Change

I have some big news! HUGE news! We’re moving cities!

What?? Yep we’re moving interstate! Not what we thought we’d be doing for the rest of the year!

Why?? My husband has been chosen by his workplace for a project. It involves tailoring and implementing his workplace’s software, and the customer wants him on site to help smooth the whole process.

Where? We’re moving to Canberra!

When?? Well apparently his start date is still Monday 12th September, as it was set a couple of weeks ago when the project came up. Yep, as in next Monday!! It seems that that is still going ahead, despite the fact that his workplace still haven’t organized our accommodation at all!! They are meant to be covering our moving costs etc, but right now it feels like what move?! Are we really moving? In a week? Like next weekend??

How long? The project is meant to be for 3 months, but you know projects…we’ll see. We might still be up there in February!

So! Once the shock subsided, I think we like this idea! I think we like it a lot. So many new things to be experienced.

Of course the list of down sides can be significant: missing friends and family, feeling displaced or lonely, far from my doctors/support network, leaving my stuff behind etc. But let’s leave all that til it happens. Right now, the opportunities are spilling out in front.

It’s going to be exciting!

What better time to be an unemployed pharmacist with no job ties? Talk about silver linings! This has to be a pretty big one. No taking leave, or a leave of absence. No having to quit a job I like. I can just up and go at a moment’s notice; which as it turns out is just as well, since it might come down to that!

I’m going to be a tourist in a new city with unlimited time to check out all the fun places it has. I’m smiling spontaneously and getting a buzz just thinking about the endless possibilities, the sights I might see and the people I might meet. And I’m off the hook about jobs! It is a relief. I’m unlikely to fall across a short term part time job while I’m up there so free time! Like last time when I was off work, when I was still sick enough to not need to think about returning to work, but well enough for short daytime adventures. Like an organ concert, a blogging class, a river cruise, taking the tourist bus or the city circle tourist tram around the city, a couple of hours at the zoo or wildlife park, sketching in the botanic gardens…I had so many hobbies and attempts at hobbies and really tried to get around the city as much as I could for free or cheap.

Remember this, self, remember the excitement when your anxiety about not knowing when you’re leaving for this new city, when you need to be packed up by, where you’re going to be living, what you need to take, how you’ll get around, if you’ll miss home, if you’ll find new friends, if you’ll….argh!! The big ol’ IF!!

I don’t deal as well with change these days, not like I used to. I tend to get anxious and become stressed about the unknowns in life which I would have sailed right through before I got sick. I need more notice, more time to think and consider the options, and I’m generally just more of a pain in the butt about the details! I need details!! Ask my poor long suffering husband! I have to be reminded, and reminded that things will work out just fine and not to get bogged down in the minutiae of a situation. Just breathe, and things will be fine. Of course they usually are just fine, but my brain doesn’t keep a record of all the times things have been just fine. It still goes straight to the what ifs.

And now I’m feeling thoughtful and pondering after that little detour, instead of happy and anticipatory of the future! Annoying. Let’s get this back on track: excitement, happiness, adventure!

I started a list of things to do once I get there, whenever that turns out to be. A reminder of all that I can look forward to, and a prompt for me to get out of the house once I get there and make the most of my time.

I’ve looked up places to go bird watching and practice my photography. I’ve ordered some tourist brochures for all the typical things to do. I’ve thought of a couple of friends I have up there, as well as my brother and sister in law. I’ve started checking out women’s bike riding groups and places to go riding. I’ve planned visits from people who may not yet be aware that they are coming to stay! I’ve chatted to some people who live an easy weekend away from where we’ll be living. Actually there’s so much to look forward to if you put your mind to it. Which I try to do these days.

I’m still writing my packing list and checking it twice. But since nothing has been happening about accommodation and no new information has come up, I’ve sort of put the packing thing off until I know for sure there’s a furnished house with our name on it that I can direct my things to. I had my initial freak out about which knives we must take and which tea towels were essential, but a Valium and a good night’s sleep mostly calmed my heart rate and thinking speed down to normal levels about that, and I’ve only been a normal level of anxious since. Well I think so anyway.

I will miss being close to my doctors. I think that will be the hardest thing. I don’t want to find new doctors; I’ll stay with the ones that I have. That probably means a couple of trips back for my psychiatrist, and I’m not sure what I’ll do about GP appointments. I know I can always call them on the phone so that’s reassuring. I’ll need to get new scripts for everything before I go. I just have to remember that I’m only a phone call away, rather than thinking of it being a 6 hour car ride away! Or however long the flight is. But nothing is impossible really. Just have to think of another way around it.

All of this shows, I think you’ll agree, that I’m going pretty well right now. Being able to see the positives, the blessings, the advantages, is not something you can force while you’re unwell, however much other people try to get you in the frame of mind. It comes with time, and with health. I’m grateful to have been able to take this enormous change so calmly, for me, and so positively. It could have thrown me well off kilter and returned my to bed for days. I’m glad that’s not the case.

So, all things being well, I’m off Canberra to have a fun and adventurous time for a couple of months, and I’ll certainly be filling you in on my life living above the blue line!

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Last night I had a dream…

Anxiety, depression, antidepressants.

Condition, condition, treatment.

Cause of dreams, cause of nightmares, cause of crazy, surreal, nonsensical, weird-as concoctions of ideas and sequence.

Either way, not a great night’s sleep!! And a poor night’s sleep leads to waking up tired and already sick of the day, and that’s no way to feel better about life!

