Ups and downs - and uppers

It's been three and a half weeks since I started the day program at Kfar Shaul's Maon Yerushalayim. (No official website for anything beyond "under construction". But I did find an article saying that on a random unannounced visit, deputy health minister Yaakov Litzman said if he could, he would close Kfar Shaul - and an English equivalent. Granted, this is the same haredi non-minister that wants sex segregation as well. Way to go, mental health!)

My progress has been nominal, at best, and has been met with some regression, to boot. While there has been a marked improvement in my depression and anxiety, my ability to concentrate and sit still has taken a dramatic turn for the worse. The drugs may be working, but I get the impression they're also uncovering my ancient ADHD diagnosis.

With the depression, at least I have the ability to go about my life without moping around the whole day. I can manage to make it more than an hour without thinking of new and creative ways to off myself. (Oh, the dangers of an education in human physiology.) I still want to spend the whole day in bed, but I can fight it easier. I can actually laugh and enjoy my surroundings to a certain extent, and I'm not completely shut off to the amazingness that is my daughters. It's not gone, and is far from optimal, but at least the depression isn't as debilitating as it was a month ago.

The anxiety has a lot longer to go before it's at a remotely acceptable level, but it has gotten better. I'm not freaking out at every little thing, and can contain myself better than before when faced with a defiant two-and-a-half-year-old. Heck, there's even been a decrease in the intrusive thoughts of harming myself or those around me (please note that acting on these thoughts is not remotely likely as I've got an incredible defense system in place). But like with the depression, the anxiety is still there. As with a month ago, the anxiety is worse than the depression, and while there's been a marked improvement in my depression, the anxiety is even farther from optimal. I still have weekly mini-panic-attacks on Fridays, usually minutes before Shabbat starts.

My current drug regimen is now fluoxetine (Prozac) 40mg, perphenazine (Trilafon) 4mg, and lamotrignine (Lamictal) 50mg in the morning, and escitalopram (Cipralex) 10mg in the evening. I have the option of lorazepam (Ativan) 0.5mg as needed for panic attacks, which is currently around two a week. The side effects are numerous - dry mouth, drop in libido, increase in weight, little to no ability to self-regulate how much I eat, exhaustion, sleep disturbances, and one hell of a low alcohol tolerance.

But of all the "side effects" that bug me, it's my near-complete inability to concentrate on one thing at a time and my inability to sit on my ass for longer than a few minutes. I always hated the ADHD theory; I hate the disorder, the lack of a diagnostic tool or practice, and I especially hate the treatment, and I really fucking hate how every other child in America is on uppers of some sort because they're, well, kids. I was given an extremely half-assed diagnosis at 12 and put on Ritalin. Instead of having its "intended" effect, the Ritalin had its actual effect of overclocking my brain beyond what most would consider physiologically possible. At 12, I got high on a street drug because some jackass doctor suggested it, and my parents, in their innocent ignorance, agreed to it.

Truth be told, now that I think about it, I've been experiencing a drop in concentration for a few months now. Sitting on my ass to study for exams was a marked difficulty for me, and writing that massive 15-page paper was hell. I'm wondering if my lack of blogging can be attributed to it, too - I'm having trouble just sitting here, typing this up. No wonder Twitter is so popular - we've raised a generation of kids with zero attention span.

I usually attribute my complete lack of zetzfleish (Yiddish, literally "flesh on one's seat", meaning inability to sit still) to being raised in a day and age where everything is instant, from instant food (microwaves) to instant entertainment (TVs) to instant answers (the Internet). In this sense, I feel I am no different from anyone else who was born past 1975. But at the same time, my age-group peers almost all have degrees, whereas I don't. Most of my friends can concentrate on one thing for longer than a few minutes, whereas I can't. Of my religious friends, most have the patience to go to a full prayer service, whereas I can't even make it through the most basic prayer without my mind wandering. My usual psychologist has been pushing me to get treated for ADHD for the past few years, and every time I just wave it away by simple denial or flat refusal.

In the past few weeks, I've been facing this drug-dealing demon by trying to very strongly hint to the staff at the day program that maybe, just maybe, we need to look at my fractured mental state from a different angle. I've been unable to get through to my psychiatrist or my therapist, which means that this week I'm going to try and talk it through with the nurse that I can tolerate (the head nurse is a haughty self-absorbed insulting dickhead). I kinda feel like most practitioners of psychiatry have been just as badly burned by the ADHD craze of the mid-90s as were the patients. At the same time, there has been plenty of documentation since of true cases, ones where the medication worked. Diagnostic tools, though still iffy, have been invented and improved. There's more pharmacological treatment plans available, and the notion of therapy has been expanded.

So while I don't like it, and I really, really don't like it, it's worth a shot. Who knows? Maybe I'll even be able to return to being myself for the first time in months - years, even.

(Note: This post was written at the beginning of the week, but couldn't be posted since LJ got DDOSed. The week that followed was probably my most unstable week since I started the program. More on that later.)