Still here

Hello. I'm still alive and kicking. I've been trying to write a post about genetic testing. It's taking me a while to make sense of everything.

Meanwhile, I AM getting up in the mornings! I make my breakfast, go outside on the deck, eat, journal, and read for 30 minutes. Then I come back inside and waste the rest of the day on the computer. That's right, I've been here all along, just not blogging.

I feel so ashamed.

Camp NaNo starts tomorrow, and so my big dreams of completing my thesis will finally come true! I hope.

What does "normal" look like?

"I just wish I could be normal" is the lament of a lot of people who are dealing with mental illness. Well, there's a funny thing about normal, at least from a psychological point of view. The DSM V is 991 pages long. In it there are definitions of all kinds of mental illnesses and disorders from Acute Stress Disorder to Voyeurism (actually from the Index of Psychiatric Disorders for the DSM IV). But there is no definition of "normal."

Google defines "normal" as "conforming to a standard; usual, typical, or expected." Hunh. Conforming. That's an orange alert word for me. Does "normal" mean everybody should look the same, think the same thoughts, believe in the same things? Eric Maisel asks these questions in his Psychology Today blog post, "What do we mean by 'normal'?" and continues the discussion in other posts. 

More relevant to the discussion of mental illness, should everyone feel the same things, react the same way to an event? The fact that many, but not all, veterans of war show symptoms of PTSD means that not all people experience events, even traumatic and violent events, in the same way.

And even normal events aren't experienced in the same way by everyone. I see a movie; I really like it; my sister hates it. Rotten Tomatoes gives it 23% on the Tomatometer. So a lot of people didn't like it, but I enjoyed it.

I think "normal" can be scary. I mentioned in a previous post watching "The Book Thief". It adeptly illustrated what "normal" was in German society at that time. "Normal" was conforming to Nazi beliefs. People who didn't were shunned, imprisoned, and much, much worse.

Today, there are many politicians who proclaim, "We live in a Christian nation." That comes as a shock to me, being Jewish, and having friends and acquaintances who are Muslim, atheist, Buddhist, and so forth. 

For people diagnosed with a mental illness (and by the way, Eric Maisel, along with many others, argues mightily against these labels), it's easy to feel a long way from "normal." But maybe we need to rethink whether "normal" is a good standard to hold ourselves against.

I prefer two other standards: "stable" and "functional." "Stability" means for me no longer being on the wild roller coaster ride of overwhelming emotions. For a schizophrenic with auditory hallucinations, it may mean either no longer hearing those voices, or realizing that those voices aren't real. So definitions can vary.

"Functional" is what works for you. I have been chasing this sleep routine for a while now. I can give you many reasons why I want to have a sleep routine, including: I think it contributes to stability and physical health as well as mental health; it makes it easier to make and keep appointments; and it makes it easier to run errands. 

George Dawes Green, on the other hand, a novelist and founder of The Moth, has learned to live with his body totally out of sync with a 24-hour schedule (USA Today article that I first found on the Non-24 blog). So that works for him.

Why worry about what is normal? What is your "functional"? How do you define "stability"?

Thunderstorm

There is something truly comforting about being snuggled in bed while a thunderstorm rumbles outside. I woke up to a thunderstorm, the rain sheeting off the eaves, the lightening striking far enough away so that I only heard the echoes, not the scary flashes where you wonder if it's going to strike in your backyard. I was safe in my warm bed, wrapping my covers around my ears, thunder grumbling on about something, but so far away that it sounded more like the loud purring of a cat...the susurration of the rain...another reason not to have to get up and move around. I enjoyed it for about fifteen minutes before finally surrendering to the actual need to get out of bed.

Other than that, not much forwarder.

Taking a different tack

So I saw my therapist yesterday, yay, made the appointment two weeks in a row despite my sleep issues. We decided to try to do something different to motivate me to get out of bed and get going. We picked one activity per day that I wanted or needed to accomplish by leaving the house. Hoping that having something to look forward to will help me get up.

My psychiatrist also added Adderall to my list of meds as kind of a pick-me-up for the mornings. Except I haven't filled the prescription yet. So I guess that needs to go on my list of things to get out of the house for.

Other than that, things are about the same. I keep thinking of things that I'd like to do, but don't actually do them.

