In which I fall back into my life

I know, I know, terrible to tempt fate. But it seems that the lithium + Wellbutrin combo is working. I’m not 100%, not even 50%. But I am not bat-shit crazy right now, and that brings both tremendous relief and tremendous horror at how I have acted over the past year. All the flying into rages, the inability to sit still, the impatience, the hating everything and everyone – all the stuff the shrink blamed on personality flaws and not mood – it has all just faded away. Now that I am not in the middle of it, I can fully appreciate how awful it was. How awful I was.

And now I have to put my life back together. I missed almost every opportunity this last year to learn something, to enjoy my work, to live my life. I’ve been horrible to everyone who cares about me, either from the irritability or being so sunk in my own misery that I couldn’t extend myself to them at all. By being so irritable and angry and short-fused, I’ve ruined my reputation in almost every department I’ve dealt with. Not the brilliance reputation, which might have even been enhanced (I aced the medical boards while in a similar manic-irritable state – in half the alloted test time), but the idea of being someone that anyone would ever want to work with.

I haven’t been to the shrink in about 3 weeks and honestly, that feels good too. I have a lot of work ahead of me, mending fences or bridges or however that expression goes. I am not sure if I owe him an apology for being so crazy and difficult and aggressive, or if he owes me one for not identifying that more clearly as a fairly severe mood state. Maybe both of us do.

I think I might need slightly more Wellbutrin and soon I need prescriptions for both things (I am still trying to hold fast to the principle of not messing with this stuff myself, getting prescriptions from a treating doc). And the Wellbutrin seems to be making me something of a worrier – every wound I close, I can’t sleep at night wondering if it will open, if it is bleeding inside. This is causing me considerable distress, and maybe I need a whiff of serotonin to tone that down.

I left a message with him last week, never got a call back (he is usually good about calling on the same day) and I’m hesitant to call again because, well, I’m always so ambivalent about dealing with him. In the meantime, I’m assuming he’s out of the country or something, though there is that nagging question about whether he possibly snapped himself and jumped off a roof somewhere. Occupational hazard.

But I don’t really want to go back to any kind of therapy. Not now. Not with him. It has felt good to have that weight and dread of appointments off me during these three weeks. Right now, I need to work on rebuilding my life, making amends, starting to function again. I know how to do that, more or less. Unfortunately, I’ve had to do it many times. A few of them, I’ve picked up and moved and started my life all over, so hard it was to face what I was during the episode, to face the people who saw it.  Sometimes, it’s easier to just start over than to try to fix what is broken.

I think a comment I left over at Secret Life of a Manic Depressive was sort of hurtful, though I didn’t mean it to be. It’s so strange, you learn as a doctor, how sometimes something that you say and mean in a totally different way is interpreted as insulting or hurtful. It’s happened to me. I guess the lesson is, once again, be gentle, for everyone around you is engaged in a great struggle. I’m sorry.



  1. There are a select few who understand and love you anyway. It’s hard to make amends, yes, but sometimes that relationship that remains is resilient and unbreakable.

  2. Good to hear you’re making progress.

  3. It’s more the lighter friendships, the work relationships that I worry about. The ones that won’t weather a year of crazy…

  4. Hi Sara,
    I am glad to hear you are feeling better. You mentioned the Wellbutrin making you a worrier…is it possible it is a bit of depression coming through and you need a higher dose of wellbutrin to lift you a bit more and stop the worrying? I know for me worrying/catastrophising is a big part of my depression.

    As for your “hurting” others while manic… please cut yourself some slack and recognize the illness was making you behave that way. People will see the real you if you allow them to now. Personally I suspect even the manic you was nicer than you remember being.

    Good luck with your newfound mood and keep us posted as to how things are going. I love reading your posts.

  5. I hope so, but I’m afraid that when I’m like that, I think I’m being totally reasonable, and only now I realize how horrible I was. I even think that maybe some of the things the doc said taht I got so upset about, I misinterpreted and overreacted. Like, now I don’t get so upset about that borderline comment. Or the makeup one.

    I was never much of a worrier/anxiety before – I think it is a little bit the Wellbutrin. It gave me the first panic attack I’d ever had…but I can live with that. I’m thinking maybe I need something like one prozac a week to just give me a little teeny bit of serotonin. And I’d love to get off the lithium…

    Also, I’m only at 150 of Wellbutrin, which isn’t a full dose. I’m a little scared to up it without seeing my doc, but he hasn’t called me back so I don’t know. I guess I could do it alone. But I’m nervous because of how I flipped out at first, and how it gave me so much energy right away. I tend to be an angry rageful violent manic, not a happy one, so I’m scared to push in that direction. I know the depression isn’t fully treated right now; I have a lot of residual symptoms, but it’s so much better than I’ve been all year that right now I’m ok coasting with that.

    I’ve just been such a bitch all year. Every time someone has needed me to do something, I’ve jumped on them with “Why me?” and been angry and resentful. Everyone knows those people who are so negative all the time, who always complain and seem to hate everyone and everything and feel like everything is an imposition and an insult. That’s what I was. I am so ashamed…it’s hard to just fall back into regular life now.

    Thanks for writing.

  6. Increase the Welbutrin to the most common dose and don’t go off the lithium. Do not mess with your medications when they are working, do not always think that you are okay and that you now don’t need one of them. You need them, it’s as plain and simple as that. Just for a long extended period of time stay on the same dose of medication and see how well you do. Don’t go back inti therapy if you don’t want to, it’s so much a mind game, instead get practical day to day advice, coping skills that will help you more. Be sensible and your own best adviser. You know what you need if you think about it well enough and put it all in order of importance. Good luck, sweetheart. Follow your common sense.

  7. I’m writing a post that I’m “dedicating” to you. Check my blog soonish…
    More soon.

    Love love love

  8. Great post. Glad things are on the up.
    Hope you don’t mind…I used (with a quotation) “be gentle, for everyone around you is engaged in a great struggle” in a blog comment on RuralDoctoring and before I read that post was going to use it in a post of my own. It just resonates with me a lot today after I had someone (a medical student of course, it should be a DSM category, honestly) rip my head off because of their own issues.

  9. You know it’s not original, right? It’s one of the Ancient Greeks…

  10. I’m positive I wrote a comment here saying don’t worry about your comment, where’s it gone or did I hallucinate it?

  11. Ah uncultured me 🙂

  12. You are being hard on yourself I think.

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