Abilify, Not I : Adventures in Antipsychotics

Lately, I have written a series of posts over the last two months describing certain troublesome symptoms I associated with the worsening of Bipolar Disorder, or the potential for comorbid disorders.

In my last post, When Medications Go Wrong, I briefly wrote about my recent discontiuation of the pharmocological treatment using Abilify as part of my medication regimen:

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

I went on to describe some of the awful side effects I was experiencing as a result.  However, the list was truncated for the sake of keeping word count down.  The description is rather limited in terms of accurately depicting exactly what I was subject to.

  • Cognition Disturbances and Memory Fragmenting.  Originally, I wrongfully blamed Lamictal in Vitamin L : Medication Adventures for my aphasia-like symptoms.  The disturbances felt like aphasia.  At first, it was almost indescernable.  I started word dropping again, meaning I would be reaching for a word, but was unable to grasp it.  Instead, I would be able to get to every synonym around it, however, those words did not fit the exact context.  Eventually, it became a more severe form of word dropping, and I found myself dropping sentences entirely at the loss of any word or synonyms around it.  It progressed into entirely dropping conversations at the loss of a sentence.  Then, I found myself

    I started forgetting things again.  These were simple things, like losing my purse or shoes in the house.  It seemed like just a simple case of forgetfulness, maybe stress related.

  • Emotional Blunting and Partial Flattening.  I had never had too much trouble with emotional blunting in the past.  While I’ve found myself in times where it was difficult to express my emotions, this didn’t indicate a lack of emotional response.  I describe it as a partial emotional flattening, because it wasn’t an entire lack of reactivity.  It felt like my spectrum of emotions had been significantly reduced, although not completely removed.  There was a certain inaccessibility to certain strong emotions.  Rather than completely removing extreme emotions, it threw a wet blanket on top of them, leaving them to bubble under the surface.  So, the emotions still existed, but were muted and unable to be adequately expressed.

    At it’s worst, I began to lose most feeling entirely, with the exception of irritation and the sensation of boredom and fatigue.  I began to lose love and my attachments to meaningful people and my relationships with them.

  • Dissociation I touched on a summary of the dissociative symptoms that Abilify had brought on.  I have been writing articles on the experience throughout the last few months on the subject, describing the feeling in great detail, but remained unable to exactly identify is appropriately.  The dissociation probably occurred as a response to the prior bullet points.

    The dissociation cited was experienced as a removal of self and removal from my own life.  I had felt as if I had been separated from myself and my world.  It was a feeling of something being stolen from me, or something fundamentally inaccessible.  Like, I was being locked out of my own life, or becoming transparent and just fading away.

  • Worsening of Depressive States.   This is probably a direct result of the first three bullet points.  I started to disengage from my life.  I lost interest in just about everything.  Most things were considered to be either boring or tedious.  Important things started to lose meaning.  This was experienced as a part of the emotional flattening, but it caused a concerning and distressful reaction.
  • Exacerbation of Social Anxiety Since I had lost the ability to carry on a conversation and found myself completely disinterested in socialization, my social anxiety went through the roof.  I simply didn’t care about anything anymore, especially trivial things I used to find interest in.  Therefore, I found it difficult to carry on a conversation.  This caused extreme distress in social situations, and encouraged further isolation.
  • Disturbed Sugar Levels.  While I have no concrete proof in terms of tests, certain symptoms have come to my attention.  They are notated below in the next two bullet points as thirst and weight gain.
  • Loss of Sensation of Bodily Hunger, Thirst, and Fullness.  Within the last few years, I started to become more in tune with my body.  I was able to feel the sensations of hunger through my sugar level, which probably caused the loss of bodily hunger.  The disturbed sugar levels probably also caused an extreme thirst that could not be quenched.  At first, I craved water.  Eventually, I started to put the soda back down, which probably caused part of the weight gain mentioned below.  And I felt an extreme pressure in my stomach, which was also exacerbated by the influx of so much fluid.
  • Extreme Weight GainTruthfully, I don’t dare get on a scale at the moment, so I am unable to notate at this time exactly how much weight I’ve gained.  By the fit of my clothing, I will estimate that I have gained somewhere between ten and fifteen pounds in the last three months.  That is a substantial gain for me, especially since I was losing weight prior to the start of this medication.
  • Exacerbation of Eating Related Problems.  By all definitions, it’s completely possible that I am living with an undiagnosed eating disorder.  However, I am not entirely convinced, since it isn’t an ongoing and prevalent problem.  Therefore, I define it as eating related problems and difficulties.

    The concern for weight gain and the sensation of fullness caused a very terrible reaction of binging and purging.  I was unable to control my eating, as notated above, therefore the sensation of extreme fullness would cause me to perceive the overeating as worse than it actually was.  Unfortunately, this led to a very vicious cycle and encouraged further weight gain.

