If I Could Just Turn Off My Brain!

I’ve been off-line since my last entry five days ago. I almost feel guilty to have let so much time pass considering the content. Yeah, I’m still here. The BP is becoming so consuming. I’ve swung way back to the manic side again. I’ve been awake since 0400 and right now it’s 0040. Give me almost four more hours and I will have stretched “today” into a 24-hr marathon. Tired? Not at all. I worked for 13 hours straight—no breaks, no lunch. When I logged off the network, I called my mom to wish her a happy birthday. I talked a mile a minute. I barely let her get a word in edge-wise. Towards the end of the call, she actually told me that she was glad to hear how happy I sounded. Geez, mom, get a grip. It’s called being MANIC, not happy…LOL. Then I called my friend and did the same with her. At one point she begged me to shut the hell up. She said, “My God, you're manic, aren’t you?” Then it hit me. Another cycle. How long will this one last? It’s a bite to stay awake for the whole weekend. By the time Monday rolls around, I’m gonna wonder what the heck happened to my weekend OFF. You’d think after working on my laptop all day the last thing I would want to do is get on my personal computer and start banging away at the keyboard. My eyes do feel like sandpaper, but I can’t shut my mind off. There are all these jumbled, random thoughts just racing through my head. I can’t just do nothing. I don’t watch TV and right now, I don’t have the patience to read anything. And even though I am wired tighter than a drum (that metaphor just doesn’t sound right), there is nothing else to do at this hour (try to remember that I do not live in a major metropolitan city…hell this state doesn’t even rate that…LOL). After having lived in Atlanta and DC, Greenville, SC is quite the sleepy community. Well, despite all the stupid, racing thoughts, I just plain don’t have anything else to say. ©2009

Yup, It Has Started

Well, I've been at this keyboard now for most of the day.  It's now 0430 and I am just grateful that today is a holiday.  No, I won't get any sleep...way too wired for that.  But I guess it's official:  I'm converging into my manic phase.

The State of Balance

Mania: a wild and violent insanity
Fifty percent of the component of bipolar
It’s what drives our creative forces

Depression: A pathological state of despair
The other fifty-percent component of bipolar
It’s what drives us to the utter brink of destruction

Balance: a state of equilibrium
Do you know what that means to a bipolar patient?
It is the very nature for which we attempt to strive

Balance is a very elusive element in the bipolar world
It can exist for brief moments in time
Or it can last for as long as a few months

Everything is contingent upon the medicine
A highly refined cocktail, precariously metered
In hopes that it is that magical touch

If you’re lucky, you’ve found that sought-after mixture
Even if it means that it becomes your ball and chain
For bipolar patients, the choice is which drugs, not if drugs

Medicines become the way of life
Ideally one can be reduced to one maintenance drug
However, at times, a combination may have to suffice

The side-effects can be debilitating, but carefully weighed, a solution
Most cocktails are written off-label
The majority used as mood stabilizers are often, in fact, for anti-seizures

The need for life-long medication is disheartening
There is no known cure for this condition
At best, one can be at peace with herself

There is a catch-22: the state of mania can be addictive
Because it does allow for creativity
We miss that element when we are in balance

I wish I could be balanced with a touch of mania
I love my creative side; it propels my juices to flow
But you can’t have your cake and eat it too

I never miss the depression; it’s far more than merely a bad hair day
Its very nature is destructive by definition
And often can be life-threatening at worst

The wildest state is the mixed-phase dilemma
Being manic and depressed at the same time
Going for days without sleep, yet wishing for each day to be your last

So, in the end, being balanced becomes a trade-off
The creativity is stifled, yet you strive to live for yet another day
In any event, being bipolar becomes an art form in which to survive.
©2007

My Zyprexa Dilemma (and a Diatribe On Smoking Pot...Go Figure!)

