[Rose76]

I have an appointment to see a psychiatrist the middle of April. It's a long while since I've seen a p.doc for a scheduled appointment. I concluded some years ago that it's up to me to pull myself together . . . or not. I did therapy for years. I was tried on a dozen psych meds. I end up just taking amitriptyline, which makes a difference.

My hope in seeing this p.doc is to get some med to straighten out my sleep. I keep waking up at night. I'm exhausted for the first half of the day. I would like to try taking a stimulant in the morning. I wouldn't mind getting a benzodiazepine to take at night. I doubt I'll get both. Actually, I doubt I'll get either.

I already take hydrocodone 20 mg per day for pain. Where I go for healthcare, they don't like to give multiple controlled substances. I'm very discouraged that anything would help anyway.

I don't get any real break from caring from my s.o. I can get a few hours here and there, but that doesn't seem to help much. I get tired of this routine I'm in with him. Then I think that when he's gone, I'll feel even worse. I don't know that there's any point in going into that at this appointment. I'm not sure what I should talk about. I hate for it to be a complete waste, which I think it will be.

[Wild Coyote]

I think you should talk about it all. S/he will certainly understand you are in a very stressful situation and may have some mercy as far as prescribing goes. I would also share my concern that the appointment might disappoint me.
Just my own humble opinion.

I find you very intelligent and very articulate and I feel really quite inadequate when it comes to offering you any advice; yet, you have my support, for sure!


WC

Just my thoughts and experience. I tried adderall xr after telling my psychiatrist that I had taken my sons to see what it's like. I told him its used off label for depression and he was surprised to hear that. He's not a psychiatrist that doesn't take things seriously, but with my honesty I think it helped. I was only on it for maybe a week total. I couldn't sleep at all. I barely ate. Sure there was a nice feeling with it, but focus was about all. It didn't make me want to do more, or give me energy. That is only MY experience, it affects people differently. Try to write down all of your concerns so that you don't forget, and mention all the things you mention here. Surely a doctor will take concern for you, since you are having so much responsibility for your s.o. Best to you.

[MickeyCheeky]

Just tell him/her the truth - you can even just quote what you wrote to us here.

[Rose76]

Thank you all. I think I should prepare, so I don't let this opportunity go to waste. I might not get another any time soon. I'm leery of sharing much with shrinks cause I've been burned in the past. I've been given wildly divergent diagnoses by different psychiatrists, which makes me think there isn't a lot of science driving what they come up with. A lot of the time I feel pretty okay and glad that my bf is surviving. But periodically I get like an attack of severe depression.

I'm thinking I might do well to start a sleep diary. That gives the doctor some hard data to look at. They don't really listen when you just narrate a summary of a problem.

I took Ritalin for a fairly short while a few years ago. It seemed to make me sit and ruminate, with my mind going round in circles. I felt very awake, but no more inclined to get going and accomplish anything. Also, I cared little about eating.

I have to find a way out of being sucked into a trough every morning. Maybe I will just tell the doctor how my life is. It never does help though to overload them with too much detail.

I appreciate the support, as I've become very isolated. I might sound organized, but I get myself very mixed up about a lot. Neither my s.o. nor I have any family around for thousands of miles. There's no burden sharing with his family. I haven't seen my relatives for 4 years. One of my sisters doesn't even call me anymore. At times I feel abandoned.

I will use the advice above. Right now I feel like I need to go lie down and sleep. My eyes are closing. Yet I still have to put dinner together and clean up the apartment. (We were at the VA hospital today.)

My s.o. keeps pretty regular hours. I have to stay in sync with him and his needs. I can't think further right now. Did not sleep enough.

Hi. I know you've tried seroquel/quetiapine before and it gives us the munchies. Bad munchies really. But I still keep 25 mg. in case I need it. I didn't take any for a very very long time, but I got desperate for sleep. My bf said he shook me and I didn't wake up. I'm a very light sleeper.

Just a thought. You are only on one controlled substance right now, so you could ask for a benzo. Diazepam is safe, and if he gets a small glimpse instead of great detail, and a sleeping log, maybe, just maybe he'll offer help. Hope you get some sleep and rest tonight.

