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Bipolar IN Order

August 14, 2018

Had my visit with Dr. Goodenough last Wednesday, and as I’d expected, he wants me on the new Zyprexa dose for good. It’s OK, because I’m over the idea that I’m on too much medication (an idea he thought was quite laughable when I mentioned it) and I don’t have the slightest wish to mess with the magic formula. We chatted about how much I’ve settled down since the last time he saw me and how quiet my brain is now, and I thanked him heartily for being so on top of my illness. He was happy things had worked out, but he also decided that we would forever after meet in the late winter, before the annual springtime festivities commence.

But best of all was the note he left in my chart: In full remission. As in completely well. Mentally healthy. Dare I say it? Normal.

I’ve never been here before. Even Dr. Awesomesauce, as dear as he was, never gave me a clean bill of health. I was always “in partial remission”, or “depressed”, or I exhibited “manic behavior”. It almost gave me a complex: what did I have to do to earn that blessed pronouncement of full remission? But looking back over the years, I can see why he was so stingy that way, because I really WASN’T well. Maybe not sick, but definitely not where I should have been. Who knew that all it would take to get there was a tablet and a half of the miracle drug known as Zyprexa?

I look back over the last few months and wonder what on earth made me think that not taking all my meds as prescribed was an option, or that not sleeping was a good thing. Yes, I enjoyed my hypomania even though it was mild compared with past episodes, but I don’t enjoy spending money with nothing to show for it, or having racing thoughts 24/7, or dealing with excessive energy that had no place to go but through my feet and legs. I couldn’t even channel it into something productive, like cleaning or cooking. Instead of talking a mile a minute, my mind was so cluttered that I couldn’t really speak at all. Everybody thought I was just being quiet, but my brain was like a sky full of shooting stars—brilliant but utterly disorganized. I wrote my blog posts only on days when it all slowed down enough for me to make sense.

All that’s in the past now. The rapid cycling is gone and relative serenity has taken its place. That’s not to say everything is perfect; in fact I had a couple of VERY bad thoughts this evening due to tensions in the house, but they were easily dismissed as I realized that the feelings were coming from an entirely different place. I’m lonely, dammit, and sometimes I need to acknowledge that fact. I miss my husband, and never more than when I see couples loving, laughing, fighting, and living together.

But I’m well, and for the most part, I’m safe and comfortable. And for once, I don’t have bipolar DISorder, I have bipolar IN order.

Thanks, Doc.

 

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You Mean My Brain Has an OFF Switch?

August 7, 2018

I’m four weeks into the Zyprexa experiment, and I think this is the quietest my head has ever been. I’m serious. For the first time in ages my thoughts aren’t zipping around at 100 MPH, and there are times I actually catch myself thinking about absolutely nothing at all.

This must be what Will and the kids must have meant when I’d ask them what they were thinking and they’d say “Nothing”. How does anybody think about nothing?? I used to wonder. I couldn’t understand that most people’s brains come with the ability to shift into a lower gear when not actively being involved in something requiring their attention. I also never knew it was possible to think only one thought at a time; unlike a lot of folks, my mind races whether I’m manic, depressed, or stable.

Who knew that a small increase in the ingestion of a simple chemical could make my brain slow down to the point where it’s even become a bit sharper? It may not be noticeable to anyone around me, but I’m remembering things better, like where I put my phone and how to navigate my new Facebook page. I’ve even bought a book to try to read on the plane to Florida later this month; it’s a book of short stories which I hope can hold my attention for longer than five minutes. (It’s a long flight.) Maybe I’m getting ahead of myself here, but without a barrage of thoughts flooding my head all the time there are all kinds of possibilities!

