Bipolarcoaster

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Well, it’s been an interesting week. The last seven days or so are the first time that I’ve been hypomanic and actually aware that that’s what was happening. I’ve come to realize that prior to being diagnosed, I had these so-called unexplainable bouts of  terrible insomnia a few times a year. Nope. Hypomania. I just dismissed or didn’t notice the other stuff that went along with the insomnia.

I slept a maximum of four hours a night over the last week but still had tons of energy. It was like I couldn’t talk fast enough, think fast enough, move fast enough to keep up with everything I wanted to say and do. I got an insane amount of organizational projects done at home. I wanted to spend every dime I have to my name because hot damn shopping feels good. I wanted to screw anyone willing and able because…well, I don’t think I need to explain that one. For me, to be manic is to have no anxiety, no sadness, no pain, no fear.

It’s goddamn amazing.

I didn’t realize how afraid I’ve been, and for how long, until I got this break from it. Over the last six to nine months or so, I was looking at my depression as something that was most likely going to kill me. I knew I couldn’t hold on forever in the pain I was in; one day, maybe not for years, but someday, it was going to hurt just a little too much and I was going to be just a little too tired to carry it anymore. I had expressed the fear that that might happen, but I never told anyone that the fear had turned into certainty. Not even my therapist. And that is a godawful thing to walk around with. And then I got my diagnosis and suddenly it made so much sense that my depression was so severe and my treatment wasn’t working, which was a huge relief, but holy shit, this hypomania. This hypomania almost made me forget I was ever sad. I haven’t been able to even fathom the idea of dreading a new day, much less wanting to die. No anxiety, no fear. If I didn’t know any better, I’d say this hypomania is a gift. How weird that mental illness, at least this one, can feel good sometimes, right? How bizarre.

I think I’m coming down now. Last night I actually felt tired and fell asleep at a decent hour and didn’t wake up for the day at 3:30 in the morning like I have been. Today I feel like I’m talking/thinking/moving at a more normal speed for me, and the elevated mood is sliding down into irritability. What I have to do now is keep my fingers crossed that I don’t keep sliding and end up in a depressive episode, because OH MY GOD I have spent enough time in that place, fuck you every much. I saw my psychiatrist today and he said it could go either way. I might level out and just be normal until my next episode, or I might get depressed. Everyone is different. Bipolar II is annoying as hell because it can look so different for each person and doesn’t have the predictability of bipolar I. I’m still on a super tiny dose of Lamictal but I’m on enough Abilify now for it to be doing its thing, so my doctor said I may just level out or if I do get depressed, it’ll be over quickly.

I can’t even tell you what that feels like, to know that I’m on medication that is going to help – not hopefully, but actually. At last. The fearlessness of the hypomania is not sustainable, but finally having the right diagnosis and getting the right treatment is taking away my fear in a more real and enduring way. And it feels so good to not be scared.

 

 

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Thoughts, sponsored by Not Your Father’s Root Beer

I had a good night tonight after a series of not-good nights (and days) and there’s some stuff on my mind I need to get out. I’ve gained some clarity and made peace with some things lately, and I think that’s a sign of how much better I’m getting. 

He hurt me because he’s broken. I’m broken too. So are you. Some people just manage their brokenness in a way that doesn’t further break other people. And it’s not all-or-nothing. Sometimes you contribute to breaking someone, sometimes you don’t. Being broken doesn’t make it okay, it just makes you a person. Sometimes it also makes you a giant fucking asshole.

Someone who rolls their eyes at your mental health, or ignores it, or acts like you talking about it is something to be endured with gritted teeth and barely-suppressed eye rolling is not your friend. In fact, they are a giant fucking asshole. 

People who try to control your behavior as a way to ease their own unaddressed neuroses are not your friends. They are broken, yes, but they are also giant fucking assholes.

The world is full of giant fucking assholes, and you don’t need to tolerate their nonsense. There are a lot of other people who are lovely and understanding and kind. They’re flawed and broken too, of course, like we all are, but they try really hard to not be hurtful or selfish, and those people shine in the darkness. Find some of those lovely shining people and make them part of your clan. I’ve found quite a few of those, and my life is better for it. And everyone else can die in a fire.

It sounds harsh. I know. But honestly, I’m tired. I’ve been tired for a long time. Nobody is perfect and I would never expect anyone to be. I’ve hurt people and would never try to claim that I haven’t. But people who hurt and break other people as a matter of routine are a different story, and I’m not going to make excuses for people like that anymore. I’ve made so many excuses for people who treat me badly because I don’t want to believe that sometimes a person is just a giant fucking asshole. I can always see that a person has the potential to not be that way, so I excuse inexcusable things and sweep my hurt under the rug and perform mental and emotional acrobatics so it makes sense to me in some twisted way. I cling to mistakes for the sole reason that I’ve spent a lot of time making them. And I don’t want to do that anymore. I feel good, feel honestly and truly good, for the first time in years. I feel big joy again, and it’s been so long. I don’t cry all the time, and I don’t feel this gaping black hole of raw, intolerable pain in my chest all the time anymore. It feels so good to be able to be happy again, and after so much time spent in misery, I’ve realized that I don’t have time for people who routinely contribute to making me feel sad or angry or bad about myself. Fuck those people.

