Medication? Who me?

Lithium Capsules...truly a lifesaver for me.

Yeah, I'm still on my bipolar thought process roll. It doesn't usually last so long, but here we go again.

I am a terrible patient/former RN when it comes to my own medication compliance/adherence (adherence is the new "feel good" terminology since it doesn't make a accusation regarding the patient). I am one of those nurses who unfortunately lives by the "Do as I say, not as I do" motto. I've been on and off meds for my bipolar disorder since 1997. When I'm on the, most of the time I'm pretty stable or "normal" by some people's definition. Like I've said before I don't believe in "normal" anymore, I much more prefer "stable."

Anyway, there are times that I stop my meds on my own...and I mean abruptly stop them, something that should not be done with psychotropic meds...just because I'm feeling really good AKA in a hypomanic episode. I don't recommend stopping meds without talking to your psychiatrist, but if you do do so taper them down over a couple of weeks do not ever just suddenly stop them! Like I said I really recommend talking to your doc first...I'm a little dangerous because I have that extra knowledge that lay people don't typically have. During these episodes I really feel more like my old self than ever...except that I tend to overspend, have issues with lack of sleep or not sleeping at all, racing thoughts, etc. but I've never gone into a full blown manic episode that becomes possibly life threatening because there's a lot more risk taking involved. It's not uncommon for those with bipolar disorder to think that they feel good so they don't need their meds when the reverse is actually true. Mood stabilizers will help quell down the overly active/risk taking behaviors and in extreme cases an anti-psychotic may be needed in addition to the mood stabilizers to maintain the moods in check. Typically both these medications will be taken long term.

For depression of course antidepressants are prescribed. The problem is that antidepressants can actually trigger a  hypomania or mania. So it's not uncommon (or it shouldn't be) to only use antidepressants for short term...what I mean by that it 6-12 months. Please remember I was studying and two semesters shy (2 clinical courses and 2 theoretical courses from graduating as a prepared Pysch/Mental Health advance practice nurse or qualified to certify as a PMH-NP) of graduating so that's where a lot of my statements are built from...my educational background. After the prescribed use a trial off the antidepressant should be attempted and if all goes well the patient may be taken off the med...if it doesn't go well they stay on or maybe try a different one.

I digress, so on those occasions when I do stop my meds it can just be a few days simply because I forgot, or weeks & months (I've been off my meds for about a month and a half and just restarted taking them yesterday) simply because I feel "good" and I've even gone years off of them always crashing big time into a long lasting, severe and even suicidal depression. It's stupid. I was an RN for 22+ years, I taught psych/mental health nursing for 4 years and I've been diagnosed for 15+ years. You'd think I'd have my head all together and a grasp on this, but no.

So right now in Spring through the Summer this is when I can almost guarantee that I'll drop into a severe depression. I'm actually surprised that it hasn't happened considering how long I've been off my meds, but it's enough to scare me into starting them up again. To help with this I have a 7 day pill box to set up all my twice daily meds...OK, I have it somewhere but I can't find it but that's what I usually use to keep my meds straight. I've also downloaded an app called MyMedSchedule that has charts you can print out to track your meds and mobile apps for iPhone and Android that can be set up to send you email and SMS reminders to take your meds at whatever setting you determine. Once I got this set up correctly I started getting my reminders...now if only they could send reminders to Twitter/Facebook since I'm always on those and sometimes allow my phone and tablet to die and forget to recharge them.  However, the email can also be seen on your regular email account...as long as you check it regularly or have some sort of pop-up set up for the message when it comes in. Hopefully this will be something hat really helps with my med adherence.

Yes, this is in face my actual printable med schedule/checklist from MyMedSchedule

The printable medication schedule from MyMedSchedule

I've got one and a half days of medication on board and because I am familiar with the intricacies of these meds I know which ones that I can return to a full dose and those which I need to taper up to my normal does over several days. Depending on your meds never go straight back to the dose you were on unless you talk to you psychiatrist!! It can be dangerous to do so...and please don't decide that you're going to catch up on several days of medications all in one go. I know a lady who ended up and the mental health unit with me during my first psych hospitalization because she took  a week's plus of medications when she expected her husband to come back from a business trip!!

