Adding a New Medication

I saw my prescribing nurse practitioner, and she’s added a mood stabilizer to my regimen of medication. It’s called lamotrigine. I don’t know what the non-generic name is. It seems that the past two times I’ve seen her I’ve been manic. It’s a concern, because I make rash decisions when I’m manic. I can’t think things through in a calm way. I rush headlong into projects and take on more than I can handle.

I noticed that I’ve spent a lot of money buying books on Amazon lately. It’s money that I shouldn’t have spent that way, but it’s done now. Spending sprees is an unfortunate symptom of bipolar disorder. The upside is I have a lot to entertain myself with for quite some time.

I continue to be surprised at the way readers discover this little blog. Most people find it through Google searches, and the one search I see often is a bipolar sufferer’s inability to watch television. I am amazed that this symptom is not talked about by researchers.

I can’t watch television, and it seems I’m far from alone. I’m allergic to it. When I try to sit down and relax in front of the TV, I last for five minutes at most. I start to squirm during those minutes, too. If I manage to keep the TV set on, then I start to pace around the room. Finally, I’ll end up turning it off.

Many people I’ve explained this to laugh and say I’m better off for it, but they’re missing the point. I can’t watch TV. It’s physically impossible. My mind won’t be still. The racing thoughts come like an itch at the back of my head that spreads like ants making me jittery. I miss out on shows that I would honestly like to see. Many of my friends watched “Downton Abbey” regularly, and I wanted to join. My brain won’t let me. Their discussions about characters and plot twists are lost on me. It’s a real loss.

I have trouble reading, too. I can only do it in short spurts. Gone are the days when I could sit and lavishly lose myself for hours in the pages of great writing. I complained about that for years to my psychiatrist and then to the nurse practitioner. Nothing seems to help. I’ll just have to take my time working my way through the stack of books from Amazon.

I almost forgot to mention I’ve had two panic attacks in the past month. What joy!

Keeping busy

If there’s one thing that helps this bipolar person, it is keeping busy. I stay out of my head and stay in the here and now. I’ve been trying to keep busy the past several weeks since I wrote last.

My visit to my prescribing psychiatric nurse practitioner went well, and she gave me some samples of a new medication to add just for the time being, just until the mania passes. It’s called Geodon. I took it for a while many years ago, and it had some serious side-effects. One of them was drowsiness. I couldn’t stay awake. I’m glad to say I’m not having that reaction this time around. I do have to take it with food, though, since it gives me a bit of indigestion otherwise. It is having one possible side-effect that I don’t like, and I’ll get to that later.

The nurse also increased one of the other medications I’m taking. It’s called Depakote, and it has a horrible side-effect of increasing a person’s appetite. There’s a lot of weight gain associated with it. I can tell you for a fact they’re not kidding. I swear I could eat nothing but grilled chicken breast for breakfast, lunch, and dinner, and I’d still gain weight. I hate it. My regular doctor hates it, and there’s nothing that can be done about it except stop taking it.

There’s my medication in a nutshell at the moment, but I promised to talk about one possible side-effect to the medication Geodon. It’s a sexual one, and it’s not pretty. While I can still get an erection, I can’t ejaculate, which is not only embarrassing, it’s downright painful. Thankfully, the Geodon is temporary, so the problem should be the same. If it’s not, all my health care advocates are going to hear about it loudly and strongly.

Keeping busy shouldn’t seem like a problem to a manic person. The difficulty lies in keeping busy doing things that will be healthy in all ways. I’ve spent some time hunting for sex. That’s a common occurrence during mania. This time I was sure to keep it safe and enjoyable, even if one attempt did end or not in the way it was supposed to. I spent time reading a play that I’m going to direct. It’s a Christmas play, and I’m very excited about directing for the first time. I’m relieved that it’s short and should be a lot of fun for all involved.

I’m also keeping busy with my kids’ busy schedules. It seems like they all have to be somewhere at the same time, but it’s a joy to help out. I’m very lucky to have people in my life who need help.

If you’re reading this and you think you have nothing to do, I can recommend what I do. I have volunteered at the library. They need help even if it’s just dusting the books. I read. I study about bipolar disorder online. I read other blogs written by people with the illness. I write to friends. I go to A.A. meetings, which may or may not be an issue for you. I meditate. I daydream.

But I try not to think too much. That’s never been helpful for me.

