Across and Inside my Universe

Unsafe

Well, I'm not safe.

Lability is uncomfortably high (I hope I'm using the term correctly).  My state of mind, my emotional perspective, keeps shifting so much that any decision I make, even fully believing and commiting to it, I can be doing just the opposite five minutes later (or half an hour, hour, etc.).  The place from which I am interacting with the world from, feels as though it's on a mess of shifting tides and currents.

Part of me thinks, well, isn't this just weakness of character, not being able to stick to anything or operate from a stable state of self or being or mind or whatever?  That word, stable, though, is part of the key.  The whole shifting currents thing, is another.  I'm NOT STABLE right now; I'd not call myself UNstable in a crazy, psychotic way, but  . .. well, basically what I've described above.

It is tempting to fall into the trap of thinking, hey, since I'm seeing this problem, and acknowledging it, doesn't that mean I'm functioning well enough to be or feel safe?  I've fallen into that trap before.  While identifying this stuff, prioritizing it, taking some actions with it, etc. are positive and functional, healthy things, the very nature of being so . . . well, volatile isn't quite the right word, I'm not going to lash out in an extreme way (although I guess suicide and other things actually are pretty extreme) at anyone else (hrm, I've been highly irritable and rather snappish, which I've been not pleased to have acted out as much as has been, the last few days; it has been uncharacteristically frequent and drop of the hat.)  I've been quite reactive and on a short fuse, not even necessarily being aware of having a short fuse, until I snap at my husband.

I've been irritable and snappish before, without the high lability; mixed states suck.  There is more here than just that, although mania and depression certainly make matters rather worse . . . 

I have therapy tomorrow, and I don't know if my psychologist will recommend the hospital.  We've already taken some familiar and not so familiar steps, around here.  Any excess medication my husband has hidden.  A step taken once before, for a time, that I've asked of him again, is to not leave me alone at home for three hour+ stretches.  Two hours feels like it'd be kind of rushed for anything extreme, but that may be because I'm particular.  I hate to scare him like this, but on the other hand it feels the responsible thing to do.

So, he may need to stay home from church on Sunday.  This would carry us to next Wednesday, when I'll be home alone for most of the rest of the week.  If I am still highly changeable/feel like my behavior could turn 180 in the blink of an eye/feel like my mania or mixed state or whatnot is pushing me to danger, then we'll have to probably hospitalize me or figure something else out.  I am REALLY hoping that I'm not like this, then.  It usually has only ever lasted a few days, 3 or 4 tops, but I had this a week to 10 days ago for 4 days or so, and now again and it's just rather scary.

I dunno, maybe I'm a wuss and not taking responsibility, when I say that I can't seem to be able to say that what I decide right now will be the place from whence I could reasonably still be operating an hour from now, etc.

The pull to reckless and harmful, serious things of a variety of types is strong, although I am currently fighting them.  Some things you can't come back from, and some you maybe  shouldn't (okay, definitely stuff to bring it up tomorrow in therapy.)

Edit:  This talk of lability, and danger, and unsafeness, and my assessments thereof, are based mainly on how my psychologist has assessed me most recently last week when discussing the same kinds of things, as well as in the past, the few other times that it has been this bad (all since early 2012, really).  Things I'm saying here are based on concerns he's discussed with me about my safety and stability and such when I'm in this/these states, having experiences as I've been this week and being all over the place, and stuff.  My safety has been a major issue and concern to him, in many of the ways I posted about here, and some things I haven't posted.

Edit:  Also, I do have upcoming appointments with my psychiatrist, later this month and then in August as well, since my urologist cleared me for going back on psych meds/back to the psychiatrist (I know one doesn't necessarily mean the other but he has pronounced my kidneys fine, after a CT and a cessation of the most distressing symptoms . . well, I may need to check one more thing with him, but he did clear me.)  Still, I may be contacting her sooner, by email I guess, if my psychologist thinks I need to go to the hospital.  Maybe her emergency nmber would be better, I don't know?  I' ve left a message on there before.

What a Not So Beautiful Mess . . .

To riff off of a Diamond Rio song title . . .

I'm being brave in posting this. I want to track my progress on organizing this, although the rest of the house is a mess too (mostly not as bad, but this is BAD, so that's not saying much).

