Mania Strikes Again

Why does it always happen the night before I have an appointment?  Not even an anxiety-inducing appointment, just a regular one that I simply need to get myself to and show up for.

Last night I took my bedtime meds at the usual time, did my whole pre-bedtime ritual: take meds, brush teeth, give Noga the Wonder Dog her brief nightly training session and resultant treats; get into bed with a book.

In general, by the time I make it into bed, I’m crashing, and sometimes don’t even make it through the “putting on pajamas” stage, but wake up in the morning to find myself half naked and freezing. The nights here are still chilly and I might not have got to far along as to pull up the covers.

The important part out of all of this is sleep.  I have never been good at sleeping.  Even as a child I spent many nights wide awake reading by flashlight under the covers.  At about dawn when the birds were waking up and sleepily cheeping, I might fall asleep for the two or three hours before it was time to get up for school.

Last night there were warning signs.  An hour after my bedtime cocktail of 50 mg. Seroquel, 1 mg Clonazepam, 1 mg Lorazepam, 10 mg Ambien, plus 300 mg Lithium, I was not remotely sleepy.  Not good.  I waited another hour.  No dice.  The book I was reading became hilariously funny, and I convulsed with laughter.  My Psychiatric Service Dog, Noga, alerted, and left her spot at the foot of the bed.  She peered into my face, assessing my condition.  She parked herself nearby, keeping an eye on me.

Noga, the Angel Puppy

Noga, the Angel Puppy

I started my prescribed protocol for incipient mania.  First try to knock it down with benzos: a couple more milligrams of Lorazepam, another milligram of Clonazapam.  Wait another hour.  Nothing.  I’m starting to look for a wall to climb.

Time to pull out bigger guns.  Another 50 mg of Seroquel.  Wait another hour.  Nothing.  Another 50 mg.  Nope.  Another 50 mg.

All this while, I am feeling like I have bugs under my skin.  Antsy, fearful that this is going to go into full-blown mania with hallucinations and everything.

It has started to pour down the rain, buckets.  By morning my rain gauge would measure two inches, and the river below my dwelling raging out of its banks.

My whole-body arthritis, aggravated by the weather, is making it hard to play solitaire on the iPad.  That’s my usual ticket to boredom leading to sleep, but after a couple hours of painfully tapping cards, I give up and take a pain pill–a very mild one, ten mg. codeine and 500 mg. acetaminophen.  Not enough to dangerously interact with the piles of pills I have already ingested, but by this time the only thing that concerned me was what would happen to my dog if I died.

Meanwhile, Noga the Wonder Dog has glued herself to my side and won’t budge, even when I jockey for more room in the bed.  I move her over and slide over myself so I won’t fall out when the drugs finally (hopefully) hit. She immediately sticks herself back in position against my body, licking whatever parts of me are exposed.  We snuggle and smooch for what seems hours.  She loves snuggles and smooches.  She is my Angel Doggie!

I send my morning appointment an email apologizing for canceling.  Of course I lie, saying that I was sick due to something I ate.  I turn my alarm off.

It’s three o’clock and I’m finally slowing down and getting sleepy.  Noga is cuddled up by my head.

I wake up around noon.  Fine, except that I really do have to go into town today (town is an hour away) to get some things for Friday night dinner.  I struggle out of bed, make a strong cup of coffee, get into my recliner under my “happy light.”  I’ll go as soon as I’m safe to drive, when the muzzy druggy feeling wears off.

Noga starts vomiting.  Why do they always have to throw up on the carpet when there is a perfectly good expanse of bare floor available?  I catch her before it comes up and place her on the floor, petting her while she pukes.  Lhasa Apsos routinely vomit when their stomachs are empty for a long time.  She’s been watching over me for 14 hours now, setting her own needs aside in favor of taking care of me.

After she gets done puking I call her over to the “treat station” and put a few yummy things into her tummy.  Her food is in her dish, but she ignores it until her dog treat hors d’oeuvre piques her appetite. She gobbles down her breakfast and hops up to her usual place on the left arm of my recliner, where she is now firmly established.

She literally stuck with me all night, watching over me and caring for me as if I was a sick puppy (I was).  And now she’s back on the job, after a bit of breakfast and a drink.