[Rose76]

That's a modest dose of seroquel. I might be willing to take that occasionally. In the past, it made me stuporous and unsteady on my feet, but I was on higher dose. So what you describe jibes with my experience.

I did fall asleep before for 1 1/2 hrs. Now I'm up. It'll be hard getting back to sleep tonight.

Thanks all.

I've read from a few people on here, that the smaller dose is actually more sedating than higher, of seroquel. I just wanted to add that. I wish you the best with appt., please don't give up on it.

[boomerango]

Rose, I'm so sorry you have this stress in your life. Being a caretaker is very taxing, beyond all the love you have to give. It's so important to find respite, and some way to nurture yourself and replenish! Sleep deprivation is a big deal, too. I hope this Dr can help you find your circadian rhythms. I truly hope the Dr has time and is able to listen carefully to whatever you say.

[Shazerac]

I can understand the being reluctant to share with a new doc. I tend to freeze up and plaster a smile in my face. Then I claim “oh everything is fine...just fine.”

Maybe you could try to make a list of issues and then prioritize it by which issue do you want help with the most. I agree with the fact there that maybe a low dose there Seroquel might help with sleep.

[Wild Coyote]

Hi Rose,

I am again reading this thread and wanted to mention a couple of things.

I have been an advocate of Adderall when depression is stubborn and nothing else works. I use the immediate release, not the XR preparation. My pdoc swears the XR preparation keeps his patients awake through the night. With shorter acting Adderall, I can decide how long I want the effect, by taking 2 or 3 doses per day, every 4-6 hours. I can time it so the last dose wears off before bedtime.

I have had excellent luck with sleep by using a benzodiazepine named temazepam. I have tried so many approaches over the years. This med gives me quality sleep and leaves no hang-over (in my experience). Dosing is flexible, which can be important for a caregiver.

Please feel free to ask me any questions.

I hope your needs are heard and met in the upcoming appointment.


WC

[Rose76]

Thanks W.Coyote for that feedback on your experience with adderal and temazepam. Thanks to other posters for advice about making a list. I'm likely to forget what I want to say, if I don't.

I am having so much trouble putting one foot in front of the other today. Right now I'm putting together a simple dinner. This lethargy is incapacitating. I'm wondering if I haven't just become so deconditioned from living so sedentary that I pysically just have no stamina. But I recognize this as at least part depression.

The hydrocodone isn't helping me nearly as much as it used to. I guess that's what happens with opiates.

[Wild Coyote]

Originally Posted by Rose76

Thanks W.Coyote for that feedback on your experience with adderal and temazepam. Thanks to other posters for advice about making a list. I'm likely to forget what I want to say, if I don't.

I am having so much trouble putting one foot in front of the other today. Right now I'm putting together a simple dinner. This lethargy is incapacitating. I'm wondering if I haven't just become so deconditioned from living so sedentary that I pysically just have no stamina. But I recognize this as at least part depression.

The hydrocodone isn't helping me nearly as much as it used to. I guess that's what happens with opiates.

(((((( Rose76 ))))))

Please take care.

WC

[Rose76]

I may be hoping for too much from the psych consult.

It may be that I am unhappy living the way I am as caregiver to my longtime companion. I am thinking about not continuing to stay here in this role. I hope no one will jump to seeing that as the solution. I think it's just too easy for others to say doing what I'm doing is too much. The alternative ways I could live might not be better. It is a very difficult decision. Not just because he would be unhappy to lose this service I provide. I might end up very lonely and unhappy myself. It's not real clear what would be best for me. I wish that were really clear.

[Rose76]

I feel like I'm coming apart at the seams. This is just awful. I'm coming to hate myself.

[Rose76]

Since 8 p.m. I've been much better. I just ate supper. I think I can get the place picked up halfway decent. Today was dreadful because it felt like I wasn't going to come out of it.

This daily morning depression is something I can manage, if it lightens after a few hours or even in the late afternoon. It was so much worse today and hung on so bad. I was afraid I couldn't get out of it. If this keeps happening, I will have awful trouble.

[Rose76]

Noon and I'm still in bed.

