Saturday, December 30, 2017

Not Crazy

I work in a coffee shop in downtown Santa Cruz. We have many customers and passersby who are not well. My coworkers call these people “crazy.” And other things I won’t repeat. And it is painful.


They are not well. They have had rough lives. They have done too many drugs. They have mental illnesses. They’re actually really nice people if you can get past the paranoia and fuck-off front they put up.  I know. I did it today.

Her name was Laura. She came in with a formerly homeless man who bought her a cup of coffee. She was needy and loud. She asked for the bathroom code and I gave it to her. (My coworkers would not have done so.) Ten minutes later, she was still in there. I knocked and she yelled at me angrily. When she came out she approached the first person she saw, assuming they had knocked, and got in their face about it. They brushed it off, thankfully. I got her attention and told her that her coffee was ready and gave her ice water. She proceeded to ask for a cup of ice. She migrated outside, and then back in.

Several hours later, she was asking for the bathroom code again and my coworker was not giving it to her. He directed her to the register, where she bought another cup of coffee and got the code. About thirty minutes later, she was talking loudly to no one in particular, and a customer approached me asking that she be kicked out. Reluctantly, I found my supervisor and passed on the message. She employed another coworker to ask her to leave, who was, frustratingly, gleeful about his mission.

When I left work today, she was still wandering around the building. I smiled at her and said, “have a nice day,” and she smiled back and said, “you too.”

That is not crazy. I am kicking myself for not approaching her myself and seeing if I could quiet her down before it escalated to her being asked to leave. She wasn’t dangerous.

It frustrates me that our businesses cater to the well-minded. That an apparent mental illness makes one ill-suited  for quality customer service. No. We’re not social workers. I know that. But we’re humans. We all have our demons. Can’t we give each other a little grace?

Thursday, December 21, 2017

A "Therapist's" Prayer

I gave a presentation, or rather, facilitated a prayer, for one of my classes this last semester. Yes, I, Annie Williams, lead prayer. She who rarely prays (for myriad reasons), wrote out a “scripture prayer.” That is, I chose scripture, related it to our work as therapists, and wrote a prayer around it. I chose Psalm 13:

How long, O Lord? Will you forget me forever?
            How long will you hid your face from me?
How long must I wrestle with my thoughts
            and every day have sorrow in my heart?
            How long will my enemy triumph over me?
Look on me and answer, O Lord my God.
            Give light to my eyes, or I will sleep in death;
My enemy will say, “I have overcome him,”
            and my foes will rejoice when I fall.
But I trust in your unfailing love;
            my heart rejoices in your salvation.
I will sing to the Lord,
            for he has been good to me.

Then I explained myself: this is the natural progression of life. We suffer, we wonder where God is, we grow weary, etc. etc. BUT. There is a but. At some point, we are able to say verses 5-6 in earnest. It isn’t linear. Some people live 5-6 without experiencing 1-4 in depth. Some people circle 1-4 for decades.

So I wrote this prayer:

Dear Lord,
            We pray for our future clients and for ourselves. We pray this psalm for them and for us. We hold on to hope that in your goodness we will be able to proclaim verses 5-6 in earnest, and that our clients will be able to also.
            Help us be witnesses to that reality: that you have been good to us, that you are good to us, and that you will continue to be good to us, and that there is hope even when we have every day sorrow in our hearts.
            Help us be patient with you, our clients, ourselves, and with illness.
            Help us remember that it is all in your timing and your plan, not ours. We are nothing without you.
            We thank you for the opportunity to walk the various roads we will travel with others.
In your name we pray,

And that’s about as close as I get to proclaiming 5-6 myself.

Sunday, December 17, 2017

Multiple Personalities of Bipolar II

I feel like there are multiple me’s. A depressed me. A hypomanic me. An euthymic me. A mixed state me. An anxious me. An agitated me. A suicidal me. I behave badly in most of these states. The euthymic me is the safest. It’s where I am now. But it is constantly threatened by the possible presence of the other me’s. Well. No. Now I am anxious me and the energetic me. I am paranoid that January will lead down the yellow brick road to hospitalization.

