Sunday, November 16, 2008

When the Insidious Dark Mists Spread Their Vaporous Poison

No matter how religiously I've taken my meds, sometimes a situation derails them.

My job, a continuous stressor, finally broke me into pieces. Pieces that screamed, cried, grasped out for help. A jigsaw puzzle of a human being, frantically trying to put Tab A into Slot B before the world swallowed her up.

Not in 13 years have I had such a depressive episode. Even the death of my husband almost 7 years ago didn't send me into this kind of tailspin. I ran to Dr. B in tears. He upped my meds and told me I had to step away from the job, for at least two weeks, or I would end up in the hospital. I leaned on Mim, my therapist. She reinforced what Dr. B said and told me I had to get out of the job. I couldn't face going on disability but the prospect seemed certain.

Drugged to the gills, with doubled Xanax, increased Lamictal, I sat in silence in my chair, knitting day after day, sleeping when groggy. And then, two special things happened. Two shining moments that cleared my head and my heart.

The first was a reconnection with a man whom I had gotten to know through a dating site and then pushed away, because I was afraid of being hurt again. But Jerry and I found each other again. I let him back in. And he made me laugh, night after night on the phone, and then in person a week ago. Funny, smart, caring. Just what I needed. He brought me roses, took me to lunch, we went for a long drive in the country, and then out to dinner. And he's called me almost every night, teasing me lovingly and making me happy. I'll see him tomorrow again and I can't wait.

The second wonderful moment was a call from a recruiter with whom I had had contact last January. This time, she had a perfect job offer for me with a pharmaceutical company, doing the technical writing and procedures analyses that I can do so well. A week and a half ago, they took me out to lunch for my interview, I managed to pull my ass together and smile and be personable. The two people, Rick and Katy, were incredibly nice and I'd be working with them. Three days later, they made me an offer. With more money than I've ever made in my life.

It's funny how my higher power works in mysterious ways and watches over me. I was close to losing my faith but when push comes to shove, if you hang on, life does get better. I've always believed that I have the strength to overcome whatever gets thrown in my face. Once again, I've pulled myself out of the well. But not without help from He who always loves me, my family, and my friends.

This disorder that we all share can be a curse to some. To me, it's the fount of my creativity and the life challenge that has built my character. When it threatens to take over, I take no prisoners. Ever.

Saturday, September 27, 2008

Through a Glass Darkly

That has always been a favorite of mine. Because being manic-depressive often means just that: Seeing life through a glass darkly.

It comes from the New Testament, specifically 1 Corinthians: 13. "For now we see through a glass darkly." Supposedly this actually refers to mirrors.

In the midst of a manic episode, I can oddly step outside of myself, an almost spiritual detachment, where I see the behavior and cannot stop it. This is generally when I put out the call for help and go to see Dr. B, which I did this past Wednesday. There's much to be said about the aura that precedes a manic episode. He compares it to an epileptic aura. I believe this to be true.

So, what are my manic episodes like? Not unlike driving a car with bald tires full tilt boogie down an unpaved country road, with my brain pounding like the engine's pistons. Thoughts flit here, there, around the top of my head, and then disappear, only to be replaced by more unconnected ideations. The only thing that will stop this racecar is a tree. Splat...

During a manic episode, there is much energy to be put into projects. Like a whirling dervish, I operate brilliantly (or so it seems at the time). I climb the peaks of performance, thrilling myself by peering over the dangerous precipice. If I willed it to be so, I could fly. I actually believed that as a child. As an adult, it takes on a more nuanced cloak. I fly, indeed, through my writings. You could say that my writing is my sanity keeper. As it has been for so many others.

Once I'm at the top of the peak, the paranoia sets in. People really don't like me and they're talking about me behind my back. I become frustrated, highly irritable, and with those very close to me, often verbally combative. My impulses are out of control. I get into the car at 1 a.m. and drive around aimlessly, waiting for the medication to work its magic. Sometimes it does, sometimes it doesn't. I'm hypersensitive to all things that touch me, both physically and existentially.

And then suddenly, I rappel rapidly down the slope.

