Medication Madness: A Recovery Story

Gianna first asked me to write this back in December for the Recovery Page at her blog, Beyond Meds. It was posted there about a month ago, but I thought I'd put it here, too, since this blog is kind of about reclaiming one's life after being misdiagnosed with bipolar disorder and buying into the bullshit for a while before finally seeing the light.

In retrospect, I find it interesting, tragic, and infuriating that a gp and a psychiatrist were able to take an otherwise healthy woman suffering from situation-induced anxiety with a history of two brief periods of depression probably caused by as-yet undiagnosed hypothyroidism, and parlay that into a bipolar diagnosis and a life-sentence of medication-or-else.

I'd always had ups and downs. As a child, I'd been very anxious and very creative. As a writer I'd experienced intense writing highs when I could write for hours at a time and get by with very little sleep, and I'd also experienced intense creative lows where my mind seemed to be mired in muck and I couldn't eke out a single sentence for weeks on end. It never occurred to me to medicalize of pathologize that behavior...it was just part of me and who I was and how I operated.

In the fall of 2003, I went to my gp to get something to help me sleep. I'd taken Ambien before, when I had my creative periods and just couldn't get the wheels to stop turning long enough to fall asleep, and figured that was probably what I needed. At the time, we had a very difficult, anxious family situation going on—my best friend, who was in the process of getting a divorce, had moved in with us, and had promptly met and began an affair with my then-married brother-in-law, putting me smack in the middle between her and his bewildered wife. When I lay down to sleep, I couldn't stop thinking about what was going on and how to fix it. When I went to see my gp for help, my regular doctor wasn't there, and I had to see one of his partners. I was running on maybe three hours of sleep a night for the past week, and felt like I had way too much energy for having had that little amount of sleep.

The doctor asked me if I'd ever been depressed. I recalled two six-week periods, on in 1999 and one in 2001 when I had felt really down, unmotivated, and exhausted. Each of these periods of "depression" resolved on their own without medication. Sure, I'd felt horrible, but I was a young mother stuck at home with two small children and no car (let alone no time to write), which hadn't exactly been part of my career-oriented game plan. The doctor decided that I might be bipolar and asked me how I felt about seeing a psychiatrist. I was a bit surprised, but figured she probably knew what she was talking about and said I would make an appointment. She told me it would probably be a number of weeks or possibly months before I could get in to see anyone and that she would prescribe something for me to take to "bring me down" until I could get an appointment.

She gave me Zyprexa.

She also drew blood for a thyroid test, saying it was possible that my thyroid levels were high.

I managed to get an appointment with a psychiatrist six weeks out. In the meantime, I thought it wouldn't hurt to do some research on bipolar disorder. What I learned did not make me very happy. I read the DSM laundry list of symptoms of bipolar disorder, and realized that I had had all of those symptoms at one time or another. I began going through my journals and noting times when I had been down and times when I had been unusually creative or energetic. No pattern emerged, but there were an awful lot of ups and downs.

A week after my initial appointment with the gp, the thyroid results came back, and I learned that my thyroid levels were low and that I would need to start taking Synthroid. This was no surprise, really, as my mother had been diagnosed with the same thing years ago. But I have to wonder now just how long that had been going on, and whether it might have played a part in those two periods of "depression" I'd experienced a few years earlier.

The Zyprexa took a week or so to kick in, but it did seem to help. By the time I went to see the psychiatrist, I was sleeping better and my anxiety levels had come down somewhat (former best friend had moved in with brother-in-law, so I wasn't having to deal with that situation on a daily basis), though they were still a lot higher than normal. When I finally went to see the psychiatrist, I believed I had educated myself about bipolar disorder, and was fully prepared for him to diagnose me and medicate me. After a 45 minute interview, this man whom I had never met before and knew nothing about me other than my answers to his standardized questions, diagnosed me with bipolar II and told me that I would need to start medication immediately and that I would need to take it forever.

He did not once ask about anything that might be going on in my life.

To his credit, he wasn't too thrilled that the gp had prescribed Zyprexa. "We don't like Zyprexa," he told me, "but I'm sure she was just trying to help." He prescribed Depakote for the mood swings and trazodone (an older antidepressant with the helpful side effect of making one extremely sleepy) to help me sleep.

