Sunday, June 29, 2008

All Fall Down

Ten hours sleep, mostly; still I feel drowsy and sleepy. I'm a bit unsteady standing up, too, lightheaded, you could say. Quivery, too, like I'm a washer on spin cycle.

Yesterday was quite nice, actually. Maybe I'm coming back down from the mania that seemed to rule a few days ago, on the way to a hopefully mild mostly-depressed period. After the spikes that came my way lately, that might seem like a vacation (although I'd rather be "normal" for a few days, instead).

I just learned yesterday that one should not mix lithium and ibuprofen. It can cause the lithium levels to build up too high. Oh, great. Here's another complication, something that probably contributed to the weirdness of last week.

No caffeine, no alcohol, no ibuprofen.

Alcohol, in and of itself, will not be missed. But pizza is just not pizza without an ice-cold beer. And I will sincerely miss our traditional Asti Spumante toasts on anniversaries and holidays.

Caffeine's a problem. I think I'll just include two cups of coffee in my daily regimen and let Doc medicate around it.

Ibuprofen? Arghhh. This is one we'll have to discuss with Doc. Maybe I can cut down the lithium. But then I'd be required to take ibuprofen instead of using as needed. Maybe the two can be balanced: take ibuprofen, skip one lithium, that sort of thing. Doc, we need to talk.


Took a nap. Now it feels like my water pressure is too low. Everything on my end is in slow motion. But other stuff happens far too quickly. I was watching grandson Aiden play on the floor; it was like somebody took his film and cut a few frames out here and there. His reality was kind of jerky. Mine is very smooth. I have to concentrate really hard to understand what Mary is saying.

No. 1 daughter Randi just walked through. We had a most entertaining conversation, as I couldn't understand what she was saying, and apparently wasn't making myself clear to her:

"Hi...I said 'Hi'...I said...ah, nevermind. Whatcha got?"

"Mphf dot grogh gleltplug mech rugs."


"Whemf jher nelt gold ment rugs!"

"No, I said 'What have you got?' What are you saying?"


"You and Mom need to look at rugs? What do you have, there?"

"Yes! We need to larkly-al rugs! What do you mean. Where?"

"What have you got there, in your hand?"


"Cheese? May I have a piece? ...Thanks. "

"What? What? Oh, never mind."

Then Mary came in and said something unintelligible. I had to ask her to repeat herself so I could decipher the conversation. It turns out she was talking to Randi. Then as she turned to leave she told me in no uncertain terms that " sister has all the spiders, for some reason."

I think I should just go back to bed.

Friday, June 27, 2008

Into the Night


Or, as I usually think of it, just black. I haven't discussed the blackness before, to anyone. When it comes it's a plane of empty light-sucking darkness that starts somewhere above my head, pierces my head and body, and extends an unknown distance down past my feet. Anyway, that's how I imagine it.

I've only felt it a few times in my life. When it comes there is an overpowering hopelessness, a feeling I can only describe as pure anguish, a dispair I can't adequately convey. All I can tell you is this: I know what Hell is; I've had a preview.

Luckily, I suppose, it has never lasted over a few minutes, maybe thirty minutes or an hour at most. It's hard to tell, though: it's easy to lose track of time when you're being tortured by the Almighty.

I had several spells of black in the past several months; they're one of the main reasons I decided to (finally) seek treatment. It was getting impossible to pull myself out of depression, and I couldn't face the prospect of being caught in the pit. That, and I felt the black getting wider, almost as wide as my body. During my 20's there were a few black episodes; the blackness was at that time about a wide as my head.

During the year I first became aware of my condition, during my 7th school year, I had one episode, a few weeks after one of my conversations with God. I thought He was punishing me for giving Him an argument. That black was about a hand's-width.

Now some other things I've never discussed, never, with anyone:

When I was five I had two black events. I was just a kid, I didn't know anguish; to me it was just pain and anger. And in pain and anger I strangled our pet rabbit. It wasn't hate, just uncontrollable pain, and I took it out on that poor little bunny.

Several memories remain of my life at two years old. In my earliest recollection of my mother, she was chasing me around the dining room table. That's all, just running around that table. But I have other, fragmented memories of pain and anger, and a black thread piercing my head and body, as I systematically and methodically killed all our goldfish. Mom never knew, she would puzzle about it her whole life, mentioning it over and over again, until just a few weeks before her death: "Well, we just never had any luck with fish and aquariums, ever since all our fish died that time in Oklahoma City..." I could never tell her, and I'm so sorry for that.

The Big Nothing

Nothing. Nope, nyet, nada, zilch, zero. We last left Rand gulping down the midnight pharmaceuticals, vigilantly waiting to record the effects of the latest round of lithium carbonate and desvenlafaxine succinate. What he observed was: nothing. No nausea. No manic episode. No dance-y feet. No dizziness. No racing thoughts, forced speech, irritability or aggression. No brain farts*.

Ok, maybe my system was fully out of whack from the flu, maybe I was so mixed up I messed up my medication schedule. Maybe I was actually having a major manic episode and the medications were helping, causing not pulses of mania but cycles of normalness. Or maybe a hundred other things. Whatever, I got a really good night's sleep, finally.

One problem is that I just don't know what to expect. Doc didn't give us any information on how this thing is supposed to go, or what to watch for, etc. I don't know just what the performance envelope is supposed to be. The "Patient Information" inserts read like a side effect wish list, with no explanation or description or hint as to severity. Oh, and the warning signs of toxicity are pretty much the same as the normal side effects list. That helps a lot, thanks.

Most of what I know about my condition and the expected course of treatment has come from books, and lately, the internet. Which is where I found the first hints about:

*Brain Farts: That's what I was calling them. I think most other people call them Brain Zaps. They're hard to describe. For me, it's a great desire to lower my chin, turn my head to one side, tip the head to about 30° from vertical, close my eyes, and silently vocalize "Mmghhh..." while the muscles of my neck, shoulders and torso tense up momentarily. Think of a big bite of pickled lemon covered in rich, creamy milk chocolate. That's just the physical part, of course. While that's happening, the brain (mine, anyway) feels like it's sloshing around in skull that's temporarily a wee bit too big and the universe doesn't exist for an instant. I told you it was hard to describe.

