The Middle Road

Just a quick note to mark this place in time:  I've reached the blessed state of -- balance -- ; I'm not depressed or bouncing off the walls or cutting myself or wishing to die:  It's The Middle Road.

I finally found a doctor to prescribe my Depakote:  my primary care physician.  I'm in a very good place right now.  No side effects (knock on wood) and life is going well. 

I can't ask for anything more.

Just to be clear, and as a note to my future self:  I need my medication.  If I stop taking my medication, everything falls apart.      

I'm Trying

I feel like absolute, total, fucking shit.  My moods are swinging from one extreme to the other, and it is exhausting to maintain and not kick in somebody's car or smash myself in the face or cry for no reason or race around like a lunatic. 

I'm trying, so very hard.  I'm trying. 

No flourish of words.  I just want peace and rest for my body and brain. 

We Must Do Better

I met with my therapist today to discuss a new psych doctor for med management.  After an hour of discussion and catching up, she referred me to someone who came highly recommended.  Unfortunately, that individual is no longer accepting referrals so we're back to square one.

There is an extreme shortage of mental health professionals in this country.  We have to do better in this regard.  I vowed never to preach, proselytize, or otherwise proclaim any sort of authority on anything when I began this blog.  My only intention was to create an outlet for my diagnosis and to record my ongoing struggles/successes along the way.  That said, I think it is safe to state that we - mental health patients - are underserved in this country.  Our prisons are full of underserved mental health patients.  Our hospital emergency rooms and acute psych centers are overrun.  When presented with an individual in crisis, law enforcement personnel either charge the individual with a crime, or bring them to the nearest emergency room for a psych eval.

We must do better.  It should not be so hard to find care.  It should not be so hard to afford the medications that we all need in order to carry out daily tasks of living.  If we ask for help, help should be there. 

It is not.  

The More Things Change

I recall a conversation with my therapist last year during which I asked,

"Am I really bipolar?  Couldn't this just be a time of crisis?  Some sort of fleeting thing?"

Her answer surprised me.  I expected her to agree with me and say that I was right - this was just a temporary thing and everything would be fine.  However she said no such thing.  She chuckled and said,

"You have a biochemical disorder - bipolar disorder.  YOU are not bipolar.  You are you.  You just happen to have a challenge not unlike a diabetic; you manage the condition but it is not who you are."

That wasn't what I was asking.  I truly wanted to know if this shit was for real because every now and then I felt normal.  Calm.  The voices in my head were relaxed and the screaming silenced.  I did not believe my diagnosis during those neutral times.

It has been several months since my last post and a lot has happened during my absence.  I got a job - a very good job.  I stopped seeing my therapist soon after due to issues of scheduling.  I settled in at work and spent my days navigating a steep learning curve. 

I stopped seeing my psych doctor right after the new year - January 2nd, to be exact.  I forgot about an appointment.  I was so busy at my new job, so worried that someone would find out about my illness, that I was jumping through hoops to impress right out of the gate.  I figured out that I missed the appointment when I received a bill in the mail for $200 for the missed appointment, and a note that this amount was my responsibility and not covered by my insurance.  No reminder call prior to the appointment, no inquiry regarding my health with the invoice - just an impersonal, face-slapping bill.  I cut all ties on the spot.

That put me in a difficult situation.  I never cared for my psych doctor, but I needed him for ongoing prescriptions.  Our appointments were ten minutes at most and it was clear that he had to relearn who I was with each visit.  He often confused me with other people which left it up to me to explain what medications I was taking, at what dosages, etc.  I found that dangerous given the types and amounts of medications we were dealing with at that time. 

So I was without a psych doc for meds, which meant that refills were impossible.  The only reason why I was even able to see this doctor was because my therapist pulled a favor to get me in faster than the usual 3-4 month wait.  With the realization that I would be without medication in less than a month, I made the decision to titrate down and off of my medications. 

Dangerous?  Yes.  Stupid?  Yes.  Unfortunately I felt completely alone and vulnerable so it was the only choice. 

I brought my levels of Depakote and all other medications down very slowly.  I experienced no side effects whatsoever.  Everything seemed fine, only I wasn't really fine.  I'm not really fine. 

Depakote was a fucking bitch of a medication.  It was better than Lithium and Risperidone, but not by much.  It did nothing to help me lose the monumental weight gain from Lithium and Risperidone.  It was not without side effects, but it DID level out my moods.  I was never super happy or sad - just living in the middle.

I have been without any sort of mood stabilizer for a couple of months now and things are starting to get scary.  The intrusive thoughts are back.  The deep sadness, self-harm, explosive anger, mania, screaming inner voices - all are back. 

I am doing my best to manage this on my own (regular sleep schedule, proper nutrition, supplements, etc.), but I know that I will need help.  Soon.