Through depression, through mania, she is my Psychiatric Service Dog, always on the job. She takes her job seriously.  I would love her anyway, even if she weren’t my Service Dog Angel, but the psychic connection between us is so strong that she’s like an extension of me.

I wish everyone could be so blessed.

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  1. Precious puppy; sorry to hear about the lack of sleep. I’ve been there as well lately. “Ugh,” is all I can say, except that I empathize.

  2. I know you’re going through tough, rough, horrible times so I sent you an email last night with a link to click onto that I hoped might entertain you a bit — take your mind off things for a few minutes. I hope you received it and I know you’ll get to it when you can. Purely mild entertainment and neat information. 🙂

    Always thinking of you and your folks. Prayers abound!!


  3. It’s always tough for me, a caregiver of my husband who is bipolar, as I know the suffering you went through. I’m so happy you have the loyalty of your psychiatric service dog.

    • That must be a very hard road you are traveling. I wish you strength! Yes, a PSD is a wonderful thing, especially for those of us without supportive partners. Even with a partner, a PSD can bring a lot of joy when you’re feeling good, and comfort when things are not so good. They are always glad to see you even if you feel awful, and they force you to laugh with their silly antics even when laughter is the last thing you thought you could do. The PSD is there just as much for the caregiver as it is for the afflicted. Yes, this is an unabashed advertisement for Psychiatric Service Dogs!

  4. Hope you are doing okay today! What a generous person you are to share this as I know it’s helpful to many of your readers. I was bobbing at the childhood tossing and turning or reading in bed…insomnia and I have had an affair for decades. Monday, I went to a lecture at our Mental Health facility in Montreal and the psychiatrist was telling us how he tries to empower his patients by managing manic episodes. Your could have given the lecture with this one post. You are an amazing person, kiddo!! and I love your puppy…she is a gem 😀 May I reblog your post?? on my blog (I have 2) StopTheStigma?

  5. Laura, I am so glad Noga is there for you! Know that you are in my prayers.

    I am particularly grateful for your vivid descriptions of the ways the bipolar affects you. My son wants to protect me, I think, and rarely says much about it unless he’s very manic, but your blog has helped me understand what may be going on. Thank you for your willingness to write and the vivid quality of your words.

    • Thank you, dear. Noga is a furry angel! I don’t remember knowing that your son is BP. I might have known at one point. Yes, from the perspective of a person with BP, I don’t say much about it to anyone else, especially my parents. Now, my parents, as I’m sure you know, are not the kind of people I would say much to anyway, except for my dad, but even when he was healthy I was careful not to speak of my mental illness with him. Funny thing was, before it was diagnosed, I shared my feelings with him all the time, but once I had a label and meds and all that, the stigma made conversations about it very stilted and uncomfortable. He had an uncle (mother’s brother) who was like me a physician, and ended up institutionalized for “manic depression,” so once I got the label there was always this association and fear on his part, and shame on my part–yes I know, nothing to be ashamed of, so they tell you–but it’s there anyway. So I will not tell my parents that I missed the meeting because of mania–I’ll tell them it was because of the massive asthma attack I was also fielding at the time. So long story short, I don’t talk about it because I don’t want to deal with the fallout. Even if it’s sympathetic, then it makes me cry, so that’s not good either. I have a therapist to talk to, and she doesn’t get uncomfortable if I cry and snot all over her office LOL.

      But I have digressed. I’m glad my lurid descriptions of my episodes are helping you and others to understand what a crazy thing it is to just simply depart from what I would call “everyday reality,” and go for an unplanned journey down the rabbit hole. All I can say is, it’s really good to come back and know that one is really back, although I do find that I’m exhausted for a day or two afterward, and very much hope for a long respite. I’ve stopped hoping that this will never happen again, as it does seem to be the reality of the disease, but at least I can hope to recognize the prodromal symptoms and get out the big pharmacologic hammer before I get too far gone to think of it.

      Thanks so much for your support and kindness, and Good Shabbos!


      • I don’t know if I’d mentioned my son’s troubles or not. We’d been very close up until his diagnosis eight years ago, and I still feel the connection, but there have been barriers since that I suspected were shame. I am sad about that, but it makes some sense. I wish there were a way to adequately communicate to him how proud of him I am. He’s a good man, and I am only more aware of that since this nasty thing got its claws into his head and tore his life to bits. Mostly I just try to help him when he wants it and love him the rest of the time.

