Trouble with tramadol

Today is a dark day. Not dark because anything terrible has happened, but dark because I can see the darkness. Dr T made a casual comment in therapy today about how the world might seem like a joyless and heavy place, and it hit me afterwards that that was spot on for me. I don’t look forward to anything. I start to doubt the concepts of happiness, and love. Creativity. It all melts down to obligation and pressure, with no real ‘win’.

I thought about sitting down and drawing out a mind map of what the world looks and feels like through the eyes of MQ, but my instincts warned me not to. Outlining all the reasons I don’t enjoy living (now and/or in the forseeable future) could be dangerous, and I could do without that given its the time of year when support networks (docs, therapists) tend to be away on holiday.

I’ll come out and say it: I don’t feel all that safe at the moment, because the theme of overdosing has emerged again recently. When I started taking lithium, I had to stop taking ibuprofen (Advil/Motrin) which had always been a bit of a lifesaver for me, so my doc started giving me prescriptions for tramadol. These prescriptions started at a time when I was rebuilding my overdose stash after the last lot was confiscated (after I ODed), and I got in the habit of asking for more tramadol every time I went to collect my lithium. I deliberately hardly ever took those pills, even when I REALLY needed pain relief, because I was dedicated to piling up this stash *in case I needed it*.

A year or so later, circumstances have changed slightly, and I can take ibuprofen, so now I have absolutely no excuse to ask for tramadol. But I will keep asking for it. I know I will. I’ll just feel more guilty about it.

(Yes, I know I should hand all the boxes over to a pharmacist or someone, but I can’t bring myself to do it. I’ve collected boxes of tramadol for months, and I can’t let it go. My brain just tells me I might need it.)

I never claimed to be intelligent…

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A confession

It’s confession time. I wish it wasn’t. I wish everything could be normal, and I’d post about my day. I guess I willingly gave that up. My confession is that last night I overdosed, deliberately, on tramadol (/Ultram).

I’m not sure I even really know why I did it. I was swallowing my nightly med mix, and the thought entered my head that I could add in a tramadol pill (50mg), to help knock me out. And once the strip of pills was in my hands, it occurred to me that I didn’t have to stop at one. I quickly popped them out and chugged them down, knowing that if I didn’t do it fast I would change my mind.

I don’t have any difficulty sleeping now that I’m on mirtazapine, so I really didn’t need any help from tramadol in that sense. I didn’t get high, and I wasn’t hoping to. But there was something about the danger – the possibility of something bad happening – that was irresistible. I’ve never ODed on tramadol before, so I didn’t know what to expect, but from ODing on Nytol (/diphenhydramine) and sertraline (/Zoloft)) I know the effects can be quite dramatic.

I am not proud of myself.

I don’t get why I did it.

Embrace the fire

I sit here poised to write this post not quite knowing what the contents will be. And yet at the same time, I know beyond a doubt that I need to write something. It’s like there’s a huge blob in front of me, jumping up and down while waving flashing signs, but the words are too blurry for me to make out.

Let’s start with how I feel. I feel…weird. I know I’m too drugged up; illness alone can’t account for how much time I need to spend asleep at the moment. It’s ridiculous, but probably not surprising when you combine mirtazapine (Remeron) and tramadol. I sleep in until late morning, need an afternoon nap, and then go to bed around 9pm. I’d go to bed earlier if I thought no one would notice.

Mentally I feel weird too. Very weird. I think that without lithium, I’d be angry, and ironically it’s frustrating that I can’t feel that. Like a blocked pipe; I’m just getting drips. But I have to keep reminding myself that lithium is also keeping me alive. Brain dead, but breathing.

Today I saw my old GP’s car parked outside the surgery (I notice these things), and it hurt. At least, I think it did. I do miss him, and I felt something unpleasant, but it was watered down enough that I can’t be sure. Or lithium-ed down, if that can be a word. Once someone I cared about/trusted leaves, I need them completely gone from my life. For some reason I’m very black and white about it, so once my GP retired he was GONE, in capitals. Forever. It’s uncomfortable when life doesn’t follow my absolutes.

