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.

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The Friday Confessional : Baby Weight


TRIGGER WARNING : This post contains material that may be a potential trigger for some.  It’s contents include talk of eating disorders and self-injury.  If you are sensitive to this material, please use your discretion before reading.

I am by no means a thin woman.  As a matter of fact, according to my BMI, I am actually slightly in the overweight range.  It’s not really unusual for a person who lives in the good ol’ US-of-A.  Obesity is considered an epidemic in this region of the world.

I have bad body image.  This started as a very young child when the other kids would pick on me for being overweight.  At that point, it wasn’t my fault.  I wasn’t responsible for my diet, and my family had terrible eating habits.  In fact, as I started to notice while my parents were watching my child, they encouraged recreational eating for lack of other engaging activities.  As a result, I ended up a fat, miserable kid.

I remember I stopped eating my lunch at one point.  A lunch aid came over and asked what was wrong.  I recall telling her, “I’m on a diet.”  She looked shocked and appalled.  Now that I’m an adult, it’s completely understandable.  I was eight, and I was confessing that I was unhappy because of my weight.  To her credit, she attempted to explain to me that I had a lot of years to grow into the weight, and it was unhealthy to deprive myself of food.

Essentially, she was trying to talk me out of developing an eating disorder.  Unfortunately, talk is too cheap when you’re eight.

Eventually, people close to me stopped mentioning my weight.  And I continued to grow.  By the time I was in the fifth grade, I was obese.  I was eleven, 4’8”, and weighed approximately what a fourteen year-old 5’1” teenager should have weight in a healthy weight range.  My clothes continued to shrink rapidly, and the only excuse my mother could come up with was that I was just “having a growth spurt”.

It wasn’t lost on my peers or teachers, though.  While I had the brains, I didn’t have the body.  And the outside was all that mattered.  Summer break came, and I was about to enter middle school.  It was at that time that I decided that I would shed my “baby weight”, as people were so eager to call it, and become a slender woman.

That was the summer where it all began.

The real secret is something I’ve hinted at throughout the last year, but could never bring myself to actually come out and say.  Even now, I find myself typing and retyping the sentence that will start to change everything.  It will change how people think of me, and how people treat me.  It will have people worry and watch me like a hawk.  And those are all things that I’ve tried to avoid over the years.

I have undiagnosed disordered eating.

As a child, it developed from recreational eating into comfort eating.  I would gorge myself far beyond bursting, to the point of where it felt like the contents of my stomach were backing up into my throat.  The act of eating was comforting and satisfying.  The sensation of fullness seemed to fill this hole inside of me.  It took away the emptiness that I had tried so hard to fill with accomplishment.  Even for a moment, I was full.  I was whole.

That led to another problem.  Childhood obesity.  And the lack of friends I had resulting from my obesity and the intimidation of my perfectionism and accomplishment created an even bigger hole.  What started out as a small snag in the woven fabric of my life started to unravel into a gaping hole, threatening to tear seam to seam.  Comfort eating turned into binge eating and created a cycle that continually fed into itself.

The summer before middle school, I decided to start dieting.  How absurd – an eleven year old on a diet.  I restricted my food intake to half of what I was eating.  I refused to eat between meals.  I started both biking and running once a day for at least an hour.  When my clothes started to become loose, it only served to encourage all of these behaviors.

I was a child on a mission.  I started only eating half of what I was eating, leaving me eating meals off of saucers.  I added running stairs onto my exercise regimen.  I would spend a half an hour each day running the basement stairs, as to not bother my parents.  My clothes became so loose that I became reduced to wearing my 90lb mother’s clothes.

I had done it.  In fact, I had done so well that most of my peers didn’t recognize me anymore.  Many people started referring to me as “the new girl”, as I didn’t have any friends to correct them.  And much to my surprise, those shallow little girls I had come to despise welcomed me to their clicks with open arms.  I was no longer intimidating or disgusting.

Throughout the years, my weight bounced up and down.  I would binge and then go on an exercise craze.  In my mid-teens, I discovered those ephedra pills that could be found at any gas station.  Friends and I would take handfuls of them and stay up, bouncing off of the walls, for 72 hours at a time.  I remember lying in bed just vibrating, desperately mentally exhausted, but completely wired.

