Someone I don't recognize

I am doing better. On my last visit to Dr. G, she reduced my dosage of Lamotrigine further. From 100mg, I am now taking 50mg a day until all my Lamotrigine tablets are consumed. I am still taking 150mg of Quetiapine and 15mg of Escitalopram. On my next visit, our goal is to reduce my dosage of Quetiapine if I continue to do better.

Dark clouds no longer surround me like before. I no longer plunge into a depressive state for a long time. I should be happy with this development, right? I am. But somehow, I find this new state a bit bothersome. This is my new normal, and I am not used to it. I have been plagued by depression almost my whole life (although I did not know it back then as I had not yet been diagnosed). Now that I am getting out of it, I feel different.

Sometimes, I look for that gloomy but familiar feeling. The kind that connects me to my core. The kind that allows me to feel any emotion so deeply that it becomes carved onto my soul. Now, the familiar gloom is gone, and I find myself adjusting to it.

Don't get me wrong. These are improvements that I welcome with open arms. It's just that at times, I feel that I have a new self. That this is the new me.

And then, something bad happens. Something stings. Someone hurts me. The universe throws me something that I can handle. I start crying. The familiar gloom is back. The pain. The dark cloud. Only then will I realize that I am still my fragile self, easily broken, capable of intense emotions. Then, I will wish again that I am not any of those.

An active mind

My mind is jumping from one task to another. Not just today. I can't point out exactly when it started, but lately, I've been experiencing it every day. I had experienced this before, when I still wasn't seeking treatment. It alternates with my depressive episodes. Now that my depressive episodes are no longer that often, this state is what I am in.

I am afraid that I am experiencing a manic or a hypomanic episode. But I am afraid of reporting it to Dr. G on my next visit, because she might bring my dosage of Quetiapine back to 300mg. I cannot afford the full dosage anymore, especially now that my fiance and I are getting married in December and I am allotting cash for wedding preparations. I also don't want to go back to that knock-out dosage, because it makes it difficult for me to get up in the morning.

I am trying to rein in my thoughts so I can concentrate on one task at a time. It's the only way I can deal with it. My mind is doing cartwheels as I type this, and if I allow my mind to continuously do so, I might not finish any task today.

This is not to say that being in this kind of state is bad all the time. In fact, on good days (what I call the days when I am not spiraling into depression), I become creative. Once, I was able to write a song for Dr. C and Dr. P (my and my fiance's friends who are getting married next year) effortlessly. The melody and lyrics just started forming in my head, and I just went with the flow.

On a day like this one, when my mind is in overdrive, I watch my behavior. I don't want to do things on an impulse and spend all my money on impromptu shopping sprees or worse, engage in high-risk activities driven by a temporary high. I don't know if this is right, but I like this state. I feel that it is 100 times better than being down and depressed and insecure and feeling worthless. On a day like this one, I feel good--even great, at times. And if it drives me to create beautiful things (like the song I talked about), then I will take full advantage of it.

Good news

I am happy to announce that I am being weaned off my medicines. Last January, Dr. G reduced my dosage of Lamotrigine (anticonvulsant) to 100mg from 150mg, and retained the rest. This morning, when I saw her again, she lowered my dosage of Quetiapine (antipsychotic) to 150mg from 300mg.

I am elated and thankful at the same time. At the start of this year, I set a goal for myself--that I want at least one of my three medicines to be taken off completely. With the way things are going, perhaps I would be left with only one medicine to take.

It helped that a lot of good things happened to me ever since the year started. I found a new job. I already finished the first draft of my novel. I am working on another book project with a fellow writer. And the biggest news of all: My boyfriend and I are already getting married! Hooray! I have waited, at times quite impatiently, for the moment when he would propose. And he finally did! He asked me to marry him during our Baguio trip two weeks ago. I said yes, and ever since that moment, it has been all sunshine and no gray clouds for me.

Now, I am busy with wedding preparations. My sister and my cousins are helping me out. I have already booked the church, the priest (who happens to be my uncle), a makeup artist, a photographer-videographer, and my designer-friend who will make my wedding dress. My fiance have already bought our wedding rings, too. Everything is falling into place.