  • Disturbed REM Sleep.  I was waking up tired, and noticed that it felt like I had stopped dreaming.  This caused my mental state to take a considerable dive.  It caused extreme fatigue and excessive, unproductive sleeping.

While I am cleared of most dissociative symptoms, emotional flattening, and my depressive state is lifting a little, some side effects have remained.

  • Cognitive Disturbances.   The aphasia-like symptoms remain, but to a lesser degree.  I am back to just being a little forgetful, and have some minor word dropping.
  • Memory Fragmenting.   Some of my memories remain dull, but seem to be returning.  However, most of the last three months remains inaccessible.  It may never become accessible, due to the disruption in the formation of short-term memory.
  • Disturbed Sugar Levels.   I am still thirsty, but I am no longer engaging in carbohydrate seeking consumption behavior.  I figure it will take awhile before my sugar is regulated properly again.
  • Weight.   Thankfully, my weight does seem to be coming down.  I have only been completely off of the medication for less than a week, and my clothes are already fitting better.  I’m going to assume that in addition to the weight gain, I was retaining water and constipation.  My regularity has come back, and I don’t feel as puffy as I did

Unfortunately, I am experiencing a return of some of my milder psychotic symptoms.  In Imaginary Enemies, I described a cognitive disturbance I described as “The Voice”“The Voice” can be characterized as a singular persona, as I wrote about in Conscious, Subconscious, and Extraconscious, where I described a theory of a third consciousness that exists between the subconscious and the conscious mind.

The Extraconscious is postulated as where the persona(s) reside, laying in semi-dormant waiting, perfectly aware of the current reality that is being experienced.  “The Voice”, in more severe psychotic states, can be experienced as a separate entity entirely, detached from the consciousness.  That is the defining line between a cognitive distortion and an auditory hallucination, when a persona detaches itself from the extraconscious as an external sensation.

As an extraconscious persona, “The Voice” can best be defined as a quasipersona, lying somewhere between Dissociative Identity Disorder and psychosis.  It is experienced as a semi-active part of the conscious mind, as the dominant persona is well aware of it’s existence and there is a certain interaction that occurs between the dominant persona and “The Voice”.

That is the best theory I can offer as to the existence and function of the quasipersona, known to me as “The Voice”.

The mild auditory hallucinations and visual hallucinations have returned, probably defined better as a sensory disturbance, rather than a symptom of psychosis.  When experiencing a sensory disturbance, it’s not full on hallucinations as described in the definition of psychosis.  There are not entities separate from the body.  They are recognized as a disturbance in the current reality, distorting shapes, colors, and contrast in the vision.  In the hearing, it is experienced as a distortion in sound, causing sounds to be sharper, duller, muffled, or louder than they actually are.  It can only be sensed by a sudden shift in perception.

So, instead of hearing things at a normal sound level, the sound volume may increase to deafening levels or may become muted and difficult to discern from nonexistent static that occurs in the mind.  My visual disturbances may be perceived as viewing the world in high contrast, extremely bright colors, and / or extra high definition resolution.  Or, they may be seen as duller than usual, muting colors, distorting shapes, and / or clouding the vision with that appearance of a veil or foggy goggles.

Intrusive thoughts have returned, but not with the same extreme nature as experienced several months ago.  In truth, they were never completely removed by the Abilify, and at some points were made worse by the drug.  Instead of experiencing them as a truth in reality, I am now able to separate them using logic.  I can talk myself off of the ledge and separate them from the reality of a situation using DBT techniques of mindfulness and distress tolerance.  Prior to the cessation of Abilify, I was unable to utilize those techniques.

I don’t mean to put anybody off of treatment with psychiatric medications, but I felt this was important to document and have as a resource on the internet for anyone who is thinking about taking the drug.  Some of these side effects aren’t listed in the pamphlet, as they are probably isolated to a condition.  But, I feel they are still a distinct possibility for anyone who is being treated for similar conditions.  It is vital that this information be notated and readily available for medication education purposes.  This information probably should not be generalized to all psychiatric medications, especially in the class of antipsychotics.

 

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When Medications Go Wrong

For years, I’ve pretty much been medicating myself.  I take my scripts home and medicate how I see fit for my situation.  I realize that makes me medication non-compliant.  The trouble I come to is my trust in doctors.  I have been burned so badly before that I find I have a lack of faith in them to know how they are really treating me.

When I was in my teens, and being treated for Major Depressive Disorder (misdiagnosis – strike one), I was put on high doses over a slew of medications for years with little result (overmedication – strike two).  I suffered extreme side effects, with little done to relieve them.  I took Zoloft in increasing doses over a three year period.  I continued to complain of extreme fatigue, anxiety, motion sickness, and periods of flu-like symptoms.

The doctor’s answer?  More medication.  It came to a head when I found that if I sat still for too long, I would drift off to sleep.  Sitting in school became impossible, and I was sleeping fourteen to sixteen hours a day.  Eventually, I was put on 300 mg of Zoloft with Provigil to combat narcoleptic symptoms.

