RealMental

Raise your hand if you’re struggling to function right now.

I’ve suffered some occasional migraines, ne’er suffered before bipolar, since starting my Effexor XR.  Fortunately, they’re not so bad, pain-wise, compared to other folks I’ve known– they usually resolve with a nap and my meds.  But lately, they’ve been worse, not so much with the pain, but in frequency and in new manifestations– smell sensitivity, dizziness, nausea, hot flashes, generally unbearable wooziness.  I want them to stop, because if they don’t, I’ll have to stop taking the Effexor, and that means another round of trial and error on a new antidepressant, and feeling depressed and anxious in the meantime.  I’m too exhausted right now to start a new trial of meds, and to bring the necessary vigilance to bear.

If it’s a temporary side effect of titrating my new dose, and/or a withdrawal from going up one dose too high, hopefully it’ll go away.  But if this is the trade off for less craziness?  I need to try something else.  I can’t work when I feel like barfing whenever my secretary walks into my office, because her perfume is too smelly that day.  I can’t work when I get a hot flash and the whole room moves in front of me, so badly that it’s noticeable to colleagues (fortunately so far, only those already in the know and on my side).  I can’t work if the smell and taste of food makes me gag, so that I don’t eat anything, and then get low blood sugar.  And I can’t drive home if I am feeling like I am going to pass out, because what if I do?  I couldn’t bear hurting someone.  And I am not ready to give up on work.  Only if I can’t handle the stress of continuing private practice will I give up, and do something less stressful.  But that’s not a tradeoff I am willing to make.  Yet.

I’ve been having a hard time at work, and debating leaving, and some things that occurred recently confirmed that it just isn’t the place for me.  I’ve actually been debating leaving for a long time, just based on salary issues, but recently had the crazy waved over my head for no (to my mind) justifiable reason.  So I was describing this to my therapist last night, as being the final straw, and she said, “Oh good.  You needed a kick in the ass to get out the door.”  I so heart her.  After I told her not to hold back, tell me how she really feels, we got down to brass tacks.  But I love having someone who is frank, who challenges me, and who doesn’t just sit there nodding, or saying “that must have been hard for you.”

That is basically what I’m doing. I’ve immersed myself in so many projects that I don’t have much time to think about anything at all. Next week I’m going to see my parents. I want to make plans to visit everyone in the entire world so I don’t have to sit still. But I don’t actually want to go anywhere. My house is littered with half-done activities and it’s like walking through a field of bombs. If anyone came over they would be appalled. But it’s working for me, so nothing is likely to change. Except it will. On the downswing.

They upped my meds yesterday. I’m now at 6mg once per evening. And twice the Trazodone so I can sleep. Instead of mixing in new drugs (anit-depressants and mood-stabilizers) they decided just upping the Invega, giving it the ol’ college try, would be a better next step. I’m not sure I agree. But I’m not sure I don’t, either.

She kept raising her arms high above her head and then bringing her arms in close and clasping her hands together while saying, ‘Do you see what I’m trying to do here? Do you? Like glue? Do you see? I’m bringing you together.’ I thought she looked ridiculous but I didn’t laugh since it wasn’t funny. I just looked at her and kept nodding. And then, about the 6th time she did it, I said out loud, ‘Yes. I see. I get it.’ and then she stopped.

I talk to people on the phone, people that care about me, and they keep asking, ‘So, you’re better? You’re fine now?’ And I want to reassure them and say, Yes! I’m fine now! Thanks so much for asking! Whoop-de-doop! But the best I can do is a mumbled I’m doing a little better, thanks. I don’t add in the rest of how I feel. I think it might scare them too much.

Sometimes my voice sounds wrong to me when I hear myself talk. I’m trying my best to not split in my mind but I’m a little afraid that it’s happening anyway. Dissociating is what my mind has to fall back on so I guess it’s not out of the realm of possibility. But it disappoints me. I doubt it would go as far as creating another personality like when I was young but I’m definitely doing something.

I’d upped my Effexor XR recently, and was achieving nice results at 112.5, but went up to 150 at the recommendation of my shrink. Two weeks in, I was feeling even bouncier. And then … anxiety in whole-body washes of hot, and cold, and tingles. Hyper-focused attention, impatience, inattention to idle conversation, and spaciness–verging on what I associate with my hypomania. Nausea and acid stomach if I ate more than 1/2 cup of food at a time. Nightmares. Ugh. No thank you. I called my shrink and left a voice mail with my symptoms and that I was going to knock it back down to 112.5 and see how I did. 12 hours in, I am feeling less verge-of-hypomanic, not so nauseous, and able to eat 3/4 cup of food at a time. Whoopee! I need a plateau, I really do.

Republished from BipolarLawyerCook.