I can't believe this is happening. That my dark days are over. Yes, there would still be dark days ahead, but I am now stronger and more equipped in dealing with those. I am now able to evaluate my negative thoughts using all the exercises Dr. G taught me during our sessions. Negative thoughts no longer consume me like they did before. They no longer pull me into a downward spiral. Thoughts of Z no longer put me in a dark place. And besides, the ring is on my finger and not on hers.

With my meds already being tapered little by little, I can now breathe as far as my finances are concerned. I'll be buying fewer tablets, which will be easier on my pocket. I can now set aside more money to cover my share of the wedding expenses. I am also thankful that my relatives, especially my aunts and uncles in the U.S., are willing to help me out should I run short on cash. God really does provide.

Now, I am looking forward to a lot of things, such as our wedding, my novel getting published online (and hopefully in print), finishing the book I am working on with a fellow writer, and other exciting projects. A friend of mine once told me that 2017 is going to be my year. With the way things are going, I believe he is right.

Reset

Before 2016 ended, I told myself that 2017 would be the year for me to reset. January was my warm-up month. Last February 1, I started with my new job as a copywriter in one of the hotels here in Manila. And that signaled my fresh start.

Speaking of fresh start, Dr. G gave me a new format to follow for my therapy journal. I find it more helpful than the previous format I used to follow. In the new format, I process a negative thought by answering several questions. Here they are:

1. Identify your unhelpful thought. Is there any evidence that contradicts this thought?
2. Can you identify patterns of unhelpful thinking?
3. What would you say to a friend who had this thought in a similar situation?
4. a. Benefits of thinking this way
    b. Costs of thinking this way
5. How will you feel about this in six months' time?
6. Is there another way of looking at this situation?

After answering all six questions, I am then asked to write down a balanced thought--a more rational thought after evaluating a negative thought. I find this helpful with dealing with my issues, especially my insecurity towards Z. It is a pattern of unhelpful thinking, something that has been causing me so much stress and anxiety since the latter part of 2015. With this new format, I feel like I am slowly building a solid armor against my insecurity. I am able to fight this negative thought by processing it instead of simply fighting it and willing it to go away.

Writing my answers to all these questions may be tedious, but I don't mind. I have my trusty journal with me all the time. When an unhelpful thought strikes, I'd sit down, take out my journal from my bag, and start writing. This is also how I establish my safe zone. When everything around me goes wrong, I am thankful that I have my pen and journal to keep me company and help me feel better.

However, this process is not perfect. I still find myself see-sawing between feeling insecure and feeling good about myself. It is a constant tug-of-war. But I think I'm getting better at it.

Now, I think that going off meds (or at least having one medicine removed from my daily doses) this year isn't so far-fetched. To paraphrase Dory's mantra, just keep going, just keep going.

Selfies, self-love, and self-assurance

In one of my sessions with Dr. G, she asked me to list down pleasurable activities, or activities that make me happy. They can be as simple as walking at a leisurely pace while listening to music or eating ice cream. I listed down several, and she told me that I am free to add more activities to the list.

Then, part of my homework is to do at least one pleasurable activity every day. This is on top of keeping a thought journal. Sometimes, I am able to do at least one of those activities that make me happy. But on really bad days, I am not able to. When I'm having a bad day, I feel like every hour is a struggle. And when the clock hits midnight, that's the only time I can breathe because, whew, I was able to survive.

Lately, I've been enjoying taking selfies and posting them on social media. Last week, when I was having another depressive episode and was feeling so insecure, I compiled my best and prettiest Facebook profile pictures and created a collage out of them. Then, I posted this collage on my Instagram, Twitter, and Facebook pages. It was my way of assuring myself that yes, I am pretty and I am enough.

Sounds shallow, doesn't it? But if you are constantly down and insecure, won't you do anything--no matter how shallow it is--to make yourself feel better? I don't mind if people would call me vain or conceited. When I finished that collage, I felt good. I felt great. I felt beautiful. These positive thoughts pulled me out of insecurity.

