Crash

The SRA stuff is relatively contained right now, so it seems the appropriate time to let everything else fall apart, no?  I’m developing psychological neck injuries with the rate of ups and downs regarding food issues.  Things have been going relatively well in that I’ve only slipped in to the b/p cycle a couple of times as opposed to daily.  As of yesterday, though, the calorie count is falling again.  I think I have this reaction to my psychiatrist.  I feel like he’s either not hearing me or not believing me, so I take on the attitude of being a ‘better’ bulimic.  In regards to food issues, I feel like he’s driving a division between my therapist and me.  She tells me he isn’t, but my mind can’t quite accept that for some reason.

Yesterday, I brought up this issue with the therapist.  I told her I’d likely hacked off the psychiatrist and wanted her input on how the interaction unfolded.  She keeps telling me his response to food issues reflects her inexperience in treating them.  Still, I keep seeing the doctor as this smug overlord who’s telling me I’m doing this bit wrong.  Truthfully, the responsibility is on me.  I need his help with this, and it’s up to me to tell him that.  Until then, he is just a passive participant.  Being me and being excellent at standing in my own way, however, my courage drops before I get the words out.

The important bit to figure out, then, is exactly *what* I need and where would be the most likely place to get those needs met.  Just like with trauma, I think the main thing I need is understanding.  I need someone to understand exactly how it feels to get caught up in that cycle and to see food controlling your life.  I need to express that sense of desperation that comes with wondering when or if I’ll be able to get back in control and when or if the control will break yet again.  Definitely something to take to the therapist (and hope she’ll listen).

Even though I’d never be able to tell him, I’d like the doctor to stop trying to box me in to his medical school textbook on bulimia.  Yes, cuts on the knuckles are tell-tale signs of bulimic purging.  They’re also very easy to avoid if you purge in a way that does not cause cuts.  I’m not a walking advert for the disorder.  Why would I *want* to create visual signs of the behaviour?  Between working in medicine and having a good sense of the balance in my body, I can recognise many symptoms of electrolyte imbalances, and I can work to correct them.  It doesn’t always fix issues, and I have had problems in that regard.  The symptoms are fairly easy to hide as well, though.  Dizziness, fatigue, body aches, et c can be attributed to many other problems.  (I won’t say here, lest someone use this post as a guide for hiding bulimia.)  I want the bloody doctor to understand that I might appear fine on the outside and feel miserable in a physical sense on the inside.  This seems a lost cause.

Always, always, always, I feel stuck in the trap of this stupid disorder.  It shifts about in my brain like a living creature.  I’m back to the idea of bulimia as an addiction, though.  As much as I want it out of my life, I’m still terrified at times to see it go.

Well That Didn’t Last

Effing psychiatrist.  Mental healthcare workers in general really need to mind their words.  Now that’s said, I’ll move on to the actual explanation.

At my last therapy appointment, we discussed a conversation the therapist had in length with the psychiatrist.  The therapist misunderstood something I said, which led the doctor to suggest that I was either under-reporting caloric intake or purging more than I admitted.  To me, that sounded like an accusation.  I will *not* report anything to the therapist or the doctor that is inaccurate.  I won’t waste their time or mine for that.  I told the therapist that there was ONE DAY when I only ate 300 calories.  She told the doctor I was doing that every day, and he told her I’d be dead.  Really, doctor?  Are you sure about that?  *sarcasm*  She said the explanations he was giving her about electrolytes and various blood levels made sense.  Really? Shocking, no?  *more sarcasm*  This is beginning to sound like children at play.

Unfortunately, it also feels like a challenge.  It feels like they’re telling me to be a better bulimic.  I know with absolute certainty that that is not the message they were sending.  The completely-illogical-reason-I-am-already-effed-up part of my mind says otherwise, though.  I was already struggling to counteract those thoughts.  Now they seem to have reinforcement from the very people who were helping me.

I told the therapist in no uncertain terms that the conversation irked me.  She said it was more a problem on her behalf– that she didn’t know what she was supposed to keep up with, so she couldn’t answer the doctor’s questions about my cycle of eating.  So here I sit, 99 calories taken in over the past twelve hours or so, trying to convince myself that this should not bring me back to the abyss I was crawling out of and failing miserably in that regard.

