Insomnia Means Means More Time to Blog, Right?

Howling coyotes (if you can call the sound they make howling) woke us up at 3.  They must have been very, very nearby as they were so loud.  As suddenly as the howling started, it stopped.  But I was awake.  I thought for a few minutes about the wild rabbit we have seen the past couple of mornings, or as we like to call him, the Yard Rabbit.  But 3 is early for crepuscular animals such as yard rabbits, so I am hoping he is safe.

I tried to fall back asleep, but the room was too quiet and too dark. And dh was snoring.  And I just didn’t feel sleepy anymore. Then I started thinking about chores and laundry….I know I will  be miserable later because I started my day at 3 (well…technically 4:06 cuz that’s when I got out of bed.)  We are due for some nasty weather later today, so being home and napping in the afternoon is a definite possibility.

The question I am being asked is, “How are you doing?”

I am overwhelmed.  And I am surviving.  I have had a lot of anxiety over doing this all perfectly…Yes, I know.  The last thing I need is perfectionism right now, so I am really trying to cut myself a LOT of slack.  Basically, re-integrating the first couple of days, I just felt kind of stunned and numb.  Yesterday was much better. <phew>

I am eating.  That’s the first and most important thing, right?  And despite a lot of anxiety about it, I am pretty sure I am eating my meal plan correctly.  I won’t know that for myself, I need to wait to be weighed and then someone will tell me how I am doing, but they only will if there is an issue.  So…I will keep doing what I think is right and see where it leads me.

I saw the AT yesterday.  I was soooo glad to see him.  Despite me feeling pretty anxious and worrying about reconnecting with him, it went well.  We actually had a bridging phone call last week when I was still in the program. My program therapist, the AT and I talked for an hour.  I think it was key to re-building my trust with him.  And I wrote a self-assigned piece about what he needs to know about me now.  So, yesterday I felt a little awkward at the start, but slid easily into safe comfort with him.

I have reconnected/connected with half my team now.  (I mean of the clinical team…Dh is always part of the team, even if I don’t mention him outright every time.)  I met the new dietitian Saturday.  She seems okay…I have a couple hesitations but I am going with it for the moment.  I saw the new Couples’ Counselor (CC) with dh yesterday.  He seems really nice and I think seeing him is going to be really helpful.  As I just mentioned, I saw the AT.  I also had a phone “interview” with an OCD therapist.  At the end of the interview, he accepted me as a client and I will be starting with him next week.  So, that’s contact with 2/3 of my clinical team in my first 3 days home.

Today, I see my primary physician.  Tomorrow, I see my Psych NP and the AT (again).  Then the rest of the week, I get to relax and recover and catch my breath.

Between all of Team Heidi, I will have 7 appointments a week to start.  The AT commented yesterday that it is like I will be having a job and that it is exactly what I need to be doing right now.  I felt relieved when he said that because I worry that all of my appointments are selfish, or like I am taking too much from all of my clinicians.  Or that I should be getting a real job and diving right back into the world of employment (which would be a bad idea at the moment.)  I like it when my therapists say things that actually make me feel better.

Tomorrow, I will write about my/our (dh is on board and helping with this) project of changing the physical environment of our home to help me not fall back into old habits and patterns of behavior.

And I will write about my plates.

 

OCD Exposures

Not sure what to write about today…So, here’s this:

As a method of reducing my OCD behaviors, my anxiety therapist has started me on germs and contamination exposures. I made a hierarchy of what things bother me from least to most.

Germs and Contamination

  1. Using a communal blanket
  2. Wearing clothing after someone else has worn it (i.e. like if I lent a sweatshirt to someone)
  3. Dirty tables in restaurants
  4. Touching things that I consider yucky (a used sponge, mine and other people’s dirty laundry, things that have landed on the bathroom floor, raw meat, etc.)
  5. Reaching into a trashcan for something
  6. Not washing my hands after using the toilet
  7. Not washing my hands (if I feel like they are dirty) before I eat
  8. Using food that has a broken seal (like fresh from the store, but the seal is torn or cracked or coming off, like on a yogurt)
  9. Touching the inside of the garbage can lid or having to push the flap in on a garbage can to throw things away
  10. Eating something that has fallen in the sink
  11. Drinking out of someone else’s glass
  12. Bumping my hands in public bathroom sinks or knobs or paper towel dispensers after I have washed my hands (I will have to re-wash my hands)
  13. Touching my face if I feel like my hands are contaminated (especially with sick people germs)
  14. Getting in close physical proximity to sick people
  15. Eating near sick people
  16. Breathing when sick people have coughed/sneezed/sniffled close to me
  17. Turning faucets on/off with bare hands esp. in public places
  18. Touching doorknobs (especially public bathroom or doctor’s office)

