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Botox for Depression and PTSD?? Maybe

I’ve had Botox, and I never thought I would. But not for cosmetic reasons. And I think I may be experiencing more than the intended benefits to my treatment.

I’ve always had migraines, but I’ve lost a year of my life to nearly daily symptoms of uncontrolled, unmanageable hemiplegic migraines. I tried changing my diet, managing stress, losing weight, adding anti seizure meds, calcium channel blockers, magnesium infusions…and I was still suffering. My neurologist suggested Botox and I kept putting it off, wanting to try everything else first. I was skeptical that it would be effective, how could paralyzing the muscles outside your head affect the inside of your head? It didn’t make sense to me. Plus I was not keen on having 50 needles poked into my head, silly me.

But I did the research, and I agreed to give it a try. I was at the point that I had nothing to lose. My quality of life could not get worse. I either spent every second in fear of a migraine, about to get a migraine, in the middle of a migraine, or recovering from one. An attack would last days to weeks, with the muscle weakness not recovering in between.

I had Botox for migraines in the end of March. That same day of my treatment, my mother passed away. Two weeks later I had spinal surgery. Needless to say, but I’m saying it anyway to be exceedingly clear, this a HIGHLY stressful time period. I should be suffering a worsening of depression, PTSD, migraines, etc right now.

But I’m not. I feel good.

Huh? What’s up with that?

I tried giving myself and my new counselors credit, which I did a little, but it didn’t add up. Something had drastically shifted in my brain. I feel lighter. I realized I haven’t been fighting away suicidal thoughts and images all day long. I’ve felt loved, and connected to my family. Instead of the horrifying void, the usual ache of emptiness, I feel the warmth when my kids hug me. This is new, spectacularly new, and amazing.

So I started thinking. Of course I started thinking, it is what I do best. Start up the old analytical engine. What happened? Why now? What lifted my depression? What did I do differently? I racked my brain until I had what I thought at the time was a silly thought. Hmmm, I never had Botox before… that was new.

Now you may be wondering if the Botox worked for my migraines, and I am pleased to report that I have not had a migraine since right after waking up from surgery, 5 weeks ago! This is the longest stretch of migraine free time I have had in years, and no hemiplegia. So is that enough to account for the shift in mood? Perhaps…but I don’t think so, because I used to only have a few migraines a year and still battled some level of depression and suicidal ideation most of the time prior to the hemiplegia.

So I did some research, and it turns out that Botox is actually being explored as a treatment for Depression. I was stunned. I’ll share some of the links to the research here in a bit, but the main idea for why it may work is fairly simple. Botox in your forehead prevents you from making several negative expressions, especially frowning and furrowing the brow from sadness, concern, anxiety, and fear. Preventing the face from expressing the emotion breaks the feedback loop those muscles send to the brain – the exact science behind preventing migraines actually. Put simply –  It gives the brain a rest and gets you unstuck, out of the rut.

So your brain gets less “I’m sad” feedback from your face. That’s a good thing. But take this a step further. You manage to go out grocery shopping, guess what, the people there get less “I’m sad” feedback from you too. They smile at you warmly because you no longer seem unapproachable. Suddenly your world is full of more positive social interactions instead of everyone asking you what is wrong.

I used to think the smile I plastered on my face was a good mask, a good disguise for my pain. But I can tell you now, after seeing the grimace actually gone, it wasn’t a good disguise at all. I only thought I was hiding it. It was still there in my eyes. This kinda wrecks a lot of what I thought I knew, but, that’s okay, because I didn’t like the world I knew.

Here are some of the guys studying the effects of Botox for Depression, Dr. Finzi and Dr Rosenthal. Here’s an excerpt from the results of their double blind clinical research:

Comparing the scores at the six week visit versus baseline, there was a significant improvement in the OBA group compared to the placebo group; there was a 47.0% reduction in MADRS scores for OBA, versus a 20.6% reduction for placebo subjects…

The MADRS is an interview given by clinicians to assess depression. I’ve included screenshots of it here (taken from http://narr.bmap.ucla.edu/docs/MADRSstructuredInterview.pdf) in case you are curious of the questions it asks. It is short, but because it involves a face to face discussion with the patient, it can provide an accurate snapshot of mood and functioning. They usually give me the Beck Inventory to fill out myself at my counselor’s office, which is similar, but I think could be less accurate.