In my research, I had read that many writers and artists who had been diagnosed with bipolar disorder refused to take medication because it stopped them from being able to create. I told him I was a writer, and I was concerned about my ability to write while on medications. He gave me a condescending look and said, "Depakote won't kill your creativity." I took my prescriptions and dutifully made an appointment to see him again in four weeks.

At my next appointment, I told him I was still feeling a lot of anxiety, although I was sleeping better. He prescribed Lexapro, an antidepressant, because he said it would help with the anxiety and that he was concerned that untreated anxiety might lead to depression.

I swallowed all the propaganda, hook, line, and sinker. I became a student of my moods. When I felt good, I was "hypomanic" and needed to call him and ask him to increase my Depakote. When I felt lousy, I was obviously becoming "depressed" and needed to have more Lexapro. There was no room for normal, human emotions in my illness, for any emotion I felt might be the herald of disaster. My doctor told me on every appointment that the medications were "saving my life" and that if I ever stopped them I would ruin my life.

My Depakote dose went up and up and so did my weight. Within six months I had put on sixty pounds, and within a year I was suffering from terrible pain in my feet from plantar fasciitis, which the foot doctor whose advice I sought told me had been brought on by gaining so much weight so quickly. He prescribed orthotics and stretching exercises, but also told me that it was likely that I would not find a whole lot of relief until I lost some of the weight. I tried the orthotics, I tried the stretching, I tried to lose weight, and finally I submitted to painful cortisone shots, which brought some relief, but alas, only for a few weeks, and then the pain would return.

Pain became my constant companion. It was so bad that many evenings I was in tears. I couldn't be on my feet for more than ten minutes without excruciating pain. Housework had to be done in fits and starts. Grocery shopping became a nightmare, and I had to strategically plan shopping trips that would keep me in just one area of the store for the minimum amount of time. I missed out on taking the children places like the zoo, the science museum, and the amusement park because I just couldn't be on my feet for that long.

Soon after starting the Lexapro, my moods began to cycle rapidly. During my first year on Lexapro, I experienced three depressive episodes and two hypomanic episodes. My doctor took this as validation that being on medications was the right course, because obviously my illness was worsening, and it was a good thing we'd caught it before things really went off the rails.

It never occurred to me that the medications might be the cause of the mood swings.

As the doses of medication increased, my mind started to shut down. Where once I had possessed a rapier wit, now it was all I could do to get the right word out without stuttering. My hands shook and I couldn't do the fine needlework I'd always taken pride in. And worst of all, my verbal abilities disappeared. I couldn't write. I couldn't remember things. I couldn't even find the right words half the time. I also lost all interest in sex, and I found myself unable to care about anything. Life just drifted by, and nothing ever seemed to touch me. In fact, the only time I really felt anything was when my moods cycled up or down.

But I had to keep taking the medications, right? Because if I stopped, I'd "ruin my life", and I was damned lucky that we had caught this problem before things got really out of hand. A doctor had told me so, and he was Educated and Informed, so he had to know what he was talking about, right? After all, he was a professional psychiatrist—an expert on mood disorders--and a professor at a respected university, to boot. I could trust him...right? And after all, my mood swings had become much more frequent and much more severe in recent months. All proof to me that I was doing the right thing.

As time went on I became more and more drugged and disillusioned. I couldn't write anymore so my dreams of writing and publishing novels for a living went down the toilet. By the fall of 2004, over-medicated and overweight, the future no longer seemed bright and full of colour and energy. It looked cold and numb, the colour of ash. And I had pretty much resigned myself to the idea that this is my life now. I have bipolar disorder and I'm lucky to have a life at all.

I tried complaining to my psychiatrist about some of this, but although he listened, I do not think he ever really heard me. And he had an answer for everything:

"I'm concerned about the amount of weight I'm putting on," I told him at one appointment. "When do the risks of carrying around this extra weight outweigh the benefits of taking the medications?"

"You are taking the best medications we have available," he told me, and his manner made me feel like an ungrateful child asking for a second helping of dessert.

"What about going off the medications for a while and seeing what happens?" I persisted, aware that weight loss wasn't going to happen on Depakote—I'd already been trying, and was having no luck.

He gave me a severe look and said, "You are an intelligent woman. Your episodes have been more frequent during the last year, and you know that if you stop taking your medications, you will ruin your life."

