A little dose'll do you ya

I found a handy little guide from the Mayo Clinic on side effects. You can click on each one and it tells you a little about how to handle them. Some of the recommendations wouldn't work - like taking a nap during the day, since most people can't nap at work - but there are a lot of good suggestions in the pages. And, of course, one of the suggestions on almost all of the pages is to get regular exercise.

Sigh.

I'm working on getting up the motivation. When I think about going for a run I just think how draining that is, when in reality a run usually energizes me. But all I can think of is the long, arduous process of getting ready to work out, working out, and then getting back into clean clothes. It's all too much for me when I'm depressed. It just seems so overwhelming.

But I have to do it. There's no way I'm going to let myself gain those 40lbs back. It took me a while to lose them, and I can't imagine having to face myself if I failed by gaining it all back. I recorded what I ate today on Weight Watchers, and there's nothing but yogurt, popcorn, cheese, and beans on there, but I still went over the calorie quota for the day. It's just all about volume. I can't seem to stop eating. I feel hungry and thirsty and like I need to chew!

But I have a lot of willpower. I just need to put my mind to this one task and get motivated by losing weight. I can do this.

Pick a feeling, any feeling

How am I feeling now, after a few days of the new meds? I don't know. I think I feel kind of flat. I haven't had a suicidal thought lately, and I've even stopped researching it. I lost interest. Isn't that funny? I lost interest, like it was some sort of neat path I could be researching. Bored? Hey, let's come up with ways to kill ourselves! Like a game that I just stopped wanting to play. How bizarre.

Do I feel better? What is better? Not being suicidal is better, I suppose, but what have I traded it for? I've traded it for the incredible urge to eat and the feeling that my stomach is being twisted into knots. I've traded it for the cold sweats and the urge to vomit, which comes in waves with the sweats. I've traded suicidal thoughts for physical pain. A good trade? You tell me.

Before, I was scared. I never knew when the thoughts were going to come. Everything was dangerous because everything can be used as a weapon. Now, I'm just getting fat, which makes me depressed, and my brain hurts. Physical pain for mental pain.

I know when I see Julie on Tuesday she's going to go through the list of depressed or manic characteristics to see where I am. But I wouldn't have any idea how to answer. I can only focus on my physical feelings right now. And maybe that's the trick of big pharma. The meds don't make you less manic or depressed, they just make you so physically sick that you can't even think about how mentally ill you feel. Smooth move.

Temper tantrum

"But I never move on from bipolar. It isn’t a thing. It’s everything. It’s sleep schedules and med schedules and bipolar symptoms and medication side-effects and moods and therapy and doctors and control every day of my life. There’s never a break. Not for a moment. I’m bipolar now. A minute from now. A day from now. A year from now. Always sick."

I felt bad the other day when I mentioned that I hate having the diagnosis of bipolar. It's a life-long, debilitating, deadly illness that no matter what kind of medicines I take or meditation I do is not going anywhere. It's a part of me: it's my personality.

I can never escape the fact that I'm bipolar and need to be on medication for the rest of my life. Sure, I can stop taking medication, but that's just letting the illness takeover.

Natasha Tracy(the woman who wrote this) also had a neat article on the worst things to say to someone with mental illness. Amazingly, people do say that stuff. My dad says that stuff all the time. Actually, I think he may have said all of those things to me at one point, which just ups the guilt you feel and makes you hide your symptoms. A hidden madness is more dangerous, I think. When people see you're crazy they tend to help. But when you hide everything no one can help you.

So no, it's not fair. It's not cool that I have to take medications that make me a zombie and disrupt my thought processes. It's not fair that I have to be careful of sharp objects. It's not fair that anything I do that's too much fun I worry is mania creeping up on me. It's not fair, damnit.

Your food is making you depressed

What you're eating could make you depressed. Apparently, trans fats from food aren't just bad for your heart, they can cause depression, too.

"In addition, the study demonstrated a dose-response relationship, "whereby the more trans-fats were consumed, the greater the harmful effect they produced in the volunteers," the expert stated."

So where are trans fats? Everywhere. They're in cereal, pastries, fast food, some meats and dairy products, and more. I think they would be impossible to avoid, but the best way to not go overboard is to eat a vegetable based diet. Veggies don't have trans fats. Basically, stay away from processed foods.

There's so much you have to do in order to stay healthy! Don't eat this, don't eat that, meditate, exercise, don't drink, don't smoke. It's a wonder any of us can keep up! And researchers change the evil food of the week constantly. Remember when we weren't supposed to eat eggs because cholesterol was so horrible? You just can't win.

Monitoring everything I eat and do is exhausting when I'm full of energy, and incredibly impossible when I'm depressed. I suppose if I ate fast food I could just cut that out, but I don't, so here we are.

It's a zombie's life

"...Zyprexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert." Zombie.

Celexa also makes you tired and dizzy when you stand up. Zombie.

And lithium? "Be careful if you drive or do anything that requires you to be awake and alert." Zombie.

I've been sleeping since I got off work. I just came upstairs, laid down, and that was it. I woke up about 3 hours later and started gorging. Again, it's just little food, not meals, but it all adds up.

I don't want to be a lightheaded zombie who sleeps all day and, when awake, has trouble putting together responses to customers. I really should go out and do something, but I'm kind of afraid to drive. I could take the metro, but to wear? It's all a little overwhelming right now.

I feel like I could just lean over and fall right back asleep. I bet I could. I suppose I should cut myself some slack - it's only day 2 of meds - but I don't want this to become a pattern. And it's Saturday, for crying out loud. There's a lot to do out there in the world. I think.

Lithium hurts my stomach

I feel so nauseated. It's the kind of sick when you just want to curl up on the bathroom floor where it's cool and protect your stomach. Like a horrible hangover kind of nauseated where you know greasy food will help, but the smell of it sends you running to the bathroom. Just standing here is making me want to vomit.

I also have an incredible headache. It's beating through my brain; pounding against the insides of my skull. I want to take something for it, but I don't want to mess with the meds. I know I can take Tylenol.

I wish I could down some Pepto, but I'm not sure if it's safe to use with the lithium. You have to be careful with this stuff. Lithium reacts with everything.

Usually when I feel this sick I'll sleep. I need to lie down somewhere. And I'm starting to shake. Ugh. I feel awful.

Lend a helping hand?

I love when you dig deep down in articles and there's a more interesting truth there. A study just came out that says alcoholics who help other alcoholics are more likely to stay sober. "Helping others in the program of AA has forged a therapy based on the kinship of common suffering and has vast potential." There's tons of evidence that giving back does as much or more good for you than it does for the cause you're supporting. AA encourages everyone to help other alcoholics, even if it's just making coffee at a meeting.

But then you look at the statistics. "...the investigators determined that 40 percent of the alcoholics who helped other alcoholics during their recovery successfully avoided drinking in the 12 months following three months in chemical dependency treatment, whereas only 22 percent of those that did not help others stayed sober. "

40%. Less than half of the alcoholics who helped others stayed sober. So if you turn it around, 60% of people who help other alcoholics don't stay sober. That's huge. It means you can be in the "middle" of the pack, doing all your service work and sponsoring people, and you can still be struck down by this disease. No one is safe.

