Seeing the new doctor

I think perhaps G-d is taking care of me.

I saw my new psychiatrist's assistant today and I like her. She is very perky and energetic and talked fast today but she was running late and we had a lot of ground to cover in a short time.

She is leaving me on the Prozac at the current level and concurrs with everyone else's diagnosis of Major Depressive Disorder. I don't think, with my history, anyone can argue with that. She saw that my previous psychiatrist had indicated OCD and with as recent as that diagnosis is, she wants to work with it a little and see if it is true OCD or some other anxiety disorder with obsessive compulsive tendencies.

The thing she said that surprised me the most is that she thinks the fact that I'm not in as good a place as I could be is that we're missing--that is, not treating--something underlying. She said the things I described with my sleep and anxiety sound very much like post-traumatic stress disorder, PTSD.

I was diagnosed with PTSD years ago, but I assumed it resolved when I stopped having flashbacks and excessive hypervigilance. She said if it is PTSD, it might mean a slight alteration in my meds, but mostly she thinks I'm on the right thing.

Except for sleep. It's too hard to say right now, she said, if I've built up a resistance to Lunesta or if I'm just not at a high enough dosage to combat the Prozac or if there's something else going on. So until I see her again in about two months--her earliest appointment, she is very busy--I can increase the Lunesta up to 6mg/night.

I know I am sensitive to medicine so I'll increase 1mg (1/2 tablet) at a time and see what happens. I don't want to take 6mg tonight and wake up on Friday!

Or maybe I do. I have been thinking about how nice it might be to hibernate and avoid this difficult time of year altogether. But then I think of how many things I might miss out on, too.

One thing she said is that she wants me to expand my list of things I do for "fun." She thinks there is too much in each of my days that is about taking care of others and not enough taking care of myself.

Of course in my mind, it is just the opposite. How dare I take a full eight hours for sleep! Think of all the good I could be doing during that time!

I think I have just figured out that my taking care of others around me is related very much to my having high expectations of myself, and others too to some extent. I will have to explore that further.

For tonight, a little more Lunesta and hopefully a full night's sleep.

My new anti-anxiety kit

It is amazing that after years of therapy, I am still learning things about myself. What I've learned recently, now that I am recognizing the signs of anxiety and the OCD features, is that I am a very tactile person. Touch is a primary way that I can ease the anxiety.

I learned that when my counselor suggested aromatherapy, to find a scent that would relax me, and all the scents I tried didn't do anything for me other than make me sneeze. But she got me thinking about what I do when I'm sitting and anxious.

I pick at things: skin, hair, scabs, cuticles, fuzz. I pull hair out, which I discovered is a diagnosis all by itself and part of the OCD spectrum called trichotillomania or TTM for short.

I'm attracted by textures. In fact sometimes I wish I could wear a tallit katan just so I could finger the knots in the tzitzit (fringes). A friend suggested worry beads but my first reaction was that it would be mistaken for a rosary!

So I went on a scavenger hunt around home and started collecting things in an old small sewing box:

• satin binding from a childhood blanket
• set of four 1-inch ball bearings, to manipulate in my hand
• palm-sized smooth stone
• pair of strong magnets to play with
• hand-held bathing brush with bristles on one side and pumice stone on the other
• Koosh ball
• Rubik's Cube
• and to top it off, hand lotion in a Eucalyptus/Spearmint scent that I can massage my hands with

Then for Chanuka my husband gave me a home manicure set from Israel, with Dead Sea minerals (or so it says). I tried it on one nail and it's smooth and shiny like I polished it and lately I've been rubbing it instead of picking at hair.

My counselor thinks it is great that my answers to anxiety are things that are self-care. I fear becoming vain or superficial, yet at the same time these things are allowing some of my hair to grow back.

While I don't usually like labels because I think they often are unhelpful, having a diagnosis to help me understand why I do what I do--when I'm not thinking about what I'm doing--has been very helpful. Finally I can stop fearing the manic episode that has never come and work on finding ways to deal with and tame my anxiety before it turns into depression.