The Great Experiment Ends

I’m sharing this story because it is funny, but also because, well, I was hoping so much that things would work out, that lithium and I would be a love affair that would last a decade. Guess not.

I quit taking it med altogether. I had a series of poor coordination accidents over the last two days that started to worry me. I slammed my face in the car door. That was bizarre. I was driving extra careful, and then I got out of the car, bent over still half in to get my stuff, and I kept saying to myself, “You’re all spacey, so be careful and DO NOT LOCK THE KEYS IN THE CAR DO NOT LOCK THE KEYS IN THE CAR KEEP YOUR FUCKING EYES ON THE KEYS DO NOT SET THE KEYS DOWN WHEN YOU PICK UP SOMETHING ELSE OR CLOSE THE DOOR.”

So, eyes fixated on the keys in my hand, still half bent over the open car, thinking the whole time, I AM LOOKING AT THE KEYS AND THEY ARE IN MY HAND, I reached out with the other hand and slammed the door and WHAM, something hit me so hard in the side of the face I saw black. I had no fucking idea what it was until I looked up and saw the side of the car door, inches from my face.

That was pretty much enough of this med for me. There was another smaller incident like that, but holy hell…

Just today, someone online discussed how it takes 3 months to know if it will be for you. I have been at it less than 2, and I chose this slow point in my life as a time to try changing meds. But I can’t afford any more time; a new project has come up that has to be done by March 24th. I need my brain. I need some real sleep.

Who the fuck in the world can just take 3 months out of life to sit around and stare at a wall while waiting for a med to work? I think I might be more jealous of them than of people who aren’t crazy.

Appointment in three days to figure out the next step. I may have to just stay off meds through March 24th so I can handle that situation.

Lithium freak out

Last night I woke up in a strange, activated state. The lights had a halo around them, my ears were ringing, and my coordination was shot – tremor, and not just my hands.

I felt like I was going to die, like my brain was on fire.  Nothing was coherent but all was going too fast. This, after weeks of a mind empty of thought.  And at a lithium level of 0.4, last check.

What the fuck was that? Too much and toxicity? Not enough and some breakthrough psych phenomenon?  The only relevant thing I found in a pharm textbook lying around was that the levels, despite how they make a big deal about them, are guidelines, and people can go toxic on a lot less, or take a massive amount and not. That you should deal with the patient, not the lab value.

And now that I drank a lot of water in a panic last night and didn’t take a morning dose, it seems to be better. I don’t know now even whether to call the doctor or just wait for the appointment in a few days. But I don’t think I can bring myself to swallow another pill.

I hate how my life has descended into revolving only around medication, function levels, and illness. I’m hardly a person anymore, just a black box to pour drugs into.

The psychiatrist, round 2

Today was the big day, put off a week due to a ridiculous conference at work. I got in this morning to him, and it was the usual ambivalence.

He doesn’t know what the problem is, thinks it’s some kind of depression, not a side effect. But whether this “depression” (I’m not totally convinced) is from the lithium or not, he doesn’t know. He gave me the option of upping the dose – the levels were low-therapeutic – and seeing if the antidepressant effect will kick in, or switching, which I wanted to do, but he recommended the raising the dose. So tomorrow I have to check levels, and then take more.

But I’m going back a week from today, and if this isn’t better I’ll switch. Of course, that’s another three weeks lost. I am starting to panic about all the shit I have to do. I also know that raising the dose will take forever to kick in and I just don’t have that kind of time now.

I’m not sure it’s the right decision to stay on. I think it might be if I had more time to up the dose and get it working, but, again, I don’t. But he thinks it is the right thing to do, and I think he’s competent more or less (as much as anyone in that field is), and at least is respectful and willing to work with me. He pointed out what I already found out for myself, latest studies show that lithium alone is the way to go, that there’s not much point in adding an antidepressant, though not too long ago, they used to do that.

I also told him about that conversation I had with the psych med pharmacist, how he didn’t have any more information about the tricyclic than I did. He asked who it was, and I told him, and also added that he was a major asshole per my conversation with him (which he was, holy hell, I don’t know if I recounted that whole thing here, the gist of which was he couldn’t believe that I could be what I am and have manic depression), and he said, “Oh yeah, he is a real asshole.” So at least we agree when we sit in judgment on others, which I am taking as a good sign for the therapeutic relationship.

Oh, and because he’s a psychiatrist and doesn’t understand shit, there was one lab value that was a teeny bit high – totally insignificant, but he doesn’t know how to deal, so I gotta do MORE lab work, in addition to the levels tomorrow, which is inconvenient.

In other words, trying to end positively, thank you tons and tons and tons to the people who leave comments, emails, everything. It is deeply appreciated, and thinking that my story might help someone else, well, it doesn’t make it all worth it, but it does soften the blows.

