Playing with Chemistry

Why would a previously beneficial medication suddenly stop working?

It's a question several women on my listserv have asked. After about 18 months, they see a recurrence of symptoms. To my knowledge, this phenomenon is not well studied. But it happens.

I have a theory on this. I think that people who are a bit off—whether it's anxiety or psychotic hallucinations—have the wrong homeostatic code programmed in their heads. When a doctor gives a person Prozac, it works for awhile, but their brain believes something is wrong and starts shutting down seratonin production in an attempt to reinstate a faulty balance.

How can medical science battle the brain's attempts to help itself?

How does homeostasis work anyway? I mean, does the heart regulate itself so that it doesn't explode? Nope.

So why would the brain have its own regulatory system? It's infinitely more complex...that's for sure. And survival is largely dependent upon emotional stability. After all, we can't all believe we're invincible or hear voices or see things that aren't there.

It's all about checks and balances. All of us feel outraged, or in love, or nervous. But some of us lack the ability to quell the reverberations normal emotions generate in the brain. It's like watching someone toss a stone into a pond. The ripples go out, but in an alternate reality, they bump off the shore of the lake and create waves that rise higher and higher. What eventually calms the waves is a mystery. But putting up a breaker wall only makes them smaller. It doesn't create a normal response to the stimulus.

Does that make any sense?

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Emotional Overload!

Every now and then, my emotions just run off the charts. It's like I feel so many things that I get entirely frustrated because expressing each and every emotion is pretty much impossible. Want a demonstration?

Currently, I am so ANGRY that I want to beat someone to a bloody pulp. I want to throw things, break telephones, plates and any other breakable object in the house. Everything is intolerable to me. I want to shave my head because my hair itches. I want to take a knife and slice my shoulders because they are so tense I can barely move my head. I want to claw my own skin to get out of it. I want to throw a tantrum so loud and shrill that my neighbors would call the police because they'd think someone was murdering me. I want to rip a stranger's balls off and make him eat them.

I am so SAD. I feel like the world is so cruel, that life will never improve, that every second life persists is another second of torture. I mourn for everyone I've let down. I cry for letting myself down. I cry because I feel persecuted by my boss, who basically wants to quarantine me. I feel so awful for everyone who finishes fourth in the Olympics. I feel so horrible for every child stuck in Najaf who has to hear explosions and gun shots and words of hatred. They should be playing. And it's just a horrible world that we live in where people are exposed to such horror.

I am so SCARED. I'm scared of failing. I'm scared of the future. I'm scared of looking in a dark mirror and seeing someone else reflected there, like a knife wielding maniac ready to kill me. I'm scared that Brendan, my love, will meet someone more stable and more beautiful in law school and decide that he wants to cut and run. I'm scared that everyone in my graduate program thinks I'm a nutcase, a freak of some kind. I'm scared of the future, of breaking down and having to go back to the hospital. I'm scared that if I have kids, they'll be like me. I'm scared that I'll die and no one will find me for days and my pets will go hungry. I'm scared that my fan will drop off the cieling and scar me for life. I'm scared of crossing the yellow lines and hitting someone head on. I'm scared of SO many things.

I'm FRUSTRATED. I know that I'm being irrational. I want myself to snap out of it, to wake up and do the things I need to do instead of moping around. I hate watching my thoughts circle around in my head without coalescing into some coherent idea. I don't understand why I'm stuck like this! I just want to SNAP OUT OF IT!!! I want to be better NOW!

I HATE. Hate is a strong word. But I hate. I hate being lazy. I hate feeling the way I do. I hate hurting other people because I have yet to master my moods. I hate sleeping for 15 hours and still feeling exhausted. I hate having a dirty house and not having the motivation to clean it. I hate watching the books for my thesis sit on my floor unopened and unread. I hate being out of control. I hate it when people don't understand me and I can't explain my situation to them. I hate feeling like I have something to hide.