Like a love-starved puppy, the inevitable depression begins to follow me, panting, a deluge of anxiety, sorrow, fear, and morbid thoughts. My world comes to a standstill. Yes, I can still work but I can no longer focus on minor details, so that work becomes the battle to stay intact. Somehow, I always manage, if barely. And hide the severity of my illness as best I can.

These are the warning signs that I've come to know and fear. As of this writing, I am on an increased medication dosaging schedule. Besides being ready to pass out from the extra Seroquel, I've had Xanax added to the cocktail. I will take it sparingly but it's there to help. And I have faith that I will once again overcome the demons that rage inside of my head.

If you are in the midst of what I call fighting the good fight, go back and read both of Kay Redfield Jamison's books--Touched with Fire and An Unquiet Mind. Jamison is my heroine and through her research and writing, she has done more to help me stay on the straight and narrow than any other writer.

Stay well, my friends. And keep fighting the good fight, side by side with me.

Thursday, September 18, 2008

More on Baby Bipolars

This past weekend, the New York Times Sunday Magazine featured an article on bipolar disorder in children. This remains a controversial issue but I'm very glad that it's getting increased publicity. Awareness leads to solutions, eventually.

Whether or not these children are in fact bipolar is moot. The fact remains that they have distinct behavioral problems, as I did as a child. I frequently had rages, temper tantrums, acted impulsively, and was then branded as a "naughty little girl." Of course, that was the '50s. When child psychiatry was virtually unknown and certainly not known to my parents.

In the meanwhile, as a rapidly aging bipolar, there has been more research on my age group, 50+. The disorder does not get better with age, that's for sure. However, staying on medication will actually improve your brain, apparently. Fine with me. Although I don't always like the fuzziness my meds cause, I've found that with a little extra effort, I can overcome it.

I'd like to hear from over-50 bipolars. Do you find that your disorder has worsened? Are your manic periods more out of control? I do see that I have to have my meds monitored far more closely than when I was younger. It would appear that their effectiveness wanes much faster than previously. That's simply my observation of my own situation. I have been going through yet another dysphoric period, so Dr. B will see me next week for a review. Fortunately, my dosages are on the low side, so we have plenty of room to play.

Saturday, September 06, 2008

Dysphoria Rears Its Very Ugly Head

When I say I'm cranky, that's part and parcel of being manic depressive. It's the double-edged sword. Dysphoria. Not depression. Two different things entirely. Dysphoria is that part of mania that's not fun. It's savage, nasty, and destructive. The polar (pardon the pun) opposite of euphoria.

Today I had a major brain seizure. I saw something on someone else's blog that set me off and I immediately went to town on this woman. I thought she had "stolen" something from my blog, The Knitting Curmudgeon. Um, no. But when I'm in the throes of a dysphoric episode, I can't see anything but red. Bright, bloody red.

When Dr. B told me that bipolar disorder is a seizure of the brain last year, I realized how right he was. Right before I go off the wall, I can feel the pressure in the back of my head. My brain is malfunctioning. You'd think at this point I'd be able to stop myself when this happens.

I didn't. I just went right on and ran my mouth. Fortunately for me, the object of my ire was gracious and understanding. However, I'm sure I left a big bad taste in her mouth. When I "came to my senses," as it were, I was bowled over as to what I had just done. And tried to make amends. I hope I have.

My loving gatekeeper, N, was out today, going on a job interview. He called me from the road and immediately said, "What's wrong, sweetie?" He always knows. And when I explained to him what happened, he told me he had thought I was a bit crabby this morning before he left. I hadn't seen that at all but looking back, he's right. I wish he had said something then but he was running late for his interview and didn't really have the time.

It's time for a medication review, for sure. With the fall coming and the "Danger Zone" of the shorter days, I need to see Dr. B this week before this spirals into something worse. Managing the disorder is always a full-time job but I believe that everyone needs a gatekeeper, someone who knows them well enough to put the kibosh on bad behavior.

N is that person. And I love him for it. I'm feeling better now. But that doesn't mean shit. The dysphoria is back and I'll give it a run for its money.

