The Big Bad Blues, they’re a-comin’

anxiety, Authoress, bipolar disorder, major depression, personal experiences

The Blues are back in town, and unfortunately, I don’t mean the Snooks Eaglin, ramblin’-soul-man-with-a-guitar type. Thanks, winter!

Don’t get me wrong–I am loving the Maryland weather. The winter has been mild, but when it’s 70 degrees one day and 30 the next, oh man, that’s like hitting a brick wall doing 90 miles an hour.

I like to imagine that there’s some kind of a party going on in my brain. I  picture my synapses and neurons and all those delicious chemicals that enter my body in pill form each morning to keep me sane, dancing around in a conga line with lampshades on their heads before passing out with permanent marker on their faces.

The party bit isn’t what troubles me. That feels okay and decidedly un-manic these days. It’s the afterward, that insidious unraveling of the good-times and how they fray bit by bit until all that’s left is the worst kind of loneliness–the loneliness that is you and your brain and nothing else.

There is a vast emptiness that comes with depression. When I decide to stay up after Paul has gone to bed (because our sleep schedules are pretty different–he has day classes, mine are at night), I’m often struck by an aching loneliness. Even though I know he’s fifteen feet away in the bedroom on the other side of the wall from me, a dark antsiness sets in. It’s not because we’re not together, because I can be my own company and take care of myself. It’s how frightening it can be in the quiet of the apartment when the day is done but I’m not tired enough for bed and while my brain isn’t especially active, the emotions hiding just beneath the surface start to make me feel bad for no reason.

Sometimes I get shivers, but on the inside. It’s like having someone reach out from inside your organs and tickle your ribs, disconcerting and uncomfortable. It makes you want to cry for no reason, but then when you try, you find that you can’t. There is no catharsis. There is only waiting and distracting yourself until it calms down or you go completely mad (and sometimes both, by turns).

These are the Big Bad Blues, and it seems they’re back in town.

Sometimes they show up only at night, and only for a day or two. It’s unavoidable; no matter how well-medicated and well-adjusted you are, things are going to slip in through the cracks from time to time. It’s the nature of the beast. My body and my mind are like a drafty house in that way. I take care to shut the doors tight, to put plastic on the windows and check the vulnerable spaces with candle flames to see where there’s a leak, but in the night, little wisps of cold sometimes slip in and wrap around me. If I don’t catch it early and fight back with whatever’s within grabbing distance, I begin to feel as though I’ll never be warm again.

Then there are the ones that come in the late afternoon, just before sunset, when the shadows stretch long and the light begins to turn golden in the before-dark time. The Golden Hour, I’ve always called it, but it doesn’t mean anything good. I have about a thousand theories as to why this time of day gets me down harder than anything else, but I’m not sure what I’ll do with that information once I figure it out or how the insight will make me feel better. For now, all I can do is turn my head away and get through it until it passes and the calming near-dark comes.

When I start to feel like this late at night, I slip quietly into bed and read for a while. The proximity to someone I love who loves me back is comforting, and whatever book I’m currently reading relaxes and distracts me. When I get to feeling low, distraction seems to be the only thing that can snap me out of it. I spend a lot of my time hanging out by myself in the apartment with the cats and my textbooks, but having something to do keeps me sane. It’s the nothingness that’ll get you, and it will get you every single time.

I’m pleased to report that I woke up today (albeit much later than I wanted) feeling just fine. At present, I’m working on reading ahead a week or two for my classes, though I’ll inevitably forget to cross it off in my planner and then go back to it on the appropriate week and wonder if a mysterious ghost-highlighter has gotten hold of my books. It’s actually a good source of humor and plus, it’s always a relief to realize that you have less homework than you thought.

And I know I’ve been promising-promising-promising that series, which at this rate will be out by sometime next year. (I kid! I need to make some sort of research schedule for each day, though, because I am spectacularly unmotivated and there always seems to be some other thing that grabs my attention.)

Until next time, readers, stay safe and lovely.

 

Advertisements

News Day Tuesday: Bipolar Awareness Day!

a cure for what ails you, explanations, major depression, medication, mood diary, News Day Tuesday, ptsd, rapid-cycle bipolar disorder, stigma, therapy

Happy Tuesday, readers! Today (October 4th) is Bipolar Awareness Day, so I wanted to share an article with you that outlines the basic symptoms (for the uninitiated, as I know there are some new readers here) as well as what’s on the horizon in terms of treatment.

