Wednesday, September 11, 2013

Another mental health update

Two weeks ago, I spoke with the psych and told him about my pregnancy and overall results with the Cerefolin. He was pleased with my progress and gave me samples of Deplin 15 to try, and a prescription for the CerefolinNAC that I could fill when the Deplin ran out or if the Deplin didn't work as well.

The Deplin 15 made me super anxious and ragey, (overmethylation?) so I discontinued it. I didn't fill the prescription for the Cerefolin because it costs $4 per pill and is not covered by my insurance.

Instead I researched over the counter options and found Methyl-Life but forgot to actually order anything for a week or so.  I ordered the 2.5mg dose, $36 for 90 pills. I decided to start with that level and bump it up to the 5mg dose by taking two pills if it seemed necessary (the CerefolinNAC is 5.6mg of the l-methylfolate for comparison).

I am pregnant (8 weeks or so!) and of course am going to be tired and emotional, but I think without the methylfolate my brain doesn't work as well and my thinking and mood is more negative overall..

Oh, and I'm still mostly grain free, but on Labor Day, I cheated for my brother-in-law's birthday and mother-in-law's famous corn tortilla enchiladas, with beans and rice (she used GF sauce and left the cheese off for me).

That whole week, I really struggled with anxiety. My thoughts went in circles. I was worried about Curly-Q, about DH, about our new house, about the move, about the new baby, about everything!

I don’t think it was a coincidence that that level of anxiety came on the heels of "cheating" with grains  at my brother-in-law's birthday party, or that I continued to "cheat" for a few days afterward with the gluten-free chocolate chip cookies left over from Curly-Q’s school birthday party.

Between not having the methylfolate and adding grains/sugar back in, it put me back where I started but maybe even worse because I know now the anxiety and depression/dysthymia I was living with isn't normal, and more importantly, what it's like without it!

So finally the Methyl-Life brand of l-methylfolate came in and after a few days of taking it, I started to feel much better.  I started out with the single pill (2.5 mg) dose and then after a few days, increased it to two pills for a 5mg dose.

5mgs is my sweet spot I think. Since starting at that level, I have almost zero anxiety, clear/positive thinking, and an ability to plan ahead and execute tasks.  It’s like l-methylfolate gets me to the place where my coping mechanisms work again!

Saturday, August 17, 2013

Mental Health Progress Report

When I was formally diagnosed with ADHD by a psychiatrist two weeks ago, we discussed trying Wellbutrin but decided to try l-methylfolate first because I’m still nursing Ziggy and planning to add more children to our family at some point.  We also discussed that a grain-free diet may be beneficial.

So I started taking CerefolinNAC daily and began moving to a grain-free diet.  And it is definitely helping improve/lessen my symptoms of inattention, distractibility, problems with executive function, and the anxiety and depression that go along with that.  I kept a food log along with noting changes in the way I feel and noticed definite improvement with the CerefolinNAC and days when I stayed grain-free and an increase in brain fog and anxiety on days when I cheated with grains and sugar.

Day 1:

I took the first dose of CerefolinNAC mid-morning after spending time in the park with DH, Curly-Q and Ziggy.  It felt good to be outside and in the sunshine so early in the day.

It was such a relief to get a formal diagnosis and have a treatment plan and have hope that I might not have to struggle so much to stay organized and worry so much about making careless and costly mistakes or forgetting important things.

All day my mood was very positive all and I was much more patient and felt more connected to my kids, but how much was from the relief, how much from the time outside and how much from the CerefolinNAC remains to be seen.

Day 2:

I wonder how long until I can tell if the CerefolinNAC is working or not? I thought I saw positive effects yesterday but then again it could have been the high of the validating diagnosis and treatment plan and the time outside in the sunshine in the early morning just as well, and I don't know if an immediate effect is even possible.

I gave myself permission to be on the computer for an hour this morning to write this and do other work and leisure activities (for me a significant measure of how well treatment is working will be how much/easily I'm able to pull myself away from screens, in particular the internet).

Later:

I'm noticing today that I'm still checking the computer a lot but it's easier to get up from the computer and get moving again.
I'm also noticing that tackling small messes as I go is just happening without me having to think about it too much, whereas often I get paralyzed wondering what to do first or where to start.

Even later:

I feel pretty good this evening. Not exhausted, physically or mentally, though I was pretty productive today. I got a lot done but it didn't feel like as much effort. Pretty cool

Day 3:

I have a realization/thought that I'm not sure how to express. So I'll just start typing and hopefully it will make sense.

Before beginning this treatment, I was spending so much effort trying to maintain focus/filter out distractions and organizing myself and accessing executive functions of my brain. I didn't realize exactly how much effort that took me to do until now that that effort is lessened.

Before when I walked through my house, I would see things that needed to be done EVERYWHERE, it was like I couldn't filter out anything, and it was overwhelming and exhausting. And I'd try to do too many things at once, fearing that I'd lose focus/drive and never come back to what I was doing. Like I'd walk around with two different things in my hand and try to pick up a third because now or never.

When I feel overwhelmed like that, I'd feel the pull to sit down and go online. To be in the zone where somehow I feel more in control and able to focus. Yes, I'd have lots of browser windows open at a time and follow lots of rabbit trails, but it was fun/calming.
 

Sometimes.

Other times I'd feel trapped by the computer, by the pull to keep reading, click refresh, wanting to get up but also not able to.
 

I'm getting carpal tunnel symptoms in my mousing hand but the pain is not enough to dissuade me.

Does that sound like addiction? Just a coping mechanism for the ADHD? Hyperfocus? Some of all of it?


