RealMental

It scares me that I, the crazy one, seem to understand best what’s going on in my mother’s head.  It also scares me that despite all the harm that she’s caused me over the course of my life, that I am also the most diligent at spanning the 3000 physical miles and 3 million mental and emotional miles in order to check in with her.  How scary that I, the one who hates and loathes her with much of my being, am the one who’s the most responsible.

My aunt, an older sister, has no insight into the mania/paranoia/delusions, and still takes it personally when my mother lashes out at her during an episode.  Almost a year from mom’s first diagnosis, she’s only now beginning to understand that distancing isn’t just necessary, it’s a lifesaver.  Granted, she’s got her own issues going on, and isn’t yet properly medicated and/or in a working therapeutic relationship, but you’d think that a lifetime of sisterhood would lend her better insight, better tolerance, than I.

My younger brother, the summa cum laude biochemistry graduate from an Ivy League school, perfect-scorer on his MCATs, decade-long pharmaceutical reasearcher who’s practically his own controlled experiment in SSRI’s, MAOI’s and tricyclics, tends to treat it all as pathological.  He doesn’t think, or doesn’t want to think, about the problems of underlying personality (narcissistic to the point of delusion) and the way they factor in to the difficulty to date in managing her disease.  He doesn’t yet get how the lack of a proper med combo to control her manic swings isn’t just the mania itself, but is further fed by her narcissistic insistence that she knows best when it comes to discontinuing her antipsychotics– she’s no longer feeling paranoid, and the voices aren’t so loud, so why shouldn’t she, she knows herself best– and so he thinks that it should be enough just to tinker with the meds until she’s on a better mood stabilizer and an antipsychotic that work.

And her psychiatrist, who seems to know what he’s doing, but he only sees her every two months and not usually during her worst manias, because she’s become a clever liar and because she cycles every six weeks?  Well, he just doesn’t see her when she’s bad, when she’s calling in the middle of the night, wanting me to do something from 3000 miles away, when she can’t even write down the phone numbers that I look up for her because she says she can’t find a pen or can’t make her hands form the numbers, or more usually, that “God says I can’t call them, you have to,” or that “God made the phone stop working, except for the speeddial.”  He doesn’t see that.  He also doesn’t see the narcissism at work, erasing the memories of those episodes in the aftermath, so that she says “oh, no” when I remind her what happened and tell her to update her speeddial.

Someone has to put the fear of God into her, and my attempts have failed.  I can’t make her stay on her antipsychotic.  I can’t jolt her from her narcissism, provoke the rock-bottoming that is sometimes necessary to break through that lying self-regard.  But if I can threaten her independence with the assistance of the county mental health social workers, and threaten to lock up her bank accounts against her spendthrift tendencies, make it so that someone out there is checking in on her every two weeks?  That might do it.  The concern of people who she ought to love enough to listen to isn’t doing it.  And frankly, if she never spoke to me again because of it?  I’d be happy, so long as she took her damned meds and went to therapy and did the stuff she’s supposed to do to manage her disease.

The problem is, she’s never acted like a grownup my entire life.  And I’ve been too much of a grownup since I was barely out of toddlerhood.  It doesn’t so much scare me that I, who still struggle with managing my own bipolar, know best what she’s going through.  It scares me that I will have to continue to mother a mother who never mothered her daughter, and that I will always know best, that no one else will step in to fill the gap.  It scares me that I will always be her mother.  I don’t want to be her daughter, or anyone’s daughter.  I don’t want to be her mother, her anything.  I want a chance to find a “just me” that doesn’t require those roles.  I want relief.

Sometimes, I think our partners have the patience of saints. Is it just me, or do we Real Mental types tend to find the most supportive, understanding, kind partners, ever? From what I’ve read on others’ blogs, it’s not just me. Our mates, they are pretty awesome. I’m so very happy I finally found someone who understands me and accepts me for who I am.

Here’s an example:

If you’ve been following my blog, you know that my jaw is currently wired shut because of a recent jaw surgery. Because of this, I’ve had to find alternate ways of taking my meds. The Celexa can be crushed and sucked back with some juice, but the Wellbutrin is a slow-release tablet and can’t be crushed. It has to be swallowed whole, which is a bit of a problem when your jaw is wired shut.

While I was in the hospital following the surgery, I devised a clever way to take my pill. I pushed it along my top gums until it reached the very back of my mouth, and then I finessed it into the small crack behind my back molars. I poked and prodded and sucked at it until it popped through the other side. To help it along, I also doused the thing in juice from a syringe.

I was pretty proud of myself, and my surgeon was most impressed. I just knew that I had to find a way to take it, because there was no way in hell I was missing a single pill. It had taken me so long to get to a place where my meds were in the proper balance and I felt like a human being again. I couldn’t take the chance of jeopardizing that.