My View

I’ve just finished watching two hours of video on youTube.com about bipolar disorder. To be honest, I watched the first hour-long episode yesterday and the second today. The star was the famous British comedian Stephen Fry who has bipolar. (Here’s the link to the beginning portion: http://www.youtube.com/watch?v=gXkmb5s8Igc) Those of you who’ve followed this blog for some time know what an achievement it is for me to sit and watch a television show, even if it is on the computer. You can search the archives for “I can’t watch TV” to read about my troubles in that arena.

The show aired five years ago, but I believe many of its ideas still ring true for today. It was autobiographical in many respects, and Fry talked about his own troubled past, which included being expelled from school, incarceration, and suicide attempts. He was finally diagnosed bipolar at the age of 37. I was 38 when I was diagnosed.

In the two episodes, Fry interviewed many people with bipolar and their families, experts in the field, psychiatrists, and therapists. Fry also points out that he has never taken medication for the disease. He meets other people who do take medication, some who have and have stopped, and others who take it at times and go off it at other times, and some like himself haven’t taken it at all. He and the other people not taking medication readily admitted to terrible depressions and exhilarating manias. It was frightening for me to watch that part actually.

It’s difficult to conceive of the seduction of the manias when the black depressions always follow. The reasoning is that it might be different this time, and it never ever is. In the middle of the mania, logical thought flies out the window. As one of the therapists interviewed said, there are no troubles in the whole world to the manic bipolar person.

I’ve been stable for a number of years now and have had no serious delusions for some time. The reason is plain and simple. My medications work. They do not numb me. They do not take away my personality. They do not disarm me.

On the contrary, they enliven me. I feel like I can accomplish daily tasks. When I’m depressed, I can’t even manage to brush my own teeth. When I’m manic, there’s no end to the glory that I can dream up for myself. Medication tempers those extremes and gives me a framework to live inside. It’s a comfortable range of emotions. I do not feel the black despair, and I’m spared the teetering highs.

I do not for the life of me understand the reluctance many bipolar people have to medication. I cannot comprehend the delusion that so many harbor about the drugs taking away one’s personality when there is so much experience to the contrary. The medication available in 2011 is so far advanced from what it was just a decade ago. It is light-years ahead of what was available 30 to 50 years ago.

I live with bipolar. I take medication. I’m not numb to life. No, I’m living it.

Trusting Caregivers

I’m lucky to have people in my life who care about me. Some are friends, and some are professionals. I have not always been the best friend I could have been. It’s strange, but I’m almost more trusting of the professional caregivers in my life than the others. Do I give more weight to the fact that the professionals have credentials? I’m not sure of the answer to that.

When I was first diagnosed bipolar ten years ago, I was in a terrible state. I had an awful time of it for quite a few months, and I had one caseworker for that initial period who was a godsend. He helped me get the necessary paperwork filled out for medical help where I live. He listened to my concerns and fears and reassured me. He helped me obtain food assistance and other charities. He got me plugged into the system, and he got me help that I needed to live.

My current caseworker is also a hard worker who listens when I need to talk. He helps me keep my priorities straight about some of the mundane things in my life. He helps me order my life in such a way that I know what to take care of when. I listen to him. He looks out for me.

I know for sure that I treat my psychiatric prescribing nurse with respect, because she has a great deal of knowledge about the medicine that keeps me stable. I can’t imagine where I’d be without medication. I don’t take a lot of different things. I have in the past had to take many kinds of pills, but it’s narrowed down to four at present. The nurse is my doorkeeper to what is working and what’s not. I report to her what’s going on with me, and she evaluates it according to the criteria that she’s devoted long hours to studying.

I can’t talk about caregivers without talking about my therapist. I’ve been her patient since 1997. She’s guided me through coming to terms with my alcoholism, my homosexuality, and my mental illness. She’s helped me see my issues by allowing me the time to develop the ideas on my own. Over the years, she’s seen me laugh and cry, get angry and be calm, and a myriad other emotions. She’s been a rock when I’ve been desperately depressed. She’s been a help when I’ve been over the top with mania. She’s a close ally in all ways.

I have a few friends who know everything about me and stay close. Those friends I hold dear to my heart. Some are close at hand, and some are far away. I try to keep in touch with all of them as best I can. It’s more difficult to say how friends have affected me and my mental illness. They have often simply been present when I’ve needed an ear to hear whatever it is I have to say. Most importantly, the close ones give me nonjudgmental love. It’s like breathing. They are that important.

