Wednesday, April 30, 2008

Psychiatrists Say the Darndest Things

My first psychiatrist was a short, dumpy little guy from somewhere in the middle east. He is a well-respected psychiatrist, and has impressive credentials. We shall call him Dr. F. I will not divulge here what the "F" actually stands for, but I'm sure you all have active imaginations.

On my first visit, while discussing medications:
Me: I'm a writer, and I've heard a lot about these meds making it difficult to do anything creative.
Dr. F: Oh, don't worry, Depakote won't kill your creativity.

On a later visit, twenty pounds heavier, and expressing my concerns about the side effects I was experiencing on Depakote:
Me: I'm concerned about side effects...I've noticed that my mind doesn't seem to functioning at its normal clip. I'm having trouble multitasking, I can't write anymore, and I've put on quite a lot of weight.
Dr. F: Depakote doesn't do that.
Me: All the same, I was wondering if there was some other medication I could try. What about lithium?
Dr. F: You wouldn't like lithium. Besides, you're already on the very best medications we have.
Me: Well, I really don't like the way they make me feel.
Dr. F: You are an intelligent woman. You know that you need to take these medications. If you're having issues with that, you should be in therapy.

On an even later visit, after having put on a total of forty pounds in only a few months:
Me: I'm really concerned about the amount of weight I've put on.
Dr. F: Well, you need to watch what you're eating. If you eat less, you could probably lose all that weight without even having to exercise.

At my next visit, The Scale appeared in his office, and I was subjected to the additional shame of having to step on it at every visit thereafter. As if I wasn't already painfully aware that my size 6 body had ballooned to a 14, and I could barely stand to look at myself in the mirror.

Another visit, now sixty pounds heavier than when I started:
Me: I'm concerned about the amount of weight I've put on. At what point do the health risks of being overweight become more serious than the risks of not being on medications?
Dr. F: You need to be taking your medications. The risks of being overweight aren't nearly as great as the risk of you becoming hypomanic again.
Me: I've put on sixty pounds in the last year. That can't be healthy. My feet hurt all the time, so I can't even exercise.
Dr. F: I may not have been entirely honest with you about the side effects of Depakote...
Me: Well, what about trying a lower dose? Or stopping it entirely?
Dr. F: If you stop taking your medications, you will ruin your life.

That was my last visit with Dr. F.
How am I supposed to be a partner in my own health care when my doctor won't be straight with me about the risks and side effects of the medications he insists I take?

I have a new psychiatrist now. His name is Dr. L. I haven't come up with anything snarky to call him yet, because so far he's been up front with me, answered my questions, and hasn't made any dire prophecies concerning my currently unmedicated future.

Time will tell, eh?

Tuesday, April 29, 2008

Sibling Rivalry

Canis Feisticus and Canis Dafticus, who are litter-mates, have just turned three. In dog years, this means they are young adults. In truth, today's events lead me to believe that the sibling rivalry is only escalating, and that young adults or not, there are still growing pains to be experienced.

Like many three-year-olds, Canis Feisticus is becoming a tattle-tale. It started when she was quite young. Once a week, the fur-children receive a marrow bone to gnaw--one each, because we all know what happens when you play favorites with siblings. Canis Dafticus, being a bit of a pig, generally finishes his off in five seconds flat and then goes looking for more.

Often after giving them bones, I go to work in the studio, and after a relatively short period of peace, along comes Canis Feisticus. She wanders in, plops herself down in front of me, and stares at me until I acknowledge her. As soon as I make eye contact she howls. This is dog for, He took my bone, Mom. Sure enough, I follow her out into the kitchen, and there is Canis Dafticus with both bones. I get her bone back for her, and she settles down happily. This scenario is usually repeated several times until the bones become old enough that they are no longer interesting.

This morning, Canis Feisticus came into the studio, plopped down in front of me, and fixed me with her laser beam eyes. I said, "You haven't had a bone today. What do you want? Do you want to go out back?" I got up, intending to let her out, but she went right past the basement door and on into the living room, where Canis Dafticus was happily shredding a tissue. Which he knows he is not supposed to do. (I think.) Canis Feisticus plopped down on her butt and howled again: See what he's doing, Mom?

I took away the tissue and told Canis Dafticus off. And as I turned back towards the studio, Canis Feisticus settled down to work on her bone with a satisfied gleam in her eye, and I could almost hear her thinking, Got him in trouble again! Bonus points for me!

I'm a sister, too, you see.

Monday, April 28, 2008

Medication Withdrawal: A Warning

After reading one of Gianna's recent post about her own journey withdrawing from psych meds, I feel compelled to chime in on the subject of medication withdrawal. If you're reading here because you are looking for info on withdrawing from psych meds, I would urge you to do your homework before you begin. Talk to your doctor. Get medical support if you can. Learn all you can, check out Gianna's blog, Psychiatric Withdrawal and Recovery for links to a lot of other helpful sites. And above all, as Gianna cautions, listen to your body.

If you've read my previous posts about medication withdrawal, you know that I stopped taking most of my bipolar medications over a very short period of time and without medical support. I was stupid. And I was damn lucky (it happens--we are all different. What one person can do cold turkey with no problems could be six months of withdrawal hell for someone else). I was not aware that these drugs were something I had to withdraw from. My knowledge of drug withdrawal was limited to what I'd seen in the movies concerning street drugs and what I'd learned in health class in the 8th grade. It never occurred to me that the same might be true of prescription drugs (other than opiates). I mean, they're legal, aren't they? (Yes.) And safe? ( Isn't that what the FDA is for? (In your dreams.) Wouldn't my doctor have told me if there were serious issues like that concerning the drugs he was recommending I take? (Apparently not, since he didn't.)

Well, they might be legal, but I certainly wouldn't call them safe. Now that I have more knowledge, I'm withdrawing from my last medication--trazodone--very slowly, and I'm letting my body adjust to each change in the dosage. And even going slowly, I'm still having withdrawal symptoms--headaches, suicidal thoughts, and insomnia.

So if you're thinking about coming off of your medication, don't just stop taking it. Do yourself a favor and do your research, talk to your doctor, and above all, listen to your body.

Okay, I'm done now. I'll slither down off my soapbox and go wash some dishes or something...

Sunday, April 27, 2008

Creative Recovery?

So part of what I'm doing here is trying to put myself in a position where I have to write every day. The idea being that I've got to do something to loosen all the sediment that is clinging to the pipes in my brain. Once, the words flowed freely through those pipes and came pouring out onto the paper faster than I could catch them. The buckets overflowed, and my head was packed with ideas.

Now, it's a struggle to find the words. I have moments when I can just tool along without thinking about it. Brief moments. But I can't seem to call back the ease with which I used to do this. I can't seem to find the passion I once had for it.

My hope is that once I've managed to get the trazodone out of my system--which probably won't be until sometime late this summer--things will start to improve.

If they don't, I'm not sure what else I can do. I've worked through Julia Cameron's The Artist's Way and Walking in this World...and I started her book Vein of Gold, but I've reached the point where I'm sick and tired of all this introspection, and it isn't helping me get my passion's just making me dwell on what I can't seem to do anymore.

When I think about working on the novel which I am trying to work on, my head fills up with glue, a wave of exhaustion washes over me, and I come up with twenty other things that need doing much more than me sitting down a the keyboard...or twenty other things I'd rather do.

