Category Archives: Medication Treatment

The Brightest Red

I make my way through the streets of my city driving to my psychiatrist appointment. As usual, the weather is beautiful in my lovely Californian town.  It is considered a Mediterranean type of weather here which evokes temperate warmth, sun and cool breeze of the nearby ocean.  I turn right then left and always have to remember to go straight through the intersection and not turn left as I have done a few times on previous visits.  Visit.  A nice word to use when seeing not a friend but my doctor who is the leader of my mental health team.  My team consists of a psychiatrist and counselor.  They are my guides who navigate me through my wants, needs, feelings, and moods with the effects of my medication.  They are an imperative part of my life now, and I am getting use to this.  There is a comfort in this arrangement.

I bring my truck to a stop in front of the building.  The parking lot is emptier than normal since my appointment is after lunch.  It is quiet here today.  My hand grabs the key from the ignition, and I pause in my seat. A deep breathe pushes out from my between my lips, and I mentally settle in for today’s discussion of how my new med is working out for me.  The inside of my truck is tan as my handbag.  My hand slips into my purse reaching for my favorite red lipstick. It is the brightest red. I adjust the rearview mirror to get a good look of my face in order to adjust my makeup.

My face is an olive canvas of the finest material, and I enjoy wearing a lot of makeup as a sort of fine painting.  My eyeliner is particularly black with sometimes two coats of smudge coal running along the top and bottom of my eyes.  For dramatic affect, I wing the black out to the sides like an Egyptian goddess, but I am not Egyptian.  My eyeliner is smudged more than it should be, and with my finger tips, I clean it up ever so gently.  In the reflection of the mirror, I look into my eyes and see that I am aging and that is quiet alright.  The wrinkles of time have started to slightly show from a life of moods and emotions.  Finally,  I open my red lipstick and generously apply it to my full lips and fix up the outlines.  I take another pensive breath.

The waiting room is completely empty which makes the pale white walls and sparse decor even more austere.  I sit quietly with my hands in my lap and admire the fine lines starting to appear on them.  I can remember what they looked like as a young woman.  A young woman who had no idea what lie ahead.  How vast my possibilities were in those days.  I certainly did not ever think I would end up here in a psychiatrist office treating bipolar disorder.  However, I am thankful for the treatment.  As fearful as I was at the beginning of it and the great unknown it posed, I feel deep inside that it is what is best for me, my child, my family and friends.  It is a necessity of my life as much a necessity as my emotions and raw passions.  I hold them all dear and want to do the best to balance them all so I can live a colorful life.  As colorful as the brightest red.

As the minutes tick by on the clock on the wall, I reach into my purse and pull out my mirror and check my lipstick one last time.  This is a habit of mine.  I use to love watching old movies where the ladies would always pull out their finest compact and apply their lipstick ever so properly or seductively.  The waiting room is very quiet and lights gleam off the pale white floors.  All the seats are tan like the inside of my truck and have a blonde wood framing them.  In my mirror, my lips appear the brightest red like the petals of a red rose arranged gently against my soft olive skin.  I try to recall all the effects of my new med so I can relay them to my doctor.  Some memories are heavy with hurt and discomfort.  Other memories are champion good stories of how I believe my treatment is going well.  A long sigh draws out from my rose petal lips

The door into the doctor’s office opens and my name is called.  My psychiatrist appears and greets me with a smile.  I return her greeting and follow her down the hall.  “I love your lipstick,” she says, and I respond politely, “Thank you.  It’s the brightest red.”

 

 

The Hurt

When I start a new medication to treat bipolar disorder, there is a learning curve of the primary side effects.  This holds true for any medication; however, bipolar medications directly cross the blood-brain barrier and target the brain.

In the beginning with a new med, I am learning to be cautious in order to learn how and when it affects me the most.  In the case with my new med, I opted to stay indoors for the first two weeks and take advantage of my new way of experiencing my moods. It was a carefully forced situation where I turned down parties and hanging out with friends.  I had become somewhat reclusive but was content in my cocoon for now.  Safety and certainty permeated my surroundings.

In my apartment, I am surrounded by my art supplies, books on philosophy, political theory, art, and the rise and fall of nations and civilizations. On my new med, I can read for leisure again. I am changing.  Art and reading these books were all things I had loved but had lost during my years of rapid cycling.  At any given time, my friends reached out to me through text and phone calls with their constant invitations of going out to parties.  Sometimes, they would visit.