First of all, let’s hear about what bipolar disorder actually is. I’m referencing bt.com for the purposes of this tidbit, as the article I found gives a really great Reader’s Digest condensed version of the illness.

National charity Bipolar UK characterise the condition as “a severe mental health illness characterised by significant mood swings, including manic highs and depressive lows”, and note that, “the majority of individuals with bipolar experience alternating episodes of mania and depression”.

According to this article, it takes 10.5 years on average (in the UK) for people with bipolar disorder to be properly diagnosed. The National Depressive and Manic Depressive Association (NDMD) paints a similarly grim picture: it can take ten years or more for a diagnosis to be reached, and 69% of cases are misdiagnosed.

What are the symptoms?

There are two sides to bipolar: mania and depression.

During a bout of depression, it is possible to feel: grumpy, without hope, guilty, self-doubting, suicidal, pessimistic, worthless, lacking curiosity and concentration.

And with mania: elation, full of energy, ideas and plans, easily distracted, feeling invincible, risky behaviour including spending huge amounts of money.

Both can feature: lack of appetite, insomnia and delusions.

-bt.com

My experience began very early. I remember fits of agitation and depression as early as eight years old, which at the time was chalked up to the incredibly rough hand I was dealt–a broken home, a mother who struggled with bipolar disorder herself as well as alcoholism, extreme bullying, and persistent nightmares (which were later diagnosed as a feature of PTSD). NAMI states that rapid-cycling bipolar disorder, the most severe form of the illness, seems to be more common in individuals who begin exhibiting symptoms early in life.

From NAMI.org:

Early Warning Signs of Bipolar Disorder In Children and Teens

Children may experience severe temper tantrums when told “no.” Tantrums can last for hours while the child continues to become more violent. They may also show odd displays of happy or silly moods and behaviors. A new diagnosis, Disruptive Mood Dysregulation Disorder (DMDD), was added to the DSM-5 in 2014.

– See more at: http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Overview#sthash.l0XKtkSy.dpuf

When I was eighteen, I decided to see a therapist and psychiatrist for the intense mood swings that had plagued me for most of my life. I was initially told that my deep depressions were the result of PTSD. I was prescribed fluoxetine (brand name Prozac), which only made the agitation worse. And I was still depressed.

At 22, I relocated to Wisconsin and began the search for something, anything, that would finally help me feel “normal.” The misdiagnoses continued: major depressive disorder, for which I was prescribed Abilify and trazodone. I felt amazing on Abilify for about two weeks, and then I crashed. Trazodone made me a zombie. (Note: It is not atypical for antipsychotics to be prescribed to treat both MDD and bipolar disorder.)

Bipolar disorder is most often misdiagnosed in its early stages, which is frequently during the teenage years. When it is diagnosed as something else, symptoms of bipolar disorder can get worse. This usually occurs because the wrong treatment is provided. Other factors of a misdiagnosis are inconsistency in the timeline of episodes and behavior.

-healthline.com

When I was 24 and in my first “adult job” with health insurance, I found a wonderful psychiatrist who, over the course of several sessions, examined my family history and asked very specific questions to find the root of my illness. At first, I didn’t even think to mention my “up” periods, because even with the agitation and sleeplessness, I actually felt good–and no one goes to the doctor when they’re feeling well. But upon deeper probing, he came to a conclusion: first bipolar II, then, after further investigation and a few weeks of mood tracking in a journal, rapid-cycling bipolar I.

That first year was rough. I cycled so frequently that the days were exhausting. One day, I bounced between depression and mixed episodes several times in a single 24-hour period. Slowly but surely, the medications my doctor had prescribed (venlafaxine/Effexor, lamotrigine, and lithium) began to take effect. I began to stabilize. There were no more florid creative periods, but I was also able to sleep for more than an hour a night for the first time in weeks. My misery began to ebb, and though it didn’t disappear completely (a dysfunctional marriage contributed, among other things), I began to feel like a person again instead of a defective thing that needed to be turned off and fixed.

Aside from pharmaceuticals, NAMI’s website mentions cognitive-behavioral therapy, psychotherapy that focuses on self-care and stress management, and, in rare cases, electro-convulsive therapy (ECT). Learning to recognize the triggers for each type of episode is key; one suggestion offered by the numerous therapists I’ve seen over the years is mood tracking/journaling.