Eventually, in the winter of 2005, after months of me pestering him at every visit, he finally agreed to let me try Lamictal. I was very excited at the prospect, because I had read that Lamictal was not as sedating as Depakote—I might actually be able to think and write while on this drug—and it was weight neutral, so I might be able to lose weight as well. I was instructed to cut my Depakote down over a few weeks from 2500 mg to 1000 mg, and then start the Lamictal, then taper the rest of the Depakote after I was up to 100 mg of Lamictal a day. Within three months, if all went well, I would be off the Depakote entirely.

Unfortunately for me, I developed the dreaded Rash, and was told to stop the Lamictal immediately. Cold turkey. I was on 100 mg at the time, and stopped as instructed. A week later I came down with the worst "flu" I'd ever had and was in bed for six weeks with the worst fatigue I had ever felt. I was so exhausted I could barely get off the couch to stagger to the bathroom. I didn't have the energy to make dinner or do laundry, or anything I normally did. My husband had to take over pretty much all the household chores as all I was capable of doing was lying on the couch sleeping 18-20 hours a day. At that time I'd never heard of Lamictal withdrawal, and my doctor had not mentioned anything about the risks or symptoms associated with stopping it so abruptly, and so I assumed I'd had a rotten bout of flu. I know better now.

So the Lamictal experiment had failed, but I was down to only 1000 mg of Depakote, and was beginning to be able to think a bit more clearly. My memory was better and I didn't feel like I was groping for the right words all the time. The shakes had mostly gone away, although I still couldn't do really fine needlework. And I was starting to care about things again. I felt so much better on the lower dose that I told my doctor I wanted to stay there for a while. He agreed.

The turning point came that spring when my husband suffered a severe heart attack. In a cold, numb daze, I dealt with it. I called the ambulance, I called the neighbor to take care of the kids, I drove (with my terrible sense of direction and fear of getting lost) into the big city to a hospital I'd never been to before, and I held it together. I didn't cry. I didn't feel much of anything, actually.

Fortunately, my husband survived. He had a catheterization procedure done, which he came through with flying colours, and was out of the hospital within three days. But I still couldn't feel anything. I couldn't even cry, and I knew that wasn't normal.

At that point, I decided that I'd had enough of being drugged numb. I was completely unable to respond to normal human emotion, and I began to fear that I was not able to respond to my children appropriately. When I told my doctor that I was concerned about the fact that this traumatic, life-changing event had occurred and that I had been unable to react to it, his response was, "Well, the medication protected you."

Yeah. Thanks ever so, doc.

That was my last visit to him. Without having a clue what I was doing, I tapered my medications down over the next month, and by the summer I was off of Depakote and Lexapro. I was still taking trazodone to help me sleep, because I still believed I had bipolar disorder, and that I needed to do everything in my power to stay stable. I embarked upon a program of healthy living—excellent nutrition, supplements, regular bedtimes with trazodone to make sure I got my sleep. I even gave up caffeine. I'd been a regular Diet Coke drinker for years, but I knew that caffeine could mess up my sleep, and I'd had it hammered into my brain for the last year and a half that proper sleep could be the difference between stability and a manic episode. When I was on the medications, caffeine was often the only thing that allowed me to see through the drug fog long enough to get the kids off to school in the mornings, but with the dulling effects of medication gone, I found that I didn't need caffeine any more. For exercise, I started a simple yoga routine because that was about the only thing I could think of that didn't involve impact that would hurt my feet. I found that I enjoyed yoga a lot, and this naturally led me to an interest in meditation, which I added on to the end of my yoga program.

The first week completely off meds was rough. My emotions were all over the map. But I refused to pathologize them. I told myself that I'd had everything deadened for the last year and a half, and that I had to become accustomed to feeling things again. I told myself that I had a year and a half of chemically suppressed emotion that I needed to deal with, so I let myself cry, I let myself feel whatever it was I needed to feel, and embraced the fact that I could feel at all. After that week, things eased up and I began to feel more like my old self.

I began to lose weight slowly, and the yoga had an unexpected benefit—even before I had lost much weight, the pain in my feet began to ease up (although it did not disappear entirely until I had lost thirty of the sixty pounds I'd put on). Soon I was able to go back to my usual activities, and even take short walks.

I was still taking trazodone, and I still believed that I had become that most dangerous of creatures, an Unmedicated Bipolar. Months went by and I was still unable to write. I was afraid that something, either the bipolar disorder or the medications, had damaged my mind, destroyed my creativity. I tried everything to bring it back, but nothing seemed to work. The ability to write seemed to be intact, but it didn't move me that way it once had, there was none of the sparkle I recalled, and I lacked the drive to do the one thing that I had once believed to be my life's purpose.