I feel lazy and stupid.
Maybe I am.
Maybe I've forgotten the first rule that I used to live by:

Just do it.

Saturday, April 26, 2008

The Definition of "Well"

What, exactly, does the term "well" mean?

The definition is important, because my doctor and I need to be on the same page about what we expect to get out of any treatment I might agree to.

The first psychiatrist I saw had a pretty narrow definition of "well". "Well" for him meant "not manic--not even a little bit happy." And don't smile at him, or he'll up your Depakote or put you on antipsychotics. In his mind, "well" did not include being able to think, multitask, create, write, articulate clearly, read, stay awake, exercise, cook healthy meals, maintain a healthy weight, or have the energy to do anything other than sleep and convert food into poo.

Since firing him and taking myself off medication, I have come to the conclusion that any doctor I entrust my care to needs to have the same vision of wellness that I do. I expect a high level of functionality. Being a brain-dead zombie is not acceptable. Being a fat, brain-dead zombie is even more unacceptable.

My family don't seem to have a clue what "well" means, either. They assume that because I am not currently taking medication that I must be "well", and I have noticed that since going off meds, no one asks me anymore, in those annoying, hushed, solicitous tones, How I'm Feeling.

I guess if I'm not on medication, everything must be okay, and I'm cured now.

I suppose things will go on like this until I Lose My Mind again, reminding them that oh, yes, there is a Problem, isn't there?


Friday, April 25, 2008

New Disorder is "Most Under-Diagnosed"

A new disorder is being considered for inclusion in the DSM-V. The DSM-V, due out in 2011, is the latest revision of the American Psychiatric Association's Diagnostic and Statistical Manual, the checklist-style compendium of all of the mental illnesses that currently plague our culture.

In order to be diagnosed with this new disorder, patients must exhibit at least one of the following criteria:

  • occasional inability to sleep
  • exhaustion caused by fourteen-hour days with no breaks
  • profound sadness in reaction to a stressful life event
  • profound joy in reaction to any life event
  • feelings of anxiety and/or frustration at one's financial status or future
  • feelings of inadequacy due to being the only one in the neighborhood who doesn't drive an SUV
  • anxiety over world events over which one has no control
  • feelings of helplessness when one watches the evening news
  • feelings of anger at the injustice of it all
  • urges to cheer oneself up with food, chocolate, or a day at the zoo
The name of this horrifying new disorder?

Being Alive.

"It's important for people to understand that there is no shame in being alive," said Dr. Phill Pusher of the Itasca University Medical School in an interview yesterday. "Managing the condition is a lifelong challenge, but there are many medications that can help smooth the way." Doctor Pusher urges anyone showing signs of being alive to make an appointment with a mental health professional. "Being alive is one the most under-diagnosed, under-medicated conditions we have yet encountered."

But there is hope. The condition of being alive, although serious, can be treated with medications. Antidepressants are recommended to battle sadness and other annoying emotions connected with the condition, antipsychotics remove one's ability to ruminate or think, and tranquilizers can help sedate patients for long periods of time, making it possible for a patient to sleep through a lot of the more unpleasant aspects of the condition. Mood stabilizers can also be considered if a patient who is alive exhibits both joy and sadness or anger in the same 24-hour period.

Are you alive?

Visit your mental health professional today to find out what medications maybe right for you.

Thursday, April 24, 2008

The Relic

Every night before bed, the children and I go up to my bedroom and sit on my bed with our snuggly-blankets wrapped around us while I read a chapter of our bedtime story. And every night, Little Mouse, who is nearly eleven, brings an old, folded nightgown with her and places it reverently upon her lap. She calls it her Relic.

The Relic is a white tricot nightgown with lace trim, sparkly beads, and a picture of Ariel, Disney's Little Mermaid, on the front. Little Mouse received the Relic when she was four years old. It was a Christmas gift from an auntie who understands traditional little girls who like pretty things far better than I.

When she was four, it skimmed the floor when she walked and with her long, pale blonde hair, she looked like a little ghost-child gliding along. Now, it barely covers her knees, and I'm amazed she can still pull it over her head.

A few weeks ago, when she wore it to bed for the last time, I gently suggested that perhaps it was time to retire it, as it looked rather uncomfortably tight about the arms and chest. The look on her little face was tragic.

I can only guess what the demotion of her favorite nightgown to mere relic means in her mind, but I know exactly what it means in mine.

My baby is growing up.

Wednesday, April 23, 2008

Genetic Roulette

Spring in the Appalachians is beautiful. The mist wreaths the hills in lacy trails of cloud stuff, and lingers far into the morning before the sun reaches all the way into the hidden places to burn it off. Visiting from Minnesota, my winter-weary eyes drank it all in--the trees, the hills, the rhododendrons in full bloom, a riot of living color. The view from the window of my cousin's house, perched halfway up a mountain, looks like something you'd see on a postcard.

We sat around the table after dinner, admiring the view while we sipped white wine and talked about people long dead, and places I'd never seen. My parents moved to the States when I was not quite four, and ever since then the Atlantic Ocean--and an emotional gulf even wider than that--has divided my family.

The conversation turned to my grandfather, who died of lung disease caused by exposure to mustard gas during WWI. My father barely knew him--he'd been only three when he died. My cousin, whom we had met only days before, had a different version of that story to tell.

Turns out that my grandfather was terrified of living through another world war. So terrified that in 1939, he took his own life. It is speculated that his sister, a nurse, obtained morphine for him in order to "help him along."

A year or so later, on the other side of the family, my grandmother was stopped from committing suicide when she attempted to step off a bridge with my infant mother in her arms.

My mother tells me now that her family are all "a miserable lot." I've a cousin who has attempted suicide. Another cousin who, although undiagnosed, most certainly suffers from bipolar disorder. I've another cousin who battles recurring depression. I have a brother who is currently being treated for depression. And those are just the ones I know about.

This is my genetic legacy.

This is what I may pass on to my own children.

I look into their bright and happy faces now, and I can't help but wonder...are they going to have to worry about the Beast as well? Will they, too, frantically check behind all the doors in their minds, scrutinizing their behavior, wondering if the joys and griefs of their lives are pathological?

Would I have played genetic roulette with their lives if I had been diagnosed earlier?

I don't know. I honestly don't know.

Tuesday, April 22, 2008

Picking up the Torch...?

Furious Seasons, Soulful Sepulcher, Depression Introspection, and BPD in OKC have all written recently about the number of mental health blogs that have either shut down entirely or are taking a break. I was sad to read last week that Gianna of Psychiatric Withdrawal and Recovery (one of my first friends here in the blogosphere) is among those who are taking a break, although, being new to the blogosphere, I can still enjoy reading her archives.

But I can understand, even after only a month or so of doing this, why people need to take a break. Coming up with something somewhat meaningful and relevant to say every day or every few days is hard enough, without trying to do it while battling mental illness. Or withdrawal from psychiatric medication.

I know I haven't been around very long, but I've already noticed that some of my readers have been directed here by search engines, a number of them looking for information about trazodone, the drug I am currently withdrawing from...and that right there is reason enough for me to think that maybe I can be one of the ones who tentatively reaches out to pick up the torch with the intention of carrying it for a little while. Maybe a long while.

