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Roller Coaster Redux

October 3rd, 2007

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.

When You Just Ain’t Right

September 30th, 2007

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

Walking the road of clarity

September 29th, 2007

Being the one that throws up the signal that something is wrong is not the popular course. Even if that signal is as silent as you trying to take care of yourself and setting boundaries with no words spoken.

You are denied and judged by your peers, your very own family of peers. They want to know, “what is wrong with YOU?” “Why are you always bringing up the past and trying to ruin everything?”

No matter how much your therapist, your sponsor, your safe friends tell you that YOU ARE OK. You wonder if you really are ok.

Maybe the family of origin is right? Maybe I am a waste of space that is always living in the past. They ask, “What is wrong with YOU?” as if, I am the root and soul of the problem. No, those questions are merely a distraction from what is really the problem.

Now, I know better. The pain that comes with questioning yourself. No more, I know better. Now, I do.

You are trying to remove yourself from the insanity that lives in a hoarded stack of papers, plastic things, and food from 1996 that cannot be thrown away. The thick smell of smoke and of a person that hasn’t bathed.

The smell of sickness, the dark, pungent smell of mental fucking illness. It makes you physically ill, and no breakthroughs in therapy can protect you from the despair or emotional reaction of knowing that this is what you came from.

WHY DO YOU ACT LIKE EVERYTHING IS OK?! I won’t do it. I will not act “as if” EVER AGAIN FOR HER OR YOU!

You are all sick, banding together stifling the sickness with alcohol and drugs. If only we all could be as peaceful as you try and convince me that you are. I know you are not. I know.

Now more than ever, I am assured that I am on the right road for me. Your road is different from mine, and that’s ok. I am no longer so emotionally intertwined so that I believe everything I do must also be done by you in order for you to be ok.

I only know what I need to do for myself. After many years, I’ve never been surer of anything else in my life.

This is the road of clarity that I never thought I’d walk, but I made it. I’m here. It is possible.

And, NO ONE can take it away from me. Once you know, you cannot ever NOT KNOW.

Impeccable timing

September 27th, 2007

By Heather

I have this great track record for getting depressed at the worst possible times. Like every time I’m feeling good to go and like I could take on the world or at least get out of bed and to work before 9:30. Things are usually going swimmingly when my Seratonin levels decide to take a nose-dive and suddenly getting to work in a timely fashion is the least of my troubles especially since on my way to work I’m too busy contemplating taking a nose dive off of an overpass.

And that pretty much sums up the last two weeks. Me being depressed, wholly inarticulate and crying as it takes me four days to write a letter consisting of three paragraphs. And then more crying when told that my middle paragraph makes me sound like an idiot with a big vocabulary (oxymororn, no?). Then comes an eye twitch and teeth grinding and me driving back home on the same overpass seriously wondering what would happen given that I’m only like 50 feet from the ground.

Seriously could not have happened at a worse time, which leads me to believe that stress does not bode well for my psyche. Whereas some people, nay most people, can handle stress quite well and without the use of narcotics. I see stress as overwhelmingly difficult and a hindrance, not something to learn from or grow from, more like something that has the sole purpose of making me crazy.

At this point, I see myself taking a “sick” day (read, I can’t go to work with my eye twitching like this or else I’m going to scare people) once a week until I retire. This does not bode well for the next 40 plus years. I’m thinking that my options are to either win several million dollars or to learn to deal with stress better. And today, I almost feel like the former is more of a possibility.

I’m Trying

September 26th, 2007

By Violet

Autumn is a mixed-bag of emotion and memory and experience for me.

On the one hand, it (in theory, at least) marks the start of cooler weather and less yard work and the opportunity to eat thick hearty stews and homemade oatmeal bread without breaking a sweat.

I can wear my sweet, precious hoodies again and dig out some of my soft fluffy socks to wear inside my combat boots. There’s an anticipated trip to the Rockton Fair and that unmistakable smell of decaying leaves and, quite often, beautiful sunsets. Good things.

There are many good things about autumn and winter. I can see them and name them and touch them.

But the flip side, of course, is the Seasonal Affective Disorder creeping into my mood and my energy levels. And the depression that lurks.