It was at the doctor’s suggestion that I continue to exceed maximum dose and go to 350 mg that my mother finally put her foot down.  “Put her on something else.  We’ve put three years into this, and it clearly isn’t working.”  And much to my doctor’s chagrin, I was switched to Lexapro.

Wrong answer.

Immediately, I started to have dissociative symptoms.  I recall laying in my room, laying on the floor, and staring at my ceiling in the dark.  My mother stood in my doorway, just observing me.

“What are you doing?” she asked.

“Nothing,” I answered blankly.

Yes, I was finally awake.  But, every moment was torturous.  I lost my sense of self, and started to drift away.  My memory began to fragment, and I sunk into a deep, desperate depression.  I was frantic and crazed, while feeling numb and blank at the same time.  I became paranoid, and started to assert that everyone was doing things against me.  They were intending to harm me, and I started to give meaning to harmless comments and phrases.

I attempted suicide several times in the first month.  The cutting became so bad that I was doing it in rather public places.  I was caught one time at my boyfriend’s house, and I had a dull exacto set ripped off of me and immediately chucked into the local creek.

We were unaware of all of the side effects at the time, because all of the medications I was placed on were brand new.  When a pharmaceutical representative left her office prior to my visit one day, it became clear that I had become an experiment to brand new medications.  I was taking expensive, largely untested medications for her financial benefit.  Strike three.

I had gained thirty-five pounds over a six month period.  I was 4’11” and 165lbs.  That put me at a BMI of 33.3, and in the obese range.  And despite all of my best, and even worst, and unhealthy efforts, I still couldn’t manage to get my weight below 145lbs.  I was starving myself on 900 calories a day, and I still hovered around obesity.

I couldn’t afford my medication once I was kicked off of my parent’s insurance, and I just decided that since it failed to ease my symptoms, I would stop taking the medication entirely.  They failed to mention that if I attempted to stop the medication cold, then I would be stricken with the worst withdrawal I had ever known.  It was a good thing my parents had been through this before with my father, because they knew how to ween me off.

It took me years to get the rest of that weight off.  But, by then, the medication had already done long lasting damage far worse than just weight.  I had begun to develop a drinking problem.  I had engaged in risky sexual behavior due to hypomania.  And it sent me walking with bad eating habits.

After that, I distrusted doctors and medication entirely.  I had lost faith in mental health treatment.  I was left with a feeling that I didn’t have a disorder at all, and instead, it was just me.  I was convinced that I wasn’t treatable.

It took a lot to make me realize that I was in desperate need of treatment.  I had taken psychology courses and was suggested by several psychologists in my college to have bipolar disorder.  I knew my behavior wasn’t “normal”, just as I had always suspected.  It took the my marriage, my depleting mental health of my husband, and the birth of my son to encourage me to start treatment again.

Three years, four doctors, and a another slew of medications later, and here I am, again the victim of overmedication and bad medication choices.

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

Suddenly, I was able to think again.  I started to feel more like myself.  I became more aware of what I was thinking and feeling, and I finally started actually living in the world around me.  It actually felt like living again.  And that’s when I noticed the weight I had put on.  I had fell victim to Abilify’s weight gain, among other things.

I can blame the dissociative symptoms on Abilify.  It had created an emotional flattening, and I started to dissociate from myself and my world.  It had robbed me of my ability to write and care for my family appropriately.  I wasn’t feeling, so I wasn’t caring.

The anxiety?  Well, I recently started to run out of a supply of Wellbutrin I can’t really afford right now.  I started to cut back to make ends meet, and I discovered that was starting to subside.  Other than rebound depressive symptoms, I was feeling better.  It didn’t matter to me anyway.  I was still going through crying jags, whether I was taking the Wellbutrin or not.  The difference was between whether they were loaded with distressful urgency to cut or not.  I decided that I would prefer to keep my near streak of four months without cutting.

I don’t blame my doctor.  He’s an old school doctor who works off of the biological model and treats symptoms.  I have declined therapy several times, though my requests to be seen since have not been honored.  All of my symptoms point to mild psychosis in general, aggravated by extreme life stressors.

I blame myself for not listening to myself and taking action sooner.  Treatment happens on both ends, and I have not been holding up my end of the bargain.  I have not been mood charting, and I have not been notating subtle symptoms.  It has become abundantly clear to me since my extreme meltdown and psychotic break during the summer that I had been probably Bipolar 1.5 all along.

Though I don’t experience full on mania, I do experience mild psychosis, practically all of the time.  I have not been pressing the issue about invasive thoughts, paranoia, “The Voice”, or any of the mild hallucinations that I experience.  Only when I had my break did I bring it to my doctor’s full attention.  And I was met with extreme medication.