My relationship with my first love, my high school sweetheart, started going south around the time that I was seventeen.  And the binging started once again.  I hated myself for it, and I watched myself grow out of my clothes once again.  I knew he had to have found me repulsive, and I knew he was eyeing other women.  But, it only served to make it worse.

I will never forget this.  I had my eighteenth birthday at my boyfriend’s place.  I was surrounded by many of my friends, and we ordered several pizzas that I paid for.  I watched all of the girls daintily eat one or two slices of pizza, when I realized that I had gorged myself on four.  I looked at their slender bodies with envy.  What a disgusting pig I am!  I thought.  No wonder I’m so fat!

I went to the bathroom and locked the door.  I leaned over and stared into the bowl.  I was about to do something that we all had accused and ridiculed thin cheerleaders for.  It was this, or being doomed to a life of obesity and loneliness.  I extended my index finger and pressed down on the back of my tongue.

The vomit came pouring out like a fountain into the bowl.  The taste was awful, like orange juice mixed with something foul.  But, the sensation was incredible.  I could feel the load lightening, and my stomach shrinking.  I did it again, this time making myself gag harder, almost to the point where I made an audible noise.  It felt like all of the awful feelings were just pouring out from inside of me.  It was almost like cutting, but without any noticeable tell-tale scars.

I purged until there was nothing left but stomach acid.  I sat against the door, breathing heavily and relishing in the hollow feeling in my belly.  There was something so beautiful about feeling that emptiness.  It ached, along with my raw throat, and the bitter aftertaste of vomit in my mouth.

This doesn’t happen regularly.  It only happens when I have a severely awful body image.  My clothes start to get tight, and automatically, my stomach starts to churn, as if it knows what’s about to come.  If I’ve eaten just before a fight with someone, I find myself getting queasy and running for a bathroom.  If I am rejected, I automatically assume it’s because I’m not attractive.  I find myself hell bent on getting back a body I once had.

But even worse is when I do it as a form of self-injury and control.  I binge, feeling the sensation of my belly swelling with all of the emotion I can’t experience.  The contents rise into my throat, without a place left to go.  I excuse myself and wrap myself in an awful embrace with that cold, unforgiving porcelain.  For a moment, just a brief shining moment, I stare into the bowl, trying to talk myself out of it.  There’s no other way.  I lean in, and the deed is done.

And each time, the whooshing of the flush brings shame to my already teary eyes.  I stare at the bloodshot eyes, ringed with raccoon eyes.  My face is red and looks exhausted.  All I can do is take to cleaning up the mess I created.

The Friday Confessional : Romancing Suicide

 

 

Though I confess the things that are most intimate to me, I don’t know if I am accurately painting the picture of the real me.  To everyone here, I am Lulu Stark, the writer, the mother, the wife, and most importantly, the woman who bares herself in the name of mental health and disorder awareness and advocacy.  But, I wanted to put some truths out there.  The uglier side.  The real side.

I only Lulu Stark in the persona.  The one that you read about.  The antihero, the antagonist, protagonist, the victim, the perpetrator, the survivor and occasionally, the hero.

What I don’t talk typically talk about is one of my darkest, sickest secrets of all.

 

Suicide.  I regularly have suicidal thoughts and occasionally ideation.  The little voice goes through the back of my mind, sometimes as an unintelligible whisper and other times as clear as a bell, I want to die.  I want to kill myself.  It would be so easy.  No one would miss me.

I imagine ways it would play out.  I idealize all of the scenarios of suicide.  In a way, it seems I’m under it’s spell.  It seems like the only way out of this torturous world of disorder and dysfunction.  I am more crippled by my illness than I let on.  I feel pathetic in my bones, and I desperately search for my solace in this place of distress and despair.  An endless string of hopeless days and bottomless pits.

I fall deeper, clinging to my last shreds of hope.  I am flirting with suicide, with his silver tongue, soft, familiar caresses, and honey sweet kisses on my neck.

I see a sturdy rope swung around a rafter in my basement, tied with a tidy slipknot instead of an impossible noose.  I stand on a rickety chair, dressed in my Sunday best, leaving a pretty, cold, lifeless corpse behind.  The shell of a woman who never really existed.

