my year of living bipolariously

I haven’t written about my manic depression since the end of May, and I’ve had the diagnosis for a year, so it’s time to update it all here, so I have stuff to look back on where necessary.

Hi, my name is blahpolar, I’m bipolar. It has been a year since my diagnosis, but my psychiatrist reckons that trauma activated it at around the age of five.

I’m not sure if that sounds more like a Catholic confession or an AA meeting. It doesn’t matter, it’s not something I announce irl. A little while ago, I wrote down the meds I’ve tried during the past year; here’s the list (in no particular order)…

Citalopram
Escitalopram
Buproprion
Alprazolam
Zopiclone
Quetiapine
Lithium
Methylphenidate
Lamotrigine
Chlorpromazine
Sulpuride
Sertaline

Fun side effects: various rashes, headaches, vomiting, diarrhoea, head rushes, brain zaps, breathlessness, too much/too little sleep, restless leg syndrome.
Full diagnosis: continuous, rapid cycling bipolar I, with mixed and psychotic features.
Co-morbid (gotta love that word) disorders: c-ptsd, adhd, migraine.
In the remission-mission toolbox: regular sleep (mostly), regular healthy meals (uhm…), meds compliance (always), cbt (26 weeks as part of a trainee psychiatrist’s PhD thesis, weekly), excellent psychiatrist (monthly), regular exercise (mostly), support network (my dog, a friend 15kms away, two more 45kms friends over 1000kms away, nextofkin 6000 miles away, blog friends), fresh air (lots).

“How will I recognise euthymia?” I asked my psychiatrist. She said, “you won’t, but I’ll tell you.” I said, “I’ve fucked up half of my life during manic and mixed episodes, and I’ve spent the other half depressed.” She said, “don’t you feel better now, knowing that it was the disease, not you?” “Nope,” quoth I. Luckily she’d told me a few years before, that I must stop looking back, so I returned to my new ability to distract myself and quieten my mind. Books, embroidery, TV, walking, photographing the sky, occasional visits to game reserves. I started blogging again, and for a change I didn’t give a damn about visitor numbers. I researched bipolar obsessively, until the urge began to drift away and I began to mix normal posts into the manic depressive marathon. I made friends (and advisors).

And so here I am. I still haven’t tasted euthymia, and I don’t know whether I hate anhedonia or mixed episodes more. I’m in better shape than I was, but I still have no hope and no dreams. Also, the better shape, when looked at in the context of the past two and a half years, can be attributed to the two and a half years being those after the death of my mother. I don’t think there’s been much space for working out whether there’s been an improvement in the bipolar yet. At some point – and perhaps it’s now – I’ll be able to start trying to find the difference between bipolar and grief.

In retrospect and in terms of the good ole acceptance of the diagnosis, I’m calmer about it, but still pissed off (mostly by the unnecessary fecking delay in getting the sodding thing, and all of the curséd ramifications of that). Anyroad up…

Somewhere along the way, this post stopped being an AA intro or a confession, and shifted into a state of the nation address. Let me change gears and tell you the tale. And by that I mean tell myself the tale.

Once upon a time…

Once upon a shitty time, which surprised me by being even shittier than the shitty years before it, I started hearing things. Specifically, I heard songs, quiet as a subdued radio; they were good songs, my sort of music – but they never, ever stopped while I was awake. Low level songs all the fecking time and it scared me. It took two and a half months to get an appointment with my psychiatrist, because I hadn’t seen her for a couple of years. The brain-radio continued thus for a month, and then it went feral on me. I’d get a very few songs streaming 24/7 for a few days, a few days peace and then different songs. The click song stayed on repeat for four days – and I only know the first two lines of it. Interspersed with it all, were moments of the sound of footsteps on a floor above. There isn’t a floor above me, I’m not close enough to anything to hear anyone walking like that. Or any other way.

Time passed, the way time does (inexorably). The appointment came forward, by a week, I think. It was the day of my birthday, which last year, almost everyone (even nextofkin) forgot. Idgaf about my birthday usually, but it made the day a bit lonelier. I drove to a friend’s place, she drove me to the appointment – I knew I’d be in a rough state (even before I sort of crashed into her at her door, weeping, “and it’s my fucking birthday“. And thence to the shrink, where I was prescribed meds including seroquel. I don’t remember much about the appointment, except that I totally forgot to mention the in-brain sound system till I was on my way out. “That’s early psychosis,” she said and off I went, with a script and a hollow feeling. After that, I dunno. Life, pills, that sluroquel feeling and the video ‘psychosis is nothing like a badger’. I was fretful and not enjoying being on seroquel for the second time, and I emailed my shrink a lot.

A few weeks later, I had another appointment, I was panicky, I probably spent the whole month alternating between panic and sleep. Towards the end of the session, I asked for a diagnosis and got the B word applied. Bi-fucking-polar. I went home, sat on the couch and stared into space. Then I cried, those horrible, heaving sobs that hurt physically as well as emotionally. That was the start of my year of living bipolariously. It felt as though I sat in that couch for the rest of the year. The tale doesn’t have a happily ever after or an end. Well, it’ll end, but not yet. I’m not drawing any conclusions, apart from the fact that I hate this fucking disorder, there is no making friends with the fucker. So what’s next? Well, it’s time for another brain imaging journey.

Hypercortisolemia also has been shown to cause brain damage. This is seen in untreated or inadequately treated BD. It does not affect the brain globally. Rather it selectively damages parts of the frontal lobe (anterior cingulate) and the hippocampus. Both of these brain structures play a crucial role in regulating emotion. With significant and progressive damage, this leads to more severe BD symptoms. Also damage to the hippocampus can result in memory problems. Fortunately some bipolar medications can protect and help to repair some of this damage (especially in the hippocampus). The drugs that do this are: lithium, Tegretol, Depakote, Lamictal, and Seroquel. All of these drugs increase BDNF: a protective protein. source

It’ll be fine though.

Onwards.