That's why there are so many aspects to the program. You have to do the steps. You have to reach out to others for help, not just to help. Those phone numbers are there for a reason. AA is a multi-faceted program of recovery, and it demands your full attention. They say put sobriety first. "First things first."

I'm in no way saying helping is bad. Helping is awesome. Where would we be without sponsors or people to listen to us? Nowhere. People who help other alcoholics are essential to the survival of the individual. So go get that service position. Go talk to a newcomer or give them a ride to a meeting. But don't forget to reach out to someone and ask for help for yourself.

I don't want to be fat again

I feel like I'm expanding every moment. Quickly, I'm becoming the Stay-Puffed Marshmallow man - all thick and round in places only babies should be round. My pants are all way too tight, holding down around my hips and bursting rolls above the waistline. My sweater is bursting at the seams trying to contain my ever growing bosom. Even my footfalls are heavy.

I've pretty much stopped exercising at this point. I don't think I've worked out since the first of the year, and I spent the last few weeks eating out with people too often. At home, I survive on cheese wedges, yogurt, and cereal - a diet you wouldn't think could make you gain a lot of weight, but I must be a statistical anomaly.

And it's making me more miserable. I don't have the psychic energy to go work out; it's just so much, and the fatter I get, the more I don't want to be seen on the treadmill. But I've got to do something. I can't gain back all that weight I lost. I can't afford the wardrobe change, anyway.

I signed up for Weight Watchers again a few weeks ago, but haven't been using it. So that's step #1: Use the damn WW tools. Document just how much I've been eating. Eat less. It's a matter of volume, I'm sure.

Step #2: get to the gym. I want to run, but I'm not going to force myself to start off running. I'm going to make it a plan to just go to the gym and get on the treadmill. It doesn't matter how long, just do it.

A combined effort, and I should be able to lose a little weight, even with the Zyprexa weighing me down more. I really want to give myself a break and not do any of this until I'm used to the medication, but waiting only gives me an excuse to not do anything about it.

So tomorrow, we're going to the gym. It has to happen.

So now I can sleep

I slept all afternoon and canceled an appointment I had tonight. I came upstairs and by 2 had determined I just couldn't stay awake. I set an alarm for 3 and laid down. At 6 I woke up to a text message and wondered where the hell the time had gone. I suppose my insomnia is cured, but I don't want to be sleeping all the time! I really wanted to go play hockey tonight, but I don't know if I could be upright for it. I just feel like I'm dragging ass.

And I can't stop eating. I'm just constantly shoveling things into my mouth, but it's all been good for me: yogurt, ciabatta bread with a little peanut butter, cheese, a banana. Nothing horrible, but the volume is what counts, I suppose. I can feel my jeans are way too tight already, so let's make a commitment to think more about going to the gym. I don't want to assign myself anything right now for fear that I won't be able to follow through because of the tiredness.

I also feel stuffy in the head. Just like a cotton ball is where my brain is supposed to be, but it's a wet cotton ball: dense. I'm having trouble reading articles that are too long because I just can't concentrate on the words for very long. I keep bookmarking stuff to come back to.

And all I want to do is lie back down. I'm sure I could fall right back to sleep.

Oh please no

Sprightly, you dance your little limbs across the carpet, headed for the next sheltered area under the laundry. Wobbly on the fibers, you seem to rattle as you run.

"Cockroach! I get it." said David.

My first reaction was to stare. I couldn't think of what to do next, though I knew it had to get far from me. He crushed it with his boot and left to go back to his business at the front desk. And there it sat. Crushed, but still visibly a cockroach. I reached out quickly with my shoe and smeared it across the carpet, sweeping the remains under the counter.

And then it happened: my skin started to crawl. I can feel it on the bottom of my shoe. There's a spot now that feels different than the rest of my foot. I keep turning to look at the wet spot its death left and wondering if there are more coming.

I've gotten better about cockroaches. I'm not afraid of bugs, in fact, I used to collect beetles, but I hate, HATE cockroaches. In an LSD fueled haze one time I saw giant, hissing Madagascar cockroaches crawling all over each other in the corner of a room. I was so petrified that I couldn't move: I just wanted to scream and hide, which I did - in the opposite corner of the room - until I could get enough courage to run.

Life here will never be the same. Now I know they're out there, waiting. One could come out from under the counter at any time. One could be living somewhere in the store and jump out at me. I need to find some spray....

Forcefully awake

“'Why do we get out of bed?' Mitch wondered. 'Is there any feeling better than being in bed? What could possibly feel better than this? What is going to happen in the course of my day that will be an improvement over lying on something very soft, underneath something very warm, wearing only underwear, doing absolutely nothing, all by myself?' Every day, Mitch awoke to this line of reasoning: Every day, the first move he made outside his sheets immediately destroyed the only flawless part of his existence." -Chuck Klosterman

My eyelids are drooping. My body feels like lead. I'm dreaming about my nice, warm comforter and all the time I have between now and tomorrow morning to just spend in bed. I'm thinking about a nap. A long, hibernatory nap.

But maybe I shouldn't give in? I can't sleep till 1 when I get off work, and I'm supposed to play hockey tonight at 7, so I could nap before that, but I'm thinking about canceling play and just sleeping through till tomorrow morning. That's unhealthy. I need to develop a schedule and stick to it. No sleeping till after 9pm. That sounds about right, right? 9 is a good time to go to sleep, especially if you get up at 6. That's 9 hours, give or take.

I need to get myself to a meeting today, but I don't think that's going to happen. And my pants feel tighter today than they did yesterday, but I doubt I'm going for a run. But I need to keep myself awake, so both of those things would be the perfect thing to do. Decisions, decisions.

Oh so heavy

I feel like my tongue is dead. A big, useless piece of flesh is resting on the bottom of my mouth between my teeth; just lying there in peace, content to be unresponsive. And the fuzz. Wool has started to grow between my ears. There's a giant cotton ball being fluffed to brain-sized dimensions and spread out like a blanket inside my head.

I couldn't think of the word receipt.

I slept through my alarm.

I'm starving, but I've already eaten. Actually, it's not hunger, it's the need to keep my mouth moving so it doesn't sew itself shut. Each moment I don't open it, the heavy my tongue feels. It's like I can't even open it. My jaw is heavy, too.

As I stand here at the computer, I get the feeling I may topple over. Just lean a little too far to one side and down I'll go, straight down like a tree that's been chopped. It's taking all the effort I have to stay standing - if I sit I know I'm going to curl up in the chair and sleep.

Day 2 of Zyprexa, lithium, and Celexa.

High functioning bipolar

I'm not feeling very articulate today, so don't mind my rambling. I was reading a great blog this morning and came across a post she did on being a high functioning bipolar person. She talks about just how much mental energy it takes to be "normal." To show up for work, pay your bills, walk the dog. It sucks the life out of you.

"So all the appearance of my functioning is paid for by utter decimation and exhaustion the rest of the time. I don’t have energy or brain space left to read, see friends, date or do pretty much anything else. The last thing I want to do is leave the house. I want to sleep. Forever. And ever."

It really takes a lot of mental energy just to act normal. I suppose that's why I sleep a lot: I use up everything I have just trying to be perky and appear sane. In my head, it's all swirling around. Sometimes my inner voice is screaming things at me, but I look perfectly normal on the outside.

