Thursday, September 10, 2009

Happy Birthday and what, what did you say?

One of the nice things about having a mental health appt on your birthday is that someone at some point is going to open your chart and go "oh hey! Happy Birthday!". Haha...and so it went. I visited my NP (Nurse Practitioner) to check in about the "new" meds. My birthday gift to him, was being on time for once.

After 3 weeks it seems that the effectiveness of the Vyvanse has worn off, and the insane anxiety that was probably caused (ironically) by the Citalopram is going away. I feel pretty decent actually, just not super-focused. So...up to 50mg of Vyvanse and we'll see what happens.

While talking to the NP (he's good at tricking you into small talk which I'm sure is intended to get you to just babble on and on and indirectly demonstrate your current frame of mind and mood...which is what I end up doing) I realized some things. Things I do all the time, but have never layered an analysis over. He was giving me the prescription for Vyvanse and he said "I have to give you the prescription in person or mail it to you, I can't call it in." For some reason this was way too much information in one sentence for my brain to handle. I asked him to repeat it and at the same point in the sentence, right after "I have to give you the prescription in person" my brain just went off on its own merry way. My actual thought as this happened was "I get it, he's giving me another option, I don't understand what he's saying though and I don't care and if I need to know I'll call him later and wow look it's really sunny outside and--oh look he's staring at me wondering why I'm looking out the window". Now, this is the first phenomenon I suddenly found myself observing. I was aware that I had no idea what he was talking about and didn't care and fuckit and ooh, look it's sunny out there, but I was also aware that this was happening...without the usual anxiety this would cause me. I used to be so caught in that anxiety.

Part two: ten minutes later we got around to the prescription thing again and he said "that's what I was saying like ten minutes ago about the prescription" and I said "What?" but I didn't mean "what?" and realized that wasn't what I meant and suddenly I realized I actually did hear what he'd said before, sort of so I said "about mailing it or something...wait, uh...what did you say about that?". So yeah, I guess "what?" really was what I meant, haha. Anyway...he laughed and said "are you going to remember that I said I could mail it to you?" and I said "mail what?" and he said "what did you think I said?" and I said "uh...I don't know, but are you mailing me the drugs or the prescription" and he said "I'm mailing you the prescription but you're going to have to plan ahead and ask me about it a week in advance, can you remember that?" and I said "well yeah, now that I know what you're talking about"...BWAHAHAHAHA! I'm glad this guy has a sense of humor, but I guess if he didn't, he probably wouldn't be a psychiatric nurse practitioner. This paragraph is definitely the one I have to make a note to self about to require as reading for the people in my life who say "ADHD? You? No way?". (Are they insane?! Haha...) Thing is, I could not land my thoughts to comprehend what he was saying in total, but I was able to earnestly engage with him in trying to get the conversation back to wherever it was supposed to be, and...was sort of observing while experiencing.

Then, all of a sudden, I realized that (Part 3) about 20 minutes earlier he had asked me if I had any side effects from the medication and I had said no. But that wasn't true, I have been grinding my teeth, which I know can be a Citalopram side-effect...I normally don't do this, so I'm guessing it's the meds. THIS delayed response thing, is one of the things that marks my days, truly, every single day and it drives me crazy. See I don't always have a strictly bad memory. I often just don't remember things until about 10-20 minutes later. Argh! (This is part of why I have taken to carrying a notebook around, for writing down my experiences with meds or therapy assignments so that I remember to bring them to the discussion at my appointments...this week I was a little sloppier about that though...)

Anyway, none of these behaviors was new or unique. The twist was that...I was aware of them even though I could not totally stop or control them. In a way I was already aware of them...aware that I had trouble paying attention in conversations for example, aware that I remember things "later"...but this was different. Weirdly, I felt like I my awareness had morphed into...some kind of slightly more objective viewpoint? Before I would just experience the emotion of the experience, but this time I was sort of observing my own behavior while still "being me", business as usual. I was very in the moment, but had some kind of heightened awareness of my actions and the whole speed of things did seem slowed down just a touch. Weird!

I don't know if I am even doing the experience justice in my describing it. As I said earlier in this post, it was like suddenly there was a light layer of analysis over the whole experience even though I couldn't necessarily control myself or where my mind was going. It reminds me of how the Strattera, when I was taking it, helped me to see the line between me, and the ADHD. The line between personality and chemical imbalance symptoms. I think maybe I was seeing that line, and like I said, I couldn't totally steer the shop back on course, but I was very lucidly aware of the fact that my traveling mind was following the wrong map. The punchline to this was that the NP said "you know, you seem a lot calmer than when I first met you.". I think I agree with him actually, but I wonder if this is all connected. It may be just that the time I've been putting into being more conscious in my actions, the time I've taken to begin unravelling old garbage from old experiences, with a little medication thrown in...maybe this experience has started to clarify an ability to observe myself, which I can see might be a really useful tool down the road.

Wow. Rock on.

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