I'm currently mom-at-home, trying to carve out a little time and energy for my own literary and artistic ambitions. So far, it's going about as well as I expected. Which is, hardly at all. A few poems published. No best-selling novels. No novels at all; they are all moldering in the bottom drawer of my file cabinet, with their respective rejection slips.

I have come to the conclusion lately that the reason I can't get anything published isn't because it isn't any good, but because the whole business is market driven, and quality storytelling isn't necessarily the point. The point is how much money they think they can make. And because of this, I am becoming less enamored with the idea of publishing.

But even if the big publishing houses don't think they can make enough megabucks off of my stuff to give me a chance, blogging is a way to use my writing to reach people and maybe help them. If I can reach out to one person out there, show them that they are not alone, show them that maybe some of the things they have experienced aren't so crazy, that someone else has felt the same stuff, that maybe being diagnosed with bipolar isn't necessarily a life sentence or the end of the world...then honestly, that will do more for my soul and my sense of self-worth than having a published novel.

Sudden insight: Boy, have I changed since college...

Monday, April 21, 2008

Trazodone Taper, Part 4.5

Right, I'm ready to fling the rest of the trazodone down the loo and flush it away for good. Headaches I was prepared for. Had a couple of bad ones when I decreased the dose too fast.

Flashes of suicidal despair I was not prepared for. Especially after four years of stability.

How can 25 mg make such a difference?

What is the advantage of putting myself through several months of gradual tapering when I could quit cold turkey and be done with it in a week or two?

I know. Brain chemicals. Let my system adjust to the new dose. It wouldn't be good idea to just stop taking it.

I'm gritting my teeth and putting up with it. But I want this crap out of my system YESTERDAY.

Trazodone Taper, Part 4

I dropped my trazodone dose from 150 mg to 125 mg the other night, and it is going better than when I attempted going from 150 mg to 100 mg. No headaches, and I was able to get to sleep. Of course, the Benadryl I took for this lousy cold might have helped with that... My GP prescribed some 50 mg tablets so I can do the taper more gradually. I plan to stay at 125 mg for a couple of weeks, then drop to 112.5. Small steps.

Not that I'm feeling any more awake today. I'm actually feeling rather like something the cat dragged in...and I don't imagine I look a whole lot better. But that's okay, cuz you can't see me!

Sunday, April 20, 2008

The Voices in my Head

The voices in my head are silent. Not the psychotic voices--I've not had the dubious pleasure of hearing those--but the voices of all the characters that live within my mind and scream to have their stories told.

I used to hear them all the time. There was always someone in there demanding to be heard, with no regard for what I wanted, what I needed to do. Often, there were several someones, all vying for my attention.

Now, there is only silence.

I have no flame. No fire. No haunting voices, and no desire to bring them to life. The song of words has gone out of me, dried up at the touch of the cruel poisons I was told would make me well...make me fit in...make me normal...

It is like wanting desperately to be a mother and finding that you are barren...unable to do the very thing nature made you for. I want to write...and I find the halls and corridors of my mind to be empty, housing only dust, shadow, and broken dreams. The ideas and images and voices that once danced there all lie dead at my feet. And instead of dipping into the well of imagination to taste of its sweet nectar, I find myself choking on dust and ashes.

And I have to wonder...did my last mania burn it all away?

Has my curse finally silenced my voices for all time?

Does this illness cause brain damage? Or was it the meds?

Tagged Again!

I'm tagged again, this time by Stephany at Soulful Sepulcher.

This time, I have to answer 7 specific questions...

1. What was I doing ten years ago?
Let's see...ten years ago would have been spring of '98...I was trying to keep our townhouse show-ready with a 1-year-old and a 2 1/2-year-old underfoot, and we were finalizing the details on the new house we were planning to build.

2. What are 5 things on my to-do list for today (not in any particular order)
Today I need to figure out what the heck we're having for dinner; nip out to the grocery store to pick up a few bits for whatever dinner turns out to be; hang up that last load of laundry from Thursday, which is still sitting in the dryer; catch Canis Feisticus and trim her nails; and fill out the registration forms for my kids summer classes (the Barrister wants to do fencing, and Little Mouse has seen a creative writing class she wants to take).

3. Snacks I enjoy
I love Snyder's Honey-Mustard Pretzel Pieces, Ruffles Sour Cream and Cheddar Chips (the real kind, not the baked ones), Lindt Intense Orange Chocolate (the little squares that only have 30 calories each), cashew nuts, smoked string cheese. Note that none of these are particularly good for me!

4. Things I would do if I was a billionaire
Pay off the mortgage and put a bunch in the bank so the Chief could quit his job and do the digital art/painting/drawing that has laid claim to his soul; put my kids in a decent school where they would actually be challenged; give money to people who need it, especially those who have been wronged by the system; kick back and quit worrying about how to pay for college and retirement; purchase a small island and start my own country...

5. Three of my bad habits
I never seem to be able to get the dishes done after supper; I nibble my nails; I don't make my bed unless my mother is coming to visit...

6. Five places I have lived
London, England; one city in Iowa; one city in Washington, and 3 cities in Minnesota.

7. Five jobs I have had
liquor store clerk; technical aide in a research lab; research assistant; post-doctoral fellow; freelance writer

Saturday, April 19, 2008

Tag...I'm It...

BPD in OKC has tagged me...I've never been tagged before, and as I'm new to this blogging thing, I'm not quite sure about this...still, it can't hurt to give it a shot....

Rules of the game …
1. Link to the person who tagged you.
2. Post the rules on your blog.
3. Write six random things about yourself.
4. Tag six random people by linking to their blogs.
5. Let each of the six know they’ve been tagged by leaving them a comment (on their blogs).
6. Let your tagger know when your entry is up.

Okay, so here are six utterly useless facts about me...
1. I can quote most of the movie Monty Python and the Holy Grail verbatim (imagine how much valuable brain space is being taken up by this...)
2. I love doing logic puzzles.
3. I collect blue and white china teapots (that Brit thing again!).
4. I hate I mostly don't...
5. I can't go to sleep if the door of the bedroom closet is open.
6. I cannot stand centipedes, millipedes, or any other -pedes.

Now, since I'm still pretty new around here, I'm don't know six that I'm comfortable tagging...but let's do:
Tilting at Windmills
Superlative in All Things
Lab Rat
Soulful Sepulcher

...and if I come up with a couple more in the next few days, I'll put them in here, too...

Trusting Myself (Not)

I used to trust myself.

Once I had a wonderful relationship with my mind. We spent long hours together dreaming up stories and songs and poems, playing with color and light, creating whatever took our fancy...School was easy...I sailed through it confident in the knowledge that I could do anything I wanted to in life if I only applied myself.

And then I Lost My Mind.

Under the influence of mania, hypomania, screwed up brain chemistry, or whatever other label you want to give it, I sought to destroy everything I had built.

And it seemed like a Good Idea at the time.

What do you do with that? In the aftermath, when you've come down and are finally able to admit to yourself that yes, you did these things, and that while they indeed did seem like Good Ideas at the time, they were most definitely not?

It has taken me years to admit to myself that the things that went on during my last big hypo/mania were part of my illness and not just me trying to have a good time and assert my independence and allow my creative spirit to have free reign. And now that I can see that period of my life for what it was, how can I possibly trust myself in the future?

