This is my summation of my research, and some personal opinions gleaned from a lifetime of mental illness:
Part Three:
Due to the length of this treatise, I am skipping the different types of psychotherapy and just saying that your therapist and your psychiatrist should communicate and be on the same page. As for the patient. Complying with treatment including psychotherapy is key to recovery or management, whichever you prefer. Also, if you are going through a tough life event, it is a good time to talk to your doctors about your medication needs and you therapy needs. You may need to add a medication or increase you already take, and you may need to see your therapist more frequently until you feel that you are safe, and can handle the situation.
In closing, Bipolar Disorder in all its various forms, manifestations and severity of symptoms is a rollercoaster ride. I tend to compare calm times to being on a long frequency sine wave where you rock gently through the ups and downs, and episodes both depressed and manic as being on the Richter scale. Then you are like an earthquake, and you never know what devastation you will leave in your wake. Hopefully, you never go higher than a 2.0 earthquake because then real damage can be done. Having Bipolar Disorder, in my opinion, requires a level of inner strength that is difficult to achieve because you will lose friends, you will lose husbands and wives, lovers and partners, jobs, and a sense of who you once were. You will question your self-worth, and your worth to other people. It is a devastating disease. It takes and takes, but will never give back. That you have to learn how to do on your own. It is a very needy disease that wears out everyone including the afflicted person. Even if you have the best doctors, and you have the disorder mostly managed, it is usually at a great cost to a lot of people including you. It can be a very lonely illness. But, this is not to say that it is a hopeless situation. You can manage it, you can find friends who will understand or will be willing to learn about it, you can find partners that are understanding that it’s not you that is acting out of sorts, it is the disorder. It is possible to rebuild your life with sympathetic people who will be there when you really need them, and they will understand that you are going through a rough patch, and need help. So, all is not lost as I once thought, and I would imagine other people have felt upon being diagnosed. If you choose to educate yourself about the whole thing, medication, therapy, mood swings, etc. you will know what you are fighting, and you can get the better of it.
BiPolar – What’s Up? – Dunno, I’m kinda Down (Photo credit: Creativity+ Timothy K Hamilton)
I am sure that most people in the Bipolar world have heard of Julie Fast. She has been living with Ultra Rapid Cycling Bipolar II with psychotic features for about 15 + years. It’s not that far away from my own diagnosis of Bipolar I with psychotic features except i am usually in a mixed state which is just the worst. You are the most motivated depressed person and the least motivated manic person. They sort of bleed into one another.
Anyway, the book is Bipolar Happens! and it has a very unique outlook on managing Bipolar symptoms such as anxiety (I knew there was a connection), depression, mania, paranoia, and other subtle symptoms of Bipolar.
She starts the book with that familiar saying and complaint: “I just want to be normal.” She states that people are often taken aback by that statement. People often ask “What is normal?” or “is anyone really normal?” which personally I would find somewhat offensive because there is such a thing as “not normal.” She states it is not normal to not be able to hold a job for more than two years (hmmm, been there), or taking 8 years to finish college (hmmm, been there too). She says it is not normal to hear voices that tell you that you are worthless and you should just die.
She states in return to these statements that everyone is abnormal to some degree, but there are normal people out there. She knows that because she knows what it means to be NOT normal as I suspect many people with mental interestingness would attest to. She points out that “normal” people think about one or two thoughts at a time, not twenty (flight of ideas) whirling around inside your brain. Ms. Fast writes that it is not normal to break down every behaviour looking for the negative meaning. It isn’t about hearing voices that tell you that you’ll never amount to anything so why bother trying (I have experienced those voices for many, many years, and I would dare say that most people with Bipolar have also to some degree).
One thing that really resonated with me is her writing that normal people live day-to-day while Bipolar people have a tendency to live in the past and feel that there is no hope for the future. I am guilty of that. Especially of reliving my childhood where I was a weird kid, but not a Bipolar person, yet.
She writes a great deal on depression and how to combat it in the book (maybe because women are more likely than men to have depressive episodes). One thing that she talks about that I had already discovered on my own is how truly beautiful this world is. Instead of walking with your head down looking at all the garbage this world produces, look at the sky, the bees collecting nectar, the unsual arrangement of pots that make up a planter; of course it helps if you don’t have a car, but I have seen more beautiful things that I would have missed had I been driving. I have met some very interesting people as well.
She asks the question: are you looking up and seeing the beauty of the world and feeling better, or are you looking down and letting depression get you? I know it is hard when you are in the throes of depression to see any beauty in anything, however I have found that getting outside and walking can be very spirit lifting. Basically, she says you have to tell the depression NO! and fight it like an enemy. She suggests writing down the symptoms of your depression so you will know it is the illness talking and not something else. Basically, you have to learn your behaviours so well that you can feel them coming, and you can take action to stop them.
