Medication, etc.

It has been a year or so since I last posted here. I haven’t felt like I have much to say. I have been fairly stable, on a steady diet of Quetiapine, Bupropion, Fluoxetine, Horizant and Clonazepam [as needed].

Things have been happening, the way they do. I’ve had a few bouts of depression and hypomania since I last visited WordPress. At one point I was convinced I could drive with my eyes closed.

Lately I’ve been on the brink of another depressive episode. I looked at my email and noticed that I have sought therapy every year from October – May. Which is strange because I hate the summer.

I’ve been anxious about my medications, and had to go without the Horizant for a few days. I’ve found this helps immensely with my generalized anxiety disorder, but it has been prescribed off-label, and I have to go through a third party so it doesn’t cost hundreds of dollars per pill.

I called my EAP (Employee Assistance Program) last week and asked for therapy. I’m still waiting to hear back.

I wish I knew someone else with bipolar. I don’t know anyone who can relate to these things, don’t have friends and can’t talk to anyone at work because of the environment and the stigma attached to a serious mental illness. So I pretend, a lot.

I’m feel that I’m letting down my wife and family when I slip into a depression. No one understands that it happens without any cause.

Oh well.

Anhedonia

“Dark Fog” Frances Lewis

I haven’t felt like posting in awhile. To tell the truth I haven’t felt like doing much at all. For the past few weeks I haven’t been enjoying anything. I force myself to exercise, or to start projects, but after awhile I just give up. I don’t find enjoyment in anything. I don’t feel like talking or doing anything else.

I can’t get in to see my doctor for another week. I’m hoping that something can be done to change my meds. I am currently on Vraylar, Quetiapine and Propranalol. The only thing that appeals to me is sleep. I go to sleep at 7 pm and wake ten hours later to go to work. That is my life.

It’s all soo boring

Wake up to an alarm,

Breakfast, clothes.

Another day at work.

I guess this is remission,

And it’s all soo boring.

Some days I miss my mania

Some days I even miss my depression-

Some times sleeping all day sounds good.

My pills make me fat,

And normal.

Apprehension

In a few weeks I will be starting work on my Master’s degree. I’ve chosen to study Clinical Mental Health.

I have to admit that I am apprehensive about the work load, while maintaining my full-time job. However, I know that I will enjoy the subject matter, as I already spend my free time researching the topic.

This is a somewhat major departure from my undergraduate degree and current line of work.

Another part of me wonders if I can be an effective counselor while living with bipolar disorder. Dr. Kay Redfield Jamison has been an inspiration, and shows that this diagnosis shouldn’t preclude someone from working in the field. I’ll continue to work toward stability and hope that I will eventually help others.

Mixed Features

“Mixed features are common in practice but poorly described in DSM. They are caused by the overlap of depressive and manic symptoms, but it’s hard to understand them by reading separate descriptions of these two states. It would be like trying to imagine green by studying yellow and blue.” – Chris Aiken, Psychiatric Times

I visited my psychiatrist again on Wednesday. Lately I have been functioning on about four hours of sleep per night. At the moment it is 12:30 AM on Sunday morning. I’ve also been agitated, isolated and full of ennui.

Because of my bipolar, I haven’t been able to take antidepressants. We’ve found that these push me toward mania and can even cause auditory hallucinations. I am currently taking Vraylar and Seroquel.

My doctor has added the “mixed features” designator onto my bipolar diagnosis. Honestly, this helps explain why I had to wait over 20 years for my diagnosis. I think that these symptoms can be difficult to identify, even when we’re looking at them from the inside.

In the past I’ve had difficulty keeping a job for more than a few years. I would always get to the point where I was so annoyed with my coworkers, and I so dreaded going to work that I would quit in some spectacular fashion. A quick move to some new city or state would usually follow.

I think this also explains why I abused alcohol for so long. Regardless of the negative implications, heavy drink does initially calm me down. I no longer drink, and haven’t in over seven years.

So, because of the additional diagnosis, my doctor has doubled my Vraylar dosage. Unfortunately this caused akathisia, discomfort staying still and a weird feeling like my tongue was sort of swollen and uncomfortable. I found this out late on Friday and will have to wait until Monday to hear back from the doctor. It sounds like he will prescribe a beta-blocker to address the side effects to my anti-psychotic. I guess I will find out more soon.

Empty

I’m sitting in an empty parking lot. The sun is setting behind a hill. Cold. Lonely.

I don’t feel like the medication is doing much at all. One pill makes me sleep. One pill wakes me up. In between I feel indifferent.

Maybe we aren’t supposed to feel happiness in life. How can the world work if everyone feels like this?

Bipolar is a terminal illness. I can’t disappear and I don’t know how to live.

Last week I was hypomanic, and my sleep is still out of whack. I take my evening meds at 6 pm, I’m awake at midnight. I take another pill and sleep until 3. I usually just get up then and sit by the fire place. What in the hell am I doing?

Wish me luck because I’m going down.