Friday, April 18, 2008


restless, jagged energy
lightning storms my brain
too much energy to contain
within the fragile shell of my skin
i leave it behind,
i am a bright shiny being of fire,
no longer contained, restrained
move move move
sing sing sing
fly fly fly
like a star going nova, burn bright white flight
like Icarus dancing to the height of the light
burn and crash, crash and burn
wings melt, dreams felt, pills dealt
burn and crash, crash and burn
groping for my pills i turn
amid the ashes alone and cold
nightmares and half memories
of flight limned in gold
etched into the stuff of my soul

Thursday, April 17, 2008

Well, That Explains A Lot...Or Does It?

My bipolar diagnosis nearly five years ago didn't really come as a least, not after the initial shock wore off and I was able to process the fact that there was actually a name for what had always been different about me.

But what has come as a surprise to me is how long it's taking me to integrate that diagnosis into my self-concept. There are so many thoughts and feelings surrounding the diagnosis that I'm still trying to sort them all out.

When I think about it, all of these conflicting thoughts are flying around my brain:

1. How dare you give me this label/life sentence after talking with me for only 45 minutes? You don't know me. You know nothing about me except what I've told you, and if I'm as MANIC as you say I am, then how can you possibly trust my judgment about what's relevant and what's not?

2. Well, this explains so much of what I've felt and done over the years. It explains the wild frenzies of explains the explains the Pit of Unending explains my intermittent non-stop sex explains all the writing all night every night on and on and explains why I don't sleep any explains those crackling, unbearable agitated depressions...If I don't take on this mantle, then how can I possibly explain all of those things that I always thought were character flaws, or weaknesses? I always knew there was something wrong or different about I have a name for it.

3. Oh, good...I've actually got a legitimate medical excuse for my atrocious behavior over the past year and a half.

4. What do you mean, I need to be on medication for the rest of my life? You mean that I don't act/feel like everyone else, so I need to medicated into submission so that you can fit me neatly into one of your little boxes.

5. Who are you to tell me I'm not "normal?" How dare you tell me that you know what's "normal" for me and what's not?

6. If I know I have this disorder and I know what can happen when I'm manic, aren't I being awfully irresponsible not taking meds?

7. But meds don't guarantee an absence of episodes...all anyone can really say is that the onset of the next one might be farther out, and it might not be as bad as it would be if you were unmedicated.

8. Do you really think this medication might help me? Or are you just pushing it on me because if you can write x number of new prescriptions in the next few months, Big Pharma's going to invite you to a week-long one hour continuing education seminar on Maui?

9. Is this really as dangerous for me as I've been led to believe? Almost all of my episodes can be traced back to some kind of stress--chemical or situational: ah, yes, that was the fall I was on steroid treatment, or, that was right after the Barrister was born, or that record three episodes in a year was when I was taking Lexapro...

10. I've managed for 38 years without medications...why should I suddenly need them now?

11. Yes, but there's no blood test. You can't show me any proof that I have this chemical imbalance you say I have. Surely, if that were the case, there would be something you could measure.

12. Maybe I'm just a Horrible Person.

I want to ignore this label and just live my life, dealing with each episode as it comes. But I have had to change my lifestyle so much in order to feel safe that it is constantly on my mind. I take medications to help me sleep. I take medications to calm my nerves when I get anxious. I meditate and do yoga regularly. I avoid certain family members and situations that I know will be triggering. I avoid crowds (not too hard, I hate them anyway!) I go to bed at 10:00 every night, whether I want to or not. I eat right. I don't eat the things I'd really like to eat, I take supplements every day....

Hard to ignore it when the things I do to help myself feel safe are there in my face every single day. Sometimes I think it would be much easier to just take a pill and forget about it.

Except that all of the pills have side effects, so you can't really forget about it. And knowing what I know now, there is no way I trust that the makers of these pills have my health, safety, and best interests at heart.

Does anybody else out there feel as conflicted about their diagnosis as I do?

Wednesday, April 16, 2008

The Tale of the Doggie Doorman

I wasn't always a Doggie Doorman. Or woman. Whatever.

Once I had dreams and aspirations of my own. I went to college. I went to graduate school. I had my future all mapped out, and I was going to be SOMEBODY (not sure who I had in mind...just somebody other than my meek, mousy little self.)

The less-than-stellar job market, motherhood and Other Events conspired against me, and now years after my triumphant graduation, here I am, secure in the knowledge that the only meaningful thing I do day in and day out is open the basement door so that Canis Feisticus and Canis Dafticus can go outside. Or inside. Or outside again.

Being a Doggie Doorman isn't all bad. There are some benefits *pause whilst I try to come up with some*. For example...*think, think, think* earns the undying gratitude of the four-footed ones, who repay my efforts with devotion, loyalty, and a penchant for tracking mud into the house at any opportunity. Which means I am also the Doggie Maid Service.

The Doggie Maid Service's responsibilities include but are not limited to scrubbing the floors free of muddy paw-prints and the greasy residue left over after the consumption of marrow bones, vacuuming up the fine drifts of hair which accumulate on the floor and couches during shedding season (which occurs about every five minutes), laundering the blankets that protect the couches from doggie indiscretions, divesting the walls of the grey shadow of dirt that accumulates at about dog-height, performing the always satisfying Poop Patrol, cleaning up when the rabbit/weed/dead animal/unidentifiable piece of garbage they managed to scoff down during a walk does not agree with their delicate digestive systems, and administering The Pink Stuff to soothe said delicate digestive systems. Which means I am also the Doggie Health Maintenance Organization.

The Doggie Health Maintenance Organization's responsibilities include cleverly disguising required medications in bits of cheese, escorting the dogs to their vet appointments, administering their monthly heartworm and flea prevention treatments, and The Trimming of the Nails. The Trimming of the Nails is an ordeal for all of us. Canis Dafticus has a sixth sense about such things. He knows, even before one has the nail clippers in hand, that the Horrible Event is about to occur, and he high-tails it to his crate, where he sits and watches accusingly through the grate in the side. It takes two of us to hold him and get the nails trimmed. And afterwards, he must be coddled and soothed. Which means I am also the Doggie Psychologist.

The Doggie Psychologist is required to deal with traumas such as thunderstorms, fireworks, The Trimming of the Nails, and The Dreaded Bath. Which usually results in me ending up just as wet (and hairy) as the dogs.

All in all, quite a large part of my day and my energy is taken up with caring for these dear fur-children of mine.

Not that I'm bitter.

What's a career compared to this?

Tuesday, April 15, 2008

The Face of Hypomania

Storm has been absent from my life for about five years now, and although sometimes I miss those wild, free, crazy times, I also fear her return.

Storm is my hypo/manic side. She embodies all that is wild and dangerous about me. She is not somebody you want to invite to a Sacred Family Gathering. Unfortunately, she has turned up at quite a few, leaving a trail of hurt and disillusioned in-laws behind her.

She barges in, uninvited, and puts her muddy boots (or more likely, her stiletto heels) up on the table. She drinks too much, talks too loud and too fast, laughs inappropriately, and flirts with everyone. She tells my deepest secrets to any who'll listen. She spends my money and she whispers in my ear about how I should dress, what makeup and jewelry to wear, what color hair--sexy, sexy, sexy.

When Storm is around, I sit up all night working on stories. I can hold hundreds of pages of work in my head and see the connections between the plots and the subplots as if they were a big glowing ball with brightly lit lines running through it. My mind connects the dots and combs out the tangled story-lines effortlessly. a writer, I realize that Storm's presence does confer a certain advantage upon me. And while I appreciate being able to visualize a whole novel all at once, I do not appreciate the chaos that follows in her wake.