I've started to see my true self-worth only recently, after countless people have assured me that I have nothing to be insecure of. That I don't have any reason to be insecure of Z. That I am beautiful, smart, and that I am enough. I am not fishing for compliments. I just need to be reminded that I am enough and that I have nothing else to prove.

The other day, I posted a collage of my photos wearing no makeup. It was my response to a challenge posed by an actress here in the Philippines. So there. While I was eating breakfast, I remembered the words of that actress, and decided to do what she said.

At first, I was hesitant. I don't go out without makeup because I don't feel as pretty as I am with one. And I am also scared of bumping into Z and looking plain. Makeup, for me, is more like a shield than it is a mask. It protects me from ugly things that people might see or say about me. It makes me feel armed against my insecurity, my ammunition against Z. But because I have started to realize that I don't need to be better than Z or anyone, I have decided to put my shield down little by little. Hence, the #nomakeup and #nofilter selfies.

When I saw my no-makeup photos, I actually thought I looked nice. I did not look glamorous or great, but I did see that I did not look as bad as I thought I would be. My face was plain and bare--I didn't even wear face powder. But I didn't look horrible. I wasn't ugly. In fact, I did think that those photos were refreshing to see.

Don't get me wrong. I am not bragging. But that #nomakeup challenge made me see that I am now in a safe place so I can now put down my shield. The battle between Z and me (the battle that Z knows nothing about) is over. Or at least, I can now see it ending soon. And it took me countless advice from PM and my friends and three #nomakeup selfies to realize that.

I'll definitely take more selfies because this activity makes me happy. I will take photos of myself wearing my go-to deep red lipstick. I will take photos of myself wearing simple makeup. I will also take photos of myself wearing no makeup at all. I won't post all of these on social media, but I will make a security blanket out of them. And whenever I feel down and insecure, I will look at these photos to make myself see and feel, again and again, that I have nothing to worry about.  

A new way of thinking

I thought Dr. G wouldn't start tapering down the dosage of my meds because of the depressive episode I had this week.

I was wrong.

And in the history of being wrong, this is the time when I am happy that I was wrong. Dr. G started to taper down my dosage of Lamotrigine (anticonvulsant).

In this post, I wrote about my depressive episode that started last Monday and ended on Wednesday night. But after talking about it with PM and my friends, I stopped feeling bad and I started to calm down. When I was already in a calm state, I looked back at the events and realized that these feelings and thoughts were just cognitive distortions.

Looking at them now, I can say that I am starting to get better in dealing with these kinds of thoughts. These thoughts and feelings are not wrong. I have reasons why I came up with these. But cognitive behavior therapy (CBT) has been teaching me how to see things from another perspective and has been helping me change my thinking patterns.

Whenever I have a depressive episode, these come in succession: sad thoughts, followed by insecurity. It's as if they form a package deal. Z is the strongest trigger of my insecurity (although she doesn't know this and this isn't her own doing. It's not her fault). And when I get insecure of her, I feel small; I feel that I am not smart; I feel that I am not talented; and I feel that I have to prove to people that I am the better choice. I feel these things. These are constantly in my mind.

But do I have concrete evidence that support these thoughts? Did any of PM's fraternity brods, sorority sisses, friends, family, and relatives tell him (or me) that I am not a good choice? The answer is no. So why do I need to convince them? As what my friend Dr. T told me, the only people that I need to convince are PM and myself. PM doesn't need any more convincing, so it is just me that I need to convince.

Putting it that way makes me see that there is nothing for me to be insecure of. Friends of mine, especially those who know Z, have been telling me that for quite a time already. But sometimes, I fail to remind myself of that. I fail to see the qualities that make me unique. All I can see are the things she can do that I can't. I dwell on the past even if the present is showing me something beautiful. Now, I can appreciate myself better. I recognize that I am also good at what I do, and that makes me smart, too.

CBT has also taught me to stop feeling bad about things that I cannot control. Negative things happen, and they happen not because of a fault of mine. Because of CBT, I have stopped blaming myself for things that I cannot control. Anyway, blaming myself won't change these negative things. It won't make the bus go faster if I am running late. It will not turn back time and let me change what I did or what other people did. Self-blame would just make me feel bad about myself and would send me into a downward spiral. It's not helpful at all.

