Tag Archives: mental illness

I don’t feel well.

Even when my mental health has been relatively stable, there is still physical illness most of the time. ‘I don’t feel well’ is a sentence loaded with meaning and insight. I don’t feel well can encompass a load of symptoms, often little I can put my finger on.

Tiredness – no, utter exhaustion. Myriad aches and pains, especially in my joints. Chest pains (reflux, pain could be anywhere in the torso and feels serious). Confused, total lack of energy, agoraphobia, sleepiness but as usual waking often in the middle of bizarre, hyper-real, repetitive dreams (I go to the same place every night).

I don’t feel well. An ache in the pit of my stomach. Lower back pain – I’ve had medication in the past for a worn disc that wasn’t deemed serious enough for surgery.

Guilt and a sense of futility at how much weight I’ve put on since starting meds a few years ago: 600mg quetiapine; 20mg fluoxetine; 500mg valproate. Probably enough to stun a small horse!

I don’t feel well. I’m tired, I can’t get out of bed. I have to get out of bed to go to my stressful job which I have no idea how I’m managing to hold down.

Just: I don’t feel well.

pumpkin

 

I miss the mad me

 

It sounds, I imagine, unbelievable if I were to say that I miss madness. Time is on its side, after all; 55 years until I sought help for what, by then, I knew well enough had to be bipolar disorder. Manic depression. This was three years ago.

I exist now with no medical or psychiatric help; all I have is a small cauldron of medications to keep me sane.

My moods are indeed more stable, with the top and bottom of them clipped. That still leaves an awful lot of space in-between for, well, potential insanity.

Something of me has gone. Maybe it’s me? After all, you live with someone long enough you get to know them, maybe very well – or what you imagine to be so. What’s gone for me is my creativity first and foremost; I am a poet, novelist, photographer, painter. Or at least I was. No, I still am. I just don’t do it as much. I’ve started to write a small amount of poetry again and I’ve always taken photographs. I’ve written no fiction in a few years and as I say, a piddling amount of poetry that I don’t know the value of. Is it any good? Well, it gets published – is that an indication in these days of online magazine and journals? Depends which one I suppose.

Madness gave me a sex life. Rather too much of one I suppose. And with it, some confidence and a way around the crippling social anxiety I have now or when sane. Luckily I escaped the uncontrolled spending that may people with bipolar have. I’ve had no inclination to go out and buy a Harley Davidson or a sports car. I did buy several Fairport Convention albums and a load of cheap watches. I am holding down a good job (I have no idea how) and I can handle this limited expenditure.

After all, in the past, whilst manic, I’ve got married soon after beginning a relationship. And bought a one-way ticket to India (and used it).

I read a lot of blogs and articles about bipolar; I’m pretty much a textbook case, though one of my psychiatrists (when I had some) said I was an ‘unusual case’. This, I assume, is because I have both ultra- ultra rapid cycling (ultradian) bipolar as well as a more typical cycling form that has varied from rapid cycling to a longer cycling model.

Some things are much easier for me now, medicated. I had several months of CBT but it didn’t seem to have worked for me. Maybe if I’d been medicated at the same time it would have helped? Some things surfaced during that therapy that I didn’t like, didn’t feel at all comfortable with. Specifically, bipolar dissociation and even DID itself. One of the more ridiculous things my therapist suggested was that I free the other self inside me (and in the mirror) to see what happens. No, thank you.

I can’t honestly say the ‘extremely intrusive suicidal ideations’ are any less present. Maybe a little less severe though. Maybe not.

You might have by now a sense of what I mean by missing madness? When manic or hypomanic – and especially when in mixed moods – I often have no idea what I’m doing. Sometimes I know afterwards, often not at all. I have memory lapses (dissociation?) that scare me. My short term memory is wrecked. I live a separate life in dreams, though I’ve not slept through the night even once in decades.

I’ve put on a load of weight since starting the meds – I usually sum up the choice of being medicated or not as fat or mad? I seem to have chosen the former, though as I said at the beginning of this piece, I’m far from convinced that I’ve made the right choice.

 

 

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.

 

Update

Wow, it’s been a while since I updated this! Is it a case of ‘no news is good news’? Well, yes and no.

My medication seems to have been settled though a mistake on my repeat prescription indicated ordinary release Quetiapine rather than the extended release I’d been taking. I decided to stick with this mistake, if only because my eating pattern wasn’t dictated by the need to take the meds on an empty stomach.

I jiggled (is that a medical term?) the dose throughout the day to suit me further so now I take: 20mg fluoxetine and 100 mg quetiapine at breakfast time; 200mg quetiapine late afternoon; 200mg quetiapine an hour before bedtime –ish.

The quetiapine has worked well at controlling moods, especially hypomania / mixed. As for side effects, I’ve put on three-quarters of a stone in 6 months and I have chronic lower back pain and a variety of other aches. I’m always sedated to some extent though even on 500mg quetiapine I still haven’t slept through the night even once in decades.

For some reason I’ve never been able to fathom I am always – always – worse on Sundays. I assumed it was because of work on Monday but being off for 8 months recently, and now being on 6 weeks summer break, hasn’t made much difference. My anti-anxiety medication of choice (as long as it’s mid-afternoon+) is a glass or two of white wine. Well, it works.

I still have some delusions; always the same ones as I’ve been having for a few years now. I have (manageable.. so far) psychotic episodes, particularly when in a mixed mood. Anxiety and OCD go hand in hand and can be a nuisance. I have extremely intrusive instances of suicidal ideation and these are worrisome; they too generally happen in higher/mixed mood.

I returned to work in my stressful job a month or so ago and it went OK. The start of next academic year this September will dictate how I am and how I feel.

 

So happy I could die.

