“I Did X, Chucked My Meds, Now I Feel Great”

I really need to stop this trolling habit, but it’s so addicting. Yesterday it was trolling for stories on bipolar disorder. This time it was alternative health. Right there I should have known the amount of BS that I would encounter. I’m not a spiritual person by any means, at best, I’d convert to reformed Judaism because I get along with the Jewish culture very well. But spiritual healing is something I rank with homeopathy as criminal enterprises that should be shut down and prosecuted. Why so extreme? After all, they’re just practicing their beliefs. However, those beliefs kill. And peddling beliefs that jeopardize other people’s lives is in my opinion, criminal. Just like refusing insulin to a diabetic child because your beliefs don’t allow it. There are facts in the world, and medicine holds claim to some of those facts, and I believe that laws should be based on fact first, especially if you claim to be able to cure people without facts.

The most entertaining ones are Reiki and things dealing with chakras. It’s difficult to even get past the bizarre color analysis and then the sometimes suggested “looking at colors” to alter moods. As far as I know, and I grew up in an orange-red painted room, colors don’t influence my manias or depressions. But what is scary is the anecdotal support for these things. Hence the title of this article. Someone with a mental illness chucked their pills and voila, the world opened up. This is a meme that is carried over into boards like CrazyMeds. People adopt some behavioral/nutritional pattern, chuck their meds, and now they’re fine.

For the record, I haven’t come across anyone who was schizophrenic that did this and now feels fine. Probably because the disease is so marked by psychosis that it’s easy to identify when something is working or not. But I did encounter it a lot with people who were depressed or bipolar. Also, for the record, I did not find anyone who was severely depressed who made these claims. Again, that might be because that too is very clearly marked in its mental state. That isn’t to say that there are not people who make claims like the title who have severe depression or schizophrenia, but in my limited search capacity along small blogs and CrazyMeds, I did not find them.

For depression, it’s understandable that getting rid of medication might help. There is a growing debate over the efficacy of antidepressants for anything but severe depression. In some cases it might make things worse. This happened to both my sister and my sister-in-law. Antidepressants didn’t help them and actually made my sister suicidal for years until taken off of the drugs. Antidepressants can have these paradoxical effects. Just like opiates don’t sedate me, but up me and can induce a mild hypomania. The effects are probabilistic, which means that there is a chance that something else happens. In the case of the miraculous recoveries after leaving antidepressants, it very well could be that they fall into the slim margin of paradoxical effects. It’s even happened to me, where bupropion (Welbutrin) pushed me from feeling horribly depressed to trying to kill myself just to escape the depression. I don’t fault “western” medicine for this, I simply realize that there are risks as well as rewards for every medication out there. The brain is unique and complex, bizarre side effects are bound to happen in some people.

So yes, sometimes getting rid of these drugs is a good idea, especially if they are not helping or the side effects are intolerable. But to move from “it didn’t work for me and X number of people” to “no one should take these and adopt my specific regimin” is a horrible induction. First, it sees a small population as a representative for a larger one, dismissing the reality that a larger number of people are helped than harmed by the drug. Secondly, it demonstrates a narrow understanding of the mind by saying that a specific avenue of action is appropriate for everyone. In reality, to get these drugs to work, it isn’t a set and forget system. Constant updates with a psychiatrist or an internal medicine doctor are required to make sure that it is working or if something else will work.

With bipolar, it gets even more scary because of the lack of knowledge about the disorder. For starters, ridding yourself of mood stabilizers, especially lithium, provokes manias. Obviously you’ll think that it was a smart move because you’re flying high on the world. It’s scary, but mildy amusing, to read some of the posters because it’s clear that they are manic just by the disorganized nature of their writing. It’s the kind of thing where after reading it you think to yourself “someone’s off their meds”. As testimonials go, these are not exactly the best endorsements for people who are bipolar or know people with bipolar because the signs are so bluntly obvious. These are short term endorsements and most testimonials don’t disclose how long they’ve been off of them.