Sunday, July 27, 2008

Life, Death, and Hope

I can't imagine that anyone has not now heard about Randy Pausch. I recall hearing about his "Last Lecture" when he first gave it. With his death, it is making the rounds again. I had forgotten how much it affected me. If you have not seen it, here it is for you to view.

His gift to all of us. Whenever I feel depressed, from now on it will be required viewing. I heard tell that his words stopped some people from offing themselves. It's carpe diem writ large.

Thank you, Randy. Dying well is as important as living well. They should be one and the same.

Sunday, June 29, 2008

For Irene and Katherine

Irene and Katherine,
May this always be the place where you feel free to vent and rant, where you know that someone wants to hear you. I hear you and my heart bleeds for you both.

My oldest daughter has suffered from depression and sought treatment without my badgering her. My younger daughter's first husband was an abusive alcoholic, probably bipolar. Her second husband is bipolar and controlled on meds--he's a real sweetheart. I cannot imagine the excruciating pain that you both live with.

If I ever make a little difference for someone in writing about my struggle with manic depression, then I've fulfilled my promise to myself. When I had my come-to-Jesus moment in the hospital back in 1995, I knew that if I accepted my disorder for what it was, I'd fight for myself tooth and nail. I'd fight against the stigma of mental illness. I'd demand the care that I needed. Your children were victims of our dismal mental health system. We should all fight for those who do not get the care that they need.

You can write as much as you want in my Comments. I would rather see you do that and feel perhaps a little momentary relief because you've opened up and told your story to me and those readers who have walked the walk.

I say that to you all. This is not just my blog--it's yours, as is The Knitting Curmudgeon. I treasure my readers of both and I want to hear those voices, be they in pain or in happiness. Got it? Good. May the higher power guide you to peace.

Friday, June 27, 2008

Jammin' It Down Your Throat

Now, you may find this very amusing. I know I do. Did you know that I was a psychiatric technician from 1973 to 1982? Yeah. I worked at a county institution, mostly because in 1973 I had a 4-year-old and a 1-year-old who needed their mommy during the day, so I worked the evening shift while my husband watched them.

No "it takes one to know one" jokes. Even though it's true. I began on the med/surg ward, worked there for about a year, learned to pour medication, give subcutaneous and intramuscular injections (nonprofessionals could do this in New Jersey at that time), and learned firsthand about death and insanity. The things I saw are forever a part of my consciousness and I hope I never forget them.

When I transferred to the short-term 30-day crisis intervention ward, it was there that I met people who were manic depressive. Amazing people, too. An opera singer, a sculptor, a writer, several seductive drug addicts who had immense charm and an unbelievable capacity for self-destruction. All of them brilliant and all of them in the desperate throes of the disorder. We'd all sit and talk for hours. I was their caretaker but they became my friends too. Little did I realize that we had an awful lot in common.

Their mania or depression very often triggered mine, although I was too lost in maintaining bare survival to recognize my own illness. And what was worse? A friend from high school, Becky, was brought into the ward screaming, out of control, trying to climb the barred windows. She was placed in seclusion immediately. And committed. Because I knew her, I was recused from caring for her. But I watched helplessly as she disintegrated mentally. It took five months of commitment before Becky was more or less stabilized. Mostly less but they let her out.

Back then, commitment was fairly simple. You went to your commitment hearing and two doctors had to pronounce you a danger to yourself or others in front of a judge. Then you got the old 60-day commitment order. You couldn't leave and you were forced to take the medication, even if it had to be administered via a shot in the butt.

Then came the public advocates and everything changed. Not for the better, either. Patients now had rights. They could refuse treatment, no matter what. So began the deinstitutionalization of our mental health hospitals. And out the patients went, all too often with no place to go, since their families were sick of dealing with them.

The question then and the question now is, when you are that mentally ill, do you have the right to refuse treatment?

This is a terribly hard moral dilemma. On the one hand, people with manic depression or schizophrenia can be helped with medication. On the other hand, forcing people to swallow pills and spend their days in straight jackets so they won't harm themselves seems to be enormously cruel.