I’m sure Dr. Goodenough will be delighted, too. I see him day after tomorrow and I expect to stay on my new dose of Vitamin Z for at least the rest of the summer, or even beyond. That’s OK, I’m over the angst about the meds. The hypomania is gone and the world is making sense again. I’m obviously taking the right number and the right kind of medications in the right amounts to keep me happy and stable. I’ve noticed too that the free-floating anxiety I was experiencing has taken a leave of absence, and I don’t miss it. My blood pressure has even dropped a little, though it wasn’t high before, and sleep—oh, the sleep has been amazing. I’ve only had a couple of sleepless nights since I started taking the higher dose, and I don’t have any more difficulty waking up in the morning than I did before. (I’m still kind of a slug, but I can get up early for church or appointments when I need to.)

It’s all still new to me, but I think I could get used to it. I love it that the incessant buzzing and conversations in my head have been muted. I love it that I’m not as distractible as I was. I also love it that I’m starting to not feel like the village idiot. I doubt I’ll ever be the intellectual I used to be—there’s still quite a lot of brain fog to deal with—but I can live with that. Now, if I can just remember this the next time I get a bee in my bonnet about coming down or off meds…

 

Heavily Medicated For Your Protection

July 26, 2018

The Zyprexa is working.

Dammit. I should have known how much I needed it.

Like I said a couple of posts ago, I’d really hoped to come down or even off some of my meds. But the truth is, the higher dose of Vitamin Z is taking care of both my sleep and my racing thoughts; with rare exceptions I’m getting to bed by 1 AM, and I sleep through the night. What astonishes me is how much my brain has quieted down…the static in my head has faded out, and I’m not chasing stray thoughts all over the universe. I didn’t know there was anything that could do that.

The other night I was lying in bed thinking (not obsessing) about all of this. It’s kind of like sleeping in the most comfortable bed you’ve ever been in, and waking up every 90 minutes or so to marvel at how comfortable you are. I have actually done this. Will and I once stayed in an exclusive hotel that was right on the beach, and I remember this huge queen bed with down pillows, a down mattress topper and down comforters. It was like lying on a cloud. I barely slept at all that night because I was TOO cozy. Does that make sense?

Yes, the fire of hypomania has been banked, and as much as I hate to admit it I feel a lot more settled. It’s nice not to lie in bed at 4 in the morning, staring up at the ceiling and wondering if I should keep trying to fall asleep or if I should just get up, drink some coffee and start the day. It also doesn’t hurt that I made it through the second anniversary of Will’s passing and am on a more even keel emotionally. I don’t like being groggy in the mornings and I’m definitely more so than I was, and I average about 9-10 hours’ sleep now. But it’s better than 2-3 hours a night, and I really do enjoy the slower pace of my thoughts. You just don’t know how bad the noise and the disorganization are until they’re not there anymore.

Of course, this probably means I’ll stay on the increased dose for awhile, maybe even for good. Or maybe it’ll just be through the summer…all I know is that I have three months’ worth of refills. After fielding some slings and arrows from friends, I’ve come to the conclusion that it really shouldn’t matter how much medication I’m on, I have to take the amount that works. And Dr. Goodenough is more on top of things than I gave him credit for. He wanted to increase the Zyprexa a month sooner, and I refused. Bad decision on my part. I was starting to spend too much money and my checking account was overdrawn for the first time in years, and I wasn’t sleeping well at least three nights out of the week. I may have only been mildly hypomanic, but if I hadn’t regained some control of my sleep I would have gotten a lot worse. I know. I’ve seen me do it.

Now, all I have to do is get past this notion that I’m overmedicated. Sometimes in the mornings when it takes an act of God to propel me out of bed, I want to chuck the whole kit and caboodle. I HATE being so drowsy when I wake up. I’d rather be able to pop up like I do when I’ve slept only a couple of hours. But as we all know, sleep is crucial when one is grappling with bipolar disorder, and historically I have not done well when I don’t get enough of it.

The extra Zyprexa has also been helpful in keeping my anxiety at bay during the past few days. Some things have happened lately that are causing all of us to worry, and of course I go from 0 to 60 in seconds when I’m stressed AF by events beyond my control. It’s hard not to freak out when everything seems to be going to hell in the proverbial bushel basket. But so far I’ve been able to stay relatively calm and be something of a voice of reason. Who knew?

