Sunday, February 26, 2006

Taking My Time

It's been a while since I posted an entry to this blog and to be honest, if it weren't for my friend Carol encouraging me to continue, I was seriously thinking about giving it up.

Why? Because there's something in me that says it's not all that healthy to write constantly about your illness. This could be interpreted two ways: First, as avoidance or second, as a sign of health. After all, if you're really mentally healthy, why would you want to keep dredging up the subject?

It would seem that a number of people have benefited by my discussion. And maybe I've benefited, too. So I'll keep writing, when the spirit moves me. It may not be on a regular basis but if nothing else, people use the links.

One of the last comments asked a few pertinent questions that I'll try to answer:

Mar tell us what it feels like when you take your meds. Does it makes you feel sedated? antsy? Why is it so common to stop taking them when a person does so much better on them. How long after you stop taking them do you begin to once again slip back into manic or depression. If you had a teenager would you sit on top of them until they took their medication for the day? Will you listen to someone telling you that you're not on your meds, or do you resent someone trying to direct your?

When I take the right combination of medication, I feel OK. When I went back on medication more than a year ago, it was a bitch. I had terrible tremors, I would fall asleep at any time, which made driving very dicey, and I couldn't focus on my work at all. It took a bit of doing and adjusting but now I'm fine. The anxiety is gone, the depression and mania are kept at bay, and I can still write, knit, spin, whatever.

People generally stop taking medication because they feel good. Duh. It's the medication that makes it so. I stopped my medication only once, in June of 2001. And it was not because I really wanted to or felt that I was "cured." It was a financial decision. My psychiatrist no longer took insurance at all, so I had to leave her. I couldn't afford the $180 a session. My primary care physician refused to continue my medication. So I went off meds. And stayed off for more than three years. During that time, my husband became ill and died, leaving me with no money and a big mortgage. I had to sell the house we built together and move. And still, I managed to stay balanced. I have no idea how.

However, in November of 2004, I again became extremely dysphoric, as is my tendency at this time in my life. Bad crying jags, extreme irritiblity accompanied by anxiety. It's sometimes hard to differentiate between dysphoria, a type of mania, and depression. However, with a true depression, it's very difficult to do anything. With dysphoria, you can still function, get up, go to work and so on. So back I went on meds. I was fortunate to find out that UMDNJ had a center not too far from my work that would take insurance. I didn't need anyone to tell me I needed to go back on meds. I know that better than anyone else.

Slipping back into depression or mania or both happen quickly or, in my case, slowly. It's a crapshoot. Everyone's different. The thing is, you are playing Russian Roulette if you go off your medication. Sure, you might not feel anything right away. But depression and mania are insidious and they can sneak up on ya before you know it.

As far as kids taking their meds, that's one I've never had to deal with. I think that rather than making medication a point of contention, I would work with my child so that they understood exactly how important medication is. And that's not easy either, especially with teenagers. The bottom line: You can't force anyone to take anything, be they adults or teenagers. It has to come from within. And if you force the issue, it becomes worse. Bipolar children are a special case, one that warrants specialized handling.

I do listen if someone says I need to be back on meds. Actually, I know it before it's apparent to my family. In fact, generally they don't have a clue because I tend to keep my behavior steady in public. It's in private that I don't do too well.

I think it's a good thing to feel someone out before suggesting that they need medication. Rather than say, "You need some drugs, your behavior is ridiculous," I think a better approach would be "Don't you think you'd feel better if you saw the doctor and see what s/he can do for you?" People with mental illness respond badly to demands, especially manic depressives.

However, everyone responds to love and caring. No matter how off the wall they are.

Tuesday, February 07, 2006

Have you ever stayed up 48 hours straight? No, but I did 60 once.

I've been thinking a lot about Birdie's comment the past week. She asked: can you tell me how you personally proceeded to receive help? You know, that initial step?

I didn't think I was at all sick until 1994, when I was 44. All the years of depressive and manic phases were nicely hidden from all but my husband. My first severe depression was about three months after my father's death, when I was 17 and a senior in high school. My mother was dealing with her own grief and was drifting into alcoholism, so she really didn't notice that I was skipping classes to stay in bed. My grades went downhill but at that point, I was already accepted into college.

My first manic episode began in October of my freshman year of college. I met a guy at a frat party at another college and we proceeded to have a wild affair, with me living in his room most of the time. That ended and I went back to my boyfriend, whom I married a few months later because I got pregnant.

Nice, huh? A real happy story so far. Terrible pre- and postpartum depression, when I tried to cut my wrists, landed me in therapy with a friend of my mother, a woman who had no bona fides other than she had counseled a lot of people in lifestyle management. She was no doctor and therefore, although I benefited greatly from her advice and help, did not see the deeper problem of manic-depression.

For the next 20 years, I managed to be a decent mother and wife, work hard and advance my career from a psychiatric technician (another great story I'll have to tell sometime) to the point where I became an editor without the benefit of a degree. But all along, there were continuous bouts of mania and depression. I don't know how I controlled their severity but I was always good at talking sane and thinking crazy.

One day, my husband Jimmy came home from a visit to the doctor and handed me a pamphlet on manic-depression. "I dunno, honey. This sounds an awful lot like you."

I read it and I realized he was right. Still, it took another two years and a terrible depression, one that I couldn't control, to make me desperate enough to call the local hospital and ask for names of psychiatrists. That's what made me call. I just couldn't stand living such a shadow life, with the ups and downs.

Once I was under care, it took my psychiatrist two years to make a firm diagnosis of bipolar I because I neglected to discuss my spending sprees and my out-of-control rage with her. I was better than I had been, simply because the depression was under control. However, a dysphoric manic episode convinced her that there was much more to the story.

It's critical that you tell the psychiatrist everything. I didn't, and it was the reason I was not diagnosed faster. I was afraid of appearing less than perfect. I was embarrassed that a person of my intelligence would do stupid things such as spend money I didn't have and run my mouth when I should have controlled it.

Psychiatrists have heard just about everything. You won't be judged for your behavior. Your behavior is the one symptom you have that will help the doctor make a diagnosis. And even then, it's not that easy. But taking the first step and calling is the biggest one. Once you've done that, you've started to participate in your wellness.