It's not. As someone who has been off the wall crazy and shoved into a hospital against her will, I honestly thank God that I was forced to face my disorder and deal with it. Trust me, I was a hard sell. Maybe in my next post I'll tell you the story. It's in its way funny but also dead-on serious.

I was close to commitment but they didn't go through with it because in actuality, I was not suicidal but rather having suicidal ideations. Now, sometimes those can lead to the real thing but my history was ideations rather than actions, so they let me off the hook. To a point. I wanted to sign myself out but the doctor informed me that if I went out AMA (against medical advice), he'd get me commited. Yikes. I stayed.

When your sense of mental balance is so incredibly warped and out of control, you can't be capable of making sane decisions. Your brain is fucked up. You need someone to support you and maybe sit on you so that you take your meds and do what you need to do to get better.

This doesn't work in many cases. Trying to force someone who's off the wall to take meds is frequently a no-win deal for both sides. But I do believe that anyone that sick can't help themselves. I know I couldn't, when I was at that point. I will be forever grateful to that doctor at Fair Oaks who didn't give into me and made me take what I needed and face my demons.

Incidentally, I saw my high school friend Becky at my 40th reunion last weekend. I could have cried. She barely recognized me and I could see the madness in her eyes. Her hair was done in weird little braids, she wore a dress that was somewhat strange, and a mutual friend of ours, who is a nurse, was staying with her the whole evening. Lisa, the nurse, told me that Becky was very fragile and she was afraid that Becky might act out. She didn't but I could tell she was agitated.

It was then that I realized what I've probably known all along. There are striking degrees of manic depression. Even though I am diagnosed as bipolar I, I am what is known as a high-functioning manic depressive. I haven't been back to the hospital since that time, through the grace of God. I am blessed. I can function, even though it's a daily battle. Becky cannot. And clearly, all the commitments she went through, all the medication she's taken over the years, have brought her scant relief. I grieve for those for whom nothing works. But I don't know if commitment is the right answer or not.

Wednesday, June 04, 2008

Baby Bipolars

Last week, Newsweek had a very interesting cover article on childhood bipolar disorder. A condition that evidently is discounted by many so-called medical experts.

I was most certainly a bipolar child. Perhaps not as severely bipolar as the young boy in the article, whose behavior is so out of control that he frightens his parents, his teacher, his schoolmates, everyone around him. A child who wishes to kill himself? Absolutely. I know. I was that child.

I was "trouble" from the moment I was born. In fact, before I was born, since my mother was in labor with me for almost three days. Once I popped out, I then made her life a living hell with colic, screaming, not sleeping, and generally driving her to a nervous breakdown. She and my father temporarily moved to her parents' house because she could not cope with me. They stayed for three months until I "settled down."

As Mom always says, I didn't learn to walk. I ran. Into walls. Literally. And at 18 months, I perpetrated the first of many "stunts" (quotes are all my mother's). While she was on the phone, I climbed up onto the stove, turned on all the burners and plopped myself in the middle. Stunt #1 was a doozy. Out of control already.

Then, at 3, I pushed an old lady in a wheelchair down a hill at the Forest Hills Tennis Club. My mother was sitting on a bench, talking to her friend Joyce, Joyce's daughter Vivian was not interested in playing with me because she was 5 and much too sophisticated. So I was bored. And saw the old lady, whose nurse was also talking to a friend, and decided she was bored too. So I hopped onto the back of the wheelchair, released the brake, and down the hill we went, with her screaming. Yes, I do remember doing this, very clearly.

Besides impulsive actions, which my mother dealt with by literally leashing me so that I wouldn't run away, I had terrible temper tantrums. Constantly. These seem to have started when I was around 3, or at least, that's as far back as I remember. I would be overtaken by uncontrollable rage, and would throw myself onto the ground screaming. I had to be physically restrained so that I wouldn't hurt myself.

So I was a "bad" little girl, at least to some of my family members. My maternal grandmother was the only one who gave me unconditional love, who saw that I wasn't bad at all. And I rarely had mood swings when I was with Grandma. She was a calming, loving influence. My paternal grandmother, a dour German woman who had her own mental health issues, would chase me around with a stick, yelling that she was a witch who would cook me and eat me. Crazy Hansel und Gretel time. I despised her.

