Follow Up

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.