I'm CONFUSED. I honestly have moments when I am completely baffled by this disease. Often, I don't know how I feel. Other times, I don't really feel anything at all. I don't know what to do to make myself feel better and I have the notion that I'm a guinea pig in some larger experiment.

I'm SUSPICIOUS. At the risk of sounding paranoid, I truly am suspicious of other people. If someone shows me kindness, I wonder what they want. I wonder if my doctor wants to see me to line his pockets with cash. I suspect that people talk about me behind my back and they are NOT saying nice things. I suspect that people are fed up with me. I suspect that my cats like Brendan better. I suspect that people feel sorry for me. I suspect that my illness might be related to some toxin in the environment.

I'm a VICTIM. I feel victimized by this freakin disease. Why did I have to get it? Why couldn't one of my siblings be the sickly one? Why is medicine so retarded that it can't fix me? If a doctor's motto is "above all, do no harm," why can't I harm them when they fuck up?

I feel NAKED. Everyone must know and see that there's something wrong with me. I know that I can't hide it very well. I know I must be like a walking freak show sometimes.

But oddly, I'm HAPPY. Sometimes, I feel exuberant. Despite all the crap that comes with being bipolar, at least it distinguises me from the masses. I feel like I'm on top of the world, like everyone is jealous of me because I am just that darn cool. I feel giddy and smiley. I could laugh for hours at nothing at all.

I'm damn SEXY. Dude. I feel like God's gift to men. My body is gorgeous. My face is delicious. My hair is like gold on my head. I have a mystery about me that entrances even the most grumpy. I make women jealous because sometimes, my self confidence is overwhelming.

And, I'm freakin HORNY. Seriously, I think I'd screw just about anything that walks, male or female. I'm overloaded with passion, with the need to taste someone's skin and be awed by the beauty of humanity. I feel sensual, irresistable and damn, I want to have sex right NOW! I would do an entire platoon right about now.

I'm feeling a bunch of other stuff that's harder to put into words.

But man, you can see why I'm so stuck right now! I can't make sense of myself. How can you be happy and sad at the same time? How can you want to be alone and crave sex so much? How can I be scared and euphoric?

In my opinion, being in a mixed state (a blend of mania and depression) is a horribly wonderful dangerous beautiful and terrifying place to be. It's fun and annoying.

But it is dangerous. And maybe that's why I have a drive to be alone, for self-preservation. After all, being impulsive is one thing, but being stupid is something else entirely.

Ugh. I'm so ______.

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Everybody's Coming to Get Me

Or maybe I'm out to get them. I can't quite decide.

There are so many times in my life that I've just hated other people and hated to be around them. In fact, for as long as I can remember, I would spend quite a bit of time by myself. I remember crying to my mom that I didn't have friends when I was a child.

At this point, I just don't really care if people like me. I'm content to spend large chunks of time by myself.

As an undergrad, I was baffled by the fact that other people would wait to go to dinner until a friend could accompany them. Some people were so dependent that they would only take classes with their friends.

I enjoy going places by myself. I'll go to the movies, museums and restaurants alone. I find the quiet comforting. I dread polite conversations brought on by unnecessary interaction with people I don't particularly like or care about.

A lot of the time, I feel like people are judging me and frankly, I'm too exhausted from holding myself together to care what most people think. I don't trust many people. I don't trust other people's intentions. I think most people collect friends as status symbols and if someone offered them a million bucks to stab you, they probably would.

I hate people today. I feel like no one understands me, like people are just looking for any excuse to toss me to the dogs.

Grrr. Stupid people being all dumb.

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Pause

The instant before Olympic swimmers leap into the pool in a fury of activity, there's a pause. Muscled bodies, taught with nerves and eager for action, are frozen on the starting blocks, waiting for the signal. Sway backward and four years of training are obliterated by the word "disqualification." Jump the gun and you've similarly destroyed your chances.

And so, you wait.

I'm on that starting block. The pause is agony and I just want to throw myself into the pool, let the water shock me into action. I want to start the race, to get off the damn block and into the water.

But the timing is precise. When the moment is right, the race will begin.