In December last year I got started on a second and more sedating antidepressant to help with my anxiety, and depression. I was initially scared of being on two antidepressants simultaneously. The pharmacist in me was screaming “serotonin sydrome, serotonin syndrome!” [see author’s note]. But then I took it, as directed, at 9pm at night. Within in half an hour a warm fuzzy feeling was spreading all over me and I was feeling sleepy. So I went to bed. I fell asleep straight away, no tossing and turning and trying to force myself to sleep. No fretting, anxiety, stress, fears for tomorrow. Just pure sleep. Bliss!

I fell asleep, and stayed asleep. All night! In fact I couldn’t get up the next day! The doctor had warned me about this so I had started the medication on Christmas Day. I dragged myself out of bed about 9.30am, tried to keep my eyes open over breakfast and finally gave up after a shower and went back to bed about 11am. I slept solidly for two hours and woke up feeling a bit better, but still sleepy – luckily it was a small family lunch for Christmas so it didn’t matter too much. The next day was better, the next even better and within four or five days I could wake up bright and early as soon as my alarm went off and head off to work. And I was getting a full night’s sleep every night!! I was no longer waking up feeling like someone had “punched me in the face” as my doctor describes it, pretty accurately!

Oh mirtazepine! I still have a soft place in my heart for this wonder drug that put me to sleep, kept me asleep and then allowed me to wake up and get on with my life.

I’ve changed medications a lot since then. I had to get rid of mirtazepine because the doctors wanted to start quetiapine instead, an antipsychotic/mood stabiliser to stop me swinging from one end of  the spectrum to the other. It is also sedating. It does a pretty good job with my sleep: it certainly puts to sleep, and keeps me asleep, but I’m having this annoying phenomenon of waking up every morning at 4am or 5am bright as a button!

And to all the helpful people who say “just get up” – thank you for your advice but I respectfully decline!! What kind of time to get up is 4am?? What am I meant to do at that hour of the day? How am I meant to occupy myself all day? It’s hard enough as it is! So I go to the toilet and get back in bed and start the fight with myself to get back to sleep. Unfortunately by the time I succeed it is time for my hubby to get up and a much more reasonable hour of the day to be awake, and I’m conked out! Completely out to it! So my actual getting up time is more like 8am, 8.30am, 9am, 9.30am. Which doesn’t work well with a plan to go back to work eventually on a 8am to 5pm shift…but hey, I really shouldn’t be getting ahead of myself!

I asked my psychiatrist about this early waking thing. At first I thought it was just going to be a temporary thing, but it’s going on and on. He doesn’t want to increase the quetiapine dose anymore; I’m already fat and have cholesterol problems which are in part due to this medication and neither of us want to worsen that! Besides I’ve been started on lithium since which he hopes will be my main medication and the idea is to eventually reduce and possibly cut out altogether my antidepressant and mood stabiliser. His opinion on the matter is that depression is the cause. Early waking can be a typical sign of depression in his view. Bummer!! I was hoping it was something medication-induced that was more easily fixed than depression! Ah well, at least I got most of a good night’s sleep. Mostly.

There’s still the odd crazy antidepressant dream. I’ve heard about other people on antidepressants having strange out of context or deranged dreams, so I guess it’s something that can be part and parcel of treatment. I’ve had a lot more in the past but since being on a mood stabiliser they’ve been a lot rarer.

However I had one last night that got me thinking about this again.

Here’s the reality as background. My sister is a chemistry and nutrition teacher and mostly we get on well. We had a phone conversation last week that was really nice, we had a good chat about different things and only stopped because we had to go out for a date.

Now here’s the dream. I get invited to go to a private girls school to give a lesson on nutrition but I can choose exactly what I want to give the talk on. I choose to talk about waist circumference and it’s link to heart disease. I go to give the talk but I get lost and I’m running late so I have to call ahead and tell them I’m going to be late; not impressive for a guest lecturer! I finally get to the classroom and there are 5 girls; a bit surprising for a guest lecture but okay. Somewhere in the dream the classroom becomes a car and the number of girls drops to two!! Anyway when we get to the car part my sister (the nutrition teacher) turns up and begins heckling me about my facts, saying that they are not evidence-based, the greatest insult in modern medicine! I respond but suddenly I can’t find the evidence that I had before and can’t fight back against the allegations. It turns into a bit of a shame fest for me as a lecturer and then I start getting criticised for my lecturing style, my notes and my slides and it descends into a big higgle-di-piggle-di and I wake up!! Ridiculous!!

Questions: I have no idea on what authority I’m giving this talk, why me? I don’t really have to guess why waist circumference; it’s clearly because mine is well over the line and I need to do something about it other than eating chocolate! Why am I running late – I don’t actually do that much anymore; I’ve really turned over a new leaf. How did we get into the car and why? Why a private school; I went to public schools and have no idea what private schools are like. Why is my sister even there, she lives in a different state? Why are my facts being questioned, especially by my sister who would absolutely support them in real life?

There is no reasoning why with these dreams, they just have to be brushed off as we go on with life. Sometimes they are harder to brush off but I’m sure that looking for meaning in them isn’t very productive. If you beg to differ, and can find a meaning, I’m listening.

So sleep, dreams, life. All wrapped up together and getting the perfect balance is an art. It’s not perfect now, but it’s a long way better than it used to be so I’d like not to fight it but to be glad for what I’ve got and make the most of it!

[Author’s note on serotonin syndrome: when prescribed a high dose of a medicine that increases serotonin like SSRI and SNRI antidepressants, or when prescribed a combination of two medications that increase serotonin there is potential for a patient to develop serotonin toxicity or serotonin syndrome. I have been prescribed both at different times and have never experienced any problems; that is not to say it doesn’t happen, but it is not common. If you believe you have been prescribed one of these you should discuss serotonin syndrome with your doctor/psychiatrist. I am not an authority on the matter and won’t be giving a list of symptoms to look out for. ]