Thursday, June 26, 2008

Bi-cycle built for two

I am cycling. It's not very regular, about every three to four hours or so. Lithium seems to cause a bit of nausea, but not other overt side-symptoms; it may have some other effects (see below) but nothing dramatic at the moment.

Pristiq, on the other hand, is a bear. I started with Lexipro in the afternoon, but wanted to change to evening so the inevitable drowsiness would help me sleep. Bedtime it is. However, within 20 minutes of taking Pristiq a mini-manic episode begins: restlessness, rapid speech, machine-gun thoughts, crazy legs - I was pacing the floor last night night because I just couldn't stay in bed. The torment usually lasts around 15-20 minutes; last night it was more like a half-hour. Maybe something to do with my still-weakened post-gastroenteritis system.

Then, every so often, it starts again, usually not as strong, usually not as long, although, as I mentioned earlier, it can be stronger than the initial effect. Maybe the stuff is staying in my stomach and the pulses eventually overlap; maybe the cycles are supposed to 'fill in the blanks', so to speck, and even out the effects eventually. But if that's the case, I'll end up hyper almost all the time. Yuck. Still, I'll give the medication a chance to work before condemning it.

In any case, a mini-cycle manic-phase event is NOT the time to find yourself with your wife deep within Home Depot looking for a replacement for a broken showerhead. I'm proud of myself, though: I bought the mid-priced showerhead, only dreamed up a half-dozen or so new projects and didn't actually buy anything else. I said "It's Ok if I just look, right?" (I was panting) and Mary reluctantly agreed, yes, as long as I didn't buy anything. I finally tore myself away from the new cabinet hardware and we made a clean getaway. I was really shaking as we walked to the checkout; I don't remember it being so exhilarating.

Here's the 'see below' part: I'm going to start watching my reactions to lithium more closely. Something was going on a few days ago, before I got sick. It may have just been my system fighting the virus, but it sorta starts to resemble lithium poisoning. I don't know how long it takes for toxicity to build up over regular doses (I read somewhere that, if you're at optimum level just one or two extra tablets can push you over the edge), but maybe that's the subject of today's research. I never heard back from Doc's nurse about my first blood tests, and they usually let me know fairly quickly about lab tests (although they sometimes flub up and never let me know), so I don't know how close to optimum I am. My next appointment is not scheduled for 2 more weeks.


Two hours later and I've gone sailing again. It only lasted a few minutes, but I had to walk around the house and wave my hands wildly (it feels good, I don't know why). Otherwise it felt just awful. God, I hate this! Manic was never like this, it never hurt before (well, there were a few times in the final few days before I started treatment...). I can't tell if it's not working, or if the cure is worse than the condition. No, scratch that: those last months were pure hell; this feels bad, but I don't think anything could feel as bad as it did then - except Blackness, which is something I need to get to in the next post or so.

Wednesday, June 25, 2008


My turn. Mary had it, Adriene had it, Jen (sort of) had it, Holly had it. Jen's relatives got it, all at once. Now I had it: viral gastroenteritis aka Stomach Flu. It's 'going around' from what I hear, and the emergency rooms have lines out the door. I got it worse than anyone in the family, naturally.

For ten hours I lost fluids out both ends, even had a spectacularly runny nose. I started barfing up mostly nothing (gawd, I hate the dry heaves), but later considerable quantities of watery liquid mixed with some bits of rotting lettuce (undoubtedly the salad eaten the day before I got sick). Seven hours into the ordeal I realized that I was probably getting severely dehydrated and so decided to miss a lithium and try to get my electrolytes and water levels back in balance before the following dose. I choked down what Gatorade I could, even though most of it came right back up, until I finally threw up something that looked like a mass of seaweed and then didn't vomit anymore. Between then and the next dose I managed to finish four small bottles of Gatorade and two afterwards. Add in a few odd glasses of fruit juice and lemon-lime soda, and even with all the liquids I pumped down I've lost almost 10 pounds.

I also spit up something that looked like a miniature marshmallow: it was pure white, square, about a half inch across. I wonder if it was a Pristiq? It's controlled-release, but I don't know the mechanism for the control. Maybe it puffs up like that.

Now my ribs and diaphragm and back muscles ache - you know, all the vomit muscles - and I can't cough. I can't roll over in bed, either - I have to slide out, stand up, and reenter. I just had a bowl of rice cereal, thinking it would be fairly gentle on my poor guts, but that was a mistake.

I don't know if the cycling has continued, since I just woke from 10 hours almost continuous sleep. I do know that 20 minutes after the last daily dose of Pristiq I got nervous, agitated, and "dance-y". That lasted about 15-20 minutes. If the timetable holds, I should be feeling something in two to three hours. We'll see.

Monday, June 23, 2008

Who are you?

I wasn't me again last night. I still don't know if it's Pristiq or lithium. I do know it is the Pristiq that makes me restless and jittery before making me drowsy enough to get to sleep. When I take my daily dose (well, 20 minutes after) it's like my worse manic episode mixed with a moderate depressive episode.

Have you seen the movie Speed Racer? Imagine all the lights flashing by are replaced by newspaper clippings. That's what racing thoughts are. Now, drink a six-pack of beer and put on concrete sneakers and lead-lined gloves. Welcome aboard. Enjoy your evening.

On the good side, I only cried for a few minutes. I also cleaned the toilet and bathroom around it (the score so far is 2½ adults and one baby with gastroenteritis; I'm holding my breath - in more ways than one) so I am still functional.


Either [1] it's not the Pristiq after all, or [2] the Pristiq, being timed release, has just finished releasing a dose into my gut. It's fifteen hours since I took the last dose, and still an hour until the next lithium, and I'm nervous, irritable, aggressive, entertaining the Wild Mouse (see "Speed Racer, above) and just feel, well, boogada boogada, boogada boogada-boogada-boogada boogada-boogada-boogada BOOGADA-BOOGADA-BOOGADA!! if you know what I mean. God, I hate this.

Update 2:

It seems to be on about a 4 hour cycle. I was weird-ish around 3 PM, then again at about 7 PM. I should get antsy around 11 PM if this holds true. We'll see.

1o:10 PM:

And I'm starting to get ookie - sorry, it's hard to explain. The tinnitus is starting to scream.