Follow Up

July 19, 2018

Well, I got the news this morning that I wasn’t looking forward to: I have to stay on the higher Zyprexa dose for the foreseeable future. Dr. Goodenough is even faster at returning phone calls than Dr. Awesomesauce was; I called the office to leave a message on how I was doing at 0935, and he was on the phone by 0955. I continue to be impressed by how responsive he is. However, I was not thrilled about the terminology he used to describe my problem, e.g., he called it “rapid cycling”. I don’t want to be one of those patients who rapid-cycle. But with all the flipping in and out of hypomania these past four months, I don’t know what else he’s supposed to call it. I guess I hadn’t thought of it that way.

I’m also not thrilled about staying on the 7.5 mg, even though it obviously works because I’ve been sleeping like a baby for the past week and am settling down nicely. It’s just that I’m going through one of those phases where my brain has betrayed me again and I’ve had it up to my ass with this stupid illness, and it wants me to do something that’s totally against my best interests. I want to DECREASE meds, dammit, but it’s not going to happen.

I posted a little whine to this effect on Facebook, whereupon a number of my friends brought it to my attention that my behavior is following a pattern they are all too familiar with, seeing as how (as one put it) I go through these episodes two or three times every year. They want to know why I wish to be on less medication since I tend to decompensate when my needs change. They also want to know why I seem to see it as a failure on my part when something quits working well and I need more medication, not less.

I had to think about that one.

In fact, I’m still thinking about it. This is why it’s good for people to have friends and loved ones who can see clearly and ask the hard questions. Why DO I see it as a personal failure when my brain shits the bed and the antipsychotic dose goes up? As my constant  readers know, it’s long been an issue for me that I need to be on more than one of those drugs…it’s like I’m stigmatizing myself. I keep thinking that I should be like a lot of bipolar patients who manage the condition on a mood stabilizer, an antidepressant and one AP.

And I guess on some level, I’m still in a bit of denial. It’s been two years since I’ve needed a med increase, and it’s been relatively easy to forget how serious bipolar 1 can be. Even though these recent dalliances with (hypo)mania have been minor, they remind me that I have a dangerous illness which can flare out of control at any time, and the only things standing between me and disaster are these fistfuls of sanity. I don’t mind taking the extra dose so much as I mind what it stands for—the fact that without heavy-duty psych meds, I would probably be a hot mess. Or worse.

It’s been so easy during the stable times to become complacent. It happens to a lot of bipolar people, even though we almost always get slapped upside the head by reality. I take some comfort in the fact that I am far from being the only one to fall victim to this kind of stinkin’ thinkin’. There are many, many tales of unfortunates who, believing they’re cured, stop taking some or all of their meds; or who (like me) get enough relief  that they think they really aren’t that bad off, and can act like so-called “normal” people who can stay out late or be up all night watching TV and playing on the computer.

In the meantime, I’ll just keep taking the pills in the doses prescribed for me and try not to look at the situation as a reason to beat myself up. I was raised in a family where mental illness either didn’t exist or was the patient’s fault, and it’s hard to get past that. I guess I’ll have to do a better job of it.

Been A Long Time Gone

July 17, 2018

Well, I got through it—the second anniversary of my husband’s death. I don’t know why, but it feels in some ways like I’ve lived the longer part of my life since he’s been gone. So much has happened, so many things to learn about myself and my place in this world. I’m still working on that one; I’m still not sure where I belong in life, but I think that’s par for the course for someone who’s only been widowed for a couple of years. I’m not too worried about it though, because I think this exactly is where I’m supposed to be at this stage.