Once in school, it became worse. I couldn't sit still, I fidgeted constantly. My handwriting was illegible because I simply had not advanced enough neurologically to be able to control a pencil. However, in 1958, in second grade, I was considered sloppy and lazy, with my teacher torturing me with handwriting exercises that I could not do.

Throughout the rest of my childhood, I was always being reined in. And I remember lying in my bed at night, depressed, wishing I could die, because I just wasn't good enough and I couldn't seem to make myself better. I had no self-esteem. To give my mother credit, she realized it. However, back in the '50s, a mentally ill child was simply trouble. End of story.

Recently, my friend Marcia, who I've known since elementary school, said to me, "I thought you got sick when your dad died." No, that's when the disorder finally blossomed to the point that I became seriously ill.

I was 17 when my father died of stomach cancer. He was probably bipolar too, a man of great generosity, joie de vivre, and one of the finest impulse spenders I've ever known. But I adored him and his death at 43 was devastating for me. I did not know how to grieve. A week before Daddy died, my brother Rich and I were summoned to his bedroom, where he told us that we should be like Spartans, keep a stiff upper lip, because he was going to die.

We had not been told his illness was fatal. In fact, although we realized Daddy wasn't getting better, it never occurred to us at 13 and 17, that he was dying. Until that day.

Thereafter, my descent into madness, as the novelists like to call it, was rapid. And for many more years, it became a nightmare from which I thought I would never awaken.

So yes. There is such a thing as childhood bipolar disorder. I know. I was one of many children whose mental illness was defined as being a bad kid. There are no bad kids. Just kids who need help. So let's not push them away. Let's take care of our bipolar children. Because it is a REAL disorder.

Saturday, May 24, 2008

Getting What YOU Need

It's been awhile since I last posted. Why? Because my life has been a maelstrom of work. And although I've have been taking my meds religiously, the stress of travel, of doing the work of two people, and the inability to focus on myself and my mental health needs, are taking their toll. I fear the slippage back into the maelstrom of illness.

This morning I went to an AA meeting with my friend N. I go sometimes with him, although I am not an alcoholic. I have, however, a very addictive personality, as I have discussed in previous entries, and this week, while waiting for hours in an airport trying to get home, I could feel the pull of oxycodone, my drug of choice. Oh, how I wanted the chemically induced sense of wellbeing, the high that allowed me to stop caring about myself and anything else.

During the meeting, listening to members' stories of their struggles, I realized that every day is a struggle for me too. No, I don't drink, although I came damned close to becoming an alcoholic years ago. And I stopped drinking completely. Big deal. I switched to oxy. Then there was a real problem. One that I somehow managed to overcome without a group because it never occurred to me that I could go to one. Hey, I didn't need the support of a group. So wrong. So very wrong.

What hit me hard this morning was my failure to take care of myself. Yes, I'm taking the meds. No, I'm not getting what I need nor am I making it so. All I can do these days is work myself into a greater danger of becoming ill. And that ends today, thanks to the AA members this morning, and N in particular. When I go off the beaten path, he takes me, shakes me, and tells me to take care of ME. As I do for him, when he sails off into depression.

It's so easy to ignore this disorder that we all share. Yeah, take some pills and you're managing. It doesn't stop there. We have a disease of the brain, one that never can be cured. But it can be managed with smarts. From now on, I will say no to those demands that will cause me to go over the edge. That means that I will insist that my health and wellbeing come before any job requirement.

I missed both my therapy and psychiatrist appointments this past week. Why? Because I put work before my health. A lesson learned. This will never happen again. And if the company doesn't like it, they can kiss my ass. Because they aren't going to help me stay well. I am.

As a reminder, this is Mental Health Month. If you know of someone who needs help, don't be afraid to say that to them. Send them to the links I have in the sidebar. And don't ever let go of them. Love them, listen to them, hug them, and know that they can fight the good fight, with help. And if it's you who has the disorder, please take good care of yourself. Because if nothing else, I care about you, as well as myself. We're all in this together, so let's be good to US.