It’s quite simple: I get more energy, I work and go to school, I work opening shifts (and school is like a closing shift), I feel powerful and alive, and then, suddenly, something shifts. The energy becomes agitation seemingly overnight. My skin is in the way. I can’t get far enough away from myself. I work harder. And somewhere along the way, dragging a razor across my skin seems like the proper solution for crawling skin. It creates a burst of relief (and a pang of guilt).

Soon no matter how hard I work, the agitation prevails, and then my energy begins to peter. Soon, I just feel like shit. Soon, the energy not only peters down to “normal,” it dips to a depressed level. I become sluggish and unmotivated and utterly unhappy. Not that I need to be happy, per se, but this is a far cry from even reasonably content. Quicker than you can say antidepressant, I am a danger to myself and all I can think about is a way out.

That’s how I wind up in the hospital. I go through all those versions of me, starting with an energetic me and ending with a suicidal me. I morph from one to the next seemingly overnight. There never seems to be time to seek medical intervention. It’s fast; it’s scary; it’s bipolar II.

Friday, December 15, 2017

Proceed with Caution

I’ve written on it before, hypomania. But I can’t ever seem to nail it down. It’s just so different each time. What I’m realizing now though, is that, as written in a study on Interpersonal Social Rhythm Therapy (IPSRT) and bipolar II, bipolar is as much a disorder of energy as it is a disorder of moods. Granted, I could be noticing an increase in energy because I just finished off three antibiotics. Perhaps. But I doubt it.

This week, I have gone on three bike rides and walked the dog three times a day, with at least one walk lasting over an hour, sometimes two. I have . . . ENERGY!! It’s fabulous. I hadn’t ridden in months. The dog is getting her exercise. I’m socializing. I’m reading. I can focus.

None of these are bad things. None of these are dangerous or reckless. They’re antennas-up signs, though. At times like this I ask myself, am I sleeping? Yes. Phew. One danger averted. Am I being loose with my money? Nope. Two dangers averted. Am I agitated? Nah. Three dangers averted. So far, this is a safe energy.

My therapist said the hope is, someday, that’s what this will be for me: “oh, I have more energy, how nice,” or “oh, bummer, less energy,” instead of it being an anxiety inducing phenomenon. The hope is someday more energy doesn’t mean a full blown episode is pending, but rather, it means I clean the house or do something productive.

For now, though, I’ll be cautious. More energy? Nice, yes, but, proceed with caution.

Saturday, November 4, 2017

A Note to Myself

Between July 2016 and June 2017 I was hospitalized four times. We’ve been over this. The anxiety was crushing, the depression debilitating, and the agitation dangerous. Two of the hospitalizations failed to thoroughly treat the symptoms, so I returned shortly after discharge. In retrospect, I can see warning signs that built over time and contributed to the necessity of the hospitalizations.
Before the first stay, I was clearly hypomanic and agitated. I took on too many projects and failed to recognize my hypomania for what it was: I thought it was anxiety. My second stay and first stay were only separated by ten days. But there had been too many med changes to keep track of in that first hospitalization, so when I began to crash and the agitation returned with vengeance, we had no idea what was working and what wasn't working.
I stayed remarkably healthy for the eight months following my second stay. I had one mild hypomanic episode and some mild depression that was curtailed by a medication increase. But then school ended. And I began to work four days a week, closing once or twice. Educational tidbit: social rhythms are incredibly important for those with bipolar. That means shift work is not ideal. That means Annie feeling more energetic April 2017 and having more time on her hands and taking on closing shifts is asking for trouble, because that means getting off work at 11pm or 12am one to two nights a week. And then the energy leaves and the agitation remains and the soul sucking depression takes over. And then what? What could I have done to stop it? Nothing. It moved so quickly. There wasn’t time to call the psychiatrist and for the psychiatrist to send in new prescriptions and the pharmacy to fill them and me to take them and changes to be effected.
And similarly, after my third hospitalization, I was only out two days before the depression came back strong enough to steal my words. I sat mute in therapy and in the psychiatrist’s office. Maybe if I had the words, I would have said, “help.” And maybe we could’ve made some changes to reverse the depression, but I couldn’t speak. And before I knew it I was back in the hospital.