madrs1

madrs2

The conclusion of Finzi and Rosenthals study stated “There are several possible mechanisms by which OBA(Botox) may help alleviate depression. First, frowning may affect the way people feel about themselves when they look in the mirror and the way others respond to them. OBA, by reducing the level of frowning may cause others to respond in a way that influences mood favorably. Happier facial expressions may influence mood by facilitating more positive social interactions with others (Heckmann et al., 2003). Finally, in line with the facial feedback hypothesis that inspired this study, frowning may in and of itself be depressogenic . Thus, reduction in frowning may be in and of itself therapeutic. We suggest that the brain continuously monitors the relative valence of facial expressions and that mood responds accordingly. We term this emotional proprioception (Finzi, 2013), and suggest that it represents an important pathway for the brains’ evaluation of emotional states. According to this model, the brain continuously assesses the extent of facial muscle contraction and muscle tension by proprioception. One can view the state of corrugator muscle tension as part of a neuronal circuit involving the brainstem, with motor input from the facial nerve and sensory afferents from facial and trigeminal cranial nerves. OBA treatment of the corrugator muscle, would interrupt the normal circuitry, reduce distress signals to the brain and thereby influence mood in a favorable way. This model is also supported by work showing that OBA treatment of the frown muscles modifies emotional perception (Niedenthal et al., 2009; Neal and Chartrand, 2011) and amygdala activation (Hennenlotter et al., 2009). “

I am excited and hopeful by this research and by my own results. As someone who has literally tried dozens of psychiatric meds over the past two decades, all with little, no, or worsening affect of my mood, thoughts, suicidal feelings and imagery, lack of connection to others around me. I think my nervous system has always been on the fritz, overworked and overwhelmed since an early age. My parents didn’t smile at me. I didn’t learn to smile, I learned to frown or be tense. I learned not to cry. I learned to suppress. Botox in my forehead took away my control of that tension and suppression and gave those tired muscles a break, and possibly, those tired nerves a break too. Make sense?

Some of the scientists seem very against this treatment, despite early evidence it works well. I can tell you that I had no cosmetic concerns. I don’t even wear makeup on a regular basis. I’m so fair skinned I have avoided the sun my entire life, so I don’t have wrinkles yet, only freckles. The Botox did make me appear more relaxed and less sad, but not younger. I was actually more self conscious of my appearance as the injection sites left red marks across my pale forehead that looked like the big dipper constellation that took weeks to disappear. I did not feel better about that. And yet I was already not frowning and not showing my pain as obviously, random strangers were not making the “you look tired, rough day?” comments to me.

And as I said, this antidepressant effect was not my intended goal. I was attending therapy to decrease suicidal thoughts and thought I had months or years to go. I was just bopping around the house when I realized they weren’t there, and then I had to think really hard about when was the last time I had one, (it’s a myth you always miss something when its is gone) so I checked my journal and it was the day before Botox. It is in my journal. Nothing entered after that. Woah, right? No pill has ever done that.

Now did my mother’s death and those events give me some soul searching and freedom of spirit also? Yes of course. And the success of my spinal surgery was of uplifting. Maybe all of these things needed to happen in combination. Maybe only one alone would have only given me partial relief.

I’m not going to waste it though. I’m going to use my newly found mental energy to continue healing, focus on my PTSD therapy, creating and conquering goals that used to seem impossible because I was consumed with simply wanting to be alive and fighting off those dark thoughts. I want to be a better me, a better wife, a better mom. Me…but healthy. Hard to envision, but still I do want it, and I won’t give up.

Because don’t get me wrong. I’m not cured. Although I think Botox may have helped me get further down my recovery path, I still have stuck points and fears and social anxiety and insomnia and nightmares…and the list goes on. But my depression has lightened, I can even feel some hope trying to sneak in, like a foreign invader.

