The Keto Roller Coaster

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I have been on a ketogenic diet for about 5 months to help treat type 2 diabetes. I was taking 2 medications. Metformin and Januvia. I am monitored through a program called Virta. I have a coach and a physician through Virta, it is all done virtually. There is also an online community for people on the program. It is covered by my insurance.

At the beginning of this month I had labs that my endocrinologist had ordered. The results were really good. A1C of 4.8 and fasting glucose 98. Everything else was normal, too. For some reason my endocrinologist office cancelled my appointment so I had to reschedule for August. The Virta dr said that I could try going off Januvia since my labs are so good.

So, I go off Januvia and everything goes screwy. I get ravenous at night and have to eat after dinner. I had been slowly losing, now I am gaining weight. My fasting glucose is higher than before I started keto. I test my ketones and they are low. I chatted with people in the community and they tell me to stick it out, that my body will adapt. I am not so sure. I put in a message to the Virta dr to ask for his opinion but I won’t hear until at least Monday. I did not even know if the Januvia was doing anything but I now notice a difference without it.

I rarely talk about work, but here I go. My opinions do not represent my employer.

I work in peer support in a 20 bed mental health crisis stabilization unit (CSU). I have worked in peer support at an activity center for people with mental health issues and in a residential program. The people we see are much more symptomatic than I had worked with in the past. I am available to talk and offer groups but I don’t get much interaction because people want to sleep, are too symptomatic, want to be left alone etc.

It is a new facility and peer support is a new position for my employer. I have been there about 5 months and still have not found my footing. My boss is aware of the issues of people not wanting to interact and told me to keep being available and offering groups. She is going to give me some additional duties once they are approved.

It also can be anxiety provoking when patients are loud or aggressive. I am not involved with dealing with those situations but I feel tense. I help out where I can. I like the place and what we do.

In Our Own Voice Presentation

Yesterday I did a presentation for NAMI Orange County on my recovery.

https://us02web.zoom.us/rec/share/8I-z9RKNONCJ958C7klIYBjCf3ZzCXs_BD743CKZD0QUzGcCtPbtjjVcYygq5hk.nKTSbzmA_Jj3DrvG

Passcode +6$T%coQ

What did I sign up for?

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I volunteered to lead one day in my AA group. It is not very complicated. They have a format and I pick a passage from AA literature to read, talk about 5 minutes and then open for discussion. But, I have social anxiety. It is much better than in the past but I am still nervous. On top of that, I told my friend I would speak on her podcast in January. That I am a bit terrified about.

I picked a chapter from the Big Book, More about Alcoholism, and will talk about doubting we are alcoholics. I think it will be good for me to hear others experiences. I just finished step 1- We admitted we were powerless over alcohol and that our lives had become unmanageable.

In my youth my life truly was unmanageable. I had rules for myself about when and where I could drink, by the time I stopped, to keep my drinking from getting out of hand. It is hard for me to see my life as unmanageable. I made a list and will continue to add to it, about being powerless and my life being unmanageable. I will refer to it when I have doubts.

As far as the podcast, I am going to be talking about myself, my experience with mental illness. I had an older brother who has passed away, who had a psychotic break in the 1970s. I am going to talk about his story, too.

My friend called to discuss the podcast with me. I froze on the first question. She asked me about being a mental health advocate. I think of myself more as my job title, a peer support specialist, or someone with lived experience. I have written letters for certain bills but am not very politically involved. We are going to talk again and hopefully I can relax. She can talk enough for the both of us. I just want it to go well.

Powerless and Unmanageable

I am starting to work on the first step of Alcoholics Anonymous. My sponsor has me writing down how I am powerless over alcohol and that my life has become unmanageable.

It is hard. I like to think that with enough willpower I can do anything, but I have tried quitting on my own and that did not work. I have gotten sick, saying “never again” to go out the next night and drink again. I am endangering my physical and mental health, but I did not stop until very recently.

I considered the bottle to be a friend. It was always there, never let me down. I think I was developing a tolerance. I was having trouble getting a buzz. I was letting daily activities go to the wayside. I am terribly shy and needed a drink to socialize.