You know, I ain’t right. And I don’t really know where first to turn to try and find out why not. All I know for sure is that the last several years (let’s review: Got married, new husband went into full-blown manic episodes, no one knew what was going on, but he was disappearing for days on end, engaging in substance abuse, and emptying our bank account. Then I got pregnant, and Husband went floridly manic again, got hospitalized against his will, was released to rehab, got ninny psychiatrist who totally mismanaged his treatment for bipolar disorder, stayed a month in a rehab facility then moved into an apartment, because I could not have him come home just then. Later, he moved back home, we had our beautiful daughter, and before you could say “relapse,” he disappeared when she was just 4 days old. Manic episodes continued until spring when he finally went off the deep end and wound up forcibly hospitalized again, this time landing in a GOOD psychiatric facility and securing a GOOD doctor who prescribed a GOOD treatment and had him participate in a GOOD outpatient rehab program, the result of which has been sobriety and relative stability with NO manic episodes since May of 2004) have been hard, emotionally, and then the last three years (let’s review: My father suddenly and tragically died, ripping a hole out of my very heart and changing the fabric of WHO I AM, I miraculously got pregnant for the second time, and then seven weeks later lost that precious baby to a miscarriage…grief compounded by grief) have been…tragic, desperate, and then this past year since the hysterectomy has just been bizarre. I’ve dealt with depression and anxiety, grief over the definitive end of my childbearing potential, which seem to come and go whimsically, and catch me off-guard. I took one anti-depressant after another over these years, and suffered side effects galore without ever really feeling significantly better. Anti-anxiety meds (read: benzos) helped me through some tough spots, and then I’d go several months without any before needing them again.

The only sure thing is that my moods and anxiety/panic attacks always corresponded with something going on externally. You know, like lying awake at 4:00 AM wondering where my husband was, or lying awake sobbing for my lost child, or lying awake crying into my pillow because I NEED MY DADDY BACK. In other words, if things were going okay, I was fine. But somewhere along the line, especially since Dad died, something had gone KABLOOEY with the coping mechanisms that had served me for the first 35 years of my life. I have a hard time wrapping my mind around this, that some external event(s) could occur that could trigger a weakness, a malfunction, in my brain.

One day this spring, while I was discussing this with a wonderful friend–a friend who just happens to have been, for the last few years, a MUCH better friend to me than I’ve been to her, or to anyone else–who happens to be a doctor of pharmacy, not to mention having much personal experience with clinical depression and the meds that go along with it. I listed to her all the anti-depressants I’d tried, told her how none of them had worked, and asked her, “What (meaning what drug) can I try next?” She looked at me, and after just a moment’s consideration, said, “You know, Belinda, even though you’re depressed, you may not have an actual chemical imbalance. I mean, you’ve been through some pretty horrible, awful stuff, just year after year recently, and you have every right to feel despondent without it meaning that your brain is all wonky…like mine.” And then she laughed. And I saw a light. And I loved her like she was part of me, because she got it. And then she told me the hard part.

She said, “Sometimes, you can’t even live life ‘one day at a time.’ Sometimes, you have to live it in 30-minute increments. You can do almost anything for half an hour, no matter how badly you don’t want to. So on days when I just want to stay in bed with the blinds drawn, I make a deal with myself to go out to the barn and groom one horse. By the time that’s done, I might look over at YOUR horse” (she’s been keeping Misha for me for way longer than I meant for her to) “and decide that his mane needs detangling, so I brush Misha’s mane. Then I might want to clip his bridle path, and before you know it, I’ve spent half the day out in the sunshine, DOING something, instead of wallowing.”

Just when I had decided that Kerri was the most brilliant, insightful woman on the face of the planet, she confessed to having developed this coping mechanism after hearing a version of it in the film, “About A Boy.” She said, “Yep. 10 years of therapy and I finally learn something useful from a Hugh Grant monologue in a movie. Not the book–the MOVIE.”

She IS brilliant, my friend, and she’s definitely onto something. I can’t help but think that, since no AD has helped me feel better–not really–that whatever is wrong with my brain, it’s not something that an AD can “fix.” I’ve been off the most recent AD, Wellbutrin, since early March, with no noticeable effect at all. I don’t feel better, I don’t feel worse. Just the same. The anxiety symptoms have abated (I’m not having falling-down panic-attacks in Wal-Mart any more), but are still present to some degree, in proportion to what’s going on in my life. Every once in a while, I suddenly get HOT all over, start sweating from head to toe, my nose runs like a faucet, my heart pounds, and I just need to be HOME.

Something is particularly difficult about mornings, about just getting out the door. Once I’m out, I’m pretty good for a few hours, but my calm seems to have a shelf-life, and I need to get back home in the afternoon. I like to plan things pretty far in advance, but I have trouble committing to things in advance. Anti-anxiety meds help. I’m not wild about how they make me feel, i.e. slightly dopey, but I do use them when I need them.

