I haven’t forgotten you

Hello my mad lovelies,

I just want to say that I haven’t forgotten you or this blog. It’s just that I’m really trying to focus on my recovery right now and finding it very hard to write. My medication is still changing regularly, I’m in an out-patient program that meets daily, and I’m just plain exhausted. Lithium totally zapped my ability to string together sentences and find words, but the good news is that I’m weening off the toxic substance and starting a new med (Abilify). Have any of you tried Abilify? What were your reactions to it? Did it help you? I’m hoping it helps me because I’m getting awfully fed up of feeling like a medication guinea pig.

I love you lovelies tons and wish you love and light,

M

Xo

P.S. Here’s a puppy to make you (and me) smile

Golden Doodle

What’s in your medicine cabinet?

My mad lovelies, I didn’t have a chance to write a blog post this week. A lot has been going on in my life between doctors appointments and starting an out-patient treatment program. I’m taking a lot of medication these days, and I’m sure a lot of you are as well. I know a lot of us take our medication in secret, often afraid of the stigma associated with taking meds.

So with that in mind — I’m opening my medication cabinet to you. Right now I’m taking 1200 mg Lithium, 250 mg of Seroquel, 150 mg of Zoloft, 0.25 mg of Synthroid, and 1 mg Clonazepam when needed.

What do you take? What helps? What gives you side effects?

pills

Lithium
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Lithium: Toxic but it works

Lithium is among the oldest psychotropic medications. It was first used in 1817 to treat gout and was found to have mood stabilizing properties. Throughout much of the nineteenth-century it was used to treat a variety of illnesses. In 1929 when 7 Up was created it actually contained lithium and was sold as a cure-all. The use of lithium then disappeared for the first half of the twentieth-century. In 1949 it was used to treat manic patients by an Australian doctor, John Cade. Then in 1954 a Danish psychiatrist, Mogens Schou, undertook a controlled trial of the use of lithium for mania. The United States was among the last countries to use lithium for mania in bipolar disorder. The Food and Drug Administration didn’t approve the use of lithium until 1970, when the rest of the world had been using it successfully for almost ten years (read a more detailed account of lithium’s long and interesting history here).

lithium

The reason that the United States took so long approving the use of lithium is because the FDA feared overdose, particularly among patients with a low sodium diet. Lithium can easily become toxic within the body and requires constant monitoring. People who take lithium undergo constant blood tests to check lithium levels, kidney, and thyroid function.

Seventy-five percent of people taking lithium experience some side effects, which include:

  • Hand tremor (If tremors are particularly bothersome, an additional medication can help.)
  • Increased thirst
  • Increased urination
  • Diarrhea
  • Vomiting
  • Weight gain
  • Impaired memory
  • Poor concentration
  • Drowsiness
  • Muscle weakness
  • Hair loss
  • Acne
  • Decreased thyroid function (which can be treated with a thyroid hormone)

And these are only a selection of the side effects that one might experience by taking lithium. Since starting lithium I have been experiencing an array of side effects. I can’t eat a lot of food because of a weird metallic taste I get in my mouth. Most of these items are dairy based, so no more pizza or brie for me. Currently, I can’t even walk into a movie theatre because the once delicious scent of buttery popcorn now smells like metal and it’s nauseating.

But it’s more than food that’s a struggle. I’m so forgetful. The other day it took me three attempts to leave the house because I kept forgetting things. I walk into a room and have no idea why I’m in there. When I’m walking on familiar streets I become confused and turned around. I imagine this is what it feels like to have Alzheimer’s.

The most troubling problem for me is that I keep losing my word. As a writer, I depend on my ability to put words together. I imagine there’s a bridge between my brain and mouth and my words travel down this bridge. Up until now, they’ve been happy and safe travelling across. Suddenly, lithium dropped a bomb and has left a gaping hole in the bridge where some words fall in, only to be found hours later when it’s too late. I feel like a blathering idiot as I smack my forehead, trying to knock the words loose. I just thank God that I’m not working or this would be extremely embarrassing. Writing this post is a trial of days of work and I know it’s not my best work. I’m just proud to that I put something together.

Lithium

2 pills a day keeps the doctor away?

This isn’t the first time that I’m taking lithium but it is the first time I have been prescribed it with such disregard. The psychiatrist seeing me hasn’t asked for weekly blood tests. He gave me requisitions for them when I first saw him and when I asked him about my results at our last appointment, he didn’t have my them. He didn’t know where they were. And frankly, he really didn’t seem to care. My family doctor (who is a saint by the way) is so appalled that she’s checking my lithium levels.