And, if you are looking for some fun, the best mental hospitalization story ever is at this great blog.

Zero-point-five

That was my lithium level last week. Not quite enough to count, but enough if you are of the “low-dose” school of thought, which, of course, my doc is not.

From my point of view, I may as well have had a lobotomy. My personality is gone. And wherever it went, it took my brain and my creativity along too. And my ability to say words without slurring. I am a true psych patient now – the blank stare, the slow reactions.

Funnily, today I was at this work seminar and I went in the bathroom and all the sudden in the mirror, I see this goth chick staring back at me. I got the Eurotrash look without even trying. It was funny a little bit, and surprising.

Even worse than how I feel is that I am afraid that the psychiatrist will see this as an improvement. I am calm. But maybe stoned is a better word. I can’t tell if I am depressed, or just drugged. Is this a side effect or the effect?

I wish I were dead, not in the same way as in the past, when I have wished that just to have fucking quiet in my head for a few minutes, but in a duller, more sinister way. I see another 50 years ahead of me in which everything is washed out, there is no pleasure, there is nothing I want to do. What happened to the me who couldn’t wait to fly around the world and see its wonders? All of my dreams have become onerous.

And yet lithium is the one, probably only, drug that drastically reduces suicide rates. I think this must be because it makes suicide redundant. Why bother going through all the mess of killing myself if I’m walking around dead anyway?

Strangely, the time most like this one in my life was right before my first episode (described here). I think I felt like this then. I haven’t been this slow for, well, must be 18 years now.

Before, when I got depressed, there was a welcome side to it, at least in the early stages. I knew a downturn was coming because I became more sensitive to the beauty of art, and I would head into bed with my favorite books around me, tangibly comforting, and read something I loved, maybe the part in Lolita when Humbert sees her fat and pregnant, the ultimate anti-nymphet, and knows he still loves her and has ruined her forever. Or the world to come, where even Gimpel the Fool cannot be deceived, or the tragedy of the Witch, who is ugly and strange, and therefore gets no ever after. Perhaps the secret mannequin city under the streets of Istanbul.

I read these things and feel them and love them and cry when I get depressed. This is part of the cycle of my life and even though it is sad, I miss it;  once in a dream, my father asked me why I have no true love, and my answer was to show him my books and tell him, “But don’t you understand, these are my love.”

Now, the words that meant so much to me for so long mean nothing. I am not even sad enough to love them. I would rather be sad than be nothing.

When I can concentrate enough to form a thought, I see my life as a ruin. I went into this serious, respectable field with the one goal of not being like my family. I was the best girl in the world. And it got me anyway. Now, since I failed to beat this, I am stuck in a field that is very unsuited to my spirit (today I got the criticism – twice – that I needed to be more authoritarian). I am basically a selfish person, as narcissistic as anyone in my family, and now I am in a service to others position. The one thing that does redeem my family members who are all crazy and selfish is that they make beautiful art, things that can help others, inspire others, comfort. I should be doing that as well. In the theater and the arts, you are allowed, if not expected, to be selfish and crazy. Here, I am surrounded by uptight, rule-book types. And that didn’t save me from being crazy. I couldn’t morph into one of them.

My writing is very scattered now, I see. No steady thread of thought. So maybe I should stop.

If nothing else, at least now I will be able to sardonically say, “You haven’t really lived unless you’ve woken up with the taste of lithium salt on your tongue…” Which is a pretty good line, I guess.

Here’s another question I’ll toss out to the readership: it seems like the more and more I read, sooner or later, anyone on lithium eventually has an episode of levels rising with dehydration or something. Is this something I need to prepare for? Say, tell my boyfriend what I take?

The lithium gods

I had a morning that was either ridiculous or a sign – quite blog-worthy. I went to try to get a lithium level taken.

But…as soon as I got to the address of the lab, I realized that it was inside a building where I know all the employees, and where I hope to work someday, and where I want a letter of recommendation. My original plan was just to find some lab, pay cash, and have them fax me the results under a fake name – I don’t want to do it under the regular medical system because then it shows up everywhere. But there aren’t that many private labs, because pretty much everything is usually done by the regular system.

So tomorrow’s task is to find another lab.

Then, to make things worse, I needed to buy more lithium. Well, the first big pharmacy I went to, I stood in line and it was sooo hard for me to stand there knowing that I’d have to go up with that prescription, and one of the pharmacists was like my age, someone I could easily know via someone in this small city. So I wait, and finally I’m first in line, and then I realize they are calling people by number. Where are the fucking numbers? At the FRONT of the store, where some lady takes your prescription as you walk in, scans it in so that it comes out in the fax in back, and also is on display for anyone around there.

So I just walked out. She yelled after me, “What’s the problem?” I sort of said back over my shoulder, “My fucking privacy” but I don’t know if she heard.