10:30 PM:

Ok, full-frontal manic attack. I did the dishes, I was doing two, three, four things at once. Talking like a tape recorder with too many batteries installed. Definitely manic. I don't like it this time. It's like I'm desperate, trying to cram in everything in a few minutes. I hate this as much as the depression. Make it stop Make it stop Make it stop Make it stop.

10:50 PM:

Damn, that was fast, in more ways than one. I already feel like I'm falling, melting, sliding into lethargy. I have to take another round of drugs in less than two hours, and not looking forward to the torment. Still the tinnitus screams.


In my defense, in 1963 there were no effective options available. Manic-depression was treated with the same drugs as major depression, psychosis and schizophrenia; lithium wouldn't be approved by the FDA for seven more years. But let's go back a few months and take a quick look.

At age 12 I began to realize that something was, if not wrong, at least different. There were "slow" days and "fast" days, and it was easy to tell the difference between the two.

Fast days were fun, sunshine was brighter, music and thoughts and ideas swirled through my head. I could easily finish my homework - before I left the class. I had boundless endurance (although I didn't actually think of it that way, just that I could "get stuff done"). Everyone liked me, everyone loved my jokes. Although fast sometimes only lasted a day or two, it mostly covered entire weeks.

Slow days were a time for rest, and trying to get out of chores. When I was slow the world was cloudy, almost fogged in. Everyone else went speeding by me while I bumped along blimp-slow through the day. If it was a weekend, it was time to sleep in, maybe catch a nap in the afternoon. Slow didn't last too many days, sometimes just one day; they were something to be endured so I could be fast again.

In the mornings I would wake and lie in bed a few minutes and watch phosphenes, assessing the day ahead, deciding whether it was going to be slow or fast. On a fast day it was like watching thirty movie screens overlayed by a Krazy Kat cartoon. On a slow day, more like black-on-black seaweed swaying in a gentle surf. A fast day required discipline to get to school on time: I couldn't get distracted, start reading a book or magazine or start a drawing or fiddling with a model. I could read at the breakfast table, that was OK, since someone would be there to kick me out the door if needed. A slow day had it's own special attentions or the ordinary affairs of getting ready for school would take too long to complete. It was like wading upstream in a slowly-cooling lava flow.

So I knew something was different with me. Other people didn't seem to go slow and fast. The friends with whom I shared the feelings had no knowledge or experience of such odd things. I was an avid reader, haunting the local libraries almost daily, but my research didn't, at the beginning, turn up any information on the slow/fast days phenomenon.

I didn't tell any adults of these things, mainly because I had one more "symptom" which I didn't want anyone to know about: I was crazy. Not "that's one crazy little kid" or "hey, man, are you crazy?" More like delusions, hallucinations, the Voice of God, that sort of thing. I wasn't real crazy, and the delusions came and went pretty quickly (and a lot of the Divine Conversations were like "Hey, you're not real" - "YES I AM" - "Don't hand me that; you're part of my own brain. Now fuck off and leave me alone."). But, for all I knew, even a little bit crazy got the victim a trip to the nearest insane asylum.

You see, schizophrenia was the only insanity widely mentioned in popular media at that time, so naturally I thought I was schizophrenic. And, in 1962 schizophrenia was apparently not successfully treatable, since all the victims seemingly spent their lives in institutions. I was one scared 12 year old. I started doing deeper research into insanity and finally came across manic-depression. Manic-depression! The symptoms mostly matched (the depression part never did jibe well with my experiences, until recently - more on that later), the manic individual could have delusions, even hallucinations, and better yet, lots of really smart, famous and artistic people were suspected of being manic-depressive! It was like jet-set crazy. One problem: get too out of hand and you still get incarcerated.

That's when I shut up about my condition, not even my friends could know. I started making jokes ("Ha, ha, I guess I'm borderline manic-depressive, ha, ha.") and rehearsing excuses for irrational behavior ("Sorry, I didn't get much sleep last night: my hamster got out, see...", "Yeah, I've been kinda queasy today; I hope it's not the flu *cough*cough*.") I think I fooled most people, although a few apparently noticed that something was wrong.

That's for another post.

Saturday, June 21, 2008

Let It Rain

I'm tired of keeping track of the serialized day of my treatment and - hopefully - recovery. From now, the posting date will have to suffice.

I'm a few minutes late on the morning lithium. Son Chris and daughter-in-law Jen were rousted from sleep and assigned their own baby as well as grandson Aiden, who is spending a few days with us (his mom, daughter KC having decided that mobile homes are not a safe place for infants during major thunderstorms) while Mary sleeps in. She had a rough night, a bit of food poisoning perhaps, and I want her to rest today.

So far today things are OK, but we'll see how things progress after the AM dose. Yesterday I was fine most of the day, only one brief tearful moment, until soon after I took the evening pills. Then it was Sob City, but only for a few minutes. For one thing, I realized I was thinking Happy Thoughts (eg, "I sure do love this time of day, with my family snuggled in asleep, and Mary and I snuggled in, just listening to the grandbabies little grandbaby noises..") and moved my thoughts to something more neutral.

Mary and I went downtown yesterday and applied for counseling/therapy sessions at Family Services, a local charity which helps mostly low-income families. It's a wonder to me that we were referred there by the local psychiatric hospital, whose personnel seemed a bit confused with how to handle a cold-call from a bipolar person. I know Doc was no help; he didn't have any suggestions for counseling/therapy at all, and appeared puzzled that I'd even want such.

Anyway, we filled out a lot of papers and turned them back in with supporting documentation, and we are supposed to hear back from them in one to three weeks. Let's hope it's more like one week.

I still don't think anyone understands that I've been on the roller-coaster most, if not all of my life. I don't know what normal is. I'm lost here. And, due to my latest several-year (apparently) high, our life here is a shambles. There are a lot a pieces to pick up.

Better go hit the lithium.

Wednesday, June 18, 2008

Day 22: Wild Horses

Wednesday June 19, 2008

I started taking my antidepressant at midnight instead of afternoon, so the immediate rush will (hopefully) make me drowsy and help me sleep. That didn't work as well as hoped, and though I slept fairly well, it was only an hour at a time. I've been up since 6:30 AM. I've had a dozen or more Good Ideas since then. I washed all the dishes, including the baby bottles. I've been directing Chris and Jen in clearing their room to make space for a crib. I had a good breakfast. That's more than I've been able to accomplish in a few hours since before last month.