The anniversaries and memories of death and dying and funerals and sadness – my parents, grandparents, best friend.. From September to February, my world is full of anniversaries of loss.

And let’s not forget the November anniversary of my month-long panic attack and the diagnosis of my panic disorder.

The skies grow darker, earlier, and I find myself wishing that I could curl up in a duvet until spring arrives. My beloved reminds me not to dwell on the memories. To acknowledge them and let them go. I’ve been getting better at it but it’s not good enough yet. Letting go. Letting go of the past.

At this point in autumn – the late days of September – I can already feel the tendrils of an impending collapse of my happiness. I try very hard to put it out of my mind. I remind myself that dwelling – on any of the aforementioned subjects – will not help me get through this. It will not make things better.

Dwelling is one of those things I do very, very well. I could win a gold medal in dwelling.

I dwell on conversations and images that are stuck in my head. I dwell on moments – pivotal moments – when my life shifted. I stack these memories up, together, and try to make sense of how I got to be this way. How did I become so afraid of the changing seasons?

The truth, of course, is that it wasn’t just one event or one circumstance that pushed me over the edge. And, perhaps, the cumulative effect of those experiences isn’t to blame either. There are too many possibilities – from the food I eat to the sleep I get – to try to make a neat, tidy package of explanation.

I realize I need to fight this. I realize that, if I don’t fight it, things will crash around me. But fighting is hard – I am an instant gratification junky. If it doesn’t impact on me immediately – a rush of adrenaline or a sugar-induced laughing fit – I can’t seem to make myself follow the rituals and routines. And yet, I know the only way to make it through the coming months is to fight.

If I don’t fight my hardest, my husband will come home from work and find me weeping about my life, my world, my existence. Weeping and blowing my nose and uttering absolutely useless phrases like, “I miss.. I miss.. EVERYBODY.” or “Everybody hates me and I have no friends and I am so alone.” Trying to expel a build-up of emotion that encompasses sadness and mourning and grief and fear is impossible. And, oh, god, there is so much fear.

This morning, my beloved dragged my SAD light out of the closet, dusted it off, and moved it upstairs to the bedroom. The idea is that I will bask in that light every morning from now until, well, next spring. I do not particularly enjoy the basking – try as I might – but I will do my best to sit patiently in the incredibly bright light for 30 minutes each day. Some days, I know, I will cheat and sneak downstairs earlier than I should.

I am back to my vitamins, my precious B12 and D and assorted omegas. I swallow them with my lunch – taking them at breakfast makes me nauseated for hours and hurts my stomach – and, if I believed in God, this is when I would pray. Please let the vitamins soar through my veins and adjust my chemistry and trick my cells into believing it is still summer and I am happy. Please let the B12 boost my sagging energy levels. Please, please, please. Please make it all okay.

I’m trying to motivate myself to get more intentional exercise – reportedly one of the best antidepressants available. I hate being sweaty and tired and out of breath but, as winter sneaks around me, I find myself tired and out of breath anyway. It’s as if my muscles are disintegrating in order to keep me motionless under a duvet all day.

I plod my feet along the treadmill in the darkened basement, trying to focus on recorded episodes of CSI – happily edited of commercials. I take advantage of the cooler days, when they come, and I walk the dogs to the park. I don’t feel any different.

Evidence that diet can impact majorly on depression makes me begin to read the various literature on the subject. Fresh vegetables. Omega-filled fish. Low fat, complex carbs. I know all of this and still I fight my body’s increased cravings for sugar and simple carbs.

I fight the instant gratification of junk food. Sometimes that makes me cry, too, as my body screams for cookies that will immediately soothe the anxiety and my brain shouts that I’m making it all worse if I indulge. It’s like those cartoons with a devil on one shoulder and an angel on the other – except, in this case, they’re both angry and hostile and glaring and I can’t win.

Everything makes me melancholy. Everything makes me question myself. Everything – everything – makes me feel guilty. For being alive, I suppose. I am incredibly uncomfortable about everything – the screaming cravings, the urge to hibernate, the grief, my own body.

I struggle and I fight and I do the very best that I can but, so many times, I fear that I can’t do enough.