A Dream

I had an odd dream this morning just before I woke up. I was in a train that was going the wrong way. I decided to take matters into my own hands and took control of the train. I stopped it and started it going the right direction. However, my sight ahead on the tracks was limited to a tiny peephole in the front of the control room.

Sure enough, there was someone else on the same tracks that I couldn’t see, and we crashed. What was humorous was they were driving those long skinny cars used for what were called drag races when I was growing up.

If I had to guess what the dreams might mean, I’d say that I’d better make sure I have clear vision before I go my own way, or I might run into some surprises.

I saw my psychiatric prescribing nurse this week. She’s moved into a new office, and it was my first time there. We talked about the normal things like medication and such, and I brought up that I’m having some benign auditory hallucinations. I’m hearing chords of music. It’s nothing that makes any sense or has any meaning. It’s just descending scales of sound. It actually woke me up one night, and I had to go to the open window to make sure I wasn’t hearing something from a neighbor. I wasn’t. It was just me.

I take this to mean that I need to be diligent in my medication regimen. Like the dream, if I were to suddenly stop taking my medication, there would be some surprises.

I feel lucky to live in the time that I do. I’m glad that there is medication to help me with my mental illness.

Great News

No, I’m not cured of bipolar disorder. That’s not the great news. I’m happy to report that I got my annual HIV test results today, and I remain negative. That’s no small accomplishment for a gay man. You never know when something might have gone wrong. I am grateful that my higher power continues to grace me with such good health. I’m very lucky.

I know many who aren’t lucky. I have a very dear friend who needs a hip replacement due to arthritic deterioration, and I have another very, very close friend with breast cancer that spread from his breast to his spine and has now metastasized in his brain. The former friend is only 46, and the latter is only 66. One is battling a debilitating disease, and the other death.

While I was visiting with my doctor today, he paid me an unexpected compliment. He said, “You’re honest, and that’s very rare for me to see.” He described how most of the time he has to deal with murky disclosures or outright lies, and he’s constantly having to read between the lines of what his patients are saying. With me, he said he feels relaxed. He doesn’t have to second guess what I’m saying.

Being honest did not come naturally to me. I’ve been in therapy for 24 years, and I’ve worked the 12 steps of A.A. on a daily basis for 11 years, 11 months, and 4 days as of today. I would say that it’s a combination of those two things that has taught me honesty.

I hold nothing back from my doctor. When I went in to request the HIV test, I was honest with my worries. I hold nothing back from my psychiatric prescribing nurse either, nor the psychiatrist before her. They can only deal with the information that I give them, and if I lie, then I’m only hurting myself. I don’t lie to my therapist, caseworker, or my A.A. sponsor. Even in depression, I stay honest and report my suicidal thoughts.

Perhaps that’s the most important time for me to be honest, during depression. That is the time when I am least equipped to deal with my own issues, and I need the professionals in my life to guide me. I talk to so many people suffering from depression or bipolar disorder who innately distrust their physicians. I’m glad I have doctors and professionals that I feel are looking out for my best interests.

Don’t get me wrong. I’m not a pushover. I have declined changes in the doses of my medications in the past when I felt it was wrong. I have pushed to get other medications when I thought it was needed. Sometimes I’m right, and sometimes I’m not.

The important point is that I have built up a rapport based on honest interaction with my healthcare providers, and we complement each other.

Today, I’m breathing sweet air. I’m eating good food. I have a roof over my head, and so much more. All of that is great news.

Mania

I saw my case worker and my therapist today. That’s a lot for this bipolar person to handle. Whew. Two appointments in one day. Plus, I called and rescheduled an appointment for my regular doctor. I was busy, busy, busy.

My case worker is an excellent advocate and all around great guy. We had an in-depth discussion about some of my recent risky behavior. I made a commitment with him to call when I felt myself moving toward acting in unhealthy ways. We talked about my childhood and the–I hate to use the word but for lack of a better one I will–programming I endured. We talked about my medication. We talked about alcoholism and the twelve steps. It was a really good preliminary discussion to have before I went to see my psychologist.