And then there’s the hormone angle, which I don’t even know for sure how to approach. Something has GOT to be going on there, since the weirdness has escalated by, um, a bunch, since my hysterectomy last fall. When I first came out of surgery, on estrogen deprivation, I literally felt, for the first and only time in my life, that I had lost my mind. It’s like nothing I can describe–the misery, despair, agony, anxiety–the certainty that it’s never going to be better, ever. After a couple of weeks, I was able to start estrogen replacement therapy, and it was like a miracle…at least to a point. It made the extreme crazy go away, but like I said at the beginning of this post, I still ain’t quite right. But then, I’ve never had the dosage checked or adjusted, so there’s a thought…

And I can’t help but think that a large part of what keeps me “down” and anxious is the disarray of my lifestyle–I keep Bella clean, fed, loved, dressed well, entertained, cared for…and that’s almost (but not quite) the limit of my motivation…and THAT is my motivation for this effort. I don’t know yet if it will work, but I know that to have peace and calm, I must first have order. I need it, Bella needs it, Alex needs it. And I need to provide it. I’m on my way, I hope…the house is still a mess, but I’ve done certain chores more regularly this week, and my family has had a hot, homemade, nutritious meal on the table every night this week, with NO takeout. That’s got to be a start. And Alex, bless his ever-loving-heart, cleaned the living room today, which lifted my mood unbelievably.

I’d love to hear from anyone who’s been through, or is going through anything similar, especially from the hysterectomy angle. Or not. Just whatever. Can you just have bad things happen to you and suffer a shift in actual brain function? (Yes, these are questions for my shrink, but my next appointment’s a couple weeks off. Humor me.)

Adapted and significantly augmented from a nearly simultaneous post at www.ninjapoodles.com

By jb

One of the most interesting things about meeting new people, and starting new parts of your life, is that you get to see yourself through new eyes. I imagine that some people don’t like it, but I find it intriguing.

My most embarrassing–and perhaps most endearing–quality is that I have a seeming inability to pull shit together. I’m that girl–the one whose backpack falls open on the street, the one who always manages to forget something, the one who stands on the street in the rain while a car drives by, sending a 4 foot spray of water halfway up her torso. My med school friends Jacob and Joe take a good amount of pleasure just in watching my life; they don’t hide their laughter, and–halfway up the lecture hall, dripping wet and late–I find myself laughing too.

On Friday, I was going through my morning ritual of rummaging through papers to find that day’s lecture slides. I couldn’t find my biochem notes, and searched for three or four minutes before I found them crumpled up at the bottom of my backpack. I did my best to flatten them out as Joe and I laughed. “You’re a mess,” he said. “A mess.” And I am.

But I wasn’t always this way. I remember, once, I was walking through my high school hallway with a friend, and she looked at me and said, “You smile, and you look like you have it all figured out.”

And I thought I did. Preparing to go to the college of my choice, dating the
most wonderful boy, making good grades with lots of friends: I did think I had it all figured out. But somewhere along the way, I lost that poise and
perfectionism. I broke my back, I made some Bs, I slept through a Calc 3 test and finally allowed myself to skip a class or two. Sometimes, I thought my mind had cracked, and when I was sad, all I wanted to do was sleep or get better, but when the sadness went away, I thought my life was back on track.

I remember visiting my therapist as a sophomore, in late spring, and wondering why I was there. I was happy, wasn’t I? I had things figured out again, didn’t I? I thought I had come to terms with losing my job, and I thought things would be perfect again.

I can’t pretend that I am much older, or even much wiser, than I was then. But two years up the road, I realized that things didn’t have to be perfect, and that this is my life, and I love it. I don’t mind being a mess–it’s just what I do, and it works for me. As long as I have people laughing with me, I’m fine. It’s when the laughter stops that it gets scary.

Yesterday was the sixth month anniversary of my first dose of Lamictal, the drug I take to control my bipolar disorder. It is the sixth month anniversary, also, of the day I hit my eye on Joey’s bed during a tickle fight and he decided to stop saying “I don’t know” and “Maybe” and take me back as his mess, his bipolar wreck of a girl. The day we started laughing again.

He’s been visiting the last two days, and we have been doing our thing–lying together watching the B-52s on YouTube. Loading the dishwasher while singing to the Village People. Eating too much ice cream. Sleeping in a bed where we thrash around and steal each others’ blanket space, and roll onto each others’ pillows and turn in circles and talk incoherently all night.

Waking up, pulling the covers back to my side, I smiled knowing that this fitful oppositional sleep is the best sleep I get, and it’s the sleep I want for the rest of my life.

Loving him is the best thing I’ve ever done, even if I do it as a mess, even if I fucked it up a million times. We cannot laugh about the past, and I am bipolar, and I will be medicated for the rest of my life, and I surely am a wreck, a shambles, a hilarious mess–but as long as we can keep laughing at the present, I’ll be fine.

Originally published here.