A new regimen

"Medications work differently in each person, and it takes considerable time to determine in any particular case whether a given drug is effective at all, since bipolar disorder is by nature episodic.... Many doctors emphasize that patients should not expect full stabilization for at least 3–4 weeks (some antidepressants, for example, take 4–6 weeks to take effect)...."

Met with the doctor this afternoon, and almost had a panic attack in his office. My heart was racing, I was biting my fingernails, and I felt like I was going to cry at any second. "You're holding it together really well. You sound fine - you make sense." And then I started talking faster. I mentioned my recent studies of metro car physics and homicidal drain spouts. "I want you to take something for a bit just to get you to a normal place, but take it with the new meds we're going to pick. Now, what do I have in here."

He opened the magic closet (where everything is free), and there wasn't enough Abilify to go around, so we settled on what he had a lot of: Zyprexa. The dreaded, make-you-gain-12-pounds-in-12-minutes, Zyprexa. "I don't care," I thought, "I'll do it. Anything to feel better." Zyprexa also has a reputation as a fast acting machine, capable of destroying the manic in minutes. Well, not minutes, but you get it. So I made a deal with the devil: I'll trade my vanity for sanity.

"Now, cheap. Well, you have a few options: Tegretol, Paxil, Celexa, lithium, mostly. You don't want Paxil. Have you tried lithium? Let's do lithium and Celexa."

"But I was on Celexa once (I remember, that's what college gave me), and I think I stopped taking it cause it made me sick."

"Well, that was a long time ago, and it's cheap. What about lithium?"

"Took it in high school, but I was doing so many drugs at the same time that I wasn't really med compliant. I don't know if if works for me."

"Let's find out. You'll have to get blood tests, but lithium is $10."

So I made another deal: go back on the old drugs which could kill me with their toxicity, in favor or saving money.

God help me.

A new type of self harm that trust me, I'm not doing

I just saw this article on "embedding." It's the newest identified form of self-harm, and it's pretty wicked. People are taking objects and putting them under their skin. Imagine how incredibly painful, and over a long period of time, that has to be. Have you ever tried to butter under the skin of a chicken? There's connective tissue and stuff under there. It takes force to break the skin away from it's layers and get things under there. And some of these objects are things like eyeglasses.

Stop for a minute and really think about this concept. Taking eyeglasses and putting them under your skin.

"In the upcoming October issue of the journal Radiology, Shiels and other researchers report that between 13 and 23 percent of American teenagers hurt themselves on purpose."

Most self-injury is cutting or burning. People like me take a knife to the skin or a lighter. Quick, full of adrenaline, and good for relieving immediate distress. I'm not endorsing it at all - self harm is bad - but I get it; I'm a cutter, too.

"Self-injury is almost like a pressure valve for them," Karnik tells Business Week. "Without it, you have to ask, 'What is that kid going to do now?' We have to work with them to give them better strategies to relieve their stress and anxiety."

Yep. There are better options out there than self harm. So what are they? Well, exercise is always a common refrain. I personally have no idea what I do to stop cutting. I've been using drugs, alcohol, and tattooing in place of self harm for years. Currently I'm running on shear willpower.

8 months sober

I just realized that as of today, I'm 8 months sober. That's pretty good. I could almost have had a baby at this point.

It's hard to tell just how I feel, because the bipolar mess is getting in the way, but I can tell you I'm enjoying being sober. It's nice to not have to stuff everything down with drugs or alcohol. I feel almost less depressed, just because I don't have to be so embarrassed anymore. I'm not making late night drunken, crying phone calls or falling down. I'm not late to work because I'm hungover, or hungover at work. My skin feels better. My body feels lighter. I don't have horrible headaches or skinned knees anymore.

I remember a lot of times I would get drunk and call my mom or Adam and talk about how I had a problem with alcohol. I was always drunk and complaining, and I'm sure didn't make a lick of sense. Now, I don't have to do that anymore.

And although I'm really depressed right now and suicidal, I think I'm alive because I'm not drinking. Last time I was suicidal, I drank myself into a position where I tried to commit suicide. Now, I have control over my faculties (sort of). Bipolar and alcohol together equal zero impulse control. Without alcohol, I have a semblance of control. I can resist those impulses to hurt myself. I really believe if I thought it was an option to get drunk, I would be dead.

It's also been 2 months since I quit smoking. I can tell you, I smell a lot better, and my breathing is so much easier. If I could get up the energy to run, I'm sure it would feel a hell of a lot better.

So 8 months. I wish I could say it's been all roses, but such is life. Life is interesting, and if it had been all perfect, well, it wouldn't be interesting.

Tell me about it

It's funny how depression can make you feel so alone, so isolated in your own head. I see people every day. I work in a store where new people come in, and old faces stop by to say hi to the big boss. That's people around all the time.

And I live with another human being. Last night my dad and I watched the snow fall on the tennis courts outside and cars struggling to get up the hill. "The snow is so pretty, but look how heavy it is!" he said, and probably not with the exclamation mark I gave him. It was weighing down the power lines across the street, and the power was flickering. We sat and watched tv, eating popcorn, only interrupting occasionally to remark on the state of the weather.

I get emails from 3 people daily that I can count on (they send me funny articles), and I usually get a text from my mom or Adam.

Then how can I feel so alone? Why haven't I told any of them how I feel? Adam knows, but that's because he read the blog last week. Why can't I pick up a phone and reach out to the people who love me? I know they love me...right?

That's just part of depression: the isolation, the thoughts that no one will understand or you'll just be a burden on them. It's part of the illness. It's just your illness secluding you more so it can attack. So you have to reach out. You have to get up, no matter how much energy it takes, and go to work. You have to call someone, anyone, and tell them how you're REALLY feeling.

Will I take my own advice? I don't know. Every time I get close to calling for help I hang up the phone or delete the email. I suppose I tested some people out last night by asking for mania or depression stories. Tanya knew something was up, and talked to me a little bit about some of the manic fun we used to have in college. We used to disappear all the time, or go to the bar and cause trouble. "Let's go out and sing karaoke soon. We'll just get loud and obnoxious, again."

But I didn't have it in me to say: I'm suicidal and I need your help. I don't know what I would be asking for. When you call the 800 numbers they get you help, but I already have an appointment for help. I already have a therapist. What good would come from telling anyone any of this? I just need to hang on. Few more hours....

Links

I have come across so much this morning, all from one little link. Now, I can't keep up with myself, so I'm documenting here some of the links I want to check out.

Canada Globe and Mail: Breakdown, Breakthrough

Coming Out Crazy (old files)

Furious Seasons (old)

Spikol

Drunken phone calls

"Anne, I release you of all the resentment I feel."

Why, oh why, do you always get drunken phone calls from family members late at night the night before you have to work? I was lying there close to sleep when the phone rang. It was Diane. She wanted to ask me to help her with an errand next week, and then talked about her day. It was a perfectly fine conversation, but apparently she had therapy yesterday.

"My counselor is pissed at me! She wonders how I can purport to love you if I'm still drinking and smoking around you. So I want to make you a deal. I'll be a sober place to hang out if you'll just hang out with me. I won't drink or smoke when you're here." This is huge for Diane. She has every addiction I do, and is world-renowned for getting out of trouble with the law. For her to even think about being sober for a family gathering is incredible. "Thanks?" I said. "Good enough." she replied. So there we go.

