Today Is Another Day: Rapid Cycling

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.

What You Can’t See (might very well hurt you)

I’ve been doing a lot of “doctoring” lately.  Not the kind of doctoring that I prefer.  That’s the kind where I’m the doctor.  No, I stopped doing that ten years ago.

Now I seem to specialize in going to a seemingly infinite array of doctor-types.  I won’t go into all of them.  It’s depressing, and none of us needs more of that.

Of course I have my weekly therapeutic hour with my Ph.D. psychologist.  She’s very good at keeping track of my brain’s peregrinations.  I’m grateful for that, since I find them bewildering and tend to get lost without someone having a firm hold on the end of my hawser.

I’ve noted on other people’s blogs and on group lists that many people with mental illness have a DH, or a DW, or a BF or GF.  I really do envy those people, and I admire the significant others for their devotion and willingness to hang in there and be an anchor for their troubled spouse or SI.  I feel kind of cheated that I don’t have one, but I think the fact that I don’t is “just” a feature of my disease state.

My psychologist lately insisted that I apply for Social Security Disability.  She feels that I am paying way too much in premiums and deductibles and coinsurance, even with the Federal Risk Pool insurance that costs exactly 1/3 of what the Blue Cross people offered me ($1400 per month), out of the goodness of their hearts.  So I am proceeding through the laborious and distressing process of applying.

Distressing, because I have to go through the details of what my illness looks like and prevents me from doing.  These are things I’d much rather not look at:  “But you look so well!”  But my Global Assessment of Functioning number is 40, and that kind of puts the brakes on my delusions of normalcy.  I demanded an itemized inventory of how she arrived at this appalling figure.

So we had to go through the litany of Disastrous and Failed relationships.  I make a distinction between the “Disastrous” and the simply “Failed.”  The Disastrous ones were the ones that put me in the hospital or on the run.  The Failed ones were less poisonous.  I guess you could say the Disastrous ones were like eating Death Angel mushrooms and needing a liver transplant, while the Failed ones were like wandering lost in the forest until running across a road to hitchhike on.

Noted among the dead and decaying relationships were not only marriages and significant others, but also work relationships.  And those friendships:  the ones I don’t have.

Now, I DO have some friendships in Israel.  They are based on a form of Orthodox Judaism, and very structured.  I wonder if this is what one needs in order to form friendships in general?  I wouldn’t know, to tell you the truth.  I can literally count on one hand the people that I have become close to in this life, close in a heartfelt sort of way.

Now there’s the part about leaving the house.   I don’t, usually.  I used to get out more, especially to play music, before my hands betrayed me and started requiring operations in order to maintain the general appearance and function of hands.  But they hurt too much to use for very long at a time, so playing music doesn’t work so well anymore.  So that knocks my Global Functioning score down a few notches.

Isolation is not good for mental illness.  This we know.  And there are things that I could do to ameliorate this.  But I am not a social person, at heart.  I become anxious and start fantasizing about doors that say “Exit” when surrounded by people I’d rather not be with;  and that equals most people.

My answer to the loneliness issue is my dog.  I have a Llasa Apso who is my Psychiatric Service Dog.  Her name is Noga, which means “Glowing Object” in Hebrew. She is at this very moment tucked under my left arm, which does make typing somewhat awkward, but I’m happy to put up with that because she is here.

When I got her at 7 months, I wasn’t sure she would have the qualities required in a PSD (Psychiatric Service Dog), which are to detect negative emotional or behavioral states and to alert the owner to them.  Now, at 18 months, she’s learned to detect when I am depressed, when I am heading into a manic state, when I am going into a dissociated state, and she gives me specific alert signs for all of these, thus meeting the Americans with Disabilities Act criteria for a PSD.  This means that like a Guide Dog for the Blind or any other service dog, she has the legal right to be with me anywhere.

Plus, she’s funny and cute and makes me laugh.  And she’s very patient with me.  She is a treasure.