Am I fighting biology and chemistry or am I fighting memories that are embedded into the very core of who I am? Where does my past and those experiences end and where does the seratonin begin? How can I keep myself afloat when I am so very, very tired?

I take my daily antidepressant – the prescribed kind, I mean – and I resist increasing the dose. It sounds dramatic to say that it takes away my personality in higher doses but I’m pretty sure it does. Even my husband, who loves me and wants me to be happy, will agree that I am not myself when I am on higher doses.

And some days I am okay – more than okay – and I fool myself into thinking that every day will be like this. I will smile and laugh and enthusiastically work on a project at the dining room table. I start to think that I’ve finally won out over the sadness – I’ve won the war. I feel alive and healthy and happy. Grateful. I feel like myself.

Then I wake – the very next day – and my body feels like lead. I run the previous day through my mind and wonder what I did wrong. Was it the sandwich for lunch or did I not get enough sunshine? Or maybe it was the day before that? How did I drain all the happiness out of my world while I was sleeping?

Autumn arrives and the fight begins and I am already tired of dragging myself up the endless mountain ahead of me. And I am afraid, no matter what I say. I am afraid of the months ahead of me but I will fight.

Two Snakes

September 25th, 2007

Yesterday, I attended a meeting. I like these meetings, because this group is populated with such intelligent, friendly women. This kind of space is rare for me, and I am glad to be a part of their organization. With this in mind, you would think I would have been able to pay attention, but I could not.

My mind wandered away and thought about cedillas. You read that right. I thought about the little, diacritical cedilla, that small hook often found dangling under a C: ç. And then, I thought about the tilde that often appears over Ns (ñ) in Spanish words and how it beats the apostrophe hands down, because rather than only having the capacity to replace missing letters within a word, such as in couldn’t, the tilde can behave as a character in its own right and replace an entire word, such as in dictionary entries to replace the headword when it is repeated within the entry. And then, there is that delightful hat of a circumflex, which sometimes, though not always, indicates a missing letter in a word that was once there and is no longer, such as in the French hôtel, which used to be hostel. Hey, it says, there was another letter here once, but I’m not going to tell you what it was or why it left. I kind of miss it. Poor little gaffer. He has to point out the holes that no one can see.

I thought about all that and completely forgot that I was in a boardroom filled with a bunch of people with whom I was supposed to be actively making financial decisions. This happens to me a lot lately. It is as though my brain’s ability to actively focus its concentration has had a stroke.

You think I am lying, because how would I get from one end of an entry to another if I could not focus my energy? I am slowly learning tricks to remain at least somewhat productive. The main tactic I use is to have several things up in the air at once. I will write a sentence, knit for ten minutes, scoop the cats’ litter boxes, hash out five or seven more sentences, read some websites, watch a bit of “Law & Order”, have a good run at a paragraph or two, make tea, read a magazine, write some closing lines, talk to the Palinode, edit the entry, knit some rows, and then post the entry.

What used to take me an hour is now spread out over a whole day or two, and by the time I am done, I am rarely confident that I have made much sense. Thankfully, I usually do make sense, but it can take me several hours before I am able go back and see the entry in a linear fashion.

This recent way of experiencing the world has put my confidence on shaky ground. I am not always sure what I mean when I talk or write, which makes me wonder what it is I believe. Why am I here doing this talking and this writing? When I am out of the house, I wonder why I am out, and when I am at home, I wonder why I am not out.

My brain has ceased to be where I am, and it is making me feel like little more than a reactionary sponge, an anxious baby.

But I am suspicious of even that interpretation of how I feel.

Part of me is hopeful that I am really on simmer like a large pot of stew, bubbling away for hours and days until everything gels together in just the right configuration of flavour and consistency. I would like to think that something is happening just outside my line of sight, and that in a week or two weeks or a month I will find myself scribbling out poetry and prose and taking photographs with the storehouse of creativity that has been silently cultivating itself inside my chest.

Right now, though, I worry that this is all I have, that the medication I am taking is also taking me, that we are snakes eating each others’ tails.

(This entry is also posted at Schmutzie’s Milkmoney Or Not, Here I Come)

Crates Full of Birds of Paradise

September 25th, 2007

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.