It has been one week. Seven days out of commission--physically. Which I prefer to mentally. Strep throat was followed by my first migraine, which was inconveniently incapacitating.
Planned to go to see OFP and inform her of
A) questionably timed, and some might say questionably done (but luckily not disastrous) self-styled haircut
B) questionably timed (but ultimately satisfying) redoing of kitchen floor
C) feeling leery of having Spouse out of town when things have already been unsettled
But MOSTLY I wanted to tell her that after getting off the fluoxetine, my brain seems to be doing better, and that I don't feel that I am in the mood episode state of either Depression or hypomania. Still a bit tippy, but I'm not going to be hypercritical of the fact that I am prone to mood crap, because that is unlikely to disappear.
Nor am I likely to suddenly become an average, stereotypical... anything, I guess.
Temperamentally I am still likely to do things like cut my hair and redo the kitchen floor on impulse. So if you tell me that I need to stop engaging in spur-of-the-moment projects that appeal to me I will likely tell you where you can stuff it.
The problem is intensity, duration and timing--not the things themselves.
I reserve the right to give myself a perfectly dreadful haircut and then run immediately to a professional and have the results repaired.
I am well within my rights to take on cosmetic renovations to the house (particularly when the materials come at zero cost--having been stacked in my garage for eight years).
Part of this is who I am. Part of this is who I want to be. I don't want to (nor will I) value "common sense" above all else. Creativity, ingenuity, the spark of insight, brilliance in the true shining meaning of the word...
I will pledge not to engage in ill-advised projects that endanger myself or others. Things that will interfere with the structural integrity of the house.
I will consider your advice when you tell me that my project is too big to tackle, or that it is not the right time, or that I should get help. But I will not always listen. And that does not necessarily mean I am "symptomatic."
I am me.
Quite unfortunately, OFP got hung up on the floor. (Which I already told her I realized WAS symptomatic and I followed the episode with a call to Psych NP and got off the fluoxetine which was likely causing or contributing to cycling.)
Quite unfortunately, OFP talked about how my illness could be damaging to my children and that I needed to get myself together for their sake.
(I AM TRYING AS HARD AS I CAN TO GET MYSELF TOGETHER AND I THINK I AM MAKING PROGRESS IN THIS DIRECTION!!!! WHICH DOESN'T MEAN THAT I WILL ALWAYS BE TOGETHER--WHO IS?)
Quite unfortunately, I took this to mean that I was a terrible parent and that I must hide or lie about any times that my bipolar crap is being particularly crappy. Or that any time I dip into Depression or hypomania is COMPLETELY UNACCEPTABLE. Which is not what she meant.
I don't really know what she meant, because after I heard that I was a terrible parent (again, not what she said or meant) it was sort of a really big trigger and I spent the rest of the afternoon sobbing. And OFP decided that she should be fired.
I think her thought process was that if I wasn't motivated to take care of my illness for my sake (WHICH I AM, THANK YOU VERY MUCH), I should be motivated by thinking about how it affects my family.
But when I was focused entirely too much on my children--it was to my own detriment and not sustainable.
I have another meeting scheduled for next week--where the OFP will scramble to redeem herself. And hopefully I will be able to understand what the hell she is trying to tell me. It was the first time that I have felt WORSE after leaving her office. The first time that I have not felt that she was giving me goodish advice.
Last time I went to see her she told me that I should be gentle with myself and not be all judgy and just understand that it's going to take a while to dig myself out of the apathy/Depression.
This time it felt like I was getting beat up.
Happily, the effects don't seem to have lasted beyond yesterday. They faded with the crying hangover. (Some time perhaps I will have to get drunk so that I know what a real hangover feels like. Or perhaps not.)
300 mg lamotrigine
Trying to put everything back together. And for the moment this seems feasible. Not in the "I have energy today so I will try to do EVERYTHING" sort of way. But in the, "Hey, it isn't overwhelming to tackle a bit of ________ right now and then perhaps tomorrow tackle a bit of ________." Catching up incrementally in a sustainable way. I know. Doesn't sound much like me. We'll just try to make this last while we can.
And I'm also spending time realizing that I am not an air traffic controller or a rocket scientist. And that minor (or even major) mistakes that I make are likely not as big a deal as I make them out to be. If they were, I would have no friends, family, or coworkers left who would speak to me.
In a cruel twist of fate, just as it seems that I am starting to feel more competent mentally again... I get hit with strep throat. Feverish, headachey, painful-to-swallow, vomitous strep throat. I demanded a morphine drip, an I.V. and a head transplant STAT, but Spouse was not compliant with my requests.
Informed my boss that apparently all it takes to knock me out of my bipolar Depression is a case of strep throat that is slow to respond to penicillin. Not unresponsive, mind you, but I am impatient. An impatient patient. And I am also fairly tired of recorded voices thanking me for my patience because I quite frankly don't have any.
Thursday came down suddenly ill, Friday positive strep test, Saturday out sick from work, Sunday seemed to be getting better, but then a recurrence of fever, Monday now still getting better, no fever, knock wood.