Noga, my Lhasa Apso PSD, getting her beauty sleep

What goes around

I’ve been on a real down swing the past few days.  I want to blame it on the fact that my shrink insisted that the Lamectil was responsible for certain very unpleasant sensations that accompanied my last “mixed state” decompensation.  He maintains that the Lamectil was “feeding” the high side, causing my usual state of insomnia to become drug-resistant and all the rest of the unpleasantness to become worse.

Well, I don’t know if I agree with him on that one or not.  But my state of un-comfortability being what it was, I was willing to give him the benefit of the doubt and try decreasing the Lamectil.  It seemed to help, I think; yet, given the alphabet soup of drugs that I have been taking in order to quell the screams of my tortured nervous system, I can’t vouch that THAT particular tweak was “the one.”

Anyway.  The point is that I have been in a depressed state for the last few days, which accounts for the sparsity of blog posts.  My diet has spiralled down to ice cream and potato chips, which are really the only things my mouth vaguely desires.  I suppose if someone else were to prepare me a delicious AND kosher meal I would eat it; but I can’t guarantee that I would be able to tell you what it tasted like, because when I’m depressed my taste buds go on vacation, along with all the rest of my senses.  If it wasn’t such an unpleasant feeling, I might go, “Oh, just what I needed, a little vacation.”

Luckily I have kept on doing this for such a long time, I’ve come to understand that if I just keep on keepin’ on for long enough, I WILL feel better.  I hope. Or at the very least, I’ll feel DIFFERENT.  Which is in itself a kind of relief.  And I have started taking more Lamectil.

The main thing is to keep. On. Breathing.  One breath at a time.  Because, you know, sometimes “one day at a time” is way, way too much to bear.

Now there’s something I want to say that just doesn’t seem to want to come out just the way I want it.  So I’ll start this way:  to those of you who have sent me heartbreakingly beautiful emails, sharing their responses to things I have written here, I want to tell you that your words have lifted me up and given my heart the will to keep on taking its one breath at a time, one heartbeat at a time.  I could never have dreamed that anything I would say would affect anyone so deeply.  I am awed and yes, frightened by the prospect that anyone would take my words to heart, or that my own experiences would resonate so profoundly.

Yet, in reading your emails, both posted here and sent privately, I have found myself also deeply moved, sitting here pouring tears, resonating with your experiences as you did with mine.

So I think there might be something to this sharing thing.  We can lift each other up on the wings of eagles.  I bless you all.

Full moon, empty brain

The moon is glorious tonight.  I watched it rising over the ridge opposite my little cabin, clearing the cluster of dwellings wherein lie the miniature dachshund family, the hound dog puppy that is growing bigger and louder every day, the chicken lady and her chickens, many fewer roosters than there used to be because they shot (yes, shot) and ate a bunch of them (they had 8 roosters, far too many), the guinea fowl that shriek like banshees…in short, the small village full of critters and the people who take care of them, that live in the little hollow across the road from me.

I have been attempting to jump-start my brain tonight.  It doesn’t want to kick into gear.  I try to think about something, and the next thing I know, I’m not thinking of anything at all.  I start a task, and what seems like moments later I find myself doing something entirely different, and it’s two hours later.

How does this happen?

One advantage is that I can’t seem to get too upset about it, because my brain can’t stay on task long enough for even that.  Well, that’s a blessing, I suppose.  I have to thank G-d for that, because otherwise I’d just go from being insane to being crazy.

Speaking of labels, I’m astounded by the level of stigma that still exists out there.  I see it everywhere in the media.  Maybe I’m just paranoid.  “Just” paranoid?  No.  It’s real.  It exists.  As real as the nose on my face.

The other day a family friend visited us.  This friend had a cancerous lesion on his nose and his ear, and he had to have quite radical surgery to remove the cancer.  He has subsequently had numerous surgeries to reconstruct his face.