This is the master bedroom in our apartment. Much of the mess is craft items, information, patterns, and publications. There's a big variety of crafts and materials: Beading/jewelry making (including chain maille jewelry), knitting, crochet, spinning, and weaving (that's a four-shaft table loom under a makeshift dustcover), Rubber stamping, scrapbooking, and a variety of paper crafts, with a variety of die-cutting stuff (including a Cricut, a . . . robotic die cutter, if you will, for those who aren't familiar with this stuff), and a big wooden rotating tower of ink pads, reinkers, ink pens, and other things.

I have fabric in various places in the room, handed down from my mom when she was clearing it all out; I have no sewing machine though except a tiny one designed for stitching in scrapbooks and on other paper crafting projects. The fabric has come in handy for a variety of my daughter's school projects, though. I've even saved jeans she's outgrown, and jeans of mine as well, for a variety of recycled/upcycled craft projects. It's a good thing I saved some of my jeans that I'd lost too much weight for, because I gained the weight back and needed them. Lol. I'm working on losing weight again, though.

I have a couple drawers of adhesives, from a Xyron laminator/magnet maker/adhesive applier, foam tape, masking tape, double sided tape, photo corners, glaze-type glues, rubber cement, tacky glues, post it note glue, glue for metals, and a whole host of other adhesives for different purposes, materials, etc.

The thing about all these crafts, is, the last two years mostly doesn't count for me not touching them much, due to a year and a half of surgical recovery; with all the pain knitting simple garter stitch was the most I could handle, and I've picked it up now and again. Also, the last two years my husband's been either out of work, or at two couple months long temporary jobs . . . with jewelry making, buying the findings like jump rings, crimps, clasps, bails, etc. can add up, and so as with some of the other crafts, running out of consumables has limited those.

Also, I suffer from a variety of mental illnesses, disorders, etc. You'd think an OCD person's bedroom would look neat, but then there's ADD, bipolar with lots of depression, etc. and everything's overwhelming. These issues also lead to a lack of desire to do anything, including favorite interests and hobbies. My therapist has recommended I not ditch everything, since once (or if, in my mind) my depression improves I'll regret having gotten rid of everything.

SO. With that in mind, I'm analysing how often I've used stuff, over the last 6 years or so, and factors affecting that, in order to help with what to ditch and what to keep. The last couple years it's been mostly knit, with a little crochet and a moderate amount of weaving. A little spinning, too. The couple years before that, there were sporadic bursts of rubber stamping (often related to mania, but not always), mixed with alot of knitting and the like. Also alot of beading/jewelry making during that period. The couple years before that, was when I started the jewelry stuff, as well as the knitting/crochet/tiny bit of spinning. Scattered Rubber Stamping as well, with a year of digital scrapbooking. It's been longer since physical scrapbooking, but that's mostly due to organizational issues (ie, I can't find my stuff) as well as some money factors (do you know how much the scrapbooking and stamping industries make? It's ridiculous. TOO many commercial products, I think a simpler, less expensive approach will suit me better.

Still, at some point when you're in an apartment, you can't just leave all that space being taken up by stuff you don't use . . . I need to figure out where to draw the lines. It's gonna be hard.

I can do it, though, one step at a time. I have a budget of $200-$250, from birthday and special occasion money I've saved up for awhile. That doesn't seem like much compared to all the stuff in there; some small portion of which needs to go in other rooms.

There's SO MUCH organizing info out there, though, that it's overwhelming. I'm starting with a blog or two, like http://iheartorganizing.blogspot.com/, which has some great ideas and showcases a variety of organizing products, ESPECIALLY in use, so I can get an idea of what may and may not work for me.

Wish me luck? And also, that I don't get so overwhelmed I just quit.

No judging my mess. I should have an apron that says that . . . lol.

Next post on this project will be the list of stuff that I've come up with that needs doing in there. Although, with the rest of the house being a mess too, I'm not sure what I'll do with the stuff that gets kept but goes in another room, before I've cleaned and organized the room it goes in so there's a place for it . . . . it's like a Mobius strip. Or MC Escher stairs.

Updating the Blog When You Have OCD

I spent 4 hours updating the blog today, and several the other day starting to add tags/categories to posts.

The thing is, I look at the Category Cloud and I can see a couple I can get rid of, which is good, but then the urge to add more as I categorize further back is hard to resist.  It's kind of frustrating and a little embarassing.