One thing I really need to tackle is my senior thesis for school. Not having a bachelor's degree at my age is really embarassing. I did the usual graduate high school, go to college route, but I ended up switching schools, switching back, then dropping out because I really didn't know what I wanted.

Looking back, I'm pretty sure that depression had a lot to do with this. I wasn't having much luck getting the support I needed at college. Usually if you go to the counseling center at a college, you will end up with a graduate student. After a short time, they will tell you that they can't help you any more. At Georgetown, this happened after six weeks. They referred me to a therapist "outside", but my class schedule did not mesh with their appointment schedule.

I considered dropping out mid-semester. I called my parents to tell them. My father called me back a few minutes later, and yelled, "How could you do this to your mother?" This was all the help they offered. I ended up deliberately not taking my finals and flunking out of the semester.

I only had another year to go.

Since then I've taken classes off and on at various institutions of higher learning. I have obtained a ridiculous number of credits. Again, depression has made it really challenging. At one point I lost financial aid because of my GPA. My low grades and high withdrawal rate were directly related to depression, not intellectual ability. I even failed a class mainly because I was on trazodone, which made me a walking zombie for a semester.

Finally I ended up as an Environmental Studies major at UVM. I got all the credits that I needed. All that was left for me to graduate was to write a thesis.

This isn't a small thing. But I've been putting it off for...a very long time. I'm supposed to write about two internships that I did. Well, internships is putting it loosely, really. By this time, my advisor has been willing to make all kinds of things stretch. Even she is aware that by this time, I really ought to have a degree.

I still don't feel like I deserve it. I'm afraid that I can't write something good enough. And that's even after I know full well that she is willing to work with me (well, she was as of the last time I talked to her) to get to an end product that is acceptable.

My self-doubt is really getting in the way of this. I'm trying to look at ways to get support for the writing. There's a Camp NaNo (I think I mentioned NaNoWriMo before) in July, and since NaNoWriMo got me through a 50,000-page novella, I'm hoping that I can get some support there to complete this project.

It's funny, because while there are people who understand how important this is to me, there are others who ask me, does this really matter? And that feeds into my self-doubt again. That's why I need to look for support from people who are willing to believe in this.

Well, I think I'm talking in circles here. Mostly I've been living in circles lately. I really, really want to break free.

I've heard this song before...

My sleep is slowly drifting forward again. I'm tracking it on a sleep chart, and the bars look like the tide's coming in. Woke up yesterday and today at 4:30 pm.

Feeling like curling up into a ball of I Don't Care. But I should care, since I told my boss I'd be in today. She's pretty understanding of me missing work, but not as understanding as to why. And she gets pissy if I say I'm going to show up, but don't. As they do.

Also feel like beating myself up. Actually, I'm doing so as I type. One hand on the keyboard, the other wielding the scourge. I'm a failure. Nothing's ever going to change. I'm lazy. I'm whiny. 

And I'm enjoying it, wallowing in it, because I feel that it's just what I deserve. Hurt me some more! It's an endless cycle of failing and making up for failing by beating myself up. But beating myself up isn't going to solve anything in the long run. 

Penance doesn't do anything without repentance. Repentance is realizing that I've made mistakes, and committing to changing them. Maybe not all at once, but maybe a little at a time. And maybe there will be steps backward, like now. But hopefully there will be steps forward as well.

That stuff up in the second paragraph? From a CBT standpoint, Labeling and Jumping to Conclusions.

I feel a little stronger having put this into words. I'm not sure if I'm strong enough to call my boss tonight, but maybe I'll at least do the dishes. And pet the cat we still have. He loves to be petted and snuggled.

Here is a Big List of Pleasurable Activities for you to pick something nice out for yourself.

I lost a pet today...

Not saying this for the sympathy vote, but we had to put our cat to sleep. There is a time when it is the best decision you can make for your pet.

I am sad and grieving, but I am trying to make this about our cat, and not let it link up to every other sad thing that's ever happened to me. Because that's what happens sometimes.

Mostly doing what I learned from Al-Anon and Buddhism: trying to stay in the moment and saying the Serenity Prayer.

Blog goals

Well, writing my last post kind of started me down the road towards depression. That's the damn trouble about examining my feelings, or even talking about them. Fortunately, I had appointments with both my pdoc and my therapist yesterday, and it helped a lot to be able to talk to them about it. I think just getting out of the house and actually making it to the appointments helped, too.