 

 

Suicide is a complicated business. Or rather, bipolar suicide ideation is a complicated business.

Being ‘suicidally depressed’ and wanting to die is how most people imagine the subject. To be so low, so clinically depressed that life has no meaning other than that it should end. Wholly and completely. It is utter despair with, in that moment (which might be a prolonged moment; linear time doesn’t always apply here) nowhere to go, no escape route. No solution other than un-life.

But as I say (and of course I can only speak about my own, personal experiences) suicidal ideation in bipolar can be a very different kettle of fish. So to speak.

Medicated (Quetiapine 400mg, fluoxetine 20mg) I haven’t had an extreme low or high for a while. What I do still have however is the hypomania and mixed mood episodes I’ve always had. Rapid – or ultra-rapid – cycling, at least they don’t last long. Not long enough to dig themselves a sizeable hole or system of clogging trenches I have to drag my metaphorical feet through.

Having suicidal thoughts because one is ‘happy’ is where the complicated bit comes in. And I imagine those people who’ve never experienced it – personally or with a family member perhaps – find it impossible to comprehend.

Put some favourite music on, loud: maybe those old or new Underworld tracks, that Oceansize song, anything from ‘Definitely Maybe’ or the first Strokes album – basically anything upbeat and rowdy, something singalong.

Have a glass of wine or three. Get lost in the moment.

I’m never happy, per se. Never have been. Anhedonia. So when I feel like I might be, like in these moments I’ve mentioned, I get suspicious. I’m aware (but perhaps not entirely aware, consciously) of the mood; but it’s a very welcome relief from the usual overwhelming pain of bipolar and anxiety (with its associated mild OCD).

Fuck, yeah… I’m happy! I’m dancing, one with the music. With the wine. With the universe at that moment!

WBBcc

So hell, yes, why wouldn’t I kill myself? Why on Earth not? It’s the logical thing to do. I’m – unknown to me at the time – depressed enough to want to die but high enough to have that energy, that ultra-rare joie de vivre to carry it out.

Mixed mood suicidal ideation is the most dangerous for me, by far. Then, it makes absolute, perfect sense to kill myself. As I say, Yes! Whyever not?! I’ll never be as happy again as I am at this moment and I want to celebrate, to prolong this happiness.. by dying. Confusingly and ambivalently however, I want to live forever. In fact, I will live forever! How could that fact possibly not be true?

“Life has no meaning the moment you lose the illusion of being eternal.” – Jean Paul Sartre.

Fortunately this kind of mood state pays me a visit at home. Occasionally it descends (or ascends?) upon me when I’m driving, alone. Music playing, sun shining, countryside slipping by each side of that motorway or A road. I’m so happy that I see a lorry speeding towards me in its own lane and for a moment think I want to remain in that ecstatic moment by turning the steering wheel sharply and ploughing into that vehicle. Did I mention the sun’s shining? I’m doing 60, he’s doing 60.. that a 120 mph impact. Sorted!

Then the moment passes. For now at least. What was the trigger? Well, it was probably nothing external. Just me; my electricity.

Was I aware at the time? No, or at least barely. Was I ‘myself’? No. Was I in control of my actions? Subconsciously, automatically, hopefully. Consciously, no. But I’m alive. At least, for now, same as it’s ever been.

 

 

 

 

 

Magical Thinking

Woke last night at 11.24pm then 1.24am, this triggered an episode of hypomania and associated ‘magical thinking’: 4+2+1=7, which is a magic number. This indicated [to me] that my apparent delusions (when psychotic) are in fact entirely true. ‪#‎Bipolar‬ is rather complicated, to say the least

Suicidal

Suicidal today, but that’s OK. Isn’t it? I mean.. when did such ideation become, for me, normal? Well, a normality of sorts.

I imagine there’s a Suicide Machine. Or rather, a strip of three buttons:

3 buttons

 

 

 

 

Yes                   Maybe later             No

One would deliver instant painless death; no fripperies or fandangos. One would register a Meh, why not? I’ll think about it some more and get back to you. And one is No way, Jose!

Most mood situations, however complex bipolar can be at times (well, actually more often than not), can be resolved by pushing one of the three buttons. (I’m reminded of Alice’s Drink Me.)

Today was Maybe later, though for brief moments, it was Yes.

Welcome to normality, boyo.

 

 

Pain

I’m not well at the moment. I always keep this to myself, but I’m tired of hiding it all the time. People don’t know that mental illnesses – including bipolar – are accompanied by much physical (especially neuropathic) pain. As if struggling with one’s mind, moods and anxiety wasn’t quite enough to cope with already. ‪#‎FightingStigma‬

 

 

Secondary care assessment & diagnosis

The waiting is almost over.. possibly. Having presented myself to my GP in early July this year and handed over a letter detailing my lifelong (I am in my 50s) undiagnosed and untreated mental illness, my Secondary Care assessment and diagnosis appointment is next Monday.

I haven’t been to work this week, just couldn’t leave the house. Particularly having slept so very little; racing thoughts, agitated, OCD at 2am and every hour thereafter.

If you’ve been following my random posts on this blog you’ll have heard me say that this diagnosis is almost certain to be one of Bipolar II, possibly with some other issues.

Since I was discharged by Primary Care (after a few appointments) 6-8 weeks ago (because Secondary- had taken me on) I have had no support at all but my health continues to decline quite markedly. Hence the reason for my GP visit.

Actually there was advice, of sorts, to tide me over: ‘if in crisis, go to A&E or ring the Samaritans.’

Needless to say, this hasn’t been any comfort to me during these weeks of ups, downs and – more frequently – mixed states. They’re the most dangerous of course, as you’ll probably know.

So, next Monday.

See you on the other side!