So to anyone out there who maybe having to deal with medication adherence issues whether it be psychotripic meds or regular medical medications take a look at MyMedSchedule. It may be of assistance. Good luck to us all!

UPDATE 3/25/13 at 11:55am;
I'm gonna try something a little different in addition to a hard copy checklist. If you look on the right hand sidebar you'll see a new page "Medication Accountability Checklist." this is the same info as on the checklist above but available online. Some people may wonder why I am so public about my meds, it's because I choose to do so. I'm not violating anyone else's HIPPA rights. I choose to try this and see how it goes. Let's see if I can remember to update it daily!

Race Recap: Bataan Memorial Death March - My 1st Full Marathon

Race Location: White Sands Missile Range (WSMR), New Mexico

Race Date: Sunday, March 17, 2013

Race day - 2:
Well, the day had finally come. It was time to get ready to head towards my very first full marathon. Admittedly, I hadn't trained anywhere near as much as I should have. I had a case of nerves that I hadn't really felt since my first half marathon or the first time I did Spartan Sprint last month. In late February I had received an injection of confidence and purpose when a Facebook friend told me the story about her great-aunt who was a military nurse taken as a POW after the surrender at Bataan. I decided to dedicate this race to her and the other female military and civilian nurses and healthcare workers taken prisoner after Bataan. However, even with this new sense of purpose I had a recurring sense that I was about to fail at probably the most meaningful race I could have entered to date. I actually considered paying the $50 fee to change to the short route, but I had dedicated 26.2 to the Angels...so 26.2 miles it would be.

My veterans dedication bib and my special dedication bib
for the Angels of Bataan.

The bib I printed to wear during the race dedicating it to the Angels of Bataan.

The husband was on Spring Break from the college and university so the timing couldn't be much better. I had managed to get almost all of my pre-race ritual housecleaning done on Thursday and just had a few things I needed to do plus get my packing done. We finally left at about 12:30pm or so for the roughly 5 hour trip to White Sands Missile Range...an operating Army missile base that you may have seen parts of on Mythbusters. We stopped in Roswell to get the husband a boonie hat for the race as well as something quick to eat. Why is it that I only seem to eat at McDonald's when I travel for races?? Yuck! (And I used to be a huge McD's fan!) After that it was pretty much a straight shot to WSMR. We got to the Community Center on base where they were doing the marchers in processing. You have to go through a series of rooms to get everything done but it wasn't too bad since we arrived for the first day of registration. I think, IMHO, that in the future they should move it to a more open area but this was still workable. We picked up our packets, hubs was doing the 14.2 Honorary March) and looked around at the race merchandise for a bit. I really wish I was paying more attention because if I had seen the "I Survived the Bataan Memorial Death March" decal I would have bought one for sure (just in case).

Race packet swag.

Commemorative timing chip.

Commemorative dog tag...no bling except for those who place.

Certificate of participation.

We headed back to Holloman AFB just about 40 minutes east of WSMR where we were going to be staying for the next two nights. After we got into our room we headed into Alamogordo to eat at Carino's to continue the carb loading that is my habit for the week prior to a race. We got back to the room around 10pm and started getting our race gear together and made plans to make a trip into Las Cruces for breakfast, to buy some tech shorts for the hubs and watch  21 & Over (5th time for me, 2nd time for the hubs).