I was talking with a friend who is very involved in aa. She started telling me rules. You aren’t supposed to make changes the first year and I should be journaling were a couple. She was scaring me. I wondered what I was getting into. I called my sponsor and she said those things can be good but not required.

The meetings I have been going to are over Zoom. I can’t wait to meet people in person. I have just been going to women’s meetings. The ladies have been nice. I have 25 days sober. I am still a newcomer.

My government is trying to kill me and other news

I have a form of schizophrenia and people have been suggesting my fears are delusions, but some things are obviously true.

I am in the USA. Our president is playing games with state governors for medical equipment and supplies. If they don’t compliment, praise him in the media so he can win votes he won’t order supplies, He buys them up, or tells vendors not to sell to them. I am talking ppe and ventilators, test kits. Even if we have more tests available someone has to obtain sample and needs ppe. He has kept testing low to keep numbers of reported cases low and people don’t take the mitigation policies seriously.

He suggested that our elders and high risk people are expendable. Worth the “sacrifice” for Wall Street. Hospitals are deciding who should get first choice of ventilators, who not to resuscitate, They will choose to give up on the disabled. I don’t know where I fall in those discussions. I have loved ones that would die. All we can do is try to hide from the virus.

Our president only thinks of money and power, has no humanity, I feel helpless and the ones in power are moving really slowly. We let him become above the law.

His followers don’t care he is killing them and us. They are blinded. You would think when it is affecting you, personally, you would wake up, but no. There is so much propaganda, the media perpetuates it. He lies on tv and they still play it.

I feel like I am in a simulation (that is my mental illness) and just want it to end. I worry about myself and those around me. This virus is so infectious. I am in CA. Our governor says they predict over 50% of us over the year. I think it is inevitable I will catch it, just don’t know when. He also said maybe 12 more weeks of stay home order. People complain of boredom. If that is the main complaint that is ideal in a pandemic.

I just go to work and home. I work in a residential mental health facility. My views are my own not my employer, we need to put disclaimers. We take our temp before shift and resident vitals daily. So far the residents are restless but healthy. It is an 80 bed facility. It would be a disaster if we get an outbreak. No visitors, no packages, stay on site.

I am scared. I try to distract myself. I watch tv shows and go on social media. I do not watch our president talk, it just makes me upset. Our governor is calming. It is bad news but I feel like he is a good leader. My mom and mother in law are high risk and stay inside. Mother in law is alone. she gets lonely. We call everyday but I wish we could do more. She has not figured out video meetings yet. I wish I could just go there and show her, but if I could we would not need it. My mom gets frustrated with technology,

My husband is still working, too. He works in communications for the school district. All teaching is online now, so that is important. He goes to grocery store and anything we need. I really don’t want him to get sick. There is a shortage of masks so they told us not to wear them. I think that recommendation will change soon, I see people say how to make them but it is too complicated for me.

My children are 18 and 21. My daughter is home from college and everything is online. My son is a senior in high school. It is hard from him being away from his friends. He is no longer working, youth sports, because it is cancelled. He interacts with his friends online or goes out for a drive alone.

I had a cold that turned into a sinus infection and saw a doc via telemedicine, I recommend highly. there are so many things that are now accommodated for and I hope that continues after this is all over.

I like Biden for President. He has compassion. I don’t care to debate. This is all my opinion,

Men keep sliding into my DMs. I am not used to this. I am happily married,. I can follow on social media without messaging. It makes me uncomfortable. You can message me anything important, like how to protect myself and others, but I won’t respond generally to chit chat.

Dealing with Anxiety

I am suffering with constant anxiety. My stomach feels queasy and I am having trouble with shallow breathing.

I just started a new job and I think that is the issue. i am hoping once I settle in, it will stop.

My therapist suggested more exercise and mindfulness. My pdoc said to push through it, but he said i could increase my antipsychotic medication.  I have a number of coping skills, but I still feel miserable.

it is really tempting to drink in the evening. Anything to numb out.

Uncomfortably Numb

I saw my therapist today.