I am extremely concerned with toxicity, as everyone who takes lithium should be. Extreme lithium toxicity can result in death. On Thursday, a week after increasing my dose to 1200 mg, I started to feel shaky, my vision was blurry, I had an extreme headache, I was nauseous, and I was dizzy. All signs of lithium toxicity. My husband and I debated going to the hospital, but I didn’t want to show up at the ER and there be nothing wrong with me. I decided to go to bed and if it got worse, then we would go to the hospital. I fell asleep and never went to the hospital. I woke up feeling a bit better, although I still had a massive headache and felt weak. I refused to take my morning dose of lithium until I spoke with the pharmacist. The pharmacist said it could be lithium toxicity and suggested I contact my doctor immediately.

Great, call the doctor who doesn’t give a fuck? I called anyway and spoke with his receptionist leaving a message for the psychiatrist. I was doubtful that he would return my call. Surprisingly, he called me back but to completely disregard my symptoms.

“These symptoms are not of lithium toxicity. They are side effects, maybe the Zoloft. But definitely not lithium toxicity.”

“So what should I do for my lithium dosage?”

“Keep it the same.”

“I’m feeling really poorly at 1200 mg.”

“But do you feel better emotionally?”

Begrudgingly I admitted that yes, I was feeling better emotionally.

“So why change?”

“Because physically I feel bad.”

“Fine, reduce to 900 mg.”

Click.

And he left me listening to the dial tone. While he deigned to return my call, I didn’t exactly feel much better because of it.

Why would anyone take this hellish medication that’s been around for ages? Because when you’re desperate, you’ll do anything to feel better. Because it has a track record of working, despite the side effects. Because what else do you do when a doctor tells you to take a medication?

So for now, I’m going to live with the metallic taste, forgetfulness, confusion, and other physical side effects because at least emotionally, I’m feeling okay.

When help feels like failure

On Monday I thought I was holding it together pretty well. I managed an excruciating hour and a half long meeting. I blew through my to-do list. I made an almost insignificant mistake at the office, which led to a moment where I may or may not have punched a wall at home. (That hurts, by the way, I don’t recommend it.)

So maybe holding it together is too strong of a word.

I didn’t visibly. as far as I’m aware, lash out at anyone at work. It wasn’t like last Thursday where I snapped at my boss and told her I was too busy to do whatever she was going to ask me to do next. And it wasn’t a lie. I was completely swamped. Drowning really. Except stupidity and pride kept me from asking for help. Asking for help is a sign of weakness (despite the incredible Nicole Lyons who said in her Psych Central blog says that it’s okay to ask for help).

But by Tuesday, I was fraying at the seams. My nerves were shot, my patience short, I couldn’t understand what I was trying to read let alone what I was trying to write, and I spent more time crying at my desk than doing actual work. I wanted to rip my skin off because it felt like there were ants crawling all over my body. My only coping mechanism was to run up and down the stairwell like a crazy person. Yet, I told no one. I kept my nose to the proverbial grindstone and kept plowing through.

Don't CallOn Tuesday I left my desk to go to yoga at lunch and when I got back there was a voicemail on my phone. Here’s a fun fact about me, I loathe speaking on the phone and seeing the voicemail light causes me actual anxiety. So, seeing the blinking red light of a voicemail on my phone after feeling relatively zen post-yoga was disconcerting. Now I could have gone my usual route, ignore the phone message for weeks but I was organizing an event and was hoping for more RSVPs (why don’t people like to RSVP by the way? In the digital age where invitations are sent via e-mail, I had to make cold calls to over 20 people who just didn’t respond. Whatever, this is another topic. But if you’re getting married or had a wedding and sent out invitations, you know what I’m talking about).

The message was from my HR disability manager. It’s not unusual for her to call me since I’m still on disability (a failure that I like to use to make myself feel like shit). My phone calls with her usually involve crying in some capacity, but I was totally unprepared for the flood that came through the gates.

“Hi Marisa, it’s C I’m just checking in to see how you’re doing?”

Unintelligible sobbing.

“Do you want to come to my office?”

More sobbing in agreement.

I went into the bathroom, wiped away the mascara smudges from my face, took a deep breath, and pulled myself together enough to make it across the street to her office without looking like someone had just run over my cat.

C and I have never really met in person although we’ve spoke on the phone numerous times as we worked out my disability. She’s small in stature and nothing like what I thought she would look like. She guided me into an empty conference room, there was a box of Kleenex on the desk – never a good sign.

She allowed me to sit wherever I wanted and taking a seat across from me before asking, “So what’s going on?”

“Everything is just so overwhelming,” I balled. “And I’m trying so hard to keep it together,” I hiccuped, unable to catch my breath. “I just don’t want people thinking that I’m this girl who is bilking the system. I want people to think that I’m dependable, I try working so hard, but it feels like it’s never enough.”