I joke and smile and sincerely enjoy more moments of each day. I still struggle each day too. I still struggle to get up out of bed, to take care of myself, to remind myself I am worth all this trouble. The difference is now when I struggle, I don’t immediately think death would be better. In fact, I’m starting to think that’s a horrible idea, and that I really should stick around and start living this life for me, somehow. I don’t know how yet, but I’m confident there is a life for me on this planet. Somehow. (That is supposed to sound triumphant, not corny, so if you get it, you get it, if you don’t, well, then you haven’t been plagued by suicidal thoughts for most of your life)

Surgery story, part 2

I awoke in a recovery room, although awoke is not quite the correct term to describe my mental state. I was aware of people talking and noises everywhere. I could only open my eyes for a few seconds at a time, everything I saw was blurry and confusing anyway, so it was alright that my eyelids were too heavy to keep open and try to focus.

Next I was aware of my mouth feeling wrong, a queasy spacy feeling, and a feeling like I was surrounded by people talking all at once and no one made any sense. Several people were touching me and saying my name. I think. Or it was the same nurse or doctor walking around my bed quickly, faster than my brain could process. I can’t be sure.

Someone asked me my name and birthday and if I knew where I was, the year, etc. Identification and also mental status questions. I tried to answer but my mouth felt so weird (whats wrong with my mouth ?) and I could only whisper. I knew I had surgery and checked my face with my hand. Nope, no tube in my mouth, but my lips and cheeks felt odd. Or did my fingers feel odd. As I was trying to decide, someone wiped my mouth with what felt like a wet sponge. It helped a little but I could barely feel it. So weird. Why couldn’t I feel it? I tried asking about the tube, is this normal not to feel, but couldn’t get the words out.

A woman grabbed my hands and asked me to squeeze. I could barely do it, my arms were so heavy, like my eyelids, but I also noticed it was hard to feel her hands. Or feel my hands. I wasn’t sure which. She moved to my feet and told me to push against her hands. She said both feet sweetie. Huh? I was. I thought I was. Except I couldn’t feel her touching my right foot. I opened my eyes enough to see her holding both my feet. She said to the woman next to her “did she come out of the OR like this or is this new? Does the Dr know? This is severe neural deficit on the right and I don’t see it noted, I think it’s just happened now”

So I may have had a flashback here, remembering waking up from surgery paralyzed…but I’m not sure. I was so sleepy and sick, I’m truly not sure.

Then the nausea, oh man, the nausea hit me full force. I tried saying I was sick, but made no sound anyone could hear. I started waving my arms, but still no one. Then I started dry heaving, noisily. Gross, I know. My stomach was empty, no eating 12 hours prior to surgery, a 10 hr surgery, plus however long til now…I was empty. But my stomach was still trying. Each retch was louder than the next and growing more violent. I screamed in pain in between each retch as it pulled on my incisions, along my back and abdomen. Tears formed and flowed freely now.

This got some attention. Someone handed me a little cardboard bucket just in time as my stomach found something somehow to bring up. Someone else gave me an injection of zofran, and put a scopalomine patch on my ear.

I suddenly dropped the bucket, unable to hold it. I felt my entire arm go limp, along with my right leg curling up. Oh crap! Hemiplegic migraine! Or a stroke…and I didn’t want to tell them it was a migraine if it was a stroke since that was possible after such extensive surgery.

Someone started neuroassessment on me again and if she didn’t say it I clearly heard her think oh f*ck. When she asked me to push against her hand, push, push, PUSH!!! I can’t. She knows I can’t. My entire right side is limp and droopy, useless as a noodle, numb too.

I’m trying to say “hemiplegic migraine – need magnesium” but aphasia and my numb mouth and sore throat are making it sound like this.

Hem, hem, hem, pleeeee, Kik, mikchal, ammmmm

Mags, mags, mags, mags, ummm

OK so I actually laugh to myself here when one nurse gets the other to put her head by my mouth and they are both a bit panicked and not hiding it at all, and I think this must be what Lassie felt like. What’s that? Timmy needs magnesium? Good girl.

With me repeating and them checking my record, I heard them say OH, could she be saying hemiplegic migraine? I see that here. Can a migraine cause this? I don’t know…I never heard of hemiplegic…

Honey, are you having a migraine do you think?

I nodded yes. And closed my eyes.

Do you need magnesium treatment?

I nodded yes again. Someone patted my left hand twice, reassuringly.

