11 Commandments for People Living with Bipolar Disorder

Recovery from bipolar disorder is almost like a religion or an ethical system. Certain devotions must be part of our lives if we are to recover our balance.

  1. I shall hold myself accountable for all works of my body and my mind including those which I wreak when I am in episode.
    It is important, I feel, not to separate the illness from ourselves. We did the things that happened while we were in episode. There was no second soul seizing control of our bodies. Our mind is a stream that flows continuously, sometimes over rough ground, sometimes in placid stretches, and sometimes over cliffs. We own all these states of our being.

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Skipping a Dose

Last Friday night, I forgot to take my meds. When I discovered this on Saturday afternoon, I didn’t feel unusual so I left the meds in their compartment to be taken in a week. Saturday, Sunday, and Monday passed without incident; so I forgot what had happened. Tuesday, however, brought light-headedness and euphoria that peaked in the evening. I battered it down with my usual night meds and eleven hours of sleep. I still felt a little high on Wednesday which made me worry that I was ramping up into something more serious. Thursday found me a little below level-headed but no longer hypomanic. Then Friday arrived. I woke to a crashing depression and general fatigue, sluggishness, and stupidity.

The temptation not to leave the house was strong, but I defied it and went for a long walk in Whiting Ranch. Golden Stars had made their first appearance and Blue Dicks their last along the trails. A single Splendid Mariposa Lily signaled that there were more things to come. I had my instant camera with me and set myself to the task of taking five good photos with the last of the film: I succeeded at four. The exertion slowed the whirling of my head, but didn’t stop it entirely. I pumped the blood through my veins by walking fast up the hills and finished my circuit in two hours; leaving me enough time to work on the computer a bit and enjoy a large snack to curb my massive appetite.

Do I insert here a warning to take your meds? Do you need one? Because I had skipped one dose, the foundation that I relied on for existing cracked and slumped. The funk that I find myself in will linger for a few days more. I’ve made plans to exercise and take pictures as I usually do on the weekends. The fissures should heal, my cocktail should plane off the undulations, and my equanimity return. This is a course that I have often run: I know what happened and what works to improve things. There’s no hammer that fixes it all. Only time and attention to my routine repairs my brain.

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My Name is Not Bipolar Disorder

worldbipolarday

The roller coaster analogy never really spoke to me. I didn’t experience a thrilling ride. It was more like a tornado or a hurricane, a central column of madly swirling air that threw everything in its path asunder only to die and leave a still, bleak landscape of broken trees and shattered homes where no one could live. “Things fall apart,” goes the Yeats poem. “The center cannot hold.” Mania causes us to lose sight of our center and depression causes us to forget that we ever had one.

I count myself fortunate that I never ended up in jail though perhaps some might have made a case for it. Drugs and alcohol, at least, never presented themselves as ways to temper my emotions — I distrusted them. I let whatever flew out of the maelstrom hit me square on and I did nothing to numb the pain except hide in my room or rage unexpectedly.

Bipolar is one of those illnesses that everyone who has watched a Lifetime Channel movie thinks that he or she knows, but they have no clue. The illness doesn’t make us evil. Most of the things that I did in my rages and panics were moved by an innocent heart. I have found the same to be true of others. But often what we do is hurtful. It is no wonder that outsiders see us as brutes. When I have acted with the most vigor and erraticness, I have done so the name of one or another great crusade, marching against problems that often only I could see. Heraclitus once said that “The waking have one and the same world, the sleeping turn aside each into a world of his own.” Bipolar creates in that waking world a sub-world that we who labor with the illness experience on our own. In it we sleep a sleep of wakefulness. Perhaps this is due to the restlessness of mania that keeps us up night after night, day after day.

Eventually things fall apart and we find our minds in bizarre places.

My worst psychotic episode happened when I was working over Christmas break in college. The world became a maze of passageways like I see in my dreams, the doors to the rooms hazy and difficult to find. I believed that I was God and that I had messed up the world. Once that a coworker asked me what was wrong. I did my best to deny that the veils between us did not exist. It was a tricky maneuver but I pulled it off. Every night I returned to my room and found darkness. When the other students returned, I felt less lonely, but I felt I wasn’t one of them. I hid in my room, held my tongue and kept my condition to myself. They knew nothing of my obsession or the distortions that blurred my cognition. Sometimes they would find me staring into space and wonder if I was on drugs. I was stone cold sober. An ill gift of prophecy settled over me. I believed that I could predict what people were going to say. I became sensitive to the occasions when people would utter words that I had encountered in my reading with no connection to the class or the context. My skin jumped at their mention and my shivers from remembering the incidents of my day kept me up. The episode slowly lifted over the semester, though I did have to drop a class.

