poisonI’m grateful for medicine.

Without meds to help me regulate my moods (bipolar), I’m quite certain my life would be a series of disasters. But as all people dependent on medicine know, there is often a trade-off. There are side effects and there are dangers. There is no one more compliant with psychiatric medicine than I am, and that comes with a cost.

In the fall of 2017, I needed a med change–a regular occurrence in the treatment of Bipolar Affective Disorder. My doctor increased one drug and added a new one–something brand new on the market. It’s a drug you’ve seen in commercials a dozen times and I was hopeful that it would level me out–and it did. But as a person who was already struggling with anxiety, it began to get out of control soon after starting it. I never connected the two. The doctor then put me on an anxiety medicine to help with that.

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Bumped Up

lithium-carbonate-extended-releaseOn #WorldBipolarDay, I shared my thoughts on being bipolar.  The response was very positive.  Many people expressed that it was helpful to them.  I keep an anonymous blog dedicated to bipolar because I have been nervous about being public about it, but I’ve decided that my aim is to do my part to fight the stigmas and general lack of understanding of what it means to have a mental illness in a way that puts a human face on it.

I don’t even like the term mental illness.  It’s really just an illness.  We don’t say lung illness, insulin illness, brain illness, stomach illness, flu illness.  We generally say illness.  Also, a mental illness is an illness of the mind.  I’m not so sure that is what bipolar is.  The mind is the active projection of the brain that creates the experience of consciousness, the intellect, our thinking.  The way we think can greatly influence the way we behave and even affect the state of our brain.  So if bipolar is an illness of the mind, then we should be able to think our way out of it.  Right?

And that’s where the misunderstanding begins with mental illness.  “Cheer up.  Think happy thoughts”, we say to someone with clinical depression.  “Meditate to calm your mind.”, we say to someone who is manic.  Do you know what happens when someone in the midst of a manic episode tries to meditate?  They think it’s giving them super powers.  They do it for long periods when they should be sleeping. They talk incessantly about it.

Although there is a growing body of evidence of mind/body dependence, ultimately bipolar begins with the brain, not the mind.  Bipolar is a neurological disorder, not an emotional problem or a mental problem.  Which means that it is actually a brain or neurological illness, not a mental illness…whatever that is.  It’s a illness that does affect our mind, but it is not created by our mind.  At least that’s how I see it.  But to prevent confusion and so as not to have to go on a diatribe every time the word mental is used, I will stick with mental illness.

I saw my doctor today yesterday.  I’m in the habit of saying doctor instead of psychiatrist because it requires no explanation.  I told him I’ve been hypomanic off and on for a few months so he bumped up my lithium another 300 mg. He indicated that it might not be a permanent dose, but I suspect that it will be.  FYI, hypomania is a mild form of mania.  If depression is the downer side of bipolar, mania is the upper side.  Here’s a general list of manic symptoms.  It’s not comprehensive, but it gives the gist of it.

  • Feeling unusually “high” and optimistic or extremely irritable
  • Unrealistic, grandiose beliefs about one’s abilities or powers
  • Sleeping very little, but feeling extremely energetic
  • Talking so rapidly that others can’t keep up
  • Racing thoughts; jumping quickly from one idea to the next
  • Highly distractible, unable to concentrate
  • Impaired judgment and impulsiveness
  • Acting recklessly without thinking about the consequences
  • Delusions and hallucinations (in severe cases)

The thing is, I feel that it is some sort of failure to be bumped up in my meds.  I’ve prided myself on how low my doses have been and how well I’ve done, which is absurd if you think about it.  Although there are lifestyle choices I can make which contribute to my mental health, it feels like it’s mainly out of my control.  It was medicine, particularly lithium, which made me well in the first place

Besides the sense of failure, I wonder what the consequences will be.  The dose I was taking with lamictal, geodon, and lithium (all different kinds of mood stabilizers) was slowing down my cognitive function.  It was affecting my job significantly.   My doctor’s solution was for me to go off gluten and take DHA fish oil.  It worked very well.  So will that be enough this time?  It will take a little while before I know that.

