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.

 

 

 

Exhausted

‘You want to know why I feel exhausted?’ I asked.

‘No, not really. But go on, if you must..’

I haven’t slept right through the night even once in perhaps 30 years. Not once. I ache down to my very soul; if you thought bipolar is solely a mental illness then you’re mistaken. It’s also a physiological illness, a painful one. Between the disease and the medications they pound away at muscles, joints and bones 24/7.

Then I have to hold down a job. A stressful job at that. And when I’m not holding down a job I have to run a house and be a single parent. Not wanting to end up living in a sty that has hundreds of baked bean cans stacked on the stairs or newspapers going back to the 80s, I have to cook and clean the same as the rest of you. Pride, necessity. Being civilised and human, I guess.

And the moods.. they’re all over the place as I have a layered illness, that’s the best I can describe it. I might be hypomanic for months and depressed for months but on top of this I have acute shifts in mood, often very brief intrusions of one mood type upon another. Ultra-rapid cycling. Ultradian.

That means my mood can shift dramatically within one day: periods of hypomania and periods of depression, and most significantly periods of mixed-mood which for me are always the most dangerous and unwanted. When I’m mixed I am depressed enough to want to die but high enough to be able to make such a thing happen.

Today I stood by the kerb at a pedestrian crossing. Lorries were thundering past at 30mph and it took all that I had not to take one step forward just as the next lorry was approaching. Fighting this urge is exhausting. On the way to the crossing I’d experienced some kind of hallucination (more than, I think, a delusion per se) where I was suddenly walking along seeing the ground from 7’+ high. I’m 5’ 5”. That lasted just a few seconds, but dealing with this was tiring nonetheless.

It’s all one thing on top of another. Chronic, acute, a bit of this a bit of that.

Then there’s the meds: 20mg of fluoxetine in the morning (slightly sedating) with 100mg of quetiapine (more sedating). Then another 200mg of quetiapine mid-afternoon, followed by yet another 200mg of quetiapine in the evening.

This isn’t even a lot of meds for someone with bipolar (plus anxiety and OCD). I’ve met people who are taking 15+ doses of meds per day.

Spending most of the day (and night) sedated is physically wearing. I have to fight myself to leave the house, to walk, to exercise. To live rather than simply to exist. Plus, I self-medicate with alcohol by late afternoon though thankfully I’m in control of this and I manage to keep within my weekly recommended consumption as an adult male. That’s a miracle in itself!

I have to put on a brave face, a smile for my son so he doesn’t worry about me too much. This act requires energy and focus and tires me out also.

All of this, and more. Not just for a day, a week, a month, a year; I’ve been battling this more seriously for a couple of decades and on the whole since my late teens and indeed probably my childhood. I’ve only been on meds for several months, only sought treatment 2 years ago.

Everything I’ve described happens almost every day. Most of it happens every day.

It’s no wonder I feel exhausted.

 

Frustration and Hypomania

Horrendous week so far. A weekend of hypomania followed swiftly by a mixed state for the past four days. Sleep.. what’s that? Awake 2.22am.. and looked at my car’s ‘how many miles before fuel needed’ display: 222.

Magical Thinking is one of several things that manifests itself when hypomanic/mixed. But that’s interesting rather than a nuisance. What is a nuisance is the OCD that steps up several gears whilst in these moods. Oh, and the anxiety.

And what really isn’t helping is that I rang for an appointment with my psychiatrist (to start meds) a fortnight ago. Nothing happened so I rang again last week. Nothing’s happened again. Which means I’m going to have to ring a 3rd time.. Do they not realize that this kind of behaviour is not what we need??

And my ‘discharge papers’ arrived now the CBT has finished, from Secondary- back to Primary Care. Which means I’m having no treatment, support or guidance whatsoever at the moment.

As I said, horrendous week..

MH letter