The instant I walk into my first orientation, the antiquated cap gun will fire, the race will begin.

Until then, I suppose I'll have to be satisfied with warming up my engine.

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The Kissing Disease

It has many names—the Epstein-Barr virus, mononucleosis, the kissing disease—but virtually every person on the planet has had mono at least once. Most of us are protected for the first few years of life by our mothers' antibodies. After that protection fades, mono is generally passed among children in schools; youngins rarely show symptoms of the virus. They just get over it and have protective anitbodies that protect them.

Of course, like any other disease which persists in the body, there's always a chance that mono can reinfect its carrier. This possibility generally manifests itself in those with weak immune systems: AIDS patients, cancer patients etc.

And then, there's me.

I had mono my freshman year in college and passed it on to my sister. Ha! I figured that would be the end of it. Boy was I wrong!

In a healthy person, an Epstein-Barr panel (a blood test) will reflect a small presence of antibodies, indicating an ancient infection with echoes in the body. This appears as a number between 1 and 19. My number? Survey says 163!

That number makes it fairly obvious that I am either getting over the disease or suffering from an active infection. Ah, the justification of my feline sleeping habits!

So, of all people, why did my psychiatrist send me for an Epstein-Barr panel? He wanted to investigate the most common cause of prolonged exhaustion. Like a detective, he suspected that the cause of my exhaustion was not my medications, but rather, my somnolence was disease-oriented. And he was right.

This confirms, yet again, why I feel that having a psychiatrist is infinitely preferable than having dual treatment with a psychologist and a psychiatrist as many health plans are now advocating. Basically, many mental health patients are evaluated by a doctor once and then farmed out to a psychologist so that the psychiatrist will only have to see them four times a year. Quintessential piss poor treatment.

The true tragedy of these plans is that wealthier patients will be able to pay for the highest quality of care while the destitute will suffer from the avarice of insurance executives and their cronies. I suppose that's the way of the world, that wealth will always grant its owners increased luxury.

I guess I'm too tired to think about it.

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The Silver Lining's Cloud

Brendan and I just returned from an entertaining and entirely necessary vacation at Lake Powell, the largest man-made lake in the country. It's beautiful, with deep red canyons rising above the lake on either side. The lake, a reservoir of a dam on the Colorado River, is at a historic low; it's at something like 30% of it's capacity.

Anyway, upon returning from this trip, I find myself downright joyful. I was touched by the spontaneous kindness of other people who rescued us when our boat was beached, when our boat floated away in the night and when we ran out of gas. (We're obviously seasoned mariners!) It's inspiring to be invigorated by the kindness of humanity, the true and unadulterated kindness of people. We can never repay the favors these people gave us. But they came to our rescue anyway. You just can't get any more generous than that.

Upon starting another joyous pattern of hypomania, I confess I'm apprehensive about slipping back into yet another depression. That's the ugliness of being bipolar. Every silver lining is followed by a cloud. I realize that's a classic pessimistic sentiment; some people might say that every cloud is followed by a silver lining. But the fact of the matter is that silver linings simply don't last that long.

Sometimes I wonder if people who are mentally ill are just more sensitive to the spiritual world, like we are in tune with vibrations that other people just don't recognize or experience. Maybe we feel the profound sadness of those who died on 9/11 and we know how much they miss their families. Maybe we feel that walking into a hospital, some people are saying goodbye while others are saying hello. Maybe we understand that behind a happy face lies a troubled person.

Or maybe, we just think we feel these things because we're a little crazy.

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An Ordinary Day

It's been so long since I've had an ordinary day that I can't be entirely sure whether I'm a wee bit high or not. After enjoying a whopping three hours of sleep last night, I've had a rather productive day...well, comparatively anyway.

