Bipolar 2 From Inside and Out

Posts tagged ‘psychotropic drugs’

The Spike

It was The Year of Living With Rex, and for me that meant dangerously. I was undiagnosed and unmedicated, except for wine. I had already been through an episode of cutting. I was clueless and stubborn, isolated and emotionally abused. Tired to my soul and trying to claw my way through my last year of college and a relationship that has affected me to this day.

Then the pain started. Without warning, I would feel a railroad spike being driven through my right temple. It was blinding, all-consuming, and lasted for as much as 30 minutes straight, sometimes. If I was lucky, it was only a few seconds, but I was seldom lucky.

I didn’t know anything that would make it better. All I could do was lie down and weep until it went away.

As this continued, the fear grew in me that I had something dire, like a brain tumor. In addition to my major depressive episode, I was living with massive anxiety.

I don’t know how I made it through my senior year. I don’t know how I made it through the train wreck I was living.

But here’s how I made it through the railroad spike.

Actually, it was kind of amusing, if you weren’t me and it wasn’t happening to you. I went to a doctor, a neurologist, who took one look at me and said,”I can give you any test you want, but I’ll tell you what it is right now. Your jaw is crooked.”

It was Temporomandibular Joint (TMJ) syndrome. And this was before it got trendy and over-diagnosed, the way way gluten sensitivity is now.

My jaw was indeed as crooked as could be. When the doctor put his fingertips on my jaw and asked me to open my mouth, we could both feel it slipping sideways. I’ve been told it feels like my jaw is going to fall off in the doctor’s hands. It made clicking and cracking noises that I had somehow never noticed, and occasionally seemed to get stuck briefly.

How did this explain the railroad spike? When I was anxious, my jaw muscles would clench – and since my jaw was crooked, they would tighten up unevenly. Causing much pain.

“What can you do for it?” I asked.

“We could break your jaw and put it back together, but there’s no guarantee that would work,” he said. (This was in the ’70s. I believe treatments have improved since then.)

While I contemplated whether I really wanted to have a surgically broken jaw (I did not), he gave me a prescription to calm my anxiety so the muscles wouldn’t tighten up and trigger the pain spasms.

Good ol’ Valium.

Now I was officially medicated with benzos and self-medicated with wine. It did take down the anxiety, but plunged me even further into the depression. And I was still living with academic pressure, isolation, no psychiatric diagnosis. And Rex.

I finished up the year, grabbed my diploma, and lit out for my home state as fast as I possibly could. Rex threatened to send the police after me if I took my things while he wasn’t home to supervise and prevent theft of any of his goods. Fine, I thought. Just let him try. I was across two state lines before he got home from work. No, geographic cures don’t work, but sometimes retreating to a safer place can help.

So, all in all, a truly rotten experience. But did I have a psychiatric problem? After all, a crooked jaw is a decidedly, visibly, diagnosably physical ailment.

Of course I did. The crooked jaw was just one component of my condition. The anxiety was another –  a big, huge, whopping one. After all, I’d had a crooked jaw my entire life, and it never sent me railroad spikes until that year. And the depression made it all harder to see and to get away from.

If you ever needed proof the mind and the body are so intertwined that you can hardly tell one from the other, there it is. Physical problem + psychological problem = pain, of both sorts. Good luck trying to sort the two out. And medicating one without making the other worse.

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The Quest for a Psychiatrist

I have been seeing Dr. R. for eight years. He helped me through my major meltdown and skillfully, gradually mixed the cocktail of medications that would get me and keep me functioning at an acceptable, livable level. He got me through my near-brush with ECT (although he also suggested it).

Dr. R. is moving to another state. He sent all his clients a letter listing half a dozen or so local psychiatrists he could recommend, though he didn’t know if they were accepting new patients or what insurance plans they took. This week was my last appointment with him.

I looked at the inch-thick file he was holding. “I was really messed up back then,” I said.

“Yep,” he replied.

I left with a hearty handshake, good luck wishes, a paper stating my diagnosis (bipolar disorder, anxiety disorder – I guess there was no insurance code for bipolar 2) and six months of refills on my prescriptions. That’s how long I have to find a new psychiatrist.