“Yes. I spoke with your boss and she expressed concern over your behaviour.”

“What behaviour? I’ve done everything she’s asked of me and more.”

“No, no she was concerned about your health. She didn’t think you were feeling well and obviously she was right.”

“The pace is just so untenable. I worked throughout the long-weekend, everything is an emergency, everything is urgent, and we never say no. How can anyone keep up with that?”

“Well maybe you’ll feel differently when you’re more stable,” she softly. “So you are supposed to see your psychiatrist on Wednesday?”

“Yes, but the situation has gotten so bad that my husband and I have considered going to the emergency room almost everday. He’s on suicide watch basically 24/7.”

This took her aback. Her reaction was visceral. She recoiled away from me. The situation went from this is a stressed out young woman who has a difficult disease and is not coping well into she’s a danger to have in the building. And she’s not entirely wrong. I’m a liability for a company right now. At work, I was googling how many lithium pills it would take to die. And it wasn’t because I was concerned about toxicity. I don’t mean to sound flip about suicide, but when it clouds your brain and it’s all you think of it almost becomes mundane. Or, at least it does for me.

“Well you should go to the ER,” she suggested.

“What’s the point of going to the ER these days? It’s not like they’ll admit me. There aren’t any beds. So we’ll just have spent a distressing four plus hour wait for nothing.”

“You’re right,” she admitted, sounding defeated. “So here’s what you’re going to do. You’re going to go home for the day, can you do that?”

“But I have so much left to do.”

“It doesn’t matter.”

“Ok,” I agreed weakly, uncertain of this bail on work plan that she had. I was organizing an event and had so many things that had to be done.

“And you’re not going to come back to work for the rest of the week until you see your psychiatrist. Once you see him, I think you should be back on full-time disability.”

Og Mandino

My stomach dropped. My worst fear. My husband and I had been debating it back and forth for a while now because he knew I wasn’t coping at work. But, here it was laid out in front of me. I’m unfit to do my job. I’m unfit to be in the office. I’m unfit and unable. Two things I never wanted to be called.

This setback is a massive failure to me. I thought I could do it all, just the way I did before I got sick but I rushed it because I didn’t want to seem like that girl milking disability. I didn’t want to see them hire a temporary replacement for me. I didn’t want to know there was someone else sitting at my computer, moving my icons and changing my settings. I didn’t want there to be someone who was potentially better at my job than I am and they regret hiring me.

These are the demons I must face as I go back onto disability. I try to remind myself to take it one day at a time and that I am not a failure. That I’m sick, not weak. But, it’s hard to think positively when my situation seems so desperate.

I have a mental illness and it sucks

I’m fucking mad.

I’m mad that I have to take pills everyday. I’m mad that they don’t work fast enough. I’m mad that they have side effects. I’m mad that they stop working. I’m mad that I currently can’t run because of my meds. I’m really fucking pissed that I feel like a burden to my husband, despite his reassurances that I’m not. I’m mad that he’s afraid to leave me alone. I’m even angrier that I’m afraid to be alone. I’m mad that it seems that my husband and I have a weekly conversation about whether or not we should go to the hospital. I’m mad at how mad I am. I’m mad that I can’t handle stress. I’m mad that I can’t stay up late. I’m mad that I spend what seems like half my life in doctors’ offices. And I’m mad that I’ve had so many blood tests in the past month that the nurse can’t find my veins anymore. It’s like I’m a fucking heroine addict with collapsed veins.

But do you know what I’m most angry at? I’m fucking pissed off that I have a mental illness.

This cat gets me.

This cat gets me.

I may have won the genetic lottery in some aspects of life, but inheriting a mental illness that runs in the family wasn’t my luckiest moment. I don’t know which side of the family I inherited this damn disease from, but both sides make a compelling argument. We’ve got alcoholics to the right and severe depressives to the left, and sometimes the two happen to meet. It’s like my DNA was destined to be fucked.

I know I’m not supposed to say these things publicly because you know, fighting stigma means presenting people with mental illness as happy, healthy, and smiling. Mental health organizations and advocates want to ensure that we appear nonthreatening, so no one really talks about how shitty it is to have a mental illness. Well, guess what? I’m pulling back the motherfucking curtain (and using as many swear words as possible. Does someone want to start a fuck count?).

I have bipolar disorder II and it really fucking sucks. And despite what some mental health advocates say, our mental illnesses do limit our lives.

