Wednesday, August 06, 2008

cleaning and other impossible, overwhelming tasks

I found a book today, at the bookstore, which I had heard about some time ago, but had been unable to locate at any local stores. It is called The Center Cannot Hold, and it is the story of one woman's life with Schizophrenia. I cannot afford to buy it, so I stayed as long as I could and read the beginning in the store. It is well-written, accurately descriptive in reference to the disease, and interesting. I look forward to reading the rest. Apparently, the author is now a professor at a university. How she managed to do that with Schizophrenia is beyond me. I do not understand how certain people manage to accomplish such great feats even with a disorder that destroys one's mind as much as this one does. I am sure that the type of medical care one can afford to get has some degree of influence on whether one can manage such a recovery. Which leads me to my current thought: the community mental health center, for all the good, kind, underpaid people who work there, is not the place for me to get the optimal psychiatric care for Schizophrenia or Schizoaffective Disorder.

I think I could get better care, and perhaps function better, elsewhere. I do not know this for sure, of course, but it is an educated guess. After all about a billion people go to the community mental health center I go to. Medicaid and Medicare regulations dictate which prescriptions are paid for and which ones aren't (as will also be the case at any other doctor I ever go to), and the doctors are mostly not real doctors, but are, instead, nurse pracitioners, who can only see patients in increments of 15 minutes or less, because they have hundreds of patients to see. Perhaps, it would not be any better any place else. But perhaps it would. I have considered, many times, going elsewhere to a doctor in private practice. I have not done it, because, mostly, I am used to the routine of going the the community mental health center, and I also don't have a whole lot of faith in psychiatrists being able to help me much more than the already have. More importantly, like many people, I do not have good medical insurance. I have Medicare, and it only covers eighty percent of costs, so if I go to a doctor in private practice, I will have to shell out the other twenty percent, something which I cannot afford to do right now. But what if one could, and I, because I did not want to take the initiative to try to get to a different doctor, never found out?

There are certain problems I have which I think, from books I have read, are common to people with certain mental illnesses, and are not just personality defects. But these particular problems have not been helped, at all, by the medications I have taken thus far. One of the problems is that I am incredibly disorganized. It's not laziness, it's that my brain does not DO organization like most people's brains do. I know this because other people with Schizophrenia have the same exact problem. I cannot do housework anymore, because the entire concept is so overwhelmingly complicated to me, that it fills me with an intense panic at the mere thought of cleaning, and I cannot manage to physically actually do it. I don't get the impression that my therapist or my doctor/nurse actually understand this is a real problem for me, even though I have talked about it endlessly. I think they just figure I can snap out of this if I want to, but I really do not believe it's that simple, because, for God's Sake, I HAVE TRIED TO SNAP OUT OF IT REPEATEDLY for a very long time.

Cleaning in increments does not help me. That is not going to work for me. That is what they recommend, and I understand it probably works for other people, but it does not work for me. What I need is someone to FIX MY BRAIN so that I can organize myself.

In addition to the cleaning problem, I don't bother to take care of things like hygiene anymore, because the thought of taking a shower is so incredibly tiring and so complicated that it overwhelms me most of the time, so I just do not bother. My therapist is great, but she seems to not understand that things like this are not an aspect of my personality. I was not always like this. This is a problem related to my illness, with which I need some kind of HELP. Because I am living in a disgusting state, in a filthy, corroded apartment with dishes that have things growing on them lying all over the place, clothes on every surface and every inch of the floor, clothes not washed in months, a kitchen I do not even ENTER anymore because I cannot handle the act of actually going in there, so I eat only fast food or things that can be eaten without preparation, on paper plates or Styrofoam bowls or in Styrofoam cups with plastic silverware. My therapist was telling me yesterday to soak the silverware. I did not have the heart to tell her that I have not actually used silverware in months. It is beyond the point of soaking things. I am going to have to actually throw all my dishes in the garbage because they are completely destroyed with mold and fungus.

This is, of course, not something I am proud of. This is not something I am writing about here because I really want people to know I live like this. It is something I think is a problem for people with certain psychiatric disorders, and with which others might relate, so I am writing about it for them - the people who don't write about it, but do live through it every day. I also just want to point out, it's not like I am a pathetically lazy person. It's a mental issue, and one which I do not know how to solve, and apparently, neither does anyone else who I go to for help.

I have the same problem in my car. My car is filled with stuff - junk, empty cups, food wrappers, clothes, all variety of trash, books, notebooks, papers, mail....just stuff of all kinds. I stopped cleaning it out regularly months ago when I decided I just couldn't deal with it anymore. My desk, at work, used to always be a disaster area, because I do not possess normal organizational abilities. I am trying, at my new job, not to let this problem become obvious, as it did in my last job, where people actually discussed it behind my back.