A couple of years passed. I was still taking trazodone, and I lived in constant fear that I was going to have an "episode" and not be able to control myself. Eventually, the fear got to me and I decided that, knowing how long it takes to see a psychiatrist, it might not be a bad idea to have one on board, "just in case." I found one not too far from my house, and went to see him. Even though I had been stable off medications for nearly three years, he wanted to put me back on medication. I told him I would consider it, but I also told him point blank that I refused to take anything that would make me gain weight or make me stupid. He named three medications—Abilify, Lamictal, and Trileptal. I told him about my past Lamictal problems (the rash, at least, not the withdrawal symptoms, as I still believed it had just been a nasty bout of flu), and he suggested that if we increased the dose much more slowly and without Depakote present that things might go better. He told me to research the medications he had suggested and we would discuss them next time.

However. In my research I came across Phil Dawdy's Furious Seasons, and Gianna's Beyond Meds, and after doing much reading and thinking, I decided that this new psychiatrist had a hell of a lot of nerve suggesting that I ought to be on medication when I'd been completely stable on just trazodone for nearly three years. And in fact, I decided that I didn't want to be on trazodone anymore either, because from what I'd been reading, it just might be responsible for my lack of enthusiasm for writing.

My trazodone taper was a lot smarter than the others. It took me about four months to go from 200 mg a day to nothing. I had headaches for a few days every time I lowered the dose, and I had a couple of weeks somewhere in the middle where I'd have scary flashes of suicidal thoughts. But I persisted, because during this time, I was reading recovery stories and looking into alternative mental health solutions, and realizing that drugs might well have been part of the problem rather than the solution.

In my reading, I also came across some information about the artificial sweetener Aspartame being implicated in mood disorders. When I thought back over my own history, I realized that my mood swings had started in college, soon after I'd turned to diet soda as a study aid. I'd never liked coffee or tea, and didn't want the calories in regular soda, so Diet Coke became my drug of choice. More importantly, those mood swings had stopped when I'd stopped drinking Diet Coke.

As I write this, I've been off mood stabilizers for over three and a half years, and off of trazodone for about six months. My enthusiasm for writing seems to be returning, and I feel better and more stable than I have in years. The mood swings that followed me through college and beyond are gone, and I've felt neither depression nor hypomania since stopping mood stabilizers and aspartame. I am incredibly grateful to Gianna and others who have shared their recovery stories on her site, because if I hadn't found this resource, I might well have listened to that second psychiatrist last year, and allowed him to frighten me back onto the medication merry-go-round.

I no longer live in fear that I am going to lose control or that the Bipolar Monster is going to rear its ugly head and ruin my life. I no longer believe that I have untreated bipolar disorder. I accept the fact that I had symptoms of bipolar disorder, but as more and more time passes with no recurrence of these symptoms, I become more and more convinced that these symptoms were caused by a toxic reaction to Aspartame, and have nothing to do with bipolar disorder.

For a while, I was pretty angry. Angry that drugs like Aspartame could be put into the food supply because they were supposed to be "safe". Angry that I could be diagnosed with a major mental illness so quickly and easily by someone who had never met me. Angry that the diagnostic criteria for this life sentence left no room for life-circumstances and that the doctors I saw never asked about anything beyond those narrow criteria. Angry that my doctors saw medications as the only treatment options available and refused to consider alternatives. And mostly angry at myself, that I bought into the whole thing in the first place, that I listened to doctors without questioning. That I bought into mainstream media perceptions. That I was a sheep. Baa...

But you can't stay angry forever, and my yoga practice has helped me to accept what happened and to make peace with it. I had to go there to get here, and I like where I am now. That which does not kill us can make us stronger...and perhaps wiser, if we are open to learning from it.

Today, I've lost about forty-five of the sixty pounds Depakote packed onto me, and my feet no longer hurt—I can now do some of the higher impact activities I used to enjoy. I'm starting to write again, and rather than feeling angry, I'm starting to feel like I had a pretty lucky escape.

Hopefully reading my story might help someone else start to think and to question...and maybe give them the inspiration to stage their own lucky escape.

