Saturday, June 9, 2007

The Cost of Stability

What comes to your mind when someone says Bipolar Disorder? Do you think of a wild-eyed, ranting mess of a person burning down the house in a fit of rage? Do you think of someone who laughs one minute and cries the next? Do you think of someone who is so mentally unstable nothing that he or she says can or should be taken seriously?

If you answered "yes" to any of these questions, then you've just nailed the reason why I don't tell anyone about my condition. It's a conundrum. If I tell, then I risk be written off as a mentally ill wacko who has no credibility--the disorder itself gets pegged as the excuse for any behavior that anyone else might not particularly like. On the other hand, by never 'fessing up, I leave myself open to the brazen speculation of others who talk behind my back trying to identify the source of my erratic moods and words. I've decided to let them wonder.

The truth is, if you didn't know me within three years of my diagnosis, then you probably wouldn't have any idea that something had gone so seriously wrong in my brain. I go to work every day. I work not one, but two challenging jobs and I do them well. I pay my bills, I iron my clothes, I work in my garden, and I lead a productive life. This is why I bristle every time I hear that someone has made news because of their outrageous and unconscionable behavior and then chalked it up to Bipolar Disorder. I hate these people and the damage they cause to those of us who are trying to prove how fucking normal we are.

OK, I'm not completely normal, but I try very, very hard to maintain that illusion. Here's what happens when the medications fail:
  • I am mean. I am a bitch. I say terrible things to people that are the verbal equivalent of being poked (hard) with a sharp stick.
  • I do not sleep.
  • While I'm not sleeping, my brain processes thoughts at about quadruple normal speed--at least. Trying to focus is akin to trying to catch minnows with your bare hands, fingers splayed. And it's just as frustrating.
  • I spend money like I have the bank account of a lottery winner, just one of several self-damaging behaviors endemic to BP.
  • I get depressed. When I say depressed, what I really mean is that I want nothing more out of life than to be finished with it and to die. die.die. Obviously, I haven't killed myself, but I must admit, I remain ambivalent about that.
  • When I am depressed, I can do only two things: I can go to work, and I can lie on the couch watching TV. I can also drive while crying--sobbing in fact--without missing a turn or running a stop sign.

Bipolar depression is like the worst depression you can possibly imagine, but on steroids. It is one of the most difficult forms of depression to treat, and for many sufferers, it will always remain stubbornly treatment-resistant. There is a reason why one in five people with BP commits suicide. You really have to experience this kind of depression to even begin to comprehend how bad it is. This soul-gutting depression really does make death seem like a reasonable alternative. Why? Because it hurts. A lot.

A year ago this month, my doctor decided to take the bold step of putting me on a new medication. I don't mean it was new for me; it was on the market only about six weeks when I started on it. To understand why this matters, you should know this: When I was first diagnosed with BP, I read that it takes about three years to get the meds worked out. I felt so bad at the time, I decided that if I couldn't find relief within three years, I would kill myself.

Enter EMSAM. Before I could start EMSAM, I had to get off of several other medications I was taking. That in and of itself made me want to put a plastic bag over my head. During the withdrawal, my brain started having some kind of auto-electroshock therapy. Every few seconds, my brain emitted what felt like electrical shocks throughout my body, ending at my fingers and toes. Every few seconds for weeks. Zap! Zap! Zap! Zap! Zap! It was exhausting.

Then there was the nausea and the vertigo. For some reason nobody has been able to explain, my sense of smell became hypersensitive, and it made the nausea even worse. I couldn't sleep. I couldn't speak right, and I didn't want to even try to be socially integrated. Work was overwhelming, and my memory was like Swiss cheese. I think I missed an entire month's schedule of staff meetings simply because I forgot to go.

EMSAM took forever to kick in, but once it did, my mood improved dramatically. My moods became more stable in general. Who would have thought that a micro-thin, two-inch square of adhesive plastic would be the thing protecting me from death?

EMSAM isn't perfect, but it's close. It exacerbates my insomnia and causes its own special strain of irritability. That's OK because there are treatments for those side effects, and those side effects are a walk in the park compared to the alternative.

More on EMSAM, suicidal tendencies, and insomnia next time.


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