The Trickery of Remission

Warning: Content has potential triggers. Reader discretion is advised.

I had come to terms awhile ago that Bipolar Disorder is a lifelong disorder. There is no cure. There is treatment. An abundance of treatment.

It was disheartening. It was a huge, ever-looming, oppressive idea. I’m going to go through this for my entire life. Not just a portion, for instance, the rest of my adult life. No. This, this bipolar disorder has been a companion for longer than I can remember. In fact, I could even conclude that it was the very fire of Bipolar Disorder that gave me life in the first place. Born out of this fire and ice.

Not a cure.

When I first started taking Vitamin L, I researched it.  And emblazoned at the top of the Lamictal website is the following statement: Prescription LAMICTAL is used for the long-term treatment of Bipolar I Disorder to lengthen the time between mood episodes in people 18 years or older who have been treated for mood episodes with other medicine.

Lengthen.  Not stop.

How long is that?  A few days?  Maybe a couple of weeks?

Another resignation.  I pitched any hope that there would be any long-term stability for me.  I resigned myself to the idea that I would always be in some state, whether I was slipping down to reside at the bottom of the abyss, streaking through the sky.  It didn’t seem as though there was another option.  Things are the way they are sometimes.  It’s up to us to come to terms with that.

I had decided that there was no such thing as remission in mental health disorders.  For some, it was either dormant or active.  For me, with Bipolar Disorder, there were three states: Depressive, Stable, and Hypomanic, none of which are permanent.  It is just the nature of the disorder.  Hardly anything can have any permanency with ever shifting landscapes.

At the end of October, something incredible happened.  I was not in a state of any kind.  It was like standing between heaven and hell.  Limbo, waiting for the other shoe to drop.  I was convinced that the great plunge was coming, but I only floated down easily from the mother of all hypomanic episodes.  I planted my feet firmly on solid ground, perhaps for the first time in my life.

Initially, I didn’t roam freely around this strange terrain.  There had to be a sinkhole, a bed of quicksand, something, disguised in this lovely place.  About a month of living in this landscape, with the help of others, I started to believe that there was a possibility for full remission.  I was cynical at first.  I had no evidence in my own experience to back up this notion.  However, I began to idealize a wonderful life without living in the constant fear and ever present shadow of Bipolar Disorder.

Idealization is dangerous, and it is something I often fall victim to.  I am not sure if it is a part of the human condition, as much as it is just a characteristic of certain people or disorders.  It remains to be one of the most perilous mechanisms of my delicate mind.  Typically, I knowingly guard myself against this with great cynicism unless I am proven otherwise.  Defy me.

When idealizations occur for me, it is akin to a shattering mirror when realities emerge.  In this instance, it was as if I had come to the ledge, holding tight and gazing deeply into that mirror reflecting my stable illusions.  Distracted by the beauty of it all, I took one false step.  All it takes is one to shatter the illusion, and wake up in the murky depths of depression.

Prior to this run of stability, I had no frame of reference.  A great many people mourn the loss of their lives that occurred prior to the onset of symptoms.  There was no such frame of reference for me.  My diagnosis was a relief.  It provided explanations as to why I was different, and no matter how hard I tried, I couldn’t seem to function properly in any capacity.  I was always content with the diagnosis itself, even if I was affected by the disorder itself.  It gave a name to many of the awful things I had started to believe were just me.

I’m not sure which is worse.  Suffering the constant bombardment of symptoms with little reprieve, or mourning that loss of a blissful, stable state and life I had, but slipped away.

This post brought to you by Tallulah, my Blackberry Bold.

Oh, Fluck!

With enough wits, a person might be clever enough to deduce the meaning of this Luluism without the aid of a definition.

Fluck (fah-lah-uck): a combination term used as an alternative to a swear. It is used to describe an intense negative reaction. Derived from “f***ing luck”.

As in: Oh, fluck! I forgot to pick up my Lamictal from the pharmacy! On a Sunday night. When they close early. And I won’t have enough time to grab them until after work on Monday.

Fluck.

This realization didn’t hit me until I was going to make the attempt to refill my weekly pill case. I finally broke down and started using one. A lot of good it did me. I ran out on a Saturday.

I stood there and stared at the empty container in disbelief that I could have forgotten something so very important. I have taken my Vitamin L daily, without fail for so long. I just plain forgot.

Understandably so. Production on Thursday, sleigh ride in the van-buggy on Saturday. I don’t believe I even called it in until Saturday night. Sunday morning mass and Sunday afternoon family function. In all of that travel, I passed the pharmacy at least four times!

Oh well. A day without Lamictal never hurt me before.

Quite reassuring now that I’m in the hot seat.