Another topic she writes on, which I think is terribly important, is for your friends and family to be educated about the illness so they can see when you are ill, and take steps to help you rather than as one person I know put it when I asked them to take me to the hospital, “I am so sick and tired of all of your drama and chaos!” That wasn’t what I needed to hear from that person. If a Bipolar is asking to go to the hospital, just take them. They know what condition their condition is in, and they are asking for help not being screamed at. At the time of the above occurrence, I had all my meds lined up in a row an the counter in the bathroom, and I was wondering if I had enough to kill myself. So, yes, I think it is extremely important for those who care about you and whom you care about to be educated about this sometimes fatal illness.
She writes on how to recognize the early stages of a manic episode and how to stop them. Of course, this is very personal in how the mania manifests itself. The are a myriad of ways that mania can insidiously crawl into your life. And, it can be a very destructive force in relationships, financial matters, work place etiquette, etc. It is important to know what triggers your manic episodes.
Basically, this is a fast read, and many of the techniques she describes are ones I have tried and been successful with. If you had asked me 5 + years ago how I was doing, I would have had to lie, and say fine. And, since I am really good at hiding my illness from others, people believe me, and are then rather shocked when I become so depressed I can’t get dressed or bathe. However, I find that sticking to a regular sleep cycle, always taking my meds, trying to eat right and exercise, and doing things I enjoy seem to help. All are mentioned in her book. I guess when you have been an untreated bipolar for 15 years and treated for 11 years, you sort of work out your own “health” plan. I do, however, recommend this book. It is short, simple and to the point. And, it makes a lot of sense. She does not claim to be “cured” just very well managed.
English: signs and symptoms ptsd (Photo credit: Wikipedia)English: Emil Kraepelin (Photo credit: Wikipedia)
Since I suffer from both Manic-Depression and a couple of anxiety disorders (PTSD and Panic disorder with and without Agoraphobia), I was curious as to whether anxiety is a symptom of Manic-Depression or if it is a completely separate diagnosis. What I found were conflicting opinions on this subject. Most of my research on this subject came from the Journal of Affective Disorders v. 68, issue 1.
In 1921, Dr. Emil Kraeplin originally described the illness Bipolar depression, and declared that anxiety is a symptomof the illness. He described it as an “anxious mania” or an “excited depression.” However, he described anxiety as a specific symptom of Manic-Depression. All of this needed qualifying as anxiety is not generally thought to be one of the symptoms of Manic-Depression.
However, as reported by Freeman, Freeman & McElroy in a study done at the University of Cincinnati, Biological Psychiatry Department, Department of Psychiatry, anxiety is found both as a symptom of Manic-Depression and as a separate disorder. They state that “symptoms of anxiety as well as Anxiety disorders commonly occur in patients with Bipolar disorder. However, the pathophysiologic, theoretical and clinical significance has not been widely studied.”
Their methods were to study the existing literature on the subject compiling information as they went. They examined the epidemiological and clinical studies that have been done on the overlap of Bipolar disorder and Anxiety disorders with their main emphasis being on Panic disorder and Obsessive Compulsive disorder or OCD , and to a lesser degree Social Phobia and PTSD. Data on potential neural mechanisms and treatment response were also reviewed.
What Freeman, Freeman, & McElroy found was that an increasing number of epidemiological studies have determined that Bipolar disorder significantly co-occurs with Anxiety disorders at a higher rate than in the general population. Clinical studies have also demonstrated a high comorbidity between Bipolar disorder and Panic disorder, OCD, Social phobia, and PTSD. They state that psychobiological mechanisms that may account for the higher rates of Anxiety disorders in patients with Bipolar disorder, and that they like involve a “complicated interplay among various neurotransmitter systems. particularly Norepinephrine, Dopamine, Gamma-aminobutyric acid (GABA), and Serotonin, The studies further theorize that secondary messenger system, Inositol, may also be involved. Not knowing what inositol is, I did some further research. Okay, that was fascinating, however, I did not realize that I would be delving into some very complex neural chemistry involving molecules, cell membranes, and what not. The researcher, Earl Wilbur Sutherland, jr., who discovered the “secondary messenger” system in the brain won the Nobel Prize in Medicine in 1971, and the two researchers, Martin Redbell and Alfred G. Gilman, who discovered the mechanisms for the secondary messenger system won the Nobel Prize in 1994. So, having been raised by a man who spent his entire research and teaching career investigating the nature of cells or “histology,” I can sort of get what they are talking about with the cellular stuff, but the chemistry is beyond me. All of the following is from Wikipedia with notations of the researchers where possible.
So, I’ll start with Inositol. Inositol is a carbohydrate though not in the classical sense of a sugar. It reportedly has a taste about half that of table sugar. “Myo”-inositol plays a very important role as the structural basis for a number of “secondary messenger” systems in eukaryotic cells (an organism with a nucleus and other structures contained within a membrane; they first developed about 1.6-2.1 billion years ago).