Still struggling with sleep. I have a few little things to do today and I really want to exercise. If not exercise, then at least stretch.

I started this blog with the idea of having an opportunity to vent about depression. It soon became a road map that I was trying to create towards feeling better. I also wanted the chance to reach out to others who are depressed and maybe try to help them.

I have learned a lot of tools for dealing with depression, and I really believe that these tools can work, but only if I bother to use them. And I'm kind of lazy about it. So this is a way to keep me accountable and keep me honest.

I'm depressed, or someone with depression, but the funny thing is, I think that I am basically an optimist. I believe that even after all these years living with this illness, I can get better. At least I've learned that despite the depression, there are still times that I feel okay, and even times of great joy.

I hope that if you are dealing with depression, you can hold on to this.

Depression is not sadness.

I'm getting a little discouraged on the sleep front. It seems as if it's two steps forward, one step back. I'm having trouble falling asleep and I'm waking up later and later. Again.

Probably if I did some exercise it would help. Instead of trying to add stressful things like going to work. Now that I've got a project going on, I need to go in next weekend and work on it.

Not quite depressed but definitely discouraged today. Trending downward.

What is depression, anyway? How do you know when you are depressed, and not just, say, sad or grieving?

There is a lot of information online about the specific symptoms of depression, as opposed to feeling down. Heck there are even quizzes if you want to self-diagnose. I'd recommend discussing the results with a professional.

It's funny, I haven't looked at the clinical definitions in a while until I started researching for this post. When I was working on depression in my twenties, I wanted to try to learn all I could about my illness.

But the first thing I want to make clear is that depression isn't sadness. Everyone feels sad once in a while: maybe because a friend couldn't make it to a date, or you lost a game, or you saw a sad movie. Those are legitimate reasons for feeling sad.

But the thing about sadness is, eventually, it goes away. A different mood takes over, or something else catches your attention. And, poof, no longer sad.

Depression isn't like that. It may start with sad feelings, or be triggered by something sad. But it doesn't go away. It festers. And the sad feeling starts ferreting out all the little memories that made you sad before, and all the little failures, all the times you disappointed someone. It rolls them up into a ball, throws it at you, and knocks you down like a bowling pin. And it's better not to get up, because the ball is ready to go again.

And sad isn't the only emotion present. When I was hospitalized, we did CBT group therapy. I've saved some of the sheets that I got. The first thing you do on a CBT worksheet is to write down the precipitating thought. Then you write down the emotions that it triggers.

There's never one emotion. Here's one of mine: sad, anxious, angry and embarrassed. Here's someone else's: terrified, anxious, remorse, confused, vulnerable.

Remember, this is a response to just one thought. Think of all the little thoughts that you have in the course of one day, and the feelings that they generate. Now imagine that those feelings don't pass. They accumulate into an ocean of feeling, a tsunami heading straight toward you.

How do you fight against that tidal wave of emotion? If you are depression-prone, you shut down.

You. Don't. Feel. Anything. Because feelings, in your mind, are dangerous, toxic. So it's better to shut them out.

There may be periods of sadness, of tears, but a big part of being depressed is just shutting down. Nothing feels good any more. Nothing feels bad, either. It's safer just to stay curled up in a ball.

This is what started happening to me in high school, and has continued for most of my life. The good thing is that I don't feel like this all the time. There are sometimes periods of normal.

The other good thing is that there are treatments. I'm on medication, and I'm in therapy. There are other things that I can do for myself. I've listed some of them here. If you can get support from friends and family, that's another great thing.

I don't get a lot of support from family and friends. I guess I'll talk about that another time.

Here are some articles that talk about the clinical definition of depression, so I don't have to:

National Alliance for the Mentally Ill definition

WebMD article on clinical depression.

The diagnosis of depression is based on the criteria in this fun and entertaining book, the Diagnostic and Statistical Manual of Mental Disorders. It's published by the American Psychological Association and revised every decade or so. The latest edition, the DSM V came out recently, but the info below is based on the DSM IV.

What is the DSM?
DSM IV criterion for depressive disorder diagnosis
DSM bipolar

The diagnosis of mental disorders is controversial. I personally feel that depression is overdiagnosed, and I am alarmed at the increasing number of children who are being diagnosed as bipolar among other things. There are a lot of unknowns in the diagnosing of mental illness. It's not like you can run a culture, or do an ultrasound and say, yup, you're depressed all right. It all comes down to the right doctor asking the right questions, while the patient gives honest answers.

