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career Coping skills hearing hearing aids mental health mental illness Recovery schizoaffective schizophrenia stress Therapy TikTok work

Will it be too stressful?

Image: STRESS spelled out in scrabble

I have been stable for 15 years, but I have really decreased stress in my life. I find that when stress increases my symptoms can increase. I did not work for a few years after diagnosis. Then, I volunteered part time for years. I have been working part time for 6 years and I am doing well.

I found out about an open position at my work. It is higher pay, but more responsibility and full time. I put in a request to transfer and am waiting for an interview. I have no offer yet, but I am starting to worry if I am doing the right thing. (My opinion does not represent my employer). I want to ask my psychiatrist his opinion on taking on more, but he is out of town.. I emailed therapist but I don’t know if she will get back to me.

I have a delay with the hearing aids. The audiologist contacted my insurance and they said I have no coverage. That did not sound right, so I called. I have a $1000 allowance but it needs authorization from my medical group. I asked my primary care and she said she is not the one to ask, I had been referred to an ENT when they sent me to the audiologist so I don’t know if the ENT is supposed to get authorization. I am hoping I get them before the end of the year.

I am still doing TikTok videos on coping with schizoaffective disorder. Username Schizoaffective Dog Mom. I used to do live Periscopes. Few people came, but it was fun. TikTok has a live feature, but you need to have 1000 followers (I have 50). I guess it does not make sense to go live with no audience, but I am a little bummed I can’t use that feature. I have enjoyed viewing live videos.

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Dog Medication mental health mental illness moderation schizoaffective schizophrenia sobriety

In Sickness and In Health

Image dog on bed

I have had sinus congestion and headaches off and on for a couple of weeks.  It is finally starting to clear up.  I swear I have a barometer in my head and get headaches when it is about to rain.  We had a storm with thunder and lightening and then my head started to clear.

 

My husband and I went to San Diego for a couple of days to celebrate 25 years of marriage.  Mental health issues can be hard on relationships and I am glad we have been able to get through all of these years.  My daughter stayed home with the dog.  I don’t think she missed us but the dog did. We mostly relaxed and ate.  Everything was walking distance from where we stayed.

 

The first night we went to a restaurant, Rockin’ Baja Lobster.  We were there at happy hour.  I went way off my keto diet  and even had a few drinks.  The next day we had lunch at a Brazilian steakhouse, Fogo de Chao.  It was fancy but we just had the salad bar. It was pretty filling.  That night we went to a dueling piano bar, The Shout House.  That was a lot of fun.  They called people up on stage which would have embarrassed me.

 

Now we are home and getting back into our routine.  My mother in law is taking us out tonight and then I go back on keto.  I plan on going alcohol free until April.  I belong to some Facebook groups for moderate alcohol drinking.  I asked about any live groups and was told about one over zoom.  I went, but when I told them I drink twice a year the host was surprised and I felt like I did not belong.  My issue was, I am not sure if I want to expand on that, but I think I figured out what I want to do on my own.  I am keeping alcohol out of the house, but if we go to an event where I am not driving I am giving myself the option to drink.  With Covid there have not been many social occasions.

 

I have health insurance through my husband’s work.  They decided to change insurance companies coming in January.  Our PCPs are in network but behavioral health is different.  As far as psychiatrists, I have been on the same regimen for years so I mainly just need someone to refill my prescriptions.  But, I have so much trouble finding a therapist I click with.  I like the one I have now, but she does not take the new insurance.  I have been searching but I don’t know how to look.  I found one therapist who is great, but is retiring in 2023.  I am not sure if I want to start all over then.

 

 

 

 

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anxiety Calories depression diabetes Donation intermittent fasting keto life lessons Marrow Medication mental health mental illness schizoaffective schizophrenia stigma Weight loss

Intermittent Fasting (IF) and Stigma in Plasma Donation

Image of insulin and glucagon levels over time source Digbi Health

I saw the image above of how insulin drops between meals and while fasting. While insulin is low, glucagon can burn body fat. I was intrigued. I am 10 lbs away from a healthy BMI, but still have abdominal fat. I am type 2 diabetic and asked my doctor if fasting would be safe. My glucose is pretty well controlled and I don’t have hypoglycemic episodes. She said it is fine, but recommended 12-14 hour fasts. Which is mainly cutting out the nighttime snacking and eating breakfast later.

So far, no change. My weight has been stalled for awhile. My diabetes medication was reduced in June and my biometrics went south. Glucose up, ketones down, weight up. Thankfully, that stabilized but I can’t get my weight to go down. I log my food on an app (Cronometer) but sometimes I estimate weights. I am going to have to get better at calorie counting to start losing again.

So I am gung ho on intermittent fasting. Watching Dr Fung YouTube videos. Then, I saw this study. https://pubmed.ncbi.nlm.nih.gov/34135111/
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults

All I can see is the abstract and I heard a review but this is what I got out of it. There were 3 groups. One calorie restricted, one calorie restricted (same as group 1) but alternate day Fasting and a third group with no calorie restriction. The calorie restricted groups both lost the same amount of weight but the non fasting group lost more fat.