But there’s another kind of bipolar testimonial. The “I’ve done X, gotten rid of my meds, and Y years later I feel great”. It sounds very convincing. It’s not the short term mania that happens after withdrawing from lithium or other mood stabilizers. In fact, it sounds like they’re on to something. After all, these people have been off meds for years, they must know something we don’t. This is wrong again and even more dangerous than the above experiment that will lead to a very quick crash after the mania wears off. It’s dangerous because they’ve mistaken a few years without a mood cycle for being cured. They’re not cured, they’re in “remission” for lack of a better word. This happens with people who are bipolar, they can go for extended periods of time with no mood disturbance. A classic case is Kay Jamison’s autobiography The Unquiet Mind, where she had mood disturbances in college, but made it through grad school without a problem. It’s not a disorder that is present 24/7 for some people. It comes, it goes, it can be triggered. And by not taking a med like lithium, which has very manageable side effects and is quite cheap, they’re setting themselves up to fail with no safety net to catch them.

To me, this is the most saddening portrait that I’ve come across. The short term withdrawer will have a psychiatrist set up and after the impending crash, will likely go on meds again. This is a classic see-saw of going on meds and coming off of them. But the long term withdrawer will lose psychiatric contact and if some major stressor brings the swings back, there is no medication or psychiatric safety net to catch them and help them. And nothing is worse than finding a psychiatrist while depressed or having to wait the weeks to see them and get the proper meds.

Most of what I’ve seen is due to a reaction to the zombiefication that psych meds can induce. Drugs like Seroquel and risperidone have this effect as well as drowsiness. But being mentally ill means you have to be an advocate for yourself. Setting up weekly or every other week appointments with a psychiatrist when going on a new drug is crucial to getting the dose or the drug right. And being forceful and not tolerating the side effects is key to not becoming zombied. And the energy spent on integrating a whole new life style, be it gluten free, reiki, or anything else, that energy could be put to use in finding a proper medication. You don’t have to be a zombie or accept being a zombie, there are a lot of pathways to try. And those pathways are less likely to set you up to fail than dismissing them all.

Playing the Diagnosing Game

I do it and a lot of other people do it as well. It’s a game we play where we see if someone fits a certain mental disorder, whether it’s a personality disorder or a mental illness. I used to do it only very occasionally, because I only had a single class of psychology behind me. I knew some of the requirements and I also knew some DSM IV requirements, but I was not well versed in the material at all. But in the past year and a half, my knowledge has grown considerably as my interest in psychology has also grown. I don’t think I’m even proficient in it, but I know most of the groups now for diagnosis of major disorders and also what separates them. It’s a fun game to play because it’s like putting a puzzle together. There’s only two things to watch out for.

First is that I don’t take it seriously at all. It only becomes a language that I can use to predict actions and understand some behaviors. Even then, I allow the person to just be an individual person. This is because individual traits almost always fill out the gaps of how someone operates and behaves. Classifications in the DSM IV are simply the similarities that individuals display that align with structural/chemical disparities in the brain. And it’s the individual idiosyncrasies that inform me to a greater extent about when to cut the person some slack and when something needs to be said (which is next to never in my case unless you’re a real dick).

Second is that I don’t force anything. Often, people are just weird without anything being “wrong” about them or needing medication or therapy. They’re just weird and that’s all that can be said about them. It isn’t a negative thing at all, weird people are often the most interesting people. It gives them flavor over the usual vanilla that I’ve encountered in a lot of people here on campus. The point is though, that unless there are absolutely clear behaviors or communications about behaviors, I don’t jump to any conclusions. To do any more would be pigeonholing them based on bad evidence. And readers of this blog know that I tend to be big on evidence.