Yup– effed up.

Bipolar Disorder Sucks

to use an American phrase that sometimes says it perfectly.

I’m having trouble.  Today, I’m hypo-manic but rapid cycling all the same.  I can’t slow down my thoughts, which are racing from intense anger to deep sadness.  My hands are literally shaking from the energy, and I can’t deal with even the slightest of changes without going right in to a tizzy.  Good thing my routine is staying stable, she says sarcastically.

I just started a new work schedule.  I like my job and will always be grateful to have a paycheck.  However, the merge of our company and another has a great deal of my job mixed.  I do *not* like working for the other department.  We had very little training and are constantly being told by the director of that programme that we are horrible at our jobs, my coworkers and me.  I’d be much better if they’d bloody train me as opposed to giving me a twenty page model and telling me to read it.  Not helpful.

A major change like that affects my ability to tolerate small changes well.  My best friend is going on a well-deserved holiday.  In years past, I would have assumed he’d go away, realise he could do so much better than me, and walk straight out of my life when he returned home.  Now, I know with absolute certainty that things will carry on as normal once he returns.

The schedule shifts, though.  We miss a weekend together, and this time our Friday night will be cut an hour short.  Neither of those are big changes, but with the bipolar symptoms raising and the issues with work, the small changes become a big deal.  One of my insiders feels that our visiting with my best friend on Friday nights keeps him awake beyond his comfort level.  No matter how often we assure her otherwise, she holds the belief.  She’s taking this leaving an hour earlier bit as proof.

I’d phone the shrink, but she would immediately put me in the crisis unit.  She told me she would do that the next time I got unstable because the symptoms shift so quickly.  Unfortunately, that means I’m not willing to phone her this early.  I’ve started Zyprexa– the prn med– and am hoping I caught things early enough that there won’t be a progression.  I’m not hallucinating, which is a great sign.  In retrospect (as usual), I see symptoms that I should have picked up on earlier, but I’ve definitely started Zyprexa earlier than I did during the debacle over the summer.

I really hate bipolar disorder and the way it affects my life.  My job suffers, my friends are affected, and my general health gets bunged up.  I think a change in meds is necessary, as well as a commitment on my behalf to keep a more regular schedule.  Anti-psychotics are awful in terms of side effects and long-term risks.  If taking the Zyprexa keeps me from becoming truly psychotic, though, the risks will just have to be taken.

Madness

Let’s take DID out of the picture for a minute.  Now, let’s take out SRA.  (I know, I know).  At this time, bipolar disorder is what’s getting at me.  I have never *felt* bipolar, really, until this semester.  Now, it’s making itself the centre of my life.  It is disrupting my sleep, wrecking my concentration, and sending me from horrible depression to rapid, incomprehensible thoughts all in a day.  And this has been going on for nearly two weeks, on and off.  It’s been building.  It was at least nice enough not to happen all it once.  Tonight is the first time it clicked with me that those pesky neurotransmitters might be fighting with one another again.

The casualties so far have been work and school.  I’ve missed more work hours than I could afford simply because I’ve either not been able to quiet my mind enough to focus or have been too depressed to even consider getting the job done.  Right now, for example, I should be working.  Instead, I’m staring straight ahead, mindless, and typing sentences way too many minutes apart.

At school, I just failed a test.  It’s the second test I’ve ever failed throughout my academic career.  The first happened the day after my mother was diagnosed with lymphoma.  This one happened in the midst of my mind walking itself politely off the deep end.  Now I’m not quite sure what to do.  I’m allowing things to snowball.  Catastrophising with the elite.  It went like this:  I’ve missed too many work hours, but there is financial aid money tucked away for things like this.  But I failed that test.  Does that mean I can’t finish the programme?  Can I work nearly full time and attend a very intensive school programme full time as well?  If not, how will I get a career?  Master’s degrees are useless right now without further certifications.  How can I move forward?  What do I need to do to pull out of this rut?  Have I got *time* to pull out of this rut, and so on ad nauseam.