They called someone and started me on 2 grams of magnesium. About an hour, I think, later the hemiplegia was getting better, but I was still retching and moaning in pain. I was trying to recall the anti nausea med I usually get in my migraine infusions when an angel read my mind, or my chart, and said Dr ordered compazine for you since zofran and patch aren’t working. That was it! Hurray! I told her “oh good, i usually get that in migraine infusions”. Wait, did i speak out loud ? Yes she understood me. The trouble speaking before was all due to the migraine. My mouth still felt weird inside like it was swollen and full of cotton balls. And my sore throat only let me whisper. But at least my brain let me form words. The magnesium must already be working. Another neuroassesment proved this to be true. I was regaining strength in my right arm and leg. Everyone looked so relieved, not a stroke then, and not a spinal cord injury…phew ! I had never had an infusion right at onset before to see how quickly it could stop a migraine in its tracks. I’m usually pretty bad off before I get one so this was awesome, I was like “take that stupid migraine!”

Relief was nearly instant from the compazine. My stomach settled and with all the magnesium, anesthetics, pain meds, I slept soundly for the next hour or so.

Next thing I knew someone was touching my arm and saying “what is this? What in the world? What did they do to you, look at that bruising. That will have to come out before she can be moved. But what is it?”

I tried to open my eyes and saw a woman , a super blurry woman, holding my left arm. My eyes kept closing, too much effort. I heard another woman say she looked on my chart and it’s a Rick. They paged someone but said it would be a while for the special team to arrive so we should notify the family now then to see me while we wait.

My family ? Soon I heard hubby’s voice. Ah such a good voice. I tried to see him but I still couldn’t focus on anything. And then I heard, “sir, sir, are you alright? You better have a seat. Someone get us some apple juice! ”

I heard him say yes, he was a bit woozy and giggle nervously. (Apparently I looked so gorgeous I made him swoon)

Once he was stable hubby came up to hold my hand. I still couldn’t see him. I also heard my FIL now. I tried telling hubby about the migraine and asked if everything was OK otherwise, but I don’t really remember much of this. He says I kept falling back asleep and seemed anxious and talking fast. Seems odd to me when I felt like everything was so slow. He also told me later that others in this shared recovery room were sitting up and laughing with family members, not so sick, bruised, swollen, glazed eyed, and generally beaten up like me. But I’m guessing not everyone had just had 10 hours in OR, a 7 inch incision on the abdomen, a 14 inch incision on the back, 2 disc areas replaced with donor bone wedges, fusion across L4 to Ilium, new metal screws and instruments, a slight revision around T12 to decompress the nerve root, a foraminony, laminectomy, and a few other scary spinal words I don’t recall at this moment. I’m actually not entirely sure what all he did to me, I’ll find out in my follow-up next week.

Anyways I was sleeping peacefully until a new voice arrived, another woman, and she just kept saying “sorry”. ” so sorry honey, I have to do this, I know you’re finally resting. Sorry it’s going to be uncomfortable, but this Rick has to come out before we can move you. Just hold real still, OK, please? So sorry” (I later found out it was RIC,
Not Rick, Rapid Infusion Catheter for the nifty cell saver machine that returned my own red blood cells to me)

If I wasn’t so dopey I would have been freaked out. She started tugging on my arm and I felt something moving in my chest. She kept pressing and pulling, pressing and pulling. I looked over once and saw this long white tube dangling out of me and she was still pulling. Finally it was out and she started saying sorry again. “So sorry, but I have to keep your arm up and press here tight for about 20 minutes to make sure you don’t have any bleeds. I’ll try not to hurt but I do have to press hard.”

She held up my arm and it did hurt, but not much, and I kept falling asleep I was so over medicated. Eventually she was satisfied, wrapped my arm in gauze and then a rubber pressure cuff, which I didn’t know until the next day.

At some point they declared me stable enough to go upstairs to my room. I don’t remember the journey at all. I just know I was woken up later in a different, quieter room.