Above is a fun game, and an interesting intellectual exercise of recalling definitions, applying, understanding, and afterwards I usually know the person better even if I’ve just come up with the answer that they’re weird. The game makes me think of them and try to understand them, which in my case, promotes a lot of empathy on my part. Empathy doesn’t come naturally to me, but looking at behaviors helps me see into another person’s head.

However, the internet sucks at playing by these rules.

Again, trolling through message boards last night (which was really a bad idea now that I think about it), revealed that a lot of people play this game. The only difference is that they play it for stakes and judge people based upon it. What makes it worse is that it’s usually very misinformed ideas about what actually constitutes the diseases that create the “diagnoses”. There are a lot of the ways that it takes form. Yahoo message boards are flooded with this type of material. Material where people as “is X bipolar?” or “X is crazy, is s/he Y?”. Or of course, there’s the wonderful comments, where people, based on a paragraph of material, feel well informed enough to pronounce a judgment. It’s actually disgusting after you read enough of it, and even more disgusted when you realize that actual people are making these snap decisions on things they know nothing about with barely any evidence.

Now it might seem strange that I would bring this up, since this seems to be relatively isolated to the internet. The internet, as we all know, is a cesspool of idiocy. But I like to see it in another light. Through anonymity, it doesn’t necessarily show what we are consciously doing, but what we unconsciously do, or do without thinking much of it. And in real life, I’ve known several other people who play this game, but again, it’s for keeps instead of fantasy and fun. This is all very interesting and mildy disturbing.

It’s interesting because it means that dialogue and discourse about mental illness, and even tangent awareness of mental illness, is relatively high. People without knowledge are aware enough about disorders to ask about particular ones. And that’s good, because it encourages people to see their own behavior or see other’s behaviors and possibly provide the encouragement to seek a therapist. And even in the naive and misinformed comments, I still see some light that psychological discourse has penetrated deep into American society. Though it’s distorted and not necessarily correct, that’s a long ways from where we were 50 years ago. To summarize, as a nation, we are becoming more aware of mental illness as an ailment to be treated and diagnosed. And with more and more resources about mental illness coming out on the internet, the proper information will start to trickle in and more people will get the help they need.

That’s about as positive as I can be.

The negative side that came out is that people make snap judgments about people’s mental health. Mental health is a difficult puzzle that takes years of schooling and experience to really nail down. The most an amateur can do is get an obvious case in a ballpark range of a diagnosis. Along with this is that the attitudes that come after making a diagnosis can be very ugly and prejudiced. It doesn’t take very long to find some horrible remarks on the message boards. There is also a sense that came out of the multitude that mental illness offers an excuse to dismiss the person. A weird person needs to be understood and worked with, a mentally ill person needs to take their meds. In this sense, psychiatry has penetrated the collective consciousness with its vocabulary, but it hasn’t penetrated it with its understanding.

Bipolar is Sooo Hard For Everyone Else

I did some internet browsing last night looking for whatever I could find. Apparently, if you type in “bipolar dangerous neighbor” you get some horrifyingly intolerant crap. It probably wasn’t the best time for me to read this article by the Atlantic. It’s essentially about a family finding out that their son is bipolar and in a psychotic state by discovering him in one. It’s a sad story to hear and it does highlight something, that being bipolar impacts everyone else around you.

I’ve noticed it with my parents and my girlfriend. The wondering if I’m doing ok on my meds, taking them, etc… My girlfriend sees the impact of the drugs first hand and sees that I haven’t really been present as a human being for quite some time. That places a lot of strain on people and they should be commended for it and thanked. Being bipolar is no walk in the park for anyone.