Late last week, I noticed that my mouth tasted funny. Bitter like crushed pills. All day. I couldn’t figure out what it was. Maybe one of the fragments of Celexa had caught in my wires and left a lingering taste? I put it out of my head. Then, on Saturday, Superstar and I were out and I noticed something caught behind one of my back molars. I coaxed it with my tongue until it came free and lolled it around my mouth, trying to figure out what it was.

It dawned on me that it was the casing for one of the Wellbutrin tablets. Instead of slow-releasing in my stomach, it had done so in my mouth. I wasn’t sure how long it had been there. I didn’t think much of it and swallowed the casing.

On Sunday, we went out to the movie Juno. At the end, I cried my head off. Not just cried. Bawled. Lost it. I mean, I controlled myself in the movie theatre pretty well, but if there had been no one else around, I would have had a big sob fest for a few hours, at least. It was a good movie, and every woman I know has cried at the end, but my reaction surprised me. I passed it off as mid-30s ticking biological clock hormones, and Superstar and I went for coffee.

For some reason, I decided this was a good time to talk about the future of our relationship (since minutes after seeing the movie, I decided I wanted to pop out babies, and soon – huh?) and we end up getting into this big, emotional discussion where I sobbed my head off almost the entire time and said ridiculous things like “I don’t respect you.” Yes, it was over a specific issue that is a bone of contention for us, but I have no idea why I said that. I certainly didn’t mean it. I will never be able to erase the memory of the hurt look on his face after I said those words. It aches just to think about it.

We got through the discussion and I managed to convince him that I had said the wrong words and he misunderstood me. We made peace and left the coffee shop. As we were walking out, I became aware of all the people around us and wondered if I had made a spectacle. Then, we went home and lay in bed while I cried for a few more hours about nothing in particular, and he stroked my back and tried to make me feel better.

The thing is, I’m usually not a drama queen. I certainly don’t cry in public, and Superstar and I rarely argue or have upsetting discussions. But this day, he got a big dose of The Crazy. And then some.

It wasn’t until a few days later that I realized the emotional rollercoaster was a result of the wonky dosage of Wellbutrin from the stuck pill. It was then that I resolved never to go off my meds. I don’t want to know what it feels like to be that out of control and out of touch again.

And as for Superstar, I thank my lucky stars that I found him. I’m not sure I could be so patient if the tables were turned.

Ami asks: I have been bipolar since the mid 80’s, probably before that.  At the age of 46, I started taking medication for it.  Before meds, I guess you could call it ‘what a long, strange trip it’s been’. 

My question is this:  What about cognitive dysfunction?  Why doesn’t the side effect sheet say point blank “If you take this medication, your memory will go south to retire”?  “You will not be able to think straight” is another one I can think of.  If I had known my memory and mind would have fallen apart like it has, I sure would have done things differently. 

The only mood stabilizer I’ve ever been able to tolerate is Lamictal.  Now my liver is acting up, and I have to go back soon for more blood-work, nothing conclusive yet.  I took antidepressants for four years now. 

My quality of life is suffering, along with everything
else since I started meds. 

Read more »

I have been on medication for two years. I have tried drugs at other points in my life, but never stuck to them, or became addicted to them. Ativan, lorazepam – they are my friends. Too much so. My addictive personality. I can’t use moderation with those “downer” type  meds. So the doctors just don’t give them to me anymore.

I have been on Cipralex/Lexapro 15mg for almost a year. I switched to this medication from Effexor which made me have uncontrollable brain shivers and twitching. I wanted to believe it was helping. I wanted it to help. I don’t think it ever really did. It certainly didn’t stop me from trying to commit suicide. It didn’t stop me from being sad most of the time.

It did, however, keep me from having ten or more panic attacks every day, in every social situation. It did give me the strength to make some incredibly difficult changes in my life. It gave me the backbone to leave a toxic marriage. It helped me to get through the first few months of being single and a single mother.

I could never shake the feeling of fogginess the enveloped my brain. The twitching in bed. The insomnia. The headaches. The aching in my joints. The loss of libido. The loss of desire to read. To write. Trying to grasp at straws by drinking wine. Trying to bring back some semblance of the vibrant artistic, passionate person i used to be.

Over the past few months as i have looked at myself. Really looked at myself. I realized that, for me, the cost to my self-esteem of taking medication and it’s side-effects are too much. That i was ready to try life free from the chains of the big drug companies. To look in to a more holistic way of treating myself. Exercise, herbal remedies, vitamins, sleep, less alcohol. I am more than willing to go back on medication if this doesn’t work. I have to make that deal with myself. For me. For my children.