Now, I am going to try to explain what a “secondary messenger” system is. First of all, the neurotransmitters Dopamine, Serotonin, Norepinephrine, etc. constitute the “primary messenger” system. The “secondary messenger” system is composed of molecules that convey signals from receptors on the cell surface to target molecules within the cell generally located within the cytoplasm or nucleus of the target cell. They relay the signals of hormones such as epinephrine (adrenaline), growth factor and others, and cause some type of change within the target cell. These molecules also greatly amplify the strength of the initial signal. There are several different secondary messenger systems, however, they are all very similar in mechanism. In all cases, a neurotransmitter binds itself to a membrane-spanning receptor protein molecule (in other words, the neurotransmitter has locked itself into a receptor cell much like a lock and key. The receptor cell is membrane-spanning in that there can be transference between the neurotransmitter and the receptor). The binding of the neurotransmitter to the receptor changes the receptor and cause it to open a binding site for a g-protein (don’t ask me) which is a transducer, or a “signal” molecule that operates much like a switch does. The g-protein is either GDP or GTP which are respectively, guanosine diphosphate and guanosine triphosphate. Now we are into the chemistry, and I really have no clue, but this is how it works. Once the g-protein is bound to the inner membrane of the cell, it creates three subunits: alpha, beta, and gamma. It is then able to exchange a GDP molecule for a GTP molecule. Once this has occurred, the alpha subunit breaks free from the beta and gamma subunits and is free to travel around the inner membrane of the cell it has bound to; the remaining beta and gamma subunits remain membrane bound. The alpha subunit eventually contacts with another membrane bound protein (the primary effector) and this produces an action that creates a signal that can diffuse a cell or, in other words move across the membrane. This signal is called the secondary messenger system. Now that we are all confused (remember the scientists who worked all of this out won Nobel Prizes) let’s go back to inositol and its potential psychiatric uses. Continue reading →
I have been inspired today by several other blog posts I have read to think about the nature of spirituality and it’s healing and restorative properties. While I think it is important for anyone to have some sort of spiritual faith be it Christian, Catholic, Buddhist or Wiccan, I have no prejudices concerning people’s choice of spirituality; whatever works is what you should do.
I happen to follow a sect of Buddhism (there are literally thousands of sects) known as Nichiren Buddhism which emphasizes that you and you alone are the source of the struggle or hurdle that you are facing, and only you can come up with a solution through chanting “Nam Myoho Renge Kyo” which loosely translated means Devotion to the Mystic Law of the Universe and the simultaneity of cause and effect (“Renge” means lotus blossom which seeds and blooms at the same time) through the vibration of sound. It tends to become very meditative if you chant for a while which is not dissimilar to Zen Buddhism that teaches that one must clear one’s mind and life of earthly desires to achieve enlightenment although Nichiren Buddhism does not state that you must give up earthly desires in order to reach enlightenment.
The whole goal of Nichiren Buddhism is to reach a state of “Buddhahood” in which one understands the nature of all things, and is indestructibly happy no matter what gets thrown your way. In fact, if you are practicing correctly and are following the correct path, then obstacles will get in your way to test your faith. Nichiren Buddhism views these trial and tribulations as a means of growing spiritually, and are to be greeted with joy as opposed to sadness or despair.
Nichiren Buddhism is an inherently humanistic “life philosophy.” It teaches that you practice for yourself and for others (others being the rest of the world), and that everyone regardless of their station in life is worthy, and deserve respect and compassion. When you put these ideas into practice, your environment changes around you. As you become closer to being “enlightened” and you develop a character that cannot be brought down, your reaction to the things that occur just because you are a human become less severe, and more understanding of other people’s inherent rights to be treated with dignity. You become less judgmental, and more accepting of people in general. It is hard to explain. But, it works for me, and about 200 million people practicing in 192 countries. Another idea that is very important and is essential is known as “Dependent Origination.” In other words, we are all interconnected in one way or another with other people and the Universe that nourishes us. It is really hard to explain why this philosophy works for me, but I know I have become happier, more resilient and the episodes of mania and depression have lessened.
It does not matter what faith you follow. It is the act of engaging in spiritual activities on a regular basis is what I believe is important. Being a member of a spiritual group be it Buddhist, Christian, Catholic, Judaic, or Taoist can provide you with a sense of feeling grounded, it also provides social contact, it can provide a social support network (if you feel that you can trust people to not judge you for your struggles); some of my best friends are members of the SGI (Soka Gakkai International ~ means “Value Creating”.)
People of faith tend to be supportive of one another, and if they practice true to the values of their chosen faith, they are respectful and compassionate towards all people. The only real difference between the “People of the Book” and Buddhism is that Buddhists are taught to follow the teachings not the teacher, and that Buddhahood is within you, you just have to find it, whereas the “People of the Book” have an external sense of the divine. Buddhism is all you, your causes and your effects, your obstacles and your method of overcoming them, and Christians have God and Jesus’ teachings to follow, but believe in an external higher being. In Buddhism, you are the “higher power,” you just have to find it. No matter what works for you, I have found that many people with mental issues who are also deeply spiritual seem to have better outcomes, and a more positive way of managing whatever their life or their mental issue throws their way.