Seeing my good qualities and stopping the self-blame are I guess the biggest proof that I am improving. Maybe this is what Dr. G was waiting to hear from me, that's why she decided that we can start tapering down the dosage of of one of one my meds. She asked me which of these two do I want to taper down: Quetiapine (antipsychotic) or Lamotrigine (anticonvulsant). I chose Lamotrigine. I would've wanted to choose Quetiapine because it is the most expensive medicine among the three that I am taking. But it plays a bigger role in keeping me stable. Plus, it helps me sleep, so I chose Lamotrigine instead.

I don't know how many CBT sessions I have left. I will see Dr. G again in February. I am hoping that on my next session, we will taper down the dosage of Lamotrigine even more. And if we can taper down the dosage of my two other medicines, well, that would be even better.

In and out

This Friday, I will be seeing Dr. G again. And I am afraid that this won't be the time for her to taper down the dosage of my meds. I am looking forward to that, but I guess it's not happening soon. Not this Friday nor anytime soon.

Last Monday, I had another depressive episode, triggered again by Z. She didn't do anything in particular, but it was she--or should I say, thoughts of her--that triggered my depression. Of course, this is another cognitive distortion, but once again, I got affected by her. I also fell from our bunk bed (I occupy the top part) and got a bruise on my arm; I literally ran to catch a taxi on my way to my job interview; and I couldn't tell how my job interview went. It was, indeed, a series of mishaps.

Last Tuesday's events didn't help either. There was an event that PM attended. I found out the Z was also there. I hate it when I am not there with PM when she is, so I cried a lot last Tuesday. I was so upset. I was already having PMS, and all these piled on top of that. It was too much for me to handle.

But thankfully, after a few hours and after talking to PM and a few of my friends, I felt better. In fact, I felt great. It was as if someone flipped a switch and voila! Everything was right again in the world. I was even able to finish the fifth chapter of the novel I am working on.

That's the thing with me. I tend to linger more in my depressed state, but when I feel great, I have a lot of energy. It's not necessarily physical energy, but more of mental energy. My mind is in overdrive. I am able to suddenly come up with ideas. Most of these are ideas for creative pursuits, like for a novel, a blog post, a poem, or even a song. In fact, over the weekend, I started writing a song.

Some people who have manic episodes do things that are out of control. They go on shopping sprees and max out their credit cards all in one day, or think they are gods or goddesses, or engage in dangerous behavior like driving with rage. I haven't done these things nor have I experienced being in this kind of high, but I also watch out for these symptoms. Taking 300mg of antipsychotic (Quetiapine) probably keeps me from having these kinds of episodes.

Given all these, I can say that I come in and out of a depressive episode. It's always a seesaw of feeling great and of being down and upset. These emotions dance with each other, and they alternate in taking the lead. My homework is to identify when an episode is imminent (especially if it is a depressive episode) and take precautionary measures. When I feel down, I listen to upbeat music to help lift my mood. I always listen to music when I walk outside, and I make sure that the songs I am listening to are happy and energetic. I don't have sad or emo songs in my phone. Those will just pull me down.

So that's the thing with shifting moods and having depressive episodes. I need to recognize that I am having an episode. I need to identify what cognitive distortion I am having at that moment, so I will not blame myself for things I cannot control. This is easier said than done. As my friend Dr. T always tells me, I should be patient with myself. These things come and go, and patterns of thinking aren't changed overnight. I am a work in progress.

I have seen some improvements in my mood and in myself in the past few months. But because of what happened last Monday and Tuesday, I now feel that those improvements have been canceled out. Again, as my friend Dr. T always tells me, if I fall down, I should forgive myself, then stand up and try again. Forgiving myself is, I guess, the key to being able to stand again. Self-blame won't get my anywhere.

I'm looking forward to my session this Friday. I always look forward to my sessions. It will be another hour of sharing and learning how to deal with my moods and emotions. Hopefully, I will exit her clinic calm and collected and not a disaster.