So what have we learned? Honor your social rhythms (don’t close at work). Watch out for energy: don’t feed it; try to ride it out with grace and gratitude. Beware of the agitated depression. Speak. Or write. Well, try to, anyway.

Friday, October 27, 2017

More from Anxiety

            Anxiety speaks. Quietly. Loudly. Quickly. It says, “ you will get sick again.” It says, “December will be dangerous, but April will be near if not fatal.” And there’s nothing you can do about it. Yet it insists that I worry. Because perhaps if I am prepared—if I worry enough—I won’t be hit as hard when the mood changes. Maybe, if I’m on the outlook—if I’m paranoid—I’ll note the subtle changes and seek help early enough to stay out of the hospital.
            And then anxiety laughs. You can’t be prepared. “It’ll come faster than the speed of light and cut you down,” it says. When depression comes you loose control—you know that. Your “supranormal” lifestyle becomes depression led and directed. All you know is sleep and solitude and suicidality.

            “It’s bound to happen,” says anxiety. Bipolar ebbs and flows and turns your world upside down; it isn’t cured. “It’s coming,” anxiety says, “just wait.”

Thursday, October 26, 2017

Bipolar's (and Anxiety's) Response to My Request

I wrote my bipolar a letter. I begged it to let me be. It seems to be listening. It’s been four months since the last hospitalization. It feels longer. It’s been three months since drug-induced hypomania. It’s only been two months without cutting. It feels much, much longer. And I am thankful.
            But I am also fearful. So long as I’m busy, I’m safer. And, as shown in a research article I recently read, I am also safer if I live a “supranormal” life: go to bed at the same time every night, wake up at the same time every morning, keep a routine schedule of work and play and healthy interpersonal relationships. I know this. But I can’t do it.
            Life is unpredictable. Well. Rather, even when life is predictable, big changes and all, my biological reaction to each change is a crap shoot. I can know a change is coming, but I can’t know if a depressive episode will come crawling out of, say, school ending.

            I have plans. I hope to start practicum next fall. I’m en route to being eligible for it. But there is a sneaking suspicion that I will be blind-sided by an episode the moment I get too comfortable and hope a little too fervently.

Saturday, September 2, 2017

A Letter to my own Disease

Dear Bipolar II,

STOP. Enough. I’m exhausted. Let me get on with life.

In the last fourteen months, I’ve spent too many days, weeks, months depressed beyond recognition. I’ve spent weeks hypomanic, dangerously hypomanic. There have been weeks where I was more drug than person. Days where I cut violently: with X-Acto razors, with shaving razors, with broken plastic.  There have been too many sleepless or sleep deprived nights. I’ve taken too many medications. I’ve hurt myself and others. I’ve caused worry. I’ve wasted money.

And I’ve changed. You took a not-quite-innocent but not yet victim to severe, reckless, relentless self-damage of various types young woman and hurt her, badly. As my therapist would say, it’s not a tragedy; it’s a bummer. And it is a bummer. I’ve changed because of you.

Please. Enough. Leave me alone. Let me live. Let me breathe. Let me be without paralyzing fear of your coming, the behavior’s you’ll encourage, the damage you’ll do, the mess you’ll leave.

Please. I beg you. Go.

And don’t return.