But then she brought up one of her favorite topics. See, on that side of the family I'm the favorite grandchild of our grandfather, who passed away, oh my. I guess it's been 3 years this year. Wow. I miss him so much. He was my rock. I don't believe there was any magic in being the favorite: I called him on a regular basis just to say hi and I love you, I helped him take care of mom. It's not like I was the golden child. "You are the only child of the star child (my mom, who takes up all the energy in a room)." I don't buy it.

The only time my other two cousins called my grandfather was when they needed money. They called him to pay for this, and that, and Diane's sister notoriously used it all on cocaine. But I suppose you can be jealous of something you didn't have, even if you did nothing to build that relationship.

"Your uncle is the head of the family now, and he's stepping up." Meaning he's giving her and her son money for stuff. I never once asked or accepted money from my grandfather. I think she has the relationship all wrong, there. She thought he paid for college for me, but the other night I burst that bubble. "Dad's still paying off my school on his credit cards." Go dad.

Anyway, she's telling me I can rely on my uncle. I have no reason to get involved in any of this crap. He's perfectly capable of handling my mother himself (he's executor of her trust) and I want nothing to do with it. The more she's "self-sufficient," or not reliant on me, the better. I'm glad he's "stepping up." I don't need him. Sure, I could go ask for money, but for what? I'm fine.

"I release you of all the resentment." Gosh, thanks. I'm so glad my older cousin isn't mad at little old me for being the favorite. I'm so glad I could make you feel better by taking care of the family while you were out partying. I hope you had a good time.

Tragedy in Arizona

I alluded to it before, and after this I'm not going to touch the Arizona shootings at all, but this is a great article about the treatment of mental illness in the press and what we can learn.

When in doubt, ask!

Since my mind is so messed up right now, I thought I'd ask some people if they remembered times when I was manic, or depressed, outside of the horribly obvious - like suicide attempts.

"That time when you went home with the guy in the snowstorm was pretty manic." said Tanya. Yeah, I kinda disappeared for 3 days.

"You get all bug-eyed and physically ansty." Micheal said. "I guess it's hard for you to see it, but you get really agitated and obsessed."

Good stuff to remember. I think I'm ready for the doc tomorrow. I'm just hoping the inclimate weather doesn't get in my way.

A bipolar's daughter

I just sat down with my dad to try and think of some of my manic/depressive episodes. "Where did it start?" I wondered aloud. "Well, I think it was after mom got diagnosed. But what's funny is you would be in a bad mood and then I would take you out and you would be fine. It was always only around her."

It was always her. She was always the reason for my moods; she could bring me up or drag me way down. My dad would find me hiding in the closet cowering from her, or we would be 100s of miles away at the beach (and before the cell phone era, this was called disappearing). She would let me sleep in and skip school, or I would run away and hide in the woods. It was always her: my moods were in reaction to her.

So maybe she was diagnosed first, but I remember wanting to go to the psychiatrist when I was 14. I had already been a cutter for a long time, and I was starting to get really "crazy." I can't remember what that felt like, I just remember being worried about myself. Maybe I was really worried about her and just projecting? Maybe I was fine?

Maybe I AM fine. My suicide attempt came after a huge hormonal flux for my body, coupled with a huge amount of alcohol and a shitty life at the time. My next big episode happened when I was unemployed last time, and I tended that with food and copious amounts of alcohol. And this time? I'm unemployed, again, and my situation would make anyone depressed.

Really. Maybe it's all ok? Maybe it's situational? Maybe she's the one with the disorder and I've just got "symptoms" that show up in times of crisis?

We're all over the internet

I was reading this morning about what the Arizona shooter was Googling before he went on his rampage, and I started to think: If I do kill myself, what's my Google history look like? It looks pretty bleak. Let me give you a hint: the top three words are suicide, Seroquel, and bipolar. Typical for someone who writes about this stuff, but I can tell you I haven't Googled suicide in probably years.

What's your search history look like?

What's in a name?

"By its very nature," Dr Phelps tells us, "bipolar disorder is a problem of cyclic changes in mood and energy."

Well, I'm not buzzing out of my skin today, I think thanks in part to the 2 days of Seroquel. I didn't take it today because I kind of want to be raw for tomorrows meeting with the doc. Is that silly? Probably. It's brought me to a nice, even level where I just want to kill myself and I'm having "pauses" in thought, instead of racing so much I can't gather a single thought.

I've been researching bipolar a lot today. I fit, and don't fit, a lot of the criteria. It's never taken over my life, I don't think. I've been out of control, but.... I was going to say never hurt anyone. I think that's a lie, though. I can get pretty physical, especially during blackouts or when I'm feeling high. My impulse control just lapses and I end up kicking people, so I hear. I used to smash stuff when I was a kid as anger management. Maybe I should go back to doing that.

I've been thinking, too, about all the crap I'm angry about. Deep down in there, there's one pissed off, rabid little spirit. Did I tell you all about the time I saw her? I was doing some meditation for therapy, and she was so scary I had a panic attack just looking at her. I had to have the therapist stop the session. I suppose at some point I'm going to have to deal with that, but I think being on meds makes it easy to just "chill."

I've come to acknowledge that I'm a pretty angry person. What's funny is I don't think anyone I know would ever use angry as a word to describe me. I don't get angry. I can remain calm in any situation. But being off meds, I'm angry at little stuff. It's all seeping to the top.

And I'm thinking a lot about bipolar. When I read stuff like Marya Hornbacher's "Madness" I can totally identify with the way she describes mania and depression, yet I've only been hospitalized once, and that was for a suicide attempt. I think I could probably fly under the radar if I wanted to. My emotions aren't "out there" for the world to see, I don't think. I can function in daily life.

Or is this functioning? Is talking yourself out of paranoid thoughts (last night I thought the shower drain could rip off my hand and I couldn't get close to it) normal? Is seeing things in the corner of your eye and getting panicked that they are ghosts and if you look at them they'll attack you, normal? Do I just have an over-active imagination?

Does it matter, then, if what I've got has a name? You bet it does. It's easier to handle something if you can name it. You can Google it and follow other bloggers, join the debates, and know where to go for help. If it's just life, and life is fucked up, then what? Then you're all alone.

Problems with the DSM-5

"The new volume is an 'absolute disaster,' it could cause a seismic shift in the way mental health care is practiced in this country."

I've heard a lot of buzzing lately about the DSM-5 (Diagnostic and Statistical Manual) and all the issues it is having. According to this article in Wired, there are some people close to the DSM that are having second thoughts. Allen Frances, the man who "wrote" the DSM-IV, has an op-ed, too, on what he sees is wrong with the new version.

He recommends an abstract by a colleague, John Livesley, which says "The proposal (for DSM-5) totally reformulates the way personality disorders are classified so that there is virtually no continuity with the previous system.... Implementation of the proposal would have serious adverse consequences for patients, treatment, research, and administrative and legal applications, especially in the area of psychological injury and law."

Ouch. So what's really wrong with this DSM? From what I can gather, they're changing the way they define mental illness, and the way they diagnose. I've heard mumblings that soon no one will be "normal," and everything is a disease. One thing that's worrying a lot of people is the severity criteria. They're going to use the new criteria to put people on a scale of illness; kind of like saying you only sort of have the flu. I'm not sure what they think the purpose of that is. I can see a lot of problems, though.