So where will my inch-thick file end up next? That’s a good question.

I’ve written before about finding a psychotherapist (http://wp.me/p4e9Hv-1m), but oh, I hate the process of finding and breaking in a new shrink.

At least this time I probably won’t have to go through the whole Reader’s Digest Condensed Version of my screwed-up life, since what I really need at this point is someone who will prescribe and monitor my meds, though it will also be nice to have someone standing by in case of another major meltdown, should I have one.

My first avenue of exploration is whether my primary care physician will prescribe my psychotropics, so I can continue with just a psychotherapist. Dr. R. says that most GPs would shy away from the somewhat lengthy list of meds, but every time I see Dr. S. I update him on what meds I am taking, and I always mention the psychotropics, which have mostly been the same for years.

I have an appointment to see Dr. S. next month and sent a query about the prescription issue (his office has a robust online presence), so with luck, I may have a solution before Halloween.

My next step would be to start with the list that Dr. R. provided. Only one of the offices is at all close to me and I’ll likely start there. Does the doctor accept new patients? Does the practice take my insurance? What’s the charge if they don’t?

I’ll also need to contact my insurance provider for a list of local psychiatrists who do take that insurance, but with that I’ll be flying blind. Dr. R.’s recommendations are people he knows, and knows are good.

I hope they’re as good as Dr. R.

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mental health

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New Hope for Mental Illness

Did you hear the news?

Bullying, inflammation, anger, low self-esteem, abuse, biochemicals, unsettled gender identity, cat parasites, and anything bad causes depression/bipolar disorder/PTSD. (Double-jointedness, too, except I don’t know if that’s bad or not.)

But don’t worry. Reading, happy memories, cat videos, a new vaccine, or Tylenol can help!

Science reporting these days is confusing, deceptive, and sometimes just plain wrong. Perhaps science reporters don’t mean to mislead, but that’s exactly what they do. Among the problems are publishing demands, lack of knowledge, logical fallacies, and the difference between correlation and causation.

Let me explain.

Publishers demand big, catchy headlines, and they prefer “New Hope for Bipolar on Your Grocer’s Shelf” to “Experiments on Genes and Diseases Continue.” Add to that the fact that editorial budgets have been slashed and personnel shuffled around so much that todays’s “science reporter” may have been last month’s “political correspondent” – and trained only in basic journalism, if that.

Science is complicated and difficult to understand, unless you’ve got special training. Even then, your expertise is likely to be only in one area – the microbiology of prostate cancer in mice, for example. And most people’s understanding of how scientific research works is, well, not understanding so much as knowing that DNA is somehow like a fingerprint.

Here’s a website with videos that tackle the subject quite nicely. My personal favorite is the one about animal trials in research, which explains (among other things) why my father, who had bone cancer, always said he was tired of being compared to a white rat.

http://www.vocativ.com/culture/junk-science/

Another problem is argument by analogy, which appears more in opinion pieces than in stories labeled as science. But here’s a sample, damning research on psychotropic drugs, written by Kelly Brogan, MD, ABIHM (American Board of Integrative Holistic Medicine).

The most applicable analogy is that of the woman with social phobia who finds that drinking two cocktails eases her symptoms. One could imagine how, in a 6 week randomized trial, this “treatment” could be found efficacious and recommended for daily use and even prevention of symptoms. How her withdrawal symptoms after 10 years of daily compliance could lead those around her to believe that she “needed” the alcohol to correct an imbalance. This analogy is all too close to the truth.

Well, no it’s not, for a number of reasons. Analogies always break down after a while, some sooner than others. For example, that hypothetical six-week trial would be longer than six weeks, come only after years of animal studies (including ones that focused on unwanted side effects like, I don’t know, hangovers or liver damage). The trial would have included control groups, placebos, and other research protocols. The ten-year “withdrawal” effect wouldn’t show up in six weeks; people who drink only two drinks per day are not generally considered alcoholics or go into withdrawal (indeed they may be drinking wine for heart health).

(See http://www.madinamerica.com/2014/12/depression-serotonin/)

And so forth. Having two drinks per day is not analogous to taking a medication for social anxiety disorder. It’s associating the disliked thing (psychotropic meds) with a thing known to be bad (alcoholism) and damning by association.