His surgery team did a great job.  You really can’t see any sign of the reconstruction unless he’s in direct light.  Then you can see the “seams” where they put him back together.

But he’s hyperaware of the difference between his face now and his face before the cancer.  He feels like people stare at him.  His wife shared a story about some rude lady who did notice his scars and said, “What happened to your FACE?”  Isn’t that everybody’s worst nightmare?  To have your face look wierd, and have people notice it?

I feel that way about my brain.  If people could only see the way my brain feels to me, they’d say, “What happened to your BRAIN?”   And I find myself wondering, “Can they tell?  Do they know how weird my thinking is right now?   Can they see my Face, the one with all the scars?   But that scarred Face is  on the inside.  The one on the outside seems to look perfectly “normal.”

In a way, it heightens my connection with my dad, who has dementia as a result of his 50-plus year dance with diabetes.  Unlike people with Alzheimer’s-type dementia, Dad is very much aware of the malfunctioning of his brain.  It causes him great distress.  Dad is a brilliant man with a broken brain, and he knows it.

We spend every Wednesday together:  it’s Mom’s day off.  Dad and I very much enjoy our Wednesdays.  Some days are better than others, of course.  And that depends entirely on how both of our brains are functioning.

This past Wednesday we had our little moments, when neither of us understood the other at all.  This led to a bit of mental scuffling, as we each tried to wrap our warped brain around both our own thoughts and the other’s.  But we got it worked out.  It was all because I had to get Dad to take a shower and get dressed, ideally before Mom got home, because they were invited out that night.  And I only had five hours in which to get that accomplished.

It was a little like steering a boat in a quarter sea.  The boat pitched to and fro, and side to side, and my job was to keep it going straight, on course.  Well, we did get there.  Not exactly on time, but close enough for jazz.

Dad used to give me a very hard time about why I wasn’t “doing something with my life.”  Before he got sick himself, he just didn’t understand.  He thought that I had somehow turned lazy, content to do nothing and “live on the dole.”

Unfortunately, now he knows all too well why I never seem to get anything done.

“Half in love with easeful death….”

Darkling I listen; and, for many a time

I have been half in love with easeful Death,

Call’d him soft names in many a mused rhyme,

To take into the air my quiet breath;  (Ode to a Nightingale, John Keats)

I’m doing this NaNoWriMo write-a-novel-in-thirty-days thing.  It’s quite an exercise, for a non-fiction writer like me to just throw my hat into a fictitious ring and say, “whatever comes out, comes out.”

Last night after Shabbos I went back into my manuscript frenzy and got over the 5000 word hump.  Then I noticed something odd:  every one of the characters in my novel is modeled after someone in my life who has died violently.  One of my protagonists is even an amalgam of two different men who committed suicide by shooting themselves.

The two children in the plot, I knew from their very beginnings.

The Pretzel Lady cadaver plays herself.  I hope she is now resting in a lot more peace than I gave her, poor thing.  She was my cadaver in medical school.

I wonder if other novelists resort to such macabre strategies, mining their lives for dead people to resurrect?  But surely most people don’t know so many dead people as I do.  Or do they?

I’m not talking about the “normal” kind of death that impacts everyone’s life sooner or later.  It is natural for grandparents, and then parents, to age and die.  It is also natural for people to have long terminal illnesses, and then die.

What I’m talking about is specifically suicide, homicide, and accidental death.  The kind of thing an emergency room doctor sees over and over again.  In fact, when you see these things on a daily basis, they begin to populate your thoughts and your dreams.  So why shouldn’t they populate a novel, should you chance to write one?

It is the most natural thing on earth, for me anyway.  If I need a life to put down on paper, I reach out into my catalog of lives that have been shucked off like overcoats no longer needed.  But I’m sensing that I need to put a stop to this thread, because my mind in its current state could easily begin to perseverate on ideas far more unhealthy than these that I’ve already trotted out.