Friday, April 11, 2008

Mental Health Parity Pared

Long time, no write. I've been well, but overwhelmed by work. Must slow down the stress factor because as you all know, stress is ill advised when you suffer from a mental disorder. In fact, stress is ill advised no matter who or what your state of health.


I've been meaning to write on this topic because it's an important one to all of us who either live with mental health problems or have someone you love who's dealing with it. The Mental Health Parity Act, an amended version of the 1996 Act, was passed by Congress in early March. What does this mean for us? Well, for some of us, nothing. The 1996 Act provided enough wiggle room for insurers to limit benefits. They simply limited the number of visits to a psychiatrist or therapist, and upped the copays. Perfectly legal, then. The 2008 Act, which languished in Congress for way too long, has problems.

Did you know that if you are employed in a company of less than 50 people, the Act does not apply to you? Or if you are self-insured? Forget it, you're fucked.

My company employs less than 20 people, at least in the US division. I'm limited to 30 visits a year to my therapist and my psychiatrist. Fortunately, I can get along with that because my bipolar disorder is now well managed and my meds are working for me. But what happens to those who are having acute episodes of mania, psychosis, depression? Those who cannot be covered by the Act, with 30 visits, pretty much the standard, are still discriminated against. This must stop. The only way is a national health care plan that treats everyone equally.

I see this as a civil rights issue. Indeed, who among us have not felt the sting of the stigma attached to mental illness, who have been treated as an inferior specimen of the species, and now, treated unfairly by the government. Again. We have to fight for equal coverage for EVERYONE. I'm sure the Senate is collectively patting itself on the back for a job well done. It was not. If everyone is not included, then it remains a discriminatory piece of legislation.

With an administration that is contemptuous of everything, including this, we'll just have to wait for the change that I know is coming. In the meanwhile, the fight continues.

Saturday, January 26, 2008

Crazy Love, Crazy Talk

You know, I'm beginning to understand the value of talk therapy. Very much.

OK, so I always had a 'tude about therapy in general. "I don't fucking need to talk to no steenkin' shrink."

Wrong. So wrong. I'm almost ashamed to say that while I would pop the pills the shrink gave me, that's all the cooperation I'd give. Yeah, I'll take the pills and be done with it. For a long time, that's how I saw it. And that's why my treatment was really half-assed. Because I wouldn't open up, to anyone. I kept my dark manic secrets to myself, completely. Nobody, not even my husband, knew some of the things I did and thought.

I inhaled Oxycodone, while keeping my addiction a secret. I spent money and hid it from my husband. I went out and did wild things in the flush of mania. And then, I'd come down. Nobody knew what drove me to depression. I did and I hugged it tightly. I suffered through the horrors of Oxy withdrawal because I was too full of myself to seek help. I wasn't giving up my nasties to anyone. In fact, they were my blankie. I'm a BAD GIRL and I should punish myself for my sins by torturing my psyche. Jesus, how pathetic.

And then, along came my best friend, N, who is a recovering alcoholic, which is why I do not name him. He's known the depths of despair, the misery of life, and the epiphany that one needs to have when you hit rock bottom, whether it's through alcohol abuse, substance abuse, or the agony of mental illness.

When we first met, N told me up front that he was a recovering alcoholic. I, in turn, told him that I was bipolar. And knew then that here was the first person I had ever met with whom I could unabashedly and without any reserve talk about the awful things I had done in the past. He would never pass judgment on me, nor I on him. I would trust him with my life and I hope he would trust me with his.

I started talk therapy again six weeks ago. This time, I went with an open mind, checked my ego at the front desk, and gave myself completely to my therapist, Mim. One of her initial questions during that first therapy session was, "Who's your gatekeeper?"

Huh? What dat? "It's the person who knows you the best, who can tell you when you're getting off balance, the person in your life in whom you can confide" says Mim. Oh. I didn't hesitate with my answer. Yes, I knew immediately. N. He's as sensitive as I am, so he knows when I'm out of kilter right away. "Boy, you're AWFULLY snippy this morning." And he's always right about my moods. (Of course, it works both ways--I sure know when he's out of sorts, too.)