Here’s another flaw: the principle that “correlation does not equal causation.” The classic example comes from the 1950s, when it was claimed that rock and roll music would lead to teenage pregnancies. It’s true that some teenagers who listened to rock and roll became pregnant (correlation). But some didn’t. And some teenagers who listened to country or jazz became pregnant. And I think by now we know what really causes pregnancy (causation).

This problem is illustrated by an article, “Scientists: The ‘Tortured Artist’ Is a Real Thing.”
The first thing to notice is that the headline is misleading, or possibly completely untrue. The article explains a study that supposedly shows that “creative genius and mental disorders are connected at a genetic level,” then goes on to debunk it:

“Any particular set of genes is only going to explain a very small part of variation in any psychological trait,” says Scott Barry Kaufman, a psychologist at the University of Pennsylvania. Indeed, the variants in the new study have a tiny, miniscule impact on creativity – less than 1 percent.

The rest of the article waffles back and forth and concludes inconclusively. Are creativity and “madness” linked somehow? Possibly. Does one cause the other? We don’t know, but there are a lot of theories. There are lots of other possible factors. Without the headline, would anyone read that? How do you define “creativity,” anyway?

(See http://mentalfloss.com/article/64852/scientists-tortured-artist-real-thing).

Here’s a selection of recent articles that purport to have some relevance to mental illness or mental health.

Can Reading Make You Happier?
Answer: Bibliotherapy helps some people, possibly because of changes in the brain.
(http://www.newyorker.com/culture/cultural-comment/can-reading-make-you-happier?)

Artificial Recreation Of Happy Memories May Become The Next Big Weapon Against Depression
Thesis: “Urging a depressed person to stay positive by remembering the good things in life is unlikely to be helpful advice. That is because depression blocks access to happy memories. But what if we could somehow artificially recreate such memories to allow for some more positive thinking? A study suggests that this is indeed possible – at least in rats….However, more research will be necessary to obtain a clearer picture of how this might work in humans.”
(Again with the rats.)
(http://www.iflscience.com/health-and-medicine/artificial-recreation-happy-memories-may-become-next-big-weapon-against)

Science Shows that Watching Cat Videos is Good for You
The article, which says “research suggests that the pleasure you derive from watching cat videos can often outweigh the guilt of procrastination,” is largely tongue-in-cheek, but that headline is a grabber. Headlines that use “waffle words” like may, can, might, possibly, someday, appears to usually indicate a story that says nothing significant. They build up hope, but if a study comes along that disproves the theory, it will never be reported.
(http://www.iflscience.com/environment/science-shows-watching-cat-videos-good-you)

Researchers Are Developing A Vaccine For Post-Traumatic Stress Disorder
It begins: “New studies are suggesting a link between the immune system and the way the body reacts to stress. Research with rodents are raising hopes that one day, tweaking a person’s immune system could be a way to treat or even prevent conditions like PTSD, Nature reports.” How many warning signs can you spot there?
(http://www.iflscience.com/health-and-medicine/vaccine-help-ptsd)

Double-Jointedness Is Linked to Anxiety
One of my favorites. Correlation/causation much?
(http://mentalfloss.com/article/65333/double-jointedness-linked-anxiety)

Your pain reliever may also be diminishing your joy
Actually it says that acetaminophen blunts both positive and negative emotions. And, it adds, “this study offers support to a relatively new theory that says that common factors may influence how sensitive we are to both the bad as well as the good things in life.” Gee, who would have guessed?
(https://news.osu.edu/news/2015/04/13/emotion-reliever/)

Is Depression a Mental or Physical Illness? Unravelling the Inflammation Hypothesis
This is actually a good article. The headline question is a valid and interesting one, and the author states, “But while there may be a connection between inflammation and depression, one doesn’t necessarily lead to the other. So it’s too simplistic to say depression is a physical, rather than a psychiatric, illness.” Hooray for correlation/causation!
(http://www.iflscience.com/health-and-medicine/depression-mental-or-physical-illness-unravelling-inflammation-hypothesis)

What does all this reporting prove? Almost nothing. Except “let the reader beware.”