I also had this problem with college work. I failed my math class last semester, because no matter how many times I stared at the book, or how many tutoring sessions I went to, I could not manage to understand the concepts, remember them, or implement them on tests, and this was not even a college level class. Also, I had to drop a Biology class because I could not keep up and was failing that. I have never failed any kind of class or schoolwork in my entire life until this past year. I don't think that is a coincidence. Right now, the thing that is preventing me from getting a degree is that I cannot do math anymore, and I cannot do the science either, apparently. So I will probably never get the degree I've been working on, off and on for fifteen years. Yes, I actually started college back in 1993.

I just don't understand why, with all the medication I am taking, I still have these problems. I also still have horrible, intrusive, disgusting thoughts that are vile in nature, which I despise having and which have plagued me pretty much for my whole life. Thoughts about things that I do not want to think about come into my head. Anafranil was supposed to help this, so I suggested the doctor/nurse put me back on Anafranil recently. She did. It is not helping with this problem.

And then I have this horrible, overwhelming, sense of despair and doom. With this painful loneliness and longing to not be so incredibly isolated and alone in the world as I am, but no idea how to fix that situation. That's why I write this blog. I write because I have no one to talk to about these things. So I write words that maybe no one will read, or maybe someone will, but either way, it helps to get it out somewhere. Because sometimes the pain inside me is suffocating and I cannot bear it all alone anymore, even with the assistance of my therapist.

I am sorry if this post sounds a little gloomy. I just wanted to point out some things, that I think are problems I'm having. My sister came into the apartment the other day and saw the mess I have been hiding from the world. She said, "You do realize your medication is obviously not working, right? Because you are obviously in a severe, severe state of depression or you would not be living like this." She is correct.

But what can I do? Go back, ask for another antidepressant, switch again, go through weeks where it is not yet effective, wait to see if it ever does work. And which one should I take. After all the doctors I've seen in all the hospitals and doctors' offices I've been in over the years, there are not a whole lot of antidepressants I did not already try at some point in my life. And trying to remember whether one worked or not is futile, because I do not have a memory that can handle that database of information. I have no idea which ones ever helped or did not help or why I went off them all, and my medical records are spread out in dozens of locations in several different states across the country. Since the doctor/ nurse can only see me for up to 15 minutes at a time, once a month, she doesn't really have time to track down dozens of medical record files spread out across the United States. So she just guesses about what will work. Or asks me what I think would work. And I guess. And that, it seems to me, is not the best way to be doing this. I am getting very frustrated, as I am afraid I will not be able to maintain my new job, or any other job, for much longer, and I will end up homeless again and in some hospital ward, locked up, because I cannot function. I have been in that situation multiple times, and would prefer to not fall into that type of fate again.

Thanks for listening...

1 comment:

Ken Albin said...

Jen,

Depression can be a difficult thing to overcome. Be sure to get a good night's sleep each night. I know you were having a problem with that and it is the most important thing next to diet that you can do to rejuvenate yourself and balance your mental processes. I know it sounds simplistic but try a relaxation CD or tape that has theta waves embedded in it.

Many psychiatrists I went to school with had major problems they were trying to solve. That is why so many of them went into the profession. A psychiatrist friend of mine actually admitted this to me. I think that it is ultimately up to us to fix ourselves. A change to a high protein, low carb and fat diet will be beneficial to mental functioning. Getting out more will revive the soul and give you more energy.

Please don't take this the wrong way, Jen, but you are looking at the glass as if it is half empty. Look at the progress you have made! You have a new job and a chance for a new life. A life can be remolded into whatever you want it to be. Take control of things. I know you have a stubborn streak. Use that in a positive way to direct your life and ambition. Everyone has problems they need to overcome. I don't normally tell people this but when I was in college I was assaulted and hit in the head. It caused brain damage to the point I could not remember the room numbers of my classes and had to carry a list of room numbers. To this day I can not remember anyone's name unless I know them really well. I can not remember my students' names and have to rely upon a seating chart so I will know who they are. Many of us have deficits we have to get around. I know that your situation is very frustrating and frightening for you but you can find ways to cope. The medication will help but positive actions on your part will help even more. I have great faith in people's ability to overcome bad problems. You have so many talents you can use. You truly are special, Jen, so treat yourself well.

We are all ultimately alone and must come to terms with that. Though I have been married for 29 years now I still feel very much alone most of the time. Value and love yourself first and foremost. Once you do that the rest will fall into place. Concentrate not on your disabilities but on your strengths. Learn to cope with the weaknesses and/or work on them. Mental frame of mind is everything when living. Again, treat yourself kindly. You do have promise but you will have to do what it takes to bring out your potential fully.

Sorry for the "psych rap" but I was actually going to be a psychiatrist at one time until I saw how screwed up many of them were.

I am glad you got through the Disney trip with your mom, difficult as that was. She sounds like she has some major problems of her own and is a very difficult person to deal with. You are still here so the trip was successful.

I hope this diatribe did not upset or hurt you. Teachers are bad about wanting to jump in and "fix" problems. It is another failing of mine and I apologize for giving advice. It is an obnoxious trait but occasionally it is useful.

Take care of yourself.
Ken

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