Race Day -1:

We got out the door and headed for Las Cruces at about 9am and stopped at The Village Inn for breakfast...great timing because the place filled up just after we were seated. We then stopped at Dick's Sporting goods before heading over to the Telshor theater to watch my 2nd favorite movie after Pitch Perfect! LOL! After the trip to Las Cruces we had to run back to the room to pick up some virtual race medals for the team from West Point Military Academy who would be competing in the Military - Heavy Division (full uniform with packs > 35 pounds. After we picked up the medals, we headed back to WSMR to attend the meet and greet for the survivors. The meet and greet was in the Professional Development Center and broken out into several different rooms with a survivor speaking in each one. There were no survivor's names assigned to the rooms so it was kind of a pot shot as to who we'd be hearing from. We ended up in the auditorium where Col. Ben Skardon was scheduled to speak. The man, 94 years old now, had a sense of humor about surviving the March and captivity, along with a deep reverence for his comrades who were no longer living as well as a sly, sparkle in his eye when talking about the Angels of Bataan (whom I had asked about) as well as the nurses who cared for him after liberation from a Japanese POW camp. After his talk I went up to thank him for his time and asked if he knew Lt Thor, the Angel that I was dedicating my race to. Unfortunately, he didn't know her but he saw that I was Filipina and he went on to talk about working with the Philippine Scouts in the region of Cebu where some of my family hails from. I cannot tell you how many times I had tears in my eyes during his talk, nor the amount of laughter that he was able to elicit while talking about such a deep subject. This man would be walking 9 miles of the route the following day with the help of his family.

\

Blurry cell phone shot of Col. Ben Skardon during his talk.
Click here for a video of Col. Skardon talking about his captivity in 2012.

After the presentation we headed over to the Frontier Club for the pasta buffet. I looked around for some of the Team Red, White & Blue members and knew that the West Point cadets would be with them. This is when I presented their medals to them. I spoke for a while with one of the national leaders and took the photo of the West Point-ers. While eating we also met a couple of Marathon Maniacs (I had purposefully planned to wear my Half Fanatics shirt to meet other HFs or MMs) one of whom was an active duty colonel at Wright-Patterson AFB and another girl from San Jose plus her friend who was from San Leandro (both some of my NorCal SF Bay area neighbors). We had a great time just chatting about races, doing Bataan for the first time and encouraging each other...

The four cadets from West Point, there was a last minute addition from
Annapolis Naval Academy to round out the team who is not in the picture.

My new Marathon Maniac running friends on race morning.
Dan-O was competing in the Individual Military Light Division.

More Marathon Maniacs and I. I'm the only true Half Fanatic.
Some of the Maniacs are Double Agents, meaning that they are both
Half Fanatics and Marathon Maniacs...I'll be one of them by fall.

We were going to watch the movie Forgotten Soldiers which was about the men of the Death March, but we wanted to try to get to bed early since we would have to be heading to the base at 3:30-4am the next morning. Instead we headed back to HAFB at about 7:30pm to finish getting our gear ready and try to get some sleep. I popped a milligram of Xanax hoping for some decent sleep since 26.2 miles was going to be a distance that I'd never done and I wanted to be rested...I'd find out the next morning if it was a good idea or not.



Race Day:
Well, as always on race day the alarm went off too soon...this time at 2:30am. I was a little slow to wake up and by the time I did the hubs was already out of the shower. I had just a slight Xanax hangover which was quickly washed away after a nice, hot shower...yes, I'm one of those people who has to take a shower in the morning to wake up even on race day. Taped up my knees, calves and shins for what I truly expected to be a long and rough day then got dressed. We got everything packed into the car since we would be making...or rather the hubs...the nearly 5 hour drive home right after the race. We checked out of lodging and were on the road for the 30 minute or so drive back to WSMR.

We got there at about 5am and traffic was slow but not painful. We managed to park right across from the staging area and get everything set up. We headed over to the Team Red, White and Blue RV to meet up with some of the members and see if a "before" pic were to be had. Unfortunately there wasn't so we headed across the street to get in line for the call of nature before heading over to the fire truck that was flying the gigantic Stars and Stripes to find the group pic for the Marathon Maniacs and the one lone Half Fanatic (me). By the time we got the pics taken, it was time to get to our separate staging areas for the start. Hubs made his way to the back end of the group where the Honorary (Short Course) marchers were while I took my place among the Civilian - Light marchers.

