I stopped using EMSAM last Thursday. As you can see in this picture (click image to enlarge), it leaves a reddish spot in the area where I use it — and I alternate right and left every day. Not only that, the “itchies” (hives/welts) I sometimes get from stress increased tremendously when I started using it. The itching left me utterly miserable.

Going back over my previous EMSAM posts, this was not a problem before. Maybe they’ve changed their adhesive — who knows? I’ll tell you one thing — the adhesive sucks ass. I’m supposed to wear this thing for 24 hours, but the thing only stays on for about 10!

In addition, I became even more tired even though I’ve increased my time in front of the light box! So after 6 days of using EMSAM, I decided to shut it down. There didn’t seem to be any improvement in my mood, other than being cranky and miserable from scratching. Benadryl didn’t always help, and of course, that could have contributed to my loss of energy, although I didn’t start taking Benadryl until about 3 days into the EMSAM.

I took this picture Thursday morning and called my pdoc’s office afterward to let them know that I was discontinuing its use. This past weekend I was still extremely tired but managed to force myself out of bed after napping in order to take Hee Seop to the vet with Brian (Hee Seop’s in perfect health; just needs to lose about 1 lb., which is the equivalent of 10 lbs. in a human). Yesterday I napped for 4 hours but again, managed to get out of bed and force myself to take a shower. I’d already stopped taking the Benadryl, probably Friday. And my itchies are improving.

I’ve been trying to post a book review every Saturday, but I just didn’t have the energy. I even have 2 already written! I’m still suffering from anhedonia, as well.

This coming Thursday I have a pdoc appointment. I don’t know what we’ll try next.

For the past half hour I’ve been on the verge of tears for absolutely no reason. There are really only 2 explanations: PMS or depression. I’m thinking it’s the latter. Well, or maybe the 8″ – 12″ inches of snow we’re expecting! *wah*

I’ve been using EMSAM for 5 days now, which, it turns out, is 1 day longer than I used it in the past. Or if I used it longer, I didn’t see any posts written about it because I ended up having ECT again — and get this — although I was depressed at the time, I was doing TONS better than I’m doing now! I mean, I was still playing hockey! This was almost exactly 3 years ago. I had trouble writing blog posts, so Brian kept readers apprised of what was happening, but besides that, I was doing quite a bit better.

That doesn’t bode well. Part of me wants to go ahead and have ECT so I can feel better NOW. But I’m finally regaining my short-term memory and can actually remember things, like movies I’ve seen and books I’ve read recently; it isn’t like once I’ve seen or read them, I’ve pretty much forgotten what they were about. It’s a huge trade-off.

In other news, I’m still in therapy twice a week. I had my ankle MRI yesterday and the results will be in tomorrow. Part of me hopes they find something wrong so they can actually fix it instead of guessing at treatments. Gah.

I’ve been avoiding the Internet — Twitter, Facebook except for my Mafia Wars account, my blog, your blogs, even e-mail when possible. It’s a sign of depression for me. But this time I’m determined to continue blogging, no matter how difficult it is. I’m at least getting out of bed, though I haven’t been showering every day, if at all. My hygiene is at a minimum. I mean, by the time I’m done using the bathroom, I’m pooped. Haha. Seriously, I am drained.

This last bout of depression was beginning to improve, especially because I was also finished PMSing. Then an incident occurred on Saturday morning. We were supposed to take Basil to the vet for a tech appointment (not a full exam) at 10:30. I hadn’t gone to the bathroom yet, and by the time I did, we were running late. I can’t remember exactly what happened, but Brian and I began yelling each other, I began feeling extremely anxious — while on the frickin’ toilet — and scratched up my left arm. I didn’t even realize I was doing it until it was all red and the top blood vessels had burst like they do when I scratch a hive or mosquito bite more than I ought to. It wasn’t my intention to harm myself; it was very much like wringing my hands or working a piece of fabric (like from my shirt hem) between my thumb and forefinger when I’m anxious.

I had already had bad IBS experiences the few days before, and my self-disgust was — is — at an all-time high. I realize this isn’t my fault, that it’s the IBS, but I’m still not convinced because going to the bathroom is something we learn to control at an early age. This incident on Saturday plunged me into yet another depression. I had already seen our family doctor earlier that week, who prescribed something that’s like a preemptive Immodium. I can’t remember what it’s called. I took it for the first time that morning, 15 minutes before eating, as directed. The only real difference was that when I had to go, it wasn’t as incredibly urgent as usual — just that I didn’t have to go early enough to give me time to get ready to leave the apartment.

Anyway, I haven’t even wanted to talk to my therapist on the phone, but I have. I have a follow-up appointment with the doctor in about a month. In the meantime I’m supposed to get an MRI for my ankle and some sort of nerve test that will hopefully explain why my left hand suddenly goes numb sometimes. Not numb like I can’t feel it; more like pins and needles, even though I haven’t been sitting on it.

I’m trying not to stress eat, and it’s been tough. But seriously, the last thing I need is to gain even more weight.