Buddhism is part of my three pronged attack on my mental health problems: Buddhist practice, a psychiatrist who is extremely good with medication and is not heavy handed with it, and a therapist who has become a lifeline. These three things keep me relatively sane. They also keep others around me relatively sane as well.
So, I highly recommend that people who suffer with mental issues find a spiritual belief system that works for them. It will keep you grounded, enable you to weather the storms when they happen, provide social contact, and provide a network of people you trust to help support you when things aren’t quite kosher. But, that is only my experience and perspective. It is not written in stone or any medical journal that I know of 🙂
I just could not stomach the idea that this was a life-long illness that has no cure. It is only treatable; sometimes successfully, other times, not so much. It can be managed through medication, therapy (long-term, in most cases), and in my opinion, some sort of spiritual faith that keeps you grounded (it also provides a social circle, and, in some cases, wonderful people who lift you back up if you stumble). But, it is, in my opinion and experience never “under control”. It is simply well managed.
One of my last two trips to the psych ward involved a heavy duty overdose of two completely full prescriptions for Geodon (an atypical anti-psychotic) and Wellbutrin (a popular anti-depressant for Bipolars). I think I swallowed about 27 Geodon and about 25 Wellbutrin tablets, then sat back to wait. I was determined that this time I was going to get it right. I would not under any circumstances call 911, I would not call my mother or my best friend; this time I was all-in. Until the consequences of my actions began to take hold. I began to question whether I was really all-in or not, because the fact of the matter was that I was dying. This time I had really f*&^%ed up, and had taken lethal doses of both medications. I don’t remember a whole lot of what followed, but I have to assume I called 911 and told the operator what I had taken. Seriously rapid response time for the paramedics. I had never seen them get anywhere that fast. Of course, the police came. I was coherent enough to remember a female officer asking about a knife that I used as a letter opener, and whether I had ever cut myself. I told her no. I do not like pain of any kind. That’s why I swallow pills. However, my will to live is too strong.
This particular attempt scared any desire to attempt suicide ever again no matter how dark the tunnel I was in seemed to be right out of me. Initially, I was relatively coherent, and responsive. They quickly hooked me up to 8 separate IV‘s to flush the drugs I had taken, and by now were in my blood stream (which meant they were cycling through my brain). Very slowly, total paralysis from the neck down began to set in. Oh, and the entire emergency room and all the people in it turned a fucshia pink. Neither of those symptoms were okay with me. I couldn’t move at all, and I was becoming psychotic at the same time, and I knew it. It is the weirdest feeling I have experienced on this “ride.” I was totally psychotic, broken from reality, but I knew that I was psychotic and nothing I saw or heard could be trusted. I mean, honestly, fuschia? Being psychotic is fine, but let’s leave out the color changes; they are too weird for me. So, all these hot pink people were doing everything in their power to save my life, and I do mean that. I was so close to dead that if I had called 911 any later, I probably would have succeeded.
So, no s*&^, there I was completely unable to move any part of my body except my head, hooked up to at least 8 IV’s and having to pee every 5 to 10 minutes. The extremely nice hot pink nurse’s aides would do their best to get me up to the small portable toilet they had near my bed, and this went on for what seemed like hours. I lay there fully aware of my psychosis, and pleading with the powers that be to allow me to just wiggle a toe. It didn’t seem like a whole lot to ask. I spent 30 minutes just trying to wiggle my big toe, and then the miraculous happened! My toe wiggled and I was the one sending the electrical impulses from my brain. All was not lost after all. Slowly, I began to move other parts of my body. I was going to be okay, at least physically. I had no idea what I had done to my brain functioning. All I knew was that hot pink people were not normal.
I was transferred by ambulance to the psych ward of the same group of hospitals. During the ride there, I made a vow with myself and the Universe that if I were lucky enough to come out of this with no lasting effects, I would never try again. That was five years ago, and while I have had suicidal thoughts up to the point of lining the pill bottles up to see what was left and if a cocktail might do the job, I will never break that vow. Something very bad will happen if you break vows with the Universe as a whole. No one really knows what’s out there, and I am not willing to find out.
After being shuttled through the psych emergency room, I was placed on the ward as a suicide risk. They locked the door to my room if I wasn’t in it, and even worse, they locked the door to the bathroom both night and day. The meds I was on were extremely dehydrating so I drank a lot of fluids, and the door to the bathroom was locked. That, at the time, was high on my irritant Richter scale. I was on “suicide watch” for about 3 days.
In the meantime, I watched the walls swirl and warp into pretty patterns, and asked the psychiatrist if she saw ants marching in formation on the floor. She said no, but I could plainly see them. As far as I was concerned they were real, but here’s the caveat, I knew at the same time that they were not real. It is real strange to know you are psychotic. You are not supposed to know that your reality is different from other people’s. But, I did know. Some part of my brain was still functioning normally while the majority took a little trip. Yea!