Sunday, August 20, 2017

Not a "Cheery Disposition"

Is it just me, or are some of us just blessed with unexhausted-looking-faces? Un-anything-looking-faces? What was God thinking? Is it a product of the fall? Really! Humor me. I usually appear pretty alert. This is unfortunate. Pity me . . . boohoo. This means, when I’m too exhausted to be the preppy, “bubbly introvert” of a barista I’m supposed to be, all the customers and my coworkers see is a bitter barista’s—excuse my language—bitch-face.
A coworker today bemoaned how exhausted she was and then asked if she look it. “Well, no, I mean, you look a little out of it, but not a train wreck. You don’t look how you’re describing the way you feel.” I wanted to ask her the same question of myself.
I’m EXHAUSTED. But I knew the answer. I simply have a complexion that hides a multitude of sins. Occasionally people will notice that I’m depressed as fuck or exhausted or strung out on meds, but not usually. But take my word for it. I’m EXHAUSTED. I’m foggy. I’m confused. I’m slow. I’m blurred out on Abilify and Lithium, and a few others at inconsequential doses. Nothing wakes me up. Even the sting of getting a tattoo wasn’t enough to jolt me out of my viscous state.
I have worked up until the day before being admitted for hospitalization. Smiling. Pouring hearts on cappuccinos and wannabe rosettas on lattes. Ringing up orders with spring and positivity and patience. And I skip my merry way off to the hospital less than twenty-four hours later. I am a fantastic liar. But completely by accident. My demeanor on auto-pilot is somewhere between seriousness and welcoming while at work. But it is never one to elicit concern. I smile, I laugh, I joke with the customers. At home I remain neutral. At school, serious. With friends, I mirror them.

It is so confusing. I don’t want to be a puppet or a liar or a fake. But, depressed or exhausted or anxious as I may be, it is not appropriate to show up to work and not try to pretend to care for the customers. And what makes them feel cared for? Prompt service, excellent product, a smile.

Saturday, August 12, 2017


“Someday,” says the living part of me, “someday, I want to write a book.” The living part of me is very small right now. Nearly invisible. It’s battering around in my chest, banging fists, stomping feet, screaming for mercy. Yet it’s muted. I can only feel living-Annie. Her words are slammed into the ground by the gravity of depression. She’s hurting. That much I can tell. Every time she thinks about that theoretical book or the someday being a therapist, the pain increases. I can’t tell if she thrashes in hopes to free herself from the pain or to end the pain by bringing an end to herself. Lately I’ve favored the latter interpretation. Reality? Who knows. I don’t believe she can ever be free from the pain She must learn to coexist. She must learn to occupy space with the fire. But how? At this stage I feel I am more pain than life.

Sunday, July 30, 2017

Five-Star Sinner

“Dear God,
Forgive me, for I have sinned.”

Just kidding. I don’t care. After four stints at Good Sam in twelve months, around sixty days total, for very serious suicidal ideation, my trespasses seem trivial. Even though a sin is a sin.

Yet, I wonder, is a sin a sin if committed in the midst of hypomania? If the search for belonging driven by a less than present mind causes me to act in ways with which the church disagrees? Or, more importantly, with which God (supposedly) disagrees? Is that still evil? Am I that much more evil because of my illness?

Sometimes I act without my frontal lobe. It quite simply turns off. It turns back on, eventually; I return to reality and think, “fuck, what have I done? I’m going straight to hell, aren’t I?”

I’m a five-star sinner, always, but especially when ill.

My Catholic and Protestant friends have reassured me I am not, after all, going to hell.

So now what? Well, I wandered into Mass today and found myself praying a prayer for a dear friend and a prayer for myself. No, I didn’t ask for forgiveness. I’m not ready for that. I asked for help.