Personally, I’m at a loss as to what to do.  I’m damned if I do, and I’m damned if I don’t.  I noticed last night that “The Voice” has returned, even if it’s benign (right now).  I don’t want to be overmedicated, and I can’t risk gaining anymore weight.  The weight is worse for my mental health than anything else.

And it completely screws up my bodily function.  Now, I’m experiencing weight related problems again.  My knees and back hurt.  I have acid reflux near to the point of anorexia again.  Sexual dysfunction is destroying my sex life, my self-esteem, and hurting my marriage.  And I’m back to full on social anxiety, because I’m too self-conscious to function.

But, at the same time, I’m aware that I need some kind of medication.  While, for now, I’m better off without it, the day will come where I am asked to step up, and perform at a higher function.  My family, including Finn, has been very great about my general lower function and picking up a lot of the slack for me.  However, this won’t last forever.

Autumnal Affects

Plunged back into the frigid clutches of winter.

I’ve written something like this before called “The Grey Season” back on “As the Pendulum Swings”.  It was a post describing my current view of an abysmal autumn in Pittsburgh and the terrible affects it has on the mood.

In years past, I have always been partial to the autumn season.  The air becomes cooler, and I find that I begin to breathe without a struggle or medical interventions.  It was quite liberating.  The sun eases, emitting softer rays on my delicate pink skin.  And there is a certain crisp freshness of the air with gorgeous foliage in various shades of reds, oranges, and yellows to behold.

The beauty and majesty of autumn.

Everything about autumn is enticing.  There was a return to school and the return of direction in my life.  New challenges awaited me with a wealth of new opportunity.  Cozy blankets in all colors existed to wrap around me in a warm, snug embrace.  I could bundle up in flattering autumn attire, covering all of the bulges and rolls that were uncomfortably exposed in the summer months.  A cool refreshing breeze picked up, and whistled in my ears, taking away all of the static polluting my mind.

It was always a beautiful time in my life.  But, somewhere along the way, the season was morphed into something sinister and foreboding.

The Grey Season

November rains were something I used to look forward to.  I would lay in bed in a room cast in shadows, just listening to the soothing sound of rain on my tin rooftop.  But, at one point, I described them as:

I have felt grey over the past few days.  I can’t feel for a better word.  Something like, my flame isn’t burning as brightly. It’s a dampening effect, casting a shadow over me everywhere I go.  The vibrant colors of the world filter and leave only the grey inside of me.

Some would consider a Seasonal Affect.  But, that could not be father from the actual truth.  I have been symptomatic since my early teens, when I would enjoy this season better than all of joys of the other seasons combined.  Winter was the season that meant imprisonment and cumbersome living.  Not autumn in the slightest.

The mysterious loss of adoration for this season plagued me.  I obsessively mulled over it for quite awhile, trying to find the exact point in time where my affections changed into something loathsome.  Sure, these November rains are the precursor to the awful, miserable blankets of snow.  The shifting winds bring the lake effect chill from Lake Erie in the north.  The whole world is changing around me, threatening to bring some kind of desperate gloominess.  But, why?

Suddenly, it occurred to me.  In my time with Avi, I spent a great deal of time escaping him on my own balcony.  Summer meant liberation from the imprisonment in our singular room where we were imprisoned in an icy hell together.  Autumn was the time when the chill rolled in.  It wasn’t enough to warrant the use of our kerosine heater, our only source of warmth.  However, the days and nights were cool enough to make life absolutely miserable, together, alone in our cage.

The shiver rattles my bones when I recall the whole wretched situation.  Our shack of a home trapped us together.  I remember how my hands would freeze up so badly that I could hardly type any longer.  I remember the intense loneliness, because I didn’t dare invite guests into such a disgusting situation.  The trash would pile up, because Avi was an absolute pig.  The walls closed in, and the stiff, threatening air was suffocating.  Bottles of liquor, my only escape from such an awful life, littered the floor as a testament to my misery.  And all I could do was put on another layer of heavy, useless clothing and pray for an early spring.

I recall that detestable house.  Even after Xan had managed to save me from another burden of winter, the drafts were enough to render the electric heat useless on days that went below freezing.  There were times where we had to abandon the house when temperatures dropped to subfreezing.  The furnace ran incessantly, driving us into abject poverty while we doled our precious funds out to the electricity company.  I fought shut off notice after shut off notice in constant anxiety.

Autumn began to translate into fear.  Fear of isolation.  Fear of exposure.  Fear for myself and my family.  And the worst of all, the fear of losing my sanity entirely.

The dim rays of cloud covered skies filter into my windows, casting dismal shadows in every corner of the every room.  The grey bleeds in and threatens my very being.  I look into the now barren woods with dread.  Apprehension wells up inside of me each time I approach the thermostat.  Everything becomes filled with trepidation, each movement, each decision.  And the chill, the unforgiving, merciless chill invades my very soul.