Get away from my joy. There’s no room here for you.

In which statistics are not my friend 

I just ruined my own day by googling statistics about bipolar parents having bipolar children. At first it wasn’t too bad – with one bipolar parent, the risk for a child is somewhere around 4-15%. The rest of the story is what upset me: Children of a bipolar parent have a 50% chance of having some kind of mood disorder (bipolar, major depression, an anxiety disorder, and so on). Two-thirds of bipolar people can point to someone with bipolar disorder or major depression in their immediate family. 

I want to say “that’ll teach me to google shit,” but in this case, this is stuff I need to know. I would like to have a baby someday if the opportunity arises, but as I digest this new information, I don’t know if I can, in good conscience, have my own biological kids. Fifty percent is a lot, and I don’t think I could live with myself if my son or daughter had to suffer through the things I’ve had to. I wouldn’t wish any of this on my worst enemy. Yes, this stuff is all treatable, but treatable and curable are different things. 

Ugh. I’m already a hot mess this week courtesy of my Cymbalta withdrawal, so this is highly unwanted. But I’ll soldier on. Just needed to vent a little bit of this angst. 

Transition

I’m two weeks post-bipolar II diagnosis and starting Abilify, and I’m one week into the process of weaning off my two antidepressants. The tapering process was actually going much better than I expected until the last couple of days, when I got strapped into an emotional Tilt-a-Whirl that I can’t seem to escape. To be clear, 80% of the time I feel great. I feel clear-headed, alert, energetic, quick-witted, and all-around more like myself than I have in years. Abilify has been nothing short of a miracle for me – in a matter of days it quite literally flipped the switch on my depression and it’s gone. But, as I suspected, weaning my brain off the antidepressants it’s been on for two years is not without its consequences, even though the drugs haven’t been doing what they should because I was misdiagnosed. I’ve been shaky the last few days – mostly in a good mood, but it’s fragile. I’m fine and then I see a photo on Facebook of a casual acquaintance’s new baby, and I’m in tears because his cheeks are so perfect. Or out of absolutely nowhere, I think of the fact that my mom has a severely disordered view about food and eating and how that’s affected me negatively my whole life, and I’m crying on the train. Or I watch an episode of Girls and one tearful, trying-to-keep-it-together expression on Lena Dunham’s face causes a total breakdown. But these meltdowns last a matter of minutes, if not seconds, and then they’re over and I’m fine. It’s exhausting to not know minute-to-minute what’s going to set me off. But I know it’s temporary and after this part is over, I can look forward to being much more even-keeled and stable.

I will, unfortunately, be depressed again at some point, because my new medications will lessen my bipolar symptoms but they can’t eliminate them. But if they work the way they should, I won’t ever be as bad as I was even a few weeks ago. I won’t be so depressed that I can barely move or talk, and I won’t think about dying a dozen times a day. I won’t think about something that upsets me and immediately spiral into “This thing upsets me and oh my god I hurt so much all the time and it’s never, ever going to be over and the only way to make it stop is to die.” I’ve been living with that every single day for five months. I have been trapped in a body that’s been torturing itself for two years. (And here I go, crying again.) Since my hospital stay, I’ve found myself actively resenting the fact that I have family and friends who would be completely shattered if I killed myself, because that was the only thing that kept me from doing it, and I wanted to do it so badly so I wouldn’t hurt anymore. I’d look at pictures of my little niece and nephew and know in my heart that I couldn’t allow myself to become their Aunt Minerva who’s so hard to talk about in front of them because of What She Did. I couldn’t allow myself to leave and not see the amazing people I know they’ll grow up to be. I couldn’t allow my final act on this earth to be breaking the hearts of everyone who cares about me. And I had moments when I hated all of you for that. That is what this nightmare madness was doing to me. And the Abilify shut it off. I like myself and my life again and I want to see whatever adventure is next. And when my next depressive episode happens, it won’t be nearly as bad. Having that “I wish I was dead” feeling is a living hell to experience just once, much less multiple times a day, day in and day out. I will never be able to explain the agony of it. And while I could easily be really angry that I was suffering like that for so long without an accurate diagnosis and treatment (even my therapist says I have a right to be thoroughly pissed off), I’m not. I’m so immensely relieved to be feeling better and to know that I’ll continue to feel good more often than not from here on out. I think about that sometimes and cry from pure relief and joy.