Much of the time spent today on the sidebar widgets, was spent super-fine tuning the size or the details like the order the books are shown in, their size, etc.  I think I spent two hours alone on the boardgamegeek widget, although that one required more primitive-level tweaking in the code itself.

It's going to take me some time to add categories to older posts; hopefully I can do just a few at a time, and not feel compelled to do a year's worth in one sitting . . .

My OCD is acting up, partly because I've been taking my Vyvanse, that lets it come out a bit more when I'm more active, and I'm under a huge amount of stress.

 

The Cheapest Care Possible

I don't want to offend any nurses out there, especially the ones who can prescribe.

BUT, when you have as many co-morbid (proper term?) psychiatric conditions as I do, AND especially when you have as many chronic physical health conditions as I do, you really would feel most confident having a psychiatrist, an actual DOCTOR, prescribe your psych meds, since you have so many conditions and medications that can interact with each other.

Now, as I'll apparently be seeing an A.P.R.N, which is a psychiatric prescribing nurse? I'm sure that they have extra education for that, and plenty of experience since they are working for the county's behavioral health system, and see the most disabled and/or severe cases, since they only serve those with Medicaid/Medicare. Lots of people on disability with either of those insurances, so this would be where they go . . . the LCSW I saw for intake interview went out of her way to reassure me that the nurses see severe cases and are very capable (does this mean she thought I was a severe case, or just that knowing they treat severe cases all the time means they are competent to treat anyone?). I got the impression that seeing a nurse instead of a psychiatrist for meds is something alot of people aren't the happiest about.

Anyway, while I'm sure these nurses are capable in many cases, I just feel like I have so much going on both mentally and physically that I'd only be really comfortable knowing a doctor was seeing me; how can I know that these nurses know enough about all the physical health stuff besides the mental health stuff to be able to manage all the issues?

Then again, who WOULD be happy that they'd be seeing a nurse for what they've traditionally thought is a doctor's role . . . I think this is partly based on that, but still . . .

There is part of me that feels like, because this is a government-funded mental health care system, as well as government funded reimbursement for them, that this is why they use the lowest-level providers possible; I was told that they do have ONE psychiatrist, but I'm guessing he only gets sent the most complex or resistant of cases. I was told I'd be seeing a nurse.

I feel like, because I am dependent on government assistance for this, that I will be receiving a lower, cheaper (not necessesarily incompetent) level of care than I would if I had private insurance. I don't think you can argue that these nurses AREN'T less expensive than psychiatrists, which means they are cheaper (although I am not trying to imply that their care is valueless or without dedication, expertise, etc. - it costs less and is less educated than a doctor/psychiatrist, though, is all I'm saying). This makes me feel like I am a second-class citizen, but then, without regular insurance, I kinda feel that way anyway.

I'm sure if something like this was posted over at Shrink Rap, there'd be an outcry from prescribing nurses, and maybe even non-prescribing ones . . . the thing is, though, I feel that prescribing nurses should SUPPLEMENT what a doctor does, not REPLACE them, and it feels like in this case they are being used as replacements. THAT is what feels wrong to me, what feels like I am being given the least expensive care they can get away with.

I'm also annoyed at all the hoops and forms I have to jump through and deal with just to see a nurse . . . I'm sorry if that offends anyone, nurses are very valuable, but I do NOT, I definitely do NOT see them as the primary provider of the medical side of my mental health care. I do not think that is appropriate.

I'd prefer something like initially seeing a psychiatrist, or a psychiatrist with the prescribing nurse present (they'd never do that last, too expensive) for the first couple of appointments and then see the nurse the rest of the time, with maybe a twice yearly check by the psychiatrist; more often if moderate to high problems come up. THAT seems like it'd be more, well, working with both a doc and a prescribing nurse . . .

I guess this post is amounting to a big whine, that might affront a variety of nurses . . . but it's how I feel, and I don't think REPLACING psychiatrists with prescribing nurses is a good thing for mental health care. Supplementing, okay, I can work on getting used to that . . .

I'll have to get used to seeing just a nurse, I guess, but I will not be happy about it. And here I thought I'd come to a new, more open mind about my next shrink, about being more open-minded, more open to different personalities and learning whatever comes to be learned from them. Turns out, I don't get a shrink at all. I'm feeling like I, and other Medicare/Medicaid people, must not be worth it, in the eyes of the government and the people who vote in the people who fund or restrict how such places are staffed.