the modernity ward

Going Sane

The tide goes out.

The offshore hurricane churns away, slowly, peters out without warm ocean and wind currents to feed it. The roiling surf eases up, slips back away from the sand. You can see what it carved out, this latest storm: a new shape to the shoreline. Shells from farther south, seaweed heaped in miniature mountain ranges, and then -- some new thing jutting up from the sand, a shard of a boat, weathered but preserved and now, finally, visible.

A manic state for me is an excess of energy. Sometimes that feels indescribably wonderful and sometimes, when my energy is high but my mood is black, it feels like an outsize chainsaw I can't quite manage and can't turn off. Oxcarbazepine brought the fury down. I stopped wanting to -- seriously planning to -- smash my fingers with a hammer, slam my head in a door. Okay.

Then the bottom dropped out from beneath the place I thought low enough already. I don't know that I've ever experienced such pure depression -- mine have always been energized rather than lethargic -- and I trudged instead of walked. Spoke slowly. Could barely raise my eyes. I wasn't sad, for the most part; I was empty. Void. The constant music playing in my head went quiet. (I mean that literally -- I always have some song going on in the background in there.)

I fed everyone something every day: something out of a jar, something out of the freezer, something crunchy out of a bag. My basic caretaking abilities, like brain stem functions of breathing and beating heart, are the last to go. Crud accumulated on the floor. Sean kept up with the kids and the laundry. The garden died.

Buproprion turned the sound back on, the color back on. And my mood lifted, my energy returned, with shocking rapidity. I've been taking it a week and I have had a handful of days where I felt normal. Took an exam, ran two errands with the kids, made lunch for them, read for a while, worked out, cleaned the house, fixed dinner, practiced fiddle with Sophia (an excellent measure of both mood and energy level for me). This all happened without me screaming or breaking anything or even wanting to.

It felt revelatory. No way to take the full measure of what is missing until you find it back, again.

Now I have to quiz myself: am I too happy? Too bursting with ideas? Am I accepting of myself or crazy overconfident? Okay for now. But I get to ask myself those questions every day. Several times a day. From now on. 

About the rowboat, now.

The froth of a mixed state settles, in the clarity of adjusted brain chemistry, and what you get isn't some Perfectly Fine version of yourself, but a chance to see the junk and driftwood that was waiting under. It gives shape to the illness; the illness moves it around; but they are separable, and require different kinds of cleanup. No pill will unmake me a person with an overdeveloped sense of responsibility to the people I care about (to the point of self-obliteration), will unknot my assumption -- my acceptance and understanding -- that no one wants me around. 

No, that's my wreckage to tidy up. Without the manic depression, though (and I am going to call it that because it's a better way to describe what I have rather than try to sort out discrete states), I can see that it is just wreckage -- a rowbat that maybe served me once, when it was the only way to stay above water, but isn't fit to use today. That boat needs to be hauled up out of the sand and burned before some kid running on the beach stubs a toe on it.

But I can haul it up, now.  

Thank You

Just thank you. All of you who commented (or emailed or got in touch with Sean or whatever) or even just thought nice thoughts in my direction.

I want you to know I read all of it. In fact I go back and read every day, every comment. Some days it gets in. Some days I feel guilty for having conned everyone into thinking I am a person worth saying nice things to BUT I promise I will tell the therapist about that tomorrow.

I'll spare you the write-up I plan to dump on the therapist and psychiatrist tomorrow. I suspect that the medication is helping with the agitated part of the mixed state -- I get breakthrough irritation, less as time goes on, but it's been almost a week since I smashed a hole in the floor. Being calm to the point of stuporous probably doesn't hurt, and I am realizing now how little and how poorly I'd been sleeping for a couple years.

But I don't think it's doing much for the real bummer part of the depression. Actually that isn't what I think; what I think is that I am finally clearheaded enough to observe how awful I really am, but SOME PEOPLE might say that was depression talking so EVEN THOUGH I DON'T AGREE I am willing to report it as a symptom.

But thank you. The best part of anything I ever did was you guys. You were what made it worth doing, what made it really happen. This is no different. 

Time Out

Yeah, I'm sorry, I am having this constant mixed state thing happening and it is horrible. Sometimes I get a reprieve and feel normal or kind of sedated for a few hours and that is such a relief. 

In the breaks I try to do nice things with the kids.

I deactivated my Facebook account and I shredded the stuff in my sketchbook, save for one inked drawing of the creek behind the house I grew up in. I'm not getting anywhere near an open mic. I am not going to take down the blog but just please don't get worried if I don't post for a bit. 

I realize the irony of announcing this on a blog, but: I think it's time to hobble my creative impulse. Facebook is just another way for me to annoy the internets; the sketchbook is just more delusions of ability and creativity. It did give me pleasure, I guess, to think up a status or make someone laugh or draw something or write something, but in the end all it is is an embarrassment to me and to my family, an imposition on the people around me, something I'm waving in your faces and insisting you tell me is Very Nice.  