But I have been irritable this morning, and apparently exhibiting some sort signs of aggression, because my kids have been doing stuff as I ask without back-talk or attitude. Uh-oh, Dad's close to the edge, better not make him angry.

Am I manic? Maybe this is what normal feels like. I hope not: I feel like I want a fight, but don't want that feeling any more. I know I have to be careful if I do start to get high, because I won't have much (if any) constraint. Hmmm...I need be sure Mary knows to what to look for and will call me down if she sees it happening. Kids, too.

Tuesday, June 17, 2008

Day 21: Implosion

Tuesday June 17, 2008

Yesterday found me on an upswing, feeling good but with some barely-suppressed aggression and irritation. Luckily, I kept my tongue.

There's been more memory problems the last few days. Not just short-term, what-was-I-doing stuff. Mary and I went to a restaurant for dinner, the first time in months, I ordered steak and and forgot "medium rare"; I've been forgetting a lot of simple words and phrases. Usually they'll come to me after a while, but sometimes I need help from family members to get the thought out.

I almost lost control and started crying right in the middle of a crowded Logan's Roadhouse. It took a lot to fight the feelings back. The steak, however, was perfect.

Last night I could feel myriad thoughts and ideas bubbling up, like vegetables in a simmering stew. My own fault, probably: I missed the 4:00 pm pills and ended up waiting until midnight.

Today I'm down-er. After telling Mary (last night) I was going to try to clean out the remains of the living room, I face the new day with an absolute lack of any will to do so. We did get a good start on finishing up the shutting down of our business. I can converse on the phone, where last month I would often choke up and not be able to speak because I was sobbing so hard.


Evening brought anxiousness, restlessness, terror and tears. There were moments when the feelings seemed as bad as they did last month. The ride is headed back up. Oops, now it's headed back down. I explained it to Mary like this: as any mother will know, there is a moment during childbirth where the expectant mom says "Ok, I've changed my mind, I'm not going through with this, I said I DON'T WANT TO DO THIS!" It's the same here. I don't like this. I don't want to feel like this anymore. I don't want to do this. But it's not going to be over in a few minutes; it could go on for the rest of my life. I really understand why people with BD commit suicide.

Sunday, June 15, 2008


You may get the impression that my medications are not doing much good, but in reality (such as that is these days) they seem to be of some help already, and have been smoothing out the highs and lows, and have gotten me to a point of perspective, a wider and deeper view of my life and my condition. It's time to look back fondly (!) at the events and circumstances which bring us to this plateau.

A bit over two years ago (I'll delve into the ancient past later) - let's call it Spring of 2006 - I began having occasional bouts of emotional lability: mostly spells of inappropriate crying, but also laughter, and sometimes both together. Along with that I had brief moments of difficulty appreciating jokes and cartoons. That was scary, mainly because years earlier my father told me, shortly before dying from what his neurosurgeon called "the most aggressive tumor I've ever seen," that his first hint of that tumor were those same symptoms.

One very expensive and uncomfortable MRI later: my immediate fears were laid aside, as I didn't have a massive and extraordinarily dangerous brain tumor or, apparently, a possibly unnoticed stroke or prefrontal atrophy. Then I made a bad mistake. The emotional lability was not followed up, and no effort was made to determine it's real cause. I didn't want my mental history checked too deeply. I knew I had manic-depression aka bipolar disorder. And I kept quiet about it, as usual.

By December of 2006 I was host to full-blown mania: "This is your captain speaking. We'll be cruising at near supersonic speeds at just over treetop level. The weather is clear with just occasional mixed episodes of weeping, anger and terror. We will be arriving at some destination at sometime in the future, but who cares? so sit back and enjoy the ride."

So I quit the best job I ever had, opened my own photo studio, and blew through almost a hundred thousand dollars, all the while convinced that the business was quite successful.

I should mention that this was the sixth time I had gotten wired and opened a photo studio, and also the sixth time I'd spent almost every penny I had and then allowed the studio to die after the high wore off.

By mid 2007 I was into a kind of ultra-rapid cycling depression. There were days at a time where I just sat at the studio most of the day, unable to make a decision or take the action I know the business needed. I procrastinated, I stayed up all night and stumbled around the next day in a daze, I drank way too much coffee and consumed entirely too much sugar. I think I may have been trying to force a manic episode. A couple of times it apparently worked, but I'm not sure the outcome was what I wanted.

For instance, my mother was having problems, and was going to be moved into a managed care facility. My sister wanted me to come down to Dallas to remove all the valuables from her house so it could be shown for sale, along with any keepsakes I may have wanted. I agonized over the prospect (I hate Dallas), and ended up creating a "brilliant" scheme to bring all the collectibles and heirlooms back here and put them on sale so Mom would have some extra cash. Yeah, like I know anything about antiques and collectibles. Anyway, it's mostly worthless junk, and we'll never even recoup the cost of transporting and storing the stuff. I should have just hired someone to put on a yard sale.

Sometime around December 2007 or January 2008 I started a slide into absolute bipolar depression. I felt awful most of the time, the entire world was ugly, and even things that are supposed to be happy thoughts could drive me into a sobbing heap. (Now that I have some perspective on things, I think that the agony came from the excruciating intensity of the emotions I was feeling, such that any emotion was painful: for weeks I couldn't tell my Mary I loved her, because it hurt so much.) I could still pull off the odd manic episode - just mix caffeine, sugar, sleep deprivation, and stress - but for the most part I was useless.

In May I bottomed out, crashed and crashed hard. I was having several mixed-symptom episodes every day. My thoughts raced and fought for attention while I cried like a baby. The business was dead. The remodeling was at a standstill (Oh, did I not mention the remodeling? No big deal, we - meaning mostly "I" - removed most of the walls, replaced all the wiring, plumbing and gas lines, built a new kitchen, bedroom, dining room, family room, laundry room and two new bathrooms and the permit expired in April; Superman strikes again). I was also having fond thoughts of death by natural causes as well as serious intellectual explorations of painless and low-trauma suicide. I didn't tell Mary that, just "if I'm not better by Monday, get me an appointment somewhere." I felt better on Monday, but she got the appointment anyway - without telling me, which is probably a good thing.