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We’ve Got Demons in Our Heads

I posted this just after the Charleston shootings, but it needs saying again.

The media don’t say it in so many words, but that’s what they mean when they talk about “mental illness” after a tragedy, especially one that involves gun violence and mass murder.

Demons are responsible. And those demons are the mentally ill (and/or) their medications (or lack of medications). Any way you look at it, we are the demons.

Here’s one of my favorite examples lately:

“It seems to me, again without having all the details about this, that these individuals have been medicated and there may be a real issue in this country from the standpoint of these drugs and how they’re used.”

This was from Rick Perry, Daily Kos reminds us, “the fellow who destroyed his last presidential bid after a bizarre debate performance that he later blamed on prescription painkillers he had taken beforehand.”

(Don’t you love that part about speaking without having the details?)

And this, from Mike Adams, who calls himself “The Health Ranger” and Editor of NaturalNews.com:

The headline is “Every mass shooting over last 20 years has one thing in common… and it’s not guns.” The article is actually a reprint of “an important article written by Dan Roberts from AmmoLand.com.”

(NaturalNews sounds maybe okay, but when the source is AmmoLand, you’ve got to wonder about bias.)

Here goes:

“The overwhelming evidence points to the signal [sic] largest common factor in all of these incidents is the fact that all of the perpetrators were either actively taking powerful psychotropic drugs or had been at some point in the immediate past before they committed their crimes.”

Then follows a list of people, crimes, and drug names. The list was compiled and published to Facebook by “John Noveske, founder and owner of Noveske Rifleworks just days before he was mysteriously killed in a single car accident.”

(Again note the source and possible bias, plus the hint of conspiracy theory. Gotta love it.)

Want something more mainstream? How about Newsweek?

“Charleston Massacre: Mental Illness Common Thread for Mass Shootings,” by Matthew Lysiak:

“…. If history is any indication, the shooter most likely has a history of severe mental health issues that have either gone untreated or undiagnosed.”

He then provides a list of crimes and psychiatric diagnoses with a number of the same instances as the AmmoLand account, though not a listing of medications.

The author goes on to say that the “rise [in mass shootings] correlates directly with the closure of the mental health institutions in 1969, according to mental health experts.”

(Correlates with – not caused – please note. That’s important. I’ll have more to say about that, probably next week.)

Lysiak goes on to say that the requirements for civil commitment (read: involuntary) are too loose. He quotes Liza Gold, a forensic psychiatrist in Arlington, Virginia: “The commitment requirement needs to be less strict. Today it currently requires both mental illness and dangerousness to have someone committed. I think we need to focus more on the dangerousness and keep these people from getting guns.”

If that’s so, we should be worried more about “sane” people such as abusive partners with histories of violence and restraining orders than about the mentally disordered, shouldn’t we? Comments revealing that “most people who commit acts of violence don’t exhibit signs of mental illness, and most people who are mentally ill are not violent” are buried near the end of the article.

Fortunately, not all the media are demonizing the mentally ill, though the dissent doesn’t seem to be coming from the major media. Slate and Salon have published articles that question the automatic connection.

The article on Slate, by Anne Skomorowsky, is long, and refers to the Germanwings airplane deaths, but it’s thoughtful reading and well worth the time.

“Because Germanwings pilot Andreas Lubitz killed himself when he purposefully drove a plane carrying 149 other people into a mountain in the Alps, there has been an assumption that he suffered from “depression” — an assumption strengthened by the discovery of antidepressants in his home and reports that he had been treated in psychiatry and neurology clinics.” She adds, “Lubitz did not die quietly at home. He maliciously engineered a spectacular plane crash and killed 150 people. Suicidal thoughts can be a hallmark of depression, but mass murder is another beast entirely.”

And the take-away: “Many patients and other interested parties are rightly concerned that Lubitz’s murderous behavior will further stigmatize the mentally ill.”

Salon’s Arthur Chu talked about the more recent Charleston, SC, shootings and other incidents in “It’s not about mental illness: The big lie that always follows mass shootings by white males.”

“I get really really tired of hearing the phrase ‘mental illness’ thrown around as a way to avoid saying other terms like ‘toxic masculinity,’ ‘white supremacy,’ ‘misogyny’ or ‘racism.’