It’s quite amazing the quandary I am now facing. For the first time since January of 2006 I actually feel as though I’m getting my life back. Everything seems to be balancing out the way I remembered it being so long ago when I was in remission. However, my remission is coming at a great cost to me. These little oval-shaped pills, while incredibly effective, has caused me to gain 20 pounds within a period of a month. At this rate, who knows how much I’ll weigh at the end of the six-month weaning regimen the doctor wanted to use. I told him I was willing to go back on Zyprexa under the condition that if I gained any weight I would quit taking it. In one of the videos I uploaded, there was a question posed: which would you rather have—a sane, balanced fat person, or a skinny psychopath? I think I’d rather be skinny again, not that I was ever actually skinny. But your talking to someone who worked incredibly hard to lose 250 pounds. Even a 20-pound weight increase is a depressing thought.

I am to talk with my shrink today on the phone and think I’ve finally reach a point where I am no longer willing to continue to take the Zyprexa. I will be the first to admit that this has been the one drug that has made a significant difference in my fragile state of balance. However, I fear gaining the weight even more so. In addition, the eating pattern is bizarre. I’m not eating because I am hungry and I am wrestling with an increased appetite. It’s like I’ve moved into this grazing mode where I just walk into the kitchen to see what I can eat—whether I’m hungry or not. It’s almost as if there is an oral stimulus attached (similar to problems people have faced when trying to quit smoking).

I really like how I have been feeling these past couple of weeks, even if I do miss my manic highs (which girl group of the 80s did “Manic Mondays”?). I can’t say that everything is perfect, but I am the closest I’ve been to balanced yet, and just in time for my 50th birthday this Friday. I find it absolutely ironic that I was born on 4/20…the international “smoke a joint” day. It’s a shame I don’t have any killer weed I can roll up to celebrate my 50th in style right at 4:20 pm. Life can really suck sometimes. It just kills me that I can’t get high anymore. You know, I don’t drive a forklift at my job, I don’t have to drive a van, or operate any serious machinery where I work. Why should it matter to some egg head in HR that I must pass a random drug screen? I already know what I want for my retirement gift. A QP of absolute golden buds. Thai stick would be nice, but I don’t think the kids these days even know what Thai stick is. Now, some golden hash, no, make that dark, tarry hash, would be quite nice as well. And forget the rolling papers on the killer weed. I’d only use a bong. Less waste and it packs a more powerful punch. Oh, yeah, I forget, I can’t call them “bongs” when I hit the head shops…they are referred to as ‘water pipes” no—like who is going to use them to smoke tobacco in them? Face it, anyone shopping at a head shop has only one thing on their mind…all of the accouterments of fine pot smoking (OK, I grant you, there are people that hit the head shops just to buy incense, but just a few). And, the other day when I was in one, I couldn’t believe how much “water pipes” were costing. Me? A nice ceramic pipe and some screens and I’m good to go IF it wasn’t for these stupid drug tests that I always have hanging over my head. Yeah, corporate America has it all backwards. They don’t care if you’ve got some burned-out alcoholic working for you who reeks of beer or whiskey by lunch and can’t do their job half of the time, but God forbid someone smokes a joint from time to time. OK, I’ll give the corporate dude his due as far as tweakers go, and the more hardcore junkies (one of which I was for quite some time), but cut me some slack if I just want to take a few hits off a bong now and then. And, you know what really bites—I found out from my son one day that an eight-ball of coke costs less than an ounce of some premium weed. Now that’s an insult. Hmmm—I think I have digressed from the point of this post…LOL I’ll get off my soap box now!

Anyway, I’ve made the decision to come off the Zyprexa and I hope I can shed those twenty pounds I’ve gained. I wonder what the shrink will say when I tell him this afternoon during our phone conference. I’ll be the first to admit that the Zyprexa has been the ideal drug bipolar-wise, but I’m not going to grow out of the clothes I have. We’re just going to have to come up with a new game plan.©2007

Stolen Moments

There is this still quiet silence
That falls like dew upon the grass
My manna from heaven
My mind is free of the racing thoughts
That once choked the being of my sanity

There is balance in my life
This state I do not dare to upset
While I miss my manic highs providing my creativity
I do not miss those crashing blows that always follow

