Tuesday, January 10, 2006

I'm Not Sick, It's Just Hormones

Being manic-depressive, really understanding all it entails and then managing the disorder means having an epiphany of sorts.

Like being a born-again Christian, only not nearly as obnoxious.

A good, swift kick in the ass helps the process along. In my case, it was hospitalization. I'd finally reached the point in July 1995 where the antidepressant I was taking was not making a dent in my condition and Dr. D, my pdoc, decided that perhaps I wasn't just clinically depressed, I might be bipolar.

It didn't help that up until that point, I hadn't mentioned the continuous out-of-control spending sprees that had gone on for years and that had driven my poor husband Jimmy absolutely crazy. Dr. D immediately decided to put me on a lithium kicker and hospitalize me for observation because I had made this damning statement:

I want to stay in bed until I rot.

This, my friends, is considered a suicide threat. I didn't quite see it that way; after all, "rotting" has no time limitations and is a pretty ineffectual tool. If you're going to kill yourself, you usually pick a more efficient way of doing the deed.

So off I go to the local psychiatric/rehab facility, The Charter House, which is located in Summit, NJ, and was formerly known as Fair Oaks. Its main claim to fame was having treated Papa John and Mackenzie Phillips for their drug addictions. I believe it has again changed names to something else.

I was a mess when admitted. Crying constantly, unresponsive to other people. I was barely able to sign the admitting papers. Somebody, a counsellor, took me up some stairs and into a large dayroom, where I sat at a table with my head down, crying, for several hours. And then, suddenly, I felt fine.

And I knew why. It wasn't manic-depression, I had gotten my period. Why, it was simply a bad case of PMS. Of course. That explained everything.

It didn't quite explain why I had been severely depressed for weeks, but hey--a minor detail. I was now a well person sitting on a ward with a bunch of crazy people. This was going to come to a screeching halt. I was not about to waste my time here. But having worked as a psychiatric technician myself (yes, this is true--the crazy leading the crazy), I knew that the only way I was going to get my ass out of this hole was to present a reasonable case to the attending physician, whom I was due to see momentarily.

Presentation is everything. The attending doc seemed like a reasonable guy. So I figured, if I treat this like a job interview, I'll present my facts intelligently and coherently and he'll have to agree with me. Anyone who can do that, doesn't belong in a nuthouse.

He took my medical history and when I told him that I didn't drink, he looked at me askance. Many manic-depressives drink to self-medicate--in fact, more do than not. So right off the bat, he was skeptical that I was telling him the truth. And then, as I presented my PMS situation to him, he simply listened and said nothing. That was not a good sign.

"So I think if I just go home and take a hot bath and some aspirin, I'll be fine." That's how I finished up. And his response? "You can discuss your plans with the ward doctor tomorrow morning, when he comes in."

Shit. Foiled. I'm in a rather shabby dayroom, with people watching "Baywatch" on the TV, for crissakes. And then I discovered my NJ Transit monthly train ticket in my pocket. The train station was a block away. Escape was in order.

But the doors were locked. I tried every single one. I waited to see if I could slip out when someone came in. Nothing doing. We were taken out for a cigarette break. Into an enclosed courtyard. No exit there.

Back upstairs I went and sat in a chair. Nobody spoke to me and I was damned pissed off. I went up to the head nurse and loudly demanded that I be released. Sure, fine, she said. But if you leave against medical advice, you, not the insurance company, will be responsible for the entire hospital bill.

So back I went to my chair. And sulked. And cried. And called Jimmy from the pay phone and told him I had to come home, I couldn't stand it. He calmed me down and told me he wasn't coming to get me, that I needed to stay at least for the night. He had forsaken me. I slammed the phone down and went back to my chair.

And then, something happened. It hit me from nowhere. What if they're all right and I'm wrong? What if I really am manic-depressive? Doesn't being manic-depressive explain all the bad behavior, all the ups and downs, all the unhappiness for all those years? And if it's so, maybe I should just shut up and listen for once. Maybe I haven't done a great job in managing my life and maybe I can stay here and try to learn something.

I tentatively went over to a group of patients sitting at a table and introduced myself. Sure, they were a little whacked out, but being manic-depressives, they were intelligent people with stories to tell. Stories that I could relate to. Stories that mirrored my life. Talking to them and slowly coming to accept the fact that I had a serious chemical imbalance but that it could be treated.

I spent four days at that place. And got far more from talking to people who had been in my shoes, who understood exactly what manic-depression was and who were in most cases bright, intelligent, successful people.

I've not been hospitalized since. Probably more from luck than from learning to manage my disorder. But I became a believer and that is critical to managing any illness. There are days when I don't even think about the disorder and days when I do. But most of all, I accept that it's not PMS.

In the ensuing years, I spent a good deal of time juggling my medication and spending time in one-to-one therapy. The therapy helped as much as the drugs insofar as it taught me how to manage the disorder. Get enough sleep. Eat properly. Learn the warning signs. Don't wait to get help. Let your family help you.

With the latter, I've always been fortunate because my family has been enormously supportive. My brother, who has clinical depression, in particular has been the one family member with whom I could share my trials and tribulations. He knows. He's been there too, although he doesn't get the manic highs. It's all in the family, you know.