Imagine, you meet the criteria for bipolar - you've been manic, you've been depressed - but you've never been psychotic on either end of the spectrum. You've maintained relationships and jobs, you've been ok. So you're probably a on the low end of the crazy spectrum, right? Well, does that mean your health insurance doesn't have to cover meds? I mean, you're doing fine, right? Or therapy. Can you get by with less? It all seems like a slippery slope to me. By any sort of scale system I'm just suffering, not sick. I can manage to work and interact with people. So does that exclude me from the right to services?

I'm not sure I understand all of it, but there is some interesting dissension amongst the rank and file.

Here's what they're doing with bipolar disorder.

Can you see it?

We've already established that I love trivia, and so you can imagine how excited I was to find a study on mental health. OK, so it's all about 2009, but studies are always a year behind. It claims 1 in 5 Americans had a mental illness in 2009. That's a lot of your fiends and neighbors. I wonder if it's self-reported or doctor/heathcare reported.

One thing I thought was really interesting was: "Adults who were unemployed last year were twice as likely to have serious thoughts of suicide as people who were fully employed, with 6.6 percent of the unemployed considering suicide, compared with 3.1 percent of those who were working." Imagine, it's still 3% of working people. Look at that guy in the cubicle across from you. Do you think he ever thinks of killing himself? Or your boss. She's human. Maybe she's hiding a serious depression, or even schizophrenia.

I wonder sometimes if people ever think about that. I'm just a little store clerk, but here I am thinking about offing myself. Do any of the people who come in see it? I doubt it. My own dad can't tell. It's amazing what we hide from others. We're all so disconnected.

Zero is the perfect number

There's a really interesting thing going on in Detroit. The Henry Ford Health System came up with a plan for zero suicides, and actually achieved it two years in a row. How?

Some of the performance improvements in the program include:

* Establish a consumer advisory panel to help with the design of the program.
* Establish a protocol to assign patients into one of three levels of risk for suicide, each of which requires specific intervention.
* Provide training for all psychotherapists to develop competency in Cognitive Behavior Therapy.
* Implement a protocol for having patients remove weapons from the home.
* Establish three means of access for patients: drop-in group medication appointments, advanced (same-day) access to care or support and e-mail visits.
* Develop a website for patients to educate and assist patients.
* Require staff to complete a suicide prevention course.
* Set up a system for staff members to check in on patients by phone.
* Partner and educate the patient's family members.

Imagine if every health system could take the time to do this. It just looks like staff training, patient and family education, and easier access for the patients. I used to be on Kaiser, which had email visits, too, and that was so helpful. I could email my doctor and tell her how I was doing instead of having to go through the nurse helpline, which was awesome for quick questions. Access is one of the best things in healthcare. If you can get your doctor quickly, you're going to have better treatment success, in my opinion.

Get off your butt

I have my workout clothes on. The gym is on my way home from work, and so I thought I would just wear my workout clothes and see if that motivates me to stop there on the way upstairs.

I know exercise is good for depression, but Jesus, just getting the motivation to get out of bed is hard enough. Getting dressed takes forever, and being upright this long is killing me. It's weird, though. I'm in a mixed state where I'm so depressed I want to kill myself, but my body is up and running. It's at work, stocking shelves. It can't sleep very well. But my brain is fuzz.

Know what would help? Exercise! I just need to get to the treadmill, get on, and move for 30 minutes daily. That's not so hard, is it? But then I think of the whole process and it overwhelms me. Get dressed, go downstairs, turn on treadmill, workout, go back upstairs, shower, get dressed again. That's a lot! That's a lot of time and energy.

My dad said the other day that people his age live one year longer if they exercise daily. He calculated it out, and it would take him a year and a half on the treadmill in order to live an extra year. He does it anyway, but man that just sounds silly. But how else would I use that time? Sleep, probably, which is also good for you.

So will I exercise on my way home this afternoon? Probably not, but I'm halfway there. I'm dressed for it, at least.

All meds are good meds

"For bipolar disorder, we have no evidence that the atypical antipsychotics are safer or more effective than alternative treatments. They are certainly much more expensive. But use of the atypical antipsychotics has grown rapidly, displacing treatments that are less expensive and more well-established," Simon said in an e-mail.

This from an article on the over prescription of anti-psychotics. With all the ads on tv about meds like Abilify and Seroquel, people seem to be requesting these things, and doctors appear to be prescribing them more. Why? Do they work better? There's no evidence they do. Americans are weird. We always want the newest, latest gadget or toy, and I suppose that same line of thinking comes to our health care. Is it new? It must be improved! Some of the old ones are just as good.

I'm hoping to go on something old school and inexpensive. It doesn't mean it's not going to work just because it was developed 5 or 10 years ago. Right now, I'm looking for the biggest bang for my buck. I guess these will be my choices. Not that I get a choice in the matter. I just don't want something that's going to make me fat. Why? Cause I'm vain and lazy, and my pants already don't fit.

Mental health parody

Dear Congress,

Ok, first, thank you for voting in the mental health parity laws. I'm very happy that insurers have to provide coverage equal to physical coverage, and at the same rate. But there are some things you missed.

No one HAS TO offer mental health coverage. They can just avoid it right there. Sure, maybe in 2014 something will happen, but that's really not helpful. It doesn't cover individual policies or small businesses. I understand that for small businesses it would mean no one gets health insurance, so good compromise, there. But for all of us who don't get coverage through our employer, or qualify (yet) for high-risk pools, or better yet, WANT to be taking out meds instead of using up emergency beds, what do we do? How do we get coverage?

Do you know how much meds cost on their own? Thousands of dollars. I'm not exaggerating. One month of one of my meds cost me $1,000. Or would cost me, if I had that kind of money to throw around. And I'm on three meds. Which, with the current state of the economy and my current unemployment means I'm off meds for the first time in 6 years. And I don't WANT to be non-compliant. I want to be a productive member of society. Instead, because no health insurance company will cover me, I have to pay out of pocket for medication, and I can't.

Thanks for making health care for all.

"Q: Since the law does not apply to individual policies, what advice do you offer those patients and families seeking care right now?

A: It's not so bright for the next four years. Everyone I've gotten calls from in the individual market who wants to go to a high-risk pool … well, you have to be uninsured for six months [to qualify]. In all fairness, I think the pools great and they have enormous potential. There's a reason for [the waiting period]. … And the high risk pool requirements won't change between now and 2014. For a lot of people, they will have to wait."

Short end of the stick

There I was, just innocently reading along this article about mental health care, and getting a little angrier about the lack of coverage, and I came to this blanket statement:

"The life expectancy for someone with serious mental illness is 25 percent lower than that of the average person, according to Nordal, in part because of metabolic problems resulting from the long-term use of powerful psychotropic drugs."

Um, first I've heard of this. I'm sure it's got some basis of truth, but I've sure never heard it before, and you all know how much research I do on a daily basis. And, of course, you find what you're looking for.

"Patients with psychiatric disorders are not only at risk for psychiatric complications, but are also at greater risk for medical illness, and at an increased risk for more complicated medical disease and worse outcomes."

We lose about 4.5 years, apparently. Heart disease is still the number one killer (it's #1 in the US population, too), but of course they think people with bipolar have increased risked already, and a lot of meds mess with your heart.

You just can't win.

Suicide stats graphic from OnlineSchools.org

Via: OnlineSchools.org

Why is college so fuzzy?