However, I had to stop at one point because, in the heyday of my illness, I began to obsess over the cycles, sometimes tracking up to ten or eleven times a day. Instead of the journaling soothing my mind, I began to worry that I was untreatable. I found my mood journal during a recent move and it was difficult reading, to say the least. But it was also a reminder of how far I’ve come and how much my quality of life has improved since receiving a proper diagnosis.

These days, I’m doing much better. My medications have been adjusted slightly to accommodate the deep depressive episodes I’m prone to during the fall and winter months, but I am proud of myself for being able to recognize that the winter storm was a-comin’. Three years ago, I would not have been able to see the symptoms for what they are: a warning sign and a signal that I need to not only keep up with my medications, but to practice good self-care. In the past, I saw fall and winter as something awful that I had to endure. Now, I realize that I can still enjoy life even when the days begin to get longer and darker. The seasons are no longer a metaphor for the overall “climate” in my head.

How long did it take for you to receive a proper diagnosis, readers? Are you taking care of yourselves as winter approaches? I hope you’re all doing well and staying healthy and safe. And spread the word–this illness is massively misunderstood, even by mental health professionals, so it’s our job to reach out and counter-strike against the misinformation and discrimination.


Like what you see on Dissociated Press? Check out and “like” the Dissociated Press Facebook page for even more posts, links, and news articles!

Return of the Dark Core

major depression, ptsd, rapid-cycle bipolar disorder, self-harm

About ten minutes ago, I was standing in the kitchen trying to eat a bowl of strawberry ice cream. My hands were shaking so badly, I could barely even hold the spoon, and then the dark core started its shit again. I’ve been feeling anxious, guilty, and extremely depressed lately—I shouldn’t have to add this qualifier, but I feel sad for no reason. Or rather, no reason that others can see; my brain chemistry has decided to take a dive again and I think I’m in the beginning stages of a major depressive episode.

We’re struggling financially right now and I’m still feeling a lot of guilt and self-loathing for not being able to work; I know those things don’t help. My meds aren’t quite right but I can’t go see my psychiatrist until I get my lithium checked. He fucked up the lab sheet again and the clinic I go to won’t take it without a time written on it along with the date, so I’m not sure when I can have those levels done. I’ve stopped going to therapy for the forseeable future because our deductible just reset and we can’t afford it.

In short, things are not going that well these days.

My cycles have been getting longer, which I was told is a sign that I’m getting better. But while it’s okay to have a two-week-long hypomanic, or even manic, episode, the major depressive ones frighten me, not because I don’t know what I might do but because I know exactly the sort of things I’m capable of doing.

I’ve been feeling out-of-sorts for several days, but things started their usual downward slide this afternoon. I put myself to bed for a few hours in hopes that I could sleep it off, and I did feel a little better when I woke up…but it’s back. The worst part is feeling helpless to stop it. Oh, I know some ableist scum would argue that I could do all sorts of things to “cure” it, but the fact is, it’s a simple matter of brain chemistry that’s not quite right. And unfortunately, type I bipolar tends to be very tricky to treat even if it’s not rapid-cycle (mine is).

I’m counting the time until D. gets home so we can talk about a safety plan. It’s important to discuss that before things get really bad up in my head. For now, I think I’ll indulge in my usual anti-self-harm strategy of hugging a cat and listening to music. If I fall asleep again, so much the better. Anything to get away from these thoughts.

Manic Depression: A Brief Explanation

authoress in motion, explanations, major depression, medication, rapid-cycle bipolar disorder, self-harm, stigma

I finally got around to editing the explanation video on bipolar disorder/manic depression (I prefer the latter term as I feel it’s more descriptive).

In the video, I talk about the different categories of bipolar disorder, what each phase (from depression to mania and mixed states) is and what it feels like, and tips for dealing with a mixed episode.

Dissociated Press is finally on Facebook!

major depression, rapid-cycle bipolar disorder

WordPress is a bastard, so here’s the full link: https://www.facebook.com/couldhavegonemad?fref=ts

I’ll be posting book recommendations/what I’m currently reading (research for the memoir), brain droppings that aren’t quite long or substantial enough to warrant their own blog post, and whatever else pops into my head (so in other words, anything goes). I’d love it if you guys would “like” the page and jump into the fray by asking questions or whatever it is people do on Facebook nowadays.