Feeling mostly useless

My current state of mind and body is all new territory. I am either mentally or physically unable to do most of what I used to do just a year ago. I’m feeling mostly useless now, like I’m mostly occupying space. ( granted much less space than I used to, I’ve lost so much weight which is good)

I used to create our budget and pay our bills. Hubby does this now. I asked him to take it over out of necessity last year when the migraines hit full force, then asked him to continue to minimize my stress. Other than feeling a bit out of the loop, I don’t miss it. So lately when hubby has seemed stressed and pressed for time, I’ve offered to help out and pay bills if he wanted me too, or take that chore back from him if he preferred. Surprisingly he said no. He prefers to keep doing it himself. As much as I wanted to be helpful, I was greatly relieved by his response.

My other household tasks include washing dishes, vacuuming, sometimes making meals, helping with homework, calendar planning, driving kids to school, and general light duty tidying. The kids and hubby do all of the lifting, pushing, moving, etc.

I fill my days with TV, video games, therapy homework, chatting to online friends, exercise, and distracting myself from pain.

I used to be the person with ideas, with skills and talents, with more use than time. Now I have all of this time and I feel mostly useless.

Hemiplegic Migraine Triggers – Figuring me out

Starting to figure out some of the sources of my migraine misery with direct cause and effect.

Tannins!

Wow this took a while to figure out. I’ve been on a strict trigger free diet eating only whole foods, nothing processed, no alcohol, nothing aged or fermented like cheese or yogurt, nothing smoked or processed like deli meat, no bread at all for no yeast or malt or sourdough or other processed items.

I’ve had some better days and some not, and I wasn’t sure why not.

First, I’m fairly certain the anticonvulsants are doing nothing to prevent the migraine attacks, I think all the improvements are due to my diet changes, hmmm.

I’ve noticed some specific symptoms for years like I can’t drink red beer like Killians without an instant killer headache. I never called that a migraine, because just head pain and no weird neurological stuff. I stopped drinking that beer and no problem. I have a similar but much milder headache from green tea. These headaches are instant and felt after just a few sips right in my forehead.

The biggie seems to be bread and I thought it was yeast, but now I’m thinking its the malted barley. I’m getting a predictable reaction to this now as well, and its not a headache. Its a hemiplegic migraine. I’ve had no bread, no pizza, no crackers, nothing. Now that I stopped eating all of that, I can clearly see my reaction to it, and it isn’t pretty.

I tried again yesterday. I made waffles for the kids, and added chocolate chips and blueberries. (guess what chocolate and berries also have tannins, I know this now..) Oh they looked and smelled so good and I haven’t had anything like that in sooo long so I joined them for breakfast. I knew it might make me sick or blur my vision or something but I had nothing planned, didn’t need to drive, and wanted to experiment on myself. Sigh. Not fun being a human guinea pig like this but I need some answers before I see my neurologist again in a few weeks.

Link to Foods that Contain Tannins

These phenols are also in aromatics like perfumes, which just ties it all up in a nice big bow for me. Aha! it all makes sense. So if I eat it, wear it, or even smell it, these phenols are hurting me. The weird thing is – they are antioxidants and should be good for me. But we all know how much good it does to say SHOULD. I can’t explain it yet, I can only say this is my story, and the pieces are starting to fit together at least. I hate random. This isn’t great, but at least it doesn’t feel random and I feel like I can control it somewhat, or at least try to manage it.

Anyways, it hit me hard. it was not instant. It was a few hours later. See below to see the sequence of fun events I have from eating this waffle. Its unbelievable. I’m starting to put this together. The biggest culprit seems to be the malted barley. I’ve been thinking of the ‘allergies’ and ‘sensitivities’ I’ve had my entire life and wondering how much is related to tannins and polyphenols, it is making sense chemically now. Problem is, America puts this stuff in everything processed, and its also in many healthy foods too like nuts, beans and berries.

I just need to stop eating. Problem solved. I had the right idea with my anorexia in high school, maybe I was actually trying to feel better and not self harm….wouldn’t that be something.