One evening, I decided to join a friend for her birthday.  What could go wrong? Well…I am a fun-loving type of woman and see the bright in everything.  I am not the type to stay home and fawn over tall tales and love stories.  I live them.  I write them. That is what can go wrong.

The evening started with a beautiful full moon covered by wispy clouds.  The weather was warm for this time of year, and the wind felt good on my face as I drove with the window down. The road opened up, and we played the music loudly, talked and laughed the whole way to our first place.  We went to a bar and instantly hit it off with the patrons. When they learned of my friend’s birthday, drinks were sent our way.

There was no reason, at this point of the early evening, to think about my med.  I felt great. Laughter filled the bar.  The evening ended in a wonderful restaurant with good food and much celebration.  My friend offered to continue the party, but I realized it was past my med time.  I had not brought it with me because I did not want to be sedated while out on the town.  We ended the evening at 10:30 pm, and I returned home at 11:00 pm with my med at the forefront of my mind.  See how this is playing out? So carefree at first.

My med time is at 8:00 pm, and sedation lasts for two hours until bedtime at 10:00 pm, but here, it was 11:00 pm.   Even though I am sedated for the first two hours after taking my med, I cannot sleep at all because I am mentally alert but sedated at the same time.  It is a restless mind.  Next morning was going to start early at 6:30 am so I had to sleep.  I thought about not sleeping in order to ensure I would be awake on time like many times during my more hypomanic periods in the past.  But, this was not the past, I was here, now, in my new treatment, which had to be taken seriously.  I just did not think going to dinner and drinking was going to end up so late and screw me up.

At 1:00 am, I finally fell asleep.  It felt like as soon as I fell asleep my alarm went off at 6:30 in the morning.  I opened my eyes and thought, “ouch” and “no, no, no this cannot be happening.”  I just laid there and stared at the ceiling.   Boy, was I out of it. I tried to fall asleep for a few more minutes but was restless–this is a side effect.  I need at least 12 hours to feel the med wear off from my brain.  Here I was, at barely over seven hours.

Slowly, I got out of bed and started my morning routine.  My shoulder hit the armoire, I tripped over the rug, walked into the wall, made it out of my bedroom, and then held onto the bathroom counter to get a fucking grip.  A moan escaped my lips.  I pouted and whimpered. This hurt. What does hurt mean? It is not a sharp pain kind of hurt or a headache type of hurt.

It is a hurt I have experienced before and know well but not from a med.  The closest thing I can compare it to is how I mentally felt during my times in the Army when I had to stay up physically exerting myself for 48 hours or more with only four hours of sleep–we are talking complete physical and mental exhaustion.  Where my mind was forced to stay alert and perform but was numb from exhaustion.  Numb, agitation,  buzz, narrow, focus and intense are all good words to describe that sensation.  My med on the other hand lacked focus and intensity and my thoughts sounded like sounds in a sound proof room.  It felt bizarre and mentally agonizing. The hurt.

Yet, the experience in the Army was a mind and body unison of hurt, and I could see why I hurt. I could make connections from what I was putting myself through to the hurt. That connection gave me focus.  The med on the other hand was invisible and my body did not hurt. It was isolated to just my mind.  My body and mind seemed disconnected.  For 16 years, the Army taught me how to push through pain. I knew how to will myself through the hurt.

My will is not a mood.  I think it comes from my Amygdala and is more an emotional reaction.  My honed response. A force.  However, my will is not a match against the affective mood changes such as hypomania, mania, and mixed state or this med or I would will myself through this entire disorder.  I can use my will to push through a moment.  It is a reserve stored for moments such as this.  It gets used up by one moment against this disorder and then takes awhile to become strong enough for another time.

I managed to arrive at work, which was actually at a different location than my office. Let us not even go into the details of the drive to work except know that everything was white from the sun.

All week, I was in a training class to learn new things.  I just met the instructor and barely new my other colleagues.  The class was eight hours long of lecture in a room with an echo.  The room was large with windows that looked out to the sky blue and manicured garden, but I sat in my chair and blankly stared ahead.  I could not understand the instructor because I was too busy trying to focus.  My brain has never felt so restless in my life, but you could not tell.  My body was still, and I was not jittery or anything like that.  My mind was obdurant and would not think, I could not receive transmission. Everything, including his words stopped at my eyes.  It was complete torture.