And to burn out the remnants of it, to cripple my ability to force myself upon other people, that's something I have to do while I have this clarity. Before the joy chemicals saturate my brain again and I start thinking it might be a good idea to tell a story or draw something. 

There is a bit of loss attached to that but that's a selfish vestige of an inaccurate self-concept.  It has to be, you know? I'm more like a bubo than a repository of insight: what's inside me, if it gets out, is something foul, something that should be purged in private rather than shared. 

Oh and don't worry, the therapist and the psychiatrist know about this. They agree it's a good idea.

 

The Thing About Doing All Your Shopping During a Manic Episode

is that you end up with a lot of clothes that are two sizes smaller than your regular body (because who needs to eat while we are having SO MUCH FUN MOVING AROUND WHEEEEE) and all of those clothes are either revealing or skin tight (because can you see the sexy just coming off me in waves? I KNOW I CAN SEE THAT).

I need a Bipolar Fashion Survival Kit like those Pregnancy Survival Kits, where you get two black t-shirts, a black tank top, and a black spandex skirt and black yoga pants. Except mine would have a pair of jeggings and an off-the-shoulder top for mania, and a giant gray t-shirt and baggy jeans for depression. Mix and match for mixed states.

 

Med Check

I think the Tri-reptile or whatever the hell it is is starting to work. I don't know. Remembering things like words? and concepts? is not my strong suit these days. 

But I do get these stretches, now, of feeling...ordinary. Neither flooded with happy juice nor sitting at the bottom of the Marianas trench. And when I do start bouncing from one extreme to another, I am able to recognize it rather than being consumed by it. Of course that doesn't shut off the faucet, one way or the other, but it gives me just enough distance to exercise a little self-awareness.

For example I spent most of Friday's daylight hours driving our van eastward, happily contemplating each of my friends and acquaintances and how much I loved them and how happy I was to have them in my lives and we are all connected and just wonderful and I am so glad to be here, and you know what, I am going to make a comic about this but after I hug everybody and food, no, I'm not hungry, it's cool.

Until about 7 pm when I suddenly became the most horrid creature ever to settle into a hotel room and I can't believe I ate that cookie and here's what I'll do, I'll just NOT EAT for the rest of the weekend and then I will have really earned that cup of fat-free yogurt and I will let myself have a tiny slice of wedding cake and THAT IS ALL but NO FOOD ALL DAY OTHERWISE and I am going running now, at 9 pm after a 9-hour drive. Maybe I will just skip the wedding. Or offer to watch the kids so everyone else can talk. GOD THE KIDS STOP TALKING KIDS NOBODY TOUCH ME

Next morning, fine.

Sunday, fine. Mellow, even, with the children. Able to withstand talking/wiggling/minor property destruction without an outburst. 

Monday, fine (and up another rung on the dosage ladder). Was able to decide on run vs. weight lifting without an angry panic. A little slowish and stupidish but even of temperament until, round about 11 a.m., I remembered that I am an ugly sack of crap who will never be good enough, never ever, and I am failing everyone who loves me, and I don't understand why these amazing people love me but I will trust that they do and that is just a new realm in which I am failing them, that I don't understand why they care about me. 

The difference, now, is that I've had a taste of the even mood and the perspective that brings. I can see that this IS a mood, not gospel truth, and I can hope that it'll end. 

Be interesting to see what's under it. Like, is that some low self-esteem in there, left over from the '90s? Do I have to address it? The interconnectedness of everyone, that's real. I'm sure of that. Because it keeps me alive.

 

I Am Too Tired to Make This as Awesome as It Was

Short version: Doctor Excellent wrote me a list of meds and said, okay, go research these, come back in a week and tell me what your thoughts are.

And I looked at it and said: Lithium's too big a gun; Depakote gives you PCOS and I already have that; Lamictal is good but requires a very slow titration up to dose to avoid Stevens-Johnson Syndrome and we want something faster-acting for now; Tegretol is a little heavier than Trileptal in terms of side effects and it's more likely to screw up my birth control; so that leaves us with Trileptal, which is weight neutral and that's what I want. 

Oh and Lamictal may be affected by my estrogen oral contraceptives. Serum concentrations of lamotrigine were substantially lower in women taking estrogen.  

And the good doctor threw up his hands in the air and laughed and said yeah, that was what he was going to recommend.

And THAT is how I have fun these days. I totally got an A+ in mood stabilizers. And saved myself an unmedicated week. 

Speaking of: I am up late enough that I am getting punchy and silly, but today was a rough one. This shit cannot start working fast enough. It would be downright magical not to fly into insensate rage at the possibility of the broccoli water getting the taco shells soggy when both occupy the same plate. Or see a jogger, on my one well-earned rest day (I am underslept and got a bunch of vaccinations yesterday), and not feel a wave of panic and rage and self-hate at not being out running myself. Or read a graphic novel or a biography without the bully chorus in my head shrieking about how I never do anything like that, I'm a quitter, I never SHOULD do anything because everything I do is crap and everyone wants me to just stop trying to make things and go away and quit coming around and don't I see I'm embarrassing myself?