Normal

My therapist asked me to describe complete remission, what I see as an end goal.

  • I’m able to tolerate working and being around people without aggravation and the need to isolate.
  • I have regular moods- I am able to feel happy and sad without a mood episode that may last days to months.
  • Be able to control my spending- when hypomanic I have the tendency to become fascinated by a subject and begin buying things with money I don’t have.
  • Be free from disturbing thoughts and compulsions, these are usually centered around hurting people, (I never act on these).
  • To not feel the need to alter how I feel by taking in drugs and substances.
  • To have normal sleep patterns, (lately I have been operating fine on 4 hours of sleep).
  • To feel stable enough myself in order to help other people.
  • To not be embarrassed by the stigma around mental health.
  • To feel secure when discussing my mental health with my family.
  • To feel comfortable wearing short sleeve shirts in public, (to not feel the need to hide the scars from self harm).
  • To have friends.
  • To want to live.

Night

Another night with little sleep. These lonesome, listless midnights are such a bore. The world outside black like frozen ink. I could write a bad poem, or eat an English muffin, email my psychiatrist to ask for more medicine. I want to feel normal or I want to feel nothing at all.

Genetics and Bipolar Disorder

Scientific studies suggest that genetic inheritance explains 60-85% of bipolar cases, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3637882/#!po=0.381679.

Even before my diagnosis I’ve heard of and in one case witnessed bipolar traits within my immediate family.

Two years ago, (before my diagnosis as bipolar 1 and subsequent research) I received a strange phone call from my Dad at 3 AM. I couldn’t quite follow the conversation because I was half asleep. I was able to determine that there wasn’t any emergency and told him I’d talk in the morning. I knew that sometimes he goes without sleep and can get worked up about things, sometimes to the point of delusion.

Shortly thereafter I received a call from my grandmother, worried about my Dad. I decided to check on him and he was in the midst of psychosis, centered around religion, he was seeing angels and demons.

I called 911 because I knew it wasn’t safe to try and transport him to the hospital. I told the dispatcher my guess, that I thought it was a diabetic emergency.

In the emergency room aid had to explain that I thought he was a danger to himself. The doctor thought that it might be early onset dementia. They sent him to another hospital for a 72 hour mental health hold.

At the end of his stay they sent him home with a diagnosis of medication induced delirium, (he was taking too much Benedril, which mixed poorly with his pain meds). Looking back on it now I am all but certain that this was mania induced psychosis.

—-

I have tried to find out more about the history of mental illness within my family. Obviously, this isn’t a topic for polite conversation over Thanksgiving dinner, and details can be hard to come by. So far I’ve found the following:

  • My maternal great grandfather died in a police drunk tank.
  • My paternal great grandfather suffered a “nervous breakdown” that ended his career and caused an early retirement.
  • My maternal grandmother was diagnosed with severe depression.
  • My paternal grandfather’s brother’s son became convinced late in life that a conspiracy had placed him in the wrong family, and that his father was an imposter. This lead to him evicting his elderly father.

Anyway, I am sure that there is more, but those are a few issues related to mental health which I have uncovered.

My wife and I cannot have children, so for better or worse there isn’t any chance of me passing on this disease.

I’m curious if I have things like this uncommon with others diagnosed with bipolar?

Try to ignore the body in the living room.

*Trigger Warning: death of a loved one*

Friday afternoon my mother-in-law came to our home under hospice care, a weekend full of visitors and family. The company came and setup the bed, oxygen concentrator. Nurses explaining how people die. She was a very nice person.

Saturday evening, almost asleep, my sister-in-law knocks and says, “she’s passed,” It’s strange how different people look when they are dead with sunken cheeks and open mouth, lying silent.

Sunday morning, drinking coffee in the dark. I try not to look toward the body in the living room. The mortician will be by later to collect the remains, the contractor to collect the bed.

I wonder who will visit me when I’m dead?

Ghosted

Image source outlookindia.com

 

It’s a coincidence that this post comes the day after Halloween, but this post isn’t really about ghosts, or maybe in an emotional sense it is?

Today I was listening to the wonderful Podcast, “Mentally Yours” as they discussed an unfamiliar term. The guest explained how she had been “ghosted” by her two friends. I had to look up the definition because I had never heard of this.

“The opposite of love isn’t hate; it is indifference. Ghosting, for those of you who haven’t yet experienced it, is having someone that you believe cares about you, whether it be a friend or someone you are dating, disappear from contact without any explanation at all.” (Jennice Vilhauer Ph.D. writing for Psychology Today)

I then realized that I have ghosted every friend I’ve ever had. In general I did this without malice or forethought. When I was younger I would often and suddenly move away, usually to a completely different city or a state. I now realize that I did this in hope of escaping the hell I often felt inside. I also dropped friends when I went away to University or changed jobs. And, as time passes by it becomes harder and harder to reach out, and easier to just never try.

I have to admit that during this time I was f*cked up. Twenty some years of undiagnosed bipolar disorder, (and subsequent self medication with alcohol and drugs) didn’t make me the most stable person to be around.