I spent one last day yesterday on the patio.  I didn’t long for the crazy summer with people hanging from the rafters, and my brain short circuiting.  I breathed deeply, taking in the essence of autumns long forgotten.  I let the beautiful autumnal winds blow against my bare skin.  I recalled fond moments from years past.  The birth of my son happened in an October rain, right on the first fall rain.  Xan and I were eagerly planning our marriage during this time, five years ago. We both took our first steps into our careers during the days of November rains.  We laid together in empty rooms of a house we were fixing, the house where we first lived together as a couple, just listening to the rain on the wooden roof.

The sound of the remaining leaves filled my mind, and the sparrows chirped to one another.  And for a moment, just one moment in time, I was at peace with this season.

The Friday Confessional : Always a Passenger

The Friday Confessional is probably well known by now as a very soul baring exercise in writing.  Today, I’d like to talk to about something rather embarrassing for me.

A major milestone in most people lives happens at the tender age of sixteen.  There’s the sweet sixteen, usually accompanied by the awesome responsibility that comes with a person’s first driver’s permit.  And the teenager blossoms into an adult as they take on that adult responsibility and freedom of driving.

I am nearly 30, and I never learned how to drive.

Originally, it wasn’t because of my lack of enthusiasm.  The prospect of the freedom that was associated with driving was intoxicating.  It was all I could ever want, being able to drive.  I could take myself places and not have to rely on anyone else.  It would open up new worlds to me, and allow me to do so many things I had always dreamed of.  I could pick my boyfriend up and see him more than twice a week.  We could go park somewhere and maybe make out for awhile.

My mother doesn’t drive, and my father refused to use his precious vehicle to teach me.  I was crushed.  They claimed they didn’t think I was responsible enough to take on driving.  But, as with everything else, it was an excuse not to allow me to have any kind of breathing room.  They could continue to circle me like vultures for my remaining two years in that house, ever judging and scrutinizing me while I remained under their thumb.

I was stuck for any options to circumvent this decision.  There is a law in Pennsylvania that prohibits teens from teaching other teens how to drive.  Most of my friends were under 18, and those who weren’t didn’t have their own cars at their disposal.  It seemed that I would have to wait indefinitely to gain all of that freedom that I craved so deeply.

Time passed, and most of my friends still remained as pedestrians.  It used to be easy in a city like Pittsburgh to get by without a car.  Most of the places anyone would want to go were accessible via bus.  And taking the bus was infinitely cheaper than owning and maintaining a car.  College came and went without a driver’s license.

Once out of college, I had already developed an alcohol problem.  Driving became less important.  My job was within walking distance, and everything else wasn’t quite as important anymore.  Most of my friends had their own license, and the responsibility of driving seemed to great for a person who was perpetually drunk.  It didn’t matter to me anyway.  I was broke, and there was no way I could possibly afford a vehicle of my own to drive.

More time passed.  I got married, had a kid, and jobs came and went as I settled into family life.  The need for a license started weighing on me, as I was begging for more favors from people with vehicles.  I lived poorly and saved every last penny to buy my very first car.  And eventually, I got it.  I paid outright to avoid financing.  It was a black 2000 Volkswagen Jetta.  It was beautiful and one of those 0 to 60 in ten second cars.  It would have been perfect for street racing, as it was the sport edition.  Of course, that wasn’t the plan.  The plan was to get my license in the spring.

A whole year passed without any attempt on my part to get my license.  The idea started filling me with dread.  How could I possibly drive while so incredibly medicated?  I had just started treatment that year, and I was foggy most of the time.  I couldn’t focus on a task for more than a few minutes at a time.  Driving seemed to be an impossible task that had become far out of my reach.

Then, it happened.  The car that I had paid in full was totalled in an accident with Xan.  I was devastated.  It was my very first car, and we had hardly seen more than a year with it.  I was supposed to learn how to drive with that car.  It was compact and would have been perfect for my needs as a driver.  But, no more.  The car was completely gone.

For awhile, we borrowed my MIL’s car.  I refused to begin learning on that car.  It didn’t matter, because fall was coming.  I was beyond hesitant to start to learn how to drive in inclimate weather.  The car didn’t feel entirely safe, and I was too nervous about the possibility of getting into an accident with it.  It would have been different if it was the Jetta.

That car died too.  It died up on a rack during an inspection, just a few months after we borrowed it.  It turns out that the undercarriage was completely rusted out.  The car was in such bad shape that we didn’t even get charged for the failed inspection.  Instead, the mechanic told Xan to get the car out of there, and get rid of it as fast as he could.

We were at the lot that day.  The problem with the car was that it wasn’t even ours.  There was no possible way we could trade in the car, even with the express permission of the owner.  Instead, we had to eat the entire cost of a down payment. It seemed that there wouldn’t be yet another Christmas in the Stark household.