Developing a routine

So I worked yesterday and today. Only about seven hours, but I feel a sense of accomplishment. I think that, while working while depressed can be stressful, not working can make depression worse. My worst depressive episode happened when I wasn't working, back in my twenties. I haven't worked much since, except off and on, like the newspaper job I wrote about the other day. I haven't gone into work at my current job since October. I'm really lucky that my boss is so flexible.

So after getting up early on Friday, I slept ok Saturday, but after working I "forgot" to go to bed on time, and slept until noon today. Didn't do my morning sunlight this morning either. It's so easy to get off schedule for me.

I think that having a routine is helpful for coping with depression. Varying from a routine occasionally is okay, but not having a routine is really throwing me off kilter all the time.

At one time, I considered myself one of the "creative" people, and as a creative person, I felt I should live a bohemian life and sleep until noon, party all night. Things like having a routine were for normal, bourgeois people, not artistic folk like me.

A lot of writers have shared what they know about the writing process, and most of them agree that a writing schedule is essential. Routine is a way to avoid demons that plague writers, such as procrastination and writer's block. So, so much for my notions of the creative life.

So I am hoping to develop more of a routine in my life. That's why I've started with the whole sleep thing. And the eat breakfast outside thing. Maybe I can add more elements this next week.

My parents couldn't be more different when it comes to routines. I think that my dad maps out his week hour by hour. Most of it is the same every day. For example, I have observed him in the morning when he wakes up. He prepares his oatmeal and puts it in the microwave. Then he goes to the bathroom. Then he goes outside and gets the paper. He eats and does puzzles in the paper. After a while, he makes my mom a cup of coffee and brings it back to her (which is sweet). Then he takes his shower. So goes his day. If he has times when he has to differ from his normal routine, he makes lists. He checks off the items on the list as he gets them done.

My mom has zero sense of time. She gets up whenever, and stays up late reading or watching TV. A lot of times she falls asleep while doing this. She'll say something like, I have an appointment at 10:00, and then spend the half hour leading up to the appointment doing something entirely different, until it is 9:58, at which time she freaks out and starts rushing around getting dressed, finding her purse, forgetting something, rushing back for it, and so on and so forth. She's kind of like the weather down here, which can be calm and tranquil one minute, and a raging, tree-shaking thunderstorm the next.

Of course, I generally take after my mom, although I'd like to think that I have a better sense of time than she does. Most of the time. Maybe. I don't think I'd like to be as precisely scheduled as my dad, but I think I can maybe learn a lot from him as far as routine goes.

Weird sleep and work

Just a short one today...I have a few posts in the wire but I need to flesh them out. I woke up at 5:00 am this morning after a restless night, and I decided, what the heck, might as well get up. So my task today has been staying awake. We'll see about tomorrow. Maybe I'm approaching something like normal sleep. Wouldn't that be exciting?

I'm enjoying my mornings dining al fresco on the patio. It's not too hot early in the morning, and the birds are delightful to hear. This morning it turned out to be one bird, but he was taking requests, so he sounded like a whole forest full of different birds.

I'm going in to work tomorrow for the first time in a while. I do odd projects for a friend of my mom's. Mostly catch up work, organizing files for her office. The place is very laid back and I don't have set hours, although my boss kind of appreciates it when I come in when I say I'm coming. So hopefully I won't sleep the day away tomorrow, and will actually come in as promised.

So while staying awake today I watched several Mystery Science Theater 3000 episodes with my sister. Some of the comments make us laugh so hard we have to pause the video in order to breathe. The show is not for everyone, and some of the references are a bit dated now, but I love it, and I've exposed several people in my family to it as well. It's contagious!

Laughter is good for depression. If you can find something to laugh at, do it.

Therapy and more sleep stuff

First off, a correction. The book that I read about CBT was not  Cognitive Therapy and the Emotional Disorders, although I believe that this is the first published book on the subject. The book I read, and used pretty often, was Feeling Good: The New Mood Therapy, by David Burns, MD. It looks like it's been updated, so it probably has information about the SSRIs and other medications that weren't on the market when the book was first published.

