My lovely self, in the psych ward.

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So there’s this thing I never talked about, before I stopped talking altogether. I didn’t talk because I couldn’t talk, because it was all too close and awful, and the other day I read this thing and now, in my head, I can’t stop talking.

http://www.psmag.com/navigation/health-and-behavior/lovely-wife-psych-ward-95567/

I didn’t talk because I couldn’t, because, in June 2013, I was committed, which is different from admitted, and all of a sudden talking felt dangerous. In June 2013, something changed.

~~The following may be triggering. Please read with care.~~

The run-up was very much the same old tune: an uptick in work stress, an increase in self-harm behaviors, verbal explosions, days in bed. Except there was something uncontained about the whole situation – how it bled all over my life, and now, how everyone could see. Everyone was aware. My partner would call my therapist, who would advise him to call the cops and/or my parents. There was discussion about what ought to be done with me, as though this “me” were some other entity, something who didn’t have her own priorities.

Given that my ONLY priority was to stay Bin-less until my sister’s wedding, I was not a willing participant. I don’t like to think about those days before my second hospitalization, that hour before I was half-dragged into the ER by my then-boyfriend / now-husband, the indefatigable B!. And the most horrible: my mother, who, having been summoned, walked in to a nurse swabbing my secret wounds with alcohol. The way I cried when she saw me, because I knew what it was that she saw.

I have not forgiven myself for the harm this caused to my family, this falling apart, time after time.

It had been easy, before, to speak of my mental illness as if it were “over”, and it was nice to think of life as having that arc. Health to illness and then better than before. It had been easy, before, to deal with it alone. But June 2013 annihilated the fantasy of my mental health as a solitary island.

I thought I was writing about one thing, but it seems now that I’m writing about another.

It is certainly one thing to be the spouse or partner, and to see your beloved fall into madness. It is one thing to be a parent or sibling, wondering how you can help. It is another to witness one’s own fall, knowing the chain reaction one’s own madness will cause, not understanding how to reach out for whatever it is that might slow your annihilation. Gravity. Vertigo. The pull and weight of the inevitable as your soul wanes thin or burns up in a nuclear blast.

For me, the biggest takeaway from this article is having a “mad plan”. Limits that are set before the descent begins. If X then Y and we all know it. Because without a plan, the free-fall can feel unbreakable. Without a plan, the “healthy” partner has no recourse but to play the enforcer of ad-hoc rules made, often, without the patient’s consent. Without a plan, the patient can be rendered unfit to GIVE consent, her concerns dismissed as excuses or worse.

This is what happened to me, that June. My voice was not heard, and my treatment, therefore, was a farce. In the hospital, my medication was switched, for the third time in as many months, I cried during all my yoga classes, and, after a mandatory three-day hold, I was sent home to a situation much more precarious than the one I’d left.

My sister was getting married. I put on my bridesmaid gown and raised a glass.

 


Quiet, now.

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This has been total hell. The whole spring-into-summer. One slow-burning, creeping infection that reinvented itself hourly. There was the hospitalization, of course, but that was just the beginning. That was only the spark.

It wasn’t like last time, this past time – again, June. There was no brandishing grand hopes of success or faith in newly devised treatments. Rather, I harbored a dreadful certainty that this scene would play itself out again and again, rippling its dark water into every corner of my life. Call it what you will, premonition or self-sabotage, but damn if it hasn’t been just like that. My entire basement is flooded, at this point – I’m draining it out a bucket at a time.

Things got really weird for a long time. It’s kind of like, “woah, what was in that brownie” and then forgetting you ever ate the brownie. You’re left unmoored, disembodied, completely immersed in a tilt-shifted world of your own making. It’s different – eerily hollow – but familiar. Then you wake up seven hours later wearing your roommate’s favorite dress, inexplicably covered with butterscotch ice cream topping.

Except that last part never happened. Not this summer, anyway.

Somehow the real-life aftershocks seem even more shattering this go-round, which is saying a lot, I suppose, since my last breakdown resulted in the end of my marriage. But it’s a true statement if there ever was one.  If I tried to list the ways this summer’s trials have screwed up my scene, I wouldn’t even know where to begin. And it would probably be super depressing.

I have a new therapist who specializes in DBT, and, for better or worse, I’ve given up trying to give up Abilify. It works too well, this designer-drug miracle, and pulls me together so completely. Having a new job helped a lot, that much I will admit – having to pretend to be OK sometimes leads halfway there.

So here I am, facing up to reality and moving along. Still pretending from time to time, but mostly just analyzing the cost of the metaphorical sump pump. Getting sick was expensive.


Intra-synaptic swordfighting

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Somehow, I don’t know how, I mis-read the instructions on my bottle of Venlafaxine (generic for Effexor) XR and wound up amping my already high dose to nearly double what’s recommended for human consumption. I’ve been reading since I was two. Like, HOW do you mess that up.

Anyway, not only did I *completely* mess that up, I (unwittingly) spent a few weeks that way.

Oops.

So I ran out early, of course, and decided to just go ahead and cut myself back down where I ought to be with no taper. WHAT COULD GO WRONG!!