Sixteen years passed before I sought the aid of a psychiatrist. Eleven more needed to turn over before I started telling the truth about my experiences. Oh the rages, the insomnias, the dark nights of the soul, and the mind-crushing paranoias that troubled me even though I took antidepressants and thought myself cured! The word “bipolar” was, at last, used. During the eleven years of denial, I refused to believe that it applied to me though I numbered it in others. One day in the hospital, it caught up with me, though. The new attachment to my identity electrified me. I read all I could, kept finding myself between the pages, and in the end surrendered to my diagnosis. Then I took my pills as prescribed, dieted, exercised, and broke down the walls that kept the world outside of my dream.

Though my doctors named my condition, my condition was not me. I had always had doubts about this wreck of a brain that always seemed to say and do things against my better judgment. Outsiders sometimes tell me that mood stabilizers erase the personality. They have no clue. When I got on lithium and it started working, I found myself able to be the me that I knew I always was, free of the control of the randomness-loving demon who operated my body like a slot machine whose prizes were shame and sorrow. Over the years, I have added and subtracted more medications to my cocktail until I had a firm foundation upon which I could finally build a brick house. When the madman tried to seize control of my inner weather, I had a series of steps that I could take to seal myself inside my house and wait out the storm. This security enabled me at last to separate myself from my illness. I knew, at last, who I was. Life was no longer a bad dream.

Today

I don’t know if reading through my posts I sound like I have a lot of present mood disorder issues. I wish I didn’t have it or have to deal with it, but I am much, much, much better than when I was first diagnosed.

At that time, I was psychotic, but even before then, I had times when I would cry for no reason or not leave the house. I haven’t been hospitalized since 2005 or had psychotic symptoms since 2006. I have coping skills. I don’t micro-manage symptoms. If i have a good day I enjoy and take advantage without worrying if it is going to turn into mania.

My biggest issue now is anxiety and even that is better. It is hard for me to notice, but people around me tell me I seem more at ease. I do presentations for NAMI which is hard for me to believe with my social anxiety. I am not a great speaker, but they go over well.

I am married. I was diagnosed after 7 years of marriage, so my husband didn’t sign up to marry someone with a mental illness but he has been supportive. I have 2 teenagers, who are doing well, for teenagers. I do some volunteer work, I would say an issue i have now is time management.

lorib

 

The Medical Marijuana for Bipolar Lie

UPDATED

Everyone seems to have a friend who has been helped by medical marijuana. When my wife had chemotherapy, we had it as a backup in case the anti-nausea drugs did not work for her. Glaucoma is a disease with medical research backing the effectiveness of medical marijuana. But the medical marijuana industry goes beyond what is proven by science. It welcomes those who use it for many other diagnoses despite the absence of peer review studies. In other words, if you can get a doctor or a nurse practitioner to write you a script, you can get high legally for any disease you can name. And the worst of the lies medical marijuana prescribers and retailers let fly is the lie that marijuana helps the symptoms of bipolar disorder.

Here is my full disclosure: First, I do not oppose legalization of marijuana provided it is regulated at least as well as alcohol. There need to be laws governing its sale to minors, bans against driving under the influence, etc. But other than that, I have no problem with seeing it available as a leisure drug. There’s considerable evidence that the liquor industry does not want this, but alcohol is worse than cannabis in some regards. Second, I have smoked marijuana. Here is where my strong feelings about the subject come from. When I was in college, I was talked into toking by my peers. They did not force it down my throat, they did not blow smoke into my lungs, they did not deceive me in the sense that they told me things that they knew were not true. I started using the drug by my own choice.

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Just Another Manic Blip

I take a prescribed Ritalin to prepare myself to study, to give me the energy to get through the remainder of the day. This last night before the final is the most important. I’ve had a whole quarter off, a whole 10 weeks plus winter break, because of my manic episode. It has given me time to finish a class that I took an incomplete in because I broke my wrist (but, in reality, it wasn’t so much the broken wrist, as much as it was my cracking mind that forced me to take the incomplete).

My dad comes home with food and the coffee I asked him to buy me. I start sipping at it and realize what’s happening. The ritalin is kicking in, the coffee is too. I’ve got too much energy racing through me. My thoughts are going off left and right like a firework finale. I’m agitated. I’m texting long rants to at least 4 people, I’m writing blog posts. I feel amped up, wired.