I feared the worse when the mania subsided
I panicked at the potential loss of my imagination
Yet I find in this still quiet silence the words
Words to express my conscious state of being

I think I like what balance feels like
I can inhale without constriction
I can be at that place where I am one with the moment
I can be mindful of all that is around
And choose not to select the darker path

For the first time in ages I feel at home in my mind

I can look in the mirror and see the hope and possibilities
I’m not quite sure yet how to grab the brass ring
But the fact that it is there for the taking
Finally lets me exhale with peace.©2007

Meds Update

I’ve had a different medication added to my cocktail—Zyprexa. I know its propensity to cause massive weight gain as I was on it before I had my gastric bypass surgery. As a result, I am monitoring my caloric and volume intake very strictly. The goal is to get me down to one drug as I progress into remission. I have quite a way to go before I reach that stage; the doctor indicates it will probably be a six-month journey for me.

I’ve noticed a difference in the stability of my moods (and the increased appetite!), and I have discovered that I am missing my manic highs. It was during those periods I was most creative. I haven’t felt the urge to write any poetry or much of anything else since I started the Zyprexa. I’ve heard other bipolar patients say that the reason why they would go off of their medications was to gain back the mania and creativity.

My main concern is achieving mood stability that has been a long time in coming for me this time around. I have been battling the depression end far more frequently this time than the mania—depression that has become completely crippling and affecting my job performance and everything else in my normal daily routine.

So, After two-and-a-half weeks of Zyprexa I am just beginning to see some sense of increased balance at the expense of the loss of the mania. This has definitely become a double-edged sword for me! I don’t know if I will ever be able to write again, or if I am just suffering from writers block. Time will tell

I am also trying very hard to cling to my faith right now. In my angst in the midst of a bout of depression, I just fell to my knees in despair knowing that the only person I had to turn to was God. He reminded me that it was time to fish or cut bait. He told me that he has given me the tools to walk upright in His glory and to claim the victory, so use the tools and grow up. I recognized that as being a loving chastisement of a loving Father.

In the midst of the depression it is often the hardest to remember to use my spiritual tools, but today I can claim the victory for these 24 hours and I’ll take what I can when I can. The true test now, for me, is how I will handle my next bout of depression. Will I allow myself to succumb to my weakness, or will I decide to call upon my Father to intercede on my behalf, knowing full well that He knows exactly what I am going through because Jesus walked in the same footsteps and understands my trials and tribulations. I want to become a mature Christian rather than staying stuck as a child looking for guidance. I am in the Word every morning and I study it faithfully and what resonates for me right now is “Trust and Obey” I know for a fact that He will never leave me nor forsake me, and I stand upon that promise.©

I'm Bipolar: So Who Am I?

Most people don’t understand bipolar disorder. However, if you use the older term, “manic-depression,” you might get a few “Ahhhs.” Even then, the general consensus of the population is one of enormous misunderstanding. The official definition of bipolar disorder is a psychiatric disorder marked by alternating episodes of mania and depression. Bipolar disorder is one that causes unusual shifts in a person’s mood, energy, and the ability to function. These shifts can be quite severe and have nothing in common with the every day ups and downs that most people experience. Damaged relationships, poor job performance and suicide can result.

And then it becomes more confusing when you throw two sub-categories into the mix: Bipolar 1 and Bipolar 2. The first is marked by swings from extreme depression to extreme mania. The latter experiences the extreme depression but a milder form of mania. “Mania can be described as an elated mood (excessive happiness and expansiveness), an irritable mood (excessive anger and touchiness), a decreased need for sleep, grandiosity or an inflated sense of themselves and their abilities, increased talkativeness, racing thoughts or jumping from one idea to another, an increase in activity and energy levels, changes in thinking, attention and perception; and impulsive and reckless behavior.” (The Bipolar Disorder Survival Guide, David J Miklowitz, PhD, pp 15,16). Erratic spending sprees and hypersexual activity are two examples of impulsive and reckless behavior.