And then I started this blog.

Day 19: Song of Tears

Sunday June 15, 2008

Happy father's day, damn it.

Sitting at the computer (what else is new?) reading some material I came across from psychiatric journals. The subject touched on suicide, and I remembered that I lied to Doc (yes, I have thought about suicide, but I considered it more an intellectual exercise: how to make it quick and painless and not traumatize my family - so no slit wrists in the shower) and I thought again how I don't want to hurt my family and I realized that suicide would be an acceptable resolution to this mess and I started sobbing...and I just did it again.

I only came to tears about 4 times yesterday; I've stopped trying to hide it from the family, they don't pay me much attention anyway, they just stay out of my way. That hurts; only my youngest ever offers a hug or pat on the shoulder these days. She knows what it's like (and is under treatment, too). If I'd known the genetic factor in this condition would I have had so many children? Any? I think probably so. After all, for most of my life I was SUPERMAN!, Man of Steel! and master of all reality.

I woke up crying this morning, cried through an early piss, rinsed out my dry, sticky mouth and went back to bed. I was better for a while after I re-awoke. I wonder if any of that good vibe was due to missing my morning lithium by a few hours.

"Rapid cycling" is defined as 4 or more episodes lasting more than (I think) one week over one year. I must be ultradian: I can can do a complete cycle in one day.

Saturday, June 14, 2008

(Still) Day 18

Saturday June 14, 2008

Just read something, several somethings, disturbing about Pristiq, the new antidepressant Doc has me on. Pristiq, it appears, may be one of the least effective antidepressants on the market. I hope not; I really need some help.

Day 18: It All Comes Out as Fear and Sadness

Saturday June 14, 2008

It was the title of a drawing, little more than a sketch, done some 30 years ago. The exact time and circumstances elude me now, but it still echoes the feelings passing through my body like slow gravity waves of open ocean.

The early morning brought tears, more so last night. This should just all go away. Just leave me alone. Please, Dear God, I don't want to play these games any more.

I want to try to paint, but the media and brushes are not easily at hand, no canvasses here or panels prepared. Will I even have the spark? Before, meaning when mania ruled the world, I had to wait for the "muse" to take over; the muse may be dead, or, more likely, in a coma, drowned in lithium and serotonin reuptake inhibitors.

You'll notice less griping about side effects; we've come to a state of uneasy coexistance. They are still here, but none, so far, are deal-killers.

Friday, June 13, 2008

Day 17: Flip-floppin' Away

Friday June 13, 2008

Despite the flippant title, I really don't feel good. I was OK when I got up, but now, around noon, I'm uneasy. In fact, I'm scared. Ok, so it takes up to two weeks for the antidepressant to work; maybe I'll feel better then.

For now, I'm scared - I already said that, sorry. I have been trying to figure out what I'm going to do for the rest of my life, and haven't come up with any good answers.

Mary and I have agreed to shut down the studio, or, rather, the portrait business, as we don't have a studio location anymore. She can't guarantee that she'll be available to help me, and I don't feel able to handle it myself. Our dream was to work side-by-side, but that hope dried up rather quickly, due to family obligations. We had actually taken her availability into account when we start the studio, and thought we could work around her schedule, but it never worked out, and when we added the complications of two very welcome but inconvenient grandchildren, well, it just completely fell apart. The probability of an appointment conflict - that the driver may not be available - starts to approach 100%. This is not even considering that there is no verifiable way to ensure the photographer won't be sitting drooling in the corner or pacing the floor in a growing rage.

As to why I'm scared: I'm not me. I don't feel that I'm inside here. I do realize that there must be some of me still here, but I don't feel like me. I look in the mirror and don't completely recognize the person looking back. The memories are the same, and I know where all the body parts are, and why, for instance, this muscle here hurts. But it's like I was assigned this body as a loaner because mine is being serviced or something. I'm hoping this feeling will go away, but I can't see that it will: I've been bipolar for so long, I don't remember what "normal" is.

And I'm wondering if I still have the creative spark. Was it a result of the disease? I was able to rebuild the new air conditioner to work with our rather odd conditions of our crooked old house, so maybe it's still there. I want to try some painting again, to see if I've still "got it". We'll see, I guess.

Thursday, June 12, 2008

Day 16: Don't Worry, Be Happy

Thursday June 12, 2008

So I took a nap, floated through the rest of the day, and went to bed early. Doc changed my anti-depressant because he said I wasn't "happy enough." Well, today I'm droozy (yes, droozy) and have been walking around chuckling at all the funny things in my life. Like peanut butter. Did you know that, applied to bread, peanut butter looks just like Google Earth? Who needs a computer? Just load up on Extra Creamy! I misspelled Thusday, too, and that's kinda funny.

Maybe I'm too happy. Yes, I know that this stuff is supposed to take two weeks to work. Yes, I know that thousands if not dozens of depressees are even still depressed even taking the stuff even as we speak. I can't help it. I'm lol-happy.

The peanut butter and apricot preserves (that's what I used to cut the peanut butter) are because it's time for the 4:00 PM pills. I'll let you know (who are "you" anyway?) how that turns out.

Wednesday, June 11, 2008

Day 15: New Antidepressant

Wednesday June 11, 2008

Had a follow-up today, and Doc wanted to try me on another antidepressant, Pristiq (desvenlafaxine), a kind of double-barrelled serotonin-norepinephrine reuptake inhibitor, as opposed to serotonin-only Lexipro.

Thirty minutes after my first dose (50mg extended release) and I'm unsteady, the tinnitus is screaming, and my face feels even funnier. All the usual side effects, in other words, just a bit more heavy-handed. I think I may have to take a nap and finish this later.

Tuesday, June 10, 2008

Day 14: Sad to Say

Tuesday June 10, 2008

It's a day of sadness. I've been crying off and on since morning. Mary tried to get me to go for a morning walk, later to run with her to the bank, and just now to go to an evening of Music in the Park. I couldn't. It's like I'm trapped here. I want to leave, but I'm afraid to. Let's hope this little symptom doesn't last long.

I have to leave the house tomorrow. It's time for a two-week evaluation. I'm going to suggest to Doc that I visit the local loony bin psychiatric facility, just up the hill from his office, for a more complete assessment and evaluation. Or maybe he has a suggestion. We'll see.