Medications and their various side effects kept her at bay...but they also imprisoned my mind. Now, med-free, I don't know what will keep her contained...and I'm not sure I want to keep her down. Sometimes I really want that clarity and the ability to see all the connections back...

Monday, April 14, 2008

In the Write

The attitude I bring to my writing is different every day, and highly dependent upon my mood. Some days I'm on fire and I can't wait to start spewing words. Other days I am tired and indifferent, and on those days, just opening a notebook is far too much effort. Sometimes I am angry and irritated, and my journal is filled with biting diatribes on my family...other times I am happy and content, and could write sonnets about how well-adjusted I am (*snicker*).

I've actually noticed little difference in the quality of my writing on days when I'm hypomanic vs. days when I'm so depressed I can hardly bear to string words together to form a coherent sentence.

But attitude isn't the only thing that shifts with mood. Perspective shifts, too. And what interests me more than the influence of mood on how well I write or how easily it flows is the influence of mood on what I write. How, I wonder, would a given pivotal scene in a novel have gone differently--potentially influencing the path of the entire story--if my mood state had been different on the day that I wrote it?

Obviously there's no way to's a bit like wondering how my life would be different if my parents hadn't decided to move to the U.S. when I was a child. But my mind is the sort that likes to latch onto such unanswerable questions and worry them to death, and so it is the sort of thing I lie awake thinking about.

I wonder if my mood influences how receptive I am to new ideas about the story I'm working on, or if it might cause me to discard ideas that, in a different mood state, I would jump all over. I wonder if I would solve a plot problem differently if I was hypomanic vs. depressed. I wonder how many different stories could be written from the same spark depending upon the pattern of my moods. I wonder if some of the novels I gave up on--the ones that are sitting, half finished, in the bottom drawer of my file cabinet--might actually be salvageable if I could just have a go at them in a different mood.

Ah well. I suppose I should just be glad that after five years (two years on bipolar meds when I couldn't write, and three years after stopping bipolar meds when I didn't want to) that I feel like I want to write again.

So today I'm going to pull the last novel I was working on before my diagnosis out of the bottom drawer of my file cabinet, brush the layers of dust off, and start looking at it through the filter of my current mood: the mood to write.

Sunday, April 13, 2008

Well, What Sort of Chance Does That Give Me?

I spoke to my psychiatrist the other day about whether or not my diagnosis was correct. After all, I've not had an episode in three and a half years, and since I stopped taking mood stabilizers and antidepressants nearly three years ago, I've felt more stable than I have ever felt before. And the last two episodes I had I'm pretty sure were caused by my first psych doc giving me antidepressants. Maybe everything I'm doing for myself (My Bipolar Survival Toolbox) is working. Maybe, I suggested hopefully, I was better. Maybe, I dared venture, I was never bipolar at all.

He pulled out the history of episodes I had given him during my first visit. And the thick sheaf of notes he'd gotten from my last psychiatrist. One of the hallmarks of bipolar disorder, he informed me, is that when one is not actually in the grip of an episode, one mistakenly thinks that one is well. And one often thinks one doesn't need medications, he added with a meaningful look.

I felt a bit like Brian in that lovely Monty Python movie The Life of Brian, when he is trying to convince all of the followers that he has inadvertently acquired that he is not the messiah:

"I'm not the messiah, I'm not!" he insists.

And the woman at the front of the crowd declares, "Only the true messiah would deny his divinity!"

Poor Brian throws his hands up in the air and says, "Well, what sort of chance does that give me?"

I wonder how many years I'll have to go med-free and episode-free before he will consider "un-diagnosing" me. Can you even be un-diagnosed?

On second thought, making it official might not be a good idea...the insurance company would probably want all their money back...

Saturday, April 12, 2008

Feminine Trials

I hate bra shopping. I really do.

I haven't been bra shopping in an age. Not since I put on all that weight with the Depakote. Now that I'm well along the way towards losing that weight, I've noticed that there's a certain amount of...sagging...going on. Some of this may be due to the weight loss, and some due to my hitting forty a couple of years ago. But whatever the reason, things (two of them, to be precise) are definitely going south, and so (heavy sigh), it's time for a new bra.

I can hardly wait to find out what's "in." What some flaming fashion designer in Paris--who probably doesn't even own a pair of breasts--thinks they should look like. Last time I went bra shopping I had a terrible time finding something that didn't make me look like I had a couple of weapons of mass destruction strapped to my chest.

What's wrong with a plain old white, cotton, comfy bra? Seems like these days everything's either
  • padded (don't need any padding, thanks, got enough of my own),
  • push-up (if they get pushed up I'm going to have breathing difficulties, thank you)
  • covered with lace (it must be men who design bras with lace, secure in the knowledge that they will never have to suffer the torture of wearing one),
  • shot through with enough hardware to set off airport metal detectors,
  • fluorescent enough to show through all but thickest of winter coats, or
  • made of some horrid modern fabric that requires dry cleaning or other delicate handling (if I can't just chuck it in the washing machine, I'm not buying it!).
So it's off to the department store today to try on a bunch of fluorescent, padded, push-up, lacy, underwire instruments of torture, and choose the one that is (a) comfortable enough to wear for more than five minutes and (b) doesn't make me look like a glow-in-the-dark nuclear missile silo.

Oh...and I wouldn't mind feeling somewhat attractive in it, too, if that's not too much to ask.

Sometimes I envy Gladys. The Chief finds her alluring no matter what she wears.

Friday, April 11, 2008

Things That Make Me Furious

Danger: Rant Ahead...

If I have to listen to one more parent stand up in front of our school board and urge them to cut gifted services in favor of sports, I'm going to commit a crime. Or at least an embarrassing act.

If I have one more parent come up to me and tell me that "It must be so easy having gifted kids...they're so smart they do so well at everything," I may have to tear some hair out. Easy?

Um. Easy is not the word I would have used.

I have spent more hours advocating for Hell's Barrister and dragging him, kicking and screaming, through this imperfect system we have than I want to think about.

My oldest has been described by some of my adult friends as "scary bright." His test scores are off the charts. His grades are not. Trying to keep this child challenged and motivated in a school system designed for "average" has been a daily fight.

The last three years of elementary school, he spent in a blissful state of misbehavior and underachievement. He had three years in a row with teachers who either refused to or were incapable of challenging him in the classroom, and so we also had three years in a row of complaints about his behavior in class. "He's bored," I would say when they called me about his latest escapade. "You have to challenge him."

Unfortunately, their idea of challenging him usually involved busy-work. If he finished a worksheet in five minutes instead of the allotted forty, he was given (drum roll please) another worksheet. In his eyes, a punishment for doing his work efficiently. Or they'd allow him time to read some of the books in the classroom. Okay, but this is a kid who tackled "Moby Dick" in the second grade. He's not interested in "Encyclopedia Brown" or "The Boxcar Children."

I spent a lot of time those three years trying to keep his love of learning alive by providing enriching activities at home.

What ticks me off the most about this system is that we have plenty of services for kids at the other end of the spectrum. But nobody seems to think that we need to do anything for the "gifted." (I abhor that word, but it's the word everyone understands.) The attitude of most of the people I've heard speak against gifted education at school board meetings is, "Well, they are gifted. They'll get through just fine."