[Wild Coyote]

Oh dear. It seems the depression is worsening.

I am having trouble getting up this week. My husband has been trying to encourage me. I don't know what I would do if he was ill.

Thinking of you and your Significant Other.

Take care, Rose.

WC

[Rose76]

Thank you, WC, for your sensitive post. I'm glad you have a husband who encourages you. Someday, he will go through an illness of some kind. You will remember him being supportive of you, and your heart will want to reciprocate. You are that kind of a caring person.

My boyfriend did used to care for me in ways. He liked to cook and did do most of the cooking for both of us. If I was sick, he would even bring breakfast in to me on a tray. I thought that was wonderful of him.

I am finding it hard to believe that the last time he got a nice dinner together was in January of 2012. And he already wasn't doing too well at that point in time. This is a long time that I've not had him to care for me. This makes me cry now to even put these words down. He needs so much help, as he couldn't make a piece of toast or pour a bowl of cereal.

I guess in 2014 he was still heating up simple things because I did leave him alone for a week, while I went out of town, due to tragedy in my family. But when I came back, I saw he had been living off of cookies and cups of Jello pudding. So I haven't left him since then. That's four years of daily caregiving. I stopped working in 2012, so I figured it was good that life gave me a new job. But now I'm faltering. I'm irritable with him at times.

He never did understand much about depression. I can't really turn to him to feel comforted. On the other hand, he is not demanding, but patient. It annoys him that I'm not keeping the apartment up as nice as I used to. It disappoints me too. But I can't seem to make myself do what I know I need to get done.

We are watching the evening news now, but he is actually asleep in his chair. I feel awfully alone. The attendant was here all day, so I just stayed in bed. Somehow I have to get out of this morbid, paralyzed frame of mind. I see these hockey players on TV who've been horribly injured. People go through worse than I'm going through and manage.

At least I'm out of the bed now. I'll take some fish out of the freezer for dinner tonight. I expect I'll get the dinner made. The more I get done, the better I'll feel about myself. I have to not act crabby toward him like I did last night.

Even to give up caring for him and get him into a nursing home would be an undertaking that I don't have the energy for. It would result in me being even more alone, too.

I think any psychiatrist I tell all this to is just going to think, "Well, since you didn't plan your life out better, this is where you are. Too bad for you."

[Rose76]

I made the fish and we ate, but I just left the dishes. The kitchen's a mess. I just don't care about it.

I'm unhappy with my life. I'm unhappy being here with this man. I thought I could hang on for what is left of his life. But that could be for I don't know how long. I keep falling into this same pit of resentment - resentment toward him. It was never a great relationship. I feel cheated.

I can't keep staying here feeling like this. Maybe I'll be worse miserable back in my own apartment on my own. But I have to change something.

Nothing he and I ever did together ever turned out how I hoped - nothing . . . ever. From the first year I knew him, he always had some huge need I was trying to meet. I've been drained. He doesn't mind just consuming me.

But it's hard to leave. He just doesn't do very well without me. But there is so little in it for me. I can't keep on this way. It may already be too late for me to even save myself from falling apart.

[Rose76]

Today I feel sorry for how irritable I've been with him.

I guess this is not very interesting.

I don't know what to say to help. I'm still kind of thinking you should go ahead and get him into a nursing home. You can still go and care for him there. That way you have a chance, on your own, in your own apartment, to build on your life. Get out to groups if there is those. I know its easier said than done. I know how much you want this one thing to end well for him.
I know depression sucks the desire out of you already, as it is, to do things. If you were on your own and part of the problem is loneliness and the need to have a job to do, can you try other ways to build up your self worth, like a hobby. Maybe pick up a musical instrument. Maybe gardening a little. But i think you especially need some close friends. Where can you start with that? Join a caregivers group and possibly use the time when the support worker is there to go out to a group like that? You need support, and forums are not enough for that. If it wasn't for me continuing to call my long time gfs, I would have no one to vent to except my bf, who is very very tired of hearing me talk about my life.
You could also try, med-wise, the suggestions here and slightly tell the psychiatrist that you believe those meds will improve your life. Be sure to really relate that things are not "OKAY", and tell them how deeply depressed you are so much of the time. I wish you well, I wish there were concrete answers.