Thursday, June 29, 2017

The Hospital, The Real World, Determination, and Hope, Perhaps

            Four hospitalizations in twelve months = high risk. However, I had a remarkable eight month stretch of (mostly) health, of positive coping. I started a Masters’ of Marriage and Family Therapy program and completed the three classes I took with high marks. The highest grades I’ve ever earned, actually. That’s got to count for something . . . sure, I had episodes of depression and hypomania, but I managed.
            But then I crashed. After spring semester ended, I became agitated and anxious and soon enough, depressed. I spent twelve days at Good Samaritan Hospital/Mission Oaks inpatient unit in May. I came out irate with God and disgusted with myself. I had cut deeply enough to require stitches. Two weeks later, I was back. But the fourth hospitalization was actually encouraging. I didn’t come out angry at myself or angry at God/the universe. I came out determined. Determined to live life in a way that my commitment to and love for people and life would be louder than the voices of depression, anxiety, self-harm, doubt, and agitation. Determined, that is, not to go back to the hospital. Determined, as Leslie RN said, to trust G/god/the universe, love people, and show up. Determined to reach out, as Tracy RN suggested, and to put a person between the emotion and the action. Determined, as Shery RN pointed out that I need to, to figure out how to honor my soul and what it needs, to not medicate away its needs.
            I also came out terrified. You see, after a total of 58 days in the hospital, I knew the nurses and they knew me. The inpatient psychiatrist, who has a habit of saying provocative (and irritating) things, had even become someone I was grateful to see. They were my support group during the eighteen day June hospitalization. Tracy RN, Shery RN, Christine B RN, Christine C RN, Leslie RN, Laura LPT, Dr. Hirsch MD. They asked hard questions. They listened. They paid attention. They shared what they observed. They encouraged me to go to the Trying to Say “God” conference. To keep writing.
            I was desperately lonely the day after I was discharged. And heartbroken. Will I ever see them again? Probably not. Dr. Hirsch was right: the hospital is a safe place for me. I am immediately surrounded by people I can trust. The real world isn’t like that. Mine isn’t, anyway. And in that discrepancy lies my challenge: to create a world in which I can reach out and find not just a soft place to land, but support. People who will say things that make me think. People who will respond rather than react when I’m feeling out of control. Who will say, let’s get a beer or a coffee or go on a walk, when I say that I feel like hurting myself, rather than threatening or shoulding me or carting me off to the hospital right away.
            Because those thoughts won’t ever be washed away, no matter how much ketamine and naltrexone and lithium I take. My brain is melancholic by nature, and we live in a sad, frightening, dark world. The ketamine will space me out for an hour, and it will perk me up once the dissociative side-effects have worn off, but it won’t stop my mind from spinning lies of my worthlessness when the county mental health supervisor talks down to me. The naltrexone will slow the agitation and compulsiveness that leads to self-harm, but it won’t erase the desires completely. The lithium will, to an extent, curb the extremes of my mood swings; I shouldn’t become violently hypomanic while on it. But it’s not magic. Brain and body chemistry are powerful.
            That is what I have learned from my last eighteen days in the hospital and four days with Sick Pilgrims at a writers’/literary conference: I need people. Yeah, after twenty-six-odd years on this planet, you’d think I’d know that, but I’m a slow learner. I don’t need the county’s 24-7 support. I need to learn to pick up the phone and make a phone call when in crisis. No. Before crisis. I need to make people a part of my life when I’m semi-stable. Because mental health is fragile. And I’ll have better luck staying out of the hospital if I reach out when I am well AND when I am not, than if I wait, as I am wont to do, until I have been suicidal for days.

            So, thank you, readers. Simply by reading, you are being a support. By dipping your pinky toe into the mosquito-infested swamp of mental illness, by interacting with me, you are offering me a hand. And for that, I am grateful.

Thursday, May 25, 2017


I wrote my therapist a letter several days ago of an epiphany I had. I invited her to tell me it’s bullshit. She didn’t. Here’s what I wrote:

I’ve had an epiphany. It’s probably bullshit, but that’s for you to tell me, that I’m out of my damn mind. (I know I am, but sometimes it takes an outside opinion to drive home the point.)

