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.

Holding My Medicine Hostage

If only there were chains...

Today was the big day. I was rescheduled to see my psychiatrist’s nurse. I had to beg my mother to babysit T.D. and bribe my father to drive me the 15 miles up there in rush hour traffic, but I made it.

Here’s the big deal about going to see my pdoc. He’s located 15 miles away, I don’t have access to a car because C.S. takes it to work, and I have no one to watch T.D.

To be honest, I don’t have a great relationship with my parents or siblings. We don’t feud anymore, but decades of doing so has left our relationships strained. The state of our relationship only matters a little. They aren’t very giving people, and each “favor” ends up being a debt that can be called for repayment at any time. I’ve known more understanding loan sharks.

My friends work. And I’m also very particular about who watches my son. I prefer mothers, experienced nannies and babysitters, or female teachers. Those seem like high standards for babysitting a kid for an hour, but I consider it to be reasonable for a child with PDD-NOS and a significant speech delay. Would you leave your baby with someone with limited experience with babies? Though T.D. Is not quite a baby chronologically or physically, the same principals apply.

I actually made it there early, despite the traffic. But, it was certainly a “hurry up and wait” situation. Not only did I end up waiting the 15 minutes that I was early, I waited an additional 15 minutes past my appointment time. That is 45 minutes that my father had to wait around in the parking lot for me.

And all for what? Exactly what I predicted – a pitiful, unproductive, and largely inconvenient appointment with a nurse practitioner who probably shouldn’t be dealing with the likes of me.

I outlined the problems and ineffectiveness of my medication very clearly for her:

      I’ve been so depressed that I gained 10 lbs in three months. She answered,

“That kind of weight gain is practically impossible on Lamictal and especially Wellbutrin.”

      Yeah, I know. Both of them are notorious for weight loss. I have a genetic predisposition for extreme weight gain. That’s why I chose them.

My anxiety is unmanageable. I have regular anxiety attacks over every little thing. I’ve developed migraines over this again.

I don’t sleep anymore, apparently. I’ve been taking supplements for insomnia and now they don’t work. I started taking over-the-counter medication for it, but you can only take that in moderation without risking frying your liver. So, now I’m stuck with increasing sleeplessness.

It’s been about 6 hours a night off and on for two months now, and has been every night for the last week. And some nights, it’s 5 or less. Last night, I slept 4 and a half hours. I used to become hypomanic when this occurred. Now, my brain and my body are so tired that I am in a perpetual fog where I am completely dysfunctional.

    My moods are all over the place and I am highly reactive. This began slowly about two weeks ago. It started as only certain things that could trigger an unpredictable response. I would laugh hysterically, cry uncontrollably, or fly into a fit of rage at the drop of a hat, for seemingly little reason. Now, it’s progressed into constant states of arousal. I’m either delirious with hilarity, extremely irritated, or crippled with depression.

The nurses solution? Increase the dose of Wellbutrin and let the doctor determine the rest two weeks from now. My suspicion? She’s not allowed to adjust any medication other than antidepressants.

So now I take my medicine like a good girl and hope that I can manage my life within my two week period of the waiting game.

I decided that I hate nurse practitioners masquerading as psychiatrists more than I hate doctors.

Ugh.