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Next Stop, Toronto!

As Inch Label pointed out in a comment, my brain is going a little manic. Cross checking some dates and this is about when it starts to happen and I swing up into the summer manic period. A little early this year, it usually crops up in April, but my brain isn’t a calendar. So, it is with trepidation that I say that as soon as I get home from California, I’m headed off to Toronto.

I don’t have a passport yet, which will be the biggest thing. And I have to make sure that my car can survive a 1200 mile round trip. But I did the math, I need a passport anyways as an adult, so that’s a good thing to have. And above all, I get to spend time with my friend who I’m driving to a conference there. I haven’t seen her since December, and she has a apprenticeship over the summer, then she’s moving away for good. Spending a weeklong road trip with her and touring around a beautiful city I’ve always wanted to go to seems reasonable. I’m thinking aloud in my writing to make sure that this isn’t completely irrational. It doesn’t seem that way, it just seems a little spontaneous.

Which won’t be a bad thing. When else am I going to be able to do this? And I’ll probably regret never trying to make it work.

And that’s the big one. I’ve discovered in the course of this illness that regret is terrifyingly bad. When I go into a depression, or even have a mild one, everything I’ve ever regretted, felt bad about, felt embarrassed about, etc… floods into my mind to make me feel worthless. Making the effort to do interesting things or even just positive things like learning how to play chess has paid off by providing me with things to hold onto. Strangely, with both the negative force behind me from depression and the positive force of mania, it’s helped crack what I went through in childhood. I had chronic migraines and everything set them off. As a result, I didn’t do much, couldn’t do much. Now the two forces have pushed me into a much more interesting life than I originally thought I would have. Who would have thought that being bipolar would have turned me from a hermity nerd who did professional level Counter Strike into someone outgoing enough to drive to Toronto at the drop of a hat or live in California for several months or run music festivals?

In high school, I would never have thought of myself doing any of this. Actually, in high school I wanted to teach economics at the college level. That one worked out.

One thing I am worried about is travel. I have no experience with how prolonged travel impacts my mood. Some say it’s destabilizing. So far, I’ve just found it makes me cranky and mean.

Telling People I’m Bipolar – A Revisit

I’ve learned a fair amount in my years about my illness. I’m comfortable with it and my close friends all know that I have it. I don’t exactly have the hang of it, but I doubt that I will given that it keeps shifting under my feet. And from time to time, I have to tell people that I have it. In fact, anyone with a reoccurring mental illness or a chronic one will have to at one point tell people about it. If it is any factor in your life where you cannot ignore it yourself, others will notice.

I have a rather uncomfortable circumstance of having several layers attached to my diagnosis. On the one hand, I have a fairly vanilla bipolar 1 diagnosis with mania predominance. I’m up for about half the year (with a few pitfalls here and there) down for a quarter, and the other quarter seems to have some psychosis attached to it. The first two are pretty understandable to the general population, at least, in my dealings with it. The other quarter, the psychosis, much harder to explain. If you think that bipolar disorder is misunderstood, wait until you encounter how paranoia is understood. So my experiences are mildly clouded from this situation, but I believe that my input still applies.

The first thing that I’ve discovered is only tell people who need to know. When working with people or living with people, if my erratic moods will impact them, I owe it to them to give some sort of heads up. It doesn’t require a life story, it doesn’t even mean that one has to divulge the entire diagnosis. Just keep it simple, “I’ve been diagnosed with an illness and it sometimes causes my moods become erratic. Feel free to tell me if it’s inconveniencing you or if I need to adjust something.” It’s simple, straight forward, and it doesn’t say anything more than needs to be said. If I am making it difficult for you to do something, tell me, there is a physical diagnosis that causes this. It’s not a lie, it’s a bare knuckle truth without mentioning anything in particular. If you’re like me and you have anxiety on top of it, then throw it on, that’s an understandable condition. Additionally, keeping it light and simple prevents other people from projecting on you what they think you are capable of. You give the consequences, they decide, but no personal judgments are issued.