I stand with a glass of juice and a bottle’s worth of blue pills in my hand.  I am ready, stripped to nothing but a bathrobe.  Down the hatch, the medication leaves a bitter aftertaste.  I draw myself a hot bath and arm myself with a razor.  And then, I wait.  I wait until I am almost seeing double, and world starts to blue around the edges.  I dig the razor into my wrist and drag it with all of the force I can up to my the bend of my elbow.

Or, I just await death.  I lie in the tub, feeling myself slip away under the surface of the water.  In my mind, I imagine all of the people that would be thankful that I am finally gone.  How in a year or two, I will become a distant memory that only leaves the tiniest pang.  How my sullen face starts to fade from everyone’s mind and any trace of me begins to disappear.  I think of how easy the clean up would be.

Or maybe, I would clean myself up to begin with.  I would be powder fresh in a pretty pastel little girl dress I bought for the occasion.  I would empty all of the contents of my medicine into my stomach, washed down with an entire bottle of vodka.  I would tuck myself into a warm bed, and swaddle myself in blankets.  It would look like sleep at first.  My final sleep.  My resting place.  The only place in my life where I ever felt warm and safe.

 

For the record, I’d never do it.  There is an uglier side to suicide that I’m painfully aware of.  It could possibly be the most selfish act I could ever commit.  The finality of it all is too much for me to even wrap my head around.

My son asks where I went when I am gone for an hour for class.  I imagine his confusion and sadness when he comes to see that his mother will never return. I imagine the possibilities of who would raise him if I were to be gone for good.  He would likely fall into the hands of my own parents, and I would be sentencing him to a similar fate that I experienced.

There would never be enough of an apology for my Xan.  A piece of him would die inside, and he might go mad himself.  There wouldn’t be another out there for him.  He couldn’t possibly recover.  Leaving him to his own devices at work, cutting off communication, it’s too much for him to bear for a few hours.  What if I were to be gone for the rest of his lifetime?

And then there’s the matter of the afterlife.  What comes after death?  Through my Christian upbringing, I fear the day of judgement and the sentencing to an eternity of hell, separated from my friends and family, endlessly tortured in unimaginable ways.  Ways that are beyond my comprehension.

But, what if there is nothing?  What if I sacrificed my life for a world of nothingness?  What if a person just dies and there is nothing behind?  What if I am condemned to walk this Earth as a true ethereal being, and not just the kind I feel as a flesh and blood person?  I stand there and watch as people file in for my funeral.  I see my family overlooking my lifeless body, consumed with grief.  Then, I get to watch my family and friends mourn the loss, as someone irreplaceable that met a tragic and unfair end at my own hand.

Sometimes, I feel as if I am condemned to life.  Sometimes, I feel like I’ve chosen life over the alternatives.  Sometimes, it’s for the sake of my family and friends.  And there are those brief shining moments where I live life as the gift it was meant to be with the promise of tomorrow.

BPD and Me

A post by Angel, concerning Avoidant Personality Disorder, had me thinking again about the possibility of me having Borderline Personality Disorder.  This is a suspicion that has plagued me throughout the course of my treatment within the last year or so.  Instead of going straight to the Borderline Screenings, I went to a personality disorder screening to see the possibilities of what I may be dealing with.

Disorder Rating
Paranoid Personality Disorder: High
Schizoid Personality Disorder: Low
Schizotypal Personality Disorder: Moderate
Antisocial Personality Disorder: Low
Borderline Personality Disorder: Very High
Histrionic Personality Disorder: High
Narcissistic Personality Disorder: High
Avoidant Personality Disorder: High
Dependent Personality Disorder: High
Obsessive-Compulsive Disorder: High
Take the Personality Disorder Test
Personality Disorder Info

I really never imagined that I would be symptomatic of multiple disorders in Axis II.  Since BPD still remained the highest, I decided to take a specific screening.

Results of Your
Borderline Personality Test

You scored a total of 43.
Severe Borderline Personality Disorder Likely
You answered this self-report test in a way that’s consistent with people who have been diagnosed with severe Borderline Personality Disorder. This suggests that these concerns may be an issue for you as well, and something that you should seek out further assistance with this issue from a trained mental health professional immediately. Borderline Personality Disorder is characterized by a pattern of unstable and intense relationships, as well as frantic efforts to avoid abandonment — even if it’s not real.