So that conversation with my therapist regarding my disbelief that I am, in fact, bipolar, runs through my mind.  I no longer doubt my diagnosis.  It's a shame that I had to fall through the cracks to finally accept it as fact.

   

Signs of Life

A couple of days ago The Chair was moved to another room.  At my direction, my fully functioning command center/jail cell/dining room/office/bedroom was dismantled and moved to my bedroom.  The prescription bottles, notepads, over the counter medications, and everything else within reach was put away.  There are other chairs and sofas in the living area, but the self-imposed prison is no more.

I sat in The Chair all summer long.  I only left the house for therapy/psych appointments, and those were scheduled on the same day or one day apart because I still can only manage to shower once a week...sometimes.  I did not drive because my brain could not handle the speed of it, so I had others ferry me back and forth to my appointments.  On the rare occasion that I did drive, I had someone with me, just in case.

Over the last several weeks I have titrated my dose of Depakote up to 1500 mgs daily.  My side effects are mild and not enough to cause me to discontinue the drug.  My once thick hair has thinned, but it's not horrible.  I have stomach pain on occasion, but that is usually solved by drinking more water or taking my meds with food.  I have gained a considerable amount of weight, but am working to take it off.  I still continue to take valium, as needed, for severe anxiety/panic.  My psych doc added Zoloft this week to assist with that and depression.  I think we are on the right track pharma-wise because I do feel better ... more even.  However, I did have a week-long manic episode a couple of weeks ago.  I did not sleep for almost 100 hours (over 4 days), spent $2,000 on crap that I did not need or use (all of it was returned), and acted out in other ways that are not worth mentioning here.  I did the smart thing and managed to call my therapist and psych doc and they helped to bring me back down.

I do have angry outbursts on occasion, but those have greatly reduced.

Things are better on the depression side.  It has been several weeks since my last episode of suicidal ideation. 

While I still encounter hurdles along the way, I am improving.  The Chair has been replaced with a tidy living area.  I am engaged in the workings of my home.  We are moving in the right direction with medications.  The main concerns at this time are my weight and fear of leaving my home.  I told my psych doctor that walking outside felt so expansive - as though gravity had lost it's ability to hold me fast on the Earth.  Of course this fear has developed because of my extended in-home stay, so I do my best to get outside and take a few additional steps each time I venture out.

The good:
Meds are working
Moods are more even
Self harm has greatly reduced and is almost gone

Need improvement:
Self care
Overcoming fears / anxiety / panic / frustration / anger
   

 

The Chair

The weeks since my last post have been very difficult for me.  I know - broken record - but they were the worst in many years because they robbed me of the last thing I held dear: the ability to put my thoughts into words.  The fear consumed me, wrapped around me, suffocated me, and forced me into a tiny three by three foot square:  The Chair.  The Chair is my safe place - home base - no evil can touch me here.

Of course the warped part of that is the fact that The Chair is, in itself, evil.  It is my prison.  I don't see it that way, but it is.

The Last Stand.  

If you are of a certain age you remember the old tube televisions.  After turning off the set I used to watch the once vibrant and engaging picture get smaller and smaller until it glowed as the tiniest little dot in the middle of the screen.  That dot stayed there for quite some time, and then it was gone.  Much like that concentrated speck of light - an entire universe on the head of a pin - my world has shrunk to the size of a recliner.

After the failings of Lithium, Risperidone, and Lamictal, which gave me Stevens Johnson Syndrome (still dealing with the side effects of that), my doctors have moved on down the pharma line to depakote.  My doctor was so concerned about side effects that he started me on a very small dose - 250 mg daily for four days, and 500 mg daily thereafter for a couple of weeks.  We will move up at that time if all goes well.  I took my first 500 mg dose last night.  So far, so good.

Swallowing that first depakote pill took every bit of bravery and strength I had.  It took me two days to build up the courage...turning the prescription bottle over in my hands for hours.  Pills have not been my friend.  In fact, the pills charged with bringing me back from suicidal ideation nearly killed me. 

The words come so much harder now, so I have very little to say.  It is important to mention that I am not a victim to my diagnoses.  If you could see inside my head you would see an epic battle being waged against the disorders by my desire to be well and live a balanced and joyful life.  I do not sit here because I've given up.  I sit here because I'm holding this fucking mountain as a last line of defense against disappearing forever.           

Symptoms

Just took 10 mg of Valium.  Mind racing, unable to speak clearly, frustrated, want to claw my face off.

Heart pounding. 

Extremely overwhelmed.

Dizzy.

Single thoughts or actions cause me so much pain.  It's too much. 

I went to the market and could not handle the choices.  No one was helping me make choices.  I panicked.

Must calm down or I am going to lose control.