After the longest ten minutes of my life and thinking I could go stark raving mad if I sat for one more minute, I quietly stood up and and walked out. Now, this is my profession, and I have to be in the class.  What was I to do?  I realized I needed a few more hours to let the med wear off so I went back to my SUV, jumped in the back seat, stretched out and fell asleep in the parking lot. This is why I bought my SUV in the first place–to have a place to sleep in between classes during graduate school six years ago. After one hour, my alarm went off, and I went back to class.  It did not matter, my mind was still reacting to the med, but now, I also felt mentally worn out.

Again, I just could not sit in that class.  After five minutes, I left.  I did not care how I appeared because I was dealing with the hurt.  I returned to my SUV and rolled down the window for air.  This time I threw caution to the wind and stretched out in the back more. I laid on my back with my boots out the side door window in the parking lot. There, I fell into a deep slumber for more than an hour.

My alarm went off, and this time I opened my eyes feeling alert.  The hurt was gone.  I walked back to class with my long hair knotted up in the back, my make up smeared, and lipstick gone.  As I walked across the parking lot, I looked back at my SUV and imagined someone seeing my boots hanging out of the window and how ridiculous that probably looked.  With the sun in my face and a pep in my step, I continued to the building and thought, “yippee ki-yay mother fucker” to the hurt.

 

 

Psychosis

Psychosis is a special word isn’t it?  It certainly conjures up scary images of insanity. Like bipolar disorder, psychosis exists on a spectrum.  I am either a little psychotic or a lot of psychotic.  Either way, it is a definitive state that is disconnected from time and space; meaning, I have been disconnected from reality.  I have experienced psychosis in two episodes–one last summer and another just last month.  My clinical diagnosis is Bipolar Disorder Not Otherwise Specified (NOS) with Psychotic Features. (Read my first post titled, “Rattlesnake, Dreamer, Child and King”)

Being told I had psychotic features, sent me quickly into denial.  I mean, basically telling me I had Bipolar Disorder for rest of my life was hard enough to handle, but to tell me I had psychotic features was another twist. Of my mind.  The word itself “Psychotic” sounds well… like the center of all things insane.  Bipolar Disorder is a mood disorder and psychosis is another realm of the mind.  “Psychotic” each syllable sounds surgical and succinct.  Like a drill.  I have spent many nights researching the word Psychosis.   Psychotic means having psychosis.  Medline plus defines it as

“Psychosis occurs when a person loses contact with reality. The person may:

  • Have false beliefs about what is taking place, or who one is (delusions).
  • See or hear things that are not there (hallucinations).”1

What I learned is that psychosis occurs from a chemical imbalance in the brain and not from an internal disposition.  Studies have shown cause and effect with an imbalance of dopamine and serotonin.  That’s why anti-psychotics are used for it. They balance the dopamine and serotonin.  Medication treatment is the only way to not experience psychosis.  No herbal remedies, sleep, yoga or meditation can prevent psychosis from occurring.  However, my psychosis is triggered from mania–I have to be in mania for psychosis to occur.  I have not experienced it in the reverse order.  All the stars have to be completely fucked up and misaligned.

So what does psychosis feel like?  I can assure you that when I experienced it,  I knew to be terrified by the disconnect from time and space.  Terror becomes the basis for my irrational behavior.  It swallows me up whole.  Psychosis is an intruder.  It is an invader that enters and quickly removes the ropes that keep me firmly tied to time and space–reality.   I cannot tell when it starts happening because the ropes are released all at once.  All this while I’m in the throes of mania.

At the time, I am not able to say, “okay, I need to chill cause I’ve disconnected from time and space” and then go lie down or stay quiet.  However, as I lose grasp, I will scream at you “What is real?” or “Is this real?” or ask if what you are doing “Is it real?” The first psychotic episode this past summer, I thought I was back in Iraq and thought it was 2008; but really, I was laying on my carpet in the middle of my living room and crying.  These behaviors are my cry for help and indicators that the ropes have unraveled.  I am in great distress as it happens.

I have not experienced auditory or visual hallucinations or maybe I did and that is why I believed I was in Iraq.  I am not quiet sure because I cannot remember.  My manic response to the delusions in psychosis is paranoia.  The two start working together to assault my understanding of my “self.”  My being.  My identity.  The worst part is that they play off each other like dominoes slamming down next to each other.  I think I know I have lost a grip with reality and that explains why I am terrified.  I must feel like there is nothing to hold on to but not for certain because I cannot remember.  I cannot stop it and probably feel like I’ve fallen into worse than an abyss–an unknown.