This is Dr. Burn's website: http://feelinggood.com/

Second: Apparently my body currently needs 13.5 hours of sleep. I once again went to bed at 8:00 pm, and woke up at 10:30 am. I probably didn't fall asleep until 9, and I definitely woke up at 4 and was awake for at least an hour, so maybe less. But anyway, I'm still on some kind of schedule, and I am still hopeful that it will get better as I stick to it. And I'm still doing the 30 minutes of sunlight thing.

Also, complete disclosure: I was worried that since I'd slept so late, I'd have trouble falling asleep at 8:00 pm, so I took a Benedryl to help me fall asleep. I use these sparingly, and with my psychiatrist's permission. Desensitization, meaning the drug no longer has an effect, can occur in as little as three days in a row. The drug is not recommended for people over 60, as it can exacerbate dementia. Consult your doctor for more information.

Today was therapy day, and it went well. Some goals achieved, some not, some things not on goal list accomplished. I meant to talk to her about CBT but I forgot.

Also, I've been writing this blog for three weeks now. I'm pretty pleased with myself for keeping up with it.

Self-flagellation: putting the whip away

I woke up late this morning. My phone alarm did its part. It jingled politely at 7:00 am, then again when I reset it to 7:30 am, and even when I ignored it at 8:00 am. So I can't blame it for my oversleeping. I can say that despite falling asleep at around 8:00 pm, I wasn't awake enough to get out of bed at any of those times. I finally arose at 10:30 am, loaded with guilt, anger, and fear. I felt guilty at not getting up at 7:00. I felt angry at myself and beat myself up for not getting up. I felt afraid that I was repeating old patterns (not so old, really) and that I was a failure and would never get better and who was I to think things could get better after so many years of things being the same?

I got a little saner while I made my breakfast. I reminded myself that I haven't always been in a crazy sleep rut. And that there were times that despite the sleep rut I was still able to go out, have a good time, enjoy life.

By the time I got outside, having talked myself out of "well, I might as well give up on the whole sunlight thing, that's another hopeless avenue of well-being, I started remembering little tidbits that I've learned of cognitive behavioral therapy.

Most of what I've learned about CBT came from working on it in group settings in hospitals or day treatment programs. You fill out the sheets, identify the cognitive distortions, and try to replace them with alternate ways of thinking.

The idea is that after a while, challenging your emotional responses to situations becomes more natural. I couldn't remember all of the cognitive distortions that I was having in my thoughts, but I knew that one of them was all-or-nothing thinking: thinking that what happened today was always going to be the way it was.

I actually felt a little better after that.

I ate my breakfast, wrote in my journal, read a little bit of the non-fiction book that I have been attempting to finish for about three years now, and wished that it was earlier because the sun was really hot at 11:00 am.

I'm putting this out there because I've learned a lot of tools to get better, but I have a hard time remembering them and practicing them.

I've also had a hard time finding individual therapists who are willing to work within the CBT framework. A lot of therapists I've worked with have claimed the "client-centered therapy" stuff, meaning that they let the client choose the direction that therapy goes. Apparently that means that even if I request CBT, and they are trained in CBT, they will still be willing to drop the whole thing if I don't do my homework or come in in crisis, or for any other reason.

Sigh. Maybe I need to fill out a worksheet on this.

Because I was planning to write this, I looked up some links that will better explain CBT to people unfamiliar with it:

Aaron Beck's Cognitive Therapy and the Emotional Disorders. This is the classic, first text on CBT, published in 1979. It was my first exposure to CBT. There are many other books and workbooks on the subject, and this may be a little difficult to read. But I wanted to put it there for historical purposes if nothing else.

Article from PsychCentral.com on cognitive behavioral therapy.

Nice printable list of cognitive distortions from Therapist Aid. They have some other good worksheets and information about CBT there, too.

Lazy day...

but at least I got up this morning. And did my 30 minutes of sunlight. Then I was a vampire the rest of the day. No, I don't sparkle in the sun. I think I might be a bit sunburnt on the back of my neck, though.

So nothing really major in the think tank.

Tune in tomorrow. I won't sparkle, but maybe I'll scintillate.

Putting my sleep disorder in order

I decided to try and maintain my sleep schedule by doing light therapy in the morning. A sleep doctor I saw gave me a handout which, among other things, prescribed 30 minutes of sunlight upon arising as an effective way to get my sleep in sync.It helps the body generate melatonin, a natural hormone that regulates sleep. Some people also take melatonin supplements. Those you take at night before going to sleep. I'm thinking about doing that too. One thing at a time.