Pandora's Box

"Instead of elders, we now have elected politicians who speak with corrupt and self-serving voices; instead of fragrant local wisdom we have homogeneous civil law and institutionalized religion to guide us." --Caitlin Matthews, "The Celtic Spirit"

I often find myself yearning for a different time, a simpler time, when we lived in harmony with the turning of the earth. Although technology has done much to improve our lives, in many way it has also impoverished us. The society we live in is driven by the holy dollar, and there seems to be very little room here for the idea of the "common good".

Our media-driven culture teaches us from infancy that the most important people in our world are those who have everything and look good...not those who have the wisdom to guide us and have lived in the world long enough to speak from experience.

We live in a world where human connections are transient, fragile, and even unnecessary. Families are separated by oceans and divorce is easy with no real consequences.

I'm not saying the world was perfect before all this technology came along. I think that in many ways it was a harder, grimmer place. But I think there was much more of a sense of family and a sense of community.

We may have gained a lot in our technological achievements, but I think we have lost a lot, too. We have an entire nation full of lost people with empty lives, many of them popping antidepressant medications because they know that something is wrong...they're just not sure what.

I'm not sure what the answers are, though. All our technology is like Pandora's Box, and there's no stuffing it back inside and slamming the lid shut once it's out there. Perhaps part of the answer lies in listening to what's really in our hearts and stop letting other people tell us what we think.

Writing Prompt: What does your heart tell you about how to live an authentic life? What kind of life resonates with your inner self?

Social Anxiety? Or Just Me?

I quit my quilters' guild. I was supposed to go on Monday night, and I just couldn't deal with sitting in that room with all those women that I don't feel I have anything in common with...except that we all make quilts. Of course, my quilts don't look anything like theirs...mine aren't these pretty, traditional things in country blues and pinks with perfect points and lovely neat blocks. My quilts are abstract-flowing-full-of-rivers-of-color things that look like someone spilled a paintbox and then threw water all over it...

Okay, well I like them!

So anyway, I'm not sure what it is with me...I have a really hard time belonging to groups. Part of it is never feeling like I have anything in common with the people in the group. Part of it is not wanting to commit to anything too far ahead (this comes from the bipolar thing...not knowing if I would be too depressed to get my butt off the couch when push came to shove). Part of it is me being me, which is to say, shy and introverted and just not needing or wanting to have a whole lot of people around me. Crowds irritate me to the extreme. I can't stand that amount of energy around me.

I'm sure my psychiatrist would be happy to diagnose me with Social Anxiety Disorder and put me on Seroquel for life. But what if I'm quite happy with the way I am? What if I've learned to adjust and accommodate for my needs, and know what I need to do to keep myself happy and functional? Is that still a disorder? Or is it just me?

And why should someone else decide that I'm not the way I should be, that I should be more like everyone else, and that I should therefore be medicated?

Writing Prompt: In what ways are you different from the rest of the world? Do you see these differences as strengths, or do you wish you were like everyone else?

Unsticking Yourself

Beyond Meds has an interesting post up today about a Newsweek article in which Dr. James Gordon is interviewed. Gordon is the author of the book "Unstuck: Your Guide to the Seven-Stage Journey Out of Depression."

I read the interview, and it really struck a chord with me because these are exactly the recovery methods I used to get myself off of bipolar meds and to stabilize myself: excellent nutrition, plenty of exercise, and meditation.

The fact that Gordon has had success working with people suffering from PTSD is particularly encouraging, as the number of people with wounded psyches coming home from Iraq increases.

Gordon's method sounds like plain old common sense to me, although I suspect it will be a hard sell to a culture that would rather pop a pill than do the hard work involved in a radical lifestyle change. Still, it's nice to see some alternatives to medication getting some press. It's important for people to know that there are other ways to get through depression than to take potentially dangerous medications.

Writing Prompt: What are some small, common-sense things that you can do to improve your quality of life right now? Remember, they don't have to be big things...some ideas: coming up with three things to be grateful for, or three things that you find beautiful, every single day. Taking a ten minute walk...or a five-minute walk, if that is all you can manage. Lighting a candle and sitting quietly for a few minutes watching the flame and centering yourself. These are all small steps we can take toward wellness...and even a journey of a thousand miles begins with a single step.

Identity Theft

One of the most insidious effects of my bipolar diagnosis was the way it robbed me of my identity...