Almost every major decision that I make is influenced by having bipolar disorder. For example, at 29 years old I have to weigh the consequences of going to a party and staying up late because this means taking my meds late. Taking my meds late means that I’ll be incapacitated by grogginess the next day and waste it in bed. Every time I have a social engagement, I have to ask myself, is it worth it? Instead of agreeing or disagreeing based on my schedule, I weigh the consequences to my mental health. This may seem like a ridiculous, insignificant aspect of life to be worried about. But do it for 10 years and then come back to me and tell me how insignificant it feels. I guarantee eventually you’ll want to just say, “Fuck it! I’m partying tonight who cares!” And then you’ll feel like shit the next day, not because you’re hungover (because being bipolar means you shouldn’t really drink) but because you’re medication is slated to meant to sedate you. You’ll wish you were hungover because it will feel better than being groggy.

Sick person

Or how about this? My ability to manage stress is significantly lower than yours. I don’t know if this is standard across people with bipolar disorder, but it seems the more stressful the situation the more my disease rears its ugly head. This
sucks because I work in a fast-paced, high-stress job that I’ve just realized is not good for my disease. To make matters worse, I’m really good at what I do and I actually like it. A year ago I would have told you that this was my career and I would move up the corporate ladder. But now I’m floundering and debating quitting to work at a coffee shop. This weekend, I saw a job posting for a sales clerk in an odds and ends shop. The store was incredibly quiet and I thought – that would be the life! I know as soon as I can leave this corporate job, it’s the end. There’s no high powered, high paying job in my future. I feel deep in my soul that my life will be filled with part-time work that pays a minimum wage.

stressedSince I don’t manage stress, everything is so fucking overwhelming. I used to be a clean freak, now cleaning my house doesn’t even register on my radar because it’s too stressful. I’m so stress out that it’s a fucking miracle that I get out of bed. It’s a feat that I shower, dress, and put make up on. And guess what? It makes me so angry when I’m having a particularly hard day and someone says, “But look at how well you’re doing.” Well guess what? That’s because I slave away at showing you the put together, efficient, and intelligent professional that you think I am. I would love to show you the crying, angry, insecure mess that lives inside of me, but you don’t actually want to see that. Despite what you say.

When I’m home (never alone, obviously) it’s my husband who gets to see all of these nasty bits. My favourite thing to do right now is to rage cry. This is when I fly into a sudden fury and start throwing and slamming things around until I tire myself out and fall apart and start to cry. This rage is frightening. I’ve never felt anything like it before. On Friday, I flew off the handle in the  middle of the grocery store because I didn’t like the way our groceries had been bagged. The kid doing his job had used too many bags and not filled them with enough things, which made walking home with them impossible. I grabbed the bags and started flinging produce into the bag, screaming “this is how you bag fucking groceries. It’s not fucking rocket science.” (I would know, I worked in a grocery store for 2 years).

Luckily we weren’t in front of the poor kid, but I had completely lost myself inside the anger. This wave of anger was the first time I felt like I could potentially hurt someone else. As I slammed produce into bags, my husband asked if we should go home. He was worried. As a joke he said, “I’m afraid you might kill someone.” I shouted back at him, “Well if I killed someone they would probably deserve it for being so fucking stupid!”

Hurting myself is a regular thought of mine, but hurting someone else has never crossed my mind. And it terrified me.

depressionNormally the rage that lives inside of me is more self-directed. I was so angry this past weekend that I was seriously considering vaulting myself over the ledge of my 6th floor balcony because I just couldn’t take it anymore. I’m not being hyperbolic. I was weighing whether or not the distance from my 6th floor balcony to the ground was far enough to actually kill me, or just paralyze me. I don’t want to be fucking paralyzed and fuck up my husband’s life further than I already have.  I’m actually panicked by the impulsiveness of my rage that I might actually act on it. But suicidal thoughts aren’t new to me. It’s rare that I go one day without thinking about a way to die. Waiting for the metro, and all I think is how easy it would be just to step out and be gone. A cabby takes a left hand turn too quickly and I think, man wouldn’t it be great if he hit me and I died. I pass bodies of water I can’t help but think about drowning. I’m prepping vegetables for dinner and I think, man this knife just wouldn’t be sharp enough to slit my wrists.

This is the reality of my life. I am incredibly unstable right now, which is why everything is so extreme. So, no this isn’t the normal everyday life of a bipolar person, but it’s one part of what it’s like to have bipolar disorder. The hardest part of the disease is that stability is never a guarantee. Sometimes you bring it on yourself, and others it comes out of the blue.

But right now, I’m exhausted by trying to appear normal and pretending that living with my mental illness is no big fucking deal. So the next time you think about “how good I’m performing” or “how good I look” or “that I have a spring in my fucking step” remember that it’s all a performance, an act for your benefit.

The reality is, I have a mental illness and it really fucking sucks.


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