My psychologist is even better. She is insightful and knows how to draw things out of me in helpful ways that I may not want to fully face. We started talking about some of the good things that happened during the holidays, but we cut quickly to the heart of why I was there. Her assessment of the situation was a bit different from my case worker’s. She thinks I’m in a manic phase, and to really get down to brass tacks, she pulled out her frayed copy of the DSM-IV. It lists six or seven symptoms a person has to exhibit to be considered manic. I have five of them: decreased need for sleep, talkativeness, racing thoughts, risky behavior, and spending sprees.

I’ve even experienced manic eating the past few days. I allowed myself to run out of chocolate. That’s right. For two days, there was no chocolate in the house! During that time, I found myself eating anything I could with sugar in it. I binged on cookies. Unfortunately, they were not chocolate chip. I even thought about eating sugar straight out of the bag. It was unbearable. I rectified the situation and bought chocolate yesterday, plain Hershey’s, and my blood pressure immediately came down. It only took a few bites to fix me. I didn’t even have to eat the whole bar. Still, the behavior to look at was the obsession over not having chocolate in the house.

In the attitude of a winner with bipolar, I practiced some affirmations with my therapist: I love and fully accept everything about myself, I am a snazzy dresser, I have people who love me deeply, I have a nice place to live, and I have in the past felt like a real winner over bipolar. I worded the last one in that way, because I have felt broken and despondent recently, but there have been times in the past when I have felt like a winner.

I had a lot to think about today, and I have a lot to talk to my prescribing nurse tomorrow.

Busy. Busy. Busy.

Just “ugh”

Mania. It’s a strange mixture of feelings of invincibility and depression. It’s euphoria mixed with self-loathinig for me. I woke up in the middle of the night again tonight. It’s a desperate desire to be normal added to a feeling that I never will be, which triggers self-hatred.

I was depressed. Desperately depressed, so the doctor reluctantly put me on a low dose of an antidepressant not wanting to trigger a manic episode. After 2 months, I can see he was right. I can’t go back to that blackness, but I’m on the edge of dangerous behavior. No, I’m not on the edge; I’m living dangerously.

I’m also having these unreasonable urges to go out and spend and spend and spend money which I do not have. I know that’s part of the disease, but where does this crap come from? Jeez!

I’m calling the doctor first thing in the morning, and I’m going to ask to go off the antidepressants or change them. I’m going to be open and honest as I have been in the past. I’m going to calmly advocate for myself as I have done in the past.

Sigh.

A damn shame

My psychiatrist is moving. He’s actually being transferred from one public clinic to another one in a town two hours away. I’ve been seeing this doctor for three and a half years. He knows me inside and out. I’ve built a solid relationship with him.

Now, I’m going to have to start all over again. His replacement is a nurse practitioner. That’s not the problem. The difficulty lies in dealing with somebody new. I’m going to have to build a new relationship, and that takes time and effort.

I’ve been feeling like quitting lately. Not life. Everything else. I want to cut myself off from all the hurt the world throws about. I have been seriously thinking of quitting the few clubs I belong to. I want to lie down and sleep. Just sleep.

Simultaneously, I’ve been putting out personal ads asking for men interested in long-term relationships. I’m tired of hurting, and instead, I want touch. I want intimacy, yet I desire isolation.

I am conflicted.

This too shall pass.

Helping Myself

There are some pretty simple ways that I take care of my own mental illness.

1. I take my medication daily as prescribed. You can read about that here.

2. I exercise. You can read here what I wrote about walking.

3. I keep my appointments with my psychiatrist and my therapist, and I tell them everything that is going on in my life.

4. I remain sober. I’ve written about the hell of my drinking days here. I plan to write more on the miracle of sobriety.

5. I try to eat wholesome food. This is probably where I fall short, because I think I live on peanut butter.

6. I share what I have learned. I don’t believe that it’s possible for me to remain happy and healthy without helping others. I do it by participating in a 12-step program, through this blog, and by being available to talk heart-to-heart with friends and others.

7. I stay active by reading, being with family and friends, watching educational TV, playing games, laughing, loving, etc.

8. I take care of myself and my apartment. I brush my teeth twice a day. Some days, that’s the only thing I can accomplish, but in my view, if I’ve done at least one nice thing for myself each day, then it is a successful day .

9. I meditate. I’m not a religious nut, but I believe that meditation helps me remain healthy and happy and useful. You can read my entry entitled “My Happy Place” for more on this subject.

10. When I get depressed, I remind myself that it is not a permanent condition. I tell myself that I will eventually feel better. And I say positive things to myself, even if I don’t believe them at the moment.