The most distressing things revolve around public sinks, doorknobs, sick people and trash cans.  These are the things that I use behaviors to avoid every single day, and multiple times a day.

So, now I am practicing “easier” exposures.  So I was sent home with my first exposure tasks and a form to rate my distress.

bans

She told me to use the SUD scale to rate my distress.

Subjective Units of Distress Scale

0   No distress at all. Feeling okay and calm.
1   Feeling little if any stress. Not quite fully calm.
2   Faint tension or mild stress.
3   Feeling slightly unpleasant or uncomfortable.
4   Growing distress or discomfort. Mildly agitated.
5   Verging on becoming very uncomfortable and distressed.
6   Very uncomfortable affecting my attention.
7   Emotionally painful becoming severe.
8   The emotional pain is taking over my attention.
9   The emotional discomfort is almost unbearable.
10 The emotional pain is overwhelming me–the worst possible

And so…It has been a long few days.

Struggling So Much

I feel like a failure.

I am not going to make it to  yoga this morning.  Saturday morning yoga is my favorite part of my weekly routine and the class has my favorite instructor.  And I am not going to make it because I spent 45 minutes trying to will myself out of bed to shower, get dressed, eat breakfast and be ready to go….And I couldn’t do it.  And now, it is too late to get my shit together and go to yoga.

What is wrong with me?  Why can’t I shake this depression?  It is not helping me at all right now…Although I don’t think depression ever actually helps.  But really, it is impeding my recovery process.  I suppose it is a good sign that I still care, because when it gets to a point that I stop caring about recovery, then I will know the depression is out of control.

I didn’t struggle with the PTSD episodes last night.  Last evening, I went grocery shopping with a peer.  I didn’t have a good time.  Last time I went out with this peer, I didn’t have a good time.  I think I will stop doing things like that with her.  She just is always distracted, texting, doing her own thing.  I mean, that’s all fine, but if you are going to do something with someone, it would be nice to actually spend time together, iykwim.

We were out through dinner time, a tactical error for me.  She didn’t care because she isn’t eating right now. I cared.  By the time I got home, it was over two hours after I usually eat.  I was fascinated by the fact that I wasn’t actually hungry.  (When you mess up your body with an eating disorder, you mess up  your body’s ability to cue you about hunger.)  I did eat.  I made myself some quick mac n cheese and had tomatoes dipped in salad dressing.  I am guessing my friend went home and ate nothing.

After that, I video chatted with dh for a while.

I don’t know if it was the being with people, or chatting with dh, or change of routine, but the Friday night PTSD torture did not happen and I am sooo relieved.

But now, here I am, in the depression hole. I have self-harm urges, passive suicidal ideation, emotional pain and no energy for initiation of anything.  I haven’t even gotten out of bed to pee.  And…now, I am going to miss yoga.  F.A.I.L.U.R.E.

I have spent some time this morning, as I have been trying to will myself out of bed, asking myself why I feel so depressed, why I feel like self-harming, why I feel suicidal ideation.  What purpose is this serving me right now?  I can’t come up with much.  The last two days of programming this week were kind of tough.  Yesterday, I did that me-in-the-group check in.  I also checked in about the use of eating disorder behaviors I have had this week.  That was hard…and didn’t really make me feel better.  We had a really hard discussion in our sexuality group on Thurs about trauma effects on sex and masturbation.  I shared something I had written about it on my trauma timeline, which was really hard to do.  (And despite my shame about what I had written…I had several peers thank me both during and after group for my candor and putting words to a hard topic and opening it up for people to talk about it.  Because as ashamed and embarrassed as I felt, I was in a roomful of people who had the same experiences and felt the same way.)  Sharing that probably pushed me farther into trauma stuff than I should have gone.