Ladies and gentlemen, I can now personally certify that hatcheting off 300 milligrams of Effexor, a psychoactive drug with true physical withdrawal and an awkward half-life, is not a good idea, under any circumstances, for anyone. Go here and do a page search for “Venlafaxine”. Go on, now. Good times, right? I’m goddamn lucky I didn’t get hauled back to the ER.

Although the sudden worsening of depressive symptoms is especially welcomed when received alongside a wad of unpayable medical bills from June’s stay at McLean, I have to say that my favorite part so far has been the full-body brain zaps. The who what now? Allow me to expound!

You know that feeling you have when you’re falling in a dream, and you wake with a start the split-second before landing? Like, you can almost feel the bones crush with ground but JUSTalmost / NOTquite? Imagine that times 15, and it’s happening while your head is enclosed in a skintight pleather mask with a brushed silver zipper – large teeth – securing the front seam from chin to hairline.

Now imagine someone ripping that sucker open. Hard. Right as you land.

And maybe someone also has your skull inside a paint mixer for a breath or two.

If you’ve ever succeeded with Salvia divinorum, it’s kind of like that, except awful. It feels SO bizarre and SO unpleasant and only happens (thank God) at night. But man. I’m totally not doing this ever again.


Delusions.

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Like most people with mood disorders, I’ve always loved reading books about other people with mood disorders. More than one of them have had a bipolar protagonist. And I’ve always thought, while reading: “Huh. That kind of reminds me of… me”. This is not to say that I’m inclined to wear a tutu to the grocery store or buy spur-of-the-moment tickets to Vegas on a newly opened credit card, but the way things tend to cycle inside my head has always made me wonder.

For example.

Syracuse, NY (home of my alma mater) is not known for its fine weather, but the perpetual slate-grey skies mirrored my dysthymic mindset to such an extent that I could only conclude that the pairing was meant to be. I went to class, kept my grades up, and partied like a rockstar, but, behind the scenes, my mind was an abyss. I sought help on more than one occasion, but no amount of talk therapy seemed to lighten my load. And, at the time, I was resistant to medication. The summer before my senior year things got so bad that I had to quit my waitressing job in Boston, bow out of my prizewinning internship at an ad agency, and move back to SU, head in hands. My boyfriend and I had just recently ended our year-plus relationship, and I was terrified of all that lay in store. That first semester was a nightmare. Horrible.

Then, suddenly, it wasn’t.

I remember the moment everything turned roses – it was the screening night for my film class – and finally, to quote the great Sylvia Plath,

“All the heat and fear had purged itself. I felt surprisingly at peace. The bell jar hung suspended a few feet above my head. I was open to the circulating air. ”

It was wondrous.

But, as we all know, the only constant in life is change. And it wasn’t long before my euphoria plunged back to black despair. The moment the switch flipped back is just as clear as the moment it flipped on, and I cried on Katsu’s shoulder, knowing that my reprieve had ended. Not knowing when, or if, it would ever begin again.

Those switches are less clear now, but I’m beginning to think that some have flipped. The first was euphoria – living alone, freewheeling out to my new boyfriend B!, even moving home bothered me less than anyone could have imagined.

The second, of course, is now. The realization that all those good times were on some spectrum of yet another mental malfunction – a symptom of this suspected disease. All the progress I thought I’d made? Nothing but hypomania triggered by my stint in the Bin.

And you know what? That really feels like shit. Seriously.


Better Living Through Chemistry

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“It’s time to get off Abilify,” I thought to myself some time ago, and began the (supervised) process of titrating down. Abilify is the miracle drug that keeps me together like glue. It’s also a $500/month prescription that’s only available in brand-name. I mean, I could lease a really nice car for that much money, or rent a second home somewhere in Alabama. Priorities.

15mg down to 7mg? No problems whatsoever. Vitals were fine. Then, this past weekend, I forgot to take my dose for two nights in a row. Ever the overachiever, I decided to ride that wave and try to ditch the helper drug entirely. “What’s 7mg?” I speculated.

What, indeed.

Yesterday marked the 4th day of withdrawal. Waking up at 8:20am, having dead-slept through two alarms, I thought something might be off… just that feeling when you know there is no way you’ll ever be able to get out of bed. Driving to work, I noticed a distinct edge to things: my skin felt too tight, my jeans were itchy. As the day progressed it became clear that my mood was not just dark, but flattened as well – a patina of disaffection shielding the turmoil in my mind. Coffee? No thanks, I’m so over everything.

Small problems began to seem insurmountable. Answering an email became a sisyphean task. That familiar numbing of the brain and extremities that requires you to take life breath by labored breath. I recognized these signs. I knew them. And, though I’ve worked to become strong, I still don’t know how to manage these moments when I can’t pull myself up.

It is a related truth that my car is a disaster area. Unpaired high heels, a video tripod, and a pile of Diet Coke cans that would be shameful if I weren’t so excited about the eventual bottle deposit – people have stopped asking me for rides. Lucky for me, a quick rummage through the mess turned up a half-full bottle of my wonder drug. I knew it would take awhile for my body to absorb the medication, but just knowing I’d taken it made me feel better. And then, later, it made me feel worse. I’ve never had any illusions about being able to go med-free. But I did think I’d really be able to do it with this one thing, this one time.

Kind of disappointing, if not entirely unexpected. Sometimes, I guess, 7mg is at least 5mg too much.


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