I thought about the entire year and the instability of my own marriage – the most solid thing I can think of.  I had all of these paranoid delusions that my husband was cheating on me, although in the back of my mind, I knew it was not a possibility.  I sabotaged myself at work with the line of thinking that everyone was against me.  I started severing ties with coworkers and hiding in my classroom.  I had always thought that was characteristic of bipolar psychosis, but now, I’m not so sure.

Using the same site that Angel used, I discovered something kind of shocking:

You may be at risk for developing BPD if:

  • you have a family member who has BPD
  • you felt emotionally unstable or emotionally vulnerable as a child
  • people in your household were impulsive when you were a child
  • you were emotionally abused as a child

And all of those were true.  My mother does not have a confirmed case of Borderline Personality Disorder, but it seems she is symptomatic.  When she was a very young child, she was put into foster care.  She has absolutely no memory of this, and none of her family members will detail what happened.  My mother married her first husband on a whim, because his draft number came up to go to Vietnam.  She had an extremely turbulent relationships with him, and he mostly left her alone all of the time.  That’s how she met and fell in love with my father.

Their marriage isn’t much better.  In private, she has gone on and on about my father’s faults.  They have had a rocky relationships, where I recall them throwing around the word “divorce” probably far more often than they should have.  She binge drinks and sometimes takes too much medication.  Medication that isn’t even hers to begin with.  She is as impulsive as she can be in her restrictive environment and goes through so much emotional turbulence.  But, she will never leave my father, no matter what.

I was an emotionally unstable child, and I wasn’t the one to immediately notice.  My preschool teacher had mentioned to my mother that I needed to “toughen up”.  That one little phrase was enough to spark years of tough love and general emotional abuse and neglect.  It gave them a free pass to call it “good parenting”.  As a result, I developed this need for achievement as a means of recognition.  I was designed to people please.  Regardless, another comment came from a teacher stating, “Doesn’t take constructive criticism”.  And the idea that criticism was encouraged compounded what I was already going through.

Impulsiveness!  My father used to just go drive off in his car without telling my mother where he was going.  He’d be gone for hours, and she’d be a wreck.  One time, he went through the house waving a gun, terrorizing us with suicidal gestures.  Honestly, I can never get that scene out of my head as hard as I could ever try.  My parents have both run their credit into the dirt over impulsive shopping sprees.

Now, here’s where things get tricky.  Friends and family in the past have suggested that I may be suffering from Borderline Personality Disorder.  An ex used those weaknesses against me.  So the presentation is convoluted because my actions are purposefully deceiving.

frantic efforts to avoid real or perceived abandonment

I self-sabotage in this area.  When I perceive abandonment, I start to shut that person out of my life.  I have this funny idealization that person will perceive my own emotional abandonment and come running back.  It’s what my parents and my ex did to me, and I seemed to have picked it up.

I’ll also become more sexual and start having defensive sex or performing certain sexual acts to peak someone’s interest and entice them into staying with me.

I also have this habit of changing everything about myself to appease my partner.  This is an effort to avoid abandonment.  And it’s one that’s been preyed on before.

pattern of unstable and intense interpersonal relationships, characterized by alternating between idealization and devaluation (“love-hate” relationships)

People that are close to me are also subjected to this regularly.  Honestly, this is a major reason why I don’t let people get too close to me.  At first, I idealize someone and pick out the best of their characteristics.  Then, I start to idealize how the relationship with them will go.  Soon, I will become disillusioned at the first sign of trouble.  And it is at that point that I begin to demonize someone.  Everything about them is bad, and I have ever right to be suspicious at their deceptive behavior.  Except, it wasn’t deceptive.  I perceived them to be something that they weren’t and assigned them to the task of living up to my unrealistic expectations.

extreme, persistently unstable self-image and sense of self

I’d like to paraphrase the way I perceive myself.  I have lived a dozen lives, and each time, with every death, I’ve risen like the phoenix out of the ashes.  In my life, I have been a dozen different people and will be dozens more, each with their own birth, life, and death, only to start once more.

