Don’t let me slip away

I want to write a post about a self-harm patient I saw last night. (Seriously – I guess the message for what I should be doing with my life is clear, medical treatment for crazies. I went maybe 9 months without seeing any psych patients and then this stretch of them just when I’m ready to quit medicine…) Especially since the topic of scars and regret has been going around on a few blogs lately (for example, here and here). I think as far as damage goes, it was a fairly severe case, though, as I said, I haven’t seen many.

My point is – if anyone wants to hear about that, remind me, sit on my ass to do it, because so much material gets lost by my laziness and losing interest or having moved on to the next thing and forgotten the incident that I wanted to write about in the first place. I write only a fraction of what I want to, and if I don’t write, I forget.

But I need to get some sleep before the all-nighter sets me off; I think this bupropion seems to be pushing me toward the manic side (that’s a good thing for me) – it’s ok as long as I am super careful about light and sleep and caffeine and exercise, but last night I worked until 2 AM or so, and then we split to sleep, and I couldn’t – because I was full of racing thoughts that jumped from one topic to another. Not worries or anything like that – the real true racing thoughts. And then the panic of realizing what that meant. I was in the stupid on-call room bouncing off the walls. Usually you PRAY for your phone not to ring at night. I think my most sincere prayers, considering I’m pretty much an atheist, have been those ones.

But last night, they called me at 3 AM and I was glad for something to do, another patient to see instead of lying there crawling out of my skin. I think I joked with them a lot more than I have been doing lately. In the morning, right before going home, I actually made a cup of coffee, because even though I was all over the place, I wanted to keep feeling good.

And now I came home, and instead of going straight to shower and bed, I made breakfast, and wanted to come see if I got comments, and now I’m writing this! And I could easily keep going all day. That’s exactly how my last manic episode started – a long night and then I should have gone to bed, but at 5 AM the sunlight was so tempting,  and I spent the day shopping on foot in the city, meaning I was most of the day in that sun. And boom.

Which means it is time for some heavy benzos. I got the shrink to agree to leave the Wellbutrin and no mood stabilizer if I’d take zolpidem or something similar when I start to not sleep. So I guess I better.

I went and pulled a lot more of the “cyclothymia” references at the medical library last night. Some were in the actual paper stacks, they were so old. I love going up there to the fourth floor where there are medical journals from the 1930s and back, in all kinds of languages. The material is interesting; I read some of it while I was bouncing around and not sleeping. If anyone wants, let me know – most of the files are PDFs. All kinds of funny little tips in there, as in, “They are the patients who like both uppers and downers.” Meaning, purely depressed patients like stimulant drugs, anxious patients like relaxants – benzos and so on. Cyclothymes are the few who enjoy both. Actually, you can tell a lot about a person’s psychiatric makeup by their favorite drug.

They are the ones most likely to refuse mood stabilizers because it flattens them (because their personality is greatly shaped by the mood states, that is the way they know themselves and not having that will make them feel weird).

Or, from way back, something like, “the job of the psychiatrist is not to try to change the person’s temperament, which cannot be done as it is almost certainly a biological substrate, but rather to be supportive through the numerous crises in which the cyclothyme will inevitably become entangled.” I seriously thought of copying that and passing it on to my psychiatrist. I think there was something in there about medications also not being great because we quit because of feeling flat; though when I feel good and not flat (which means that I am fairly unstable, with bad times too, just with also good times), I am incredibly med-compliant.

I answered some comments on the last post as well. I notice that the comments are getting longer, more philosophical.

So write me and tell me to write the damn post! (Oh no, is this the “uninhibited people-seeking” phase? Does my writing sound manic?)

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7 Comments

  1. Sara, I love having a cup of vanilla green tea when my thoughts are racing… I am wishing you well beautiful.
    love from Milo

  2. Speaking to the “no time to write it all” problem. There are as many strategies for dealing with that as there are writers. What I found useful is to carry a small pocket sized journal (no tear out sheets) with me at all times, and I write catch phrases and topics when I get that inspiration without the time to allow it to develop to fruition.

    I also keep a draft blog post to enter notes and piecemeal stuff that defies categorization, development, time, thought and other scarce resources. It’s the equivalent of a kitchen “junk” drawer – some of the stuff moulders there, but I frequently grab bits and pieces for use elsewhere.

    Maybe you need a new tool or two to deal with all of the influx of info and experiences.

    As to wakeful nights on call – does your facility have a chapel or meditation room, or can you access the medical library? Those places are usually deserted at night, and they would allow you to move around, read, think and adjust the light to suit your needs. Better than the junk in the vending machines and tossing and turning in the on call bunks.

  3. i would love to hear the story of the self-harm patient (surprise!), if you have time. i hope your “up” mood continues to be okay and you don’t suffer any negative effects, that’s what i would worry about for you. i am so happy to see you posting.
    Band P,
    tracy

  4. Tracy – one story, coming up. It was really awful.

    Annie – part of my problem falling asleep is that I just, like so many of us crazies, am easily overstimulated. It always takes me time in the dark room to just wind down – maybe an hour and a half. The ER call rooms are rather nice, it’s not the bunk bed thing, the building is new, so they built this little wing where each room is private with a bed, table, and bathroom. The library is not a 24 hour one now. I often go outside and walk the grounds, but it was really cold and wet last night.

    I sometimes do the “draft” thing, but I never, ever go back and finish it. The drive is gone.

  5. I would be really interested to read the story about the self harm patient if you feel like writing it. If you can tell alot by a persons favourite medication what would zopiclone say about me? Hope you ok, Love Hannah X

    Oh and I am blogging again

  6. Hi! Glad you’re back! Thanks for saying, I wouldn’t have noticed otherwise.

    Zopiclone to me would say strains of anxiety/restlessness, as well as depression and a want to escape. I like it too.

  7. Send a little mania my way. I hate it when I say that and then the doctor launches into how destructive a manic episode is, and blah, blah, blah.

    But what kills bipolars? It ain’t the mania.

    I hope it remains hypomania for you, and you can enjoy the extra energy.


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