I am happy to say with a great deal of gratitude and indebtedness that I have only been back to the hospital once in these past 5 years. Apparently, the Universe heard me, and has held me to what I promised. I still cycle far more often than I would like, but at least now I understand more about what signals the onslaught of an “episode.” Depressive episodes are usually precluded by a great deal of agitation, restlessness, and bouncing from activity to activity with none of them holding my interest for very long. So, knowing that, I can head it off at the pass by having my psychiatrist renew my anti-depressants or up something or lower something. The manic spells I just don’t really have them much. However, the same agitation and restlessness are there but it is accompanied by a great deal of highly focused activity usually writing. So, this blog is fueled by rapidly changing highs and lows. Manic-Depression is……well it is what it is and it is different for everyone. There is no typical mentally “interesting” person. And, I find that makes the world an even more wondrous place even if it is filtered through a now stable madness.
Okay, for anyone who doesn’t know me or my blog: I have rapid cycling Bipolar type I with psychotic features, PTSD, and Generalized Anxiety disorder with and with out Agoraphobia, oops, forgot Adult ADD. Basically, all this means is sometimes I can’t leave the house without having a panic attack, I am very jumpy, hyper-vigilant, and can recall the incident that caused the PTSD vividly in both the first person and the third person. It has been 24 years, and while I largely do not think about it, I do have dreams every now and again. It is part of my past that I live with much like the Bipolar type I with psychotic tendencies diagnosis. The whole purpose of this blog is to help me better understand how to manage this illness, and to let the reading public know that we are just as ordinary as they are.
Okay, so Rapid Cycling Manic-Depression is a symptom of the illness in which the Manic-Depressive experiences 4 or more distinct episodes of either depression or mania within a year. That‘s the “official” explanation. People with Rapid Cycling Manic-Depression can cycle faster. I find that I tend to cycle faster when I am under extreme duress like I am now. That’s a whole other story altogether. Maybe I will tell it when I stop crying about it. I actually diagnosed myself with Rapid Cycling Manic-Depression because after reading the symptoms, I saw myself in those pages. I tend to cycle very rapidly. I have roughly 7 or 8 major depressive episodes per year, and about 3 manic episodes. I usually write when I am manic. Most of my blog is fueled by mania, and partially by severe, bone crushing depression which has recently been the case.
Rapid Cycling Manic-Depression is often very difficult to diagnose because the patient usually presents in the depressive phase. Frequently, a diagnosis of Unipolar Depression is given, and the doctors set about treating the depression which can paradoxically cause a manic episode. More women than men present in the depressive phase. My guess is that the manic or hypo-manic high feels good for a while so men don’t see the need for treatment, but there is always the crash, and it is painful. One day you are on the top of the world, and the next you are crying and depressed for no real apparent reason.
I, myself, presented in the depressive phase along with Agoraphobia. I hadn’t been to work in 11 days. I refused to speak to my supervisor. I left voice mails to say that I wouldn’t be in that day. I eventually lost my job due to the fact that I missed so many days of work. I had not yet been diagnosed with Manic-Depression type I with psychotic tendencies. I knew from previous experiences with severe depression that this was not a normal depression for me. I have been having major depressive episodes since I was in Grammar School, and this was not like any of those. I was paranoid, and I couldn’t leave my apartment for fear of a panic attack. I was paralyzed with depression and fear. This wasn’t right or normal for me. I always went to school, and even completed college (albeit on the 7 year plan). The Agoraphobia was new and different. Different enough that I compiled a list of psychologists, and sent it to my primary care doctor to see if he knew of any of them. I wasn’t going to be tossed around between different docs like I was in my teens. I wanted someone who could understand me, and understood what was happening to me. I was, at this point, 31 years old and had been an untreated Manic-Depressive for about 14 years. I was always treated for depression.
As it turned out, one of the therapists on the list had worked under my Primary Care Physician, and he recommended her to me as I am pretty eccentric, and so is she. She also happened to specialize in mood disorders. So, on 09/03/2003, I drug my depressed, agoraphobic self out of my apartment, got in my car and drove to her office which was a lot further than I wanted it to be. C’est la vie. I spewed out everything that I had been through as a teen, as a pre-teen, and as a child to her. I really do not where it all came from, but I sensed that maybe this was someone I could finally trust. She seemed very, very bright which for me is essential since I can convince most docs that I am fine and do not to see them anymore, and then turn around and swallow a bottle of aspirin. I have not been able to do that with her.
This was wonderful! I finally had met a psychologist who could help me. She was certainly more eccentric than I was. I made another appointment to come back the next week. She administered the Minnesota Multi-Phasic Inventory; no one had done that before. The test measures levels of trust, paranoia, depression, mania, and is a wonderful diagnostic tool when you are trying to figure out a diagnosis. She was doing something to try to figure out what was actually wrong with me. All the other psychologists I had seen were too easy to manipulate, and what are teenagers are really good at: manipulation.
