty down. I'm pretty upset/ disappointed. The first ketamine treatment helped, but ever since then hasn't been any better. I've been sleeping a lot, like 12 hours a night. Last night I slept about 12 hours, but I woke up and was able to do things. I still didn't particularly want to do things, feel like doing things, but I had the energy to. And I was able to. A lot of days I wake up and I just can't. Today I woke up and I could. I've been pretty productive so far today. Not sure what I'll do with the rest of the day. I start TMS therapy tomorrow. I'm still hopeful, but not as hopeful as I was that it'll work. I'm just tired of feeling down every day.

I was feeling really off/ anxious before my 5th ketamine treatment. Therefore I was given Ativan. It worked really well. My current nurse practitioner doesn't prescribe that class of medication so I'd have to switch providers if I want to take it again. Debating if I should or not. Ativan increases the chance for dementia with prolonged use and it can easily become habit forming. I'm wondering if it's worth it to use it short term. If it'd somehow cure this off feeling I get. 

I was told that maybe ketamine hasn't been as helpful as I'd hoped because I went off of lithium at the same time. Maybe it was helping more than I thought. I was hopeful that the ketamine would make up for the loss of lithium and I wouldn't notice a difference coming off of it, but that didn't seem to be the case. The nurse practitioner said I'd probably notice a difference in a couple weeks. I'm supposed to get a maintenance treatment of ketamine every month from here on out until I no longer need it. If I get pregnant I'll stop doing it as well. 

I've been doing a lot of research on different insurances offered by my husband's work. We'd be spending quite a bit more money a month and for the year but it includes IVF. So if we were to do IVF we'd actually save a ton of money by switching insurance. However, if we end up not doing IVF then we'll have spent a bunch of money unnecessarily. At this point I don't know what I want to do. Sometimes I wake up and I really want a baby and I want to grow our family. Other days I wake up and I don't have the energy, I don't want that level of responsibility again, and I don't know if I could take care of a baby anyway since I still feel off so much and have nausea everyday. Hopefully I get clarity sometime soon that lasts. 

Ketamine #3 and #4

 This week I have felt pretty down. Both days I had ketamine I fell asleep around 5:30 in the evening and slept pretty much straight through till 8:00 the next morning and struggled getting up still. Didn't have any motivation to do anything, pretty much just felt like I was existing. Felt hard to make it through the night. I wondered how am I going to get through tonight. Felt like a tall task. I'm hopeful that next week will be better. I really hope the ketamine works and I start feeling better like I did after the first treatment. One positive is I didn't have any serious intrusive thoughts that I can remember. 

Week 1 recap

 The first ketamine treatment seemed to be really beneficial. The next morning after doing it I woke up and started cleaning the bathrooms. I walked up and down the stairs effortlessly.  I was more productive than I had been in months. The second day after the first ketamine my stomach was hurting but I still put away some clothes before going to my second treatment. I'm not so sure if the second treatment was beneficial. The last couple days I've been kind of back to the way i was where I just want to sleep all the time. The last two nights I've just been so tired I fall asleep early not feeling off because my muscles aren't twitching or anything just like in a calm way I felt like really tired. So some was similar to when i fell off but i didn't need propranolol because my body was calm. However tonight I feel off again, my legs won't stop moving. I've taken Propranolol all that I can take. Not sure it did any good. If it did it didn't work as well as I needed it too since my legs are still shaking. Propranolol is supposed to take away the physical symptoms. Still unknown whether I have akathisia or if it's anxiety. Ever since I did the second treatment two days ago I've felt like I've been in a daze. I've been able to function just not quite feeling like I'm all the way present. 

I saw my counselor yesterday. She said it was nice to see me laughing and smiling and my facial expressions just seemed more animated or lighter or something she said. She said I was talking about stuff still, but it wasn't so heavy, it seemed lighter. My Suicidal Thoughts have increased the last couple days. That concerns me. The good thing is they've just been fleeting. I haven't been stuck on them. But still they're there and I have to fight them off. I don't think it's from coming off the lithium because last night was the first night I didn't take it and the increase in Suicidal Thoughts had started probably a day or two before that. So I'm supposed to take lithium tonight, skip tomorrow night, take it the next night, then be completely off of it. I'm hoping the ketamine makes up for it and I don't notice that I stopped taking it.

I've been listening to music pretty much non-stop for the last couple days. In the past I had to listen to it to focus on something because my mind would wander and it was just full of too much stuff. This time it's more like I'm in a daze and it's kind of like keeping me awake and engaged in something. It's also helping me fight off intrusive thoughts. 

Ketamine #2

 From what I understand ketamine comes in three forms which are oral, nasal and IV. I am doing the IV infusions. My nurse said that those are better than the nasal ones because you get 100% of it whereas the nasal you only get like 60 to 80% of it and you really don't know how much you got. With the IV you get it all. I thought it was interesting that they have something they can put in the bag with the ketamine to lessen the effects if they're too much for you.