I was not suicidal, nor was I psychotic, or even a whole lot out of control. I initially went to my GP because I couldn't sleep. I hadn't slept more than a few hours for nearly a week, and wasn't feeling tired, and I figured that wasn't normal, I ought to be exhausted...so maybe I better get this checked out. I was also under an enormous amount of stress, and my anxiety levels were sky-high due to some extremely stressful Family Bullsh*t that was going on at the time. Did anyone ask about that? No. Instead, I was asked if I'd ever been depressed. And since I said yes (although I'd never been diagnosed or medicated for it), I was sent home with Zyprexa and Ambien, and told I should call a psychiatrist.

This led to an ever-descending spiral of self-doubt. In my reading, I learned that my writing highs--those times when I could just let go and write for hours on end--were actually "hypomania". And those times when I felt like I just loved life and really enjoyed everything I was doing--that was "hypomania", too...so the last two or three years of my life, which had been wonderful, happy years in which I felt productive, and excited about my future, suddenly took on the sinister aspect of an "illness". Which must be "managed." I learned that if I ever felt that way again--exuberant and loving life--that I should talk to my psychiatrist immediately, because I urgently required a "medication adjustment." And that if I didn't have my medications adjusted, the hypomania could steamroll on into full blown "mania" in which I would be completely out of control and need to be hospitalized (even though I had never been close to being "out of control"). I also learned that if I felt just a little bit sad, I needed to consider that a "warning sign" and to talk to my doctor because I might be getting "depressed". Which would require that another medication or three be added to my "cocktail" in order to prevent me from becoming so ill that I might kill myself (even though I'd never really considered that seriously before). Overnight, my perception of myself went from creative, confident and happy to "very sick and in need of medication for the rest of my life."

For the next two years, I would be haunted by the question, "How much of my personality is me and how much is it?" The answer, according to my psychiatrist, was that a lot of my drive, my energy, my productivity, and my creative whirlwinds could be attributed to it. So I figured whatever was left over once the medications were working, that was probably the real me. And since I lost my ability to think, laugh, create, write and enjoy life once I was medicated, I began to think that the real me wasn't worth very much, was she? She was actually a hopeless, dull-witted, exhausted lump who couldn't even speak without stumbling over her words, and didn't want to do anything but sit on the couch.

Life was pretty dismal for those two years. I no longer had the capacity to enjoy life, and the medications I was taking actually made me more sick. My moods began to cycle, and within a year I'd had three "episodes" each requiring that my medications be adjusted (read "increased") and that new medications be added. My doctor pointed this out to me as proof of just how sick I was.

I am so glad that I retained enough clarity and sense of self to say Enough. Unfortunately, it took a near-tragedy to shake me back to my senses (my husband's heart attack and my inability to respond to it in any sort of normal way). But however it happened, I did finally see the light and realize that my misplaced trust in psychiatry was only making me sicker, and that there had probably been nothing wrong with me in the first place that a little therapy or education in stress management wouldn't have taken care of.

I stopped taking medications over a very short period, probably too short, but then I didn't have much in the way of medical support--my psychiatrist's view of stopping medications was that it would be "stupid" and that I would "ruin my life". He didn't say It would be a bad idea, but if you're hell bent on doing it, here's how to do it safely, no, he just said Don't.

When I came off of meds, I was a mess. I had no idea who I really was anymore. After being told that all the things I had loved about myself were due to my illness, my self-confidence had taken a serious hit. I was terribly overweight and out of shape and dreadfully ashamed of myself for having let myself get into that condition. It took a long time for the anger to fade, for me to accept what I'd allowed to be done to me. And in some ways, I think I am still working on that acceptance, because the anger is still smouldering away in there.

After I was off most of the drugs, my sense of self, my sense of humor, and my ability to enjoy life slowly returned over a period of a few months. It took a longer time for my creativity and my confidence in myself as an artist to return--after all, I'd been told that all of my artistic achievements were actually manifestations of my "illness". For a long time I wondered if my drive to create--to write and to "make stuff"--would ever come back, or if the medications had damaged my brain in some subtle way and I'd never be able to create again--or worse, even want to.

Thank goodness I took my life back into my own hands. I dread to think where I would be now if I hadn't. I certainly wouldn't be myself.

Writing Prompt: Has there ever been a time in your life when your identity, your sense of self, was threatened by a label, an event, or a person/group? How did you deal with it and in what ways did this experience change you? If you've never experienced a threat to your sense of self, what sort of event do you think it would take to do this? Where are your vulnerabilities?

Thoughts on Wanting Wellness

Susan, the Bipolar Wellness Writer had an interesting post up yesterday about wanting wellness. Her key question to people who are on medication for bipolar disorder or depression but who are not moving in the direction of wellness is "What are you doing besides taking medication?"