I would like to be “reasonably content.” Not “happy.” “Happy” is a character in Snow White, not a state of being that lasts any mentionable amount of time. I know, with an attitude like this I’ll make a great therapist. But. I dropped my class, so, I’m not MFT bound at this moment. Anyway. Maybe, what I need to do, is be content with a life tinged with depression. I don’t seem to have much of a choice in the matter. Depression comes. And makes a fucking mess. And I’m assuming the mess is as bad as it is because I fight it as hard as I do.

If I could learn to live with depression, instead of against it, I wouldn’t need to be stable to go to school or work. I could do school and work depressed, stable, or hypomanic. Hell, if I could do that, I wouldn’t even need meds.

Really, though. What good is all my anger doing me? I’m mad at what I’ve lost with this episode of depression, but as mad as I am, nothing’s coming back. I dropped both classes. I think the Cymbalta is making me queasy. I’m isolating. Every time I try to text someone I stop myself. I won’t even call the psychiatrist. (But, apparently, I’ll email you and an old professor.) So I’m lonely. 

My epiphany is seeming stupider by the moment. I’m too passively angry at depression to accept it. I’m too tired to actively fight it.

What did my therapist have to say about my epiphany? She encouraged me to accept the depression, as I proposed, and let go of the meta-feelings. I get stuck in fear about where depression will take me and anger about time lost to hospitalizations and more fear about how the future will be effected . . . all the while feeling very depressed. That’s too many feelings. Heavy feelings. Depression alone is more than enough to carry.

So when I start awake from nightmares of returning to the hospital, I will reassure myself, “yes, Annie, you are depressed. No, you don’t need to go to the hospital right now. You’re safe at home, where you belong,” rather than inviting an anxiety attack of questioning what the next twenty-four hours may bring.

Wednesday, May 17, 2017

Admonition to be “Strong” in Good Sam

            Breathe. Be strong. And move on. This will pass, and then next time it comes around you’ll be more ready and stronger and you’ll handle it just like that, like a Real woman. You won’t cut or cry; you won’t get depressed or anxious; you won’t need help; you won’t have to put your life on hold; you’ll just keep walking and breathing and being. And that’ll be enough.
            No, you don’t need any more Ativan. You’re stronger than your anxiety. You’ll survive. No, you don’t need tea, not even chocolate; just have some water. Don’t go looking for things to use to cut; that’s your weakness of mind. Besides, they’ll never let you out if you don’t stop.  The only purposes of cutting are 1. endorphins (which are not found by cutting with a plastic spoon) 2. suicide (which can’t happen here). So knock it off.
            Stop relying on other addiction-prone substances to stave off the agitation and thereby the cutting. If you abuse coffee and wine, you will lose them. Just. Don’t. Cut. Let the agitation fuel your life. There is much to be done and none of it will get done if you rely on your pathetic level of energy.
            No, don’t lie down. Don’t try to “sleep off” the feeling. Feel it and be stronger for it. Don’t break the window, either. There are better uses of agitation.

            That’s better. Let those tears dry. No need to cry over a few haywire emotions. It’s all temporary. You’ll be fine, just as long as you’re strong.

Friday, March 24, 2017

"Unholy ghost,/you are certain to come again."

            Reading about hurt and suffering caused by addiction, mental illness, or physical illness, the hurt that radiates out into the family and support community, is heartbreaking. I don’t want to be that person whose condition affects those around her. It is why I try so hard to keep my pain to myself. But it doesn’t work, because eventually the pain gets so bad, so big, that even someone with a high pain tolerance breaks. By then the pain is so much it inundates surrounding lives, like a flash flood. The extent of the suffering is hidden until I am en route to the hospital. Or, if it weren’t for the little outlets I have, until death. Suicide. Which is it’s own kind of inundation.
            The guilt for being the reason my parents, siblings, friends, therapists, and doctors suffer is unavoidable. Sure. They want to be there. But don’t tell me they want to hurt. That’s bullshit. We all want some color of clean. Depression is not clean.
            I don’t want people to suffer with me for as long as I suffer. There is enough suffering in the world without my contributions. But I can’t help it. The pain comes and stays:

“Having it Out with Melancholy”
Jane Kenyon

            . . .
            8  Credo

            Pharmaceutical wonders are at work
            but I believe only in this moment
             of well-being. Unholy ghost,
            you are certain to come again.