It sucks that I’m bipolar. But that’s just a word in my medical record. The reality here is that we’ve finally figured out what’s the matter and now we can treat it properly. And if I didn’t believe in miracles before, this tempts me quite a bit.

Did NOT see that coming.

Well, gosh. I’ve had quite the afternoon.

I had an appointment to see my psychiatrist in three weeks for a routine 12-week check-in, but I’ve been feeling so lousy that I asked to come in sooner, so I saw him today. I talked to him about how I’ve been feeling terrible, and in what ways, and how frustrated I am that I’m on two antidepressants and go to therapy every week and I’m not getting better in any kind of lasting way. I said I’m taking a lot of heat at work because I’m behind on deadlines due to my complete inability to focus on anything for more than a few minutes, and that just isn’t acceptable so something has to be done. We had talked in the past about adding Abilify to my medication regimen. Abilify is an atypical antipsychotic/mood stabilizer that often works well for depression patients when used in conjunction with whatever antidepressant they’re already taking. So, fine, sign me up for that shiz, because something has to change.

My psychiatrist is taciturn and a bit chilly. I’ve been seeing him for almost two years and I have never once seen him smile. He scares me a little, to be honest. So when he started silently flipping back through my file and scowling, I got nervous. After an impossibly long silence, he said, “Your moods don’t make sense to me.”

I didn’t say anything, because what does one say to that?

“Do you have mood swings?”

Shit, I thought.

“Do you find that you have periods when you feel really good, have lots of energy, your thoughts race, maybe you get easily distracted, or feel grandiose?”

SHIT, I thought.

“Not grandiose,” I said. “But I’ve always been a bit mood-swingy…and yeah, I guess I do have phases where I feel absolutely fantastic for a few days or weeks and then I come crashing down again and am as depressed as ever.” As the words were coming out of my mouth, I realized what he was getting at, and the cold buzzing wave of anxiety that I know so well washed over me and my heart started racing and I felt the blood draining out of my face.

“I think we need to consider the idea that you’re bipolar,” he said.

“Shit,” I said.

His reasoning is that my periods when I feel better and the ones when I feel awful don’t seem to correspond with much, and some of my depressive symptoms are atypical (example: I tend to feel my best in the morning and things go steadily downhill from there, whereas for most people with depression, mornings are the worst time). And attention/focus issues can be a feature of both the high and low episodes of bipolar disorder, along with irritability, which I definitely have. If he’s correct, I have bipolar II, which is different from the textbook manic-depressive illness that first comes to mind when you hear the word bipolar. With bipolar II, people have hypomania, which is nowhere near as intense and can often go unnoticed or be easily written off as “hooray, my depression decided to recede for a while.”

Sounds familiar.

Unfortunately, the depressive episodes associated with bipolar II are not comparably mild. They can be very  severe and can also last much longer than the episodes of hypomania. It’s very common to have the low-energy, can’t-get-out-of-bed type of depression symptoms, which I absolutely do. And suicidal thoughts occur in a lot of sufferers.

Again, sounds familiar.

Turns out that antidepressants can make bipolar disorder worse. (Which would explain why I haven’t gotten better after almost two years.) So we’re adding Abilify to my routine, and if that makes a big difference for me mood-wise, we’re going to get me off my two antidepressants and add another mood stabilizer called Lamictral, which has a great track record. Added bonus: he said this type of drug typically has very few side effects, especially compared to antidepressants. Sign me up for that.

I read tonight that 7 out of 10 people with bipolar disorder are initially misdiagnosed, and the average timespan between initial onset of symptoms and a correct diagnosis is 10-12 years. That makes me sad, but I get it, especially for bipolar II because the hypomania can be easy to miss.

I won’t lie – all this threw me for a major loop. “Bipolar” is a scary word, way scarier than “depression.” Also…depression can go into remission. Many people can recover and not need to be medicated forever, or can at least go off medication until they have another episode (if they have another episode). Bipolar is forever. I had pretty much gotten to a place where I accepted the idea that a significant part of my depression is caused by a chemical imbalance and therefore I might need medication for the rest of my life, but still, if I’ve been misdiagnosed and am bipolar instead…that’s a blow. The stigma and public miseducation about depression is bad enough; it’s even worse with bipolar disorder. That, to be blunt, fucking sucks. When I walked out of my psychiatrist’s office I was fighting like hell not to cry because I was so floored and overwhelmed, but then I talked to my closest friend and she brought me around to the idea that this is, after a fashion, good news. It sucks if I’m bipolar, but it’s great that maybe I’m getting an accurate diagnosis after all this time because that means I can get the right treatment and finally start feeling better. She’s 100% right…what matters most is feeling better and living a happier life and not ending up dead or back in the hospital. That perspective is calming me down significantly and also preventing me from having a pity party.

To be continued, I guess! I leave you with this, courtesy of the amazing Allie Brosh, whose blogging about her depression has been a light in the darkness for me many times.

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