It's a good question because so many things feed into our health and well-being, and taking medication is only one of them. I have a friend who has been battling depression on and off for most of his adult life. He takes medication when the depressions come on but other than that has done nothing to change his lifestyle, which is incredibly stressful both in terms of his emotional well-being and his physical health. It is frustrating to watch him lose hope and lose heart when there is so much else that he could be doing for himself. But he is not willing to make any of the changes that might help him.

Or is it that he is not able to make those changes?

I am reminded of the place I was in three or four years ago. Bipolar medications made me so ill that I was unable to do the things I knew I should be doing. I had no energy, no motivation, no clarity of thought. The things that would have been good for my body--like eating more healthfully and exercising--were beyond me, as I literally had not the energy to do them. Planning healthy meals was an exercise that was beyond my mental capabilities...and cooking healthy meals was beyond me physically--because of the 60 lbs I had put on (due to the medications) I was suffering from painful tendonitis in my feet, and was unable to stand for more than ten minutes at a time. The things that would have been good for my spirit were also beyond me--I was too mentally dulled to do much of anything. Writing would have helped me a lot, as that is the way I process things and gain insight...but Depakote took that ability away from me.

I wanted wellness badly at that point. I wanted to have the energy and clarity to care for my family, I wanted to be able to do the creative things I'd always done. But I was not able to do any of the things that would have moved me in that direction. Because I trusted my doctor, I believed that the choice was medication or illness and chaos. There was no middle ground, and I was not encouraged to do things that might minimize the amount of medication he thought I needed. I was not able to make healthy decisions for myself until I decided to trust myself and stop the medications that were making me so sick.

I think that our doctors need to take more responsibility for making sure that we have the ability to pursue wellness. Drugging us into oblivion may make them feel safer, but it is not conducive to wellness.

Writing Prompt: The pursuit of wellness often requires us to make sacrifices. Sometimes it's something as simple as sacrificing some of your hard-earned free time to exercise when you'd really rather be doing something else, or perhaps sacrificing your favorite foods because you know they are not good for you. Sometimes these sacrifices have a far deeper impact, both on yourself and the people around you--like cutting toxic relationships out of your life or making a decision to pursue an alternative treatment for an illness that those around you may not approve of. What have you sacrificed in your pursuit of wellness?

Sensory Overload

I have been pondering silence lately. Silence and peace.

Silence is extremely important to me. I can't stand a lot of noise around me. I don't have television on, or the radio, or even music, most of the time. Sometimes I like it, but mostly I find it irritating. I even have my computer's sound muted because the constant blipping and beeping drives me bats.

It's the same with visual input. I can't watch movies or videos with a lot of fast cuts, and I find those new billboards that change pictures every few seconds extremely irritating and distracting. I guess I don't deal well with sensory overload.

Even artificial smells irritate me, particularly strong perfume. I can't stand scented soaps, scented shampoos, scented laundry products...all those clashing smells. And I can't stand next to some heavily perfumed person in an elevator.

It makes me wonder if there's some sort of connection between our noisy, flashing, smelly, overstimulating modern environment and some of the mental health issues many of us deal with. Particularly anxiety and depression.

Writing Prompt: What is the most irritating environment you have ever found yourself in? What was the most restful environment? What sort of place would be the perfect environment for you--a place in which you feel you would function your best?

Do I Really Have Bipolar...

...or am I just a horrible person looking for an excuse for my sometimes admittedly rotten behavior?

Self doubt occurs with alarming frequency, these days. If I do have bipolar disorder, then where are all these "episodes" I'm supposed to have, one after the other? Seems the only time I had episodes one after the other was when I was taking medications that were supposed to help. Go figure.

And the thing I call the Big Mania happened during a period of incredible stress and Family Bullshit. I don't know how anyone could survive it intact.

So maybe I don't have bipolar disorder.

But...there is a pattern of depressive episodes and hypomanic "writing on fire" episodes that must then be explained. And I can't explain them. All I can do is look at some of the things I got up to when I was supposedly manic and shake my head and mutter, "WTF was I thinking?"

So, okay, maybe the diagnosis does have some merit.

But...if that's the case, don't I need to be on medication for the rest of my life? Because if I really do have bipolar disorder, isn't it awfully irresponsible of me to be running around unmedicated? I mean, after all, it's not just me, here, I have a husband and kids...