“’The real issue is mental illness’ is a goddamn cop-out. I almost never hear it from actual mental health professionals, or advocates working in the mental health sphere….Seeking medical help for depression or anxiety is apparently stronger evidence of violent tendencies than going out and purchasing a weapon….Doing the former is something we’re OK with stigmatizing but not the latter.”

I’ll let that be the last word, fellow demons. Until the next time, that is. Until the next time.

Correction: The Skomorowsky article appeared on Slate, not Business Insider, as originally stated. I have fixed the text and regret the error.

Here are the references for the articles cited, in order:

http://www.dailykos.com/story/2015/06/19/1394713/-Rick-Perry-says-guns-aren-t-to-blame-for-Charleston-accident-it-was-prescription-drugs

http://www.naturalnews.com/039752_mass_shootings_psychiatric_drugs_antidepressants.html

http://www.newsweek.com/charleston-massacre-mental-illness-common-thread-mass-shootings-344789

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/germanwings_co_pilot_mental_illness_suicide_is_linked_to_depression_but.html

http://www.salon.com/2015/06/18/its_not_about_mental_illness_the_big_lie_that_always_follows_mass_shootings_by_white_males/

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Abilify: The Next Chapter

I’ve been taking Abilify as an add-on to my other psychotropics for about six months now, and I have some pieces of good news to share.

Good news #1: The generic (aripiprazole) is now available! There was a slight delay between the time the FDA gave approval for the generic (April) and the time it went on sale. But now it has arrived in drugstores. (I understand that the same company makes both the brand name and the generic, which strikes me as goofy, but then what do I know about drug marketing?)

Good news #2: Between my insurance and my pharmacy, I now have to pay only $15/month for the generic. The brand-name Abilify was $800 without insurance and $125 with. My insurance is not cheap, though it is still less than the cost of brand-name Abilify. When you add in all my other prescriptions and doctor visits and tests and such – plus all my husband’s drugs and other medical expenses, the insurance suddenly doesn’t seem so pricey. (I got this insurance through the Affordable Care Act, and I hope the Supreme Court doesn’t screw it up for me.)

Good news #3: Despite my tiny dosage (2 mg.) I have noticed significant effects. After six months on the drug, I have more energy, better focus and concentration, and fewer down/useless days (unless I overdo and run out of spoons). (See http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/ if you don’t know what I mean by that.)

I’ve been doing major housecleaning/sorting, going out – actually outside the house – to run errands other than my shrink appointments, and I even went to a party – a reunion of people I used to work with. I wore my new skirt, navigated the social milieu successfully, and stayed an hour and a half. (The next day was one of my no-spoons days, though.)

This is only the third time in my life that I’ve noticed a significant effect from taking a new prescription. The first was Prozac (fluoxetine), which felt like looking at a color television after years of black-and-white. With static. Showing only commercials. The second was Lamictal (lamotrigine), which felt like a switch flipping and turning on my ability to think rationally. And now there’s Abilify.

Whatever side effects I may have, I’m willing to live with. (Unless I get the tardive dyskinesia. That would be a deal-breaker.) This feels like real living and I’m happy about it. I don’t think this is hypomania, either. I think I’m supposed to feel this way. I’m going to run with it.

Of course this isn’t the end of bipolar disorder for me, or the end of this blog. I still have plenty to say about my experiences with bipolar depression, mental health in general, and particularly mental health in the media and society.

Sorry if I sound sappy, but it’s good to be alive and functioning!

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Crazy Pills

Once upon a time in the land of Jublia lived a kind and powerful queen named Lunesta. One day the dragon Cialis and the evil sorceress Humira attacked the castle, but Jublia was saved by Lunesta and her faithful dog Boniva.

And the peasants rejoiced.

Honestly! The names that pharmaceutical companies give their drugs these days! It’s bad enough that the drugs have a list of side effects longer than the symptoms they’re supposed to cure. Not to mention the drugs where the side effects are the same symptoms they are supposed to cure, or the ones where the side effects are considerably worse than the condition they’re being prescribed for.