Something else we talked about was my overdose at age 18 and whether or not that was my first suicide attempt. I don't know if I'll ever know, but it was out of character for me to mix meds and illegals. I just never did it. And then suddenly I do? I don't remember that morning at all, but I remember everything about that day from the moment I started to feel weird until I passed out, and then when I woke up till the moment I got home. I don't think it was an accident.

Anyway, we were talking and it occurred to me: in the five years between one suicide attempt and another, I didn't get any significant help. Imagine, your kid is bipolar, angry, and obviously has drug problems, and all you do is make her get a job? And then let her move out and in with some boy she's known for 2 days? What in the hell was my dad thinking? Why didn't he immediately get me help when I got home?

We went back to get my meds later, but what I remember was we went to get my allergy shots (and then left them in the car). But there was at least a few weeks there where I wasn't allowed on campus and so didn't get my lithium. Did I just stop taking it? Was my last day of lithium the day I overdosed? What happened next? Apparently there are no withdrawal symptoms for lithium, so there's nothing obvious I can try and think of. So what happened?

The next time I think I got in touch with the mental health community I was in college and probably 21 or 22. I could call the University and get my records. I was taking drugs from them for a while, but all of college is kinda fuzzy.

So, really, since 2003/2004 I've been on continuous meds, but have had a lot of sketchy periods in-between. What was I doing all those times? 1998 - 2003. Well, I know I was using a lot of alcohol, cigarettes, and sex with strangers to make me feel better. I was moving in with people and making really rash decisions. Those were my college years, so I know I was taking something....

A Twitter chase

“We’re harvesting our lives and putting them online,” Calacanis writes in his piece. “We’re addicted to gaining followers and friends (or email subscribers, as the case may be), and reading comments we get in return. As we look for validation and our daily 15 minutes of fame, we do so at the cost of our humanity.”

I thought this was an interesting quote. I suppose I'm right there with them; putting my life in the public eye; even though I'm doing it anonymously and I don't read comments (not cause I don't care, I just don't remember to). But it's attention-getting all the same.

I got to this site via an interesting article on suicide on the web. It all starts with the @WhiteBentley story which broke on Twitter. A man was leading police on a car chase in L.A. one night, and someone created the Twitter name to tweet as if they were the person. People all over tweeted about #white #bentley, and in the end the man committed suicide. I'm not explaining it well (read the article), but it talks about how people lose their humanity online. People were egging this man on, talking about how he should just kill himself and save the city some money.

It's fascinating to see social behavior. We like to believe in the good of people at their core, but episodes like that and 90DayTania (another piece in the article where people were egging on this woman's suicide - thank God the blog was a joke) show the inhumanity of people online. We all put ourselves out there, and sometimes receive amazing support from like minded folks, but a lot of times the public can turn against you.

Be careful, bloggers.

All about suicide

I love trivia. I learned some interesting things from Julie today:

-April and December are the months with the highest suicide rates.
-The older you get the more likely you are to commit suicide (and succeed).
-Older men are more likely to commit suicide.
-Single, celibate people are at most risk.

Julie says she always worries when she hears about depressed older men, dads especially. They've got the highest risk. You would think it would be teenagers, but it's not. Teens have built in networks of family and friends to watch out for them, unlike older, single people.

We talked a bit about my last suicide attempt tonight, and she went through a questionnaire the center gives her about risk. She had to, for my file. I aced that thing! "Yep, definitely suicidal, as if we didn't know, but what do you really think your risk is? I think it's low. You're so practical about it." I think it's low, too. I'm not having impulse control issues, yet. I'm able to talk to myself and turn away from the bad things.

I went to the grocery store after therapy because I was thirsty. I was walking down the aisle and saw the bleach. For a quick moment I thought, "I could just open the bottle and chug," but I quickly reminded myself of the consequences: that would burn like hell. What a painful way to mess yourself up. We're awful close to a hospital, so there's a likelihood it wouldn't kill me - only severely disable me from breathing on my own. Sounds pretty horrible to me. I don't want to be incapacitated, I just want to hurt myself.

And that's where I am, I think. I get the thoughts of suicide like that one, but I don't really want to die. It's just my illness talking for me. Luckily, I can still talk back.

Just read the list

Why? Seriously? Why do I have to have another interview? I just got a call to have an interview next week ("It'll be an hour but save some time after for the writing sample.") for a great position. So why do I have to feel like this? And to have to do a writing test? I'm having trouble typing and making sense on my own blog! I can't possibly make sense to a panel of academics! Jesus. I'm in trouble.

No, I'm fine. I just need to calm down about it. Everything is going to be fine.

I don't know what to do with myself right now. I took more Seroquel, and I know if I lie down I'll be able to rest, but I'm up and getting panicky. I have a few hours before therapy, and I'm just sitting here reading articles. Of course, I can only read the first sentence of every paragraph before it gets too confusing to continue, so a lot of them don't make sense. But this one did: "Top 10 Cracks that Crack and Other Addicts Fall Through on Their Way to Recovery." It's just a list of stuff that can trip you up in early sobriety. I was going to write a post around it, but I lost the point.

The plan 2

Ok. I need a plan for when I feel like this. Who can I call? Who do I reach out to? When I think of names all I can think of are the reasons why I shouldn't call them.

So wait, maybe what I need to decide is what's best for me when I feel like that? What do I want? Jesus, I don't know. I don't want to leave the house because I start to get paranoid about accidents and metro cars. I start getting really scared of accidental death and dismemberment. I know it doesn't make sense to be suicidal and yet scared of something happening, but that's what happens.

I don't know what I would want from people, so I don't know the right person to call. I suppose having the person in the same general vicinity is a good right step. Someone who can get to me. Yeah, being with someone else is good. Being alone is bad.

Sleep is good. Sleep is less confusing. I'm all confused, now. My brain is just all up in arms. Nothing is making sense, and it's giving me a headache. I'm starting to feel crazy again, and I haven't even had any caffeine. Time for more Seroquel.

The plan 1

"The most important thing to remember is this - your symptoms have gone away BECAUSE THE MEDS ARE WORKING! It's not necessarily because you've been cured. There are no cures for a lot of these disorders. It's not your fault that you're crazy, but it is your responsibility to stay as sane as possible. You're not the only person you hurt if you really flip out."

Just like it's my responsibility to stay sober, it's my responsibility to stay sane. But Adam reminded me last night that that doesn't mean I have to go it alone. One of the most awful parts about depression is that your brain convinces you you are all alone. I have a million phone numbers in my phone, email addresses, friends on Facebook, etc., but in that moment when I was freaking out all I could think was, "There's no one I can tell." Now, is that true? No. Am I going to freak someone out? Probably. But is that ok? Probably. That's what friends are for. They're there for you in bad times, too.

Adam asked me to make a list, a personal care packet, almost. My "plan for safety." Hm. Plan. My plan is to not drink so much caffeine. I feel shitty today, but it's a different kind of shitty. I'm not buzzy, but I'm still having racing thoughts and such. They're going so fast that I'm having trouble stopping them to pull one out. It's funny, I catch myself sitting here like a schizophrenic listening to voices - staring up in the corner of my head, just waiting for the one I want to repeat.