The temp was in the low 50°'s and the wind was fairly calm. The local high school choir sang The Star Spangled Banner and a bagpipe regiment played after the names of the most recently deceased survivors were announced. Prior to the names of the recently deceased, the survivors in attendance were identified in a roll call with their voices strong over the sound system. The poem written by journalist Frank Hewlett during the war to call attention to the men of Bataan was read:

The Battling Bastards of Bataan emblem
with the Philippine Defense medal.

We're the Battling Bastards of Bataan,

No Mama, No Papa, No Uncle Sam,

No aunts, no uncles, no cousins, no nieces,

No pills, no planes, no artillery pieces,

And nobody gives a damn!

It was after this that the tone of the start focused solely on why this race was happening...to remember those men who suffered through the 80+ mile forced march with little in the way of provisions, medical care and in the worst possible conditions during their days as POWs. This race is to be sure that their courage, bravery in the face of adversity will never be forgotten.

There was a multi-wave start with the Wounded Warriors leading the way. With each different wave a cannon announced their start. There were the survivors at the sides of the start shaking hands with those of us who went towards them. There were 15 total survivors in attendance and I had the opportunity to shake hands with 3 of them as I headed out on the course.

The first part of the course was on the roadways of the base, by mile 3 we were on groomed/bulldozed trails  out past the sports complex. Things were a bit crowded, but the course was flat. I found it necessary to jog past people occasionally to get past slower groups or to simply get away from the dust being kicked up by so many people in one place. The sand as never too bad here and most of the course was fairly well packed.

Around mile 3 or 4...

By water/aid stop #3 we were back on the asphalt. This was also where the two different routes diverged and I headed off the base towards the "hills." We remained on the roadway for a few miles with some slight inclines and then came this view...

Water/Aid stop #3/#9...the point where the two routes split up.
Not too long after I was passed by the 3rd runner headed
back to the finish...his mile 19!

Around mile 9...the hills begin.

At about mile 10 they had set up some misters...to bad the wind was blowing one side of the mist back onto the desert instead of the marchers! By about mile 11 we were back on groomed trail although it was quite a bit sandier than the previous portion of trial...

Back on the trails at around mile 11. The sand isn't too deep, but it's there. 

At this point in the race it became mostly an uphill climb...near constant. Those of you who know me know that I am not a fan of hills, but I persevered often wondering to myself if this climb will ever end. I made it to mile 13 and was elated that I was almost at the halfway point. I also thought that I was at the top of the climb, but WRONG!! There was still more to go...I stopped at the mile 14 water/aid station (and hot dogs, hamburgers, chips station) to empty the sand out of my shoes for the first of many times during the remainder of the race. By mile 15 or 16 I had reached what I think is the pinnacle for the climb...

The Canadians had been here!

Yeah, that's WSMR way down yonder!

I was fooled again into thinking that it was all downhill from here. It was downhill for a bit and then the climb started again. At about mile 16 or 17 they had a clock up and this is my time as of then...

I didn't think that was too bad for hiking the course.

By the time I got back on the asphalt at about mile 18 or 19 I was never so happy to be on solid ground. I had stopped at least 6 times since my first stop to empty the sand from my shoes. My feet were tender from forcing myself to keep going with the sand/pebbles in my shoes and I was tired from all the climbing. Lesson learned from this first experience...next year and thereafter I would wear gaiters or running boots!

I was happy to be back on the asphalt for even just the few miles before we ended up back on a trail. My feet were tender and tingling like pins and needles. About a mile past the #3/#9 water and aid stop where the two courses had split up, we turned across the road and back onto groomed PT/marching trails. The sand in some points was terrible, especially in the region of mile 21 where I'm told that the man made "sand pit" is. The sand did seem slightly deeper here than in other places, but I didn't think it was as bad as people were saying...until I went in nearly ankle deep and got a bunch of sand in my shoe again! I stopped at the mile 22 water/aid station and literally sat there for 10 minutes emptying out my shoes and just long enough for the med techs to come and check that I was okay. I was just dreading putting my shoes back on because since I had rested them there was blood flowing freely again and I knew that as soon as I stood up the pins and needles sensation would start all over again.