I have greater mental clarity than I have felt in some time. The big picture kind of mental clarity. Feel able to interact with the wider world. And by wider world I mean people beyond the family who live with me and two unrelated friends. I have been dealing with other people, but haven't really felt ready to do so. And haven't felt that any of the interactions were more than superficial.
Which is hard to explain. Because it is all internal. How can "hello" be superficial or not. Whether it is rote. But it sounds the same.
I will not whine and say that I wish I had a physical disability. Because I don't. I think I just wish that bipolar--which is technically considered a disability-- were viewed differently.
I am afraid for the first time (in a way that I was not when I thought I was just Depressed) that my being bipolar-- my openness about bipolar-- will affect my future job prospects. And yet I don't/can't regret being open. And I don't think that I would not hire me because of my bipolar status. Any more than I would discount someone with limited mobility, or with a seizure disorder, or a hearing impairment, or...
Now I must go rest. Because the family voted and they say that is what I need to do now. I may need to start taking the advice of my thirteen year old. I was highly smart and right about everything at that age. Perhaps he has the same mystical powers.
lamotrigine 300mg (appointment to meet with psych NP this Friday)
I forgot I was going backwards in the alphabet so you'll just have to put up with the fact that there are two Ns surrounding M. And I will pretend that it doesn't bother me, although it is likely I will go back and fix it. In fact I'm going to do that right now... just a second.
Spouse was out of town for two nights. This does not sound like a disaster, and it really wasn't. But I was still really freaked out about it. I would make a terrible single parent. I am in complete awe of people who do this on a regular basis. Getting children fed and out the door is a herculean task when all other tasks also fall on you. (Perhaps if I had a spouse who regularly sabotaged everything I was trying to do, it would be a relief to fly solo.)
Sunday, I went over to a F/friend's house and started reflexively cleaning her kitchen while she was on the phone--because I had energy to do so, because I like it when I have a clean kitchen and I know that she does too, and because it was keeping me out of trouble. "This is keeping me from ripping up my kitchen floor," I explained when she told me quite sternly that I was to sit down and drink tea instead.
"WHY would you do that, this is a terrible time to tear up the kitchen floor." (because Spouse is out of town)
Because this is the perfect time to do this--Spouse is out of Town and can't talk me out of it, can't say no, can't be the voice of reason.
So I went home and tore up the kitchen floor. I only worked on the floor until 11:30. (putting in new flooring, so I didn't leave a disaster)
Elder boy, when he heard the commotion said, "Mom, what are you doing?"
Tearing up the floor
"... ... ... That sounds like kind of a big project... are you sure this is a good time to be doing that?"
Who is the grown up here? You're not the boss of me.
Naturally the following morning we were all very crabby and tired. And I called psych NP and said that I wanted to go off the fluoxetine entirely. I had only been on 10mg. A baby dose. The babiest of doses. Still.
Kitchen floor seemed symptomatic. It didn't feel like I was deciding to tear up the floor--it felt like I had to tear up the floor.
The same kind of not-stopping that I experienced when I piled up stones to cover the sandbags at the cabin.
The same kind of not stopping that accompanies my bouts of zombie gardening.
The same kind of crappy feeling that you are driven to do something and cannot stop driving. Because you are not the driver. You are just the passenger and the best you can hope for is that eventually the driver will have to pull over to refuel.
Following day I did not do anything ridiculous. Even went to bed at 9:00. Spouse returned to a disaster area--kitchen partially demolished (floor okay, but the rest of it kind of a wreck) and the rest of the house having a lovely lived-in toronadic aesthetic.
Asked for help from boss to get some things set up. Then had the courage to open email and find that she has taken care of the things that I found overwhelming. Still hate being sub-functional, but like that I am getting better at asking for and receiving help.
Also happy that I am starting to recognize the difference between project-oriented behavior that is my normal, and project-driven behavior that is a sign of illness. The main difference is duration, amount of energy required, inability to pause for routine (and necessary) activities, and lack of impulse-control.
Have also been visiting the Goodwill again. Hypomanic crap.
Will NOT let things swing into full-blown mania. Because that REALLY sucks and is much harder to recover from. Right now, energetic, not sad, not happy, not very moderate. Tippy.
Why can't I just catch normal in the middle of swinging from Depressed to manic? Why must it swing just a bit too far?
P.S. when people look at my behavior and think: hey, I must be bipolar too because I do that sort of thing... this is me while being treated. And my behaviors--the behaviors of many bipolar people even when they are having a "mood episode" are not really beyond the pale (on paper).
I don't want to downplay other people's experiences, nor do I want to play the martyr (particularly because my bipolar is mild and fairly well controlled)... I just want to encourage people NOT to assume, not to self-diagnose, not to think that we all must be the same. Because we are all different, which is a good thing because I'm pretty sure I couldn't take one more of me.
