Friday, September 24, 2004

A Curve Ball

If mania feels like the exhiliration of downhill skiing on the edge of control, there's always the chance that you might hit a patch of ice. If you're lucky, you'll just get a good scare.

Being manic is living on a precarious throne. You feel fantastic and you could even forget how temporary your high will be. But when you fall, you'd better be sure you don't impale yourself on your crown.

Today brought me another pdoc appointment, and yet another medication. Eskalith CR. Fun. Now I get to be a card carrying bipolar patient because I'm telling you, every bipolar person is put on lithium at some point in their course of treatment. Next thing you know, I'll join the ranks of the chicks who pop abilify and symbyax on a regular basis. If my voices get much worse...hmmm...maybe seroquel or risperdal or zyprexa.

Anyway, my appointment also exposed that charming patch of ice beneath the crunchy white snow, to return to my skiing metaphor.

Being that my flippant and anti-authoritarian side always gets the upper hand when I'm up, I asked my doc why in the crap I would take a drug to bring me out of my mania when I spent the past eight months living the life a bump on a log would call boring. Obviously, I realize that every bipolar person who can control their mania enough so that the hallucinations and delusions are manageable wants to stay high. I know I'm treading down the beaten path of noncompliance that my bipolar brethren have carved out for me.

And I suppose my good, ole pdoc knew that too. So, he posed the question--why take medication at all? Isn't that my dream in a nutshell? To be able to get through a day without having to whip out my handy pill box, without having to swallow a daily reminder that I have a poorly controlled illness that's fucking up my entire life?

Of course, you can't exactly say that in polite conversation, can you? So I mumbled something lame about not wanting to go back to the hospital and pragmatically knowing that I technically should take meds even if I don't want to. I guess that wasn't the best answer.

I'm not exactly sure what the best answer would have been. I suppose that if someone asked me why I wore my glasses, I would say, 'duh! so I can see!" But with this whole bipolar crap, it's much different. If I found a good medicinal cocktail that actually worked, maybe I could say that I'd take my meds so I will retain some kind of stability in my life, achieve some kind of emotional calm that would otherwise elude me. But why should I take meds that cost a fortune even though I still feel like crap when I'm on them? I sure as hell wouldn't wear glasses if my vision was still blurry.

Anyway, I suppose my pdoc was less than impressed by my unenthusiastic response. So, he looks at the cards in his hand and pulls out the no-relationship-will-survive-uncontrolled-mood-swings card. Trust me, having that card pulled is like walking through a rose garden and having a bowling ball fall out of the sky onto your head.

I told him flat out that dude, that's just not right.

The last thing I need to worry about right now is the idea that Brendan might decide to cut and run because my being bipolar is too much for him. Just the idea makes me physically ill. There is nothing more precious to me in the entire world than my relationship with Brendan. He's the best thing that's ever happened to me. If I lost him, I don't know what I'd do.

But that's the thing. My pdoc doesn't really know how much Brendan and I have been through together. He doesn't know that Brendan has lived my rollercoaster life with me. He doesn't know that Brendan's held me when I was hallucinating through withdrawals, he doesn't know that Brendan worried and laughed through my manic stages and he doesn't know that Brendan braved hell and hours of LA freeways and busses to hold my hand when I was locked up in the psych ward. Brendan knows exactly what this disease can do and has done and he's made the choice to deal with that. I know, beyond a doubt, that Brendan will not walk away from me because of this.

So why the emotional warfare? Maybe it's something they teach doctors in med school. I can picture a closet sadist lecturing his eager students about how psychiatric patients aren't the most rational at times, so you have to manipulate their souls into compliance. Ah, then this lecturer returns to his office and electrocutes his hamster.

But I digress. I don't approve of this tactic—this 'I don't know how to get you to take your meds, but let's threaten the greatest source of stability in your life to try to intimidate you into complinace.' Grrr. I'm all hostile.

Of course, Brendan, my adorable optimistic love muffin, challenged me to smite my reactional thinking and consider the merits of a poorly articulated argument. Damn lawyers.

Okay. Giving my shrink the benefit of the (massive) doubt, I suppose he was trying to get me to think of other reasons to take my meds—mainly, the people that I care about. The more stable I am, the more stable my relationships will be. Accepted. Maybe he was even trying to get me to think about the psychic relief my loved ones will have just knowing that I'm doing something to try to get myself better.

But I'm not an idiot. I know that this crap impacts my relationships. Just ask my close friends who just got their first phone calls from me in about a year; thank God they call me or we'd never talk!

Yet the greater issue—the overall efficacy of these meds—was swept under the rug in the name of compliance. The concept that I would comply with drugs that actually work wasn't discussed. That reasonable encouragement that I just need to hang in there and eventually we'll find the right combination for me---absent.

Instead, as if I didn't have enough to worry about, I can see this tiny seed of insecurity rooting itself in my psyche. Okay. Shrink's logic = if I'm not stable, Brendan will leave me. Stability = taking my meds.

So, does that mean that Brendan will disappear when we have kids, because I really don't want to be taking meds when I'm pregnant and nursing? Does that mean that I should hide my inner turmoil from the one person I fully trust so that I don't lose him? Does that mean I'll never be able to experience a true spiritual intimacy with someone because my moods will infect their lives?

Does that mean that I should let Brendan go so that he won't waste years of his life on me when he could find himself a nice, normal girl? Cuz in my mind, even with meds, I'm always going to be moody and unpredictable. If that kills relationships, maybe I should be alone. Maybe I should shove Brendan away as hard as I can--break his heart--so that he can be happy, so that he won't have to suffer through the pain of a divorce, through the failure of knowing that despite his love, this illness overwhelmed us. That's a tragedy I don't want to be responsible for because I only want the very best for Brendan, even if that means that I'd have to disappear to give it to him.

Quite a patch of ice, eh? One minute, you're a happily engaged girl thinking about starting a family with the man you love and the next, you're confronting (yet again) the fact that an illness you didn't choose to have has the power to poison the happiness of anyone who dares to love you.

Makes me feel so very, very alone.