I woke up late, and seemingly amongst chaos. I could not wake up this morning for the life of me. I literally stumbled around, trying to get my footing. I never did find it, honestly.

C.S. left for work, and everything was mostly typical. I should have felt it happening. Slowly, the reigns slipped out of my grip. The horses started running more freely. The ride became bumpier. When I did notice, it was too late. Each time I’d made a solid grab, I opened my fist to have them fly further away.

I dare say that my emotional stability is crumbling under the very path I’m walking on!

By afternoon, I was spitting certain phrases like a bad taste in my mouth. “I hate my effing life!” “That irritates the hell out of me!” “Shut up!” It’s as if I were dangling by a flailing string. The wind would shift and suddenly, “I’m so sorry. I’m sorry. I hate myself for being so horrible.”

Over little things. T.D. got into my makeup and my jewelry again today. He has made a real mess of things in my room. I was infuriated. Makeup and jewelry are expensive!!! But – they are just stuff. The world was ending! I couldn’t find my good headphones where I can actually hear music and conversations on my Blackberry! And I carried on about it to C.S. for at least fifteen minutes of his break.

Yup, there are plenty of reasons to hate myself today.

Then, the ultimately bad phrase popped into my head. I want to kill myself. Red flag. And I threw it out there on my playing field, oh so silently. I don’t want to rouse suspicion. I am at work after all.

I should have realized this was going to be the result at the very time I skipped the dose. Not even an hour later, I had the best sex of my life. It was complete with saturation of every sense from every nerve. My brain was throwing out visual and auditory stimulation that it doesn’t usually do. I don’t know why I don’t find the clearest clues, right in front of my face.

Live and learn.

Don’t sound the alarm. I’ll be fine, but it is my top priority to get some medicine into me, fast. Something is going very, very wrong. But, until at least 7PM, I’m stuck in the hell of my own making.

Lesson learned. Don’t skip your medicine. Ever.

The Case of the M&M Interactions

I had a psychiatrist once tell me that the psych meds were all “M&M’s a different color”.  Doctorspeak for, “Same thing, different packaging.”  How refreshing.  At least she was honest about it and didn’t make it seem like one thing was going to be the miracle cure.  That’s now how I refer to my cornucopia of medications.  M&M’s of a different color.  I’ve got my big white ones, little white ones, my shelled white ones, the big bulky blue breathey one, and the mac-daddy of suppliments I take to keep everything else under control.

I’ll take you through a quick run-through of the normal of chronic ailments and then medications.

Bipolar II
Mood Stabilizer:
Lamictal (lamotragine) – 100 mg twice daily = 200 mg

Antidepressant:
Wellbutrin XL (bupropion) – 150 mg once daily

Sleep Aid: (insomnia)
L-Glutithoine (nutraceutical)
L-Theanine (nutraceutical)

Generalized Anxiety Disorder
Anti-anxiety (benzodiazepine):
Ativan (lorazepam): 1 mg, three times daily = 3 mg

Asthma:
Ventolin (no generic)- 2 puffs every 4 to 6 hours or as needed

Migraines:
Maxalt (no generic)- 5 mg when you feel a migraine coming on

Tendonitis of the Knee and Genu valgum (Knock Knee):
Ibuprofin – 200 mg every 4 to 6 hours or as needed

High Cholesterol:
Garlic (nutraceutical)
Omega3 Fish Oil with DHA and EPA (nutraceutical)
L-carnatine (nutraceutical)

Regular Suppliments
Vitamin C
Vitamin E
Vitamin B-12 with Folic acid
Pantothenic Acid
Bioflaviniod Complex
Bromeline 3000
Ubiqinol (I highly recommend this one for fatigue but it’s pretty expensive)
And probably like 10 others I’m not thinking of right now.

And of course, I am a woman of childbearing age, so throw in an oral, hormonal contraceptive.

Throw in 60 mg of prednizone, and a Z-pak and you’ve got a medicine soup.

Think about all of the doctors we have. Pdoc, PCP, OB/Gyn, Neurologist, Orthapedic, etc. Now, consider that despite the hundreds of times I relay the medications from one doc to another, it probably widens the margin of error.

I’m finishing this on my phone so I have to put the full link on.
http://reference.medscape.com/drug-interactionchecker. This is a comprehensive multi-drug interaction checker. Slap ’em all in there and it’ll tell you. Of course with a little doctorspeak.

Turns out azithromycin (z-pak) doesn’t play well with hormonal bc. Pregnancy risk. Hormonal bc doesn’t play well with lamictal and prednizone by increasing the metabolism rate and having higher concentrations in the blood.

Who knew?