Sometimes these little mini-episodes happen to me. I think the Ritalin and coffee set me off. My therapist says that, since I’m so young, I may sometimes have episodes more like a child’s- rapid and short. And I do have these, quite often. I’ve also been told that these may happen when you’re stabilizing on medication. All I know is that they’ve always happened to me.

My day has been long. I had to wake up, go to psychotherapy, then immediately go to physical therapy, then immediately take my cat to the vet and then immediately start studying. But plans never go accordingly. I managed all the doctor’s visits fine, but it was the studying that threw me off. I tell myself I can relax a few minutes, but here I am- 5 hours later, and I haven’t studied. What went wrong?

Well, after the Ritalin and coffee kick-started me, I felt I had to run an errand. You see, I had an infection recently (of a nature I won’t describe) and I’m afraid it has come back. I already called the doctor to make an appointment, but I am impatient to know. I get the idea that maybe the drug store sells tests for them. I text my boyfriend, who manages a drug store, and he says they do sell those.

I figure maybe getting out of the house, getting the test, that’ll ease my mind. So I go, and I walk around the store, buzzing with energy. I look everywhere, my mind racing so fast it is hard to focus on the words on the labels. I feel lost but determined to find them on my own- which I do.

I get home and I read the directions, my eyes are glazing over as I read it. The words aren’t processing. I try to slow down. It takes a while, but I think I get how to do it. Which is ridiculous, I realize, because I used to conduct these same tests at my old job.

I come out positive, figures.

That’s over. But I’m still alive with energy. I realize it’s been long enough, the Ritalin has peaked in my system and I should be settling down, the coffee can’t possibly be keeping me this abuzz. It dawns on me that it’s the stress. The fact that I am unprepared for a test I had ample time to study for. I should ace this test (given all the time I had), but I know that I’ll barely pass it, if that. I was too manic over my break to study. I was barely able to do what I did. And now it is my last day- and I am so panicky that it set my brain off. The stress caused me to crack, to have a mini-episode.

I know I need to shower, that should calm me, right? Don’t they always say showers will calm your nerves? I hop in and the water pours over me. I put my hands to my face and run them back over my hair. It’s always this way when I’m manic- it feels like I’ve never showered before, the water is foreign. It is so bizarre. At first, it’s overwhelming, overstimulating. But then I get lost in my thoughts, consumed by obsessive thinking.

A thought pops out at me like a big red stop sign that’s been unusually placed in the middle of the road. I realize I am self-narrating. It’s a phenomenon I’ve never heard anyone else have or even describe, but I’ve never bothered to look it up to see.

Self-narrating is as follows: My thoughts have made a transition in their style. Instead of just thinking, I am writing a first-person story in my head. I am tracing my every movement, my every thought, as if I am writing it in a book. To put it simply, what you are reading right now is exactly what my thoughts are like.

It took me years to realize this is something I only do when I am very sick. I did it all throughout high school and never thought much of it, but I was also in an incredibly deep depressive episode. It wasn’t until my last manic episode, when I started self-narrating again, that I realized I had stopped for a while. It is now something I use to judge how sick I am. If I self-narrate, I am very sick or stressed out (although the two seem to go hand in hand).

I continue my shower, all while being obnoxiously conscious of my self-narrating. I wish I could write out what my self-narrating sounds like, but I can’t. It is literally what you are reading right now.

I may be a writer, but sometimes it is not by choice.

I step out of the shower and snag my towel. I put it to my face as usual, but I hold it there for a minute and let my tears soak into it. The moment passes and I continue on. I feel strangely calmer. Maybe it was the shower but I figure it was probably the Ativan I took before.

I’m annoyed with myself, I realize I am going to have to write this out before I can start on my studying. Sometimes the thoughts in my head get so built up that there is a pressure, an ache to get it on paper. It is not a want, it is a need. This is also something that only happens when I am very sick. In high school, during my depression, I would write obsessively. I was un-medicated then and if you ever look back at my writing, it is painfully obvious that I was a very sick teenager. After I was medicated, the writing stopped becoming a need, and soon faded into a past habit.

But I was inspired to start a blog and ever since then the need to write has engulfed me. When I had my manic episode, I not only wrote many long blog posts, but I also started writing a “book.” By the end of my episode I had over 60 pages of a single-spaced word document written. I believe that translates into easily over 100 pages of a standard size book? I’m not too sure though.