Between N and Mim, I've begun to see the light. For the past two Saturdays, I've gone with my beloved friend to his AA meetings. And today, I had yet another mini epiphany.

It's good to be with people who understand your illness, who've been there themselves. It's past good. It's wonderful. And where I always pooh-poohed group therapy, I now see its value. The group supports, the group loves, the group knows. Although my addiction was to a different medium, as it were, addiction is what it is. Often, it's self-medication to mute the sadness, the insecurity, the agitation. But the lesson I have learned from attending these meetings is that when I open my heart, nobody's going to thrust the stiletto into it.

Tonight, before I began writing this entry, I went to the Depression and Bipolar Support Alliance site to make contact with the East Stroudsburg support group. I will continue to go with N to his meetings, because I love him and I want to support and understand him always, but I will also go to my meetings too. And with an open heart, an open mind, and a giving soul. That's the guidance I've received from my Higher Power.

So stop. Look. Listen. And keep yourself open to all possibilities. You'll benefit endlessly. Life is filled with these epiphanies, if you let life happen to you.

Thursday, January 03, 2008

Seizure the Day

I must say, I am tremendously thrilled with my new pdoc, Dr. B. Any doctor who would willingly give you an hour's worth of his time (and who is a wonderful listener) is a gem.

And he made a few things about bipolar disorder completely clear, stuff that had me a little confused. This guy is the first doctor who's answered my questions in a direct manner. Perhaps my questions and his responses will help you. Or at least, leave you a little better informed.

Mar's Question 1: Why was I initially diagnosed as bipolar II and then 10 years later, rediagnosed as bipolar I?

Dr. B's Answer: Because sometimes the nature of the disorder changes. Maybe originally you were more depressed and had very few incidents of rapid cycling and mania, hence the diagnosis of bipolar II. Then as the years went by, you became more manic, with dysphoria rather than euphoria, and rapid cycling. This would indicate bipolar I.

Mar's Question 2: What's the connection between bipolar disorder and epilepsy? And why do anticonvulsants seem to work so well?

Dr. B's Answer: Bipolar disorder is really a seizure of the brain rather than the body, which is what epilepsy is. Both types of seizures respond well to anticonvulsants. When you are manic, your brain seizes up and you are subject to impulsiveness, delusions, bad judgment calls, paranoia, anger, and all the things that indicate mania. The anticonvulsant helps to stop that activity and allows the brain to work properly.

Mar's Question 3: I think I finally understand that I must stay on my medication for the rest of my life. But is that really true? Will I ever be able to go off of my meds?

Dr. B's Answer: Yes, it's true. And no, you should never go off your medication. It is believed that multiple episodes of the disorder cause brain damage. Your cognitive abilities become impaired. Without medication, the brain will sustain more damage as you grow older. The medication not only allows you to function but may in fact help repair some of the damage already there.

I left his office feeling more and more comforted that I have a neurological disorder, one that can be controlled. Even though I've always espoused this, there have been times after a particularly bad episode that I've doubted it. When your brain goes haywire, it's hard not to blame yourself rather than the disorder.

Case in point, regarding anticonvulsants being of enormous value in controlling these brain seizures. Last week, I had a terrifying episode, where I could actually feel my brain seize up. It happened while I was driving and suddenly, I felt almost suicidal. I began crying. I felt incoherent. Somehow, I got home safely but suddenly, I felt a wave of sheer anger overtake me, anger directed at a dear, beloved friend and companion. I wrote an angry email but somehow had the sense not to send it. I then hand wrote a note to him, the note being rather incoherent and vague.

Now, I'm on medication but fortunately, I can take an extra Seroquel or two if this happens. Which is exactly what I did. Within a half hour, I was OK. This time, I understood exactly what was going on, whereas before, I'd just get worse and worse until suddenly I felt better.

The next time I seize up, I'll know exactly how my brain felt from the previous episode and maybe I can nip it in the bud. The path to understanding this disorder is becoming less and less ambiguous. Thank God.