        I’ve had depression most of my life, in and out of therapy and on antidepressants for the last 13 years. I have some experiences that parallel – I know depression very well – but I know I don’t know squat about what he’s going through. I went nosing around in the blogosphere to educate myself on the experience of bipolar. I want to be supportive, and part of that is finding a way to learn while respecting his boundaries. You and some other writers on here have been a gift from heaven in that respect, in addition to being lovely people, too.

        You are still very much the healer, and I am grateful for your words.


        • Thank you, dear Rabbi Ruth, for your kind words, and for seeking out ways of understanding your son’s feelings and predicament. I’m sorry you’re battling the Black Dog. Depression is a terrible drain on the soul. I’m glad you’re here. I know there are many others who share my gladness that you are here on the planet, gentle spirit.

  6. I am happy you have such a caring friend.i am blessed as well. He is not trained but he is my therapy dog..he watches over all my many moods and helps alot to keep me in god spirits..i am always amazed at hunky dorys willingness to be there for me….dogs are amazing

    • Oh, I’m so glad to know you have a canine buddy to help you! Psychiatric Service Dogs are born, not made…in other words, you can’t train any random dog to do what our dogs do. They have to have the innate empathy, and the two of you have to have that bond that must happen through a mutual connection, as you have so well described here. So in fact, my dear, you DO have a Psychiatric Service Dog, since he monitors your moods and does things to help you stay well. If you live in the USA, I can give you resources for learning what your rights are as far as public access for your PSD. Let me know!

      • I would like that info…it was a struggle to buy our home because he was to big according to my park..but i was unoffically allowed. Meaning if anyone complains about him or someone decides its not fair that i could keep him….yada yada yada….they can make me give him up.

  7. I have a PSD as well. He is invaluable to me. He certainly has that born-in empathy. He looks a lot like noga in that photo – almost identical in fact – except Luca is a Shih-Tzu. (Course, both dogs are from Tibet!) As for PSD’s, girlofmany, even if your dog was not a service dog, with a letter from your doctor saying you are disabled and need your dog at night to help you sleep, feel safe alone at home etc., your park can not tell you to get rid of him. Get a letter from your doctor now for protection!

    BTW, you said your dog was a therapy dog. If he helps you, and you are disabled, he is not a therapy dog, he is an ESA or a service dog. In order to be a service dog he has to be specifically trained to help you with a symptom. He can’t just make you feel good. You have to have a disabling condition to qualify for a service dog or an emotional support animal. Emotional support animals, which can be cats etc., are not allowed public access. Only dogs (and miniature horses) are allowed public access now with the change in regs in the ADA. Therapy dogs are dogs that are seriously trained and certified to go into nursing homes etc. to help other people feel good. The owner is not a person with a disability. (or if they are, their therapy dog is not doing anything to help them therefor is not a service dog and is not allowed public access.) A dog can not be a service dog and a therapy dog at the same time. Either he is on duty helping you OR he is making someone else feel better. He can’t do both at once. The good news is although there are strong regulations and certifications for therapy dogs, there is no certification for a service dog or ESA. Get a letter from your doctor tho. You can find sample letters online. There is also tons of info online if you google “psychiatric service dogs.” You can train him yourself or hire someone to do this for you. (Hiring someone can be very expensive!)

    Hope it was ok to have said all of that on your blog Laura. I didn’t sleep a wink last night either. I empathize.

  8. Wow – I had no idea that such a thing as a Psychiatric Service Dog even existed. What an amazing concept – and such a sense of support and comfort for you!

  9. Yikes! What a terrible time for you. And thank goodness for Noga. Hope you are feeling much better now

  10. Reblogged this on Stop the Stigma and commented:
    Monday, May 12, I attended a lecture at the Douglas Hospital on Bi-Polar Disorder. The Ex Director and Chairperson of Revivre each shared their personal stories as well Dr. Beaulieu, Psychiatrist generously answered questions from the audience for one hour. What struck me was how he tries to help his patients manage there condition…empowering them to prevent possible episodes of psychosis. This reblog was so refreshing to read! She generously shares how she manages her health. I have to say, I truly admire this amazing and generous person.