I'm going to go now and register at a few bipolar forums I've found, places where there are posts by people who, like me, have been bipolar since bipolar was manic-depressive (40 years or more, in other words) and the atmosphere seems supportive. There doesn't seem to be an active bipolar support group in Amarillo right now; maybe I'll be directed to one tomorrow.

Monday, June 9, 2008

Day 13: Steady as She Goes

Monday June 9, 2008

So far, everything's just fine. That is to say, I'm floating slowly through the day; I have a feeling I'll be edging upward by evening, though.

I was hoping that treatment would leave me feeling "normal", but it may be a faint hope, and my life will only be less polarized. I do have brief moments of ordinariness, interludes of fairytale perfection. You can't imagine how good that feels, or how awful it is to lose the feeling. Mary and I had breakfast together this morning, an all too rare occurrence these days, and it was heaven. The feeling passed now, I'm just slow and numb.

The power went off for 4½ hours last night; I handled that well, and with good humor. And today Mary and I sat down and waded through several months' worth of mail ignored during my latest and greatest depressive episode. One of my biggest fears has been that I would not be able to function but I think some of that has been allayed.

Update: Well, maybe. I couldn't remember if I took my midnight lithium last night. Now I can't remember if I took my 8:00 AM dose. In 45 minutes it won't make any difference, but at the moment my whole body is quavering, my face feels funny, the tinnitus is screeching, I'm twitchy - like I'm nervous - and the halos are here again. Yuck. I must have missed both doses.

Sunday, June 8, 2008

Day 12

Sunday June 8, 2008

Today started well; no nausea (yet) and no rowing-through-syrup feelings. I even got a decent night's sleep (although I did have some of the usual wakefulness around 3:30 AM). Mary and I went fruit shopping, but I insisted we go before my 4:00 PM medication. It's 4:15 now and I'm getting a bit woozy. I'm going to be alert today (I tell myself) to see if I start getting high. It occured to me that an afternoon antidepressant might just set off a hypomanic episode (hypomanic because the lithium is holding me back from a full manic flight, perhaps).

Update: I did get a bit manic-er after the afternoon dose. Now, I know that these medications are not supposed to even start working for two weeks or more, but I swear they've been affecting me. I have unusual sensitivities to a number of drugs, so maybe this is related to those effects.

Last night I watched shadows crawl and auras glow. That's a symptom I usually only have when I'm really flying. It's better today, but for several days colors have been brighter, vibrant, more saturated.

I came to tears a few times today; more happy thoughts, damn it all.

Saturday, June 7, 2008

Day 11: More of the Same

Saturday June 7, 2008

Maybe this is the new pattern to my life: slow in the morning, fast at night. I've been drowsy all day, napping intermittently. After my 4:00 pills I absolutely felt like the walking dead. Now, at 9:30 PM I'm starting to fly. Adriene and I fixed the new air conditioner - it has to slope away from the window, but that wall of the building is unlevel, so the AC drained water into the dining room today.

My face still feels funny, and I spent a good part of the day nauseated.

I apologized to Mary today, for everything I'd put her through. She said she thought something was "funny" with me, but didn't ever say anything because she thought it was just me, how I was, and she didn't think she could dissuade me, anyway. I'm very glad we had almost 30 years of near-stability (at least my episodes didn't get too disruptive), 30 years to raise a family and be in love. High or not, now I'm crying.

Friday, June 6, 2008

Day 10: Helter Skelter

Friday June 6, 2008

It's still Day 10; the morning brought mollases, the evening brings quicksilver. I'm speeding up again. I feel fine, I feel GREAT, I'm going to take a shower and take Mary out, maybe for a movie. I really don't like this, being manic again so soon after sliding in a psychological ditch. I mean, I like that I'm not depressed anymore, but son-of-a-BITCH it means I'm cycling. I can't continue like this, I need to finish my taxes and the house and I've still got to figure out a way to make some money, so I guess I need a job and I'll have to go back to programming if there's any type of openings in this town because I don't know just how I'm going to be able to continue taking portraits when I get like this, I mean it sort of scares me about how I'll cope if I get an appointment but end up slow or even worse, mixed, like I have been most of the past two or three months.

Dear God, It's started again

This is day 10. I can feel it starting again. I woke up "slow"; I feel bad about that, because there were things - there are - things I need to get done today. Mary wanted me to go with her to the store, but I didn't feel like it. It's 3:15 now and I'm still in my pajamas. It hurts, Dear GOD it hurts. I'm sitting here typing in tears.

I realize now that I was hyper the past few days, even though I pretty much had a grip on my actions. I kind of knew that, but I guess I was hoping that my good feelings were a result of drug therapy. Ok, maybe I was wrong. Maybe I felt good because the drugs triggered a mostly-manic episode, and the lithium gave me the ability to control the high. I don't know though, maybe I really was never in control.

Appetite is wonky again. I thought about ham sandwich, didn't gag at the idea, and made myself a nice deli-style sandwich, which I couldn't eat. Maybe it's Miracle Whip. But I tried just meat on bread, and couldn't choke that down, either. I ended up eating four naked pieces of thin-sliced smoked ham for lunch.

I just re-read that first paragraph and can't really understand why I was crying when I wrote it. I don't feel it now. That was all of five minutes ago, and already the anguish has vanished. I am wondering if that is why my life seems to be mostly manic periods. I have memories of terrible, gut-slashing angst, but they seem few and brief. Maybe I just don't remember most of them.

Mary suggested I go get evaluated at the Pavilion, the local psych facility - an upscale Bedlam. Maybe I will.

More side-effects: today I'm dizzy, unsteady on my feet. I didn't mention it earlier, but I have had scratchy eyeballs almost every day.

The big thing today, though, is the slow. My arms are leaden, my feet feel too big, everything is moving in slow motion. My sleeping is back to "normal": I get to bed around midnight, sleep soundly until 3 AM, then toss and turn until morning. Then I go back to bed after breakfast. Today I slept past 10:00 AM and then took a nap until after 2:00 PM.

Even slow, though, my thoughts seem to dance and skip. There are, not voices exactly, but jumbled thoughts, like torn-up scripts all mixed together and squeezed under the back flap of the tent. In the past I would expect those when I was fast; it's a little worrisome to have them intrude when I'm slow.