However, that’s not what worked me up. Over the past few months I’ve encountered several articles solely focusing on the impact of bipolar disorder on the families and friends. Which could be interesting if the articles did a well rounded piece about the general impacts of the disorder. But they haven’t. And the Atlantic article is a prime suspect for what I hate the most. It’s purple prose that over dramatizes the situation to sell the idea that people with mental illness are a nuisance and draining on society. If you read through the article, there’s only the story of how heart wrenching (and I really do emphasize that it’s purple prose there) the experience of seeing someone say such mean things. Never once mentioning that the mentally ill person is not of sound mind at that time. Mark, the man who experienced the psychotic episode, was merely a prop for the outflowing of the family’s emotions and self pity. So much for being another human being, instead, he’s just a “madman”, whose life is summarized in a paragraph.

Part of it is just me being irritated right now. I know that. And the internet didn’t help. I blame teh internet. But the Atlantic article, being a prestigious publication, really highlights a crap article. If they are really looking for something traumatic, they should look away from a sad, but explainable, event and look instead at the fact that Mark has about a 1 in 4 chance of killing himself since he isn’t medicated. Where’s the outrage about that? Where’s the weeping and gnashing of teeth over preventable suicides? If they wanted something biting and sad at the same time, interview the families of wonderful people who killed themselves because of depression. That would give both the perspectives of the family as well as highlighting a very tragic reality of mental illness. And that only took me 2 minutes to come up with!

At the bottom of this is of course the fact that there is just a bare minimum of positive exposure on bipolar disorder, schizophrenia, ocd, and panic disorders. And that exposure usually comes from celebrities. Even movies don’t do a good job. There’s A Beautiful Mind (which I don’t really like for a variety of reasons, but I am a movie snob), and finally Melancholia, which is the first movie that really portrays the reality of being unbalanced and depressed. But very few people will watch Melancholia because it’s hard to understand despite its beauty, and only people who have been depressed really seem to connect with it on an emotional level. There just isn’t anything positive in the same way that women’s rights and gay rights have. And if we took to the streets, people would flee. Maybe in a decade or two it’ll improve, just like it has since the 60s. But in the meantime, I guess I’ll just have to rant about the Atlantic.

Klonopin Withdrawal – 2 Weeks In

I’ve had to take a step back in my titration off klonopin. I was supposed to be off of it in 4 weeks, now it’s 6 weeks. The change was just too sudden and the complications were too many.

At first, it was the usual physical symptoms of shakiness and anxiety. Those I could deal with. I even had some mild paranoia, again, that’s fine with me. It might sound strange to some readers that having a constant feeling of an impending panic attack is manageable, but it is. There’s something about cycling several times in a day that makes anxiety seem more of an afterthought than as a present danger. I obviously took breaks and kept a relatively stress free lifestyle to manage these symptoms. I’m relatively lucky as a student to have this summer vacation where I can relax. But I also think that being bipolar (or schizophrenic or other serious mental illness) has a hardening power. Where two years ago, anxiety was high on my list of problems, but now psychosis has replaced it and anxiety just seems like something I’d rather not do. It’s like going to work an 8 hour shift while sick. Unpleasant, yes, but no longer in the “worst things to go through” file.

Part of it also comes with the shift in psychologists. I’ve gone from mindfulness to social rhythm therapy and cognitive behavioral therapy. That change has produce massive results. The rhythms set up by SRT helps keep my moods in check and alerts me to any changes. And the CBT has me constantly challenging my thoughts. So rather than just letting the anxiety pass as an afterthought, I assault it, question it, and it often dies down to a certain level. But even if I don’t use CBT, the anxiety just no longer bothers me as a symptom that I really care about. I’d rather be off klonopin.

What’s getting to me is the pain. For a while I was very uncomfortable in general. My skin crawled and was hypersensitive, so everything was painful. I was shaky and weak like I hadn’t eating in two days. And then on top of it came the migraines and the leg pain.