I had received a text from the hubs saying that he had finished and to let him know when I got to mile 24 so he could meet me. From that point on all I could think about was my cold post race chocolate milk, teriyaki beef jerky and the ability to take of my shoes and put on my Birkenstocks! I kept moving on listening to my music with a lot of Pitbull and David Guetta in these last few miles. That beat really kept me going and still singing to myself (aloud if no one was around) taking one step at a time. By the time we hit the backside of base housing the wind had whipped up and was probably well into the 20+mph range. A few times I actually had to use my bandana to keep from breathing in the thick dust. Then I saw it...that magic mile 26 marker. There were a bunch of active duty Army women there doing the Military Light Division resting and just getting up to try to keep going. It was nice to know that I wasn't the only one moaning and groaning about my tender feet! I took a group pic for them and they returned the favor and took my first pic at mile 26 (hopefully one of many to come).

Hot damn! I'm actually doing this!! Only 0.2 miles to go!

We all pretty much headed out to the finish together. In the last 100 feet or so each of the Army ladies took off in a jog to finish (teams had to finish within 20 seconds of each member) and once they were all there they crossed the line together. I started a strong jog about 75 feet from the finish...I didn't even really look at the time but I think it was about an 8:31 clock time (my MotoACTV had died along the course so I had no real idea of my time). I went straight for the med tent just to get some ice to ice up my calves but you had to go through and get seen and checked out even if all you wanted was ice. Along the way I reassured one of the other Team Red, White & Blue females that I was just wanting to ice my legs and that nothing else was wrong. So because of all the red tape I skipped that and headed ever so slowly back to the car. 

After we got settled we drove by and saw that most of the Team RWB camp was broken down already so we headed back to Holloman AFB so I could go to the gym to take a shower and so that we could stop at Popeye's for dinner. I could've gone to the base on WSMR but they had people sleeping in there for the race so I thought it would be less of a hassle at HAFB. Once at Holloman I had the hubs drive me to the door of the gym and I slowly made my way to the women's locker room. I knew I was going to have a crazy suntan between my compression shorts, KT Tape and compression socks and this is what I ended up with...

I'll never have an even tan this summer unless it's fake!!
Unfortunately, I didn't have any baby oil to loosen the adhesive
so I ended up taking a layer of skin off while removing the tape in the shower...

After I finally finished my shower we headed over to Popeye's to eat only to find out that they close early on Sundays. We ended up at Denny's where I ordered fish and chips but barely at any of it. It may have been the quart and a half of chocolate milk I drank, plus nearly half a liter of Gatorade but this was the first time in many races that I wasn't anywhere near being starving at the end of a run! So odd!

All in all it was a great, inspiring and challenging weekend. This is a race to do for all the right reasons...not necessarily a race to complete for time or a new personal record. This is a race to remember the sacrifice of the men and women of Bataan/Corregidor.

What I liked (loved) about this race?

Everything!! Seriously...the reason and importance of the memorial...to remember those that suffered through the Bataan Death March. I'm honored to have had the chance to meet and/or shake hands with some of them. This race touches me on so many different levels from being a female military veteran, to being a nurse having worked in the Air Force and Veterans Affairs healthcare systems to being a full blooded American born Filipina. The story of the "Angels of Bataan" or "Battling Belles of Bataan" is something that I will not let die and be forgotten! I also thank Col. Skardon for telling me "...the Philippine Scouts/Army doesn't get the recognition it deserves..." in reference to the Death March and WWII. That truly means a lot to me.  Course support is OUTSTANDING even though it's primarily a closed course.

What I did not like about this race?

The only thing really is the in processing...everything else was great! Well...I wouldn't mind the hills not being there but that's what this race is all about...being uncomfortable in a controlled situation unlike the veterans of Bataan.