So maybe the next time I post, I'll talk about getting the cure if there ever is one. And in the meanwhile, if you have something you'd like to discuss, put it in the comments.

And for those of you who read my other blog, The Knitting Curmudgeon, be advised that my manic spending sprees encompassed buying yarn. Of course.


Barb B. said...

Very well done description. I think I understand the "manic" better from your post.
My problem is just (great word that) depression brought on by hormonal imbalance. My heads up was realizing I was trying to figure out a way to commit suicide that would not be too upsetting to the kids. This because I didn't like the way my husband was using my good kitchen knife to prepare dinner for me.
He is very supportive, but bewildered. I've looked on-line for articles on menopausal hormone imbalance and so far have come up with nothing except crap about keeping a positive attitude. Like we don't try? The pills work pretty well, especially now that they've levelled out, but sometimes in the evening I get a little down, but not to the suicide point, just think about bulding a little house out in the toolies where no one can find me. If someone out there knows of any good articles I could pass to the old fart, i'd appreciate it. All he knows is what I've told him, and God knows I'm not expert.
Barb B.

Anonymous said...

Thanks Mar. My maternal grandmother was bipolar, and treated with electroconvulsive therapy, as they did then. I never knew her, but it's left my mom in a bad place mentally, and she's now being treated as well.

She's been at the stage of not being able to tell anyone what's wrong, so hearing some of the what might be going on, now that you can articulate it, has been a big help.

bess said...

hi--i hope three is the charm--this is the third time i tried to post--i can really relate to your experiences--i suffer from clinical depression--the nice thing about it is that now i understand what is wrong with me, i can get help and if i need medication so i go on it--and through various means have learned to quiet the "noise" in my head--
finaaly-- i love your name for this blog "swing Time" it is yet another nod to your cleverness, creativity, humour and honesty--thanks! bess

Dharma said...

This sounds a bit like my mother. Only she has avoided hospitalization, though her husband and I have discussed at crucial points. Thanks for writing about this. I understand the depression as I suffer from that, but I don't think I have even the hypo mania that mom does.

And Anonymous, I have family members who were treated with ECT also.

Marilyn said...

Well, it's hereditary. That's not been proven conclusively, I don't believe; however, given my family background, and from what I've heard from other people about their families, I have no doubt it is true.

Barb, check out some of the links I've put up, particularly the one for SOs of bipolars. Even though you have just the depression, there may be some stuff there for ya.

ECT is coming back. I met someone when I was hospitalized who had to have it every six months in order to function minimally.

If I hadn't checked myself in voluntarily, I'm sure I would have had to be committed at some point. It only would have gotten worse and I shudder to think what might have happened.

Anonymous said...

I've been reading the "curmudgeon" for over a year, laughing, wondering, learning, being quiet. My respect for you has risen exponentially over that time. I've had the sense for a few months that you are fundamentally in a better place than in earlier times, and this blog seems to indicate your stronger, calmer (not necessarily happier) state. Hang in there and keep writing. Your stuff is worth reading. Linda

Kimberly B said...

Marilyn, thank you so much for this blog. A friend who is a knitter (Laurie; I don't recall her knitting blog name at the moment) pointed me to it. I'm 42, was diagnosed with depression when I was 20, and diagnosed with bipolar in early November, and I was diagnosed with being at the beginning of menopause, not peri-menopause but menopause, a year and a half ago. Oh joy. I crochet from time to time and have a husband who is thinking of leaving me. No children, thank goodness, the poor things would be a mess. Haven't been about to work for about 8 years. Always take my meds. I hope having the new diagnosis and trying new meds will help.

There hasn't been a day for many many years that I haven't thought about my disorder. I hate that it's so much a part of who I am. Thank you for letting me know that there might still be help for me.

Shades and Shadows said...

Hi (ignore the wierd name) I'm 17 and have just realized i'm probably bipolar which would explain a lot. Steven Fry's manic depression documentary which can be found on you tube has helped enormously, I can't say how highly i think of him. Anyway, the point is that recently i've been treated for polycystic ovaries (not bipolar!) which invloves being given Estrogen tablets to try and balance my hormones. I didn't know i was bipolar until just these last few weeks when its really hit me. I think actually it is these hormone tablets which have really done some damage. I wonder if i should tell the doctor what it's doing, or try and stick it out? I can deal with depression thats fine, its the sick sort of hot rushing in my mind which is well, the most terrible word you can imagine to replace 'unpleasant'. Anyways there's allways hope. So for all of you out there, I'm sure that trying to be rationable about it is the only thing to do. The hardest thing in the world was asking my mum for help, don't be too proud like me- it was almost too late.

knitty_kat said...

I know this is an old post . . . but it struck something with me.

I've been thinking for some time that my moods and swings have been hormones, but I really wonder. I've been diagnosed and treated for clinical depression. In the last year I missed 1 appointment & the doc didn't call me back. I'm not on anything anymore and there are many days that I would very much like to stay in bed and rot.

I wish that there were some easy way to make me feel more normal. I'm very reluctant to speak to people about it because it either results in losing friends or people talking about you behind your back. Both are things that have happened to me repeatedly and I don't wish to go through them again.

Thank you for sharing this.