Therapy PRN?

Image: dinosandcomics cartoon I hate leaving the house, why are you here then, well…, I have to have something to talk to my therapist about

I started seeing a new therapist when my insurance changed in January.  He started spacing our sessions further apart because I am doing well and run out of things to say.  Last month he told me he thinks I just need to see him, as needed, and to contact him if I need an appointment.

I don’t know what to think.  I am happy I am doing well but did not know I could finish, with a chronic mental health condition.  I do like checking in with someone but I have a psychiatrist and support group and people around me.

When I ask people about it they think I am unhappy and tell me to speak up, but that is not the issue.  I am unsure how I feel.  I am getting used to the idea now.

 

I also changed psychiatrist with the insurance change. But, I am having more insurance issues. He is part of a medical group that is covered but they are not recognizing him in their system. They covered the first appointment but denied the second. I filed a grievance and the psychiatrist office says it will be taken care of.  It still makes me nervous.

 

Work is going fine. I work 2 days and they hired someone to work the other 3.  I was wondering what he was doing. Work would be piled up for me when I came in.  I just found out he has not been working there for over a month  I feel silly for not knowing, but no one told me.

 

Weight watchers is going fine.  I had a birthday and celebrated with some desserts.  My weight has been going up and down but at least it I have not be gained.  I am getting back at it. I got a recipe book when I signed up and have made a few recipes.  I made slow cooked oats with fruit and a hash brown and egg meal.  I have coconut milk yogurt cooking overnight.  I plugged in a blueberry muffin recipe and it is 6 pts which is okay for a treat but I have to limit to one.

 

 

Empathy Postcards, CGM, and my week

Image Cover of Empathy Postcards

As part of a gift in a gift exchange I was given Empathy Postcards by Emily McDowell. It reminded me of a time I was hospitalized for my mental health . In art class I made a card to myself. No one brings cards when you are you in the behavioral health unit. I think they just don’t know what to say. These empathy Postcards are perfect for times like that. I think I will use them for friends when they are having a rough time.

Image if this is God’s plan, God is a terrible planner (No offense if you’re reading this God. You did a really good job with other stuff, like waterfalls and pandas.)

I also was given some keto friendly snacks, a little stuffed poodle that looks like my dog, dog treats and a nice note.

As far as keto, things are going well. My labs were good last month, so.my Dr took me off of one med, Januvia. Everything went wacky for a few weeks. My weight was going up, glucose went higher than when I started keto and I was out of ketosis. My Dr gave me the option to give it a couple of weeks more or to go back on Januvia. I decided to see how it goes in a week. It started improving. My weight started dropping and fasting glucose lowered. I am back in ketosis

I asked my coach from the program I am in, for type 2 diabetes, Virta, about a CGM, continuous glucose monitor. The Virta Dr called in a prescription for Freestyle Libre 14 day sensor. I got a voucher from the freestyle libre US website to bring to the pharmacy. It is a free trial. My insurance won’t cover more sensors but I am getting a lot of data. My glucose drops in the early morning and then rises. The sensor does not always agree with the fingerstick. It reads interstitial fluid. The range is set at 70-140 mg/dl and I am in range. I am going to lower it to 126 to see if I can tell the difference. It has a graph but it is hard to read. It is small. So far the biggest rise in glucose is just from waking up and not from my food. The app lets you write notes to go with the readings.

I have sleep apnea and wear a dental appliance. After my dentist adjusts it, he orders a home sleep study. I have done about 4 so far. I did one this week and have seen the results. I wore a t-shirt with tennis balls that is supposed to keep me in my side but the device read as if I was on my back most of the night. I still have mild apnea with the appliance so he will most likely adjust it more. It is not painful but it gets uncomfortable the more he moves my jaw forward and it takes time to get it back in position in the morning.

I talked with my therapist this week. She asked how much time I spend online. I don’t know so I told her that, but it is a lot. She said she spends an hour. She wants me to keep track. I don’t have to change but she says I should know. I like her but don’t like her assignments

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.

Finding Support for Mental Illness and Alcoholism

 

Originally published on Psych Central
https://blogs.psychcentral.com/triple-winner/2017/03/finding-support-for-mental-illness-and-alcoholism/

It can be hard dealing with a mental illness and/or alcoholism without support from a loved one. Perhaps, they don’t recognize it as a real problem. They may be frightened or not comprehend what is happening. Sometimes, partners may even try to sabotage your recovery.

There could be any number of reasons why you could use some outside help.

Friends and family can be of assistance, but oftentimes they don’t understand.

One way of getting help is to go to support groups. There are national organizations for many types of mental illnesses, addictions or co-occurring disorders. AA has sponsors (I have never had one). You can also make friends and have someone to contact if you are having a rough time.

There is something about peer support, and being with others who have been there, that is special. I remember the first time I went to a (DBSA), Depression and Bipolar Support Alliance, meeting. I was frustrated because I couldn’t find anything that sounded like me in the textbooks. Then, I met people I could relate to at the meeting. I had found “my people”. Now, I choose to work as a peer mentor because I believe in the power of peer support.

Professional help is good, too, though, not as readily available. I call my therapist when I am not doing well mentally.

You can turn to the internet. There are all types of message boards and chat rooms where you can go for support. You can meet people from all over the world to share experiences with.

Social media is a way of meeting people and blogging is a way to be heard.

They aren’t very common, but there are clubhouses or activity centers for people with mental illnesses. I work at one such center. We have all kinds of activities: gardening, art, music and a lot of different groups. It is a nice place to meet others and be supported.

Volunteering and helping others can help you, too. It can be rewarding and if you work with people with similar issues you may learn new resources or coping skills.

The main source of support you will find is within yourself. You will be the one to resist temptations and cravings. You will be the one to act on warning signs and develop coping skills.

When you are on your way in recovery, you may find you are stronger than you know.

Photo courtesy Max Pixel
http://maxpixel.freegreatpicture.com/Nature-Ocean-Beach-Thinking-Pensive-Waves-1927359