My daughter moved into the dorms for her first year in college yesterday. We talked about that for a while. It is bittersweet. I am very happy for her, but it does feel different with an empty room. I got shaky when I was moving her in. I don’t think it was the lifting, but anxiety. There were so many people.

Once we got all of her stuff in her room, I said goodbye. My husband and son took her shopping for a few last things, and had lunch in the cafeteria. I would not have been able to eat.

I told therapist about the shaking. I was still doing it today. In the room my son was telling me to breathe in my nose and out my mouth to try to help. He is sweet. I told her when I came home from the last visit I was unsure how I felt. We had talked about the past, growing up, and it was uncomfortable. She asked me what I needed and I said some acknowledgement that parts sucked. The unpredictability.

I tried to be invisible and would do what I was told at home and keep a low profile, and stay away from home when i could. I told her i got into trouble with drugs and my boyfriend, but my parents were too preoccupied to notice or care. She thought that would upset me, that i went unnoticed, but it was my plan.

At one point I told my therapist I was “pulling back”. I guess I was dissociating. I was there but numb to any emotions.

i mentioned how once my mom was talking about my niece, saying really nice things. She brought up my daughter, for some reason, saying she is not the same or something. I said, i know and was agreeing with her, and said that my daughter is really good, but she is different. Then my mother said, ” well, I thought you were good, too.” It really bothered me because I thought she was insinuating my daughter might be up to something she isn’t. My therapist said, ” I don’t know what to say to that. There are so many levels.” And it came out of the blue when my mom said it.

This is so hard. My father is gone. My mom has changed some, for the better.

My therapist said, parents do what they can for their children, unless they are sociopaths, and that mine did not know how to do things differently, is that fair? I squirmed with that. Not the sociopath part. I know they did things the way they thought was the best. I don’t understand how they could think some things were okay to do, let alone good. if I can get past this it might be a breakthrough.

My dad once discouraged me from therapy, because he said you talk about the past and it makes you sad. As far as i know he had never had any therapy and I shrugged it off, but here I am. Talking about the past and feeling sad.

The Stigma of Co-Occurring Disorders

In my opinion, this is my best yet 🙂

Originally published on Psych Central
https://blogs.psychcentral.com/triple-winner/2017/03/the-stigma-of-co-occurring-disorders/

There is a great deal of stigma attached with both mental illnesses and addictions. That is one reason I talk about my experiences. So, others won’t feel alone, and, to put a face to these conditions. It is scary to get a diagnosis of a life-long mental health condition that all you have heard are extreme negatives. People can lose hope. And, people fear what they don’t know.

I also have shame, or self-stigma. I have worked on accepting the schizoaffective diagnosis and at this point am okay. There was a time when I felt, less than, because of the severe symptoms. Now, I know I could not control what happened in the past, and just work on staying stable.

Social anxiety is something I contend with daily, and I cannot seem to prepare enough. I don’t know if I can ever accept how limiting it is for me. There are some things, like volunteering at my children’s school events, that are just too busy for me. I cannot enjoy shopping or parties, I just want an exit. I have worked very hard on this and work with people now and even do public speaking, but it is difficult.

The alcohol addiction label is new to me. In the program I am doing, SMART Recovery, they don’t give labels. But, I need to call it something. The drinking is not new, just the acknowledgement.

There are choices of programs for changing addictive behaviors. Some people work more than one at a time. This was just one that seems to fit my philosophy. It uses cognitive behavioral therapy (CBT) principles and I already learned some of those for my anxiety.

I haven’t had serious consequences from drinking. No DUIs or jail time, No relationship problems. But, I drink more than I would like to and it is hard for me to abstain completely.

When I started this blog, I decided I would like to write about the alcohol component along with the mental illness. So many of us have co-occurring disorders. I was excited, and then, I paused. What will people I know think when they see ‘alcoholic’?

Then I giggled. First, because I can’t decide which is the lesser of 2 stigmas (it doesn’t matter). And then, because they all have seen me drink. It isn’t really a surprise.

The secret is that I am working on it.