            Coarse, mean, you’ll put your feet
            on the coffee table, lean back,
            and turn me into someone who can’t
            take the trouble to speak; someone
            who can’t sleep, or who does nothing
            but sleep; can’t read, or call
            for an appointment for help.

            There is nothing I can do
            against your coming.
            When I awake, I am still with thee.
            . . .

Saturday, March 18, 2017

Identity Crisis

I don’t know what I am, sometimes. I don’t feel hypomanic anymore. I’m not depressed. But I’m not “normal” either. Nor would I call this state “stable.” Perhaps “unstable” is as precise as words come. “Volatile,” maybe? Who knows.

Bipolar moods are best judged in retrospect. “Ah, I was clearly depressed.” Or, “oh yeah, hypomanic as hell.” Or, “hmm, pretty stable for that stretch.” In the midst of the moods I just do things: buy a $2,000 computer; sleep 12 hours, get up for two hours, drink some coffee, then nap for three hours; splurge $50 on books that just “look good”; question with vehemence the necessity of meds; start walking five miles a day as if it were requisite; struggle to recognize and control compulsive behaviors; go mute; hide . . . the moods are forms of madness.

But none of this musing has answered my original query: what am I? Black with white stripes or white with black stripes? Or monochromatic? Oh wait, don’t tell me: bipolar.

Monday, March 6, 2017

Undrugged (or, Wishful Thinking)

What a wonderful thing it would be to be off drugs. Completely. To not have to worry about missing doses or taking them with sufficient calories or filling the prescriptions or whether insurance will cover enough of the cost or traveling with them or . . . or becoming a parent . . . What if I wanted to have kids? I’d have to wean off before trying to get pregnant and then pray like hell that I don’t relapse, that I don’t completely fall apart. And I have always wanted kids.

These drugs have stitched my life back together over the years. With each new tear, a new drug. What would happen if I carefully titrated off? Would the seams begin to rip anew? Can I function unmedicated? I want to know. I want to be normal. Healthy. “Well” is never enough. I want undrugged. I want superb.

Thursday, February 16, 2017

Pharmaceutical Wonders

Medication. It’s real. It works miracles. Let me tell you about mine.

First, some history:

I started on Celexa. An anti-depressant. It didn’t do anything. So Dr. Bunger put me on Lamictal, also known as lamotrigine. An anticonvulsant. It was designed for seizure disorders, but it works for bipolar, sometimes. This time was a sometime. It worked. Not miracles, yet. For some reason, Effexor was added, which I would come to affectionately call “efuckser,” for its side effects. I hated it. 

The doc in Michigan, Dr. Fox, added Seroquel, which I abused for its sedative effects: don’t want to deal with the world? Take a Seroquel! You’ll sleep through the thick of depression! Problem solved! Right. Eventually I threw it out, realizing what a monster I was creating. 

The real monster came in 2014, when I had stopped seeing my psychiatrist and became suicidal. I wound up at Telecare, Santa Cruz’s version of inpatient (a joke), where they sent me on my cheerful way with instructions to get an appointment with a psychiatrist. I did. And the brilliant Dr. Gilbert put me on Lithium. Lithium turned things around. Not completely, but this mood stabilizer made a marked difference. I became depressed again that fall, so he added Prozac, the old-fashioned anti-depressant, and it worked. 