She actually listened to what I said very carefully. It took about 6 months, and then she dropped the bomb: Manic-Depression type II. So, she and I went over the DSM criteria for that diagnosis. It was almost right. A couple of weeks later, I graduated. I was given the diagnosis (label) of Manic-Depression type I with psychotic tendencies. WTF!?!?! Me! “No, absolutely not” my brain screamed!
That began a series of hospitalizations for suicidal ideation, and suicide attempts. This stage of “acceptance” went on for several years. I was not adjusting well to the diagnosis. I felt like my life was over. Everything I had read and heard about Manic-Depressive illness that had gone untreated as long as mine had made the diagnosis sound like a death sentence. I had learned that it was important to catch it early when symptoms first present themselves because Manic-Depression is a progressive disorder; it gets worse with time if it goes untreated. I was really freaked out.
I have no idea what is going to come out in this post as I am at once both pro and con on the medication front of bipolar illness. I do know I do not like some of the side effects of the medications, but by the same token, having tried to go off the medications, I can see where they are necessary to keep everybody else around me “sane.” If I go off them, I become overly moody, paranoid, delusional, yah da yah da yah. I think they (the doctors) like to neatly categorize these effects as “episodes.” They like things in neat little diagnostic boxes. This is not to say that all the psych doctors and people in the mental health profession are bad. There are some who are quite good at what they do. What I question is why do I have to be on these medications for the rest of my life?
I recently ran out of one of my medications and could not get it for about four days. Apparently, my HMO decided to play doctor as they have in so many other cases, most being much more serious than mine. At any rate, my HMO deemed it “too early” for a refill. I was fairly okay the first day off the medication thanks to it’s long half-life, day 2 was a little worse as I was developing extremely high anxiety, a feeling like nothing around was real, and just generally feeling strange, but I managed to hide this mini-trip into psychosis. I was out with my Mom looking for apartments, and that meant I had to deal with people real or not. Mostly, it meant I had to act “normal” which if are in a semi-psychotic state is very hard to do. So, due to physical addiction to this drug and my HMO paying God with my meds, I got to experience a mild psychosis for about 3 days.
I have also experimented with stopping Seroquel (quetiapine), and that caused a lot of agitation. and I could not sleep properly which is essential in managing manic- depression illness. No one told me any of this or about any side effects from the drug itself. Stopping Abilify did not seem to produce any side effects, but having to stop Klonopin “cold turkey” was quite another experience altogether. Thank you to my HMO for playing doctor, you nearly killed me (insert sarcasm here). There is nothing to be said about that other than I slowly slipped into severe paranoia and psychosis. It was like going down the Rabbit Hole but slippery as if coated with butter or something. Usually, I can feel it happening and try to stop it. It is not the case when you have suddenly quit a long term, high dosage “habit.”
These drugs, I am convinced, are more for other people’s sanity than for mine. Basically, they keep me in check so other people won’t be bothered by me. That’s my opinion anyway. Maybe I am becoming cynical and jaded, but my brain is addicted to these chemicals that I take dutifully every morning. I was a great lab rat. Knowing that I am very “med compliant”, the dutiful doctors tried regular anti-psychotic like Haldol, they tried anti-epileptic drugs like Tegretol (huge headache, loss of balance, etc.) and Lamictal. Patients should really be aware of Lamictal’s side effects which the “rash” is the most common side effect. What they do not tell you is that you can develop Steven-Johnson‘s Disease (a rare but fatal skin disease). That you can find on your own on the Internet.
In fact, if you are curious, you can find that pamphlet that used to come with the medication that list all side effects from least severe to rare. I have often wondered why they stopping including those with one’s medication(s). Conspiracy: pharmacies are the “girl friday” of the major drug companies and the drug companies do not want the consumer to know the big picture of a particular medication. I take 2 medications that if I were not getting low income help from Medicare, I wouldn’t be taking. The combined cost for one month of these two is about $2,000. That’s twice what I receive in Disability per month. But they have been deemed necessary so medicare covers them. I only wonder how these atypical anti-psychotics are affecting my brain chemistry. That I find of more concern than the physical side effects. I already know of one effect of long time use: physical and mental addiction. But, then, I have been addicted to some substance or another for most of my life. What’s another going to do? So, I’ll go to my grave addicted. Pleasant thought. I hope everyone who is in close contact with me is appreciative of the fact that I am so compliant in taking my medications so you can be sane, and I can be a semblance of sanity.
I know it’s bad when I have forsaken my Alice in Chains, Pink Floyd, and Nine Inch Nails for Marilyn Manson. I think I am slowly going mad. The Christians have a saying that God does not give more than you can handle. That’s a nice sentiment but I am Buddhist, and everything that is good in my life and everything that is bad in my life is all my own doing (or undoing, as it appears to be). I am the source of the answer and the problem, and I have no answers, just problems. I can no longer see any light at the end of the tunnel. It has gone out, or the lantern bearer is on break. I feel like I am in the boat crossing the river Styx with Charon at the helm, and he is taking us further and further down the river towards Hades and away from the light.
