2012-09-06 - 7:35 a.m.

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Don't quite know what to make of yesterday. Day of extremes in some ways - peaks and valleys. Rough, confusing morning, terrific afternoon, happiest I've been in months in the evening, and then anxiety and frustration and demoralization at night.

Next to Normal. So close to it in fact, that I can see it and sometimes it reaches out and pulls me in for a while, but then something shifts and I'm on the outside again, no idea how I got there.

I'm starting to think of Normal as an amoeba. At least an amoeboid shape: a pseudopod flows over and engulfs me, but then it flows past and I'm in the interstices again.

"No cause and effect": that phrase came up a lot yesterday afternoon.

Anyway.

Arrived on campus in time to park in the lot by the back door, a signal event in itself. Had an hour in the office to do some organizing and some further prep work for "Hot L," then went downstairs for Acting IV. All of the students huddled in a corner, bent over their pages, terrible electricity charging the air. I stood and looked at them and they looked up at me and I finally asked "so what's going on; looks like we need to do something to help you chill." Wails of how stressed they are, how overwhelmed.

Well, it's audition week. "Who has his or her sonnet fully memorized to work in class today."

No hands. Not one.

"Who has his paraphrase and scansion and operative words finished and ready to turn in."

Everybody.

"Whew," I said, "because I believe I was unambiguous.

"I heard that we aren't allowed to blah blah blah, but then another faculty told me we have to blah blah blah - "

"Wait a minute," I said, "stop right there. GO TO THE SOURCE and stop freaking out about rumors." Yes, I said, we as a faculty have sent some mixed messages. But we'll get it straightened out.

We spent the first hour reviewing Boot Camp stuff, partly to help them review and have fun, partly to bring Charles up to speed. Spent the second hour walking the thought with their sonnets and their audition monologues.

It was a fun class, and since, once I was back in the office, I had very few interruptions (no coaching allowed!) I was productive as hall and finished (!) typing out all the sides for "Hot L" and got them all xeroxed.

So why did I feel increasingly depressed, gloomy, anxious, and apprehensive during the day?

I don't know, except maybe because this big unknown was approaching, the psych appointment at three.

I could write volumes on my 90 minutes with Dr. Stice. I won't. I will record here that my first glimpse of him did not inspire confidence. Nor did our first few minutes of conversation: he talked about himself. But only a few minutes beyond that I felt a wave of relief: Vince and Elizabeth sent me to the right doctor.

In a short time we covered education, childhood, upbringing, parents, siblings, marriage. One of the first questions he asked me was if I have any religious beliefs. And, he wanted to know, why did I think he asked? "Because people who practice a relationship with a higher power are healthier emotionally than those who don't." "Exactly," he said. So he challenged me to articulate my spiritual beliefs. It depends on the day, I said. (Later in response to something else he said, "well, today's one of those days I believe in God, because I'm here.")

The gist of the consultation was to affirm and validate everything Elizabeth, Vince, and Simon had suggested: that my body went haywire because it could, in response to years of monumental mental strain. ("You had an exponentially magnified experience similar to my best friend from the Navy, who is a jet pilot. He suffers from debilitating migraines, but never when on active duty or flying. He gets them the first day of his vacations.")

He loved that I had some medical knowledge and talked to me on my level. Explained something no one else has ever bothered to explain before. Asked if I knew why anti-depressants - particularly SSRI's - take four to six weeks to kick in. No, I said, no one has ever explained that fully to me, except to give me some general (vague!) idea that it has to do with levels in the tissue or bloodstream. No, he said: what they have found (through microscopic photography) is that in depressed people the dendrites actually curl in on themselves, like fingers closing into a fist, and neurotransmitters cannot pass efficiently from one axon to the next. The SSRIs and other anti-depressant drugs help to slowly uncurl the dendrites until they lengthen out and reach the next neuron.