Um. No. They won't. The kids in the gifted program at my son's middle school are not the kids who are making straight A's. In fact, a lot of them are failing.

Nobody seems to have a clue that a child with an IQ of 150 is as different from the norm (IQ=100) as a child with an IQ of 50. You wouldn't expect a child with an IQ of 50 to thrive in a regular classroom, would you? So why is it that our "gifted" children are expected to do so? Why did it take me two years of waving test scores in front of various officials' faces to get them to grade-advance him in math?

The Barrister is doing a lot better in terms of attitude and performance since starting middle school. His pre-AP classes are keeping him interested and challenged, and I've been able cut back on the amount of enrichment stuff I need to do with him at home. For the first time since second grade, he's actually enjoying school (as much as any twelve-year-old boy enjoys school). I shudder to think how close he came to losing all interest in school. And I wonder how many other kids we're losing to a system that just wasn't designed for them.

In our district, the AP program is one of the programs at risk in the next round of budget cuts. And I'll be damned if I'm going to let them cut this program in favor of football without a fight.

They say they can't afford to keep these programs that are educating our future scientists, engineers, doctors, and leaders.

I say they can't afford not to.

Thursday, April 10, 2008

My Bipolar Survival Toolbox

When I made the decision not to take mood stabilizers, antidepressants, or antipsychotics, I realized that I was going to have to pay much better attention to what I was doing to my body and what I was putting in it, so I developed a regimen that I try to stick to (try being the operative word, here). I do pretty well with this except for the constant battle with my thyroid. I have hypothyroidism, and as soon as my thyroid levels start to crap out again, all bets are off.

My Bipolar Survival Toolbox includes the following:

1. Sleep hygiene. Very important. I need to get my eight hours; I sometimes feel myself revving after only a couple of bad nights, so even though I'm trying to get off of trazodone as a regular thing, I can see keeping it around to take least until I figure out some other things that work.

2. Excellent nutrition. Lots of whole grains, fruits, and veggies (I'm a vegetarian, so there isn't any meat in the equation), no pop or candy or junk food, very little processed food. Limit alcohol (I very rarely have even one drink these days, but I do have rather a weakness for Bailey's Irish Cream!). Limit caffeine...right now I have two cups of tea in the morning, and that's about it. (Us Brits just have to have our tea!)

3. Hydration. Drink a minimum of 64 oz water a day (not including tea!).

4. Stress management (yoga/meditation). I do yoga at least four times a aspire to do yoga at least four times a week. Doesn't always work out that way. I do biofeedback/meditation with the help of the Healing Rhythms software by the folks at Wild Divine. I also have a prescription for Ativan which I take (very rarely--that's a slippery slope, that is) when stress starts getting to me. I do my best not to put myself in situations which I know are triggering for me, and that means avoiding certain in-laws and out-laws completely.

5. Supplements. I take flax oil (omega 3 goodies), a multi-vitamin (no iron...iron make me ill), B-complex, and calcium (last ditch pre-menopausal attempt to avoid osteoporosis).

6. Journaling. I journal every morning, just to get a feel for where I'm at. I find this more effective than mood-charting, which I tried for a while, but found that I was getting too focused on every little fluctuation and blowing things way out of proportion.

7. Medical support if necessary. I have a psychiatrist I see every few months, just to check in. He prescribes trazodone to help me sleep, and Ativan to help me deal with stress. He thinks I'm an episode waiting to happen, but after three years of this regimen, I'm more stable than I have ever been. I figure as long as I'm on his patient list, if I get in trouble and decide I do need chemical intervention, I won't have to wait months to see someone.

8. People who watch out for me. Between my husband, my mom, and my best friend, I've got three people who know what symptoms to watch for and who are committed to telling me if they think I'm starting to go off the rails. (Whether or not I listen remains to be seen!)

9. Exercise. If I'm getting depressed, it's the last thing I want to do, but it really does help. Even if it's just going along with the Chief when he walks the dogs at night.

A lot of this stuff was a major lifestyle adjustment for me, and I still consider myself a work in progress. I don't stick to it perfectly by any stretch. I have days when I don't feel like hitting the yoga mat, PMS days when I am compelled by hormonal forces beyond my control to chow down half a bag of chips or a bag of Ghiardelli chocolate (you know, the stuff with the soft caramel inside...*drools on keyboard*...), days when I feel like eating healthy is just too damn much work, and days when I feel resentful because other people don't have to watch themselves so carefully.

It has been a long, slow battle back to clarity, creativity, and health, and I still don't think I'm working at the level I did before medication. But this regimen has done a lot for me in the three years I've been working with it. I've lost 40 pounds (20 more to go!), I've started doing my quilt art again, and more recently, I've started writing again.

Unfortunately (some would say) I've also regained my off-beat sense of humor...which my nearly-teen-aged son is finding quite disconcerting. And occasionally embarrassing. But we won't go into that here...

Wednesday, April 9, 2008

Trazodone Travesty

After doing a bit of research on trazodone withdrawal, I have learned that this "benign" (psych doc's description, not mine) medication that I have been using to help me sleep for the past five years does actually cause withdrawal symptoms if you stop taking it. Thanks to all four of the docs who've prescribed this drug for me at various times, for letting me know this important information.

I have found that I may have some or all of the following to look forward to: aggression, anxiety, balance issues, blurred vision , brain zaps, concentration impairment, constipation, crying spells, diarrhea, dizziness, fatigue, flatulence, flu-like symptoms, hallucinations, hostility, indigestion, irritability, impaired speech, insomnia, lack of coordination, lethargy, migraine headaches / increased headaches, nausea, nervousness, over-reacting to situations, paranoia, repetitive thoughts or songs, sleep disturbances, severe internal restlessness (akathisia), stomach cramps, tremors, tinnitus (ear ringing or buzzing), tingling sensations, troubling thoughts, visual hallucinations / illusions, vivid dreams, and (inhale) worsened depression.

I've certainly got the headache. I'm going to have to rethink this 50 mg/week thing I thought I was doing. I've put a call in to my GP, to see if he will give me a prescription for the 50 mg tablets (I currently have only the 100 mg ones) so that I can reduce the dose more gradually.

Still, I'm of two minds about this thing. I've always been a yank-the-Bandaid-off-and-get-it-over-with kind of gal, and the idea of having to slowly taper off of this stuff really sticks in my craw. On the other hand, I suppose I've been on it for five years, what's a few more months?

Well, I'll plan to do the taper because that's the responsible thing to do, and I know better now than I did when I went off my other meds. But don't be surprised if I get agitated, irritable, hostile and flatulent enough to fling the remaining pills down the toilet.

Trazodone Taper, Part 3

I dropped my trazodone by another 50 mg, so I'm down to 100 mg, and I had a terrible night. Couldn't get to sleep, couldn't stay asleep. Hopefully this was just A Bad Night and has nothing to do with the lower amount of trazodone. I suppose tonight I'll have to take some Benadryl as well.

Ah, well. I guess I'd rather take Benadryl every night for a while than trazodone.

Tuesday, April 8, 2008

The Dance of Seven Huskies

I just made the mistake of opening a can of tuna.

