Progress, or lack of such

To be honest, I thought I’d have seen more progress by now. Three years after CBT started (it lasted about 8 months) and just over two years since I began taking meds. These have changed and dosages upped several times to where they remain steady at the moment. Daily: 600mg quetiapine, 20mg fluoxetine, 500mg sodium valproate.

And yes, they’ve topped and tailed my more extreme moods. In that respect there’s been significant progress. I still get frequent – and fleeting – suicidal ideation, but I don’t have the strength and wherewithal to actually do anything about it. I tend to ere on the side of caution and add ‘yet’ to that statement. It wouldn’t do to think I’m cured. I know there’s going to be no such thing.

So two years.. I’m holding down my job and – I think – doing well at it. My team gives me some support by way of accepting and dealing with my many cognitive and memory issues that pop up daily more than once.

I have no-one to talk to about my illness; at least, not in detail. Twitter remains a source of support, albeit from people I’ve never met and never will meet. There are loads of us on there exposing our souls and craving help and attention. Whenever it’s good to talk, Twitter offers a (usually) one-directional ‘conversation’ outlet. I have no input from my GP or any other medical service. I saw a psychiatrist last before the summer but that was only because my GP referred me due to a down-turn in moods. I have no future appointment set.

It would be interesting to see if I could hold-down a relationship at this point in my treatment. Bipolar destroyed all the romantic relationships I’ve ever had, and I still feel so bad about that. Some of these were good for me, and I let them go through my – admittedly uncontrollable – moods. As it stands now, three years since talking therapy began and just over two years since meds started, I have no such relationship. Indeed, I’ve not had a girlfriend (or even a date!) in two and a half years. That’s the meds for you; I’ve been stripped of emotions, feelings, libido and effort. I create no writing work, and barely any art work – the things that I’ve always done and done well.

I don’t really live; I exist. And even then, there are occasions when I get hypomanic and don’t even believe that. I exist with moods and delusions, my physical health has taken a hard knock (illness and meds) and I generally ache all over 24/7. I still don’t sleep. My short term memory is f*$*&d, basically. I’ve put on a couple of stone in weight since starting the meds but from looking at other people’s experiences I could have put on an awful lot more. Who knows, maybe I will? I’ve had to get rid of a load of clothes and start acquiring from scratch. (Though that’s actually been quite therapeutic!)

The biggest shock to me lately has been a letter from the Pensions people; I still have 9 more years to work in this stressful job. Until I’m over 66. How the hell’s that going to happen? I’m living day to day. Small mercies.

 

https://upload.wikimedia.org/wikipedia/en/thumb/e/e5/Magritte_TheSonOfMan.jpg/225px-Magritte_TheSonOfMan.jpg

 

 

 

 

 

 

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Starting to rattle

I started going downhill again a month ago. GP tried to get me seen by assessment team the same day but it took a week. Then I had to describe it all again; for what seemed like the hundredth time.

And again, another long assessment. My psychiatrists said something about juggling my medication a little and trying to get me more (1:1) CBT therapy. Last time I had therapy for several months I’d yet to start on the meds and it did very little for me I think. If I get more therapy now it will be interesting to see how it goes alongside medication.

So a couple of days ago I had my follow-up meeting with the psychiatrists; another ‘20 minute’ one that turned into 50 minutes.

The bottom line of which is that my Quetiapine has been increased almost to maximum dose – up from 500mg to 600mg. Fluoxetine remains at 20mg. And Valproate has been added into the mix, at minimum dose: 500mg. Lithium was discussed but I was told the side effects wouldn’t agree with me – and anyway, Valproate is better for OCD (and its anxiety trigger).

I’m starting to rattle.

epilim

 

June update

I’m relatively stable at the moment, hence the reason I’ve not written anything here in a while. The sole reason for this stability is my meds. After all, I don’t have any other help or input – in this respect I’m where I was three years ago, before therapy and starting on quetiapine + fluoxetine. I am theoretically in the care of my GP though I never see my GP.

After having so much time off work last year (several months) my main objective this academic year was to have no time off at all. That’s how stubborn I am! But here we are, seven weeks from the end of the school year and I have 100% attendance.

It doesn’t mean I’m “better”. I’m not; there’s no cure for bipolar. No cure for anxiety. No cure for OCD. No cure for the dissociation (DID). There’s just medication; damage limitation.

I still, of course, get intrusive suicidal thoughts. I still don’t sleep well. Surely 550mg quetiapine + 20mg fluoxetine daily should be knocking me out all night? But no, I’ve not slept through the night in decades, if I ever did at all. My short term memory has taken a severe hit (I suspect some of this is memory lapses linked to the DID symptoms) though my long-term memory in many respects would put your average elephant to shame.

Quetiapine continues to function in making me fat. It’s a straight either / or choice with these meds: Fat or Mad. I’ve opted for the former, somewhat reluctantly.

There’s a blog piece to be written about the DID symptoms I’ve experienced through my life and I’ll write than when I’m able to collect those thoughts together.

 

Madness

However much I improve, however much I remain stable, I’m still balancing on the edge of madness. So much so that I feel, even with a smile on my face, that balance could be tilted and into the mire I slip.