    The lecture will be available on video soon…stay tuned, in French only though.

    • Hi Cheryl-Lynn, thanks so much for the reblog! I’m going to give the French video a try!

      • If you check on the link for the Douglas Hospital in Montreal and on the search window at the far right, write in mini psych courses…Every Fall they offer a series of 7 weeks of lectures to sensitive the general public on mental health. Every 2 years it is in English. All are video taped and free on the site as well you can order the DVD’s for peanuts. I bought them in French for our work. But you can view them in English…Dr. Beaulieu gives the lectures in both languages.

    • Hi Cheryl-Lynn, thanks so much for the reblog! I’m going to give the French video a try!

  11. I just got introduced to you by Cheryl Lynne and thank you for sharing your world. Your dog sounds amazing too hehe I have two but can’t say I have a bond like yours. I am on meds for chronic pain and am trying to reduce them I was I admit worrying at the amount you kept increasing to try to go to sleep though I know sleep deprivation is torture! Big hugs xx

    • Hi, and welcome! Luckily, the meds I was increasing are ones you basically can’t hurt yourself with. Also I was following a protocol devised by my psychiatrist and me. Hope you feel better–chronic pain must really be hard to live with.

  12. Hi Laura,
    The death of my precious companion – Willow – my German Shorthaired Pointer – in 2009 was the spark for the appearance of MDD with psychosis. My dx was changed to BP2 during my last incarceration. The whole time there, the occupational therapist kept harping on me to go online and find myself a new puppy. I kind of want to take the plunge and get another GSP but I’m concerned about orphaning her if I decide to leave. All in all, I believe too that a PSD could be fabulous and just the thing I need. Will have to wait and see what happens next. Hope you are feeling less manic and more stable. Take care, Doc.

    • I’m sorry to hear about the loss of your Willow. I lost my Ivan, a German Shepherd, in 2007 and it took until 2011 to get over him to the point where I could get a new dog.

      One of the things Noga does for me (as did Ivan) is to keep me from killing myself, because there’s that question of “what will happen to her?” So it’s a really important thing, I think, for giving one a reason to stay on the planet. Gets me through some times when I might otherwise take the plunge, in a different way…..I heartily encourage you to get yourself the best dog you can find, one that really suits your personality and that you are empathic with. You know, public places like hotels are allowed to ask you what tasks your dog does for you. I tell them “she keeps me from killing myself,” and after that they usually shut up.

  13. kati

     /  May 17, 2014

    I found your blog yesterday, and been reading since… I love your writing!
    Unfortunately i can relate to so many things you write about…
    Hope u feel better by now.
    And yes, you are very fortunate to have Noga ( it means feet in polish:)).
    Big hug 🙂

    • Hi Kati, welcome! Glad you’re finding my ramblings/rantings/ravings helpful. I have to say I’m sorry that you find it so relevant…Well, so Noga means “feet” in polish. There are always these language complications, like “bicho” means “bug” in Mexican Spanish but “penis” in Puerto Rican Spanish.
      Yes indeed, I do feel better now, thank you! Wishing you good feelings, too 🙂

  14. I hope you are feeling better. It gets frustrating when symptoms start to break through. Hang in there. Cudos to your dog…I have one I just rescued. Dogs are the best.

  15. So glad you have this beautiful little furr baby. She is indeed an angel.
    I did not know they vomited for that reason, wow. That’s really interesting.
    I hope you’re feeling a lot better. ❤ ❤

    • Thanks so much! I am indeed feeling better. Hopefully will have a new post up shortly, which will explain the “why” of this! Yes, she is beautiful, isn’t she? Lhasa Apsos vomit when they are hungry….I have never heard of it before, either. Well, they are curious little creatures. Be well!

  16. savemefrombpd

     /  May 20, 2014

    Loving the fact you have support from such a loyal and loving animal!
    You know where I am too should you return and need someone 😉
    I liked your post even though I am so sorry to hear the rough times you’ve had.
    I hope that you are feeling better.
    Take care and sending lots of love.

  17. Muaaahhh, love to this little angel. Take care dear. feel better soon. Love and light to you.


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