But the question of failure is bothersome.  Why do I feel this way?  My first thought is that there’s a lot of pressure on the mentally ill to stay well.  When we don’t, we worry that we are disappointing someone.  That’s a form of failure, and I do believe it is related to this, but it’s not exactly the same.  Perhaps it is simply that my pride is injured.  I’ve written and spoken about how I’m a model bipolar.  I’m compliant, as professionals say.  And yet and I’m struggling to be healthy lately.

I also wonder if this disorder is progressing.  I don’t think it is something I’m doing.  If anything I’m doing more to support my health.  I don’t drink.  I don’t smoke.  I’m eating healthier.  I started swimming again.  But the signs are there.  I’m getting intense.  I’m getting too chatty.  I’m making mountains out of mole hills.  I’m both obsessed and disinterested.  I’m having trouble sleeping.  It’s definitely happening.

When I mentioned to my daughter, who also has bipolar, that I bumped up my lithium because I felt that I was hypomanic over the last few months she said, “Ya think?!!!”  I never realize how obvious it is.

It’s not just mental health issues that people feel bad about.  We feel bad when we have to up our insulin because it means we didn’t manage our diet well.  We feel bad when we have to up our blood pressure medicine because we didn’t manage it well enough.  We feel bad when we need more pain meds for chronic back pain.  We have a love/hate with medicine.  We’re glad that we have it and we hate that we need it.

My meds have radically changed my life mainly for the best.  This formula has worked for me for several years.  I’m afraid to change it, because I’m afraid of losing control again.  But I trust my doctor.  He’s never steered me wrong.  So bump me up, and level me out.

Trying to Stay Cool

bipolarIn my bio, I mention that I have bipolar disorder.  Although I think that most people cannot tell that I have any disorder at all, other people with bipolar and people who are close to a bipolar (read “a person with bipolar”) can tell.  Even medicated, I have my giveaways.

We all have this idea of what bipolar looks like.  We’ve read novels and watched movies with bipolars.  We see ecstatic people climbing over rails of bridges screaming they’re king of the world.  We see depressed people who stay in bed for weeks.  And although these are real scenarios, this isn’t everybody.  Many bipolars take their meds and live normal lives. The other folks just make better fictional characters.  I’m saying “bipolars” in this piece because it’s easier.  Maybe I should say “persons who suffers with bipolar”, but I don’t suffer.  I’ve never suffered.  It’s the people around me who have suffered.

I don’t really care to get into all my symptoms because some are harmful and embarrassing. That doesn’t mean that I am a danger to others.  No worries.  But my behavior can be harmful in the context of relationships if unmedicated.   Harmful behavior aside, mainly I just get really intense about things and I don’t sleep, although I’ve also struggled with grandiosity, paranoia, motor-mouth (pressured speech), and a scary level of impulsivity.  You can see it in my writing sometimes. Usually, I take those posts down after my wife clues me in.  Or I listen to depressing music and write depressing poetry until I just want to slip away…at least for awhile.

This is one example of my mania.  I went through a period of hyper religiosity.  I would wake up at 2:30 am, brew a pot of coffee, read the Bible and worship with youtube praise videos until time to go to work, and I’m not even an evangelical  And when I’m manic, I don’t feel sleep deprivation.  I can live on little or no sleep.  It’s great…for awhile.  I can get a lot done when I don’t need to sleep.  But  the problem with unchecked “hypomania” is that when it becomes full blown mania, all of that productivity and creativity  ends in disaster. And yes, my religious mania ended in disaster and public embarrassment.

But because some bipolar behavior can be harmful to relationships, I have a lot riding on my treatment.  I never let up.  I take my meds every day.  If I forget to refill, I jump out of bed and run to the drug store.  I have a family that depends on my sanity, and I don’t ever want to let them down.