Then, I decided to go to this tiny pharmacy run by a nice immigrant woman and her family, but they, naturally, take a fucking siesta so it was closed.

Then, when I left work early, I thought, shit, they should be open until 8 if they only opened at 4, let me drop back in and see if I can catch them.

Nope. Closed at 7. She was actually in there counting stuff, but the place was closed.

On top of that, usual crushing depression, and a hard workshop thing all next week about serious business stuff and not getting sued. This is in the city, an hour away from here, both keeping me from working ($$$) and from being able to make another doctor appointment to just fucking fix me.
So – feeling crappy, problems with monitoring, purchasing, and reviewing with doctor.

I am wondering what message I am supposed to get from this.

Fatter and slower, but nicer

I have gained 3 kg from the lithium. It is getting to bug me, because it is on top of the 8 from the last drug. I think it is because I am just lying around a lot, not exercising, as well as the eating and water gain.

My moods have settled – into a low-level unhappiness. Not even unhappiness, just that the things that were so important to me in life have lost their glow. I cannot write. Nothing. I don’t see that coming back while on this. And all of the sparkle has gone out of life. There’s nothing I look forward to, which pretty much echoes my life from before.

I feel like I did when I was 12 years old or so…before I ever had a high. Just flat. Not enough to be technically depressed, as the shrink pointed out, so he won’t give me anything for that. But suddenly, I don’t really care about flying around the world, I don’t get the flashes of running thoughts that make me smile to write, and I don’t look forward to anything in the next 60 or so years that await me.

That said, it has been pointed out to me that I have been much nicer to deal with, that I have not flown into a rage, that I have become less sensitive to things that drove me apeshit before (noise, etc).  I even think I could concentrate if I needed to study something – maybe even like I could at 12.

But I lost everything that made life worth living to me. I lost my exuberance. I lost my joy. I lost my words. What the fuck can I do now? Go back and try to con a GP out of another antidepressant? Take less lithium, though the shrink wants me to take more?

I just wish I could be me.

I’ll toss this question out there – Ronald Fieve? Legit or a quack? I was thinking of this book of his,  as it seems to deal with exactly my problem, but it also looks like it promises more than is realistic. Anyone read it?

Going on two weeks of lithium

It’s definitely better than it was. The pills aren’t hitting me as hard, though I’m still having a hard time taking even 600 a day. I have slowly been able to do a little bit more. Nothing academic, nothing that requires my brain, but I’m not as paralyzed as I was.

The one thing I am really afraid of is that I will never write again.

The last thing I wrote was this, 4 AM the day I started lithium. Since then, I think I have been mildly depressed. The shrink thinks I have not slowed down enough and that “Lithium doesn’t slow down thinking anyway.”

It is totally different than the antidepressant experience. Within a few days it slowed my thinking down. Has done wonders for my jitteriness, my ability to endlessly torture myself. Has made me feel what I think normal people feel.

But…I tried to write a few days ago, something that was required of me, and it was horrible. I couldn’t do it, and it ended up looking like a bad 8th grade essay. This broke my heart.

Oddly, I do sort of feel like I felt when I was 10, 12. Before I got this…whatever. (I hate the word disease.) Slow, mildly depressed, not really wanting to live, nothing to look forward to. No sparkle. Even my boyfriend says, “You got so…mild.” I am feelingless, expressionless.

In the weirdness that is modern psychiatry, I guess this would be called improvement. The symptoms are gone; I’m at normal human speed. Maybe if I had been treated right at 16, I wouldn’t hate it so much. The moods wouldn’t be such a part of who I am, of the years that formed my adult identity.

I have only read one medical article (or a couple by the same guy) in which the author admits, “Because dilute expressions of the illness may persist between major episodes, aggressive treatment with mood stabilizers can comprise adaptive functioning and what is unique to the patient as a person. Except in the acute phases of the illness, the emphasis in treatment should be more on functioning than complete mood stabilization.” (Akiskal KK, Akiskal HS. The theoretical underpinnings of affective temperaments: implications for evolutionary foundations of bipolar disorder and human nature. Journal of Affective Disorders 85 (2005) 231–239.)

This normal, quiet, “mild” me sucks. I hate her more than crazy me. At least crazy me is me. I want to cry when I think about all the choices I’ve made, going into such a serious profession, being so boring, trying to shove back and quash the real me. If I had been less afraid, known what was coming, I could have gone to art school after all.

Oddly enough, the suicidal thoughts are back. This is strange because I am not really unhappy. And this is supposed to be the drug par excellence  for stopping suicide. I can see why. You couldn’t possibly care enough on it to do much.

And why can doctors only see symptoms to eliminate? Great, now Sara is just like everyone else. They’re happy.

And I am…not.