Again, I’ve found that a need-to-know basis is ideal.

The second reason that I support the need-to-know rationale is that nobody wants to hear your life story or problems. Nobody wants to hear every medical detail, or really any medical details. Coming out bipolar is broadcasting information that not everyone cares to hear and it can reflect negatively. This isn’t cancer, nobody’s going to hand out pins and a collection plate. They just become annoyed after a while. It also lessens any impact of preconceived notions being directed toward you. Specifically, bipolar disorder has developed a “fad” quality to it. It’s raised awareness, but also people believing that a lot of it is made up and misdiagnosed. And to dispel those preconceived notions, you have to go into a lot of detail about yourself. Not a great environment for a workplace or living space.

Keep it light, focus on the consequences.

On top of this, have a designated hitter. Someone who does know what you’re going through, and that you trust, to deal with the aftermath. Explaining your problems is one thing, but having someone else do some work makes it seem more objective. I have two people in my life that serve this purpose, but others who simply know that I have my disease. If something goes wrong, they understand what is happening and can lift some of the burden of dispelling the aftermath. They can be friends, professional acquaintances, even HR people. Relationships can help with this disease like no other.

Have a few people you trust to help you out when things go wrong.

Of course, keeping it direct and simple will never stop all inquisition, nor should it. It is only there to keep a lot of rush judgments at bay. If someone asks, earnestly, then be open about talking about it. If someone approaches in good faith, they should be rewarded for that. A lot of people have encountered mental illness, and if one approaches, then that can be a friend and an ally.

Be open to sincere questions and honest people.

A lot of this has come from my own observations and experiences. Some are from mental illness, some from my sexual preferences. The key I’ve found is to be honest about limitations because a lot of things can cause them and others have a right to know. But the details, the personal experiences, those are reserved for friends and family and genuinely interested people. So catalog what you can do and what you cannot do. If you’re bipolar, find your rhythm and plan accordingly. If you have paranoid seasons like me, work around them. It’s no different from my back and leg problems. I suffer from extreme leg pain and also lifting limitations with my back. I tell people that. I don’t tell them that it’s some crazy idiopathic disorder and how I stupidly injured my back. I let people know what I can and cannot do. And the same goes for my mental illness. Somethings I can and cannot do. I know when it will happen, I know steps that can be taken, that I will take, and I find people responsible for looking out for those things without broadcasting it to everyone.

Though, part of me wishes that there was an out and proud movement among those with mental illness. Part of me thinks this would be excellent since people would see how prevalent we are in their lives. But quiet revolutions take place as well. The gay pride movement can show us how it works. On the one hand, we have parades, but on the other hand, having stable and intelligent people portrayed in the media has probably done more. Having Carrie Matheson in Homeland is a bigger step forward in my mind than having us all announce our disabilities. Or, for that matter, Silver Linings Playbook up in the Oscars field. Lars And The Real Girl might also be counted as a great step forward for delusional thinking. I think that becoming accepted into society does not come from singular events, but through quiet subversion and infiltration. Being conscientious, considerate, and present is one of the best ways to let people know that we’re disabled, but not inhuman or scary. We’re just there. And once we’re there, it’s harder to get rid of us.

Ativan, Where Have You Been All My Life

I’ve been on two benzos, alprazolam (xanax) and clonazepam (klonopin). Xanax was first used for my panic attacks related to test anxiety and specific situations. It worked, kinda. It wasn’t the cure-all, it was something to augment cognitive strategies. With the diagnosis of generalized anxiety disorder and also bipolar 1, klonopin came into the picture. It’s considered the most potent of the benzodiazepine class of drugs and it’s useful for stabilizing mania, sometimes psychosis, etc… I like to think of it as a sledgehammer that takes anything aberrant and crushes it within 2 hours. When dealing with psychosis or mania, this is a wonderful drug that I’ll always keep around.