We drove off of the lot in another dream car, a 2006 Chrysler PT Cruiser.  My driver’s education teacher in high school owned a different years when they were brand new.  I had always admired that car.  It cost the same as the other, lesser cars in the lot.  I’m not a fan of Chevy’s and that’s all they wanted to give us.  But, I didn’t really want to buy another car.  I wanted the Jetta back.  But that was impossible.  It was wrecked beyond repair, with a bent frame and the entire driver’s side crushed in.

Almost another year has passed, and I still haven’t learned how to drive.  This time, it wasn’t for lack of a car.  It wasn’t a person standing in my way.  In fact, Xan has been more than supportive in this endeavor.  It is me standing in my own way.

I still don’t have my permit.  And every time I think about the possibility of getting it, I cringe.  I’m on so many medications, and most of the time, I’m falling asleep in the car anymore.  I’m so nervous that I can’t concentrate.  Even just imagining driving fills me with anxiety.

I’m Lulu, I’m in my late 20’s, and I can’t drive.

Just Snap Out of It

Society has developed some seriously bad attitudes toward mental illness.  It’s no surprise.  We see it attached to the stigma of it.  We’re treated like lepers, as if this were a terribly contagious thing.

Depression is no exception.  Today, a lot of people have been discussing the topic of the “Just Snap Out of It” phenomenon that occurs out there.  Honestly, there is a saying out there about how if a person hasn’t experienced it, then they can never truly know.  A person who hasn’t experienced clinical depression, either in the form of MDD or BP depression can never truly know it’s depth and breadth.  It is an all encompassing monster that claims every last bit of life and any possible joy that can come from it.

Having Bipolar Disorder, I am a person who naturally experiences some sometimes pretty obvious mood swings.  And the attitudes toward it are so completely off.  I have never had a person treat me poorly while I was in a manic episode.  Not one.  Not even when the plainly awful behaviors were showing.  Each person seemed to find it charming, amusing, or interesting.  Even when there were moments where I was so out of control that I was scared out of my wits, not a single person around me seemed to notice that there was something absolutely wrong with it.

No, my energy and spirits were high.  I would act impulsively, and people would take it as spontaneity.  I’d be overly, annoyingly chatty, and rudely interrupting others, but they took it as being outgoing.  Everyone seemed to think that was a sign that I wasn’t depressed anymore.  They seemed to think that it was some kind of miraculous recovery from “being like that”.

People only seem to take notice when I am depressed or mixed, like it’s some kind of disease that I choose to be afflicted with.  And the comments are absolutely endless, because everyone seems to have their own opinion about it.  It’s as if they consider themselves to be the authority on depression, anxiety and sadness in general. I will constantly hear phrases like, “Get over it” and “Get a grip” as if just snapping out of it were an option for me.

Meanwhile, people without mental health diagnoses start flinging clinical terms around, like they had some true application to their fleeting, shallow emotion.  For instance, “Oh, I’m so *bipolar* today”, instead of just saying that they are moody, or women arbitrarily making a comparison between PMS and Bipolar Disorder.   Or “I’ve just been so depressed lately”, to reference a little bit of discontent or sadness.

It’s not cute. It’s not funny. No one with those diagnoses thinks that it’s witty that someone is taking a serious clinical term with so much guilt and stigma that it could bring down a religion, and applying it to their BS, frivolous emotions!

It does everything it can to minimize those conditions.  It puts it in a light that we have some kind of real control over it.  As if it were something that a person can just “snap out of”.  It implies that a person chooses to be disordered.  It also puts a shameful connotation of attention seeking behavior.

Yeah, it’s the life, let me tell you. If I were doing anything for attention, it wouldn’t be this. It would probably be something more hilarious, like plastering myself with an obscenely worded banner and rollerblading through Downtown. Depression isn’t newsworthy, but that sure is.  Or maybe I’d be doing something a little more productive or noteworthy, like finding a cure for cancer.  But no, my depression is just that interesting that I would choose to gain that much needed attention from people I don’t even know or care about.

I have to wonder if the general public has to be so naive that they would actually be jealous over it.  So much emphasis is put on the “just get over it” ideals, as if that were possible. If I could will myself out of this state, don’t you think I would do it already? It would be more logical to think that I want to reclaim my life and be a productive person.  But no, according to others who are ignorant enough of mental illness, I am perfectly content to have disordered behaviors.   Sure, who doesn’t love ignoring their kid because the voices just got too loud? Personally, I love gripping my ears and screaming, “SHUT UP! SHUT UP! SHUT UP!!!!”

And as a result of this blatant ignorance, I am really starting to believe that some are just plain jealous.  Because, they seem to think that those with disorder aren’t being responsible for their emotions and behaviors that result.  I certainly have quarrels with wanting to thrust a sense of selfishness and entitlement out there, because it’s what I have to do to take care of myself and my own in this world.  It’s those same people that shove themselves and their ideals down other people’s throats, only to make them feel bad. Misery loves company, and we’re perfect targets, right?