Will I do this race again?
I will be here annually from now on...possibly at the expense of the Virginia Beach Shamrock Marathon which has been on my radar since I started racing. It'll be on my calendar for the rest of my racing/running life!! :D

Results:
Not too far off of the middle of the pack...totally happy with that!! :D


BETH HARDY
Gender: 376/668 
Clock Time: 8:29:18 
Chip Time: 8:19:47 
Pace: 19:04 
Bib: 1502

The Elusiveness of Self-Esteem

Self -esteem or self-worth by whichever moniker you prefer is defined by the Online Merriam Webster Dictionary as:

 "A confidence and satisfaction in oneself." 

In the user defined Wikipedia, self-esteem is described as:

"Self-esteem is a term used in psychology to reflect a person's overall emotional evaluation of his or her own worth. It is a judgement of oneself as well as an attitude toward the self."

Now, I think most people have a fairly decent self-regard but for some of us, for whatever reason, we don't have that positive self-image although some and even many around us may see us as being some kind of outstanding person in whatever aspect of or even our whole lives. Today a friend posted this status on one of the social networks:

"I need to see myself the way other people see me."  

I saw that and the first thing I thought was that I could just relate so much to that statement. The young lady who posted that statement has gone through a remarkable journey and I would love to know that she feels really good about what she has accomplished so far and what she will continue to accomplish in the future, but like I said...I can totally relate to how she is likely feeling.

Prior to my bipolar diagnosis, you could say that I have a very strong sense of self-worth/self-esteem. In my late teens and early 20's I felt, for the most, part that I could tackle the world and get out of it what I wanted. Then my symptomology for the bipolar started started to creep into the fold. My ability to handle stressful situations declined dramatically, I began questioning myself in many different aspects of my life. My diagnosis came at a huge juncture in my life. I was just getting ready to finish my master's degree in nursing when an overwhelming depression, suicidality and a lack of interest in life hit me. I struggled through and managed to finish my degree but had to drop my optional thesis which I had done a lot of work on already and because of the new diagnosis and of losing trust in my own decision making I never applied for my family nurse practitioner license although I had passed the national certification testing. I think it was at this point that my once strong self-esteem/worth went to pot. This was the first time that I had felt like a true and complete failure.

Since that time I have found it difficult to be proud of whatever accomplishment that others say I have done. I never feel that I have done enough to earn any recognition and truthfully, recognition stresses me out so badly that I usually end up in a deep, if not suicidal, depression. Case in point, I was working in the clinic of the local base and my supervisor put me in for civilian of the quarter which I won, then won the squadron civilian of the year, followed by base civilian of the year and then went to 8th Air Force competition. At the beginning of this process I had literally begged my supervisor not to put my name in the hat, but he did anyway. All I could do is smile through all the "'Atta girls" and pats on the back while all I could think was that I didn't deserve any of it and that they were making a huge mistake. This triggered a massive, suicidal depression and within months I had resigned from that position and thought about leaving nursing for good.

You would think that someone who got these commendations would be proud, but instead it just caused me such anxiety because I didn't believe all the good things that they said about me were true. To this day I don't want to be commended for anything I do. Just let me do what I'm expected to do and leave it there. Bringing attention to me just makes for bigger problems for me.

My self-worth/self-loathing (okay, maybe loathing is a strong word, but it's the only one I can think of right now) took an especially big hit in 2009 when I again hit a massive, suicidal depression after beginning work on a PhD in nursing as well as being just two semesters shy of graduating with a second master's degree in nursing...this time as a psychiatric nurse practitioner. I had started my PhD that summer in the midst of a grand hypomanic phase when I was barely sleeping and had loads of energy to spare, but by the end of summer that depression hit and I could barely function on a day to day basis let alone as a student in two concurrent programs. That was the point that I gave up my academic dreams and my self-esteem dropped to all time lows. Again all I saw myself as was a complete failure.