Day 4:

Today and yesterday too but today especially I’m noticing it’s easier to remember parenting strategies in the moment. It’s also easier to be engaged, proactive and the kind of guiding/coaching parent I want to be with Curly-Q and Ziggy. 

Like yesterday I read something in my MOPS magazine and thought I wanted to try it out and then later that day I did try it out.
 

One of the reasons I decided against homeschooling for Curly-Q was that I felt like I wasn’t present or “with it” enough to be an effective teacher. I knew I’d never be consistent enough to move us through a curriculum and even unschooling seemed terribly daunting because I’d have to be aware of opportunities to strew things and teach her about what we were doing together but we were hardly doing anything together because I was SO distracted and lost in my head that even when I tried to engage her she’d get bored and wander off.

My discipline was becoming so reactive. I’d read suggestions on positive parenting sites to set kids up for success by coaching and talking through social stories and setting expectations ahead of time and it sounded pie in the sky to me. It was like it was so hard to barely keep myself together that I didn’t have mental energy left for all of that.

All that to say I’m definitely feeling more confident about my choice of parenting style and ability to be the mom my kids need me to be.

Later:

I wrote the previous post at the high point of my day, and it started declining from there. By the evening I was feeling exhausted, overwhelmed and having trouble again. Right now I feel anxious and a little defeated. 
At dinnertime I kept getting up from the table to work on packing food for a road trip to the beach we are leaving for in the morning. I don't want to spend a lot of money eating out and don't want to have to worry about food sensitivities so we're going to bring lunch to eat in the car and dinner fixings to prepare at my sister-in-law's family's beach house tomorrow night..

I still have to finish packing and I have a feeling of dread like I’m going to forget something important like I always do.

So my suspects for my decline today:
1. My lunch of bunless hotdog with ketchup mustard and relish. Though I had planned to get water I impulsively filled my cup with Sierra Mist (and I've been low sugar and haven't had soda or HFCS in a while). I also had some of Curly-Q's Minute Maid light lemonade.
2. my lack of rest in the afternoon though I felt like I needed one
3. anxiety about the trip (though which came first chicken or egg, I wasn't feeling particularly anxious until this afternoon)
4. "that time of the month"
5. previous improvements have all been placebo effect in my head and this is it crashing down
6. some combination of the above


Day 7
Back from my trip, it was fabulous. 
After a breakfast of rice noodle pad thai from a package, spent the morning and lunch time on a play date at the splash pad and park with a friend with kiddos close in age to mine. Had a great chat with my friend. 

Went from there to Curly-Q's 'meet the teacher' day-before-school open house. At the open house, started feeling foggy and having trouble keeping track of Curly-Q and her excited antics. Started worrying that the challenging/difficult aspects of her personality will get her into trouble at school and leave her without any friends.
 

Day 8

It was Curly-Q’s first day of school and it was nice to have time at home with just Ziggy and me and he and I had fun together. I did a really good job cleaning my bedroom and was able to easily stay on task. 

That night I went to a Pampered Chef party with my friends and felt super awesome and happy, but though I didn’t eat the gluten-y dessert I may still have had cross-contamination from the things I did eat.
 


Day 9

For all that I feel and function better, I'm not improved enough. I almost got into a collision this morning taking Curly-Q to school. I focused on the people approaching the crosswalk and missed the cars heading my way as I made a right on red. I was honked at and able to pull out of the way, thank God!

After dropping Curly-Q off at school, I walked about 3 miles with some girlfriends, pushing Ziggy in the stroller. For a snack at the end of the walk I had some Enjoy Life fruit and seed mix, and one half of a small gluten free cracker before I remembered that I’m supposed to eat grain free. I may have also accidentally ingested some graham cracker crumbs that one of my friends gave to Ziggy.

This afternoon I’m feeling very tired. I’m also anxious and a little foggy.
 

Day 12

Today I’m looking back at these journals and realize that I didn’t write down the good stuff as much as the days when I hit a hiccup, which makes it seem like maybe it didn't "work."  That isn't reflective of my actual experience I don't think.  The truth is that the good things from Days 1-4 carried forward to all the days.  I'm a better mom, better housekeeper, happier and more resilient person lately.  Overall taking CerefolinNAC has made a very positive difference.   

It feels so amazing to just go through my day without my brain feeling like it’s on overdrive but not going anywhere.  I can just decide to do something and get it done without endless distraction and procrastinating.  Before starting treatment just the basics of keeping my house minimally tidy and clean exhausted me because it took so much mental coaching and coping mechanisms to accomplish.  The past 12 days I’ve been able to get lots of extra projects done that just seemed out of reach before, like without much production, I decluttered a corner of my dining room had been mocking me for months.  I cleaned out the gross area under my kitchen sink which I don't think I've had the mental energy to tackle in the three years we've lived here. 

Often in the past I could do these type of "projects" but the daily stuff would suffer.  Not so in this time period.  I kept all the living areas tidied and vacuumed and kept up with the laundry.  (Granted, having Curly-Q in school helps too).  

I'm better able to focus when I want to and shift focus when I need to.  I still sit at the computer and do things I need to do or just to relax but then I finish and am ready to move on to the next task.  I’m not feeling sucked in or stuck.  It sounds so ordinary but really it is HUGE.  It is so very cool to see such a difference in myself.

All that said, I'm not sure that CerefolinNAC is a complete answer.  I think grain-free and low/no-sugar will be another key, and there may be other supplements like CoQ10 or 5-HTP that might be helpful, or perhaps Wellbutrin could still be an option.
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