Thursday, June 5, 2008

Day Nine: Anger Management

Thursday June 5, 2008

Went today to an all-day Anger Management class, along with Mary, #1 son Chris, and Chris's bride Jennifer. Chris and Jen were attending at the behest of Child Protective Services (whose involvement in our lives could be the subject of an entire blog; suffice it to say that nobody is in trouble, but Chris & Jen and granddaughter Holly are living with us), and Mary and I were tagging along. Almost everybody else attending the class is on probation.

Actually, and despite what i wrote yesterday, I think I got more out of the class than anyone there. I have to learn what anger is, and how to deal with it.

Before now, anger was mostly out of my control. Luckily there was always a calm part of myself keeping watch on the raging maniac, a caretaker who kept me from doing physical harm to others and leading me away from other people's property.

The four-o'clock medications have me woozy again, dizzy and unsteady.

Day Eight: Mixed Bag

Wednesday June 4, 2008

Appetite is better today, but some foods still make me ill - just thinking about a turkey sandwich makes me gag. I was trying to arise at 6:00 AM, but I couldn't awaken enough to stop dreaming, and stayed in bed until around 10:00 AM. Not too dizzy, and my face doesn't feel funny.

Mary and I went out to purchase an air conditioner; she let me drive. I felt some aggression toward other drivers, but was (mostly) able to let it slide by. I was also able to resist the temptation to buy a big AC for the main living area (the dining/kitchen/family room) and four more for the other main rooms of the house. We just got one, to keep the living area comfortable during the day (104° yesterday!). The purchase of the AC is in itself a minor victory, since part of my brain is telling me how easy it would be to build a technologically advanced multi-stage solar-driven evaporative cooler and another part is telling me how easy it would be to buy the other 4 units and install them through the walls.

I'd like to get a better handle on the mania, especially the GREAT IDEAS! that come flooding into my head. If I can recognize the symptoms, maybe I can work around them. Maybe. I've been able to cope (somewhat) for 40-plus years, but even knowing when I'm manic hasn't been enough to prevent much of the craziness.

Scratch what I said about appetite. We got back from AC shopping and discovered that the nice breakfast Mary had fixed for me was only half-eaten. I hadn't even noticed. No lunch, and I didn't really miss it. For dinner I had two hot dogs, but could only eat one. Later I had a small bowl of cereal. Maybe I'll lose some weight.

Chris, Jen, Mary and I are going to an anger-management class tomorrow, courtesy of Child Protective Services. It's actually for Chris and Jen, but Mary and I are tagging along. I think their social worker was a bit concerned that I got a little wonky a few weeks back and tore two doors out of the wall. I suppose I should write about some of the things that led up to the current state of affairs, but for the moment, let me just say that I think the class may not have any real direct utility for me, as my anger and aggression were based on physical pain and mental anguish, and always under my control (at least to the point of my rage never being directed at and person or living creature, only inanimate and easily-repaired objects - ie, I knew I was tearing things up, but only things i could fix), and currently my temper is under new (chemical) management. However, I'm open minded, I'm tired of repairing doors, and I also want to learn the techniques to possibly help others.

5:30 PM

Feelings of anger and frustration are welling up. There's no apparent reason. I'm an hour and a half late on the mid-day Lexipro and lithium, but that shouldn't have this kind of effect.

Day Seven: More Pickles

Tuesday June 3, 2008

Nauseous again today. And sometimes dizzy, a little unsteady on my feet. The dry-mouth seems to be getting worse. I'm losing my appetite and merely thinking about some foods makes me queasy. Except for a tiny salad and a bit of pizza at lunch, I'm subsisting today on kosher dills, cheese, and lemonaid.

Lunch with an old friend went pretty well. She has a Master's in Counseling, and although she's never done anything professional, she's a good listener and adviser. During the meal I mentioned that, for the past few months, even happy thoughts could bring me to my knees; with that, I thought a happy thought and started weeping. Damn, that upsets me.

I'm astounded at the mess around here. I've started so many projects that never got finished. At least I got most of the construction done before the highs got out of control. The house is almost remodeled, but needs lots of detail and trim work...and, of course, the second bathroom. I want to make a list of the items that need to be finished, but I'm almost afraid of the result. There's so much yet to do.

Day Six: In a Pickle

Monday, June 2, 2008

Dizzy and nauseous; that pretty well sums up the day so far. I had kosher dills for lunch; nothing else tasted right, and I had to toss out a beautiful roast beef sandwich (mustard, ya' know -- that was the only part that I liked, but no one else in the household likes mustard; Mary won't even touch mustard for fear of condiment contamination).

This morning a simple errant thought almost brought on the tears: they're so cute, but they grow up so fast. Damn, it's even hard to type that phrase, and the tears did come this time, briefly. I have to wonder if I'm becoming tolerant of the antidepressant (Lexapro) already.

Tomorrow I'm lunching with a friend and former boss, whose daughter was diagnosed bipolar some years past. She told me today that the diagnosis was apparently wrong, and that her daughter is completely off medication now and doing just fine. Oh, well, she still has done considerable research on bipolar disorder and I still want to talk to her.

Day Five: Just Forget It

Sunday June 1, 2008

I've felt odd all day. Flushed, my face sort of numb, but not really numb. And drowsy. Sleep was fitful and wakeful, even counting my and Aiden's midnight conversations. I went back to bed after the babies were both fed, tossing and turning until around 11:30 am. The rest of the day has been spent in mindless wandering with Google Earth.

I don't remember taking my afternoon medications; thank goodness I remember going downstairs to get them. Since I didn't have the pills, but did find an empty glass with milk in the bottom, I figure I must have swallowed them. Mary may have to give me my medicine in the future.

The memory lapses are the most frightening. Will I be able to drive? Should I be alone with the grandkids? It's been happening since Thusday. One time I found myself in the kitchen with an empty glass in my hand, with no recollection of taking a glass from the cabinet (which is around the corner, several steps and turns away). Last night Mary came in and I apparently said "Hello" and we spoke a moment; then I waited up until 2 AM for her to come home, not knowing she was already in bed asleep. There were a few more cases I vaguely recall, not dramatic, where the previous few seconds or minutes were simply lost.