Transition.

a cure for what ails you, major depression, medication, ptsd, rapid-cycle bipolar disorder, three hopeful thoughts

At this point, I can’t say that I’m cured or that my bipolar is in remission, but something feels different. My mood swings aren’t as intense as they were before, and “Flat/numb” has replaced “Depressed” as my default mood state. I still can’t remember the last time I felt truly happy without also feeling some underlying negative emotion, but I actually feel hopeful.

My PTSD is still pretty bad. There’s some parking lot construction going on right outside our apartment, and when I had to walk past it yesterday to get home, I flinched, jumped about a foot, and had to clamp my hands down over my ears to get through the unrelenting roar of construction equipment. I felt embarrassed and remember thinking, “Normal people don’t act like this.” But I’m trying not to judge my reactions and emotions. My therapists over the years have all encouraged me to just experience them without having a knee-jerk response and assigning a morality to everything.

My derealization/depersonalization is present, as always, and I’ve been having unnerving spikes in severity that have unusual triggers…if I have my head turned or tilted a certain way and I say something/something is said to me, for example, the detached feeling increases tenfold and sticks around until I finally go to sleep. It seems to only happen in the late afternoon/early evening, but I’m still not sure what to make of it. But in spite of this, I feel like I’m finally starting to recover. I’ll deal with the emotional bit first; then, I’ll try to tackle my dissociation.

Medications: Lorazepam, 1 mg tablets*, 37.5 mg Effexor, 400 mg lamotrigine/Lamictal.

* I think it’s important to note that I can’t remember the last time I actually needed one of these.

I feel like a fence post today.

major depression, ptsd, rapid-cycle bipolar disorder, stigma

My current episode of depersonalization/derealization has been going on for well over a year, as I’ve mentioned before, but it’s particularly bad today. I slept way too late, until 2:00 this afternoon, and woke up feeling very disoriented and detached. I sat on the couch for close to an hour, staring out the window…it felt like five minutes. I wasn’t even thinking about anything; my mind was essentially blank.

I wish I knew of a better way to describe what the detachment feels like. I usually tell people that it’s like being in a dreamlike state, and sometimes say it’s like being incredibly stoned (if the person in question has dabbled). D. sat on the floor next to me this evening while I had a smoke, and as I described how I was feeling, I was making a fist with my free hand.

I didn’t even notice the bloody furrows my nails had left behind until I went to wash my hands about ten minutes later. I didn’t feel my hand clenching up. I didn’t feel any pain.

Today, my mind is about a thousand miles away from my body. It’s usually not this bad; I’m not sure what’s triggering it, though I suspect it’s the oversleeping. But at the same time, I can’t really help that—I’m going through a nasty depressive cycle (which, given the fact that my bipolar is rapid-cycling, should be over soon—that’s the silver lining to all of this) and tend to be especially somnolent during these phases.

I have therapy tomorrow at five. I tutor on Tuesday night, have another doctor appointment on Wednesday, and work Thursday through Saturday. I’m hoping I’ll make some decent money this weekend, now that I know how to handle my shit at work. I feel bad for not being able to work a regular full-time nine-to-five, but the combination of mental illnesses I have can be pretty debilitating. It’s hard to keep a forty-hour work week when you regularly bottom out at two P.M. and feel like if you don’t go home and bury yourself in a mountain of blankets, you’ll finally snap and do yourself in.

I hate living like this.

It’s been a full week since my last suicidal thought.

a cure for what ails you, major depression, rapid-cycle bipolar disorder, self-harm, stigma, suicidal ideation, three hopeful thoughts

I can’t say I’ve been happy, but I haven’t really been super-depressed, either. I feel content and more at peace; for now, things are pretty quiet inside my head. There have been a few instances of the “dark core” piping up, but I’ve been able to shut the nasty automatic thoughts down with an efficiency I’ve never experienced before.

Is this what recovery feels like?

I’ve been getting out and taking a walk every night, at least 30 minutes at a time. Sometimes, I go out multiple times, usually when I start feeling restless and trapped in the apartment. It’s such a relief and so freeing to know that I’m not helpless, I’m not trapped. There are places I can go, things to see. I am becoming more comfortable with being alone with myself and just sitting with my thoughts—and my diagnosis.