Right. Plan. I told my dad I was feeling crappy and now all he can do is tell me to go to the gym. "You should go get those endorphins going or they're no-dorphins." Dork. He's trying. He also thinks a lot of it is just the coming off of the meds. "It's been 2 weeks, dad." "Yes, but I'm sure they're still coming out of your system. It took me a month to get all the caffeine out." How long did it take me to get the booze out? Month, two? I don't remember now, but the physical symptoms were gone much sooner than the mental. But how can you tell whether the mental symptoms you are having are because you are not on meds and your brain chemistry is crazy stew, or because you're coming down off meds? I haven't found anything good on the internet, yet, but I'll share when I do.

I still haven't given you a plan, have I? Cause I don't have one that lasts past the week. Sleep, Seroquel, work, meetings. Yeah, I'm still including meetings on there. I promised Paul I would go tomorrow and see if the woman he wants to hook me up with is there. I just learned I have to work Thursday, so no 6am womens meeting, which I'm on-and-off ok with. I should hit the 8:30 tonight after therapy, but I probably won't. I don't want to leave the house too much. I feel weird enough, and driving has been making me paranoid.

This is getting long.

I'm awake: I'm asleep

Called the doc and the secretary told me no more than 50mg of Seroquel, so I took half my 25mg pill and immediately laid down to take a nap. I woke up to Adam calling 3 hours later. He came over and took me out to get a burger (which was tasty), and invited me to come stay with him tonight. "I'm worried about you." Don't worry. I have a plan: Seroquel, sleep, showers, work, meetings. All will keep me busy.

I'm worried about leaving the house. I hate when that happens, because it usually means I'm going to have a panic attack. I get a little phobic of "the world" in general, especially having to function in it, but I'll be just fine. I have to get out and do things. I have to. I can't just sleep till magically drugs start working.

I'm not even making sense in my head. I hope some of that made sense. And I'm having trouble typing. I'm misspelling things and my fingers are all over the keyboard. I hate this. I hate feeling this way and having to take the big guns to make me feel like I can at least partly function. I'm still buzzing, but I'm not crawling out of my skin like I was this morning.

I'm going to go back to bed.

Ignore me, I'm just rambling now

I'm feeling crazy and so what am I doing? That's right, drinking more caffeine. Cause that helps. Now that I have a plan, I can't wait to go upstairs and take the damn Seroquel. According to the website it could give me all sorts of great side effects, but I know the one it will give me: a little peace; sleep. I can't wait to just go to sleep and not wake up till I have to be back at work on Wednesday morning. I have nothing to do till then except go to meetings, but leaving the house might be out of the question for a while. I'm going to have to tell my dad not to worry about me; that I need to hibernate or I'm not going to make it. Course, I'm not phrasing it that way.

Here's a fun little distraction: drugs for bipolar and their side effects.

A call for help

Help.

I have my therapy appointment tomorrow, and the doc appointment for meds on Thursday, but I know I feel crazy NOW, and that even new meds won't make me feel better for a while. I would take the Seroquel, but that is just going to make me a zombie and I have to work. I'm the only person here every morning till Feb when the boss gets back from overseas. There's no one I can call and have cover my shifts, or I would probably check myself into someplace right now. I've never been so close to picking up the phone and calling the white coats; raising the white flag. I'm done. I feel nuts. I'm itching out of my skin.

I don't want to kill myself. I want to hurt myself, though. It always makes me feel better to bleed. It gives me that nice, calm feeling. What else helps? Not being awake, but I don't have that choice. Drinking myself unconscious, but that's not going to help.

I want to call someone, but I don't know who or what they would do. Everyone I know is at work, and I can't leave work yet. And what would they do? Sit with me? I'm no fun right now, and I don't need a babysitter, yet. Could I call Emily? Why? So she can sit halfway across the States and worry about me? No. Adam. No. I don't want to lean on him too much. Diane? She's nuts, and she'd leave work to come hang out with me, but she's got a 3 year-old to manage. That's unfair. Though yesterday she asked me to hang out with her more. "I'm lonely, too," she said.

I have nothing to give right now. I'm a total mess. Should I call the doc and ask for an emergency appointment today? Maybe when I get off work I'll just go to the club and go to continuous meetings. They have them from 2pm -8:30pm tonight. I could just stay there and drink coffee. Then, I'm not alone or near knives, and I can bum smokes if it gets ridiculous.

The big question is: do I tell my dad? The man lives with me for Christ's sake, but I don't think he has a clue just how bad things are. No. No need to worry him.

I'm going to go upstairs when I get off at 1 and take the Seroquel. I won't be going to a meeting (cause it makes me too drowzy to drive) but at least I'll sleep.

A mixed state?

"...mixed states is a condition during which symptoms of mania or hypomania and symptoms of depression occur simultaneously. During a mixed episode, the person may experience the impulsiveness, insomnia, irritability, and flight of ideas that can be present in a manic episode as well as suicidal thoughts, guilt, feelings of hopelessness, and changes in appetite that are common during depressive episodes."

Getting closer... I think this is as close to describing how I feel right now as it's going to get. The insomnia one night, then super-somnia the next; the not eating for 2 days then eating constantly, hungry or not; the irratability; the weepiness; the decision to go back to school (remember 2 weeks ago?); the definite feelings of guilt, worthlessness, and suicide.

I think we're looking at a nice mixed state, here, which is just lovely. Depressives with energy are most likely to kill themselves, especially girls, it seems. They always say people just out of the hospital are at more risk because they're more likely in that mixed state.

Can you tell yet? I'm worried?

Signs of mania

If you have three or more of the mania symptoms below most of the day -- nearly every day -- for one week or longer, you may be having a manic episode of bipolar disorder:

Excessive happiness, hopefulness, and excitement
Sudden changes from being joyful to being irritable, angry, and hostile
Restlessness, increased energy, and less need for sleep
Rapid talk, talkativeness
Distractibility
Racing thoughts
High sex drive
Tendency to make grand and unattainable plans
Tendency to show poor judgment, such as deciding to quit a job
Inflated self-esteem or grandiosity -- unrealistic beliefs in one's ability, intelligence, and powers; may be delusional
Increased reckless behaviors (such as lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs, or ill-advised business decisions)

Yeah, let's just go with "nope" as a general answer to this one. I'm definitely not manic right now.

Is it depression?

According to the National Institute of Mental Health, symptoms of depression may include the following:

difficulty concentrating, remembering details, and making decisions
fatigue and decreased energy
feelings of guilt, worthlessness, and/or helplessness
feelings of hopelessness and/or pessimism
insomnia, early-morning wakefulness, or excessive sleeping
irritability, restlessness
loss of interest in activities or hobbies once pleasurable, including sex
overeating or appetite loss
persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
persistent sad, anxious, or "empty" feelings
thoughts of suicide, suicide attempts

Let's see. On the regular list, I've got insomnia (sometimes), irratability (most likely caffeine induced), overeating (most likely boredom induced), and the occasional thought of suicide. From what I know of depression, I'm also weepy, paranoid, and don't enjoy things. I'm also still getting up for work every day, showing up to meetings, calling people, and going out with new people. I have a sex drive, and I'm able to shower and eat. I'm going with "not depression."

To medicate or not to medicate?

Bear with me, here.

