Get Help - Year One

A 1989 New Yorker cartoon by Danny Shanahan

It's been exactly one year since I started therapy and treatment for Bipolar Disorder.   I wish I had something profound to tell you about it, like my ship has been righted, but I don't.  The best I can say for one year in is that I have survived.  The year has been peppered with anxiety, fear, depression, suicidal thoughts, shame, disappointment, panic attacks, and every other emotional upheaval imaginable.  It's also proven to be a difficult year for my physical health.

I'm really struggling with putting into words the thoughts that are running through my head.  I'm not sure if I should talk about the minutia of day to day life or the effects and side effects of medications.  I'm not sure if I should talk about continuing symptoms, or if it's all been beat to death already in previous posts.

When I had my first few appointments with my therapist in July and August of last year, I was still coming down off a manic episode. It would be almost two months before I could see a psychiatrist and start medication as part of the treatment. By that time, I was swinging into the depths of depression, and so far I have not left the depressed state, though there have been ups and downs within it. The medication keeps the mania at bay, but nothing I've tried has managed to lift the gloom from my life.

This is what 9 months of trying to find the right medication looks like.

Everything is an experiment, particularly medication.  People keep telling me to be patient and to keep trying when it comes to medication, that finding the right cocktail takes time.  Time.  Everything takes time.  One thing that drives me crazy is that you start medications on small doses and work up to therapeutic levels.  You may not know for weeks or months if a medication is working, and by that time, you don't know if it's the medication that has made a change in your life or if you're just entering another up or down cycle.  When changing medications, you slowly decrease one while increasing another, furthering the confusion as to which med is doing what. 

My psychiatrist is making his best guesses on how to treat me based on my best guesses of how to describe my feelings and reactions to medications.  I don't have any way of knowing definitively if any of the medications are doing anything, and I feel completely unprepared to be judging their effects on me, thus I'm constantly afraid that I'm giving him the wrong information or the wrong impression as to how to treat me.

One of the first medications I started on was Lithium.  I went through the requisite blood tests in the first few weeks and everything seemed fine, but then as the dosage increased, I started to have tremors in my hands.  It was the weirdest thing.  I would be moving my hand to do something and it would just shoot off in a different direction.  At the same time, I also developed an incredible pain that felt like my heart was trying to beat its way out of my trachea.  That may or may not have been related to the Lithium, but my psychiatrist decided to end it at that point.  I couldn't tell that there was any appreciable improvement in my sense of well being, and with having the tremors in my hands, I was fine with stopping the Lithium.  From there we moved onto a cocktail of Prozac and Zyprexa, soon to be followed up with the addition of Klonopin and then later Prazosin.  

I took this picture outside of The Mental Health Center of Denver right before my first appointment.  

After finding that my body doesn't metabolize medications the way that most do (related post: Genetics and Meds), we're trying another path.  

Fast forward many months and many medication changes later and you'll find me today.  Still confused.  Still struggling.  I can say that I'm thankfully not in the place that I was in last May, June, and July, when I was manic and destroying my life.  I'm not in the place that I was in in August and September when every sound, thought, or action triggered a panic attack that would make my entire body seize up and make me feel like I was dying.  Thankfully I'm not suicidal.  I was trying to explain where I am to my new probation officer the other day, and the best I could come up with was feeling fatalistic.

I have been transferred to the mental health unit of probation which means I get to see my new PO more often.  I met my new PO for the first time this week, and thus had to give an account of what got me to where I am and the whole of the situation in dealing with my mental health as well as my new reality in my new life post the manic episode that so drastically changed my life.  I found myself getting emotional as I was telling her about what happened and how I'm coping.

I think it will ultimately be good to be in the mental health unit of probation because my PO will be directly interfacing with my therapist and psychiatrist, so I don't have to be the bridge in the middle.  My new PO also seemed to be very understanding and encouraging, telling me that perhaps though I had a good life in the past, a better life is waiting.  

 A wide angle mirror in the waiting room at the probation office

A wide angle mirror in the waiting room at the probation office

Perhaps one of the best things with probation is that I no longer have to pee in a cup once a week (related post: Ever had a Problem Peeing in a Cup?).  I now do an oral fluid test, which is far less anxiety inducing.  The funny thing is that I have Sjögrens Syndrome which means I have chronic dry mouth.  My body makes very little saliva, so it takes ages for the swab to collect a sample.  I can't win for losing.

I still feel completely apart from society.  When I have to venture out into the world for appointments (about the only reason I venture out) everything appears to be so haphazard, fast paced, disordered, and loud.  I look at people and wonder why they bother doing the things that they are doing.  I wonder why I bother to do the things that I am doing.  I feel as though nothing matters, that there is no future, and somehow that I will be dead soon, though not by my own hand, hopefully.

I have not managed to fully accept where I am in life.  I have not managed to release myself of the shame of my actions when I was manic.  I have not developed hope for the future.  I am simply existing, hour by hour and day by day.   If I've learned anything it's that dealing with a mental illness is the most difficult thing I've faced in my life.