Therapy Options

The last few weeks were very difficult and dark, so I am thinking about other therapy options. Sometimes waiting until the bad times are over is the best thing to do, but when the soul does not stop hurting, other options has to be considered.

Right now, I have talk therapy (DBT) every two weeks. And I have occupational therapy sessions twice a week (single and group). Last not least: Medication – three psychotropic meds every day, and one as needed. But I don’t feel like: Hey, life is good. Feeling overwhelmed, withdrawing from the world and self-hatred are the rule. And my body acts up, too: The pain in my back is worse, and my unsteady gait causes more problems – I fell yesterday evening and today at noon.

Talk therapy will end in a few weeks, we maxed out the what is covered by the health insurance. We started in fall 2015, and I dare say not one of the appointments was wasted. My therapist is brilliant, the therapy really good. When I am still feeling awful it is not because the therapy is bad, it is because of my many, many issues. Maybe my pain doctor is right, she suspects there are some deep buried problems I am so afraid of that I didn’t get them out in the open yet.

So what can I do?

The local hospital offers inpatient and outpatient (day clinic) treatment. My last inpatient stay was October 2017, and somehow everything I learned in therapy was gone when I came home, and I promptly fell into the next hole. I haven’t tried outpatient therapy yet. This would mean I would be home every evening. It would also mean the double burden of handling intense therapy and chores for weeks.

Another inpatient therapy would mean another painful seperation from my pack. I am not sure if it would really help me after the last failure. It seems as if my mental illness became immune to the treatment plan of this hospital and laughs all of us in the face.

My pain doctor recommends an inpatient stay in a hospital specialised on psychosomatic symptoms. This hospital is located in Cologne, too far away for outpatient therapy in a day clinic, but near enough that I could go home for the weekends. What I don’t like about it (except for leaving my pack) is the long duration of this kind of treatment – eight to twelve weeks. And of course there is no guarantee it will work.

My general concern is if I am strong enough for a out/inpatient therapy. I know therapy requires a lot of work.

And there is this voice in my head, saying: “It’s too late, you are a lost cause!” Everybody tells me this voice is wrong, but it can be very convincing!

Sometimes it sucks to be me. One part of me is grown up and tells me to make up my mind (because there are waiting times), and then make the most of it, whatever I chose. The other part sits huddled in a corner, covers her ears with her hands, squeezes her eyes tightly shut and hopes for the storm to pass.

 

Pain management, Part 2

If everything is under control, I have an appointment at my pain clinic every three months. First, the patient is given a tablet-PC and asked to answer questions concerning the pain. How bad is it on a scale of 0 to 10? Is the pain persistent, or are there bouts of pain? How much are sleep and everyday life effected by the pain? After that, the patient meets with the doctor. This consultation can focus on the real problems, because many questions has been answered before at the tablet-PC.

I wanted to change the fentanyl patches for less potent pain meds this time. My doctor suggested I stay on the fentanyl for now, of course she noticed that I am not feeling well at the moment. She recommended I change meds later, when I am more stable and can deal better with potential withdrawal problems. But according to her I really should consider an outpatient or inpatient treatment (again, sigh) to help with the issues that are still bothering me.

Anyway, I left the clinic with a good feeling, I am so glad I have found this team. My well-being is put first, and even psychological issues are considered. Sadly, this is not the rule – I know this from experience.

Well, if my other problems could magically disappear now…? This won’t happen, of course. The side effects of milnacipran continue to lessen (I fell twice due to the dizziness, that’s enough). I am still waiting for the posive effects to kick in, though.

Tomorrow I will go to the hairdresser. It’s time for something nice.

 

To sleep, perchance to dream

Or so Shakespeare said. But it is not always easy for me.

To those, who have their eight hours of uninterrupted sleep every night, you don’t know how lucky you are! My husband is one of those lucky people and I’m happy for him, but it’s hard not to be envious sometimes when I am awake at night and he is sleeping like a log next to me.

I always have been a vivid dreamer, but this was never a problem. A few times I had really bad nightmares, but that was the proverbial exception that proves the rule. But anxiety, depression and pain have changed my sleeping pattern over the last years.

Sometimes when I wake up, I can’t move. It’s like somebody is sitting on my chest and holding me down. I can’t even speak. My husband may be centimetres away from me, but I can’t reach out for him. How long these episodes last I can’t say, but they leave me anxious and confused. It takes me a long time to fall asleep again.

Or I have a bad dream, become aware of the fact that I’m dreaming and wake up, fall asleep again, have the same bad dream again, wake up, and so on, until I give up on sleep.

The third problem is waking up from back pain. Changing my pain medication from tablets to patches helped a lot, but it still happens. It takes a while for my as-needed pain medication to take effect, but I usually can go back to sleep after that.

Somtimes I don’t even try going to bed and stay in the living room over night with the TV on. But of course this is more dozing than sleeping, and I feel worse the next morning.

I take an antidepressant at night that is supposed to help me fall asleep. The first few days I got very tired about half an hour after taking it, but not any more. There is as-needed medication that has a calming effect, but it makes me feel kind of hung over the next morning if I take it too late. Natural healing methods as Reiki, breathing exercises or essential oils help calming me down and even going back to sleep sometimes, but they do not get to the root of the problem. Zopliclone helps, but I agree with my psychiatrist that its use is limited to really bad times when one bad night follows the other.

This morning I was haunted by a recurring bad dream again. It took me a while to shake this off. But of course, Jackie knows when I need her. She lay on my pillow,  radiating calmness and peace. Cat: strong medication without side effects!