It was a short study 4 weeks, I think, and these were lean adults. Also, they were doing longer fasts than I am. But, I don’t know what to make of it. I would have expected the fat loss to either be similar or more for the fasting group since they have lowered insulin during the fasting period. if anyone has any insights let me know in the comments. I will stay with 12-14 hr fasts and keto diet for now.

I tried donating plasma at a donation center. I tried calling ahead to ask about restrictions but they do not give that information over the phone. And, they don’t take appointments for first time donors so I had to walk in and wait. For what it was it was not too bad. First someone checked my veins, which are fine. Then I had to fill out a bunch of paperwork. Then, I watched a video on plasma donation and read through a manual for first time donors.

Then, a woman, I don’t know her title, took me to an office to go over my paperwork. She got to the medications and asked what each was for and looked them up in a huge book. I take 7 medications for various conditions. After she goes through the medications she goes over them with me.

Most were fine. I take antidepressants but as long as anxiety and depression are under control it is fine. But, I take metformin for diabetes. She said that is a temporary deferral. If I was off it for a year I could come back. I don’t know what the likelihood of me maintaining my diabetes by diet alone is, my husband is able to, so possibly. Then she got to abilify which is an antipsychotic although it is sometimes used along with an antidepressant for depression. But, I told her I take it for schizoaffective disorder. That is a permanent deferral.

Bone marrow donation has the same policy. It is not the safety of the product. They consider me a safety hazard. I have been stable for 15 years but still people are afraid of me because of a diagnosis. They should have a sign out front: schizophrenics need not apply. So, I would not have had to waste my time.

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anxiety Co-occurring job keto Medication mental health mental illness peer support psychosis schizophrenia support Weight gain Weight loss

The Keto Roller Coaster

Image of roller coaster

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.

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bipolar Dual diagnosis Forgiveness hams harm reduction Inner demons mental health mental illness moderation NAMI pandemic psychosis Recovery relapse schizoaffective schizophrenia sobriety suicide

What I Have Been Up To Lately

I had therapy last week. I started seeing this therapist after the pandemic, so all my sessions have been virtual. I forget what she asked but I mentioned I remember mistakes from the past, 20, 30 years ago or more and they torment me. She wanted me to share but I am not comfortable with that. I feel such shame and they were mistakes that I feel are unforgivable. If I did not feel shame there would be something wrong. But, I don’t want to delve into them.

My father did not believe in mental health treatment even though schizophrenia, schizoaffective disorder and bipolar run in our family. When I started therapy he discouraged it saying talking about the past just makes everyone sad. I did not understand what he meant until now.

My therapist wants me to work on forgiving myself.  I have to explain to her that some of these things are best kept hidden.

 

 

I have been able to stay alcohol free after my planned intoxication in April.  My plan is sobriety until our wedding anniversary in October.  It was pretty easy to get back to it.

 

 

I posted a link to an In Our Own Voice presentation I did for NAMI, National Alliance on Mental Illness, in a different post. I have not been speaking much lately. I saw a different program by NAMI called VOICES. It is geared towards first responders. I signed up to be a speaker, but am having trouble figuring out where to start. My initial interaction with mental healthcare and police was not until I was 39, but since mental illness runs in my family that was not foreign.

My brother had a psychotic break in college at 20 (I was 15). He refused treatment and would get picked up by the police for 72 hour observational holds in the late 70s. His is a sad story. He was severely symptomatic for 6 years when he finally was placed on a different medication that he responded well to. But, he started becoming symptomatic again, paranoid, edgy, and probably needed his medication adjusted. He went to Yosemite while symptomatic and fell at a waterfall. I don’t know if it was accidental or not, but he died from the fall.

This is supposed to be a story of hope, but it is part of my story.  If I had not seen him so ill for so long I may not have accepted treatment, but I did not want to be stuck in psychosis like he was.  I think it is okay for first responders, but not sure if it will scare the general public who may be worrying about their own children.

My story is much different.  I did go in and out of psychosis for 3 years, but I have been stable since 2006.  I have not been hospitalized for 16 years.  I am married, have healthy grown children, work part time.  I still have some doubts about what was real from the past, but I can function.

 

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Brain keto Medication mental health mental illness schizoaffective schizophrenia

Advice From a Dietician on Brain Health

Image of highlighted brain

I zoomed with a dietician this week.  We talked about ketogenic diet and brain health, specifically schizoaffective disorder.  She gave me goals for macros and ketones.  I am having trouble just staying in the requirements of Virta, the company that is monitoring my diabetes, so she suggested following that and then make changes.

The suggestions she made was: going from 30g carb a day to 22g. And, cutback on artificial sweeteners.  Keep my protein the same, and increase fat.  She also suggested, for my particular issue, that I should have 2-3 mmol/l ketones in blood.  When I started keto, I was getting numbers in that range, but now it runs around 1.0 so she suggested adding mct oil.  She also suggested balancing the unsaturated fat I use with some monounsaturated fats.