My favorite has always been, may cause death (excuse me, “increases risk of death”). That has to be the ultimate side effect. You’ll be dead, but your toenails will look great for the funeral. Leave instructions that include sandals.

I made a list of all the drugs that I’ve been prescribed in my pursuit of something resembling sanity. It’s quite long. I’ve tried almost every class of drugs there is – tricyclics, atypical, SSRIs, anti-anxiety drugs, and hypnotics – in various combinations and assorted doses, and even for off-label uses. (TIL that Abilify can be classed as an “atypical atypical,” which makes me feel a certain kinship with it.)

The only ones I know I haven’t taken are lithium and the MAOI inhibitors. which is a good thing, because I do so like red wine and cheese.

Here’s the list, as nearly as I can remember:
Abilify
buproprion
Desyrel
Effexor
Inderal
Lamictal
Lexapro
desipramine
Prozac
Sinequan
Tofranil
Topamax
Wellbutrin
Zoloft
Ativan
BuSpar
Ambien
Valium

I may have missed a few, what with the brand names and generics, the decades over which all this occurred, the memory deficits, and the ones I took for only a month or two before the side effects became too heinous.

The side effects I’ve encountered along the way include:
dry mouth
memory loss
nightmares
agitation
lethargy
weight gain

Not all at the same time, of course, thank heavens. Right now I seem to have dry mouth, residual memory loss, and weight gain. Given the alternatives, I can live with these. More or less. (That is to say, I have to.) The memories, I understand, are not coming back. I just hope I don’t lose any more, especially ones of the hot-n-juicy variety.

The side effects I haven’t suffered include:
death (obviously)
fatal skin rash (Stevens-Johnson Syndrome, which I wrote bout a while back: https://bipolarjan.wordpress.com/2014/03/07/saving-face-or…-die-from-that/)
tardive dyskinesia

I hope the drug regimen has settled down for a while. I must admit that I don’t follow the instructions to the letter. They’re simply too overwhelming: Take this one on a full stomach, this on an empty stomach, another with milk or never with grapefruit juice; something else at bedtime or half an hour before bedtime, or with the noon meal. And don’t forget the non-psychotropics (cholesterol, blood pressure, etc.), or the vitamin, fiber, and calcium pills my GP prescribes or recommends. Well, and the OTC Benadryl, Tylenol, and Immodium, as needed.

(Yes, I did once look up all my meds in a drug interaction database. Every one interacts with every other one. Maybe that’s one reason mixing an effective cocktail has been such a crapshoot.)

I knew a woman who took so many different drugs for her variety of illnesses and conditions that she had a kitchen timer that she continually set and reset every time she had to take a dose of something. Her meds were more precise than mine, though. If she screwed it up, the consequences would be dire. Her side effects did include death.

The regimen I’ve settled on is this: one set of pills when I wake up (whenever that is) and one set at 11:00 p.m. I eat whenever I’m hungry, and I don’t like grapefruit juice anyway. Anything more complicated than that I can’t be sure of remembering. It’s still complex, what with the only-in-the-morning pills, the only-at-night pills, and the take-twice-a-day things.

I have little tricks to help me remember the routine – daytime-only pills in a plastic bag, nighttime-only on the lamp base, twice a day on the tea cart. Turn the vitamin bottle upside down after taking morning pills. I suppose I should get one of those daily pill caddy things, but they never seem to have enough, or big enough, compartments.

Is this routine crazy? You should see me without the pills.

Well, no, you shouldn’t.

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Mind Like a Steel Trap

Rusty. Unhinged. Not really good for trapping things.

Especially memories.

That’s not quite true. I have that uncanny ability that all depressed people seem to have to remember every stupid, clumsy, embarrassing thing I’ve ever done, as well as every trauma. It’s like a mental DVD that stores them up, then plays them at random moments. Or maybe not so random. Maybe just when I think I’m doing okay.

The memories can be as traumatic as the time other children threw rocks at me or as trivial as the time one person asked for a glass of water and I gave it to someone else.

Unfortunately, the recording feature only works for bad memories. A lot of the good ones are MIA. I don’t remember huge chunks of my childhood, except as stories that family members have told me. I don’t really know if the memories are mine or theirs. And I’m scared to compare notes.

