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.

I itch

I'm beginning to wonder if I have a new allergy. I have a small rash on my lower legs that can be maddening. At first I was very concerned, because about a week ago I went back on Lamictal after being off it for about 5 days, longer than I ever had been. Lamictal can cause Stevens-Johnson syndrome, which begins with a rash, can cause blindness, and your skin sloughs off. (Yes, gross, but also very dangerous and possibly fatal). They really warn you against a rash when on Lamictal. But despite my hypochondriac panic, I searched out the symptoms and it didn't seem to be the right kind of rash (Stevens-Johnson hives are crusty, for example). It would bear watching, but probably wasn't THE rash. So I decided it may just be my new bodywash, which has ground up bits of coconut shells. I'm not allergic to coconut as far as I know, but they could irritate the skin, although why it would affect just my lower legs I'm not sure, beyond the fact that they're dry already.

Well today it's been really decent, no itching. Then I ate a double helping of cinnamon almonds. And my legs are itching like crazy, along with itching in my ear canals, on my side, my back, face, etc. I have lots of allergies. I don't remember if tree nuts were on the borderline or not. But it might be best to leave off the almonds for awhile to see if this gets better, then reintroduce and see if there's any effect. I've been eating far too many of them lately anyway. Also, it may be that the rash is appearing at night--so far it's worse then.

Anyway, itching sucks. I'm going to put some lotion on it to see if that calms it down and go on to bed. And maybe take some children's Benadryl (the adult one knocks me completely out, so I don't keep it in the house). I feel calmer after vegging out in the comfy chair for awhile with my comforter tucked around me. My headache is almost gone but the aches are still there, and the sniffling. But mentally I feel a little better, too. Amazing what a little 'me' time can do. Now that my house is clean, I really take pleasure in being here, whereas I used to avoid it at all costs. It seems like a home, not just a place to dump my stuff.

Okay, I've rattled on too long. Good night.

Self-anihilation is something I do with relative ease

When I was married, I moulded my entire personality to what I thought was expected of me. I did that with my parents, with my schools, and finally in my marriage. It was only after that was over that I slowly recovered the buried personality that was me.

And yet, I'm still an incredibly passive person who doesn't feel that she deserves anything good in life. I'm not sure I'll ever escape that mindset, although I've made it my life's work to do so.

What I do know is that for months now--a year or two, even--I've been doing great emotionally. Now with the stresses of bills and Cerys' death and the continued strain my psychology places on my everyday interactions, I feel like my life is unravelling rather quickly. I realise it will get better. But in the meantime I'm having thoughts of just giving up and obliterating everything about me. I'm crying uncontrollably often. In other words, I'm slipping back into depression, and it scares me. I don't want to go down that road again. If it continues much longer I'll see about having my meds adjusted. The last couple of days have been particularly bad, and I didn't have my Lamictal. I have that now and can get back on track. But it scares me how thin a barrier there is between doing fine emotionally and suicidal thoughts can be. And the fact that the days are shortening isn't helping particularly.

The best course of action is, of course, action--action to meet my problems head-on to dispel the anxiety I'm having. That's so hard for me, though. But it's something I'm going to have to do, or I'll spiral right down. At least I did start back at the store tonight--although I was slow, we got everything done for truck night, so that was an accomplishment, mostly due to my direction. So maybe I'm not a total screwup. I'm just having a month where I feel like everything I do is for naught. I can't seem to get things right the first time, except at work, where I'm still doing fine. But I always did better in that arena than my personal life would indicate. I don't want a return to having depression drain the colour not only out of life, but endanger my livelihood as well, as it did before.

Oh, well. Here's to feeling better tomorrow. One good thing about being bipolar/borderline--emotions are like Kentucky weather, just wait a little while and it'll be completely different.