My soon to be ex-husband is closed up in his little room with the door shut watching his porn, and diving deeper into his fantasy life. I wish I had a fantasy life. I have always been too practical and logical to have much of an active fantasy life. To me, if it wasn’t something tangible I could touch, it didn’t exist (I know that sounds a little like Kant‘s philosophy that as soon as an object is out of sight, does it cease to exist?), if it could not be proven scientifically, I had no use for it. I do not believe is God, so that is out of the question. It would be so nice to just be able to “turn my problems over to God” and let him/her deal with the hows and the whys. But I can’t see or touch God, therefore he/she doesn’t exist in my realm. I wish I could “Let go and let God,” or whatever that bumper sticker says. But, how can one turn one’s problems over to an entity they cannot prove the existence of? That’s too much of a leap of faith for me. It requires trust in something I cannot touch, see or conceive of.
So, I am becoming increasingly stuck in my own mind which is not a good place to be right now. I cannot seem to achieve the mind-heart disconnect that I have been able to successfully complete in the past. Even though he has taken away my sense of myself as attractive and sexy which are very feminine yearnings. I had that sense once, but that part of me is under deep cover right now. I know I should be mad about that, but somehow, I have decided that everything that went wrong with this relationship is my fault. I wasn’t tolerant of his porn addiction (and it is an addiction, at this point), I did not act or do things the way he expected a wife to do. I am NOT going to clean the house in lingerie and high heels as he seems to have come to believe that “real and sexy” women do. Porn has warped his sense of gender roles and sexuality in general. And, yet he claims to know the difference between the reality of marriage and the “fantasy women.” No, he doesn’t. With addiction came the blurring of the line, just like it does with any addiction. However, I felt very disrespected, and said so on more than one occasion. He didn’t listen. Junkies do not listen to people telling them they are sick. They believe their behaviour is within the realm of the normal. I have been an addict. There is nothing normal about it.
I cannot decide how I feel. I am decidedly not manic, nor am I particularly depressed. I am extraordinarily stressed out, and I am sad. I can tell because I am dropping weight like I was actually dieting. But, the truth is I cannot eat. I cannot sleep for more than 4 or 5 hours a night. This is going to drive me mad. Not nuts, I am already there, but completely mad. The kind you may or may not come back from in the same form you had before. There is no going back, anyway. Every experience shapes you for the better, the worse or both. This is a both situation. I have changed for the better in some ways, and for the worse in others. Like my trust factor is shot right now. I entrusted him with my heart and soul, and he broke my heart. There is nothing on this planet that I will likely experience at this point in time that will break my soul. I have already been through that, too, and lived. It took a while to pull the pieces back together, but I did it, and came out stronger. Continue reading →
On the Threshold of Eternity (Photo credit: Wikipedia)
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I have Bipolar I with Psychotic Features. I do not always perceive what is real or true, and what my own warped mind has fabricated. I get angry at things most “normal” people would brush off, I get combative when I feel I am being attacked, I experience extreme changes in mood, and the list could go on forever.
My husband is a chronic depressive (not diagnosed) who is constantly harping on me about my illness, and how everything revolves around me. He complains that no one cares about him myself included. I ask him what is bothering him, and he either tells me that nothing is wrong, or he will start talking, and in the end, it is inevitably me who is causing all his problems. I will admit to taking out past frustrations on him, and nobody deserves that. However, there are things he does in the present that have caused arguments as well. He is in nearly complete denial about his depression. He calls it “being out of it.” Call it what you like, he is depressed. I know it when I see it; I have spent most of life that way.
Currently, our marriage is barreling downhill at an astonishing pace. He sleeps on the sofa downstairs, and I sleep in the bed. This has been the arrangement for several months now. He will not talk to me, and when he does the conversation invariably turns to “No one thinks about me, they only think of you.” They are my family. Of course they have my interests at heart; and he has made more than a few mistakes in this marriage and with my family that have caused them to be somewhat against him. He feels entitled to all the attention I “get”.
When he does speak, it is almost a given that my having Bipolar disorder will become the focus of the conversation. I do not think about having Bipolar very often. I have had it for decades. My meds are like taking an aspirin for a headache. I just do not think about it that much. I do monitor my self with regards to mood, anxiety level, etc. so that my psychiatrist can adjust my medication accordingly. He is the one that always brings it up, usually in relation to two other Bipolar women he’s known. He just doesn’t see that I am not them, that Bipolar manifests differently in every person diagnosed. Some are very high functioning, and some are not. I tend to be relatively high functioning (most of the time), so I do not understand some of his criticisms of me. I think it’s transferrence or projection of his feelings onto me. I am the mirror of his own illness; it is easier for him to look at me and project his feelings onto me because I am a diagnosed Manic Depressive than to look at himself and realize that he is depressed and not functioning very well.