“These episodes alternate with intervals in which a person becomes depressed, sad, blue, or ‘down in the dumps,’ loses interest in things he or she ordinarily enjoys, loses weight and appetite, feels fatigued, has difficulty sleeping, feels guilty about him- or herself, has trouble concentrating or making decisions and often feels like committing suicide. Episodes of either mania or depression can last anywhere from days to months.” (ibid, p 16).

I did not start out this discourse on a treatise of bipolar disorder; rather, I want the general public to truly understand the incredible insidiousness of this disease, at least through my eyes (and, yes, this IS a disease much the same as if one had diabetes…just because it is a psychiatric disorder does not lessen its impact on the body). While I can identify with some of the examples of Dr Miklowitz’s aspects of mania, his take on depression has been a grave misrepresentation in my life.

Unfortunately, the population as a whole looks at depression as having a bad hair day. People will often say, “Look, bud, just suck it up and deal with it.” or some other such nonsense. People also confuse bipolar disorder with those diagnosed with clinical depression, a very real and debilitating illness itself. The depression side of bipolar is very similar, but clinical depression lacks that elusive element of mania. For me, depression isn’t about being sad or blue. It is a state of paralyzing nothingness. I don’t experience stages or levels of depression; when my mood shifts, it truly is a crash and burn. I isolate, even among throngs of people when I have to be out in public (when I am at work), otherwise, I sit at home, all alone in this massive house absolutely numb and pained at the same time. Numb to the acknowledgment of the outside world, pained to the point of self-mutilation. I stare at the four walls and wonder to myself, “Is this all I have to look forward to for the rest of my life?” The emotional pain that I feel (most often provoked by nothing) had become so exacerbated that I had resorted to self-mutilation. Ordinarily you find that with much younger bipolar patients, but I am 49 and only just recently have I stopped cutting myself. I have made the carvings on the real estate of my arms into an art of cartography. Being as anal as I am, all of the cuttings are quite parallel and perpendicular to each other, like a grid road map. And suicide? I haven’t just thought about it, but created elaborate plans and methodologies and was quite prepared to carry out my plans on several occasions. Somehow, God was determined that it wasn’t my time in each case and I never went through with any of them. The closest I came was in 2000 as I had access to boluses of potassium chloride (it is one of the chief components in the ole lethal injection scenario), butterfly needles and some heparin. Having been a junkie twenty years ago (and how I lived through shooting up speedballs as long as I did is still a miracle to me), I knew I could pop a vein, anchor the butterfly, and nurse it with heparin so it wouldn’t clot until I was ready to inject the KCl. When I laid everything out on the dining room table in quite an orderly fashion—syringes ready to go—strapped the tourniquet around my bicep and prepped the vein something snapped in my head. It wasn’t that I couldn’t go through with it. I stopped because I couldn’t believe that my life had succumbed to this point.

For some dumb reason, an inkling of clarity broke through and I called my family physician and told his nurse that I had to come and see him right away. I guess something in my voice told her to say yes without even checking with him or the calendar for the day (ordinarily, he was usually booked up). To this day, I don’t even remember driving to the office, but when I got there, I was ushered right back to his office, not even one of those small patient rooms. I waited for about 15 minutes before he came in, shut the door and took the seat next to me. I showed him my arms (I had done quite a number on them the night before) which wasn’t a surprise—he’d seen the scars from previous efforts which I would never discuss as he would write me a prescription for an anti-depressant. Then he asked me what else had happened and I told him the truth. He got up and immediately made a phone call to one of his good friends (they played racquetball together) and said that he really needed to make some time to see me. Then my doctor asked me if he could trust me to go over to this other doctor’s office without going home and carrying out my well-laid plan. I agreed.