Naturally, I’ve been thinking about Will a lot. I was listening to the classic country station on cable one night when our wedding song came on; but instead of crying, I felt a sweet sensation wash over me, and I could almost sense his presence in the room. I imagined myself caressing his handsome face and running my fingers through his thick hair. I remembered his smell, a slightly musky scent with a generous splash of Old Spice. I saw once again his big hands with their work-roughened palms and gnarled veins that I used to joke about trying to get an IV in. I thought of us, newlyweds at ages 29 and 21, and how we had NO idea of what life was going to be like as a married couple. We didn’t know that one day we’d have children and jobs and money troubles. We couldn’t foresee that I would go on to develop the mental illness that cost us so much in the long run. And we never imagined that three and a half decades later we’d have to say good-bye, long before either of us was ready.

All of which served to remind me of how much I’ve lost and how much I miss him. The night of July 12th was the worst; it was the night he suffered so terribly and it took what seemed like an eternity to get him the pain relief he needed so desperately. I will never forget his screams or the question which had no answer: “Why do I have to suffer like this?” As a medical professional, I have the technical knowledge to understand that one or more of his tumors probably exploded that night, causing massive internal bleeding and the agony that turned him inside out, but as a loving wife it doesn’t comfort me much. I still wonder sometimes if there was something more we could have done for him at home…but in my heart of hearts, I know that battle was over before it began.

In a few ways, reliving it makes it seem like it happened only last week. But I’ve gotten used to Will not being here, and it feels—shall I say it?—normal. I’m used to making my own coffee in the morning, although my son Ethan made it for me on a couple of recent occasions. I’m used to looking over at Will’s chair and not seeing him there in his bright orange T-shirt and blue plaid pajama pants (usually with a puppy or two). His voice, alas, is fading from my memory, although I can still recall his cackling when something really funny happened. I haven’t even watched Pawn Stars since he passed, and we used to watch it almost every day. I wonder if he’s run into The Old Man yet.

So I got through the 12th and the 13th, feeling anxious and tearful but not depressed, and now I’m OK again. Those days will always be difficult, but I’ve accepted that. I went out and had a great weekend celebrating Ethan’s 27th birthday, and today everything is business as usual. I’ve been sleeping well (more on that in the next post), I’m smiling and laughing, and life is being kind for the most part.

I think this is what healing looks like.

 

 

 

Going The Wrong Way

July 12, 2018

And to think I was going to ask if I could lower some of my meds…

I’m still having trouble with sleep. I don’t think I’m acting out much (although I have been spending too much money lately and can’t account for it), but I have to admit I feel a little fragile from the frequent nights of little or no shut-eye. I’m not tired in the mornings after being up until dawn, which is ironic considering that on the nights when I do get good sleep, I feel like a slug the next day. In fact, this morning I popped right out of bed three hours after my brain finally shut up long enough for me to drift into slumber, and went to my appointment with Dr. Goodenough.

I had the feeling he was going to propose an increase in one of my antipsychotics, and that’s exactly what he did. He is still concerned about hypomania even though I don’t think I’m in it right now. I was doing all right during questioning until he asked about racing thoughts and money. Oh, shit. I have admittedly spent a not insignificant amount of time dealing with hypo in one manifestation or another since mid-March, but I thought I had a handle on it. It’s like pinching a balloon or trying to contain a generous booty in a girdle…no matter where you squeeze, it’s gonna come out somewhere else. The spending is just the latest thing. I’m not kidding: I’m broke and it’s still a week till payday. I’m NEVER completely broke, or at least I wasn’t until recently. But there’s about two or three hundred bucks gone this month that I can’t explain, and my credit card balance is going up too. What the hell??

So to nip this in the bud and especially to promote sleep, Dr. G decided to bump up my Zyprexa dose from 5 mg to 7.5 mg. Not a huge increase, and (hopefully) it’s only for a week, unless it proves successful and I have to stay on it for the rest of the summer. I didn’t want to raise the Zyprexa. I want to be on fewer meds and smaller doses, and I’ve been thinking for a while that I would ask to at least come down on some of them. But I seem to be headed the wrong way. I was even going four months in between doctor appointments, and now I’m back to monthly again. Not that I mind seeing him, I just mind what more frequent visits and med adjustments stand for.