I also realise I could walk away from therapy right now. I say that a lot, and it’s not often true, but today it really is. It’s a statement about trust. And a statement about giving up on ‘hope’. Finally. Now that my psychiatrist has mentioned ECT I feel like we’ve come to the end of the medical road, as I’ve always imagined that would be the last resort. That leaves therapy. And after 2.5 years, where are we? I’m more ‘fluent’ (I filter faster). I understand more about why I am the way I am. I value these changes, genuinely. I just don’t see a conversion to life-change, past, present or future.

Last time I lost all hope I tried to commit suicide for the second time. When all the doors are shut (because there’s nothing you want behind them) the logical thing to do is End. It’s annoying I can’t naturally die of it; I certainly feel like I should have by now. If I think about it, it’s quite tempting to stop taking my meds, or at least the lithium. It isn’t removing darkness; it’s just taking the fire out of my ability to act on it. Makes me think of machines making a heart pump and lungs breathe when the body is really already dead.

I could let depression reach it’s conclusion. By all means tell me that I’m not my illness, but this partner isn’t ever going to let go.

I can’t tell you how tempting this is. Stop meds, and embrace the fire.

Hibernating

I’m stuck in bed, in pain, and feeling sick from my pain med (tramadol). This is really not going to be my week, but there we go. Today I was stretched far enough to call home, just for some sympathy from my Mum.

*Irritated voice inside my head*  = Stop moaning. Shut up. You’ll be fine. Live with it. 

To be fair, I did try to get out today. I went holiday shopping. But it was a mistake, and I ended up bent over at a bus stop holding my sides while panting promises to myself that I could cope. I won’t be doing that again in a hurry.

*Irritated voice inside my head* = Get over it; it’s just norovirus and period pain. So what if you get it really bad – it’s not like you’ve got meningitis, or ebola, or ‘insert REAL illness here’

Being at home doesn’t exactly do wonders for my mood. I’m currently thinking a lot about my life as a whole; how it’s stuck, how it needs to change, and what the barriers are to achieving that change. I’m also thinking about therapy and trust. Maybe I’ll post about it tomorrow.

For now, it’s back to the endless TV/napping.

Illustrating my stupidity

Once again I think I’ve demonstrated why I can’t be trusted with meds. As my last post suggested, last night was pretty rough, and I eventually decided I wanted to overdose on something and knock myself out (I don’t have enough pills around to go any further). The question was what to overdose on.

Usually the answer is automatically ‘Nytol’, but last night there was a pain-med competitor: Tramadol. Earlier in the week I’d told my GP that I need advice regarding painkillers, as I was expecting my *time of the month* pains shortly, and I know I can’t take ibuprofen while on lithium. This appointment ran well over the allotted ten minutes as my GP researched and discarded a long list of options: everything seemed to interact with lithium. Finally we had to settle on Tramadol, which was not ideal (it doesn’t interact with lithium, but instead interacts with fluoxetine…of course), and I was given a prescription for ten 50mg pills.

I haven’t found Tramadol to be a great pain reliever, but it does a good job of making me tired, so last night I was asking myself whether to OD on Nytol, Tramadol, or both. Decisions, decisions. I picked Nytol in the end because with my current daily med combo, my seizure risk with a Tramadol OD would be pretty high.

I slept from 11pm to 10am, and then crashed out for a further four hours on the sofa downstairs. I was supposed to be childminding today, but it was cancelled on Saturday.

I’m not proud of myself for overdosing, although I’m pleased that I didn’t touch the Tramadol – if I need to ask for it on a monthly basis, I’m shooting myself in the foot if I abuse it and have that option taken away. But to be honest, the fact I strongly considered abusing it is probably enough to warrant me not having access to it anymore (not that I’ll be sharing this with my doctor!)

Tomorrow I have to see my GP and Nurse L again, so here’s an opportunity to Be Brave and Ask For Help. I can imagine taking a risk and sharing the details of my current state with Nurse L, because I don’t feel like I have much to lose with her…except I’ve just remembered she feeds everything back to my psychiatrist, with whom I have a lot to lose. I’ll have to think about this.

My main concern is tonight. I won’t OD again because I have to get up early to go for a blood test, which means the first port of call (if the mood strikes) will be cutting. I might write on my arm ‘THINK OF THE SCARS’ in pen as a deterrent.

It’s just really hard to do the ‘right thing’ when you’re agitated and restless because you’re hiding from the bad thoughts that chase you relentlessly.