This disorder has caused me to embarrass myself and others over the years.  With poor impulse control in combination with grandiosity, paranoia, and worse, I’m capable of creating very embarrassing situations on both small and large scales.  So, if I’m feeling impulsive, I shut up or walk away.  It’s tough.  Facebook’s nice because you can delete stuff when you’ve had a moment to rethink.

I’ve shared my diagnosis on Facebook before and I felt uncomfortable with the response.  It was bipolar awareness week and I wrote about what NOT to say to a bipolar, but no one acknowledged the actual content at all.  It was just a huge thread of congratulations for being open and defying stigmas.  I don’t care about stigmas, mainly because I’ve never been the target of them.  I don’t feel brave when I tell someone because I’ve never had a negative response.  It’s a different world.  People are beginning to understand mental illness. Honestly, I think people who know me best were relieved to find out that my condition had a name and was treatable. So if you’re reading this, please consider not congratulating me.  I felt embarrassed by it on Facebook to the point that I deleted the post.  I just want to raise awareness in my own small way.

Common questions:

  1. Are people with bipolar more creative?  That is my experience. A lot of artists, musicians, actors, dancers, writers, and poets.
  2. Are you better at your art when you don’t take your meds?  Yes, but with some adjustments it is possible to still be able to do it.  Rather than the art coming out of your illness, it comes out of your wellness.
  3. Can bipolars hold jobs, stay married, be a good parent, etc.?  I’m doing all of those things, but many do not.  People with bipolar disorder, because they feel like they are not “themselves” on meds, tend to stop taking their meds.  They also stop taking their meds when they feel better,  thinking that because they are better they don’t need the meds. I don’t understand this because I know for sure that I am better because I stay on the meds.  And, honestly, I feel plenty “myself” medicated.  I didn’t always have active bipolar.  I still remember what it feels like to be well before meds.  I much prefer being well.
  4. Do you need any special accommodations at work?  This article is superb.  Accommodation and Compliance Series: Employees with Bipolar Disorder.  But honestly, the only accommodation I’ve asked for is time off for doctors visits.  Now that I’m reading this, though, perhaps I could benefit from more.
  5. Can you get fired for behavior related to bipolar?  Bipolar is covered under the Americans with Disabilities Act.  The employer would have to prove that the offense was unrelated to bipolar.  I disclose at work just in case.
  6. Are bipolars more likely to have other problems?  Yes.  Substance/Alcohol abuse, sexual issues, smoking. 70% of people with bipolar smoke.  SEVENTY.
  7. Are there terms or words concerning your illness that bother you?  Not a one.  When I’m not well, I’m crazy and insane.  When I’m manic, I’m a maniac.  Loony, lunatic, madman, etc.  All of these words have been apt descriptions for me at some point.  BUT, not everyone feels that way.  Some people with disabilities need us to use certain language in regard to themselves and their disability in order to feel respected, perhaps because of how much they’ve been disrespected.  I’ve been treated well, so call me whatever you like.

I wonder sometimes if given the choice would I choose not to have this disorder.  My conclusion is always the same:  no.  Bipolar isn’t like a separate piece of a person, it’s an integral piece.  They say the person is not the disease, but I don’t buy it with bipolar.  It is a fundamental part of who I am, not as my identity, but in my entire nervous system.  I can do what I do, think how I think, and see the world the way I do in part because of this “feature” of my makeup.  If I did not have it, I would not be the same person.  I couldn’t tell you exactly what would be different, but I suspect it’s a big part of what makes me me.

In my first year of treatment, my dear sister-in-law said.  “I’m glad you’re better, but sometimes I miss the crazy-ass David.”  When she said that, I thought “Yes!  I miss him, too!”  I have realized that there’s a difference between mental wellness and suppressing who you are.  We, the mentally ill, do this so that you won’t worry about us and so that you will feel comfortable around us.  I’m afraid, sometimes, to let the “crazy-ass David” out.  My family’s stability, in large part, depends on “steady David”.

It begs the question, is “crazy-ass” a symptom or is it just a personality trait that no drug will take or should take away?  I’ll let you know when I figure it out.  Until then, I’ll try to stay cool as best I can.