I am still not completely stable after that episode. I get these little spurts of mania, other times I get depressive lows. They happen almost every day, I am always a little up or a little down. But today I had an especially strong high.

And it is only now that I have written this out that I feel calmer. There is still an agitation residing in my heart. If I didn’t have to study I would be out, shopping or maybe hanging out with a friend. Just doing something.

Sometimes mania is described as feeling extra happy. But unless I am euphoric (which is brief but welcome), I am never happy during mania. Instead, I am incredibly agitated. It is not fun, it is frightening. I want it to stop, but at the same time I never want it to end- and I have no idea why. But that word- happiness- it does not define my mania. It does not belong in its definition. Euphoria may, but happiness does not.

Mania is incredibly uncomfortable.

But now… now that the thoughts are on paper, I can rest a little easier. I can study, I hope. All that remains is proof-reading this, closing the laptop, and sitting down with paper, pen, and notes.

I can do this. I can do this. I can pass this class. I won’t let my bipolar stop me. I will not fail, I won’t risk my dreams of becoming either a psychiatrist or psychologist be stopped by the fact that I had a manic blip in my day.

I can’t fail.

And it is that fact- I can’t fail- that drives me to feel such madness.

-Quinn

“Could it be the medication?” -My mom

My parents have always been against me being medicated. When I was 17 my dad refused to sign for me to have medication, so I had to wait till I was 18. And then I had to be financially supported by them, but my mom reluctantly agreed after a GI specialist told her I needed to see a psychiatrist (that’s a long story for another time)

Whenever I would say I feel [insert negative feeling here]. My mom would always reply, “Are you sure it’s not the medication.”

Well one night I came home from a support group. I didn’t have the willpower to eat with the group afterwards. I told my mom this as I shaking. I was stuttering. I leaned against a chair and told her I needed to eat because I hadn’t eaten all day (and plus, I only ate a couple grapes and stuff the day before).

I was having really bad anxiety, and anxiety doesn’t let me eat. It doesn’t let me eat until I feel sick and weak. It doesn’t let me eat until I am seeking professional help for the extreme weight loss. It doesn’t let me eat because when I try, I will vomit.

My mom started suggesting foods, I looked in the cabinet. And it came over me. Just the thought. 

I ran into the bathroom and my mom got up and followed me, “Oh Quinn.” It was her disapproving tone. It was as if she was saying, “Why are you letting yourself get so worked up over literally nothing?”

I thought she would understand because my dad has anxiety. But as it turns out, our anxiety is very different. He gets mad and he might overeat. I get withdrawn and I might vomit.

My stomach was empty, so I was spitting up bits of stomach acid. I was crying.

My mom held my hair back and asks me, “Do you think it could be the medicine you’re on?”

I laughed. In between my gagging and spitting, I laughed at her.

I bitterly spat some bile into the toilet and told her, “No, it couldn’t be.”

“How do you know?”

“Because I quit the meds.”

That was a changing point for her. When I was done, we sat down, and she gave me a piece of toast to munch on. I couldn’t eat the whole thing. But I told her the truth- I thought the medication (Zyprexa) was making me depressed- so I quit it. But as it turns out, the medication was the only thing holding my anxiety back. And quitting it cold turkey without a doctor’s supervision was very dumb of me.

It turned out to be a very symbolic moment. After I explained all this, she offered to go get the medicine for me, so I could take it right now. I nodded, told her where it was, and took it when she returned.

My anxiety levels went back to normal over the next day or so. But there was another occasion where she showed that maybe medication isn’t the worst thing for me.

During my recent manic episode, I told my mom I just could not take the increased dose of Zyprexa, I just couldn’t make myself do it (because part of me wanted to stay manic). I told her the doctor suggested I give the pills to her, and she could dose them out to me. But I hate when other people have control over my medications, as I feel I know better than they do, so I didn’t give her the meds. As a result, I only took the increased dose on two different occasions, and it made me very depressed. I felt bad walking into the psychiatrist’s office and explaining that I just couldn’t take that dose, I was manic (but I was unable to explain that part of me wanted to stay manic), and it made me too depressed to handle. Ultimately, I asked my psychiatrist just to put me on something new. And she did. And that’s what I’m working with right now.

Medication compliance is difficult for some people struggling with bipolar. Sometimes we think we are all better and quit them because, “We don’t need them anymore.” When in fact, it probably means the meds are working, and quitting them will just cause problems. In other cases, we are annoyed by a side effect or some other problem. We think we know better, but do we really?

I think it’s a lesson a lot of us learn the hard way.

-Quinn