I scrubbed my tub and toilets, cleaned my bathroom, repaired my vacuum cleaner and vacuumed, dusted all of my tables, cleaned all of my mirrors, cleaned my living room and bedroom, emptied and reloaded my dishwasher, cleaned out my car, cleaned off my desk, dusted the doors in front of my washer and dryer (picture blinds, it was a pain in the butt), cleaned the intake duct to my airconditioner, swiffered the corners of some of my ceilings, dusted off my my pictures and took out the garbage and recycling. I started working on a workbook for depression, but sitting down and trying to focus on it was nearly unbearable. I hung up inspirational quotes around the house and cleaned my TVs and computers. I posted a couple of comments on Brendan's website, read several news sites, went and grabbed lunch through a drive-thru and brushed my dog.

Right now, I've settled down to watch the news, but I'm already restless again. If it weren't so frickin hot outside, I'd be working on resuscitating my backyard (which is full of dead plants that unfortunately did not survive my depression). I'm a little irritable and I don't want stop working. I figure that I'll sweep my floors, swiffer them, and the run out a pick up Brendan from the airport. I'll probably drag him to the dog park and then come home to start our laundry.

I need to give Brendan my credit cards and all of the important pieces of my wallet aside from my ID and my psychiatrist's business card. I figure that he can give me money from my account as I need it for expenses. I just can't afford to run off to Target, buying new movies, CDs, books, alarm clocks, computer games, hair care products, candles and maybe a new vacuum cleaner. I'm practically salivating over the notion of getting a bagless vacuum because I could vacuum everyday for awhile to get some of the stubborn dirt off the carpet. My old vacuum is on its last legs. It gasps and sputters pathetically.

Sitting down to type like this is nearly killing me. I keep typing and doing something and then coming back and doing something else. I can't sit still long enough to write anything longer than a few sentences.

I wish I could say that my mind is clear, my ideas beautiful and my inspiration unyielding, but it's not true. I'm more annoyed that anything else and being busy distracts me from the gnawing irritation flowing through my veins. It makes my hands shake when I try to sit still.

So, voting public, do I sound normal? A wee bit manic? Depressed?

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sheep

sheep
Originally uploaded by Rmz24601.

Joy of joys, my periodic insomnia has begun. Every now and then, I have the ever-so-charming experience of not being able to sleep for four or five days in a row. If I do get to bed, I sleep for about 20 minutes, roll over and count sheep until I figure that all the sheep in America have hopped over the damn fence.

I'm not completely unproductive when I'm feeling like a crazy insomniac. I walked the dog, took a shower and I'm about halfway through the book, An Unquiet Mind, by Kay Jamison. She talks about being bipolar from the perspective of both a clinician treating bipolar patients and a psychiatric patient herself.

It's a very interesting memoir, although she's much more inclined to write about her manic phases. I'm not through it yet, so I'll reserve my final judgement.

Sitting up and contemplating the universe tonight, I'm curious about the concept that people have in their minds that being insane is somehow congruent with having astounding artistic or musical skill.

Personally, I think being crazy can be kind of boring.

I suppose it's wonderful to be up all night with grandiose Ideas floating through your mind like meteors. Wouldn't that be nice?

My thoughts aren't nearly so interesting as those of a true manic off on their own little tangent. Right now, I'm thinking about my secret pal from my Yahoo! support group. How is it that a depressed girl in Phoenix comes to send care packages to a struggling single mom in Alabama?

People are so isolated and yet we build communities of support in the most unlikely of places. I'll never see this woman's face and yet, I care about her very much. I want her to have good days. Is that profound? Probably not.

I was contemplating that incomprehensible number of people in America. Hundreds of millions of people. All of us with dreams, no matter how small, and disappointments.

What a cacophony of complaints and praise we must heap upon God and our earthly leaders! I pity the president, the celebrity and the impoverished family that they promise to help with a temporary intervention for positive public relations.

I wonder about God. One of the beatitudes reads "blessed are they who are poor in spirit, for there's is the kingdom of God." Although some would interpret this to mean that the poor in spirit are those who are impoverished, but still bow before God, personally, I think those who are poor in spirit are people who are mentally ill, people whose mentality is weak through some capricious giggle of genetics.

Then there are the corporal works of mercy, derived of the seven deadly sins and the seven contrary virtues. Do you know your sins?