[Rose76]

Thank you for response. Those are all good suggestions. I don't think I have a problem with self-esteem. It is lonely being with someone afflicted with dementia. It may be that I just don't have what it takes to continue doing this. I've been doing this for 4 to 6 years. It gets boring. It gets isolating.

He wants us to go out for dinner soon. He means well. He never much enjoys going out and can't wait to come back home. It's just more work and worry for me.

At my house, I would be busy with my birdfeeders and tending some rose bushes and visiting my next door neighbor. I could cook what I like to eat. I could go out with a friend.

I could do some of that now. It's just a hassle to arrange.

Maybe some new meds would help. I just doubt this doctor is going to take any interest in me.

I appreciate the suggestions.

No, maybe not self esteem, but I don't see you putting much value on the efforts you are making, for a man who doesn't or cant reciprocate in some way. It is a good thing you are doing, but it is coming at a huge cost, your own life (not meaning you plan to harm yourself, but that you aren't able to make some changes to make your own life better). Instead you are choosing, imo, to value his life more than your own.

That's kind of what I did in a way, although it's a much different thing when it comes to a child rather than an s.o. Buttt, I was more concerned with my younger than myself, and that just doesn't work. Also concerned for an ex who treated me like absolute crap. Different situations, but the similarity I see is that you are not taking care of yourself. Since I began really thinking of myself lately, and what I need to do to feel better, I've improved a lot. I used to think this was selfish. I even knew it was not selfish to take care of my health, my own wants, but I decided I was not worth it.
Now I realize no matter how many faults I made with my kids, or ex, or bf, I have worth because I'm doing things that give me a feeling of usefulness.

And I think that is what you are doing. You feel useful, you are needed in this job with your s.o. So the dilemma is, do you stay where your depression worsens, and even when, sorry to mention, he passes, you are left in the situation you are in. Or do you begin to prepare your life for when he is gone? Sounds silly a bit, but me, I occasionally take out a pen and paper and draw. Even if its nothing much. It feels good. And the guitar, this is weird but now I want to be totally honest in the hopes of helping someone. I used to injure myself a bit, nothing major, but the pain made things more bearable in a weird way. Now I pick up the guitar, and the feelings I get through the fingers is enough to make me feel better. You need an outlet for your frustrations, and you are feeling bad that it is your s.o., but thats just natural for that to happen. He's right there, he's the source of your frustration, and then you feel bad that you ranted a bit. Don't.

My dad looked after my mom, almost soley, for years. She had Alzheimer's. She couldn't remember some days what was going on. I feel bad I wasn't there enough, but it is what it is now. He would leave when she was alseep and do his own thing. I sometimes thought "man, that isn't nice", but the reality was she wanted to sleep and he needed to get out. Just to Tim Horton's sometimes. He is friendly, talks to anyone he meets. He refused to go to church because he didn't feel good going without my mom. He really hurt when she passed. And a few months later, he carried on doing what he did before. And made a hard step going to church, with my son by his side, and even i (not liking churches), went. My point being, life goes on, and you must think of what you need to feel better. Sorry this was so long, must be the espresso I drink. Big hugs, you are in my thoughts.

[Rose76]

Confused though I am, I recognise wisdom when I am presented with it. Thank you. I'm not valuing my own life at all . . . and there will be consequences to that. I believe that, the older I am when he passes on, the harder it will be to put together a life for myself that doesn't revolve around him. I'm not young and his needs have already consumed 6 years of my life with him as the focal point. Yesterday I was thinking that it may already be too late. And I've become so lazy.

This seems a cruel fate for me, but I recognize I'm doing this to myself. Right now the attendant is here, so I 'm staying in bed. (The apartment only has two rooms.)

I was awake till 5:30 a.m. this morning . . . then up at 8 a.m. to check on him. Now I want to sleep. But I just keep staring at my device, reading and watching videos. He needs a shower and a shave, 6so those are next on my "to do" list. The attendant can't seem to cope with those tasks.

I'm not as depressed as yesterday. I don't feel as much in crisis. I'm going to try and sleep . . . which I know is partly escapism.