As you may remember, yesterday I was painting my toenails in the middle of the night.
Alas, that was not to last. I woke up this morning with a feeling of dread in the pit of my stomach.
After I finally went to sleep last night, with the aid of more Seroquel, I woke up a bunch of times because my arms were numb and tingling.
Fuck, you know, this has been going on in one form or another for several years. I’ve been writing it off as probably due to my arthritic collar bone, but this is different.
My medical experience gives me all kinds of terrible fears. MS is the main one these days.
I remember the day in medical school when they taught us all the bad things that can possibly happen to breasts.
My then-husband came home to find me huddled in the bed hysterically crying.
“What’s wrong?” he asks.
“My breasts! They’re a ticking time bomb! I want them off right now!”
“There there,” he said, not knowing what else to say.
The next day I ran to the Student Gynecology Service to get a pre-operative exam. The kind Nurse Midwife examined me and assured me that at the moment my breasts were not explosive, and offered to re-check them whenever I started feeling breast-anxious.
I felt rather foolish, but relieved that at the age of 29, nothing was wrong with my breasts.
Why do I make these digressions when I’m depressed?
Maybe it’s because I don’t really want to engage with the depression. I know it will pass, and something else will take its place, but when it’s on me, it’s literally on me, and all over me, and in me, and I can’t shake it off. All that happens is I start crying and feeling like someone is trying to rip out my guts, and doing a pretty good job at it.
Then it passes, just as quickly as it came. What follows might be a period of “normality,” meaning, neither hot nor cold, and this is heavenly. But it never lasts.
Hypomania, or frank mania with psychosis, tends to raise its ugly head at night, about bedtime; which for me is at 9 pm because my meds take 12 hours to wear off. Actually they take 13 hours, but that is an embarrassing amount of time to sleep, so I actually set an alarm for 9 am.
I can tell the (hypo)mania is on its way because my bedtime knockout cocktail doesn’t do a thing. I’m awake playing Solitaire on my iPad, which usually bores me to sleep, except now I’m totally awake: uncomfortable in my skin, twitching, restless. I don’t want to look up because sometimes my wallpaper turns into ugly faces.
I follow the protocol my shrink and I developed for these very occasions: more Seroquel. Another 50 mg till it knocks me out. And a double dose of my benzos for good measure.
Sometimes it takes a couple hundred more milligrams of Seroquel to do the job. I have an incredibly low tolerance for Seroquel, so my maintenance dose is only 100 mg. I know, I know, some of you take 600-800. That would put me to sleep for several days. I usually get to 300 before it’s knock-down time.
The good thing about hypo/mania is that it can be controlled, if recognized early enough. Depression, though…that’s another beast.
Bipolar depression is different from “regular” depression for reasons I don’t know. I was treated with regular antidepressants for years, and was pretty much suicidally depressed the whole time. Vitamins “L” (Lithium and Lamictal) saved my life, quite literally. Blessings upon the quirky head of my neuropsychiatrist, who was on call when I was hospitalized the first time, and got my bipolar figured out.
The only adjustment we can do for the depression part of the roller-coaster is to up the Lamictal by 50 mg, which puts me at 200. More than that pops me over into mania. It’s a delicate balance, as you can see.
So the only thing I can really do with this depression is to wait it out. Sometimes it does get suicidally bad, and then I have to think about my dog and my son, and what my suicide would mean for them.
I put them in that order, because my dog is helpless without me (although yes, I could put her in Rescue, but that thought makes me cry harder) and my son second, because even though it would tear him to pieces, he is at least able to provide for himself, unlike my dog. I know that makes no sense but that is how it happens to fall out in my brain.
I’m starting to feel tired now, which means this part of the wave is coming to a close–I don’t know exactly when–and what happens next I cannot guess.