First I feel my face go numb and droopy on the right side, like my cheek is too heavy. It is hard to talk because it is hard to move my mouth, but also because it is hard to think and find words. It is hard to understand words. I hear my kids talking but it sounds funny. I laugh. I know I’m confused but it isn’t scary, it amuses me in this state. So strange to explain this because it makes no sense as I type it, but I’m describing what happens when half my brain shuts down, so I guess it doesn’t have to make sense. Next is the arm and leg and right side weakness and pain. This type of nerve pain is searing and deep. My muscles twitch and spasm. I’m unable to grasp a pen in my hand and bear weight on my leg. I stumble and lose my balance. Everything spins. I get nausea, diarrhea or vomiting. I either can’t urinate or urinate too frequently with a weird cloudiness. My vision is distorted in some way, always different what it looks like, sometimes like Picasso, sometimes double vision, sometimes like alice in wonderland. I don’t panic any more, I just enjoy the show. No not really, but I know I can’t fight it and sometimes I do have a sense of awe at what I am seeing. I take magnesium and motrin and rest with ice on my head, neck, back, arm to help with pain. And then all I can do is wait for it to go away. If I’m lucky and it hits quickly I will fall asleep, nearly black out when it first hits. The head pain comes later, like a brick, and can last for days, along with the pain in my limbs. I have to massage and keep moving to get the bad stuff out, its worse if I lay in bed or try to hold my twitches still. So I drag my limping, wobbly butt over to my cane and the wall and pace about the house for as long as I can tolerate. I try to do it for 10 minutes at a time all day long.

Air Pressure

My other huge trigger is changes in barometric pressure. This will give me the instant -I must pass out and sleep- type of trigger its so intense sometimes. I have an app on my phone that tracks air pressure on a graph and alerts me to changes and I’m analyzing the history against my symptoms in my journal. I noticed the other day I was triggered at the drs office at the hospital. I thought it was a stress trigger until I checked my pressure app and saw how high the pressure was during my dr visit, and then it went back down so quickly. I thought that was odd and started investigating what happened. Turns out buildings have positive air pressure inside! A LOT of air pressure for large commercial buildings like hospitals that are sealed tight. I never knew. I started checking my app for other buildings, sure enough the pressure is raised a bit – instantly – every time you enter a sealed building. But this hospital was a difference of like hurricane level, no wonder it got to me. The app I use is called “Pressure Tracker” if you want to find it for android and see for yourself. I had to calibrate and tweak it, but I needed something to apply my geekiness to since I’m not working. The air pressure trigger also brings on a similar hemiplegic migraine as described above, but tends to be more intense and cycle more quickly, more painful, but passes in hours instead of days.

That’s my life now. Try not to get triggered, and spend all my time recovering from being triggered. Nothing is really controlled yet but I am starting to learn and uncover what is happening. I’ve made the diet and lifestyle changes. I’ve accepted my new life. I’m going to ask the Dr about my future and possibly going on disability payments at my next visit. I don’t have much hope at this point of recovering.

I have no idea why I am more sensitive now than I was previously in my life, why the migraines I’ve always had and managed turned into debilitating hemiplegic crises. The Drs don’t know either. All they do is offer me other pills to try. If I didn’t try this elimination diet I don’t think I would have been able to walk at all at this point, just getting sicker each day. But its like some switch flicked on and I can no longer tolerate a few triggers at all, sends my brain off instantly.

Migraine and PTSD memory emotion connection

migraine and ptsd, seems to be like peanut butter and jelly.

Today my brain is like jelly, missing that peanut butter to make anything stick, but wanted to try to get some thoughts down.

Yesterday was watching ‘So you think you can dance’ with kiddos and a girl with a hurt leg from a car accident came on to audition and it triggered me big time, I guess, I didn’t know at the time.

I cried when she talked about rehab and saw her supportive family, and how brave she was to get on stage with her ugly leg. My family hid me, made me feel ashamed of my ugliness. I was overcome with happiness for this girl dancing again, but also knowing she’ll never be quite the same, so much damage, so much pain. And then I had a flood of memories of AF and his own physical therapy for my paralyzed leg, he refused to pay a dr, so he was the one to do it.

I only had a glimpse of a moment of that memory yesterday, and really wasn’t even aware of it at the time until much later last night. I didn’t hold the tears back, as it was appropriate to cry a bit during this scene, we all were affected by it. But I didn’t sob, just a few tears, moist eyes really, and that tight feeling in the throat. But then I felt overwhelmingly sleepy, and since the kiddos were all content watching tv, I lay down on the couch and fell into a deep, deep uncontrollable sleep for the next 3 hours.