There’s no doubt I’m so much better now than I was all my life until the climb began a couple of years ago. While therapy did little except drag up tons of old stuff (childhood issues, physical and psychological abuse) that was then left to fester un-dealt with, the meds – currently 550mg Quetiapine, 20mg fluoxetine – have clipped the ends of my mood swings. There’s been no obvious hypomania for quite a while now, no deep low. My sleep is still almost as bad as ever and decades have passed since I slept right through the night – if indeed I ever did so.

Anxiety is always there to some degree; it’s the main symptom of my ultradian bipolar that hangs around stubbornly poking a long stick at me. The OCD, while a nuisance and often unpleasant, is mild and I can handle it.

I’ve had to live with this my whole life – I don’t just have bipolar, I am it – and as the saying goes, I’ve survived every bad day I’ve ever had. I’m still here.

But I’m still doggedly hanging onto sanity. Those claws could slip any moment making me fall into madness.

I call it (but only to myself) the other one. That other me sharing my body but lurking in the shadows rather than being out here with Me. The one in the mirror sometimes. Dissociation is something else I’ve always had; I can remember it in existence as a child. I’m uncertain whether the other one wants to choose madness. I think we always opt for survival, and bipolar suicidal ideation I believe to be little about actually wanting to die but rather, wanting to be free. To be whole, to be well. Whatever that is.

On the edge of madness, 24/7. Fighting a range of battles, physical and psychic. It’s quite the balancing act. Sanity is winning a struggle against ‘inner demons’ or the other one. Always teetering, always throwing one’s weight in the direction of self.

 

Teacher with bipolar disorder

I rarely post links to articles in the press, but as a teacher myself this story was important to me. Last year, beginning meds and therapy, I had almost 9 months off work. Since I returned to my teaching job at the end of last July I haven’t had a single day off. This is the result of great effort (and a lot of stubbornness) and I feel proud to have achieved what I have done. I’ve had little or no support from Management, including seldom if ever being asked how I am and if they can help in any way. I’m certain if I had my arm in a sling or a foot in plaster they’d be falling over themselves to assist. But of course you can’t (usually) see bipolar… so evidently – to them – it doesn’t really exist.

http://www.walesonline.co.uk/news/wales-news/teacher-bipolar-disorder-been-awarded-12519829

 

 

So long ago. So clear?

This October has marked one year since I began taking Quetiapine (Seroquel) and yesterday my son told me I am very much better (“nicer”) than I was thirteen months+ ago. Personally, I can’t see it, though I’m aware that the meds have worked their virtual miracle on my out of control, life-long bipolar symptoms. I have no reference point to ‘getting well’ as I’ve never been well.

Although I only sought medical and psychiatric help two years ago, at the age of 54, I can recall mood swings and what I now assume were brief psychotic episodes back to the age of four. So then, a half century of bipolar and depression, untreated and ignored by those who knew me. Who know me.

Having had eight months off from my stressful job last year, I have managed to stick at it for a couple of months now without missing a single day. I’m stubborn; I won’t let bipolar dictate its terms to me anymore. I must have always been stubborn, otherwise I’d have sought help before now. Actually, as you’ll know if you’ve been reading this sporadic blog (sorry), I did present myself to my GP when I was 20 with severe depression. He told me: “Pull yourself together” and sent me away without help. I was so embarrassed I waited almost a quarter of a century before handing my current GP a letter detailing my illness.

I know exactly when the light bulb above my head lit up regarding bipolar. I’d tried several different anti-depressants over the years for reactive depression: divorces, deaths in the family. That kind of thing. But these meds had made me ill; none of them worked. Then I read a book called ‘Why Am I Still Depressed?’ and it all made sense.

Which brings me to October 2016 and twelve months of Quetiapine (and at some point the addition of fluoxetine). The Q dose crept up and I now take between 500-550mg a day in three or four doses; the days I’m in work I take that extra 50mg for anxiety.

The biggest issue for me has been the Fat or Mad? decision. It became apparent early on that I had to make a choice, and I chose not to be mad. So in a year I’ve gained over a stone in weight and my general fitness has suffered greatly. No-one talks about the physiological symptoms of bipolar, but they’re very much there. I’m sedated half the day and I ache like hell from tip to toe.

I still don’t sleep through the night, not by a long way. I wake every hour or so then fall asleep again quickly. My anxiety level is still higher than I expected it to be by now, and my mild OCD with it. The meds haven’t really touched the OCD at all. Neither did the nine months of CBT I received last year before starting meds.

I look back on hypomanic and manic phases with more embarrassment and utter bewilderment. How on Earth was that person me? A stupid question as I have no idea what or who me is.

Some things disturb me more than others now. About the illness, I mean. The dissociation is scary and confusing. I tried to get help for that during my therapy but after dragging this issue out from the depths of me, it was then left unaddressed. Yes, the dissociation disturbs me; I don’t like it at all.

The meds have lessened the occurrences of ‘extremely intrusive suicidal ideation’. It’s clipped the top off the highs and the bottom off the lows. I’m more stable. The fact that I’m compliant – both with taking my meds and attending my psychiatrist appointments – shows that I’m in a better place than I was. Not a good place, just a better place.