I told him my fear had been that maybe I should have stayed on lexapro since only one or two or three days after I stopped it I suddenly felt so much better. No, he said: the lexapro had opened out your dendrites but was no longer combatting your anxiety or depression. BUT because the dendrites were uncurled, once you started taking the Viibryd it was able to act immediately. I think the first few doses, even small, contributed to improving your mood and sense of well-being.

Fascinating.

He suggested Xanax prophylactically: take it before a meeting, a difficult class, a known source of stress, instead of waiting to see if there's a panic attack. Don't use it for sleep, he said, and DON'T drink with it, period.

He wrote a scrip for Klonopin, said cut the pills in half the first few times; they'll help you sleep.

I was so excited. I drove all the way back up 544 from Surfside Beach to Conway and waited at CVS to have the prescription filled. New day, I thought, new routine, and I'm starting tonight: celebrate with a pizza or some other dinner I don't have to cook or clean up after, take my klonopin, no drink after dinner, and I will sleep.

Some of which worked out the way I'd imagined.

I stopped at the stores, I stopped at Costa's and ordered and paid for a pizza, asking that it be delivered between 6:30 and 7. I downloaded "Tootsie" and Matt and I had a drink and a little date night at home. Watched the movie with pizza and a glass of wine and I was as happy as I have been since before this began.

Later I took my pills, and I took my half a Klonopin. Matt was suddenly very anxious and shaky before bed: he'd had a hell of a day and was facing worse today; Dawn continues to insert herself inappropriately into "Midsummer" and they were to meet today with Monica. I said "I can't take any of my Xanax tonight, so take one." He did, and felt much better, and fell asleep easily and slept well.

I wrote an e-mail or two, sitting in this chair, and within fifteen or twenty minutes of the Klonopin was having a mild-to-moderate anxiety attack. Jittery, sweating, prickling skin, chills. It didn't really abate. Went back to the info that came with the drug: 1 in 500 actualy experience increased anxiety, restlessness, sleeplessness.

Please God, let that not be me?

Around 11 I gave up and felt like I'd failed my new regimen, because I had a Xanax and a small drink and slept hard for four hours. Then was wide awake and anxious again at three. Took another Xanax and an even smaller drink, just a few sips, but it knocked me out, it did the trick.

So I call Dr. Stice's office today and ask what to do. My instinct is to try to Klonopin again tonight and see if it has the same effect. If it does, no Klonopin for me.

And I was so disappointed and discouraged. I'd driven up 544 so happy, anticipating this new med that was going to help me sleep.

Gloomy, depressed day. Nearly ecstatic afternoon and evening. Depressing, disappointing, exhausting night, especially knowing that I'll be on campus today from 9am to 10pm without a break, then same again tomorrow and then 9am to late afternoon or even early evening Saturday.

Before I work myself into sadness again, though: the vagaries of Klonopin notwithstanding, the meeting with Stice was incredible. I called Elizabeth; "how validating!," she said. Yes. Validating. More than that: incredibly ENCOURAGING. And informative. "I understand so much more than I did an hour ago," I told him.

The biggest surprise of the day, or at least the most intriguing one, is he theorizes that despite the periods of success and times of well-being, that I am not manic-depressive and definitely not bipolar. He said he thinks that whatever my mood over various periods of time that I have been depressed pretty steadily since childhood, and that I've done a remarkable battle with it especially since I've never been on any medication for it until two years ago. He says the physical symptoms seem to have been present, steadily. That my sense of well-being may have gone up or down but that the physical symptoms have been steady. One to chew on with Elizabeth on Friday.

It is after 8am, and I must shower and eat breakfast and start my long day. Will finish by recording that even at 3am, when I couldn't get back to sleep, and told Matt I was going to go to the guest bed yet again, we both agreed that this was a very minor anxiety attack, a small disappointment, hardly even a setback really: that it is so very, very clear - so observably, empirically clear - that I am getting better.

And I am.

And I'm thinking of going to church.

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ebb - flow

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