My theory about these childhood memory deficits – and to tell the truth, all the way through my teens and early twenties – is that when you are profoundly depressed, memories don’t imprint the way they’re supposed to. Whatever synapses and neurochemicals are involved in memory are out of whack. I’m also afraid to do the simple Googling required to find out whether this is even a plausible theory. If it’s not, I don’t think I want to know. I have an explanation that makes sense to me, and the memories won’t come back if I learn my theory is wrong.

Later in life, medication has helped controlled the depression and, after it was diagnosed, the other effects of bipolar 2. But if I thought my memory was going to function properly, I was wrong. Some of the drugs left me with a memory like Swiss cheese.

My memory lapses seem more random now. Good things, bad things, neutral things, all disappear into the Pit of Unavailability. Sometimes they are embarrassing – I forgot a friend’s father had died and asked how he was. Other times they are more distressing – mere scraps left of trips I’ve taken. Sometimes they’re heart-searing – total nonrecall of a never-to-be-repeated sexual encounter.

Good and bad, gone.

(“Oh, yes,” said the doctor. “That drug will do that. You can stop taking it now.”)

I guess I’m lucky. If I’d had the electroshock, my memory would probably be as raggedy as old underwear. And about as useful.

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Sensation in the Brain

I know there is no physical sensation in the brain. It cannot feel pain. It cannot feel touch. Even in a car accident when the brain sloshes from side to side and bashes against one side of the skull and then the other, the brain sustains injuries, but feels nothing.

That notwithstanding, twice in my life I have felt physical sensations in my brain – or at least what felt like them.

The first time was at the dentist. I am terribly phobic about dentists, so even for routine procedures I need anti-anxiety medication. This was not a routine procedure.

The dentist was very understanding. He put me in the children’s treatment room, which had brightly colored designs of cactus, coyotes, cowboys, all painted on the walls in comforting colors and playful attitudes.

He also brought in a traveling anesthesiologist so that I could be unconscious during the procedure instead of terrified. My husband was there with me, of course, both to drive me and to give me moral support. (It also turned out that he had to give permission for one of my teeth to be removed in the middle of the procedure while I was unconscious.)

While the anesthesiologist was putting me under, my husband and the dentist were casually chatting. My husband made a remark and the dentist said, “Oh, she can’t hear us now. She’s already pretty far under and won’t remember a thing.”

“I bet she will,” my husband replied. The bet involved giving me a word to try to remember when I awoke. They selected the word green.

“You mean like the color of my pants?” I said. They were actually more like olive drab.

“Yes,” the dentist replied. “Green – the color.”

Just for the hell of it, as I was sinking into unconsciousness, I silently repeated to myself the word green in a slow and steady manner: green green green – until the drugs took me under.

An unknown time later I awoke. The dentist asked me, “Is there something you were supposed to remember?” I shook my head groggily.

As soon as I did, I felt an odd sensation in the back of my brain. It was like a little bubble rising up through liquid. When the bubble reached the surface of whatever the liquid was, it burst and released the word green. “Green?” I said uncertainly.

“See?” said my husband. “I told you she would remember.”

The other sensation in my brain came about six weeks after beginning a new psychotropic medication. I had gone through a long, miserable time of trying drug after drug after drug – tapering off on one and ramping up on the next – all with no effect, except unpleasant ones.

Dr. R. was ready to recommend electroshock for me. And after such a long time – I think it may have been two years – of trying and failing with different medications, I was ready to take the plunge. I admitted as much in one of my sessions.

“There’s one more thing I’d like to try before we do that,” said Dr R. “Here is a prescription for lamictal”.

“Okay,” I said. “How does it work?”

“We don’t really know,” he replied. This was our standard conversation whenever he prescribed a new drug. I was used to it, but I always asked anyway.

So I tried it. And felt the usual nothing for almost six weeks. Then one day I was in my husband’s study and we were talking, when I felt it.

It was the physical sensation in the back of my brain of a light switch being flipped. I thought I heard an internal click. When that switch flipped, suddenly something in my brain changed. It remembered how to think and to feel and to not be miserable.