Info on SMART Recovery

Self-Help Addiction Recovery – SMART Recovery 4-Point Program – Alternative to AA

Info on Alcoholics Anonymous (AA)
http://www.aa.org/

Coping With Schizoaffective Disorder

Originally published Psych Central
https://blogs.psychcentral.com/triple-winner/2017/03/coping-with-my-mental-health-symptoms/. (Archived)

With schizoaffective disorder and social anxiety, I have a number of different types of symptoms to cope with.

For me, psychotic symptoms can be the hardest to deal with. The first thing I turn to is medication. I have tried a few of the newer atypical anti-psychotics and fortunately, I respond well. It takes more than medication alone, though.

Some things that can help people cope with psychotic symptoms:

• Help from others– I have issues with fatigue and motivation. If someone can help me with chores: childcare, housecleaning, cooking it is a big relief.
• Music– Listening to music can help drown out voices.
• Cognitive Behavioral Therapy (CBT) – This is a type of therapy based on moving from distorted thinking to more rational thinking. It can be used to treat people with psychotic symptoms, but anyone can have distorted thinking.
• Asking– If I trust someone I can ask them to help me determine what is real.
• Acting “As If” – I can act like consensus reality (what everyone else believes) is real. The longer I do the more I start to believe it.
• Psychiatric Service Dogs– Dogs can be trained to perform specific functions that help with your disability.
• Technology– Apps like snapchat can be used to verify that what you are seeing is real.

My mood symptoms are varied. I rarely am euphoric. I am more typically irritable and paranoid. Or sad and anhedonic. But, I can be reckless and impulsive. Some things that help me with different mood symptoms. (There is overlap with the different coping skills):

• Support groups – A number of organizations have support groups for people with mental health conditions. Depression and Bipolar Support Alliance (DBSA) and National Alliance on Mental illness (NAMI) are two national organizationsOkay.
• CBT– like I mentioned above this is a type of therapy that helps with distorted thinking. Distorted thinking can lead to depression and CBT can help your mood.
• Acting against Impulse– This is a Dialectical Behavioral Therapy (DBT) technique. If your first impulse is to do something reckless, push yourself to do the opposite.
• Talk Therapy– This goes for all the sections, but if I am irritated at something specific my therapist can help me put it in perspective.

For now, I have my psychotic symptoms pretty well under control and my depressions are mild. I haven’t been manic in years. I am still plagued by anxiety. Here are some of my anxiety coping skills:

• Breathe– I take a deep breath and let it out slowly to help me calm down.
• Visualization– I picture an event coming up, going well and I don’t get so nervous about it.
• Routine– I take my medications and go to bed, wake up at the same time, plan for change ahead of time.
• Journaling– getting my thoughts out helps me to organize them and take some of the emotion out.
• Calling someone-talking to a friend helps me to not feel alone.
• Avoiding over-stimulation– Sometimes I just need quiet time. A big crowded place is too busy for me.
• Breaking Tasks into Pieces-If I try to take on a project all at once I freeze, but if I break it up into more manageable pieces I can get it done.
• Socialize- I tend to isolate which isn’t healthy so if I am invited out, I push myself to go. I usually have at least an okay time, it is just getting out the door.

Feeling Exposed

I have social anxiety and used to barely interact with others. Enough to do my job, get my groceries, but not much more. I have slowly been building on that and as far as overcoming my anxiety- I think I have come a long way.

I have been slowly disclosing information about myself to others. People close to me and people I don’t know. I give talks on my experience with mental illness for NAMI. I have been blogging on a private site. I made a YouTube video and did periscope chats. I have been posting more personal info on social media.

Now, I am blogging out in the open and I feel vulnerable. I showed my co-worker some articles I wrote and he followed a link here. It is fine. That is what it is there for. But, I felt like he was reading my diary at the same time.

And, I put a disclaimer on twitter that my views don’t represent my employer. I know you have to be careful what you say. My work knows about my mental illness. I work in the field. I just was pretty casual on the more private site. I worry I am going to get comfortable and say the wrong thing (like complain about someone or something).

And, I just announced some things about myself that people didn’t know. Not everyone that follows me on Twitter knew of my mental health or alcohol abuse issues. I feel like I need to explain everything, right now.