As I have written in an earlier diary, I am a manic-depressive. http://www.dailykos.com/... I rely upon fairly strong mood stabilizing and anti-psychotic drugs to maintain my mental stability.
This past week, I had a problem with my medications. It reminded me again of my utter dependency on those medications to maintain sanity. I was reminded of the pre-medication reality of my life. I wish that I was "normal", but, unless there is some medical breakthrough to alter my brain chemistry, I will be dependent on medications, despite their side effects, for the rest of my life.
I attempted suicide the first time when I was about 14. I stuffed towels under the door of my bedroom, turned on the butane space heater in my bedroom without lighting it, and laid down to wait for the end. Now, almost 40 years later, I can't tell you what prompted that first attempt. But, I can recall the feelings, because they visited me again and again for almost 30 more years.
I was entering adolescence, when the symptoms of manic depression usually first become obvious. I didn't know then what it was, even though, in retrospect, I should have realized that we had a family history of mental illness because of my manic-depressive grandmother's total psychotic break when my mother was a child. I just knew that I hurt and that my mind was running faster and faster, like a hamster on a wheel. Nothing I did stopped the constant, out-of-control spinning in my head. I could see no way to end the pain except to end my life.
But, I got up before I became too groggy, took the towel out from under the door, and turned off the gas. What saved me that night - and every other night - was the thought that I could always commit suicide the next day, but I couldn't undo a suicide the next day. Like an alcoholic in AA, I learned to live just one day at a time.
It wasn't always an easy life. I blew up lots of personal relationships. I never had children because I was never sure enough that I had a stable relationship. I graduated at the top of my class from a good law school and did well at a major law firm. But, my demons were always with me. I eventually had to go to a part-time work schedule so that I could hide at home and try to cope with the moods on the days when it was too bad. I was respected enough at my job that I was allowed that flexibility, even though I never told them why I needed it. Even then, I HAD to work some days. I would stand in the shower and sob because I didn't know how I could do it, but I knew that I had to work that day.
There were lots more suicide attempts. Many were by gas - I was close to "success" on one such attempt in my mid-20s. Later, I decided the cleanest way was by gun. I had a hunting rifle. I would put it in my mouth at night, but I never quite pulled the trigger. I could always do it tomorrow.
Like most manic depressives, I was capable of tremendously productive periods when I was on a high, always followed by the matching depression. As another family member who is manic depressive has told me: I know I have to do everything I can now, because when this period ends I won't be able to do anything. As he said: When the low hits, I wake up every morning and ask God why he let me wake up to face this again.
For me, as a trial lawyer, I could run almost without sleep, on a constant high, during a trial. I remember the day I finished my last trial before I went on medications. I called the client to report. The client, a friend of mine, told me that I sounded high. I had not been drinking, as he thought, but I was sky-high on my own chemicals. The crash after that trial is what eventually got me to medications. The depression was so low that couldn't stand myself, much less my husband. I went to visit a friend in a nearby town. Luckily, she had a manic depressive sister and recognized my condition. I will always believe that friend saved my life by getting me to a psychiatrist.
Starting medications was as dramatic as flipping a switch. The depression lifted, the out-of-control spinning in my mind stopped, and the constant "jukebox" of music that had been the sound track in my mind since I was about 14 just stopped. I had been so used to that music that I was amazed to learn that it was a symptom of my disease. That is why I am diagnosed as bi-polar with schizophrenic aspects, because I hear things in mind that are not there - constant music.
I function fine on medications. There is the problem of prejudice against mental disorder, which I discussed in my last diary, but I am OK. So, why doesn't every one who is bi-polar just stay on medications?
I'm a lucky one, with very few side effects of my medications. Others aren't so lucky. But, even for me, I know that I teeter on the knife's edge of my chemical balance. A little shift this way or that, and I fall. A little less sleep, a little more stress - and the minimum amount of medication necessary to keep me on a level setting changes. I could fix that by increasing my medication levels, but I'm NOT willing to do that because of the side effects.
Medications, even the bare minimum I keep myself on, dull my mind. I'm not as quick in my thinking as I was before medications. At one point I shifted to a different medication - I couldn't even remember a 7-digit phone number on that medication. And I've always had an amazing memory - before medications.
Medications take away the wonderful highs. I told my husband once that I miss being great. That may sound egotistical. But, as a manic depressive on a high, I felt that I was great, even if that was not the reality. I actually let one high play out a few years ago. I knew what was happening. I knew that I would fall again. But it felt SO good! On those highs, I can do anything. I hate to lose them. But, I can't risk the accompanying low. I quickly reached my doctor and increased medications when the high started ending. It was risky behavior on my part - just to experience that high.
Besides the mental side effects, which are the most upsetting to me, the drugs also cause weight gain and potentially damage my liver. I have to take liver function tests several times a year. I have already had to switch medications once because I developed an allergic reaction, and another time because of the severe effect on my mental functioning. If I develop liver problems as a result of my current medications, I'm getting down to a pretty small list of alternatives.
This past week, I had a dramatic reminder of the strength of the medicines I take, and my small margin for error. I normally take my medicines at night because some of them make me drowsy. I have my routine which I follow so I won't ever forget the meds. I put them all in a little medicine cup, swallow them, then browse the internet while I wait for the effects to start. That night, I thought I felt something brush my cheek when I tipped the cup to put the meds in my mouth. I searched the desk and floor and found no pill, so thought I was fine.
Early the next afternoon, I found the missing pill by the desk. I take 3 a day of those pills. They are a strong anti-psychotic. I decided against taking the missing pill then because I still had several hours to work and I didn't want to become too drowsy to work. I just went back to my normal dosage that night.
BUT, that meant that I had decreased the dosage, then increased it again by 50% that night. I had to miss the next 2 days of work while my body readjusted to the medication. I had the same experience back in 2003 when I decreased this medicine by one pill to make it last until my refill came in and then went back up to normal dosage. I had not realized that just a one-day change would have the same effect. I was in such a mental fog that I could barely function. I talked to people without remembering it. I became nauseated because my balance was affected. AND THIS WAS BECAUSE OF ONE SINGLE ADDITIONAL PILL.
I don't want to hurt the perception of manic-depressives by my diary. I don't want others to think that we are dangerous or unstable. We are functioning, useful members of society with our medications. For me, I know that I can never stop the medications, despite the side effects, because I remember what it was like before meds. But, perhaps my experience will explain to those who are not manic depressive why so many of us resist staying on medications.
Those drugs are powerful, nasty things. They save my life, but I pay a price.
My husband, who is a biologist, was telling me this morning that he hopes, someday, science will come up with a way to correct my natural brain chemicals without the powerful medications. I don't see that happening in my lifetime. But, perhaps, someday, if research such as stem cell research is allowed to be properly pursued, that might become a reality. Until then, I'll continue to live on this knife's edge.