My mental health is very complicated. I have a LONG history of struggle. Not just a little bit of struggle. Severe struggle. Trauma, hospitalization (multiple times), not being able to keep a full time job, severe anxiety with major physical symptoms, rehab/alcoholism, and on and on. It has been hard to even determine what my diagnoses are, honestly.
I met with my psychiatric nurse practitioner yesterday, and I asked her (again) if I could possibly have Bipolar 2. I had once been diagnosed with it, but my last PA didn’t think I had it. Again, she told me she doesn’t think I have Bipolar. We even looked at the diagnostic criteria for Cyclothymia again, and I actually don’t meet the criteria for that because it says if you meet criteria for Major Depressive Disorder (MDD), then you don’t meet criteria for Cyclothymia. Cyclothymia involves slight ups and downs but doesn’t have true major depression as part of it. Bipolar 2 does, but she’s still not convinced. The main reason is that my “good seasons” aren’t necessarily hypomania. I don’t have some major classic signs like not needing sleep, etc. I am just feeling good because I’m not depressed.
She still believes I have ADHD, MDD, GAD (Generalized Anxiety Disorder which I was diagnosed with at 18), and PTSD. She also has me listed as having a tic disorder since I have a random cough when I’m anxious (but it’s not a full on cough… it’s more tic-like). All of this tracks with what I was told by my last PA. And these two practitioners are the most involved in my treatment than I’ve ever experienced before.
Unfortunately, the majority of the year (about 70%) I am depressed or fighting depression and severe anxiety. The depression doesn’t get as deep as it used to because of medication, but it still happens. I also think that not working full time helps a ton. Thankfully I don’t get suicidal anymore, and I am able to at least get myself out of bed and moving. In the past, I couldn’t say that. I tend to have a few months of the year that are REALLY good, but they aren’t mania or hypomania… I’m just not depressed. Some of that is seasonal as well which we are working through. But the depression in the late fall/winter also has PTSD that contributes to it… so it’s so hard to know what’s what a lot of the time.
Some of the other behaviors such as hyper-focus, a low after that (burn out), impulsivity, etc are from my ADHD. This is what was missed for SO many years. But I know now that I struggled so much my whole life because of the ADHD. Also, ups and downs can just be from ADHD. I tend to go “all in” on things because it gives me a boost of dopamine (which I am lacking), then I burn out.
She told me that she has a medication that she can try me on as we get into the fall that can be temporary… just for the seasons that I struggle the most. And she has samples so that I don’t have to spend money on it. It’s a new medication, so I’m sure my insurance wouldn’t even cover it. I can’t even remember the name of it. I have never heard of it before.
I LOVE how intentional she is. I have been seeing her since February, and she has been the most helpful practitioner that I have ever had. Not only does she take care of my medication, but she is also my therapist. It’s the perfect scenario for me… and I wouldn’t have this if we hadn’t moved here. Finding her was a total God thing. She was the first person I tried, and we just clicked. She truly enjoys spending time with me also which is so sweet. She told me she loves that I’m just scheduled every Friday. She knows that Fridays are “Courtney days.” How sweet and amazing is it to have a practitioner that truly enjoys me!
She also sees the boys, and they are doing better than ever as well! She’s just incredibly intentional and knowledgeable.
So. About the last few weeks.
I realize now, as I look back, that I was just trying to find something to control in my life. It has felt chaotic between the stuff with the boys (going back to school), Karis going off to college (7 1/2 hours away), and not really knowing what my life will look like in less than a month. I only have about 3 weeks of Outdoor Ed left, then I have no plans. I think I saw that space and was trying to fill it. I was also listening to the promises of life change from the 75 Hard Program… but I’m realizing now that it never lasts for people. At least not the majority of the time. I have done more research on it, and only 1% of people even complete it the first try. It’s so ridiculously strict. And there’s no research to back any of it up. In fact, there’s a lot of research to show how unsafe and unhealthy most of the elements of the program are.
I knew all of this in the back of my mind… but my brain was only paying attention to what it wanted to pay attention to. I was hoping that it would help my fall and winter to not be so hard this year.
I’ve actually decided that since I know I’m coming into my harder season, I’m going to back away from focusing on a lot of things that I’ve been focused on. I’m not going to stop working out, stop eating well, etc, but I’m going to stop making it my everything. There is so much more to life! I have good habits in place. I know what makes me feel good. I don’t have to talk about it 24/7. I don’t have to make it everything in my life. What I want to make EVERYTHING in my life is Jesus- Knowing Him and Making Him Known. Plus relationships with my family and friends, my mental health, and healing. I want to determine what’s next for me. I want to pour into the ministry that we serve in. I want to make Jesus my life, not weight loss, being “shredded,” perfect nutrition, the perfect workout routine, and my outward appearance.
The person that I was years ago is just as worthy, loved, and wanted as the person I am today. Losing weight and getting healthy is AWESOME, but it doesn’t change anything about me. My identity is in Christ… not in how I look, how consistent I am at working out, how perfect my diet is, or any of that. My physical health and appearance don’t change who I am as a person.
At the moment, my main focus is just taking care of myself. I have three weeks of a crazy schedule with Outdoor Ed, then I just have all the time in the world.
I’m going to focus on digging deep… writing my memoir, spending a lot of time with Jesus, serving in church, and spending time with my people. I don’t know how long that open schedule will last, but I know that I need to take advantage of the time that God is giving me to focus on my mental health and on Him.
I pulled out some books that I have had for a long time… a Bible study that I want to do, some devotionals, a dialectical behavior therapy workbook, etc. These are the things that I will spend my time doing (in addition to spending time with Jesus and my people).
I feel more peace today, but I also feel a heaviness that depression is on the horizon. We will see what happens. Hopefully some more rest will help me get into a better place. I haven’t slept well in a while.
Another thing that we discussed is the shame that I feel when I hyper-focus on something then crash. This might be something I have to work through over and over again… but I just can’t help how my brain works. It just is what it is. I think working on acceptance is key with this. While medication has helped a ton, it only does about 50% of the work… so I still have to do work as well.
One day at a time.
simplycourtney.org 