Now I try to avoid anything that will draw massive attention to me. Sure I'll jump in to organize things, but I'm happiest lurking in the background where no one will hopefully notice me. If nobody notices me then I don't have to worry about meeting other people's expectations...let alone my own. I've really learned to hide my lack of self-esteem/worth. What can I say...like many people with mood disorders...I've learned to wear a mask a lot of the time so people don't really see how much I'm hurting.

I'm hopeful that one day I'll be able to see in me what others seem to see in me. But until that time, I just continue to struggle with my idea of my lack of worth and will hopefully see the light at the end of the tunnel one day and come to see myself in a more positive vein.

Hopefully this works!

• How's your self-esteem/self-worth?
• What do you do to boost you self-esteem/self-worth that helps you?

A Word on Tenacity & Bipolar II Disorder

"This is the nature of my particular affliction; without warning I can change from having the confidence of a world-conqueror to the diffidence (I just learned that word at this moment) of an abused dog. Of course, the underlying issue is the disorder itself, but even with that realization a dn comprehension of the falsity that fuels the feeling, it can seem like a massive undertaking to 'right the ship.'" ~ From Bipolar II and the Role of Tenacity by Steven Pace on PsychCentral.com To the Edge & Back blog

The blog post from which this quote comes from spoke loads to me considering my current frame of mind. People who know me from before I was diagnosed or when I am "well" know that I can be confident, driven, focused, grounded, etc. and can get things done.  But what many people don't see is what happens when the depression strikes. The severity of my loss of self-confidence, feelings of low self-worth and self-loathing, the lack of ability or the expectation of being unable to complete a task does waver to varying degrees but for the most part I can overcome and maintain at least some sort of tenacity. However, when the depression is overwhelming all that goes out the door. I go from that self-confident..maybe even sometimes cocky...individual to a whimpering idiot who cuts off almost all communication with the outside world and dives head first into a pool of self-pity, negative self-talk, thoughts of not being a life worth living.

I find that the older I get and the longer I have this disorder my ability to maintain my tenacity is growing harder and harder. For instance after two straight years of crying almost daily, being unable to hold it together enough to teach I tired of the fight. I had tried for those two years to hold things together but was unable to. I was ineffective as an instructor...felt ineffective as a human being. I finally came to the realization that I just couldn't do it anymore. I gave in and went into in-patient treatment for suicidal depression for the second time in my life. After about a week and a half in treatment I was discharged and realized that my life/career as a nurse was over. I gave in to applying for a disability rating increase review through the VA and now I'm 100% service connected disabled with an un-employability clause due my affliction being a mental illness. My tenacity for my livelihood of 22 years fell by the wayside. I finally let my nursing license go in January after it expired. For 15+ years I had fought going this route but in the matter of a month I jumped into that decision with no prodding.

I don't know if my drive or perseverance has just got up an left in almost every aspect of my life, but I am thankful that I started running last year and can find the strength to drive myself through some seriously stupid crap that I have done in the name of the run. Running seems to be the one thing that I do not lack tenacity with. Maybe it's because no one is counting on me...it's just me, myself and I. But without the tenaciousness I have for the run I would literally curl up and wither away because at this point that's all my life has become. Is that a good thing or a bad thing? I don't know, all I know is that is what keeps me going...

What Goes Up Must Come Down...

You know, it really sucks at times to have a mental illness. I'm going to start off right now by saying that if you are sensitive to hearing other people's stories/issues, have a negative connotation of mental illness or are afraid of it you probably shouldn't read on. I'll try to keep the language at least PG, but I'm in a bit of a mood right now so no guarantees. And off I go...