The point is this.  If a person is out there reading this and getting offended, it’s time to take a step back and think hard.  Is it so fair to be so judgmental?  Isn’t it about time to take a look from another perspective?  Does a person with a congenital disorder choose to be symptomatic?  It would be an entirely different story if I were refusing treatment, but like anyone else, I am keeping my appointments and taking my medication according to doctors orders.  We don’t blame someone for their symptoms when they have a seizure.  Why should this be any different?

Let me assure everyone.  If could have snapped out of this disorder and been a “normal” person, I may have done it, instead of living this ongoing nightmare.

Ethereal Shadows

Anxiety runs rampantly, off of it’s leash, and unchecked.  It envelops me, trapping me in this fully contained, semi-translucent bubble.  The oxygen runs thin and the overabundance of carbon dioxide fogs my mind.  I am suffocating and immobilized, encased in thick, unyielding plastic.  I can see the world through clouded lenses all around me, but I am unable to touch it, to reach it.

The thoughts race faster than the stock cars in my mind, polluting my air within the dome.  “What if…?”  “How can I possibly…?”  “What can’t I…?”  My confidence dissolves in the thick, poisonous soup it creates.  I begin to disappear, becoming thinner within the wash.

And eventually, the cars come to a grinding halt, gears moaning and crunching at the sudden termination of everything and anything.  For a moment, the entire world, the whole existence goes blank, as plain as a clean sheet of paper.  Then, suddenly, I am propelled into pitch darkness, fumbling around for the scattered remnants that are not my own cognition.

In this blackness, there is a certain emptiness abound.  A void of mind and feeling transforms me into an ethereal creature containing the absence of any trace of matter.  I drift aimlessly upon streams of thin air, shivering as currents pass clean through me.

My soul liquifies and pours like a thick, black ribbon into a clear mason jar.  Now, it is preserved like blackberry jam, shifting and wiggling with its gelatinous quality.  My hands caress the glass longingly, for it has become as unreal as I have become.  I may look upon it, however, I may not touch.  It is now a forbidden fruit that will spoil long before I am prepared to reclaim it as my own.

Abysmal sheets of icy rain obscure my vision now.  A thick fog rolls in as dense, leaf bare woods encompass me.  Severed from me, my own emotions are carried back in with the fog, high above my head as it rolls on.  I reach, stretching my entire being high in the air above my head, attempting to get just a little bit closer toward them.  But they are not my own.

Are they?

Indistinguishable.  Everything becomes questionable in this parareality.  Wispy words come out in airless breaths within this vacuum of time and space.  Questions come rolling into reality with no discernable answer.  “Where am I?”  “Who am I?”  “What am I?”  All concepts float away, vibrating with each anxious blink.

Each push of the fog shoves me flat on my back against a frozen, unforgiving, unyielding earth.  Each successive tumble knocks even more wind from my lungs.  I squeeze my eyes shut and resign myself to this fate.  Paralyzed, I am defeated against this awesome force.

Anatomy of a Phobia

Lala at Seasons Change, and so have I reminded me this morning of some very sensitive subject matter that I often overlook.  See, I’ve programmed myself over the years to minimize my fears.  Fears are just another expression of weakness.  Or so I’ve been inadvertently taught throughout the course of my life.  Fears are irrational little demons that have no place in reality.  They are something to be ignored.  Fear is an overreaction and another possible way to be overdramatic about events that occur in life.

Fear is just another excuse not to do something.

There are a million reasons those phrases fail to sit well with me.  First, I am a person that has a complicated relationship with authority.  If fear were allowed to conquer my own free will, then it would become an authority figure.  I would become conflicted against my own self, and come to fear and loathe myself.  I can see the fallacy in the contradictory nature of all of those statements.  Because, I experience it regularly.  And the experience of fear complicates itself and entangles itself into my psyche.

I have phobias, whether I want to admit it or not.  At this point, I would rather come clean than try to diminish these symptoms any further.  It seeks to compound the confusing presentation of these intense fears.  Worse, I can’t readily dismiss fears like I used to.  As life progresses and my experience expands, I’ve come to situations that force a confrontation.  And the effects that the denial and repression produces are intense.

I fear planes and cars crashing into my house.
When I was a child, a plane crashed somewhere near my hometown.  The only reason this event was significant hinged on how it affected my area.  I lived near a fire department, a highway, and two interstates.  It seemed like there were people and sirens all night.  It was a hot summer night, and all of the windows and doors were open.  People had their eyes skyward.  And the thought of a plane falling out of the sky had never crossed my mind before.

In case I didn’t mention recently, I live in Pittsburgh, Pennsylvania.  At the time of 9/11, I lived about ten miles from our local international airport.  And we are the closest city to the crash site of Flight 93 that went down in Sommerset County, a few counties over from us.  That day was similar to the night of the crash from my childhood.  Only this time, it wasn’t an accident.  It was a terrorist attack.