I had the magic combo: Lithium, Lamictal, and Prozac. Until July 2016. I was on those three and Adderall (I had taken to falling asleep in the middle of the day—probably a side effect of Lithium), but I was not well. I was in the hospital. I came out of the hospital on seven or eight medications. Which, I do not recall. It doesn’t really matter; they didn’t work. I went back ten days later for more. So they cut down on the list and jacked up the dosage. I was up to 500 mg Seroquel, an anti-psychotic (I slept, a lot), Klonopin three or four times a day, lots of Lithium, and God knows what else. I swear the Seroquel damaged my memory. That brings us to hoy dia. Today.

But, why, before we go there, am I even sharing? What works for me probably won’t work for you or your loved one. Because it’s real. That’s why. I go to the pharmacy, three to four times a month, where I know the techs’ names, and take the stupid pills, in hopes to see one more stable day, and I want to make it clear that stable days are possible, the drugs are real, and both are necessary.

Lamotrigine: Still, I take 400mg of this sucker. It saved me the first time through, and the psychiatrists I have seen have all seen value in keeping it in my pill pile.

Lithium: The dose and specific version have varied, but currently, 900mg. I take it all at night because it makes me sleepy. Lithium is a tried and true combatant in the struggle with bipolar.

Prozac: Just for fun. 10mg. I really don’t know why I’m on such an inconsequential dose of it, but I am, and I trust my psychiatrist.

Latuda: I know, what a name. Everyone laughs. Go ahead. 100mg. It’s a new-fangled mood-stablizer that costs an ungodly amount ($1500+), thank heaven for MediCal. The website advertises it for bipolar depression, which is the part of bipolar that makes my existence miserable. Latuda is the most recent miracle in my life. It knocks me out, so I take it with dinner, and an hour later, am in bed. Shut up, I can go to bed at 7:30 if I want to. (Clearly, I’m still working out the side-effects and kinks of this one.)

There you have it. I take three mood-stabilizers and (barely) an anti-depressant. And I’m six months mostly stable. Meds. Try ‘em. They can help. 

Friday, January 6, 2017

Heart of Darkness

Heart of Darkness. The coffee, not the book. I love it. It is described as a “Dark french roast, full body, earthy-tangy.” I am not so hip as to like light roasts. In fact, I think they’re, for the main part, gross. But I love Heart of Darkness. And I love the name. And I find it all too fitting that I do.

I see my own heart as quite dark, shriveled and grinch-like. My heart is one of darkness. I am not one to overflow with positivity or cheer. I don’t smile enough. At work, my register performance is what requires improvement. I don’t “engage.”

We just had family in town for about two weeks. A long time. I got next to nothing done. I love my family. My niece and nephew, tantrums taken into account, are delightful. We tease each other, quote Robin Hood and Peter Pan, and laugh—a lot.

Perhaps my heart isn’t so dark, then, if I can love my family in all its dysfunction. Perhaps its darkness is in how it perceives the body which houses it and the mind with which it works. It is a dark lens, too, through which my heart views itself.

I dislike people. I want them to go away. I wish they talked less. I dislike it when they have an affinity for me, because I can’t comprehend why. When I am depressed I wish they would let me die, instead of dragging me through thorns, drowning me in encouragement I don’t hear, and insisting that I speak. And I dislike myself for simultaneously liking and respecting them and hating them. They make me live, which I resent, but I respect them too much to take action otherwise.

My heart is fragmented, then. Dark, but in pieces between which a little light shines in allowing me to try to love the people who somehow do manage to alleviate my pain.

“Of Darkness.” Coming from darkness. Perhaps it is true. My heart is of darkness. But, dare I say it—God help me, it isn’t where it is headed. My heart may never be a light roast like Zoom Brew—and that’s okay with me—but perhaps it’ll see a medium state, like Beethoven’s Blend, dark and medium and light all mixed together, leveling itself out with it’s depressions, stability, and hypomania.