But, I’m not manic right now. And after blasting my paranoia with zyprexa, I’m not in any form of psychosis. I just have GAD up the wazoo. The sledgehammer approach has the problem of just crushing everything in its path. My motivation, clarity of thought, everything. Plus, addiction to klonopin is very easy due to its potency and withdrawal is something I don’t want to go through again. Ever. Furthermore, if I’m on it for too long, I develop memory and cognitive problems. And on top of all of that, because of its long half life, it builds up in my system, so one bad day translates to several sedated days. Using the sledgehammer is just not the right tool right now.

Enter lorazepam (ativan). Today’s my first full day on it. In terms of it’s aggressiveness in binding to the GABAa receptors, it’s on par with klonopin. This puts it in a more powerful class of benzodiazepines. In spite of it acting on the same receptors and being fairly powerful, ativan is so much better for me. Drugs are different for every person, and this seems to be the one for me. Xanax and klonopin both just fog me up and put me in a blur. I’m not anxious because I can’t think. Ativan just relaxes me without fogging me up. My brain is firing on all cylinders, my eyes feel wide open indicated that I’m not feeling sedated. And on top of it all, it’s stopped the root of my anxiety, fretting about the future. It dawned on me that it effects me differently when I went out side to just sit on a bench and take in the sun, warm weather, and the smell of an october rain. I just felt peaceful, relaxed, and a little giddy.

The downside is that my body feels like it’s made of lead. But, the desire not to move is something that is comparatively easy compared to the other things I have to mentally cope with. Although, the muscle relaxant properties of ativan might be beneficial to my back and knee pain, so we’ll see where that goes.

I’m just delighted, this is the first drug I’ve been on that I’ve actually enjoyed being on. All too often it’s a weighing of what’s worse, the cure or the disease. Finally, I came across a drug that, for me, works well (extremely well) and the side effects are entirely tolerable. The best thing, it makes time go by slowly, I can finally focus, and tomorrow doesn’t feel like the world is going to collapse and I’ll wind up a miserable failure. YAY!

It’s Time For Psychotic Septembers!

Actually, it’s October now, but it started back in september. Again, paranoia got the best of me. It was a lot slower than last time. Last time it happened in a flash where I though invisible people were watching me and I had to board up the windows. And it was definitely at the root of my anxiety for the past 6 weeks.

That anxiety was horrible. I had an appointment with my psych but it’s always further away than I would like, even when moving it up to as soon as possible. The anxiety was so bad at the end that I was waking up and clawing for the clonazepam because it felt like my chest was being crushed in the mornings. It was worse than I’ve had before. But paranoia was at the root of it. I should have suspected it earlier, but hindsight is 20-20 when dealing with something I’ve only had for brief periods before. I missed some classes and it was then that I believed that students and teachers were discussing things behind my back and judging me. Possibly following me. Sort of a tip off. But it got worse.

By the time that I made it to my psychiatrist, I was in a bizarre functioning state. I was reading and carrying out daily chores. On the outside, one would never suspect something was seriously amiss. The only big clue was that I wouldn’t walk anywhere, I had to drive. I’m noting that for future scenarios. But the big thing that was stopped, and I know something would have happened given enough time, is that I thought one of my roommates was spying on me with hidden cameras and microphones. Yeah, I was really screwed up in the head.

Why did I think this, my ex and I don’t particularly like our new roommate. She’s a quite messy (as bad as I am when severely depressed), but believes that she’s super clean. More over, she constantly tells us how good she is at things and how much better she is when in fact she is not. She’s italian, so she assumes that she’s a fantastic cook. Never made her own pasta sauce before we taught her. Doesn’t even know the difference between oregano and basil. She wants to be a writer and thinks she knows more about literature than I do. When it comes to Jane Austen, I agree. When it comes to modern writers like Cormac McCarthy, Pynchon, Delilo, Philip Roth, or a host of others, she’s never read or even heard of some of them. And as for movies, one of my pet hobbies, she defends Roland Emmerich movies like 10,000 BC as being actually good. The only movie I like that he made was Independence Day, and that’s because it’s saved by Will Smith and Jeff Goldblum. She’s never even seen a Kubrick film or classic Spielberg like Jaws or Close Encounters. There is a serious lack of knowledge and appreciation of film if these have never been watched. It’s like talking about Dostoyevsky without ever reading Brothers Karamazov. It’s not the arrogance that bothers me, it’s the arrogance without substance.