For myself, I try not to let his mood get in my way. It is so easy for a Bipolar or anyone, for that matter, to start to feed off the feelings of someone close to them. However, for the Bipolar individual, it is even more important to not allow someone else’s feelings about themselves become your problem. As far as I am concerned, I have to look out for my health first because if I go down the rabbit hole with him, there is nobody to take care of daily household business. That, and Bipolars have a very high suicide rate, both completed and attempted. So, when I get too stressed or feel myself sliding down the rabbit hole for tea with the Mad Hatter, I become concerned because I do have attempts in my past, and the thought will flicker briefly every day that being dead would be easier.
It is difficult enough for a relationship to flourish when one party has Mental Health issues, but when both parties have mental health problems, it becomes survival oriented, communication breaks down as the depressed person becomes more withdrawn and the Bipolar half starts to cycle rapidly through episodes. I have a tendency to think everything is my fault, so when he goes off on one of little journeys, I am often left wondering, “What did I do or didn’t do?” The question drives me nuts. He will claim it has nothing to do with me, but it generally is some oversight on my part. Basically, I am left holding the bag for everything that goes wrong. He won’t even admit to himself that maybe his own problems with depression may be having a negative effect on the relationship. Nope, it is always my manic depression. This type of relationship where both parties have a mental issue doesn’t go very far. It can’t because it always in survival mode; it takes a lot of work to make a relationship like this work. One has to have basic respect and compassion for the other, otherwise it will end as one or the other begins to feel that they need to protect their sanity.
What’s on my mind? Hmmm….. maybe wishing that society would wake up and realize that mental health issues are real and are just like physical health issues. I get so sick of the stigma surrounding mental health. I have a chart that is 3 inches thick with observations, prescriptions, and other related notes. I have no problem with that. I have Bipolar Disorder, I have PTSD, I have panic attacks, I have days when I cannot leave my house. Has it limited my life? Yes, in some ways, but in others, it has caused me to take a good look at what is important to me, it has caused me to get help, and work on the issues that I have that prevent me from being truly and indestructibly happy.
Having Manic Depression has led me from one extreme to another, but that is okay as long as I learn from it. I have found a spiritual stronghold in Nichiren Buddhism because I have Manic Depression. I don’t view it as stigmatizing, I view it as a daily challenge to be overcome. People do not get all weird if you have a heart condition, so what the hell is it about mental health that everyone shies away from? You cannot be truly healthy unless you treat the body, the soul, and the mind.
If everyone in this country would take a look at the DSM (the manual used to diagnose mental illnesses) and realize that it is about 3 inches thick, that means there are a lot of people out there with mental issues. So what is the big deal? Get treatment, get better, get as well as you can, and just live your life. Don’t use it as an excuse to act out and harm others and/or yourself. Recognize that it is a facet of who you are, and treat it. Treat it with your body, your mind, and your soul. Find a good therapist that specializes in your illness, find a good psychiatrist for medication if necessary, and by all means, find a spiritual path that will ground you and balance you. And if you do not have access to private care, apply for public assistance. Help is out there, you just have to seek it out sometimes. It sure as hell isn’t going to come to you because people want to believe in a Utopian society where everything is just so. Don’t rock the boat, maintain the status quo, and above all, do not be mentally different (insert sarcasm here).
I just get so frustrated with society’s reaction to mental health, because I just do not get it. A person is not defined by their mental or physical health, they are defined by how they treat others, how they respect other people, and by their compassion for others. People do not say, “I am diabetes,” they say “I have diabetes,” or whatever it is. I am not defined by Manic Depression. It is one facet of who I am,yes, but it is not all that I am. Not by a long shot.
So, people, it is time that the stigma associated with mental illness stops. It prevents people from getting treatment, it prevents proper diagnoses, it prevents them from living as normally as they are able.
Sorry for the tirade, but the reports are coming in that the man who is responsible for the atrocious acts of yesterday morning possibly “has” a personality disorder. Of course it would have to be a mental health issue because no “sane” person would have done that. And, that is probably true, but the first thing they talk about is mental status. And, all that does is continue the stigma which prevents people from seeking treatment because they do not want to be labeled as crazy. I have a 3 inch chart that proves I am nuts. I do not care. I have been weird since birth.
So, I and many others are “different,” big deal. As long as you can see how your behavior affects those around you, and those who care about you, and learn from trying to put yourself in the role of the “other,” what is the problem with being a bit off? Just do NOT use it as an excuse. View it for what it is, and that is a challenge to be the best strange person you can be. People, even mentally ill people, are worthy of respect, compassion, and the right to be treated humanely.
I have been inspired today by several other blog posts I have read to think about the nature of spirituality and it’s healing and restorative properties. While I think it is important for anyone to have some sort of spiritual faith be it Christian, Catholic, Buddhist or Wiccan, I have no prejudices concerning people’s choice of spirituality; whatever works is what you should do. 
A Bipolar Journey Through The Rabbit Hole 