The sins and virtues are based on a sort of yin and yang balance:

humility vs. pride
kindess vs. envy
abstinence vs. gluttony
chastity vs. lust
patience vs. anger
generosity vs. greed
diligence vs. sloth

Of course, the seven heavenly virtues—faith, hope, charity, fortitude, justice, temperance and prudence—are articulated differently just to torture kids who have to memorize this stuff for religion tests.

Even though it sounds boring, I think prudence is the most beautiful of those virtues today. To be prudent is to be level-headed, practical, full of foresight and wisdom. It is to be wary of the glitz and glamour of the world, to cut through the crap and to appreciate the important things in life. To be good for goodness sake.

How to be good? The seven corporal works of mercy:
1. feed the hungry
2. clothe the naked
3. give drink to the thirsty
4. shelter the needy
5. bury the dead
6. visit the sick
7. minister to prisoners

I had to memorize all of this stuff in grade school and again in high school. When people get all hot and bothered about teaching morals in school, I can't help but think that memorizing these ideals did not hurt me.

I'm not trying to engage anyone in a philosophical discussion about teaching "religious" values in school. I guess I just think it's sad that people place more value of the deadly sins because they're "cool."

It's so easy to be seduced by our world. But there's a divine serenity in the virtues, a solid foundation on which to build a good family, a good person and a good life. To be virtuous is to be blessed. I solidly wish more people could be exposed to these concepts.

Ah the beauty of religion, the enticing nature it exerts on the insomniac. :)

Feeling religious. Yet another sign of an impending mania.

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The Doldrums

Imagine yourself aboard a sailboat. You've followed the trade winds across the Atlantic countless times bringing valuable cargo around the world. But this time, you're mired in the doldrums.

The trade winds typically propel ships along at about 15mph. They are consistent, steady and reliable. They are a sailor's best friend.

The doldrums, however, are rumors bantied about by older sailors. And now, you're stuck in them. The sea is dead calm and it's like your ship is sitting on a pane of glass. There's nothing to be done. The sailors slowly start panicking. Food is running low. There's no telling when the ship might start moving again.

That's the tricky thing about the doldrums. They move during the year. They follow a typical pattern, but nobody has figured that out yet. And so, you're crew is slowly going mad. The endless waiting is debilitating. They look to you to rescue them, but there's nothing you can do, except wait and pray.

Welcome to my current existence.

I am on this placid sea without stimulation, aching to emerge from the lack of speed and excitement. I eargerly await the trade winds of normality, or dear Lord, even the squalls of mania to save me from this current slump.

I'm as helpless as the ship's captain who whispers to Poseidon, pleading for mercy and for relief from the unexpected pause, the aggravating slow motion of his newfound existence.

The doldrums are painful. The captain can do nothing for his soldiers except give them meaningless tasks to keep their minds off of the slow and miserable death they may face, starving to death unless the capricious weather decides to push them back into the path of the trade winds.

Yep. This is where I am. Waiting.

There's not much I can do. A part of me knows just how pathetic it is to sweep the floor and call that an accomplishment for the day. And yet, I don't have much of a choice. I'm trapped in lethargy and any tiny wind I can create through the tiniest of achievements is something. I personally don't think that a congregation of these little tasks will ever create the gale necessary to shove me into action.

I suppose the only thing I can do is wait and try to appreciate the here and now. I'm sure there's some kind of ephemeral beauty in the calm. It merely eludes me like the fleeing of a phantasm, an imaginary echo of teardrops in an endless sea.

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Resuscitating a Life

FYI, my head still hurts!

I've been trying to lift myself out of this depression by changing my behaviors because I have this theory that many clinically depressed people prolong their depressions by not modifying toxic behaviors.

My first change has been to alter my sleeping schedule, limiting myself to 8 hours a night. So many doctors have suggested that a consistent sleep schedule is helpful to maintaining circadian rythems. Personally, I don't feel any differently when I sleep 12 hours as opposed to when I sleep 8. I just have more time during the day to think about how unhappy I am. But hey, if the doc demands it, I'll oblige.