Et cetera ad infinitum. It is boring in both senses of the word: indescribably dull and repetetive, and able to drill a hole neatly and surgically into what's left of my sense of self. 

Gah. I look back over it and it just looks like whining, like self-pity for a normal onslaught of feelings, like still-just-making-it-up. 

Excite the Middle Between the Two Poles

I will start at the end and work back from there. Y'all I am TIRED and I had my school physical today and many needles were poked into me and foreign substances injected under my skin and integral substances were removed from beneath my skin SUCH AS BLOOD and there's some extra stuff in that as well. 

By which I mean Trileptal. I like that drug name because it sounds less like a dandruff shampoo than Tegretol I MEAN REALLY and also it brings to mind leprosy. Oh, I'm sorry, Hansen's Disease. Hanson's Disease, on the other hand, should be what it's called when you hit puberty and suddenly the world is no longer interested in you. It's debilitating. Or seems to be, anyway. What happened to those kids? 

Trileptal. Yes. This is, for me, a mood stabilizer. Because I have a tendency to come at the world in ALL CAPS and things are either REALLY GREAT or REALLY TERRIBLE or, and this is diagnostically significant, BOTH AT ONCE.

My diagnosis, and I had to run back in the room and ask this because I was so delighted at being taken seriously that I forgot to ask before I scampered off the first time, is bipolar (mixed type). Which means I have ups and downs, you know, the obvious mood swings, but more -- dangerously? Disturbingly? Ominously? Inconveniently? -- I experience mixed states. All the juice of a hypomanic-to-manic episode, the racing thoughts and anxiety and agitation -- with the self-hate and irrational guilt and overwhelmed-ness of depression -- and that is how you end up in frantic unhappiness and desperately trying to shut off the fire hose of thoughts by punching yourself in the face, Fight Club-style. Or paralyzed and unable to accomplish anything, especially not the million incredible things you dreamed up when you were just straight hypomanic and everything was great and you needed seven drinks and a handful of Benadryl just to fall asleep but it doesn't work and so you stay up posting thirty-seven Facebook statuses that are increasingly inappropriate as the night wears on.

I liked the psychiatrist a lot. Tomorrow I will tell you a story about how well we got along and how we settled on Trileptal. 

 

I'm Not Crazy! It Turns Out I *AM* Crazy!

I will do the big write-up tomorrow. Short version, I got a diagnosis, not entirely what I expected but clearly, wholly accurate; it will come as a shock to absolutely nobody; the psychiatrist was great; I have a prescription which is a good starting place. And an enormous relief. Glory hallelujah.

EKG

I am still here, re-reading all your comments. 

I made a mood chart based entirely on blog posts and Facebook posts; it stretches back a couple years and it looks like an EKG.

Sean got an old Nintendo and we are going to play Kid Icarus every night. It will be our coping strategy. And yeah, Sean is having his own thing with anxiety, and is being treated and all that, so we are just kind of a three-legged-race of a person, kind of dragging each other through the days a little bit at a time. It turns out the 12th anniversary is the Matching Nervous Breakdown anniversary!

Right now I am so grateful for the internet. Because otherwise I am a complete recluse, or would like to be, and keeping these connections from being completely severed in the down times is such a help. Plus, you know, I am just WILDLY entertaining during the up times. Until suddenly the ride goes too fast and, you know, yells at its kids and loses all sense of personal boundaries and drinks too much just to calm down enough to fall asleep. 

It is hard to admit that the up times are not all fun. They come with such a seductive blast of happy brain chemicals that it is easy to discount the collateral damage.

I still feel like I'm making all this up, that if I weren't so, I don't know, needy and pathetic and stupid and irritable and god, just such a fucking drag, if I could just keep it to myself a little bit better, the world could just go on turning. 

Tomorrow's appointment can't come fast enough. I made Sean promise that when the doctor tells me I'm full of shit or gives me a diagnosis I don't think is the right one, that he will come in, credentials blazing, and tell them that yes I really DO suck as much as I say I do, or at least help me find someone else. 

 

 

That Which Doesn't Kill You Makes You Tireder and Eat Cheesecake

SOOooooo today was the initial visit with the counselor/case manager person at the blahblah center for Help You Crazy Brain. Dear Diary Today was fun. 

You know what, I think "Dear DIARY!" should be an exclamation. I am going to replace all my Dear God! And Dear Lord in Heaven! with it.

I still feel like a big selfish whiner with First World Problems but it turns out that is a thing they refer you to a bona fide psy-chiatrist for so yay me. There were mentions of drug therapy and cognitive therapy.

I will keep you posted.

 

Also I ate half a cheesecake. And took a Xanax. You totally can't tell, right?