Day Four: Backsliding a Bit

Saturday May 31, 2008

It's 9:30 pm and I'm sitting here crying. I was editing yesterday's post - writing it, actually, since I jsut started this blog today - and the remembrance of the last months' insanity was so heavy that I started to weep. I need to stay away from that time period until I'm better. I hope I get better.

Today started out fine. I slept well if disjointedly. Grandson Aiden is spending some time with us, and we played "find the binky" all night: he'd lose his pacifier, let me know about it, and I'd go to his crib and try to find it. Pop it back in and we're set for the next round. Mary took pity on me and let me sleep in after everyone was up and fed.

Last night Mary and I snuggled (which feels really good these days) and I opened up about how I was feeling and what my life had been really like. She has seen some of it over the years, and could hardly have not, but didn't realize that I had definite peak periods of irritability, grandiose plans, and all the other little signs of the manic cycling I'd subjected my family to all these years. She knew but never connected my behavior to the concept of "manic-depressive".

We were actually lucky: we had almost 30 years together when my condition was smoother, more controllable than in my youth, and before the depression became the controlling reality of my life. I'll write on that some other time.

To summarize (most) of the day, I'm feeling, but the feeling are not controlling me. I told Mary, that I feel emotions, but not with any of the intensity I did just a few days ago. If I'd tried to tell her "I love you" on Tuesday, I wouldn't have been able to. I think it was the pure intensity that brought on the pain.

Side effects had been less intrusive today, up to the daily dose of Lexipro at 4 PM. This time, however, I am feeling dizzier, flushed, drowsey. Part of my skin seem to be, to me, hot and dry. My left face, for instance, along with my left forearm, feels like I was out in the sun too long. At the same time I am feeling less flat, more down. The machine-gun thoughts are trying to intrude again. It doesn't help that it was nearly 100° today.

Day Three: Abnormally Normal

Friday May 30, 2008

The day went well. I feel perfectly normal (see below), side effects are minimal, and I am confindent. I still have dry mouth, but the highs seem to be gone now.

As for how I feel, the normalness itself is very strange. I mentioned earlier that I think I must have been either flying or crashing all my life, because this current state seems so irregular in it's regularity.

I've had time to carefully consider the last several months, and I realize I've haven't been merely depressed, I've been manic and depressed at the same time; everything has been so mixed up,. the pain and the elation stirred together and everything whirring around so fast I can't get my breath, an emotional trash compactor, rocky road ice cream with sprinkles and rotting fish guts and GODDAMN IT HURTS and I don't know why, just the memory of it cuts through this drug-induced flatness and brings on the pain again.

Day Two: Hello Side Effects

Thursday May 29, 2008

I've felt pretty good all day. In fact, I feel pretty normal. That, in itself, is pretty strange.

Looking back over my life I realize that I've been either headed up or sliding down the whole time. Either that, or I can't remember the normal episodes.

I think I'm getting accustomed to the medication. I don't get quite as high, but everything is still snuggly. I had a good night's sleep. My pillows are, well, "plush". Like big soft marshmallows.

Dry mouth, definitely, and diarrhea. I'm trying to drink extra water and eat watermelon (which helps the dehydration but does nothing to stem the diarrhea). So now I'm taking three medications which can cause diarrhea and eating lots of watermelon, and have another reason to stay close to the house.

New side effect: muscle spasms. I got a cramp in my lip, one teeny tiny muscle in my upper right lip. Lasted about 5 minutes. Later, in bed, a whole set of muscles on lower right side of my back began to throb gently, in time with my pulse (I checked). It didn't hurt, just felt strange, like doing push-ups with just that one group of muscles. That lasted about 30 minutes, whenever I rolled onto my right side.


Wednesday May 28, 2008

I've been an emotional wreck for three months - maybe more. After an all-day sob-fest, I told Mary that if I wasn't better in the morning, to get me an appointment with someone, anyone. I was better in the morning, but, thank God, she got me an appointment with our family doctor anyway. I managed it hold it together during the exam, only lapsing into tears twice.

Doc gave me some evaluations, multiple-choice tests, I answered them, and he decided that I was, indeed, bipolar. There. It's out in the open. No more lying and coping. No more hiding this condition from family, friends, and associates. He went through a whole list of symptoms, and it was like he'd been watching me my whole life.

We went home with a bag of antidepressants, a prescription for lithium carbonate, and an appointment for two weeks later.

First DoseLexipro (escitalopram oxalate) 10mg and lithium carbonate (generic) 300mg. I didn't know what to expect. I thought, hoped, that I wouldn't feel anything, just lose the crazy and be normal. Like Claritin: you don't feel anything, you just don't sneeze anymore.

Ten minutes later: BAM. The world got evvvvvver so warm and snuggly, and I didn't have to cry any more. So I floated through the afternoon and enjoyed the high. It's supposed to take up to two weeks for results, but I had happy sailing almost immediately.

My eyesight improved instantly. Everything was sharper and more detailed, and, for the first time EVER, I can see in 3-D. I can only attribute that to the drugs somehow preventing my lazy eye from suppressing, forcing it to cooperate with it's brother. In fact, one side effect I have is circumocular pain on the right side. Perhaps the muscles are being forced to keep my eyeball alligned, something they're not used to.

Related to that, I think, is a sort of left-right disassociation, if that's the right word. Rub your left leg with your left hand -- Ok so far. Rub your right leg with your right hand -- Ok. Now, rub your left leg with your right hand...WOW! that feels weird. It's like someone is rubbing my leg, but it's not really me, and at the same time I'm rubbing someone's leg, but it's not quite mine.

Update: My right side (left brain) seems to be getting the message a microsecond or so faster than my left side (right brain). Dragging a finger along is strange: right finger, left side it's like feeling a shadow following along behind the finger; left finger, right side is really freaky, because the finger is chasing the dimple!

Other symptoms include enhanced tinitus. I've had it since that concert in 1972 (Raleigh, NC, Wild Turkey, Sweat Hog, and Black Sabbath -- I was standing right up by the stage; Ozzie was wearing jeans and sneakers). For a while after the pills go down the singing in my ears changes pitch, gets louder and is quite intrusive.

By bedtime the worst of the weirdness is under control, if not gone completely. I feel strange, but under control. Another lithium and go to bed.