If you follow me on Facebook, you know I've been sick for most of the last month. That was mostly a physical sickness...fever, cough, gastrointestinal issues, etc., but in the last two weeks my physical illness has been joined by an acute exacerbation of my bipolar disorder. After the initial week or two of what was a simple but horrible cold I could tell that my moods were starting to shift towards the depressive state. It's not that I was anywhere near a manic state prior, but I was at least somewhat stable/even as far as mood goes for about a month and a half prior. I did have a short 1-2 week depressive episode in March (or thereabouts) but that seemed to stabilize with standard medications and a short removal from almost all aspect of real and virtual life...except for running.

As the third week of my illness began I could tell that my thinking was moving to a much more negative place. What are "normal" fleeting thoughts of death for me...something that just happens without any trigger it seems...increasingly became more pronounced ideation of "how" I would die by my own hand. Now, don't get me wrong, I wasn't suicidal at all...I just had/have some serious suicidal thinking going on there is a difference. I can't say that I didn't have a plan because I always have a plan. Anyone who has attempted suicide always has one or more reserved plans tucked away in some dark corner of their mind IMHO. I mean really, I've attempted suicide at least 6-8 times in the first 5-7 years of my illness (I was diagnosed in 1997 and no attempts since about 2005) there's no way that I've expunged all those attempts from my brain. I had the train schedule memorized for when we lived in base housing...I could walk a quarter of a mile down the road at 5am in the morning and get hit by a train going by in the darkness by 5:20am. I could tell you how many Tylenol PMs I have taken and still survived without any injury to my liver. I don't accept any narcotic prescriptions anymore unless absolutely necessary because I've overdosed on Darvocet and Tylenol #3 before. I can't tell you how many times in my recent travels that I've driven by a ravine and thought to myself, "Well, if I drive over the side of that I should roll enough times that I'll be dead in the crash." Or how many times in the last 2-3 weeks that I've been driving alone and raised my right hand making that fake gun with the finger and thumb and then holding it under my chin and pretending to shoot myself (we don't own guns anymore...got rid of them when I got pregnant in 1995). Now, tell me that's normal.

Why am I talking about this? Because someone has to. This is the reality. For me life right now sucks the big one. I can't dig fast enough to get away from the darkness. I've fought this illness knowingly for the past 16+ years. I know I had symptoms of at least depression since I was about 16 years old if not earlier. When I become this way, I withdraw from life. I don't leave the house unless there's a reason to and I'm lucky to take a shower or even just brush my teeth for days on end. Most of the time I hardly get out of bed! The longest I've been in self-imposed solitude was close to three weeks. Running has forced me to at least occasionally venture out without necessarily having to interact with anyone. Hell, if it hadn't been due to having to travel to run or go to doctor's appointments in these last weeks I probably wouldn't have gotten out of the house at all. I have close to 1,600 emails that I haven't looked at, messages on Facebook that I can't bear to open but at least I am interacting just a little bit on there now.

I'm sure people are hating on me right now due to my disappearance, but I know what I can handle and what I can't. Any additional pressure on me is sure to send me back into a spiral downward since I'm not stable yet. Right now it's a matter of me trying to regain my sanity (without having to be admitted voluntarily/involuntarily) or to do something in a less positive way. Hell, I've never thought of cutting before (not good with pain) but even that idea has crossed my mind several times.

The period between February and June/July tend to be my worst times, when I can expect these major mood swings to take place and just like it has for the past I-don't-know-how-many years it's struck with a vengeance. In 2009-2011 I spent all but 4 months (the fall 2010 semester) in a severe depression...crying daily, this-close to suicide, feeling the worthlessness of it all. At least I'm not there...yet...it could happen. So, as I wait for this to pass I continue to run...just to physically run away from my situation for around 3 hours, trying to run away from my depression. Truthfully, at this point, I think that if I were to stop running my life would be in real jeopardy. Geez, I never thought I'd think that way about running...I'll be back in due time, once this all starts to settle. Hopefully sooner than later (or never). It's bedtime now...for tomorrow I run.

Note: I've turned off comments for this post. If you're thinking well wishes for me, thanks. If you want to b!tch me out, bite me! (Told you I'm in a mood.) This was just a post more to think out loud and let people who might be wondering where/how I am.