I saw the pdoc yesterday. He brought up ECT. This morning I thought fine, let’s do this. I’m sick of feeling the way I do. I don’t want to try yet another med that I’ve already tried only for it to work for a month or so and then stop working. But I’ve been through the list of SSRIs and everything else but the tricyclics and oral MAOIs.

When I went to the bathroom this morning it was with every intention of getting in the shower afterwards but when it came time, I just couldn’t. I’m not even sure I didn’t have the energy so much as I just didn’t have the will. The motivation. And motivation is a HUGE red flag, which is why I was all about ECT this morning.

Brian took me to see my therapist this afternoon, and I changed my mind about the ECT, at least for now. We worked out that the kernel of my day-to-day depression right now and for a while, has been the IBS. So the plan is to see my family doctor and find out if I need to see a gastroenterologist or another colorectal surgeon. My current IBS doc is a CRS in the suburbs. He isn’t in the far suburbs, but I want someone closer to home.

Meanwhile, after the pdoc mentioned ECT yesterday and went through my chart and realized I’d been on all these different types of antidepressants, he suggested EMSAM, which is a patch. I reminded him that I’d tried that already, but I couldn’t remember why it didn’t work. I was ambivalent about it, so he wrote a separate prescription for it (he writes the Rx for all 3 of my meds on 1 sheet of his Rx pad). Like the Abilify, which I was on when it first came out, I was put on EMSAM when it first came out, so like the Abilify last spring, I will probably try EMSAM again.

Although EMSAM is an MAOI, it doesn’t have the dietary restrictions (no chocolate, cheese, wine unless you want to die, for real) that traditional MAOIs do, although according to their medication guide, at a 9mg patch, you can’t eat those foods. I’m starting on 6mg. There’s also a contraindication with using Tegretol, but Tegretol is also contraindicated for birth control pills and that’s never been a problem. So I’m waiting to hear back from him about whether or not I should use it because I will not take any other mood stabilizer other than Tegretol.

Aside from that, there’s the whole logistics of the thing. He said to put it on early in the morning so I’d be able to sleep at night, but wasn’t sure if it’s OK to take it off like, while working out or showering. There was nothing on the web site mentioning it, either. So I’m having obsessive thoughts/anxiety about how to use it: is it OK to take it off for a little while? What if I take it off for more than 2 hours? What if it doesn’t stick back on? Etc.

On the other hand, though I’m using everything in my willpower that I have to write this post, I honestly don’t know if I’ll have it to drive myself to my fitness class tomorrow. Perhaps I need to readjust my goals as far as that goes.

Brian took a long lunch to drive me to the first session of my fitness class last week. Several times during the lecture portion I nearly burst into tears and started hyperventilating, manifestations of panic attacks for me. Luckily, closing my eyes and taking deep breaths prevented them. It was tough, though.

I had a feeling I’d be the youngest one in the class and I was. I also had a feeling I’d be the healthiest and I probably am, since some of the other members are there on doctors’ orders. By no means am I healthy, though. For almost a year all I’ve really done is move from the bed to my desk to the couch sometimes back to bed and almost always back to my desk. This past summer I did pretty well getting out of the house, but that was the exception rather than the norm.

Maybe because it was the first day of class, but it was more lecture than workout. Last week’s topic was balance and how your abs are basically key to having good balance, which I don’t have, really. I know, it’s weird considering I play hockey, but as the instructor said, lots of things can change your gait, like injuries. Goaltending has caused me to have trouble aligning my hips in yoga because even though I used to be able to do the splits on ice, my hips weren’t straight — they faced whatever direction the puck was in.

Anyway, the “workout” portion consisted of the instructor’s aide demonstrating floor/mat abs exercises; then we split into groups and were shown 3 different abs machines and how to use them. That was pretty helpful because any abs work I’ve done in the past was mat work.

So I thought this thing was only once a week. I was wrong. I had no idea we’d have homework, or “labs” as they like to call it. This week, it consists of taking at least one of a list of classes that help build core strength and working out on 3 of the abs machines. There are exercises you can do at home for extra credit, too. Here’s my problem: Brian drove me to that first class last week, and I should be able to drive myself to the gym once a week. But now it turns out I have to be there more often.

Aside from my whole driving issue, there’s the IBS issue because the classes are at times when I haven’t used the bathroom yet, or when I’m not even sure if I’ll need to go that day. Granted, you don’t have to complete the labs the week it’s assigned, but as the instructor said, if you wait until the last week, you’ll have a lot of catching up to do.

If you complete the class, which I assume means attending each session and doing the homework, you get a coupon book of perks and who knows what else. Brian reminded me that I’m not there for discounts nor is this for class credit. I’m trying to lower the unrealistically high expectations I have of myself, but going more than once a week to do the labs isn’t an expectation I’ve set for myself — it’s part of the class. There’s a part of me that wants to take this casually, but there’s also that competitive part of me that wants to complete everything — not even exceed the expectations, just meet them.

Taking this class was supposed to be a good thing, but right now I just feel inadequate. And I hate that the IBS is not something I can control.