When I was younger, I had chronic migraines. As in, I would have a migraine about 5 times a week and an underlying low grade headache 24/7. I no longer vomit or dry heave with migraines, I just go comatose. I lay without moving and my eyes are fixed in a position where they cause me the least amount of pain. That’s when it’s bad. If I really need to do something though, I can still get it done. 10 years of experience with them has increased my immunity to them. Still, they are horrific and feels like someone is drilling into my eye with a blazing hot drill. And that is not an exaggeration. While a bike mechanic, I had the unfortunate experience of a bike chainring (the large gear in the middle of the bike) stab into my back and then rip a 4 inch gash down my back. I’ll take that any day over a migraine. Migraines also make me into a very un-chummy person. I don’t snap at people, I don’t have the energy to do that. I just bitch and everything annoys me. I also look like a drug addict since hot or cold showers (and in between), feel horrible. So my appearance is pretty bad. I can’t exactly look for jobs looking like that.

The other thing that it’s brought back is my old leg pain. I’ve had it since high school and it went away. But it’s incredibly painful. I had a little bit of it before withdrawal, but I’ve noticed that the frequency has increased. It’s not pressure sensitive, so walking or relaxing doesn’t change the pain level. It’s just insane swelling that puts pressure on my nerves causing them to fire constantly. And the swelling used to be immense, I have stretch marks on my knees where my knees swelled up to the size of grapefruits. Now it’s not so prominent, but the pain still is. The only thing that I can imagine that would hurt more is if someone was using bolt cutters to take off my leg. And withdrawal has magnified that to an unbelievable level.

There are also cognitive deficiencies. It’s a problem that philosophers call updating a belief. I’ll believe that it is tuesday, when in fact it is wednesday. And even using my phone to remind me of the day, and even doing things in sequence that are supposed to happen on that day. I will remain surprised that it is in fact wednesday and not tuesday. I have a belief that it is tuesday, and no matter how much data is thrown at it, I won’t update the belief to the belief that is wednesday. As such, I’ve had to rely heavily on my phone to get basic things done on time. The problem is also not something that happened on klonopin. While on it, I would become confused about the day or time, but if I concentrated, I could update my belief. That doesn’t happen anymore. The information comes in and goes out.

All that said, the pain, the cognitive problems, I am much more myself. My girlfriend has noticed it and I have noticed it. I’m more interesting again and interested in other things again. It’s like a veil has been lifted and I can see and think again. The powers of my cognition run into problems with the pain, but you’d be amazed at just how well you can think while unable to move lest you find an uncomfortable position. In addition to that, on good days where I’m not in pain, my powers of creativity are back in full force. I was initially afraid of taking an art metals class because I wouldn’t know what to create. But in the past week, I don’t even have to think hard about it and have 4 ideas of what I want to do, all marrying the art of metal with mathematics. It’s that wonderful world of sub-mania thinking, where there are no blank sheets of paper. Just possibilities and you have to choose one.

Hopefully, the slower progress will decrease the incidence and level of pain. I’ll give it a week. If not, I’m hunting down something and trying it. Nothing too strong, just enough to take the edge off. Surprisingly though, the pain has done nothing to impact my moods. Same with the withdrawal. I’m at a very comfortable and happy 8-9 days up with 1 day down. That’s a ratio I can get behind.

Hidden Complications of Medications

Withdrawal has not been that kind to me lately. I’ve been going through approximately a migraine a day. On top of that is leg pain. It’s an old leg pain that I’ve had since high school and it largely went away as I got older. It would flare up now and again, but it was manageable. And by pain, I mean crippling pain that shoots through all my joints from the knee and below. My toes even hurt.

Before, it wasn’t a problem. I would take prescription levels of ibuprofen and that would take the edge off of it. Granted, it would tank my stomach and I would feel sick and have a lot of heartburn. But at least I wouldn’t be in crippling pain. And after my back injury, I was introduced to another NSAID called Ketoprofen. That stuff is wonderful. It took care of severe back pain, sciatica, and my leg pain. Also, for migraines, I could take excedrin. It wasn’t perfect, but it took the edge off and I could function again. I can no longer take these drugs. Any of them.