Anyways, to get back to the point, my ex and I complain to each other about her to let off some of the steam. I started to think that our house was being bugged and she was recording these conversations to use in court when she decides to move out early and sue us. If I didn’t see my psychiatrist as soon as I did, I am certain that I would have waited for everyone to leave and then looked everywhere for bugs. Thank god that didn’t happen.

But it’s all good now, almost that is. We upped my zyprexa, which at 2.5mg is enough to stop a psychotic episode, to 5mg. Now, 5 days later, I’m pretty much back to being in a lucid state of mind. The increase in zyprexa is now the only annoying thing. It has two phases for me now, probably because of the different medications that I’m on. There’s sleepy time that occurs 2 hours after taking it. And by sleep I mean unable to move or open my eyes. This lasts for 12-14 hours. Not good since I have to get up at 6 to get to a morning class. I sleep through my alarm clock like it isn’t even there. Then there’s meth-me. After the sleepiness clears the air, I need clonazepam to calm me down. It’s like pouring 2 pots of coffee down my throat chased by a line of cocaine. But I can focus, and I am getting a fair amount done. I just need a sedative to counteract it. So as a warning, reactions to meds can change over time when other medications are added or removed. Just because it did X once, doesn’t mean it will do it again. I don’t have restlessness this time, I have insane energy cleaning reading everything this time around. But it took away the paranoia, and today, the anxiety is deflated. Another few days and it should be gone entirely.

The other thing, and this is why I really think that it’s important to note major events, is that this is the second fall, coming off of a summer mania, that I had high anxiety and a paranoid episode. Last year it was in august, this year in september. Roughly the same time, manic depression doesn’t follow a 9-5 schedule so a month off is not hugely important right now. Still, suicidal thoughts are about the same time, mania about the same time, psychosis about the same time. It looks like it’s all about a 12-13 month cycle. Of course, the kicker is, I have paranoia as part of that cycle. It’s not just up and down with a few hallucinations thrown in. It’s part of my cycle. Schizoaffective has been tossed around because of this. But, in the end, same drugs, different name.

Tomorrow I’ll talk about yesterday, which was a very bad day when it comes to rapid cycling.

I’ve Got To Stay Away From Alcohol nsfw

Isn’t this an old adage for someone who is bipolar, I’ve got to stop drinking, smoking, what have you. Anyways, it’s definitely alcohol for me right now. I’m not getting drunk every night, but I’m drinking regularly enough that it’s a really really really bad idea for my moods. I also have a strange intuition that this post is going to go everywhere as my brain is in an interesting place right now. I make no guarantees that this will make any sense or that I’ll even feel like editing it.

The reason for it is quite simple, my energy/mood/motivation levels are all over the place. Nothing is lining up into any discrete mood and I’ve shifted every psych appointment up to as soon as possible. Today I got a fair amount done, actually, an insane amount done in just 2 hours. 4 pages written and a technical formal logic article on evidentiary relations read. That’s not possible. I was speaking so rapidly and so incoherently that people couldn’t understand me and I had to repeat myself 2-3 times for the right word to be correctly pronounced. One of my study friends asked if I was on cocaine because I was running so quickly. Mind you, this happened when I was on not .5mg, but 2mg of klonopin. I tried as hard as possible to knock myself out and I couldn’t. Klonopin is the king of anti-mania meds, and it just wasn’t doing anything to stop it. I just kept going and even though I couldn’t focus worth a damn, the times I could read I was going so quickly that I nailed every major point and wrote a page on it. The rest of the time I daydreamed about being the sidekick to the Doctor in Doctor Who.