This week, I'm trying to keep my sleep schedule and accomplish 5 things per day. I haven't been very successful today, unfortunately. But I suppose that even if I only get one goal accomplished from my list, it's one more thing than I would have accomplished without the list!

The other day, I was thinking about how people gain their perception of the world. I mean, the hackneyed saying is that we see the world as we are, not as it is. Well, I wonder how other people see the world, because my views of it are colored so much by my moods.

For example, today the world is too bright. It's empty and isolating...desolate. It's the type of place where you have to hurt people to help them. It's like a concert violinist playing in the dark in a sound proof room. It's beautiful, but you just can't hear it or see it. Missing the opportunity to watch the skilled musician at their craft is painful because the opportunity will never present itself again. And all you can do is stare into the darkness and wish that you could see the world differently.

What sparked this thought? A woman on my yahoo support group was talking about how the voices in her head sometimes call her name. She was mentioning it in the context of refusing to take anti-psychotic medication because the side effects of the medication was worse than the voices. She spoke as if she thought hearing voices whisper her name was not normal.

I wonder if everyone hears someone whisper their name at some point. I know that I do. It happens more at sometimes and less at others—no rhyme or reason to it. I just try to ignore it. Unfortunately, sometimes someone really will be calling my name and I feel like an ass for not answering them.

When the listserv woman talked about her voices like they were abnormal, I had to step back and seriously ponder whether hearing voices like that was normal or not. I mean, how would I know? I hear them too! So commonly, I assume that because my life is a particular way (for example, I hear voices), then everyone elses' life must be the same way. But maybe that isn't true.

Of course, if I would extrapolate that far enough, then I can never really know anything about anyone which would make perception utterly useless. So maybe I have a gift. To be able to consider things differently. That could be worth something to someone. And if it's not, then I suppose it's worth something to me.

For what that's worth. :)

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The Headache from Hell

Throb tHrOb ThRoB THROB throB tHrob thRob thrOb throB

My head feels like its about to crack in half. I'm nauseas, dizzy and my eyes hurt. Noises are too loud, light is too bright. Both sides of my head hurt. My face hurts. I kind of want to try going to sleep to see if that would make me feel better, but I'm trying to only sleep 8 hours a day.

I can't explain how having a splittin, pounding, throbbing head feels like. Frickin neurologist didn't give me any medication to help with this. Now I'm PISSED off! Tylenol just ain't cutting it!

WaH!

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A Blip on the Radar

For the past couple of days, I've been slipping back into my depression. It's not as acute as it was before, but it's still pronounced enough that I can only focus on two major projects at once. For example, I can either work on improving my diet and writing my thesis, or I can work on waking up early and working out. Or any combination thereof.

I am working on improving my situation, but I guess I just want everything to happen faster. Only, I'm not motvated to work particularly hard for the things I want. It's frustrating. I feel like there's a giant magnet on my bed that just draws me to it with a force I can't resist. Once I'm there, I can barely move, let alone accomplish my goals and develop beautiful ambitions.

I know this blog might read like I'm complaining a lot, but I'm trying to describe how I feel. I guess somewhere in the back of my mind, I wonder if some internet explorer will find this site someday long in the future and show this blog to some psychiatrist who just shakes her head at the suffering people went through trying to figure out how to manage illnesses. I hope that by the time one of my kids manifests with a mental illness, the medicine will have improved considerably.

I'm a member of a listserv for bipolar women and the number one frustration we express to one another is poorly controlled symptoms, unacceptable side effects and general malaise over the havoc the disease has left in its wake. I feel it.

I'm seeing my psychiatrist tomorrow and I don't know what to say to him about the messy way my life has developed since our last meeting. How can I explain feeling happy and sad and irritated and anxious and angry and disgusted and guilty all at the same time? I don't think I can explain it to him. I think I'm going to complain about my depressive symptoms because they're plaguing me the most right now.

sobsobsob

I'm SO cranky.

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