The reason for these is lithium. I cannot take ibuprofen, aspirin, or naproxen (aleve) because they will increase the serum levels of lithium and push me toward toxicity. In fact, besides tylenol, there are no over the counter pain killers that I can take that does not mess with lithium. But it gets worse. All NSAID class drugs do this. So no COX-2 drugs either. What I’m left with are anticonvulsants and antidepressants (and opiates).

However, anticonvulsants are not a reality because of possible complications with lamotrigine (lamictal). All of them score a moderate interaction on the Drugs.com interaction checker. Worse yet, the best ones not only take a while to work, but can decrease the amount of lamictal in my system. That could have devastating mood impacts. So anticonvulsants are pretty much out because they are slow and interact with another one of my drugs.

Finally, there are tricyclic antidepressants and SNRIs (like welbutrin). There are two problems with this. SNRIs make me suicidal and a little homicidal. Even at low doses they destabilize me. So no matter how effective they are, I simply cannot take them. As for tricyclics, like amitriptyline, they too are antidepressants with a risk of mania. This effect is exacerbated by taking olanzepine.

And there’s one other. A low level opiate, tramadol, also interacts with both olanzepine and lithium causing increased risk of seizure. This is because it acts on both the D2 and D3 receptors in the brain. So even low level opiates are off the table because of the medication cocktail that I’m on. Which is disappointing because tramadol is the least likely to get me hooked on another narcotic.

This just reveals the hidden complications of medication. Drugs like lithium and olanzepine interact with nearly everything. And once you throw in lamictal, everything goes out the window. And adding in bipolar disorder helps clear away the remaining drugs. The only things left for intermittent moderate to severe pain are powerful narcotics like hydrocodone and oxycodone. To some, that might sound nice. But after withdrawing from one drug, I’d rather not do it with another. They are also sedating, which is something I desperately want to get away from after taking clonazepam for so long.

However, I don’t advocate dismissing these drugs because of the complete lack of access to no nonsense pain killers. It would seem strange to jeopardize one’s mental health because you can’t take ibuprofen anymore. And I’m definitely not going to stop taking these drugs simply because I have days of pain. Even if right now I’m very badly medicating myself with a little alcohol and tylenol. What it means, in my opinion, is that if you have severe pain that isn’t handled by tylenol, get to a general practitioner and find out a medication right away that you can take. I was stupid and didn’t set up a primary care physician and am now in the lurch for not doing so. Instead, I’ll have to rely on my psychiatrist for pain meds until I can get into my July appointment, and that’s a position that I don’t want to put her in.

It’s also a very good reminder to double check every interaction with every drug because even common and safe drugs like ibuprofen can have relatively devastating effects. Drugs.com has a good one that lists the severity of the interactions and what it does. Also, talk with your pharmacist about these things. I’ve found several good ones and they know off the cuff what can’t be done or what little tricks can be taken to work around complications. It’s their job, and my psychologist informed me that there is a strong movement amongst pharmacists to demonstrate that they are more knowledgable than doctors about medication. Ask questions, they are more than happy to inform you about the latest research that they have read. Plus, and this is just me speculating, I think that they like the sexier drug cocktails that pose complex interactions. It’s a stretch to figure it all out. It’s like my experience with the university health clinic, where my doctor was more than willing to act as primary care after finding out that I had a herniated disk. I think it’s a break from the norm, which is always more interesting to intelligent educated individuals.

New To Bipolar? – My Ever Changing Views on Meds

The longer that I’m on medications and the more that I’ve had to experiment with them, the less straightforward it appears. It should be a normal course for anyone, that experience heightens the nuance of someone’s view on a particular subject. It’s good, it’s healthy, and it’s natural.

Earlier this morning I was thinking about whether I would recommend trying medication to new people or even to my old self given all that I’ve been through. I’ve had a rough year and a half with about 6 months of it in complete sedation and obliteration. These drugs are powerful and going slightly overboard with them can be devastating. It’s enough to make one think that the cure is worse than the disease at times. But that’s a snap judgment about the short term.