Yesterday was my second infusion. The first one they put me on 40 and the runtime was an hour and a half. The second time they kept it at 40 even though I was hoping they'd up it. However,  instead of upping it they wanted to decrease my time. So yesterday I stayed on the 40 with a run time of 1 hour and 8 minutes. My nurse was very happy with that. She said now next time we can go up to 45. My target is 50 so the more I can do the more benefit I'll get out of it. They started me at a lower dose and longer time because of my history of chronic nausea and vomiting. The first time I had to do 12 mg of Zofran and eat crackers and drink ginger ale. The second one which was yesterday I did 8 mg of Zofran up front before we ever started still ate the crackers and ginger ale. I got nauseous a few times but by the time there was a break in conversation where I could say something I had either forgotten about it or it was gone. Therefore I never took the last 4 mg I was allowed to take of Zofran. So my run time was 22 minutes less and I used two doses of Zofran instead of three. I think a big reason for that was because yesterday my appointment was at 10:00 whereas the first time my appointment was at 1:00. You can't eat three to four hours before your infusion but it also can't be too long since you have eaten. There's like a little window of a perfect time to eat. So for the first one I wasn't really hungry but I had to force myself to eat about 8:30. Then come 11:30 I was starving but I couldn't eat so that made me feel nauseous. So I felt nauseous before I ever even started the ketamine the first time. The second time my stomach was messed up too but in a different way. I'm kind of upset with the nurse practitioner that she didn't just up my dose yesterday. My nurse thought she would since I got through the first one okay but she wanted to decrease the time first. My nurse has extra time so she didn't care that it took longer and thought it would be fine but the nurse practitioner says everyone has a two-hour window and I need to get my time down so I don't run the risk of getting over that. I want to get the most out of this that I can. 

Yesterday I felt the effects of the ketamine a lot more than I did the first time. I pretty much just felt like I was drunk. It got more intense towards the last like 10 or 15 minutes which I'm not sure why maybe cuz it like settled at the bottom of the bag or something maybe. I don't know but it was more intense. It was harder to stay concentrated. I had planned to just listen to music and let my mind wander but I ended up talking the whole time to the nurse instead. After talking to my counselor yesterday I realized that I can't give up control anymore. She said that it's probably linked to trauma that I've seen what happens when you're out of control so I won't allow myself to get that way. She said it's robbing me of being healthy out of control it's a controlled environment and I should just let my mind wander and see where it takes me. It might be more beneficial. But instead I talked to stay grounded and try to stay focused on something. I'm going to try talking less next time and see what happens. It's interesting because when I was younger I enjoyed being high and drunk and the feeling of just kind of being free and just going with whatever happens. But in recent years I can't allow myself to get that way and I can't even get drunk I just don't allow it.

It's really interesting because after they turn off the ketamine within like 5 minutes you come down and you feel pretty much fine. Some people find it hard to walk feeling like their feet are heavier, might wobble a little bit. I was told some people have to get pushed out in a wheelchair. It hasn't been like that for me so far I just got to walk kind of slow and be careful. But you're pretty clear mentally. I saw my counselor after yesterday and she said I was just easier. It seemed easier for me to talk and more willing to try new things. Like she took me through some visualization things to try to figure out what's going on with my stomach. Seemed kind of wonky but I went along with it. If I hadn't been on the ketamine I probably would have been a lot more skeptical. She said I wasn't loopy. I was just like a toddler halfway between being asleep and awake. She wants to see me the next two times after I've done the ketamine. 

So far I've been way more productive and able to do things the past couple days. I realized when I was cleaning the bathrooms the other morning that I went up and down the stairs effortlessly. Like I'd forget the cleaning stuff so I'd have to go downstairs and get something else and then go back upstairs to clean.  I cleaned on the bottom floor and the top floor. Most of the time in the morning when I get up I brush my teeth and I grab whatever clothes I'll need for the day so I don't have to go back upstairs. If I forget my ring or something I just don't go back up to get it. I usually don't walk back up the stairs until the night time when it's time to go to bed. But the other day I did it without even thinking. I don't think people understand how heavy depression is. Most people think that you just want to be happy and giggle and laugh 24/7. A lot of it is just being able to function and do the things normal people do effortlessly. It's been nice to feel a little lighter the last few days. I'm hoping it continues and just gets better. Today I woke up with a headache and my nose was a little stuffy. Colorado is dry so maybe that's why. There was a damn dog barking at 4:30 in the morning for over an hour so my sleep was interrupted. I don't know if that played a role in it too. It was hard for me to get up today. I wanted to stay in bed but I did get up. I went and got myself my own energy drink instead of waiting for my husband to wake up to go get it. I've been avoiding driving for a while but I did it today willingly. Well I was still kind of hesitant but I was able to do it. 

Other than going to the gas station and now writing this blog, I haven't really done anything today yet. Not sure what I'll do when I'm done with this.  If I'll just hang on the couch and wait for my appointment at 11:00 or clean or fold clothes or something I don't know. I guess we'll see. My next ketamine infusion isnt for multiple days, not until next week. So we'll see if I start feeling worse by then or if things just maintain or what. I'm a little anxious to see what happens with going up to the 45 next week. Also I'm on my last three lithium. I'm hoping that with starting the ketamine infusions I don't even notice that I go off the lithium. I'm a bit nervous about that too. I'm getting off the lithium because if I were to get pregnant it can be harmful to the baby.