I don’t know…I feel scrambled as I am blogging…and there is so much more that I want to say, but I feel like I am not making much sense and this post is going to get too long if I say it all.  Wait…this is a time for bullet points.

  • I am still reeling from my therapist saying I probably need to be here another 8ish weeks.
  • I am concerned about our finances and how we will afford to keep me here that long.
  • My anxiety therapist did the Y BOCS II with me yesterday (an OCD assessment) and I scored really high…I am still trying to process what that means for me.
  • I think my PNP is worried about my depression.
  • I am supposed to go meet with peers at Starbucks this morning and I don’t want to go
  • I have started to lose my boundaries with the peer that I wanted to keep distance from because our relationship is unhealthy.
  • I am furious at my friend who is not eating.  I am trying really hard to be compassionate, but why does she get to not eat?  And why does she smirk and look pleased every time someone asks her about it/confronts her about it/or clinicians talk about it?  And is she just trying to kill herself? Is it attention getting behavior?  And when she restricts at our group meals, why aren’t they following their protocol about it?  WTF.  Everything about it makes me mad. Which probably means I need to just ignore it so it doesn’t interfere with my process.
  • My PNP really wants me to do something “sweet,” as in finding something I enjoy for self-care and lifting my mood some.  I don’t feel like I enjoy anything.  How can I find something “sweet”?

Okay…now I know I am rambling. I am going to drag myself out of bed and take a shower, take my meds, get dressed, eat breakfast and try not to crawl back into bed.

Actually, I think I can hear water running which means the woman I live with is showering.  It gives me an excuse to just stay in bed for a while longer.

 

 

In Bullets

Yesterday was one of those days that is best captured in bullets because there is so much to say:

  • There have been two new admits in the past couple of days (one was yesterday) and it has totally changed the social dynamic…And I am not sure it is a change for the better.
  • I talked to my nutritionist about the comparing at dinner. I felt better after our discussion.
  • I was ultra-depressed for half the day yesterday (have been pretty depressed for about a week now) lots of negative thoughts, thoughts of self-harming etc. It taped off some as the day went on…We’ll see how tomorrow goes.
  • I am getting more support from my Favorite Direct care person and she is sort of keeping an eye on me. I like that she is helping me.
  • I met with the anxiety therapist again and I am resigned to the fact that there are going to be new diagnoses added to my psych list.
  • I mentioned to the nutritionist that I might like to have 5 minute walks just to get outside and see the trees and stuff. She said we can talk about it more.  (I was sure she was going to automatically say ‘no’)
  • I am totally burned out from coloring.
  • This weekend’s outing is to Michael’s and I really, really want to go which means I have to be on my ultra-best behavior for the next 36 hours. (No more non-compliances.)
  • I started thinking about the concept of “Productive Struggle” that they talk about here.
  • Meg is gone and it makes me anxious.
  • I worry that I will be gone too long and the AT will not take me back (I am sure that insecurity about the one has led to insecurity about the other.)
  • Sometimes, I feel like I can’t relate at all to my peers because they are all so skinny.
  • I have been working diligently on homework assignments and am due to present assignments maybe today and if not, certainly at the beginning of next week.
  • I have been upgraded to half-hour observations which means I only have to be in common areas for a half-hour after meals (When you first arrive you have to be in common space for 18 hours. Then once you are settled, it just for two hours after meals, then one hour and then a half-hour.  I don’t actually know if there is such a thing as no observation)
  • The two new admits puts Hilltop at pretty much max capacity.
  • I think I am going to be here for longer than I expected…Not necessarily at the residential level, but in terms of the whole program.
  • I love the trains that go by. All night and all day there are trains going by.  The most interesting train so far was loaded up with blades for wind turbines (like 30 cars of blades).  Other than that, there are coal trains, freight trains, and recently I have seen trains with red-ish rocks in the hopper cars.  Not sure what that is.
  • I get homesick a lot and am acutely aware of all the things I am missing/will be missing, especially seasonal foods like black raspberries, blueberries, corn on the cob, tomatoes from my garden, blackberries, etc., etc.
  • I have nightmares pretty much every night now and don’t sleep well.
  • The crazy hot weather has tapered some and now it is just really hot out.

0723161209