In the time since then I’ve sometimes thought about these people. I’ve heard that a few of them died, and I expect I’ve never heard about some of their deaths.

I have to wonder what they thought happened to me? When the last time you see someone they are abusing drugs, and when all contact is suddenly broken-off and no one else knows what happened, we are likely to assume that they are dead.

So, I guess in some sense and to these people I am a ghost. Perhaps I’m remembered for short, emotionally overpowering relationships. Maybe sometimes they wonder about me, like I wonder about them?

Hypomanic again

I’ve been hypomanic since Tuesday. Last night I woke up at 2 am, I’ve been working all day and still have energy. I’m full of grand ideas and have accomplished projects that have been put off all Summer. I have to consciously slow down my speech try to relax. When I look in the mirror I can tell that my eyes look manic.

I’m aware that this isn’t normal, but it is such a refreshing change, since I’ve been stuck in depression for awhile. I checked in with my psychiatrist, who said that if it lasts more than a week we’ll have to address it with medication.

I will have to see what the weekend holds. I have no idea how I will feel tomorrow. I’ll have to think of some project to accomplish in the middle of the night.

They call it a Mood Disorder.

Source image Stanley Nova, Wiki Commons (photo edited)

 

I’ve always felt too strongly and too much. It is very rare for me to feel “a little” good or bad. I am much more used to flights of euphoria and the prison of depression. I self medicated with alcohol for 14 years.

When I was young I often fell in love and composed shitty poetry. Once my poem was stolen, (or given?) and passed around the school. Everyone laughed.

Many nights I snuck out of the house and hid in the dark, crying and lonely. I would wander through darkened streets and along bike paths in silence. I would wish that I could stop breathing, or bleed to death. A death from consumption or exposure would suit me well, or at least they sounded nice. I was often out in the rain, which made crying easier- and the tears harder to spot.

My first year of college I fell in love with a girl named Maria. I spent all of my time with her, even after I learned that she had a boyfriend in Massachusetts. It took me five years and a near suicide to get over it.

I’ve always had this difficulty with emotion. As a kid I was taught that emotions were a weakness. Anger would get me in trouble at school. Happiness would be ok in prescribed dosages. Excitability was abnormal. Sadness wasn’t tolerated, and the only appropriate time to cry was when someone died.

Therapy

Less than a year ago I was diagnosed bipolar. So many days since then have been spent depressed, listless, confused and reflective. Some days I just drive. Hour after hour listening to Pandora and hoping for sad songs.

Last night I was thinking about all of the medications I’ve tried. Vrylar will be the ninth one. I’m worried that my bipolar is extremely treatment resistant.

Most of them haven’t done anything except cause unwanted side effects. Cymbalta made me extremely happy and not needing sleep. However when I started hearing voices I had to stop. This was my first experience with medication induced mania.

I asked my psychiatrist what our end goal should be. He said that we will work toward complete remission. I wonder if that’s even possible?

Some days I wonder what would be left of my personality if my bipolar went away. Are the best and worst times I’ve had all to be blamed on the illness?

I’ve decided that I need to get back into therapy. My last session was about six months ago. I stopped going because I was so busy in EMT school.

I also think I need to give up and tell the human resource department at work that I’ve been diagnosed with bipolar. It’s the only way I can see being able to miss work for therapy. I think I will need to go at least every week. Perhaps multiple times a week?

I don’t know. I guess that’s a theme to this blog. It helps to read other people’s stories.

Some days I think I’d be better off in the hospital.

Am I a phony?

Some days I feel empty. Like driving through a frozen prairie, so much space and ice and cold.

I feel that if my job realized how little I actually do I would have been fired a long time ago. I’m afraid that I’ll be found out and everyone will realize I’m just a big phony.

Sometimes acting makes me so tired. I play at maintaining normalcy, at work and as a husband. I don’t think people would like me if they knew how I think.

So, I just keep up the act. Does it matter how long it repeats? Is Wednesday so different than Tuesday?

Update: I have since learned that this is a fairly common feeling, in fact they have a name for it, Imposter Syndrome.

Diagnosed bipolar

In the spring of 2018 I was diagnosed as bipolar.

Last summer I underwent a spinal fusion surgery at L5-S1. I lived with back pain for several years. By the winter I had healed physically, but I wasn’t able to stop taking hydrocodone until January. When I was finally free of the pills I found myself stuck back in depression.

I’ve dealt with depression my entire life. As a child I felt this as anxiety, sadness and a persistent stomach ache.

I was diagnosed with Major Depressive Disorder when I was 21. I self medicated with drugs and alcohol until I was 35.

In the spring of 2019 I sought out counciling for depression. I worked with my G.P. and a councilor through an Employee Assistance Program.

This time I was diagnosed as Bipolar type 1. It took 40 years for a proper diagnosis.

I’ve decided to start this blog to journal my experience, but I’ve made it public in the hopes of helping other people suffering from / living with bipolar.