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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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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 psychosis schizoaffective schizophrenia

A thought on my higher power

The Universe is my higher power. I am tasked with describing how the Universe can help me. I had a point where I was seeing messages everywhere. I thought my therapist was suggesting things and guiding me by controlling the media and my environment. I imagine the Universe could guide me, but how do I trust it is not a delusion

ETA: I spoke with my sponsor about my concerns. She told me to stop for now.

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mental illness psychosis schizoaffective schizophrenia Uncategorized

What you see is just the surface

I saw this picture by u/schizocelia on Reddit and it really touched me.

My observable symptoms: responding to internal stimuli, inappropriate laughter, mood swings are the tip of the iceberg. You can’t see the hallucinations, delusions, loneliness and the pain.

When I had my first psychotic break, no one around me noticed. I am married and was working. People asked me if I was sad. I was isolating, and they can’t know what is going on inside your mind. (Although, at times i have believed people could know my thoughts).

Now, it is hard to tell if I am isolating or just following stay home orders.

I have been stable for years.  Sometimes, I worry i will have another break, but hopefully we (my husband and I) will be able to recognize it and act quickly.

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alphabet game bipolar schizoaffective schizophrenia

Schizoaffective Disorder

I was not sure what to choose for an “S” word, but this disorder affects my whole life. Also, most people have never heard of it.

Schizoaffective is basically a combination of a thought disorder, like schizophrenia and a mood disorder, like bipolar. There is controversy about the diagnosis. It can resemble bipolar with psychotic features except you have weeks of psychotic symptoms while not in a mood state (manic or depressed). Or, it can seem like schizophrenia with depression. There are 2 types, bipolar type and depressive type. I have the bipolar type and have had mania.

I had years of psychotic symptoms, it was either a long episode with periods of insight and lucidity, or a number of relapses. It all is rolled together in my mind. But, once I got on a good medication cocktail (I take several types), I have not had the severe symptoms. Now, I am more troubled by fatigue, anxiety and milder depressions.

Prognosis varies. I am married, have children, work part time. I had a psychotic break at 39. I know nothing about dating with a diagnosis or pregnancy and psych meds. Mental illnesses can be hard on marriages. We were married for 7 years before I was diagnosed. Fortunately, my husband is supportive and understanding.

I see a psychiatrist, a therapist, and go to a support group for mood disorders. Some good resources can be found through the National Alliance for Mental Illness NAMI.org and depression and bipolar support alliance dbsa.org.

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alphabet game neurotransmitters Uncategorized

Neurotransmitters

I don’t understand them well, but neurotransmitters rule my life. Too much dopamine and I get psychotic. Too little serotonin and I am depressed. Along with others like glutamate it is a delicate balance

I take medications and supplements to help restore the balance. They seem to be working. If only they did not come with side effects. My mouth is constantly dry to the point it is hard to talk. I usually carry a bottle of water everywhere. I am chronically fatigued which I believe is due in part to my medications. It is definitely worth those side effects to be functional

Chemical imbalance is one theory for mental illness. In my case it makes sense to me.

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alphabet game money

Money, money, money

Continuing the alphabet game with the letter M.

I worry about Money. I imagine that is common.

When I was psychotic I would spend and donate to causes because voices told me I should. It could have been worse, but I was isolating so I did not have a lot of spending opportunities. I remember something popped up on the computer screen once. I thought it was a message and I purchased it. It was a year subscription to something we did not need.

So, my husband took over our finances. Now, I am unsure of where we are at, which makes me anxious. I should have him go through it with me, he will, When I am ready.