I feel like Alice going down the rabbit hole.  The world is descending into my madness.  Last night, I thought I was being followed whilst driving home from my best friend’s house.  I actually swerved off the road briefly trying to get away from the person who I thought was following me.  Then, I passed a policeman and thought he might know something about me and would come after me, as well.  In the moment, these things seem so real.  Absolutely no one can convince me that they aren’t happening.  Today, though, I see how out of touch I was.

Meds are a real problem.  The atypical antipsychotics affect my blood pressure and heart really very, very badly.  The bp gets dangerously low; the pulse gets dangerously high.  Abilify made me have a seizure, and Geodon nearly gave me heart attack.  I can stand Seroquel, but even at 200 mg, it makes me sleep for 12 hours and still drops my blood pressure.  I take the absolute maximum dose of Lamictal, which has probably literally been a life saver for me.  Something isn’t working, though.  I realise that meds won’t stop every instance of mania, depression, or mixed episodes for those of us with Bipolar I Disorder, but I’d like to find something to at least take the edge off severe episodes whilst still allowing me to breathe and retain a heart rate.  The psychiatrist is frustrated, I’m frustrated, and the therapist says the issue is just a chemical response to trauma.

Let’s place DID and SRA back into it and give a technical term– the internal kids say it’s icky.  I can’t argue with that.

Atypical Anti-psychotics…

…scare me.  Following my psychiatrist’s recommendation, I took the lowest dose of Zyprexa for the first time on Saturday morning.  It took almost twelve hours before I felt semi-normal again.  The rapid-cycling bit does not make me happy.  It disrupts my life and makes me feel out of control.  As I’ve written before, though, this class of meds does not set well with me.  Abilify gave me a seizure, Geodon sent me to hospital, Seroquel (and the others, actually) dropped my blood pressure to dangerous levels.  Fortunately, Zyprexa hasn’t lowered my blood pressure.  It apparently has resurrection properties as well, because this morning, I feel like a zombie.  I’m definitely not rapid-cycling.  I recognise this nothingness, and it scares me.

My mother took the old anti-psychotics –Haldol and Risperdal– and they turned her into a lack of person.  She quite literally drooled.  Yes, my sometimes violent mother was definitely not violent on those meds, but she was really nothing at all.  She barely spoke.  I don’t want to be like that.   I don’t want to be an out-of-control manic, a suicidal depressive, *or* a zombie.  I want to find a middle ground, and Western medicine might not be able to provide that.  I’ll try the Zyprexa for two weeks as promised, but my goal for this week is to work out the meditation techniques I’ve largely stopped using.  Meditation is extremely powerful, and I need to start using that again as another tool towards helping myself physically and mentally.

Lithium, Anyone?

I was diagnosed with bipolar I disorder in late 2005 and went through several meds after that.  Abilify led to a seizure, Seroquel came with severe low blood pressure (hypotension), and Geodon gave me what the doctor in emergency referred to as symptoms of heroin withdrawal.  The atypical antipsychotics and I do not get on well with each other.  However, if you’ve read this post, you know my shrink *loves* Seroquel, which is apparently her go-to drug for bipolar.  I refuse to take it, so my best friend and I often joke that I can triple the dose if she likes.  Three times a dose of nothing is still nothing.  🙂

Said shrink and I are likely to have another meds conversation soon.  Last month was awful in terms of bipolar crap.  I started the month with a light depression, but about halfway through, I got rather suicidal.  The depression was horrible, but my thoughts were racing.  I was depressed out of my mind with more energy and less sleep than any one person should ever have.  I think that’s called a lovely little mixed episode.

I do not enjoy mania.  My ‘euphoric’ highs tend to turn rather disturbing in the end.  Fortunately, I don’t deal with mania often.  That makes more time for depression (dark humour).

Has anyone found success on meds for bipolar depression?  I know it’s a real bugger to treat, but I also know having near-constant depression isn’t acceptable, even if it’s typically light depression.  The shrink mentioned lithium and Depakote last summer.  There’s also a new med called Cymbyax that is, I think, the first to specifically target bipolar depression.  It’s a combination of Prozac and Zyprexa.  Not sure about the antipsychotic, especially as the dosage of it couldn’t be adjusted separately from that of the antidepressant.

What are your experiences?