I take one aspect of my life and characterize myself through it.  I’ve been a baker, a mother, a wild child, a caretaker, a housewife, a teacher, a crazy woman, a bipolar woman, etc.  And for some reason, I can’t seem to integrate all of those periods of my life into the same entity.  They are just all separate from one another, as if I were living so many different characters in the same skin.

impulsive behavior in at least two areas (such as spending, sex, substance abuse, reckless driving, binge eating)

It is well known that I have a substance abuse problem with alcohol. But, here are a few facts that are the most difficult things for me to admit. I am guilty of day drinking every now and again. It is never when I’m alone with my child, for the record.  I am also guilty of taking too many benzodiazepines to escape reality from time to time.  Yes, I abuse my medication every now and again.  But, it’s not a dependence kind of thing.  I don’t find that it’s necessary, until I get into a frenzy of hysteria that produces so much distress that it’s unbearable.  The drugs quiet my mind.

And the other one is very difficult to admit as well, and I’m not sure if I can spell it out in detail.  I have a difficult relationship with food, dieting, and exercise.  I am guilty of binge eating.  I am also guilty of purging if I am distressed.  Especially if it’s about my weight.

And lastly, I recently made a confession of my sexual exploits in my youth in Promiscuously Yours, in the series The Friday Confessional.  I had multiple reasons for cheating on my ex, which is something I wouldn’t normally do.  I have a better moral compass than that.  Sometimes, I was so distressed that I just wanted to feel some kind of love.  Sometimes, I was trying to prove to myself that I was something special.  And other times, I did it out of spite.  Any which way you look at it, I did it in highly emotional moments.  And I always regretted it later.

recurrent suicidal behavior, gestures, or threats, or recurring acts of self-mutilation (such as cutting or burning oneself)

My cutting has been well documented in the past.  Unless I make a mindful effort not to self-harm, I will engage in the behavior.  I’ve written posts about the whys and wherefores in Why Self-Injurious Behavior?.  It’s complicated.

unstable mood caused by brief but intense episodes of depression, irritability, or anxiety

The mood episodes aren’t brief, so it leads me to believe that I may have a co-morbid diagnosis instead of a misdiagnosis.  However, I’ve always said this, and people have disagreed with me.  The only two constants for me and my disorder are reactivity and irritability.  I was under the impression that everyone with bipolar disorder is reactive and generally irritable most of the time.  Apparently, I was wrong.

I always have this underlying anxiety.  It’s made worse by social interaction, certain phobias I’ve developed, and worst of all, having to make decisions on my own.  It’s difficult for me to take care of my personal affairs, because I am always waiting on another person’s approval.  I get anxious when I make a decision by myself, because I often second guess myself.  I am constantly seeking reassurance about my decisions and guidance from others.

chronic feelings of emptiness

This one is complicated.  I don’t often feel empty.  I often feel lonely or distant.  Sometimes, I feel invisible, rejected, or ignored.  Most of the time, I actually feel too full.  I’m too full of emotion, noise, and stimuli.  I often have several voices and personas that follow me and make commentary on my life.  It’s too much.  But when medicine gets rid of them, though I am relieved by the lack of conflict, I am lonelier.  It feels like a piece of me is absent.

inappropriate and intense anger, or difficulty controlling anger displayed through temper outbursts, physical fights, and/or sarcasm

I recently wrote a post called, “I Want My Yellow Dress” using the analogy of a little girl in a movie in the most epic temper tantrum ever known to describe my own inner child.  My anger is often out of proportion for a given situation.  I have a bad temper, and I know it.  It’s something I’ve tried to deny for a long time.

In Love the Way You Lie, I described a mutually abusive relationship.  It was the only time in my life I have ever lashed out physically, but the point is that I did.  Whether a person could classify that as self-defense is questionable.  There were times I did it because I wanted to inflict pain on him.  I felt like he needed to know my own pain.

stress-related paranoia that passes fairly quickly and/or severe dissociative symptoms— feeling disconnected from one’s self, as if one is an observer of one’s own actions

I’ve written scores of blog posts and theories about this.  I am prone to paranoia, and I experience it rather frequently.  With my recent medication change, I can say that I usually only go through it once weekly.  Prior to the medication change, it was much more frequent than that.