There’s this huge misconception that people with bipolar disorder are loose cannons, that we’re violent and unpredictable. Crazy. Out of control. I’m learning that while it may happen to the best of us from time to time, it’s certainly not the norm or the default state.

I met a lovely gentleman, also bipolar, on Monday night. We took a walk to Mendota Park at dusk and sat on the rocks by the water, discussing our respective attempts to eliminate our own maps. Just being in the company of someone who knows what it’s like and being able to speak frankly about the ins and outs of this illness was incredibly healing for me, and I found myself able to really relax for the first time since my diagnosis.

There’s not much else to report right now…I have therapy tonight, my first session in three weeks, and I have plenty of things to discuss. A dear friend of mine and D’s is coming into town on Saturday and accompanying me to my tattoo session on Sunday afternoon. I can’t wait to cover up these ugly scars, to remind myself that although it’s a part of my past, it’s just a story now—it’s not happening to me anymore. The worst, for now, seems to be over.

Bipolar II, sans mania.

a cure for what ails you, major depression, medication, rapid-cycle bipolar disorder, stigma

After two hours of evaluation with my new psychiatrist, I received a new and totally different diagnosis: Bipolar II with mixed episodes, no actual mania. It was something D. and I had suspected for a while and had discussed extensively, but hearing it came as a bit of a shock.

And then I felt relief. The reason I’ve been feeling so shitty for the last six years is because antidepressants can make the bipolar cycling worse (my doctor also suspects I’m rapid-cycling), not because I had treatment-resistant depression.

My mother is bipolar. My uncle, who committed suicide years ago, may have been bipolar. And my grandfather’s alcoholism (self-medicating) and fits of temper could have been attributed to the disorder as well, according to my psychiatrist. There is very much a genetic component to the disease.

The game plan is to keep the 150 mg of Effexor in place for now while I continue climbing the lamotrigine ladder to 200 mg. Then, we’ll reevaluate at the end of the month and see how things are going.

I received the news less than an hour ago and am still sort of in shock, so I’m having a really weird mixture of emotions right now. I’m not quite sure how to feel about all this, though I’m glad I’ll finally be able to receive proper treatment. And, as I’ve told myself dozens of times over the last hour, it’s not like I’m a different person because I suddenly have a different diagnosis. It’s just that everything makes more sense.

I guess this was nothing to be afraid of after all.

Lamictal.

medication, ptsd, stigma, three hopeful thoughts

Supposedly, this is the drug that is going to make everything okay.

I met with my psychiatrist yesterday and learned that while it’s usually used as an anti-seizure medication, it works very well for the depressive portion of bipolar disorder. She’s hopeful that this will stabilize my moods and make everything feel less dismal, though I have to build up to the maintenance dosage slower than other patients because it can cause a nasty rash (I had a terrible full-body rash as a reaction to amoxicillin when I was a child, so she wants to be extra-careful).

She warned me that there’s a chance it could trigger a manic episode if I do, in fact, have undiagnosed bipolar disorder. I’m young, and it could be lying dormant for now–she said it wouldn’t be at all unusual if I remained in a depressive state for decades before experiencing mania for the first time.

I feel that, as an advocate for mental illness who tries to do something to fight the stigma every single day, it’s not great for me to say this…but I am secretly afraid that I’m bipolar. My mother is bipolar and when I was young, “You’re just like your mother!” was thrown at me whenever I was being difficult or acting out.

I’ve been educating myself on the disease, though, mostly through memoirs written by women with bipolar mothers. I know that it’s just another chemical imbalance and that I have nothing to fear, but at the same time, it seems like the proverbial big black dog, looming just out of sight. And there is a tremendous stigma surrounding bipolar individuals, which is awful. I am taking comfort in the knowledge that if I do indeed have the illness, I can do a lot of good work to help fight that stigma, too.

But is it so wrong for me to be terrified of being “just like my mother”? It’s not just the possibility of being bipolar that scares me–I was conditioned to fear and avoid any behavior that was even remotely reminiscent of the woman, though now I’m beginning to “take it back” by trying to take the positive aspects of her personality into myself–her carefree, fun-loving nature that I remember so well from her “good” days.

My relationship with my mother is a complicated one, so I’ll refrain from discussing it further in this post; I feel it deserves at least one post of its own, if not a series.

Did anyone else grow up with a mentally ill parent? How has it affected you?