Each episode ended because my good friend was there to somehow help me out of it. In a psychotic mania, I can be dark, abusive, delusional and irrational.  I have not been physically violent and have not felt an inclination for it.

The second time, he was a godsend at at our expense, but his presence and words also perpetuated it too.  Anyone’s presence and help would perpetuate it.  It gets tricky to help me.  During this episode, he gently took my hand, and my psychosis ended in the snap of a finger.  Like the ropes instantly tied me back to reality again.   I have come out of each episode not understanding what I’ve just said or done. Out of sorts. Confused.  Tired.  Later on, I had flashbacks of what happened during the psychosis, and that is how I start to remember these episodes and a little of how I felt–through flashbacks.

The first time I think I was in psychosis for less than an hour, but the second time I was in psychosis for one hour.  After each episode, as I sifted through the insanity of what I said or felt, there can be no doubt that I felt terrified.  Mania with psychotic feature is an assault of the mind on the “self.” On my beautiful, hypomanic, joyful self.

 

1  https://www.nlm.nih.gov/medlineplus/ency/article/001553.htm

The Poop Story and Other Tales of Love

During my last manic episode,  I was in another city for a business training event. A 5-day long business training event.  My mania had started on a Thursday evening, I left for the business trip on Sunday morning out of LAX.  Why did I go?  Wasn’t I in mania?  Yes, I was but not a complete breakdown.  I had experienced the complete breakdown with loss of time and space-known as psychosis-on Friday morning and emotionally hurt someone very dear.  I recklessly tossed my meds out the window a few months earlier which is how I ended up in this situation.

During the weekend, I was in what is called acute mania.  Not like the one you think of from TV where the person is frantic, screaming or doing full paint body art on the walls with their bodies or being hospitalized.  However, my moods and energy were quickly over days becoming more manic.  I was gradually being swallowed hole.  Ultimately, I would have ended up in the hospital had it not been for The Poop Story and Other Tales of Love.

During the weekend before my trip, I was home where I live on my own.  The following day after my psychotic episode, I puttered around my home and kept busy.  I laid in bed for 4 hours and tried to read, but I couldn’t because I couldn’t focus on the words or thoughts of the authors.  I tried magazines but focus eluded me.  It feels like the words and pictures stop right at my eyes but are denied entry by my mind.  For some reason, in acute mania, the mind only wants to consider things from within.  I ended up laying in bed, staring at the ceiling and the walls.  It’s a nice feeling by the way.  It’s not like I’m laying there getting pummeled by thoughts.  My thoughts can be intrusive but not consistently.   They become worrisome when the negative ones start to have their way.  The rest of the day just passed, but I didn’t go to sleep or eat. 24 hours.

I finally made the trip to Utah to attend my business training event while I was in acute mania. I felt agitated, helpless, hyper and exhausted from a mental marathon but still maintained my grip on time and space.  The rest of the day just passed, but I didn’t go to sleep and only drank coffee, water and 400 calories of snacks.  48 hours.

I attended my first day and appeared presentable.  However, during an initial professional discussion with my new group, I spoke with confidence, but what I said did not make sense.  It happened to the first man I spoke to.  I saw the perplexed look on his face so I stopped talking.  Then I tried again to the man next to him, but I spoke in an expansive manner.  A few sentences of gibberish pushed out of my lips.  He too looked perplexed.  I stopped and realized that I was using the lexicon, but my expansiveness was making my reasoning loosely related to what we were discussing; thus, making me unintelligible.  I was able to casually laugh, and said I was kidding.  They relaxed, and I sat there feeling like I was being defeated.  This disorder. This thing.

I went to my hotel room and laid in bed and stared at the ceiling and walls.  As evening fell, I started crying and became incredibly agitated and felt lost.  I was slowly losing my grip on time and space which meant I was becoming psychotic.  I could tell because of my agitation and also my intrusive thoughts were increasingly involving  thoughts of persecution and paranoia.  I hadn’t slept and ate 800 calories in 60 hours.  So I called my best friend and cried for her to help me.  She recommended I take a Benadryl to knock me out, but I wouldn’t drive to the store to buy it.  Because, who knows what I would do if I drove off in a car at this moment in the night.  It was 10 degrees fahrenheit outside.  So I stayed safely in place.  I was still able to make safe judgement calls.  It truly is a battle within the mind.  One mood allowing me to remain planted firmly holding on to safety, and the manic mood tugging, pulling, pushing for the other to fall over and make way.