But...I'm doing everything I can to stay stable...and it seems to be working...other than the nasty effects of the trazodone withdrawal, but that's the medication, not me...

But...my doctor shakes my confidence every time I see him, because he says I'm taking a huge risk, and wouldn't I like to try Abilify, because it's got a really benign side effects profile...

This is the crap that keeps me awake at night.

(See Furious Seasons post today about the overdiagnosis of bipolar disorder for the post that inspired this one and got me thinking, again, about whether I am bipolar or just horrible...)

Depressed? Try an Antipsychotic...

Furious Seasons reports today that AstraZeneca, manufacturer of the atypical antipsychotic Seroquel, is seeking approval from the FDA to have Seroquel XR approved for the treatment of both depression and generalized anxiety disorder. It is, apparently, already approved for bipolar depression.

What disturbs me about this is the idea of using an antipsychotic medication as maintenance therapy for anything. I was under the impression that these drugs were designed/intended for the short-term treatment of psychosis, which can occur during both acute mania and severe depression.

Now, I'll be the first to admit that these drugs do have their place. Zyprexa (another atypical antipsychotic medication) knocked my manic ass right down when I took it during my last big mania. I took it for about six weeks, and it really helped. But it's not the sort of thing you want to be taking long term. Antipsychotics are psychiatry's big guns, and they are very scary drugs. They work by shutting down higher brain functions. In addition, these drugs all carry with them the risk of tardive dyskinesia (a movement disorder which can be permanently disfiguring). Not to mention the risk of weight gain, diabetes, and metabolic syndrome (which all of the atypical antipsychotics can cause, to varying degrees). And sedation. Which is the last thing anyone needs when depressed--something to sap even more of your energy.

I don't know which scares me more: the thought of psychiatrists (or even, I shudder at the thought, GPs) handing out antipsychotics like candy, or the thought of the American public seeing ads for them on TV and actually asking for them.

depression is...

...slogging through glue only to find i have arrived at a bleak, colorless place that is no different from the place i left...and the fact that i've been here before is no help...there is no map to help me find my way out...and if others have left tracks here, they've long since sunk back into the mire...

...a muffling wall of thick, heavy air surrounding me. i can see out, but nothing can get through...not light, not sound, not emotion, and to fight my way through it requires far more energy than i can ever remember having.

...like something has sucked all the joy from me and replaced it with numb indifference.

...an absence. an emptiness. a lack of life, of energy, of purpose, of light.

...an inability to decide the simplest things...can't decide what to eat...not because i don't know what i want, but because i lack the will, the volition, the energy, to even make a decision. any decision. it is too much to ask of me right now.

...slow motion. move through glue. think through glue. breathe through glue. feel nothing.

...wanting to cry but not even having the energy for that.

Sorry, Mum. A nice hot cup of tea just doesn't cut it...

It Speaks So Loudly...

I hate this feeling of detachment that floats down from above and smothers me like a warm, wet blanket. It makes me feel stupid and foggy.

I cannot think, focus, rest, imagine, dream, anticipate, work, care, love, touch, reach out...

I wander around here, restless, bored, and unable to settle to anything.

My thoughts are dark, a never-ending carousel of "what's the point?" and "is this all there is forever?" and "what did I used to fill my days with when I didn't feel like this?"

I know this is just the insidious voice of depression, and I should try to ignore it. But sometimes depression speaks so loudly, it makes me deaf to all but its grating voice...

Hopefully this is just another symptom of trazodone withdrawal.

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.

At Least You Can Eat a Cow

Feeling like shite this morning. Brain fog. Dullness. Tiredness. What's-the-point-ness. Only a few steps away from the depths of despair... wherever they are.

I want to be writing. But I can't. I need a place to work. I need a desk. I need a chair. (Excuses, excuses!) I need a new brain and a kick in the arse, too, but I don't suppose I'm going to get either one.

I feel like I'm losing my mind. Not in a going-crazy sense or a having-an-episode sense, but in a little bits of brain oozing out my ears and swirling down the drain while I look on in complete apathy sense.

I'm feeling very dull and stupid. I'm about as useful as a cow at the moment. Less. At least you can eat a cow. And I'm a hell of a lot less interesting than a cow.

I can't decide if this is depression kicking off its shoes and settling in for an extended stay, or if I am just tired or if my thyroid needs a boost. I should probably schedule a blood draw.

In the meantime, "Moooooooo."