In any case, it was a pleasant morning, early enough that it wasn't yet too hot and humid. It helps that we get the tradewinds here, so it was breezy, the wind rustling through the palm fronds and making the wind chimes softly ring. I ate breakfast, read a little bit, and wrote in my journal. So even if it doesn't help with sleep regulation, a nice way to pass the time as opposed to lurking inside the house all day.

I seem to need a lot of sleep. I've been diagnosed with sleep apnea in the past, and been on a CPAP. Here's something about CPAPs: they are a lot more trouble than the doctors think they are. At least that's been my experience. It's difficult to adjust to the mask, the whole "air blowing down your throat thing" which of course causes dry mouth, among other things. When I complained to my doctors, their response was "put up or shut up." Fortunately I found a local support group, and discovered that I was not alone in having problems adapting to the equipment. In other words, some doctors are a**holes.

I recently had another sleep study, which is when you go in overnight to a sleep clinic and they hook you up to numerous electrodes, point a camera at you, and expect you to get a normal night's sleep. Analysis of the results showed that I don't currently have sleep apnea, but I do have "poor sleep hygiene." Not that they told me what to do about that, but fortunately I have reams of information about sleep hygiene from the previous sleep doctors.

I also found a great website on sleep disorders, with forums and everything. Unfortunately, I can't seem to find it now. But there is a lot of information on sleep disorders at Medline Plus.

American Academy of Sleep disorders provides this fact sheet on different types of Circadian Rhythm Sleep Disorders (pdf), along with general treatment guidelines.

New website from the National Sleep Foundation Non-24-Hour Sleep-Wake Disorder

Website sponsored by Vanda, a Non-24 Sleep-Wake disorder drug. You may have seen their TV ads. Apparently this is a chronic problem for the blind.

Comments?

Someone told me that they were unable to post a comment on my blog. If you have a burning desire to comment, or even if you just want to say hi, and can't get the comments to work, could you please email me at vtmima3@gmail.com? I'm trying to figure out what the problem is. I'd love to have feedback on my words.

Thanks.

Holding on to last year's accomplishments

Kind of a lazy day today, after the high energy of yesterday. I'm still getting up early and going to bed early.  Huzzah!

I want to manage my life to the extent I can. I want to live with the illness, not in the illness. The more stable I can get when I'm feeling better, the easier it will be to cope with the depression when it comes. Part of me always hopes that it will never come again, but part of me knows that it will. But I think that if I can work on the things I listed in a previous post, that maybe when the depression hits it won't be as bad and won't last as long.

The trouble is that I'm not very good at keeping up with things even when I am feeling better. I am very good at abandoning projects, especially when the project involves taking care of myself.

Last year I challenged myself and succeeded in three things. I failed at other things, but these things I did. I helped my daughter when my granddaughter was born. I feel that we bonded over that, and started to mend a relationship that has been sometimes rocky. It's not easy raising a child when you're depressed, and it's not very easy being that child, either. More on that another time, I think.

The second thing I did was complete one of three classes in the Florida Master Naturalist program. This isn't a Master's degree program. It's like becoming a Master Gardener. You gain a certain amount of knowledge that you can share with others. It was 8 weeks of Saturday classes from 8:00 am to 5:00 pm and I am really proud of myself for getting through all those Saturdays. I also hope to complete the other two classes. They come up periodically in this county, so I have to jump in the next time I get the chance.

The third thing I accomplished last year was writing a novel. Really a novella, and it's a very rough draft that I may never actually revise. I participated in National Novel Writing Month, or NaNoWriMo as it's affectionately called. The goal of NaNoWriMo is to write a 50,000-word novel in 30 days. It doesn't have to be a great novel, it only has to be started on November 1 and completed by November 30. There is a lot of online support, and we also had a local group that met face-to-face at least once a week. I'm amazed that I did this, and completed it on time.

So these were the things that I did not abandon last year. I hold them dearly as reminders that not everything I do turns to crap. This year is half over and I haven't really set goals. Not big ones. Just small ones. Maybe that's enough for now, to do the small stuff to take care of myself, get healthy, and stay healthy.

But I also may write another novel.