I hope this does the job and I don’t have to stay on the higher dose. I’m worried about weight gain, and Zyprexa is notorious in that department. I wondered aloud why we couldn’t increase the Trazodone (sleep med that does absolutely nothing), but he reminded me that it’s actually an antidepressant and could throw me into mania if I were to take more of it than I do now. Well, duh—I should’ve known that. Sometimes I wonder where the hell my nurse brain went. I used to be a walking encyclopedia of pharmaceuticals; now I can’t even remember that basic information. I have to call next Wednesday to report on how the med change is affecting me, which is going to be difficult because I HATE calling psychiatrists. Dr. Awesomesauce used to complain about this a lot because I always waited until I was desperately ill to call him. I guess I’ll just have to do better about that. Besides, with any luck I’ll be back to my normal Zyprexa dose in a week.

In the meantime, I just took the extra Zyprexa and I’m starting to get sleepy. I haven’t slept worth a crap in several nights…let this be the night that it all changes.

Thanks, Doc. I think.

O Sleep, Wherefore Art Thou?

June 30, 2018

It’s a little after 6 in the morning, and I’m wide awake writing this. Why? Because I can’t sleep. Again. I’ve been up all night, and I couldn’t even sneak in a couple of hours this morning. I tried going to bed around 4, but only lay awake with my eyes open, staring stupidly at the ceiling. My thoughts are racing; there’s too much going on in my head all at once and I can’t seem to shut it off. Just another day in paradise, right?

Now, I’ve finally recognized this for what it is: a manic sleeping pattern. It’s been quite a while since I’ve experienced it, so it took me awhile to figure it out. I don’t know why, because I’m certainly not manic. The meds are still working, so why the hell I can’t sleep some nights is a mystery. On other nights, I’m ready to go to sleep by midnight or 1 AM and I’m in bed till 9 or 10. The night before last, I went to bed at 2:30 and didn’t get up until noon. Then I have a night like this one, when I was so wired that I literally could not close my eyes. And I’m not the least bit tired.

I’ve been told I should shut down the electronics and bore myself to sleep. It’s just that it’s light so late in the evening that I don’t wind down until long after the sun sets, regardless of whether I cut myself off or not. As I’ve said before, my circadian rhythm is different from most people’s; left to my own devices, I usually go to bed around 2 and wake up at 10. But this sleeplessness happening several times a week is new. I can usually squeeze out a few hours between 4 and 8, but there have been a couple of occasions recently when I didn’t sleep at all. In fact, there was one 72-hour stretch about a week ago when I got about 10 hours’ sleep altogether. I followed that with 10 hours in one night. I literally fell asleep on the couch and gave myself a nice crick in my neck in the bargain.

So last night I had the TV on low, on a station where this preacher comes on at 4 AM and goes until 6. He usually bores me silly and I fall asleep to the sound of his droning, but this time he was putting forth some ideas that I, with my Catholic sensitivities, thought were rather dangerous. It made me think, though, and that was it for the night; I gave up at 5:45 and got up to make myself some coffee. Shelley joined me about 45 minutes later. We’ve got a picnic to go to this afternoon, so there won’t be much of a chance to sneak in a nap, as if I could do so after meeting a bunch of new people. That tends to overstimulate me, but I’m actually looking forward to it. I want to go places and do all the things.

Ah, well. I have the feeling that I’ll make up for lost sleep in the winter. I’m such a slug in the cold months. That’s why I love summer so much—I feel alive! The roses in our yard are in full bloom and so colorful that they almost hurt the eyes; it’s so good to feel the sun on my face and the breeze in my hair; even the air smells wonderful! Today is bright and the skies are blue, and I don’t mind being awake so early as long as I get to drink coffee and look out upon the vividly green trees while listening to classic country music.

Speaking of which: do you know what happens when you play a country song backwards? You get out of jail, you get your wife back, you get your truck back…