Ok. So, I was diagnosed with a serious, life-threatening, long-term, incurable illness at 15. It's called bipolar disorder. How did they know? Because I was a pretty horribly depressed, weird, kind of violent, and crazy teenager whose mother was bipolar. And so they put me on litium. But what if I was just a regular teenager whose life was falling apart and so acted out? What if it wasn't mental illness? What if it was just... life? And now, 16 years later, what if all those drugs caused a mental illness?

Have I been off drugs for a period of time before? Yes. How'd it go? Not so hot. I was off drugs in college for a while (a year or more? I can't remember) and was a crying mess most of the time. But, I was also working 2 jobs, playing a sport, and taking 15 credits a semester. Anyone would be a crying mess. It was stressful. I was also constantly rescuing my mom from the streets or hospitals. It wasn't a good time for me, overall.

So now I'm off drugs again, not by my choice, but such is life. But I do have a choice of whether to get back on them or not. Of course, I'm 30, unemployed, living at home, and most of my close friends are 3,000 miles away, so it's not exactly a stable mental health environment for experimentation. Anyone would be a crying mess.

But maybe I'll stay off of them. I can't afford them. No matter what he gives me it's going to be a financial burden, and my number one peeve is financial instability. Sure, I feel like I'm going to freak out, but that could be because my body is just getting used to not being on drugs. It's used to the free and easy source of stabilizing chemicals. Like any addict coming down, you get a little weird for a while.

I don't know. I hate being dependant on them, but I'm so used to it that it's ok. I hate paying for them, but I've just been conditioned to keep doing it. Now that there's this break... I know, I know. I've been freaking out lately. But is it mental illness or life? Let's discuss.

The debate rages on

You know how I wonder all the time about meds, but now there's a debate raging in the academic world.

"Why do we, as a society, believe that these drugs fix chemical imbalances?” Why do we believe new drugs are better than older ones?"

There's a new book about meds from Robert Whitaker called "Anatomy of an Epidemic: Magic Bullets, Psychiatric Durgs, and the Astonishing Rise of Mental Illness in America." It's pretty controversial right now, and I haven't read it yet, but from this article one person said: "Whitaker’s message seemed clear and convincing: psychiatric drugs do seem to have a purpose for specific cases, but the current practice of 'long-term treatment' may have consequences that do significant harm to the patient."

You always hear about the good that meds do, but in the mental health community (i.e., those of us who take the drugs) you hear a lot about the side effects, too. My favorite site, Crazymeds.us, has a lot of information on all the weird side effects you will and won't get that have been reported from psychiatric medications. And many of them are doozies. There are flesh-eating rashes and kidney failure, blood toxicity and all sorts of sexual problems.

I wonder all the time what 16 years of medicating my illness has done to my body. How do those internal organs look? Has it made my body stop producing it's own helpful chemicals because it knows it can rely on pharma? Will I ever be able to have children or is my body so toxic that they'll end up having no serotonin for themselves? Science doesn't know. In the decades since psychiatric medications took hold, they still don't know how they work, why they work, or what they're really doing to the body. Sure makes me a little paranoid.

So are they doing more harm than good? Does taking a medication for life make the illness a long-term problem? Could we just take meds for acute episodes instead of constantly? One day maybe we'll know. I know I would donate my body to science if weren't an organ donor, first (if they'll take me). I want to know these answers. I want to know if it's worth saturating my body with chemicals in the name of "normalcy." And what is normal? I suppose not feeling like this is normal.

Once an addict...

“Caffeine-induced psychosis, whether it be delirium, manic depression, schizophrenia, or merely an anxiety syndrome, in most cases will be hard to differentiate from organic or non-organic psychoses….

The treatment for caffeine-induced psychosis is to withhold further caffeine.” Duh.

If you're a conspiracy theorist, I think this site is awesome. "Thousands are in mental institutions today because of no greater matter than that of the use of caffeine." I mean, they're right, caffeine isn't so hot for crazy people. It exacerbates your symptoms by making you even more anxious, but I don't know if I believe that people get themselves hospitalized because of it. I know all the caffeine I drink has got to be bad for me, but screw it, I've got nothing left. I'm not going to limit myself and be one of those people who takes in no toxic substances (I would have to quit meds, too). I just want to enjoy my life, and coffee makes me happy. Sure, I could cut out soda, and I will someday. Not right now. Look what happens when I cut out all my crutches? I go crazy and have nothing to lean on.

Let's not demonize everything. I understand, everything in moderation, and I suck at moderation, but let me have my caffeine! I suppose no one but me is talking about taking it away. There's no one out there pressuring me to stop drinking coffee. No one is saying, "Anne, you've obviously got a problem with caffeine." There's no support group for coffee-heads. I'm just all up in my head about everything. Feeling crazy and need something to blame? Let's look at your caffeine intake.

Sometimes the internet isn't good for me.

Sweet smell of nicotine

Cigarettes. I can smell them. I don't know if someone out on the loading dock is smoking (I'm at work) or if it's just in my nostrils because I'm an addict and my brain can pull tricks like that. I can smell them, though. I know they're out there. Actually, they're right behind me on the shelf. We don't sell my brand, but I don't think that would matter to me much right now. All I want is a cigarette.

But I told you last night I had a drag and it was awful, right? I couldn't eveinhale it. It just made me cough. But I loved the smell, the art of it. I wanted one.

Why do I want a cigarette so much? Cause I'm losing my mind. Cigarettes are my comfort, my security blanket. More than drinking, smoking is what I did to feel better. It kept me breathing at steady rates: in, and out. I have a tendency to hold my breath when I'm stressed, but smoking makes you breathe.

So what do I do? How do I get through this "hump" without substances? I suppose if I can make it now I can do it forever, but we'll see. What's nice is I don't want to drink. I made up my mind that being an embarrassment is bad, and I'm not going back there. But smoking just smells; it doesn't make you act like an idiot. Maybe I shouldn't have quit.

Gourd

Made it out of the house to a meeting tonight and thought I was fine until I opened my mouth to speak. It was a small group, so we were just going around the room. I suppose I could have passed, but it was a women's group, and I want more of the women in the area to know me.

I thought I was going to break down completely. I didn't cry, though. I just... rambled. I don't think anything that came out of my mouth made any sense. I couldn't put a cohesive sentence together, and there sure as hell wasn't a point to anything I was saying. I must have said something funny, because at one point everyone laughed, but I don't even know what I was saying. I was just trying not to freak out.

After, I went to Diane's house to eat buffalo wings and watch football. We sat in the kitchen and talked about our other cousin who is going through a horrible divorce, and about Diane's ex, who is an example of horrible human being. I was buzzing. I just wanted to freak out. I don't know what it would have looked like, but it would have had something to do with pacing, crying, shaking, and rambling. My eyes feel buggy and my skin feels like it's crawling. I want to take a Seroquel, but I have to be up at 6, and I don't think that's enough time.

I'm losing my shit. I have some Lamictal that Michael gave me left over plus the Seroquel. I don't know if I should just take them and hope for something? I can do this. I can last 5 measly days till the doc appointment. He'll give me something, maybe some Xanax for an immediate use. I took a drag off Diane's cigarette to see if that would help and it just made me cough, which is good, I suppose. Normally I would be chain smoking and it would make me feel a whole lot better.

I need to just go to bed, even if I can't sleep. I should just lie there, at least. I need to wrap myself in my comforter and feel safe. I feel crazy. I feel like I'm just going to lose it. Breathe....Breathe....