At this point I think I was in shock as I began to absorb the enormity of it all. I drove over and waited about 20 minutes and then was seen by his nurse who proceeded to barrage me with questions, all diagnostic in nature. I just sat there looking down at my lap answering monosyllabically as the tears finally began welling up in my eyes. When she was done, she left me alone for a bit and then introduced me to what I realized was a psychiatrist (my doctor may have said something to that effect before I left his office; I just don’t remember.). Having reviewed my answers, he began talking to me in a very quiet, subdued and soothing manner. That seemed to make some difference to me, because up until that moment I felt as though I couldn’t breathe. Suddenly I could exhale and breathe again. We talked at length about my long history and he asked me more questions, presented various scenarios to me to see how I would react to different situations, and continued to probe further still into my past behavior. After spending about three hours with me, he decided I was suffering from Bipolar 1 disorder and that I needed to be hospitalized (primarily because of what was waiting at home for me—obviously I was a danger to myself). He wasn’t sure he could trust me to drive myself over to the hospital; he seriously considered an ambulance, but I convinced him that I would drive directly over to the psych ward of our local hospital. Of course, he called in everything ahead of time and they were expecting me by the time I arrived. He even arranged for me to have a private room even though my insurance would only cover a semi-private room unless a private room was all that was available. There were other semi-private beds available; the nurses just wrote it up in a way that the insurance company would accept.

When they showed me my room, I changed out of my street clothes into a pair of scrubs and terry-cloth slippers that had those anti-skid rubber strips on the bottom and just curled up in the bed. I wouldn’t come out for any meals and the only time I left my room was to get my medications, a powerful cocktail that made me dizzy for quite some time. The psychiatrist, who took me on as a special favor to my doctor (he no longer treated inpatient adults, only adolescents), came to see me every day for the week that I was there. He asked if I had a friend who could get into my house and remove all evidence of my suicide attempt. He wanted to make sure when I got home, I was as safe as I could be. My friend was instructed to not only remove all of the medical supplies, but all of the liquor in my house. He also asked her to go by and pick up the prescriptions he called in so I wouldn’t miss any doses by the time I got home.

No, the medicines, nor the hospital stay made that much of a difference to me when I first got home. However, after about six weeks, the cocktail of meds finally began to take hold and my moods appeared to stabilize for the first time that I could remember.

All of that happened seven years ago this summer. Has life been good to me since this diagnosis? Absolutely not. There are medicines than can attempt to control the mood swings, but there will never be a cure for this disease. Many of the medications, such as Depakote, Zyprexa and Seroquel are massive weight gainers. What do you think that does to your self-esteem when you are cycling down into a depressive state? Sure, the medications help, but I have the learned a few lessons the hard way. I did what most bipolar patients do when they start to feel much better. In 2004, after losing all of the weight I had gained on the medications, I really did begin to feel better. So, I did what was the worst thing I could do. I went off my medication. However, I really did well without them for quite a while, until I became involved in a romantic relationship. Even then, it didn’t become evident until well into six months of being with her. She was everything I had been looking for in a partner and for the first time that I could remember, I was genuinely happy. We moved in together, but the stressors brought on by being in a relationship for the first time in many years, coupled with the fact that I was now living with someone after being alone for so many years, brought all of the symptoms back with a fury. I was still seeing my psychiatrist (every four months just for a med check since I was doing so well…I never admitted that in October of 2004 I went off everything until I told him the following April). He was amazed that I seemed so stabilized in the absence of medicine for such a long period of time. He admitted that it was very rare that someone could actually come off his or her medications. He chalked some of it up to all of the weight I lost (250 pounds) as the hormone estrogen, which is fat-soluble, can wreak havoc on a bipolar patient. He decided to put me in a wait-and-see mode and I promised him that I would call right away if I saw any red flags.

Well, the red flag appeared in June. I started to rapid cycle (meaning that I was mood shifting quite suddenly from high to low in short time spans). I went in to see him and back on the meds I went. But this time he put me on one that was weight neutral (I told him that I refused to take any drugs whose side-effect was weight gain) and I began to take Abilify. But I found we had to steadily increase the dosage as it wasn’t making the difference we were hoping to see in the time frame we were expecting. My mood swing this time went south and stayed there for what seemed like forever. I started drinking again, knowing full well I had no business drinking alcohol while taking the medication. Needless to say, all of this took quite a toll on my relationship which also began to deteriorate by November. On 01 December 2005, after being in a manic state for three weeks straight without any sleep, I crashed hard and became absolutely suicidal. I decided to call my psychiatrist and voluntarily checked myself into the hospital. This time there were some new meds on the market, all of which were weight neutral, with which we began to experiment. Within a week, I was back to feeling stable and went home.