The dissociative symptoms have been documented in Conscious, Subconscious, and Extraconscious, where I described a theory of multiple personas rather than full blown personalities residing in a place between the conscious and subconscious mind.  It’s complicated to get into, but it’s worth a read honestly.  It would give you a better idea of what I’m talking about in terms of dissociative symptoms.

When I’m doing something out of character, I often feel like I’m not the one who is doing it.  I feel like I’m trapped inside myself, or even completely outside of my own body, as a helpless observer.  When everything is said and done, sometimes I don’t quite remember the details of what happened.

It’s something I’m going to have to talk to my doctor about, because as I get older, it seems to get worse, rather than better.  Sure, I am not self-injuring in the sense that I’m not cutting.  But, I am still engaging in impulsive behaviors, and I can’t tolerate distress or disappointment.  My anger is out of control most of the time.  And that’s not when I feel too doped up to do anything.  Sometimes, I have symptoms regardless of the medication.  When I relapse, it’s usually very bad, and feels like it’s worse than the one prior.  I don’t just have a blip of an episode, but a full blown, complicated one.

With or Without You : 30 Days of Truth

Day 15 : Something or someone you couldn’t live without, because you’ve tried living without it.

Most people would prefer to choose a certain special someone or an object to contain all of their affections.  Though my relationship with this is troubled, I have found it to be impossible to live without it.  Even if it’s so hard to live with it.

Medication.

I have made the attempt several times in my life to live without psychiatric medication.  My first was a psychiatric evaluation when I was thirteen, and I refused treatment.  What thirteen year old has the intense desire for repeated therapy visits and pesky medicine?  As a direct result, my symptoms progressed, and I wound up my own cutting board.  When it became concerning, no one was willing to take me back for actual treatment.  Instead, I unnecessarily suffered until I humiliatingly revealed myself and my wounds to an outsider.

The next time was in my late teens.  After being medicated for nearly five years with no result, I was ready to give up on $60 co-pays for a medication that just gave me heroin-like withdrawal symptoms when I forgot to take it.  (That was also the first time I became strongly inclined to start carrying medication on me in clever, cute containers).  I spent a gratuitous amount of time on weekends in a different county, an hour away from my home.  The bus services were shoddy at best, and if I forgot to take my medicine on Friday, then by Sunday morning, I was violently shaking and vomiting in front of my relatively new boyfriend.

This new boyfriend, Avi, convinced me that there was absolutely nothing wrong with me.  The medication was doing more damage to me than good.  It was a waste of time and money.  Psychiatry was a joke and a con for cash.  It would be in my best interest to get off of the medication.

The funniest thing about that was the fact that I became irreconcilably depressed when I weaned myself from the Lexapro, an SSRI.  I required way more than my typical six hours of sleep.  I could no longer party until dawn.  And mostly, my only desire was to scream and cry my eyes out.  After you’ve been hypomanic for so many years, having a crash like that was epic.  Coincidentally, it coincided with the very first cliff fall in our torturous relationship.

And resulting in that choice, I developed functional alcoholism prior to the legal drinking age in the United States.  It took several abusers, victimization, abject poverty, and becoming an abuser to take me down into the depths of a bottle.

I found that I had even given up on self-medication.  When Xan and I got together, it became obvious that he suspected I suffered from addiction.  Though our relationship was certainly not new, our courtship was brand new.  In order to not put him off, and make a show of my own self-control, I slowly ditched the bottle.  I was so addicted that I found I had to be intoxicated to make love to him.  At least a little.

A few years later, I started treatment.  I had managed to remain sober, however, I had completely lost control of myself.  Several months into treatment, I ran into every medicated person’s greatest fear.  My medical coverage was eliminated.  Every pharmacy reported the same thing; Lamictal costs a fortune, and if I can’t afford COBRA, then I sure as hell cannot pay for it from pocket.  I found myself soliciting every pharmacy within a 10 mile radius for assistance.  Finally, one came through for me.  But, not before I suffered cruel withdrawal symptoms.

A similar withdrawal happened over a holiday.  I was unable to see my Pdoc before Christmas, and he had taken vacation through the New Year.  The office had a policy not to call in medications, so I had to make an appointment to go in.  Catch 22.  For four days, I laid there writhing in bed.  Xan took charge, and I had a refill that same day.