What goes up…

Oh I was so enjoying the past few days of creativity, productivity, sociability, all sorts of -ilities.  Should have used some of the energy to clean my house….but I was too busy writing my novel, which I think is going to be wonderful (and not just according to hypomanic me).

I used to write reams of poetry when depressed, only to throw it out when hypomanic;  and vice versa.  Now I haven’t written a poem in thirty years.  Nevertheless I have learned that the feelings that I feel are real, whether for up or for down.  And I don’t discount them.

My excellent psychiatrist says that just in the same way some people have sensitive lungs or sensitive stomachs, some people have sensitive brains.  Even if I were not a sensitive-braniac, I would still agree with him.  I’m sure many of you will have what to say about this.

Now it is late on Friday afternoon, and I am finishing my Shabbat preparations, which are not elaborate because I have felt like I’m swimming in a sea of cold molasses all day.  Maybe tomorrow will be better, and if not, at least it will be Shabbos and i can just do what Jews are commanded to do on Shabbos:  rest.

Good Shabbos!

New Moon in Scorpio

Oh boy.  If you’re anywhere near my age, and even if you’re not, if you’ve read your fill of R. Crumb comix, you’ll know that Scorpio is a heavy sign.  And the New Moon is the darkest time of the lunar cycle, nothin’ shining out there in the night, ‘cept some stars, and those stars are gonna be…Scorpio.  Of course, the usual culprits are all out there too:  Castor, Pollux, the Milky Way.  But you catch my drift.  We have a Darker Than Usual Dark of the Moon event going on tonight.

Could be why my neighbor’s dogs are hysterically howling.  I hope they stop soon, very soon.  I am comforted by the fact that I have no weapons at all, for I would be sorely tempted to lob a grenade into their yard.  Alas, I am without grenades.

As for my mind, why, it seems oddly balanced tonight.  I had a couple of heroism opportunities earlier in the evening that cheered me up considerably.  I love being a hero.  Swooping in and saving somebody’s day just juices the heck out of my day too.  I have to be careful with that, though.  Grandiosity lurks behind the Superhero cape, drat it all.  Do you think Superman was manic?  Green Lantern?  Spiderman, fer cryin’ out loud???   Dude goes creeping around headfirst down walls, now that guy has got to be oozing some serious mania juice.  Does he get labeled, lose his job?  Heck no, he gets famous, makes movies, gets the girl!  This proves that real life is all wrong.

Scorpio.  A deep, deep water sign.  It’s my father’s sign.  And tomorrow is his 87th birthday, in the deep black waters of the New Scorpio Moon.  I noticed today that he’s in his Scorpio mind tripping mode, where he flows through mental images in gorgeous non-sequiturs that drive my mother mad (she’s a very practical Sagittarius) and make me grin.

Dad found his place in life and kept it.  His mind is all images:  he’s an artist.  He got to be exactly who he is in life, got to do it almost right up until the end.  I know that is an enigmatic sentence.  I will explain it.

Most people spend a considerable part of their lives trying to figure out who they are and what they want to be when they grow up.  My dad fell into his field on one of the first tries, and unintentionally at that.  He’s a clay artist, has been since around 1950.  Just fell into it, fell in love with it, and has done it all his life.  He’s managed to engineer his life such that even through a few major bumps in life’s road, he still managed to keep his clay life between the ditches.

I’m curious about this, because even though I have always known who I am and what my life’s work is, I have had little success at keeping myself from careening straight into those ditches.  I have known many tow trucks.  I am no stranger to the lonely walk on the side of the road, in the days before cell phones.

Early on, it seemed that the art of life lay in the grace of picking one’s self up and dusting one’s self off, and climbing back in the saddle.  I did that a lot.  I still do, but the saddle has moved a lot closer to the ground, or so it seems.  On one hand, it’s easier to climb back on.  On the other, falling off hurts more.