I am trying to hit the macro targets now, but will really start in earnest in May.

I had asked my psychiatrist if he would talk with the Virta doctor and he agreed, but I don’t think he has called. I have been stable a long time, and am wary of making any medication changes. The dietician told me to work with my psychiatrist about any changes, which I would do anyhow.

I really can’t believe I have stuck with this as long as I have. I want to make it a lifestyle change but it is hard. I feel good and am thinking clearly. My main issue is that something does not agree with my gut. My fasting glucose has dropped 20 pts. Still not low enough to change my diabetes meds, but it is an improvement. I have lost about 1 lb/week, it’s not melting off, but I think it is reasonable.

I am in a medically monitored nutritional ketosis program and working with a psychiatrist for my mental illness. Please don’t try this alone.

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anxiety bipolar Coping skills distorted thinking Medication mental health mental illness NAMI psychosis Recovery schizoaffective schizophrenia stigma Therapy

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

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keto mental health mental illness moderation schizoaffective schizophrenia sobriety Therapy Weight loss

Medical ketosis for psychiatric illness

Image of highlighted brain

I have been on a ketogenic diet to treat type 2 diabetes, through a company called Virta for about 3 months. I have lost about 1 lb/week, my fasting glucose has dropped 20 pts, and I feel good.

My friend was pushing me to try the diet and now he has been pressuring me to find out information on medical ketosis for psychiatry. He says it has greatly helped his depression. My provider from Virta agreed to talk with my psychiatrist about how a keto diet can affect mental health. But, I started wondering what am I doing. I have schizoaffective disorder controlled with medication and also take medication and use coping skills for anxiety. I don’t know that I want to change anything.

My therapist coached me on how to tell my friend thanks, but I feel pressured. I am not great at setting boundaries. I took her advice and he was cool. He said it is not his business what I decide to do and he is just making suggestions.

Then, I read a post on Reddit where someone is working with a dietician from the Charlie Foundation on a keto diet for schizophrenia. They work on keto for epilepsy in children and have expanded. I emailed and they gave me info on a dietician and I made an appointment for a zoom call on Wed.

The diet I am on now is 30 g total carbs, 13 oz protein containing food and fat to satiate. I am sure the dietician will have something more precise with macro g or percentages. Right now I weigh some but estimate amounts, where I will be measuring more.

My therapist gives me homework. The last thing she gave me was to give examples on where I could be more assertive, like with my friend. And to think of things I am grateful for and proud of. I am grateful for many things. The people in my life, especially my husband and even my pushy friend. My car, dog, food, home… i could go on, but proud of had me stumped.

I work and take care of my family but there is nothing I can identify as I am really proud about. I thought some more. I am proud I have been alcohol free for 6 months and have a plan for moderation. I am proud I have been able to stick with keto 3 months and with the results.

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12 step AA depression mental health mental illness psychosis relationships schizophrenia Therapy

Discombobulated Thoughts

I had therapy, virtual, on Wednesday.  I went over what was going on in the present.  Then my therapist started asking questions about when I was school age.  Jr high and high school were not the best years of my life.  I had a friend drop me in 8th grade to hang out with more popular friends.  I had a boyfriend in high school who was very critical and was sometimes mean.

Creative Commons girlshealth.gov

My home life was horrific. My father had an undiagnosed, but quite obvious in hindsight, mental illness and my brother had a severe psychotic disorder. He was nice, just a bit scary to me. Everything was unpredictable. My dad would be fine one day and raging the next. I could not deal with being there so I spent most of my time out, with friends, drinking alcohol or smoking weed. I was very sad, and quiet.

After answering her questions she asked for my thoughts and I said they are discombobulated.  I don’t know what to think.  So, she told me to write down my discombobulated thoughts when they come to me.  She used my own words but I don’t  what she wants.  I am going to email mon.

She gave me other homework. To write what you can gain from AA, without spirituality. That is easier for me. I belong to a secular AA Facebook group. I tried one meeting but I felt out of place and have not looked at others. I did think the accountability and recognition for time sober helped me. I have not gone to meetings lately but I am staying sober,

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12 step AA alcoholism mental health mental illness schizoaffective schizophrenia sobriety Uncategorized

Hearing What I Needed to Hear

90 days sober!

I went to a zoom AA meeting and someone said that you don’t try to control things that are already under control.  That was what I needed to hear.

I had all of these rules and thought my drinking was under control because: I didn’t drink and drive, I only drank in the evening, I got chores done before drinking, although I was pushing even those limits.

But, normal people just need one rule. Don’t drink too much.

I listed in a previous post how my life was unmanageable. I have to refer back to it to remind myself. I still have cravings even though I logically have decided I don’t want to continue drinking. I just remind myself of reasons I don’t want to drink.

I have schizoaffective disorder and I don’t want to interfere with stability, and alcohol does not play well with my medications. And, I am not very productive at home if I am drinking. Also, I think I was walking around with a mild hangover. My head feels more clear, I feel lighter now.