But, as of this week i am med free. I am in pain from withdrawal. It is tougher than i thought it would be. But i am hopeful. I have hope. That is something wonderful.

If you knew me you would know that from the outside i used to seem like i had it all together.

If you know me now you know that in the past year i look like a disheveled mess. That my life has fallen apart over and over again. That i nearly died. That i lost my marriage. That i nearly lost everything.

And now.

And now i am slowly crawling my way back to a real life.

This week i started going off my medication. I have been unhappy and medicated for a long time. Now? Now i have all my ducks in a row to try and be normal. Happy and sad. I just want to know who i am in an un-pressured situation.

I have that now. A home to myself. No husband breathing down my back. Wanting everything to be fine. When fine was not possible.

I am scared. I am woobly in my head. My body is rejecting me. Stomach pain. Intestinal distress. But i am eager to know me again. Happy. Sedated. Unmedicated.

NAMI sent a questionnaire to presidential candidates, asking them their positions on mental health issues, including access to care for the poor, and these are their responses so far. Thanks to Emily at On Call for Life for the link.

Cross posted at BipolarLawyerCook.

Reading Belinda’s thought-provoking post about forced commitment and medication, and the thoughtful comments people have since made, caused me to think a little bit more about how medication, while a lifesaver when appropriately prescribed, is only the first step.  Once you’ve gotten past the big ifs of a proper diagnosis and a proper prescription, you’ve got to be willing to use the equilibrium that the meds bring you to eradicate the mindset that meds are a “cure,” rather than merely a means toward maintenance and repair.  It’s my personal opinion that even the mentally ill person whose “only” life trauma is the toll of the disease itself has serious mental work to do, adapting to the concept of being “mentally ill,” redefining their sense of self around the diagnosis, and adapting to the medical and emotional features of their long term diagnosis.  The grief, regret, relief, anger and confusion that come with a proper diagnosis can’t be overstated, and it’s not something to be gone through without the aid of a therapist.  Too, medications don’t work forever– even once you’ve hit on a good combination, it may not work indefinitely– and being able to identify that your mood is changing despite being good about your meds is crucial.

From my own experience, I’ve built up a variety of coping skills to deal with my anxiety, depression, and need to people-please that are very unhealthy and counterproductive as I approach the worst end of my depressive spectrum, and it’s hard for me to recognize, when I am in the midst of a depressive phase, what I am doing.  But once I’ve recovered some stability, I can use that solid ground as a base to look back from the corner I’ve worked myself into this time.  I can look back and try to figure out when I first started the most recent downslide, and see if there were any causes.  I can then try and map out what I did and didn’t do during that period, identify whether anyone tried to warn me (and if they didn’t, possibly why not), and look at what coping mechanisms came into play, and what resulted.

There are lots of good books on the subject of eradicating bad mental habits out there, but I think a good therapist is really key.  (The subject of finding a good therapist, with whom you can work, is a whole post unto itself.)  Working with friends or family to identify your “bad behaviors,” your mood cycles, your triggers, just won’t be complete, because they’re not objective, and inclined to either overlook unhealthy or exaggerate healthy behaviors.  While friends and family can be the best first defense against a recurrent episode, and have the concrete experience of your past episodes to guide them, you need these folks to be focused on the micro level, not the macro/meta level.  A therapist outside your circle, however, is objective, has training, and is someone in whom you can confide and to whom you must be accountable.

Support groups outside your circle can also be therapeutic– because they don’t know you, and take you at face value when you take part, there’s an objectivity there that allows a freedom of expression you might not have with friends or family.  Hearing others say they’ve gone through something similar, and come out on the other end, is tremendously encouraging.  And knowing that someone else understands the swirl inside your own head lends credibility to their advice and encouragement that a “normal” source doesn’t have.

The most important thing to be gained from therapy is a firm sense of your self, knowing what you need and what you don’t need.  Personally, I’ve never joined a bipolar support group because the way my bipolar has manifested itself has been primarily anxiety and depression, and the course of my illness was and is usually very different from that of others in the groups I’ve tried.  Having never been frankly manic, psychotic, or delusional, much less hospitalized, I knew I didn’t “need” what these groups are offering.  But depression and anxiety sufferers?  I crave their company, search regularly for a group that meets after the end of the business day, eagerly read posts by others suffering from the same symptoms– because in hearing their stories, I learn something new about myself.  And by collecting these tidbits, I can hope that the next episode won’t be as long, as bad, as deep, because the work that I’ve done will allow me to see that it’s coming, and know that it’s arrived.  The meds provide the viewpoint, but I’ve still got to be willing and able to look around me– the therapy allows the rest.