One the one hand, without knowing that zyprexa is such an effective medication, I would have stayed in a mental ward for a long time during my severe winter depression. And while it initially stripped me of emotions at a higher dose, it led to the discovery that a very small dose can control even my most severe psychotic states. It’s a long term realization from a short term loss.

Same thing goes for klonopin. I’ve been on it twice, and I should have learned from the first time on it to get off of it fast. But I didn’t. And now I know. It clearly works for controlling depression, anxiety, and mania and is cheap and effective. Granted, it took a while to find out all that it does, but it’s part of my armament against dangerously extreme moods and anxiety.

Then there are all the other psych meds that I’ve been on. The horrific experience of going on abilify, the failures of seroquel and risperidone. They all cost me time, money, and energy. One would think that after a while I should just give up. Or if you’re starting out, that the energy that it takes to try all these meds is worse than the energy it takes to manage the moods on their own.

I reject those ideas. I’ve always been on the side of finding a minimum level of dosing to help stabilize me and then allow psychology to help with managing the rest of the ups and downs. And that takes a lot of energy even with the meds. But the energy that I invested in finding the meds that work for me will pay off. One can think of it in terms of net gains. While in the short term I might have spent a lot of energy finding the correct medication, that energy will be saved in managing the severity of my moods. It’s restoring me to a functional level. It might have taken a bad year to figure it out, but I’m talking about the rest of my life as well. And that life will likely be longer because of drugs like zyprexa helping me out during severe depressions that will ultimately crop up a few times in my future.

I’ve also written about mood cycling before (though I cannot remember the post’s name) where as time goes on, they become easier to trigger and grow in how extreme they are. I might have been functional at one point in my life with the mood swings, but as time went on, the highs went higher and the lows went deeper, landing me in a psychiatrist’s office with suicidal thoughts. And when I went off of medication in a drug holiday, I went from a psychiatrist’s office to a mental ward. It’s best to think of bipolar disorder as a progressive disease. It doesn’t stand still and stay the same. It gets worse. It’s similar to epilepsy in many ways. So locking it down and controlling it quickly is for the best. This bad year has ultimately succeeded in getting my moods in a safe confined range where I still go up and down, but never reach anything dangerous.

Furthermore, it might be strange to think of it this way, but trying drugs that failed is a learning experience beyond just learning that drug X didn’t work. These drugs push your mood and brain around in ways that you never experience in ordinary life except for extreme circumstances. As a result of being over medicated and the feelings attached to that, I have developed a hyper sensitivity to where my mood is at any given time. Seeing what it is like to not have manic or depressed thoughts, and be rather normal, has shown me what sort of dialogue I should expect with each one. And just based upon a quick categorization of desires, motivations, and a few minutes of internal dialogue, I can tell exactly where I am and how severe my mood is. All these failures have taught me more about my mind by showing me alternative states of mind.

It’s kind of like when I had migraines every few days. The triggers were plentiful and over time I learned to avoid them. They were mainly food triggers and smells. Getting the meds right was on par with finding all the triggers for my migraines. It’s a lot of trial and error and with error comes horrific pain or zombie like states. But it pays off in the end. And in terms of migraines, I developed a sort of six sense for triggers. From just smelling something, I can accurately predict whether it’s a trigger. Took 10 years to get that, but it’s saved me from a lot of migraines. What it took was a lot of sniffing and letting my brain correlate the smell with what I ate. Just like now I have an intuition about what is going on inside my mind at any given moment. I just naturally catalog what is important and I constantly check it.

I’m never going to say to anyone that finding the right medications is easy, fun, or quick. I was lucky and did it relatively quickly and I don’t know how people go on for longer. But it’s not only worth it in terms of getting the stabilization and the energy saved from that, it’s also worth it in terms of learning more about one’s mind and how it operates.