I could not believe so much time had passed when I woke up and saw the time. I noticed my hands were tingly, but thought I must have been laying on them. Until I stood up, and saw how wobbly I was, and then the real problems were when I tried to talk the words were all scrambly and I saw sparkles everywhere, like rainbow fireflys.

I felt quite uneasy, a deep fear, a childish type of fear, like don’t turn out the light, and I noticed it was unbearable when Hubby simply left the room. I felt abandoned! I was doing anything to keep him in the room and I had no idea why. We ended up talking about all kind of things for the next several hours, until we uncovered a whole slew of fresh memories I had from childhood. They weren’t all bad or disturbing, they didn’t all involve AF, many were about the 4th of July, but all of them were so vivid I could taste, hear, smell, feel, or re-experience some part of them. Some of the memories were from early times with Hubby and he had trouble recalling what I described from 20 years ago. I think it helped Hubby to understand how intense this experience can be for me, and that I am not intentionally sitting and thinking about anything, not drudging up the past – the past came back and hit me unavoidably in the brain.

I think it overloaded my system and forced me to sleep and caused the migraine, all those memories reactivating.

The emotions attached to these memories were raw and wild, and I went through each one, like rapid fire, not knowing what to do. I kept asking Hubby if I am crazy, is this it, have I lost it, because I feel like my brain has been hijacked, these thoughts and feelings are not my own. I had all this shame and fear and confusion.

I’m still in pain, limping a bit, so much visual snow, distortions and sparkles, but my thoughts and emotions have slowed down a bit. Hubby stayed home from work to help me today, which both angered me that I need his help, and is a relief to me that he is helping. I have too many things to manage with the kids that I’m beyond struggling to do and the pressure to be the mom I want to be is too much. Constant worries and always something new to do and take care of, doctors and appointments with kids, it is too much. But I have to find a way to do it.

AND then – I don’t like ME right now. In fact I hate me right now. I discovered this last night. All this talk of acceptance and self-love and I’m back here at the loathing. I think I’m pathetic and I’ve lost patience with myself. I think its because those childhood emotions are so fresh right now, so trying to be gentle, but honestly I’m so confused. It’s like my brain is slippery and I can’t find anything solid to hold onto anymore. I need and hate Hubby in the exact same moment and with such intensity, it is truly frightening to me now. I used to make sense. I used to be logical. These migraines have turned me into nonsensical soup and I swear I did not go through the mirror or the rabbit hole drink from the ‘drink me’ bottle.

Hold myself to higher standards

Discussed in therapy yesterday how when I quit my job 2 years ago and started entry level in a new company I was ashamed of its title “customer service”. I never told anyone that title which was easy since I don’t really talk to anyone anyway. I’m not exactly a facebook blaster or twitterer. I don’t really have a social network to impress. So why the shame?

Now that job was beneath my abilities and pay grade, that is a fact. But that doesn’t explain shame. Frustration, boredom, perhaps at starting over after a decade at the last company. I chose to quit, to make this new start. I left in good standing. So why the shame?

We dove into this feeling and deconstructed some possibilities. In the warped twilight zone world I grew up in as a child, AF raised me to feel ashamed of my mother. He told me she was stupid, fat, ugly, worthless, etc. My mom worked at a fast food place when I was little to earn some extra cash and we made fun of her for that too. I think my backwards career slip has made me feel like my mom, and triggered feelings of shame I used to have for her. It triggers the “SHOULDS”. I should have a better job. I shouldn’t have quit. I am an embarrassment to my family. they must be ashamed of me. So I must be ashamed of myself. This also fits with the “Unrelenting Standards” lifetrap/maladaptive schema.

I am struggling with this right now because I am currently unable to work at all. Typing this post is a huge effort of concentration and nausea as the vertigo of this constant migraine has me. I started a new med: zonegran. It will be a few more weeks of slowly dosing up on that to see if it reduces or removes this state of constant aura I’m stuck in. Good news is the zonegran has lifted my mood! I laugh easily and I’m enjoying silly time with kiddos, thankfully, since they are home for summer now.

Looking forward to first family counseling session in a few days.