The best way to put it right now is that my brain has shorted out. It’s just completely gone. I don’t recognize it anymore. There are no recognizable moods, patterns, nothing. It’s just gone. The good news is that it’s trending out of its “depressed” phase into a “manic” phase. But that’s about as close as it gets for lining up with established mood patterns. I’d usually say that this is mania, but I don’t want to do anything that seems destructive or anything that my friend has alerted me to. I seem really normal except for an absurd energy level.

Hence the alcohol and smoking. The latter calms me down just a little bit to make me feel a little more normal, and the former makes me relaxed enough to enjoy my life again instead of feeling like I just did two lines of cocaine (which I know how that feels). And being the idiot that I am, I know that the alcohol is the worst possible thing I could do right now. It’s like smothering a fire with gasoline. Yeah, the flames die down when you initially dowse the flames with the gas, but then it explodes into an even bigger fire. I know I’m an idiot, but I’m lost. Klonopin, the bane of my existence, isn’t working. I want to talk to my psych before increasing my zyprexa because that’s an even bigger demon.

And here’s the strangest kicker.

Prednisone calms me down.

I don’t know. That’s just F’d up. A steroid calms me and makes me feel centered. For a second I thought maybe I’m actually ADD, since a stimulant helps, but that doesn’t fit the profile. ADD and ADHD doesn’t cause people to scream at the top of their lungs to blaring Ladytron. And here’s the sad part, with alcohol, at least I can read while Dillinger Escape Plan or 65 Days of Static are pounding my ears (oh, did I mention that I also have TV playing in the background while following everything?). My brain isn’t in some sensory overload, it’s seeking sensory overload and when given it, it is like ecstasy incarnate. My body relaxes and I just feel at peace with the world. It’s a strange thing to behold. A 20 something listening to math metal, where every instrument is playing a different time signature and vocals are screamed, sitcoms playing in the background, and me reading political philosophy like I’m in a tranquil library making notes like a studious individaul.

I only experienced this once before when I was on abilify. I was listening to 2 podcasts at the same time and recalled everything from every one to my then-girlfriend who read the transcripts to double check my strange claim. If this continues, I’ll be doing this with 3 or more sources for extended periods of time. The only draw back is that I need 3 or more sources going or else I can’t focus. I need as much input as possible. Like right now, I’m writing, watching the newest Parks and Rec, reading FiveThirtyEight, and listening to Meshuggah.

Maybe that’s just how it’s going to be and I don’t need to medicate, I just need to overwhelm myself and absorb everything. Maybe I should just embrace my freak mind during these periods and just absorb inhuman amounts of input. It may sound interesting from the outside, but really, from the inside, I feel like I’m going to explode unless I’m pummeled with high octane information. I know to some that they’d look at this and marvel at the amount of information that I need to absorb. But imagine that you felt like you’d implode catastrophically and die if you didn’t read everything possible while rocking out, taking notes, and critically examining. Imagine being in school where you literally feel like you’re going to die (I’m not exaggerating, my experiences with dying are more pleasant) if you don’t do everything NOW. That’s why I drink right now. To ease some of that.

FUCK MANIA. If this is what mania predominance is, fuck it. It’s not better or worse than depression. It’s just shit. Give me 5 10years, then after I have a hold on it I’ll probably be doing all right.

Meds Have Reshaped My Mood Landscape

I’m going into my first fall where all I have to worry about are my moods. No upsetting events happening, no physical problems, no nothing. It’s just me, my moods, and a cocktail that seems to be doing a really good job. But I’m having to relearn a lot.