Being dogs, Canis Feisticus and Canis Dafticus have such finely tuned senses that they can tell the difference between the opening of a can of tuna and the opening of a can of tomato sauce. Tomato sauce generally evokes no reaction (unless you are simultaneously waving a bag of jerky treats and yelling, "Do you want a TREAT?"). But open a can of tuna and you've got airborne huskies.

And therein lies my mistake. For now, energetic or not, graceful or not, nattily dressed or not, I shall be forced to perform The Dance of Seven Huskies.

Act One: Flying Huskies
Canis Dafticus glides over the couch from a standstill in one graceful leap. He tears into the dining room, hits the linoleum, scrabbles desperately as he rounds the corner into the kitchen in a barely controlled skid, and comes to a stop at my feet before the can is half opened.

Canis Feisticus is a bit more reserved. She follows daintily, refusing to move any faster than a sedate walk, lest you think she's actually interested.

Much nudging and shuffling ensues as both dogs attempt to obtain the prime position in middle of the kitchen floor from which to observe the proceedings. Just in case I should decide to do something unusual, like upend the entire can on the floor. Not that it's ever happened before, but when you're a dog, it's all about hope.

Act Two: Oh, Feed Me or I Shall Perish
As soon as they realize that I'm not about to drop the contents of the can down their greedy gullets, Dafticus and Feisticus settle in for the wait. Canis Dafticus plops himself down in middle of the floor with a long-suffering sigh. He places his head between his paws and stares up at me with an expression that says if-I-don't-get-just-a-tiny-bit-of-that-tuna-I-shall-surely-perish. Canis Feisticus doesn't bother trying to look appealing. She's all about efficiency; she positions herself strategically at the entrance to the kitchen, so when I make my mad dash to the recycling bin, she'll be poised and ready to trip me up.

Act Three: The Dance of Death
As I lift my foot in an attempt to move from counter to fridge, Dafticus raises his head to check the location of the tuna and places one paw on my ankle. I shift my weight and as I begin to lower my foot, he rolls halfway over, gaze still riveted on my hand, covering the spot on the floor where my foot was supposed to go. In an attempt to avoid breaking his paw and my ankle, I twist precariously about and manage to place my own foot on a clear space just as Feisticus raises her head and places her paw on my other ankle. I lift my back foot and just as I'm about to put it down, Feisticus shifts herself under it and Dafticus lays his head upon the other foot. I flail my arms about in a pathetic attempt to regain my balance, wondering where all these extra huskies came from. As I attempt the final approach to the fridge, both dogs roll onto their backs, following my movements intently. I manage to complete my pirouette without killing myself or injuring a dog...but I still have to make it back to the counter. With a jar of mayonnaise in hand...

The Dance of Seven Huskies is performed at least once a day in my kitchen. It has yet to end with the tuna on the floor, although it has ended with me on the floor. More than once.

Monday, April 7, 2008

Healthy Vigilance...or Hyper-Sensitivity?

Mood-wise I am in flux...not exactly sure where I am, but keeping a watchful eye. My motivation is low at the moment. When I contemplate doing something I don't fancy, my head fills up with glue. A wave of exhaustion slops over me and I have to bargain with myself to either do or not do the task in question. If it's housework, I can generally push myself to make it happen. But if it is something that isn't going to impact anyone else--like, "I don't feel like doing yoga today,"--I am very good at letting it go. And of course, there's always the excuse, "Well, I need to be kinder to myself, not push myself so much."

Well, maybe. But if I don't push myself, nothing will get done.

The thing I hate most is not knowing where to draw the line between healthy vigilance regarding my moods and hyper-sensitivity.

Sunday, April 6, 2008

Touching Fire

Touching fire is touching the creative spirit, being totally in tune with where you are and what you're doing. Touching fire is when something grabs you and writes through you and you feel like you're just taking dictation. Touching fire is when it rocks. It doesn't happen very often, but it's a kick when it does. It's better than any high, better than drugs, better than sex.

I don't know what it is you're tapping into when you touch's like hitting a vein of gold, like mainlining a comet, like the ride of your life. Everything real falls away and it's just you and what you're creating.

It's the closest I come to believing in a higher consciousness, the closest I get to my primal self, the closest I get to being something pure. Enlightenment. Nirvana. The Dance of Shiva. Oneness with the essence of what you are and what you do.

That's what I can't seem to do anymore.

And I miss it.

Saturday, April 5, 2008

Life After Meds: Creativity

The biggest casualty of my foray into modern psychiatric treatment was my creativity. The doctor who prescribed Depakote for me promised me it wouldn't kill my creativity. And I suppose technically, it didn't...but it changed it beyond recognition, and in some ways I'm still waiting for things to get back to the way they were before chemical intervention derailed my career.

The interesting thing about creativity and Depakote was that although the medication effectively silenced me in terms of the flow of language, it did not stop me from being visually creative. I could make dazzling scrapbook pages. I could draw and paint (as well as I could before meds, anyway, which isn't saying a whole lot!). And if I'd been able to hold a needle without my hand shaking, I could probably have done my beloved quilt art, as well, assuming the Depakote left me enough energy/motivation to do so...

Coming off medication did not improve matters overnight. Although I experienced only a week of very obvious emotions-all-over-the-map stuff when I stopped the Depakote and Lexapro completely, there were far more subtle effects that lingered for many months after my last dose of medication.

Emotional and motivational effects that are completely subjective, making them difficult to measure. How do you quantify damage to your creative drive?

It was over a year before I felt I was able to articulate as well as I could before meds. A year and a half before my creative spark made enough of a comeback that I actually wanted to do something artistic or musical. Two years before I felt the desire to pick up needle and thread again. And although I still have the ability to write (or at least, to string a few coherent sentences together), it doesn't hold the magic for me that it did before meds.

In some ways, I still feel very much like I am in a cage. Except this cage is not one that I can touch or doesn't have an obvious way out. And the only reason I know it exists is because I remember what it was like to be free.

Trazodone Taper, Part 2

Interesting how the last few days, after dropping my trazodone from 200 mg to 150 mg, I've had more energy and more motivation, and just a general feeling of enjoying life a bit more.

I've also had a mild headache on and off for most of the week, which is unusual for me, so I have to wonder if that's got anything to do with reducing the dose.

Friday, April 4, 2008

The Side Effects of Side Effects

In the fall of 2003 I was diagnosed with bipolar disorder and started taking Zyprexa, Depakote, and Lexapro. The Zyprexa ended up being very short term--6 weeks to quell the mania--but Depakote and Lexapro became my "maintenance meds."

One of the side effects of both Depakote and Lexapro is weight gain.

It didn't take long for the weight to start piling on--60 pounds in less than a year--and with the weight came plantar fasciitis, a painful form of tendonitis that affects the tendon running along the bottom of one's foot. It manifests as ferocious heel pain that is at its worst first thing in the morning, or after long periods of being off one's feet...although, to be honest, when it was at its peak, there wasn't a whole lot of difference between first-thing-in-the-morning pain and all-day-every-day pain.

The pain was awful, and after a while it was my constant companion. It got so bad that I had to do my grocery shopping in short trips, strategically planned so that I would only visit one part of the grocery store, and only have to be in there for 10 to 15 minutes--because that was the longest I could stand being on my feet. I had to do my housework in fits and starts. Cooking an elaborate dinner was out of the question, as were family trips to the zoo, the amusement park, the museum, or anywhere else that required me to be on my feet for longer than 10 minutes at a time. Some evenings, my feet would be so sore and swollen that I'd be in tears.