I hope that this single medication will do the trick. Side effect of other mood-stabilizers do not look appealing. Potential 50-pound weight gain, for instance. Not acceptable. (I am already over my allotment for the amount of mass considered healthy for my height and would completely wig out, not to mention feel terrible physically with that sort of increase.)
I cut my hair. It looks nice. That is luck. It was a matter of impulse. I needed to get my hair cut and couldn't be bothered to wait. So I took an electric shaver to the back and a scissors to the front and things miraculously turned out just fine. Then I colored it red. My students didn't recognize me. I wonder if this wasn't the point.
When my Psych NP found out about the haircut, she cut back on the level of fluoxetine... afraid that it was causing cycling.
Still in the Downs.
Still don't care.
Only sometimes able to put on a good show-- but mostly I have been absorbed in beading and writing and being irritated with anyone and anything that interferes with these two activities.
Here is what is going on medication-wise:
I am on 200 mg lamotrigine and 10mg fluoxetine. I need to do other things to fight the Depression but I'm just not there right now. It is hard to be compassionate with myself when I am pretty sure what I need is a kick in the ass.
Had two "pajama days" which are always disasters. Children had no school on Thursday or Friday so I allowed everyone to just do whatever the whole day long. Which meant A LOT of video games for them and A LOT of beading for me. There were two days that I didn't write and it really pissed me off.
Today my boss came in (on a Saturday) to collect my time card (which was five days late) and to let me know that there were two emails that I needed to respond to (which she also printed out for me). And she gave me a hug. I explained to my class that this is what it looks like when I am in trouble.
After she left, I logged into my email (for the first time in two weeks or more) and archived everything. I am starting fresh. Sent word to my bosses/supervisors/team that I appreciate their support while I figure out the Depression crap and apologizing for being unwell.
Having a hard time lately remembering that when I am well, I am really kind of amazing. Creative and energetic and able to leap tall buildings in a single bound. Lately I feel like I am being crushed under said buildings instead. Don't like feeling that I am a liability. Blah.
Sorry I didn't write, but I just didn't care enough to let you know how things were going. You were not a priority. Even this message-in-a-bottle communication was too much. The best I could do was occasionally respond to texts I received. And return one of the nine panicked phone calls I received.
Here is the story, as best I can recall...
Was unhappy to be on venlafaxine. Even if it hadn't caused me to sleep 20 hours per day... which was a side-effect of beginning to take the medication and would have worn off eventually. I told Psych NP that I would not be compliant on venlafaxine because I remembered it as the drug that caused my psychotic episode last spring (while trying to get OFF of it).
She asked how my mood was and I said I didn't know because I wasn't awake long enough to get any data on my mood. I slept through phone calls and emails and managed not to meet with people (but I hadn't been able to schedule with them in the first place due to being asleep). It was like the fairytale. I pricked my finger on a spindle. And the world kept going all around me.
She decided to switch me away from venlafaxine and back to fluoxetine. This is a drug that had worked for me in the past for Depression-- but which quit working before my diagnosis. I have not taken it while on a mood stabilizer before. I have not had negative side effects in the past and she wanted to stick with something that we knew would not make me sick while trying to emergency-like improve my mood/energy. Also wanted to cut back on bupropion, which seemed to be doing diddly-squat for my Depression symptoms.
So now here is where the medication stuff now lies: 150mg bupropion, 20mg fluoxetine, 300mg lamotrigine.
There was one day (a Saturday) when I had stopped the venlafaxine and not yet started the fluoxetine when i felt PERKY and ENERGETIC. This lasted until I started the fluoxetine. I don't think my body enjoys all the changes in pharmaceuticals.
Felt like CRAP the following Monday. Not HORRIBLE physically or mentally, but the combination was enough to knock me out. Through a series of miscommunications (actually just sending notice to the wrong work-related email) caused coworkers to go into a complete panic, nearly resulting in my boss coming to knock on my door to make sure I was okay. (How awesome is it that I have a boss who would drive to my house to make sure I was okay?)
The following week on fluoxetine, my sleep began to improve and I did not feel as sick. Currently I am (knock wood) at my most human. Working brain, body that does not demand immediate sleep... the things that I long to take for granted again.
Energy has returned in advance of mood improvement. I still don't much care to be communicating this to you, but I can and so I am. It LOOKS like I am doing better now because I know what I am supposed to do in order to appear better. Does that make sense?
I know that when I see people I am supposed to smile a little and engage in polite conversation. And so I do. But I still won't open my email or respond to phone messages or go out of my way to make contact with people (even if I really like them a lot).
OFP asked how it would look different if I were mood-wise doing okay as opposed to how things look now. I don't know. But it would feel different. I would know that the conversations I was having were not just some stored, rote, reflexive response. i would care. And I kinda still don't.
I care enough to show up for work, to drop off and pick up my children, and to make sure that I eat and sleep. And bathe. Almost often enough.
Now I have devoted enough time to you. Back to one of the few things that I do still care about. Writing. Done with draft one of book two. Reading through it for consistency before the actual first draft is printed for proofing.
Quaker, teacher, parent,