Lately I’ve been having a slightly odd feeling where I just feel off. I can’t concentrate or motivate myself very well. I feel blah, like I’m depressed. But I still have flights of fancy, constant day dreaming, and in general I feel good about myself. It seemed mixed, but not quite like my usual mixed states which are intense and make me nearly vomit sometimes. I didn’t know what I was going through. I still don’t. I have an idea, but the closest I can get is slapping on a generic tag like “mixed state”. In general, my moods have been much more ambiguous since going on zyprexa. There are no sharp boundaries as to what mood is what like they were before.

For instance, I thought I was depressed last week. I was just sluggish. But I didn’t have all the criteria for it. Nothing quite fit. I was just slow, abnormally slow. And that’s persisted to some degree. I figured that if this was to be my depressions from now on, I can totally take it because I did a ton of chores and cleaned up the apartment. Okay, so I didn’t make it to class, but I finished my homework and my room looked great. Now fast forward to the past few days. Sloppy room, but much more energy. What label goes on what? I don’t know. My mood chart doesn’t even capture these weird nuances so it’s going to be back to square one for that.

Of course, this is the wonderful nature of bipolar disorder. I have a weird interest in reading people’s self diagnoses of bipolar disorder and realizing how little they know of it. I do fit the big things for bipolar disorder. My manias are sustained and can be really wild and my depressions can land me in a psych unit. I’ve got the big stuff out of the way. But it’s the little weird things that can’t really be codified that people really don’t know about. Last year, when I was going on Abilify, I had another set of weird mood tics that didn’t fall into any category. Before that, off meds when I was younger, I had another whole host of odd tics derived from anxiety and paranoia. With zyprexa, those seem to have changed into another form. Meds take care of some of the old odd tics, and create new ones. But in general, people almost always think that bipolar disorder is a straightforward mood swing kind of deal. It most certainly isn’t. I’ve described moods to my friend, who has bipolar disorder NOS, and she can’t believe the crap my moods go though. PMS on shrooms she called it. Which is why I really like to think of bipolar disorder not as a polarity disorder of extremes, but a general imbalance in a lot of moods. It’s simply the inability to process moods in a normal way and as a result weird things happen.

Honestly though, it’s the little strange moods that throw me the most.

With a big mood movement, such as mania, the way to tackle it is fairly obvious. I keep extra zyprexa and klonopin on me at all times and I don’t drink. Boom. Done. Just keep an eye on it and medicate heavily if anything strange starts happening. Plus, I’m so amped that the level of sedation that I do take is comparable to staying up till 2am when your normal bedtime is midnight. I’m just unfazed by it and my life continues on. Same with depression. 5mg of olanzapine please. Tackling these mood movements is easy and straight forward since they’re big enough that only medication can help.

Not so with the little ones. I don’t want to overmedicate these. I wan’t to remain lucid. The key is to find what movements happen under a specific drug regimin and accept it as part of the side effects. Apparently, my current cocktail, with the addition of prednisone (which I suspect has something to do with it) has given me some paradoxical moods.

But something does help.

I grew tired of dealing with these moods. I couldn’t drink, I was smoking way too much. So I looked at the 60 pills of .5mg of klonopin and I thought, half of one of those tabs can’t hurt. It didn’t. .25mg usually makes me tired and need to take a nap. Nope. I felt clear headed, awake, and my energy was back. What the hell? I just took a sedative and now I’m more alert and active? Don’t ask me to break down the reason for this because nowhere can I find anything about this. I’ll talk to my psych about it, but in the meantime, my drug landscape gained a whole new element in addition to the mood element. When I’m feeling weird and in a sluggish funk, take a sedative, it’ll amp me up.

 

As a side note, for those of you who are on a new medication that you can take liberties with, like klonopin or xanax, talk to your prescriber and find out what you can take it for. Find out what the safe doses are. I know the maximum dose of every drug I can take and remain safe. Some I can take a fair amount of, like my zyprexa, others, lamotrigine, I do not dare experiment with under any circumstances. Learn about your meds, read up on them and ask questions. Cocktails are not set in stone and you have to make them work for you.

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