My psych doctor was no help. First, he told me Depakote wasn't responsible for my weight gain, and that if I wanted to lose weight, I needed to eat less. Then, to add insult to injury, he started weighing me every visit.

I finally went to a foot specialist and had painful injections of cortisone in my feet, which helped for a few months, but the pain always came back, and cortisone is hard on the body--it wasn't a good long-term solution. I got expensive orthotics to put in my shoes and I did the prescribed stretching exercises faithfully, but I knew, and the doctor confirmed, that it probably wasn't going to get a whole lot better unless I lost some weight.

I needed to exercise. But I hadn't been exercising since I'd started bipolar meds--I didn't have the energy or the motivation to do much of anything except drone through the day-to-day stuff. So the running and high-impact aerobic work I used to do were out of the question--I was 60 lbs overweight, and my feet couldn't even handle walking for ten was I supposed to get the kind of exercise that would support weight loss under those conditions?

That was when I hit on yoga. It was non-impact. It didn't require any equipment besides a yoga mat, and I still had a lot of flexibility from my years of tumbling as a kid. So I bought a couple of videos and started doing yoga, and I was hooked. Here was something I could do...and some of the more advanced videos looked like they'd give me a pretty good workout if I could work my way up to them.

Of course, knowing something is good for you and having the energy and motivation to do it are two entirely different things. My meds left me drained most of the time, and it was very difficult to make myself do anything beyond the essential chores of getting dinner on the table and making sure everyone had clean clothes.

But once I made the decision to stop the medication, yoga became a nearly daily practice. I slowly started losing weight. (Slowly, because I'm still trying to get my thyroid stabilized, and whenever it craps out, I lose all motivation to do the things I know I should.) My feet slowly started getting better. My foot doctor said the yoga was probably helping, as it involves a lot of stretching and strengthening of the feet. It took over a year of working on weight loss and stretching and yoga before I was completely pain free, but I made it, and today I can go to the zoo with the kids, go on long shopping trips, and go on walks with the family. I still have to wear my shoes with my orthotics in them most of the time, but last summer I was able to kick off my shoes and go barefoot for a couple of hours in the evenings.

I still have about 20 lbs of "Depakote weight" to lose, and I'm still fighting with my thyroid, but it's a process, I keep telling myself, and it's a lot easier now that I'm not in pain all the time.

But I think if I'd been able to foresee all of this...or if I'd been better educated about the medications in the first place...or even if my doctor had been honest with me about the side effects, I would have pushed to get off the meds sooner.

Thursday, April 3, 2008

Medication Withdrawal

I've been reading a number of mental health blogs lately, and one thing that I did not appreciate when I was diagnosed bipolar II and began taking psychiatric medications was how difficult it is to get off of these drugs.

One thing I now realize is that the terrible bout of "flu" I had early in 2005 following my sudden stopping of Lamictal due to a rash, probably wasn't the flu. It was more likely Lamictal withdrawal. I was only on the stuff for three weeks, but I was sick for nearly two months after stopping. I was utterly exhausted. I couldn't move from the couch. My husband had to take over all the household duties. Even cooking a simple supper was beyond me...all I wanted to do was sleep.

The doctor who had prescribed the Lamictal for me said nothing about withdrawal symptoms--he just wanted me to stop taking it due to the rash. And the PI sheet didn't say anything about stopping the medication (other than don't), so I assumed I had the flu...although it lasted a helluva long time for the flu.

When I decided to stop taking most of my other medications (Depakote and Lexapro) in the summer of 2005, I still knew nothing about medication withdrawal. Common sense told me I should probably taper the drugs down since I'd been on them for nearly two years at that point, but I didn't have any medical advice for doing so. The only thing my psych doctor had to say about going off my medications was that I would "ruin my life" if I did. Of course, this was also the man who told me to my 60-lbs-heavier face that Depakote doesn't cause weight gain or cognitive dulling, so he didn't have a whole lot of credit with me by that time.

So I quit the meds on my own, probably way too fast, if what I've been reading lately is any indication of how it ought to be done. I cut the doses of both meds in half for two weeks, then in half again for two weeks, then stopped entirely. The first week off meds entirely was pretty awful--my emotions were all over the map, and I was seriously scared that I was heading into another episode. But after that week, things settled down, the fog cleared from my mind, and I started being able to feel and to think again. My energy returned, my sense of humor returned, my creativity returned, my ability to multitask and to think on my feet returned...

And I have to ask myself why, when I had never been hospitalized for mania, when I had never been suicidal with depression, when I was never a danger to myself or anyone else (in a life-threatening sense), was I put on so much medication in the first place? All I really needed was something to help me come down from wherever I was. Not to be drugged into a cage with a lifetime regimen of "maintenance medications." Not to be intimidated with horror stories about what would happen if I stopped taking the medications. And certainly not to be put into the position of having to choose between the things that make life worth living and the promise of "stability"...a promise that was never realized while I was on medication, because the Lexapro started me cycling in and out of episodes every few months.

Now that I've been off most of these meds for nearly three years and am following my own regimen of good nutrition, yoga, meditation, supplements, and common sense, I'm more stable than I've ever been in my life.

Sometimes I regret the time I lost to medication. My son was having a lot of trouble in school at that time, and due to my complete lack of emotion and energy, I was not capable of being present enough to advocate for him. I'd like to think I've made up for that in the years since, and he's doing much better now...but those lost years really bother me sometimes. He'll never get that time back. And neither will I.

Wednesday, April 2, 2008

Trazodone Taper

Well, the thyroid test came back and it's definitely not's actually the highest it's been since this thyroid fiasco started five years ago. So my days of butt-dragging-no-energy aren't due to the thyroid.

I don't think it's depression, either, because it hasn't been the usual inexorable descent into hell. It's just been the odd day here and there.

So my next likely culprit is trazodone, an antidepressant which I was prescribed for insomnia during the Big Mania. At my worst, I was taking 300 mg a night to sleep. More recently I've been using 100 mg, but I'd upped it to 200 mg a night over the holidays, which always cause me much Anxiety and Hand-Wringing, and, not surprisingly, Insomnia. And I hadn't gone back down after things settled down. So now it's time to taper down the trazodone and see what happens.

Hopefully I will be able to sleep without it. Hopefully I will sleep deeply enough without it that I won't be constantly awakened by the Chief's snoring. And the various dogs' comings and goings.

Before we had kids (and before I needed medication to sleep) the Chief (whose normal bedtime is a couple of hours after mine) used to complain that I was the only person he knew who slept so lightly that the sound of him removing his socks would wake me. To which I would reply that he was the only person I knew who removed his socks with the assistance of a crowbar, a mallet, and a bagpipe ensemble.

Perhaps it's time to think about separate bedrooms...on opposite sides of the house.

Tuesday, April 1, 2008

Hell-on-a-Stick, Part 2

Okay, so I got my desk all cleaned off so there's room for the keyboard and mouse. I rearranged a little bit so I can see out the window (good for distraction!). I got out my notes on the last novel I was working on and read them over. I talked to one of my writer friends about getting together on a semi-regular basis to check in on our various projects and comment on each others' work. And I even spent some time polishing up some of the last scenes I wrote.

Why isn't it sparkling?
Why isn't it gripping me by the throat and demanding to be given voice?
Why can I not do this anymore?

Why don't I want to?