But I didn’t stop the drinking which I think was a by-product of just being unhappy in this relationship. I wanted to leave her; I just didn’t know how. I loved her with all of my heart; I just didn’t want to live with her any more. I felt trapped between the proverbial rock and a hard place. On 27 December I drank so much I passed out and she couldn’t bring me out of it, called an ambulance and rushed me to the ER. She told the doctor of my bipolar history, and by the time I had sobered up, I was given two choices: I could voluntarily check myself into a psychiatric facility, or they would go to court and have me committed. So, back into the hospital I went (voluntarily). I don’t think I had ever hit bottom this hard, or so I thought.

She wouldn’t come and visit me and only talked to me on the phone twice before announcing that she was coming to see me on January 1^st as long as there would be a therapist present to facilitate the visit. I wasn’t sure what was up with that, but I said fine. I really did need to see her again; I missed her so much. Well, she came and promptly announced that I wouldn’t be moving back into her house upon my discharge and that we were no longer together as a couple. Talk about getting your heart ripped out and stomped on. That’s when hitting bottom really slammed me in the face. It was a good thing I was in the hospital, because I can honestly say without a doubt that I would have committed suicide that night. I cried for three days straight (if you asked any of the other patients, it wasn’t crying but dissonant wailing). The two previous times I had been admitted I was in for only five days each. This admission lasted 18 days.

It’s been one year, one month and nine days since my world came crashing to a halt and I have to say that I have persevered. My psychiatrist and I have come up with what has been a remarkable cocktail of drugs to which I have not become tolerant (yet). I am living in a beautiful, huge house all alone in prime downtown real estate and, yes, I still struggle. The meds aren’t perfect. I cycle—I can be manic for three weeks at a time—but I haven’t been suicidal when I plummet down. And regardless of how depressed I get, I haven’t cut myself in almost one year. I’ve been able to hold my job throughout all of this and I have been blessed to have a very understanding boss who will be the first to tell me that she doesn’t know beans about being bipolar—she just knows I’m one of her best employees. I still haven’t figured out who I am in all of this, but I do know one thing: I am a survivor.©2007

Racing

The darkness of the night escapes me,
No shafts of moonlight to hem me in.
I soar with angels, buffeted by their wings
As the air around me sizzles and pops with electricity.

The fire grows into a molten pot deep within my belly.
The urge to create anything at all stokes the cinders—sparks fly in all directions.
My bed beckons me in this wee hour of the morning,
But my mind races forward, chasing one elusive thought after another.

The slumber my body craves is in itself a dream.
Hour upon hour I remain vigilant at the slightest vague supposition.
Any inkling will do as my mind does cartwheels in this grand space of time.
How the quiet is suppressed by the clamor of thoughts in my head.

It passes me by, one fleeting abstraction after another.
Too much noise encircles the ego in this still burnt cork of night.
They come at me like bat’s wings in frightful flight,
A blur that cannot be captured and imprisoned to evoke expression of creation.

As the nights melt into the days with repetition that knows no end,
The expectation of creation grows silent amid the dissonance that abounds,
Despite the impulse—the drive—to construct.
My mind desperately reaches out to catch even one of these thoughts that race.

And suddenly, as quickly as all these mental images beckon,
There is this tremendous thrust of despair.
What was once a dizzying envelope of energy
Has been usurped by an utter drain of force.

This crushing desolation, while unexpected at the time,
Stands at the head of the line with anticipation.
It’s time to crawl back into the void, craftily disappearing at will,
Knowing that the night has finally closed in and shut out all of the dreams that once filled the sky.©2007