The very last time was one of my own poor choices.  That is exactly what mania does – it gets your hooks into you and tells you dirty little lies.  I had decided to attempt to wean myself from medication slowly so that I could prepare to attempt pregnancy.  I did so alone.  Instead of consulting a doctor, I went ahead.  And instead of getting off of medications, I had psychotic breaks the likes of which I have never been remotely acquainted with.  The result was more medication and a lesser likelihood of having a second child.

I have been without by force, by accident, by coercion, and of my own volition.  Like it or not, I cannot live without medication.

Control, or Lack Thereof : 30 Days of Truth

Day 12 : Something you never get compliments on.

One of my more recent posts eluded to a crisis in my life.  I haven’t revealed it yet, because in all truth, I am rather ashamed of some of the realities of my life.  In personal writing lately, a rambling piece entitled “Write it Out, Right it Out“, I went on say:

I’ve always been caught in my own world of the mindf***, you know? And when I’m drunk, I am more susceptible to mindf***ery. I don’t like it. I start to lose grasp on my reality, and sometimes it disappears completely – my grasp, that is.

I have made references to my alcoholism in the past, but never with much detail or emphasis.  I neglected to mention that alcoholism is a real part of my present, mainly because I didn’t consider recreational drinking to fall under that category.  I was sorely mistaken.  I wrote to a friend:

Somewhere along the way, I stopped taking substance abuse seriously, like it wasn’t a fact in my life. I’m going to guess that mania had a little to do with it. Like I was above it all because I had gotten away with it.

And another in the same piece, “Write it Out, Right it Out”:

I don’t think I actually believed myself when I have described the seriousness of my alcoholism in my past. Or maybe I thought that it was somehow different, because this is a different situation. Or maybe I thought I was just too young and immature to handle myself.

The fact of the matter is this.  I have been suffering from terrible alcoholism from the age of 19.  At the age of 17, I took up drinking as a recreational activity.  When life events sent me into a tailspin, I spent the last six months of my 18th year in a state of perpetual intoxication.  By the time I was 19, alcohol was a regular fixture in my life, and was a part of every recreational activity.  Finally, it progressed the point of functional alcoholism by the time I was 21.  I described it to a friend as:

Except, I know that there was two years that I spent drunk every single night. I made excuses, like friends and parties, but I would drink by myself. I remember there were nights I’d drink until 4am, and have my boss call me at 6:30am to ask where the hell I was.

During the two years, I had a solid schedule. Wake up at 2pm, leave for work at 2:30pm, work three to nine, drink and eat nine thirty to four or six in the morning, and do it again. I had even devised strategies to avoid vicious hangovers and physical withdrawal. Occasionally, I would venture out with a bottle in my purse, just in case there wasn’t any alcohol where I was going.

Since my son was born, there have only been a handful of what I consider to be benders, which were periods of time where I would invent a reason to have friends over for drinks.  I never intended on getting wasted, and I usually didn’t.  But, there were occasions.  Some relatively benign, ending with me waking up with a vicious hangover and swearing off alcohol entirely for awhile.  Others, they ended disastrously with an altercation, and I would find myself resolving the situation by dumping all of the booze down the drain, with a certain satisfaction at my self-restraint and determination.

Here’s the truth.  I never get complimented on my resolve.  Because, everyone knows that I will always go back to the same old, same old.  No matter how much I appear to change.

I am not always forthcoming about my weaknesses, especially the ones that spark shame.  I am embarrassed by my lack of self-control, especially in matters that are extremely frowned upon.  There are a lot of bad character traits that I can identify, and openly and honestly admit to.  However, lack of self-control is not one of them.  I’ve never considered myself as impulsive, and people often view it as immature and juvenile.  I have always considered myself to be mature and responsible, with certain exceptions, like during college, because impulsive actions and lack of restraint were commonplace, and socially accepted.

Many can argue that impulsivity is not necessarily a character trait of mine, rather, a feature of Bipolar Disorder.  Maybe that is true, because there really was a brief period in my childhood that I recall being very responsible, consistent, and mindful.  And yet, there are still incidents that I recall as being not well thought out before execution.  A condition of childhood?  Maybe.  Facet of personality or symptom of psychological disorder, it stands as probably the weakest trait I have.