I also lived by an Air force and an Army base.  When all of the planes were grounded, the skies were filled with military planes.  It was like living in a military state.  Other than those planes, the sky was empty.  The winds were unusually quiet.  And my best friend and I laid in our adjacent yards, staring skyward for the threat.

Somehow, throughout the years of being a pedestrian, the definition of “crash” came to include cars.  And Xan always joked with me about how silly it was.

In May 2010, a drunk driver crashed his jeep into the front of my house.  It was the day after Mother’s Day and only five minutes after my husband had left to put our one-and-a-half year old son into the car to come get me from work.  Had it been five minutes earlier, my son would be dead.  The impact to the front of the house sent the sofa into the middle of the room.  The impact would have been enough to serious maim Xan and kill, then 27 lb, Beast.

Since then, I would cringe every single time I would hear a car make an awful noise outside my home.  It is among the dozens of reasons I moved from 511 to 106.  Except, 106 is only a couple of miles from the airport now.  Instead, I cringe at low flying planes, and look skyward to their shiny metal bellies.

I fear enclosed spaces and crowds.
This comes to include any area that could become cramped or would be difficult to maneuver out of. I fear being crushed.  I have dreams about it sometimes.  I’ll go in after Beast in one of those kids tubes, and it will start to collapse on me.  Or, I’ll just get stuck.  And there will always be something threatening happening.

This definition expanded after the Columbine School Shooting.  It came to include areas where I would be “trapped”.  That means classrooms, buses, shopping malls, lecture halls, and unfamiliar cars.  Anywhere where I was not openly permitted to leave, or wasn’t easily escapable became suspect.

This was compounded when I was pregnant with my son.  I was afraid that I was going to be accidentally harmed in a public place by someone careless.  And, it was made even worse when Xan was involved in a serious car accident in June 2011.  People get hurt by the negligence of others all of the time.

I fear having an episode in public.
I know Bipolar Disorder isn’t as episodic as an anxiety disorder.  Maybe I have an anxiety disorder.  I just don’t know, and I’m not qualified to make that determination.  I’m afraid of being overtly symptomatic in public.  I just have this severe anxiety that I am going to have an unrelenting panic attack and do something, for lack of a better word, crazy.  Or that I’ll break down in hysterical tears over something practically benign, like losing my scarf or breaking a pencil.  Or worse, I’ll go out and binge eat to suppress some other urge.

I fear elevators.
Combine my fear of catastrophe, a mild fear of heights, and a severe fear of enclosed spaces, and a torrent of anxiety develops.  That’s what an elevator represents to me.

I have always been afraid of elevators, because the motion doesn’t agree with me.  I don’t like that moment of weightlessness when ascending and I don’t enjoy that feeling of plummeting to doom when descending.  I don’t like the jolts and starts.  And I especially don’t like being knocked off balance.

Compound that fear with actually getting stuck in an elevator.  It was my freshman year in high school, and I was assigned a dorm room on the sixth floor at camp.  We were children, and we were stupid.  The elevator clearly stated that the maximum capacity was 14 people.  Instead, we had closer to twenty, all jammed in that elevator.  When it opened, I could clearly see the floor between the fifth and sixth floors.  We were stuck in midair in a rickety old elevator, where no one could immediately get to us.

From then on, I took the stairs.  I dragged my footlocker and luggage up flights and flights of stairs to avoid any similar occurrence.  Of course, it never happened under their watch again.  But the singular experience was enough to have me fit for stairs and hiking stairwells for the rest of my life.

My doctor’s office is on the third floor of an office.  I can’t tell you how many times I’ve been running late, and I arrive at that check in desk breathless and sweaty.

Then, there are the sillier fears.
The aforementioned are just huge fears that have come true for me.  There are fears that have absolutely no grounds in reality.  For instance, I fear toilet snakes.  I know there is no such thing.  I don’t know if there has ever been an incident of someone getting bitten by a poisonous snake while using the bathroom.  And if there has, don’t tell me.  I don’t want to know.

I fear lightning strikes.

I fear bugs in the bed.  Or just bugs crawling on me in general.

I fear the apocalypse.  Irony of ironies.

I fear being touched by a stranger.  There are a million different reasons why that’s a serious fear that has no grounds.  All my brain knows is that sometimes touch is bad.

Then, there are the more common ones.
I fear judgement.  I fear failure.  I fear unfamiliar social situations.  I fear being alone.  I fear dying alone.  I fear getting hurt and having no one there to help me.  I fear strangers.  I fear germs.

I know that some of these are rational, and these are things that should be reasonably feared.  But most of the time, they strike me, and I’m left with the deer in the headlights feeling.  That is unreasonable.

What are the most common fears out there?  What are the most uncommon?  Which are ones that my mind made up?