My best friend and I knew that I hadn’t slept for 60 hours, and we both knew without speaking what that meant.  That I had to sleep.  If I didn’t……..That mania would take total control and then what would happen to me?  So she told me to get in bed because she was going to talk me through the night to put me to sleep.  She said she would talk to me for however long it would take–hours, days, years–until I fell asleep.  What ever it took.  So I turned out the lights and got in bed.  I laid my head down and covered up.  In the dark, I heard her say.  “okay…..where should I start?……Would you like to hear a poop story?”  I smiled and we laughed.

She and I have been best friends over 30 years, and we have this thing where we share stories of our and others’ poop.  I don’t know when we started it, but it was because she use to talk about her poop to make me uncomfortable when I was much younger.  As time passed over the years, I joined her in her game. Our poop stories.

Through the night, she told me our tales of young and old. Our tales of bright and dark. Our tales of come and go.  Our tales of love.

I fell asleep.

The Waiting Room

As I enter the waiting room full of people, it dawns on me that I’m with the cool kids. Yes, in my mid-grade hypomanic state, I identify with these people as possibly ones who see life as shiny as I do.  They look solemnly down at the floor or their hands because surely being in a mental health waiting room can’t be something we’ve all aspired to achieve.  I clearly don’t recall it as being one of the things I must do in life. Yet, here I am, and I’m pretty sure our journey was sidelined by a paranoid or delusional based something we did. That, we have in common.

My mexi-blonde hair is done up in swirls and streaked in colors of the sun.  My make up applied generously finished with cherry red lips.  Clothes seductively clinging to my sexual body.  Expensive high heels that force my body to sway here and there. I perk around and smile at people. An old retired Navy man with a submarine emblem on his hat watches as I pass by, he smiles and says in his California accent, “Hey guuurrl, I like yer fur.  “It’s faux fur,” I answer politely.  We smile.  Most people smile back, but some gripped by the thoughts in their heads, do not look up to see where the beautiful scent or the click clack click clack click clack sound of heels is coming from.

The room is simple with just simple furniture on white ever so white tile floors.  No pictures on the walls just PSA announcements on how we can all attain stable mental health through diet, exercise, therapy and pills and pills and pills and more pills. A coffee maker percolates in the corner with small styrofoam cups close by.  Styrofoam is bad for the environment I think instantly.

{Note: My favorite line is “The room is simple with just simple furniture on white ever so white tile floors.”}

The Potter

Her hands run through my mind in long, subtle movements with palms and fingers gently touching the surfaces.  Jagged areas that poke about are gently smoothed down. Fingers pressing here and there.  Palms pressing inward and moving upward. The clay runs through her fingers like water breaking through a damn, covering her hands in moods of long agos, moods of yesteryears and the moods of just happens.

In her skillful way, the potter reshapes my mind into a quiet haven.  A place of solace to replace the crumbled remains of what once stood a great temple but had succumbed to decay.  During its glory, it was magnificent with peaks that soared beyond the clouds, and a moat so deep, it kept invaders at bay.  Ultimately, as with all stories such as this, the beautiful temple imprisoned her.

The potter’s hand moves gracefully through my mind smoothing out lines and slowly revealing willing surfaces.  She creates open doors instead of deep trenches. Instead of soaring, the clay gently ascends.

You Will Never

When I wake up in the morning, I like to lie in bed and feel the sheets rub my strong, brown, beautiful legs.  The sheets slither ever so gently across my skin; on my back and along my arms.  You will never make me forget how this feels and how I felt about myself.  How I loved myself even when people were making me question whether I was even lovable.

When I walk through a group of tall trees, I feel like I am walking through a cathedral and experience awe at the strength and beauty of their stature and colors.  Their limbs intertwining with bark peeling and exposing the colors of their life.  You will never make me forget how they looked to me, and the quiet strength they passed along to me when my strength was waning under the pressures of uncertainty, jealousy or cruelty.

When I hear the wind, it calms and reassures me that the wind has been and will always be here for me.   I listen as it tells me its wisdom and gives me insight into my life.  You will never make me forget how the wind and I shared secrets.  That life is for living, loving, seeing the colors, walking through cathedrals and  embracing the strength and beauty of it all. You will never make me forget.