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.

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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?

I’ve Been Shrinked

I think my shrink has a profitable deal worked out with the makers of Seroquel.  It’s either that or she truly believes it is a miracle drug that will cure all psychological ills.  As I’ve said before, I have a bit of difficulty accepting bipolar disorder as part of my problems.  It seems like DID would trump that somehow.  For whatever reason, though, I’m having quite a difficult time of it with depression these days.  Bipolar or not, depression isn’t great, and I would really like to do something about it.  Increasing Seroquel is not that something.  The conversation between the shrink and I went something like this:

Me:  I’m still having a problem with depression.  It’s not a great suicidal depression, just a gentle sort that feels like it has settled in for a bit.

Shrink:  Well, I really think you should increase the Seroquel to 300mg.  Someone with true bipolar disorder should be taking 400 at least.

Me: Seroquel gives me those nasty side effects, though.  I’m a bit sensitive to that class of meds, remember.

Shrink:  I still say you should go up on the Seroquel.  You’re at the top dose on Lamictal, so if that’s not stabilising it you should go up on the Seroquel.

Me:  It could be situational, too.  I’m dealing with some rather difficult things right now.

Shrink: Well it could be medical.

Paula (internally):  Oh god here she goes with that again.  F*cking hell, lady, if you were in our situation how would *you* feel?

Kathy (internally): Now Paula, love, she is just trying to help.  We should at least listen for a bit.

Paula (internally): F*ck that.  If you want to listen to this sh*t that’s fine.  Don’t drag me into it, though.  I will *not* take more of that crap.  It hurts the heart and makes the brain woozy.  Like we’re not woozy enough for christ’s sake.

Me (internally): Would both of you SHUT UP so I can actually converse with the shrink.  Being hospitalised is not part of my schedule currently.

Me (aloud): I’m terribly sorry, but I will not take more Seroquel.  Actually, I won’t take it as a maintenance drug at all.  It hasn’t really been shown to make a great lot of difference in bipolar depression anyway, and I’m not manic or psychotic.

L (internally): Well look who went to the swap meet and bought herself a big girl spine.  I got that from that show you like, ‘Scrubs.’  I like it too.  We can keep watching that.

Me: (trying not to laugh hysterically).

Shrink: Well, make an appointment with me for two weeks from now.  If you’re not feeling better by then, we’re going to have to switch meds.

And so on, ad nauseam.

She’s thinking about lithium and depakote.  I don’t know at all what might help medically, but we’ve definitely got to do something about this depression.  Starting internally might be best.

DID vs. Psychosis

Psych meds are a tricky subject, especially when you’re dealing with the ‘rare but serious’ DID issue.  I just finished a month-long course of prednisone for a physical issue, and the side effects from that made me think about psych meds.  Prednisone causes bloating, sweats, joint pain, and this lovely thing they call moon face in which your face literally rounds off like a moon.  Fun.  Unfortunately, that particular med is what helps when the physical issues I have creep up.  Prednisone rant over– I’m past that now.

My official psych diagnosis is bipolar I disorder.  I presented with what the shrink termed severe paranoia and extreme mania.  Bipolar or schizophrenia seem to be the going socially-accepted diagnoses for people who actually have DID, and I truly doubt their comorbidity.  My mood swings, anxiety, paranoia, et c. certainly *look* like bipolar mania and depression sometimes, but they look like different people internally.  That’s it– tell the voices in my head they’re merely chemical imbalances.  *That* would be interesting.

Based on all of that, I cycled through various atypical anti-psychotics with horrible side effects before landing on Seroquel which only had minorly horrible side effects.  I’ll agree that the Seroquel was probably necessary until I got back into reality, but now I don’t see the point in taking it.  In fact, I’ve only taken it three times this year.  While the side effects certainly aren’t as bad for me as they were with the other anti-psychotics, Seroquel still causes my heart to race and *really* drops my blood pressure.  Yeah, I’ll take my chances on being crazy with a functioning heart.  I’ve discussed this with the shrink, but she insists that Seroquel is necessary as a maintenance drug along with Lamictal (which really does help) because of my level of paranoia.  I hear voices, you know.

So here’s my question– how do you distinguish between ‘normal’ DID stuff and actual psychosis?  Based on my SRA background, I don’t doubt in the least that some of my hallucinations come from outside the realm of DID.  Neither do I doubt that some of my fear really could be paranoia.  I’m willing to bet, though, that the largest majority of it comes from DID and just trauma in general.

I’m able to recognise the voices of my internal folk, and when I hear a new person, it’s reasonably easy to tell that this is part of me.  Still, sometimes I get those voices that are distinctively Not Me, and they aren’t typically suggesting I take time to do something pleasant.  It’s probably due in part to a handy SRA technique called complex poly-fragmentation that causes alters and/or fragments to be so separate from the overall system that they seem part of an entirely different person in a physical sense.  That’s really hard to explain.  But, on the other hand, it could just be psychosis at that point.  I truly don’t know.

Merely being out of my tiny little mind would certainly be easier to conceptualise, but where’s the fun in that?