A very interesting look at bipolar disorder (and lithium)

‘I Don’t Believe in God, but I Believe in Lithium’: My 20-year struggle with bipolar disorder.

The manila folder is full of faded faxes. The top sheet contains a brief description of my first medically confirmed manic episode, more than 20 years ago, when I was admitted as a teenager to U.C.L.A.’s Neuropsychiatric Institute: “Increased psychomotor rate, decreased need for sleep (about two to three hours a night), racing thoughts and paranoid ideation regarding her parents following her and watching her, as well as taping the phone calls that she was making.”

I believed I had special powers, the report noted; I knew ‘‘when the end of the world was coming due to toxic substances’’ and felt that I was the only one who could stop it. There was also an account of my elaborate academic sponsorship plan so I could afford to attend Yale — some corporation would pay for a year of education in exchange for labor or repayment down the line. (Another grand delusion. I was a B-plus student, at best.)

After I was admitted to the institute's adolescent ward, I thought the nurses and doctors and therapists were trying to poison me. So was the TV in the rec room. I warned my one friend in the ward that its rays were trying to kill him. The generator outside my window was pumping in gas. The place, I was sure, was a death camp.

I refused meds because they were obviously agents of annihilation. It took four orderlies to medicate me: They pinned me to the floor while a nurse plunged a syringe into my left hip. Over time, I became too tired to refuse medication. Or perhaps the cocktail of antipsychotics started working. The Dixie cup full of pills included lithium, which slowly took hold of my mania. After a few weeks, I stopped whispering to the other patients that we were all about to be killed. Eventually, I stopped believing it myself.

I've never been psychotic, and there's some debate over whether I have been merely 'hypomanic' or truly 'manic', but I have bipolar disorder, officially diagnosed as Bipolar Disorder II. My main drug is not lithium, but lamotrigine, also known as Lamictal. It is a mood stabilizer. Apparently standard antidepressants, SSRIs (selective serotonin-reuptake inhibitors) are often prescribed to people who present with depressive symptoms, and while usually they work, occasionally they have a tendency to send a person into a full-blown mania, indicating that the diagnosis should actually be Bipolar. So while they are sometimes still used in someone who has bipolar disorder, they usually have a mood stabilizer in there as well. I also take aripiprazole, Abilify, which is an antipsychotic, even though I'm not psychotic. The two together work to keep me on an even keel, and it's been years since I've been too down or up in mood. I'm lucky. They found a good combination for me that worked pretty much from the get-go. I am very compliant in terms of medication, missing only occasionally, like today, when I didn't realise my pill-reminder box was empty. I'll fill that up tonight. They are just like any other tablet I take for my 'physical' conditions. (I put those quotes in, because psychiatric illnesses such as Major Depressive Disorder or Bipolar Disorder are the result of physical imbalances in brain chemistry, even if they are classed as mental illnesses.) By taking those medications, I am a productive member of society who pays her taxes and holds down a job, etc.

My biggest fear as I go forward in the next couple of years is that my job will be ending in 2017 unless I find something else before then, and that means I'm going to lose my insurance. The Affordable Care Act (Obamacare) may be my salvation. I am terrified of going off my meds, and not just the ones for diabetes, but the ones for my bipolar disorder as well. I didn't do all the crazy things that this writer did, but I did crazy things that affected my credit, my relationships, my schooling, my job, and my own sense of self worth. I don't want to be actively crazy again, ever.

I can relate so much to this article. Medication = a mostly decent, normal life. Off medication = chaos. It's pretty simple. My brain is not my friend. There is something seriously wrong with me, but it can be helped. I realise this. I have the insight, which is why I take my tablets every day. I want to be in control of my life, not at the mercy of it.