“Oh!” I said. “I remember this. This is the way my brain is supposed to work.” Since then it has kept working – not continuously in the proper manner – but often enough that I consider the drug a success.

I know that in both of those cases nothing happened in my brain that caused a physical sensation. Both times, my brain gave me a metaphor for what was happening. In the dentist’s office the metaphor was a bubble rising to the surface to explain coming out from under sedation – and a little bit of self-hypnosis.

In the case of the drug, the metaphor was the cliche of flipping on a light switch. This time something had changed in my brain, something biochemical. I should not have been able to feel it, but according to my brain, I did.

It seems I have a clever brain. It gave me ways to understand what was happening in terms I could relate to. The fact that I know the brain can have no physical sensations did not matter to my brain.

Human brains are amazing – and sometimes even in a good way.

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mental health

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The Creative Bipolar Brain

Sun or shade
feel or know
safe or strayed
stall or flow

Thought or whim
drought or rain
sink or swim
heart or brain

Stop or start
bound or free
light or dark
bipolar me

I have a lot of friends who are creative – writers, musicians, singers, woodworkers, knitters, and other craftspeople. I also have a lot of friends who have assorted mental or emotional disorders – depression, bipolar, PTSD, OCD, autism spectrum disorders, and probably many more that I don’t know about. In many cases, the two categories overlap.

Common wisdom holds that there is a link between creativity and madness. Look at Van Gogh, for example. People have spent years debating what specific disorder he may have had, but nearly everyone agrees that he had something. The question is, would he have been the great artist without the mental or emotional disorder? Or, perhaps, would he have been an even greater artist if his brain functioned in a more typical matter? Science so far has given us no answers.

Many creative people realize that their everyday functioning is impaired, but they are reluctant to seek treatment for it. They fear that tampering with their brain or thought processes will somehow inhibit their creativity – make them less than they were in some fundamental way. When you start tampering with brain chemistry, who knows what will happen?

It’s a valid concern.

Throughout my life, my brain has been all that I have, or nearly so. My intelligence and creativity were the things I was most proud of. How could I risk losing those simply because I was eternally miserable? The question seems absurd now.

Eventually I decided that I had plenty of brain cells to spare, and that if taking Prozac took away a few of them or lessened their ability, I could live with that. (Just in case, I took up pursuits that are supposed to strengthen the brain – math puzzles in addition to word puzzles, music in addition to writing. Not everything I tried was a success, but I hope they stretch my brain muscles.)

My experience with that first psychotropic med convinced me that Better Living Through Chemistry is not just a chemical company’s slogan. It turns out that – surprise, surprise – thinking more clearly and feeling more well-adjusted actually empower one’s creativity. My output changed from poems full of young adult angst to creative nonfiction, personal essays, and the occasional short story. I now make my living doing freelance writing and editing – an unstructured process that I couldn’t have made a go of before having my mood disorder treated. The ability to concentrate – to focus – is what enables me to sustain a creative effort.

So to all those people out there who wonder if they are sabotaging themselves and their creative impulses by seeking treatment, I say go for it! You have nothing to lose but your immobility. You have everything to gain – the ability to create, to express yourself and do it clearly, and the possibility to create something truly wonderful.

Sylvia Plath was a poetic genius. But she could have given so much more of her talent and vision to the world if she had not killed herself. Perhaps her poetry, had she been treated for her mood disorder, would not have been as searing and powerful. The point is, we will never know. Would she have become more ordinary, or more extraordinary? Dying young obviates the answer.

I believe – for me – that psychological treatment, appropriate medication, and more stable moods have expanded my creative process. And I try to prove it every week when I post in this and my other blog. Whether I succeed is for you to determine.

Have I lost a step? Maybe. But two forward and one back beats the hell out of one forward and two back.

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mental health

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Not Waving but Drowning

Consider this a trigger warning. The third section is going to talk about some difficult stuff, although in mostly general terms.

Here’s a list of how I know how bad my mood disorder is at any given time. Being bipolar, I cycle in and out of these phases, along with periods of reasonably competent functioning and even, occasionally, contentment or even happiness.

There are basically three stages of increasing dysfunction.

Starting to Sink
My sense of humor takes a hike.
I need more alone time.
I take mega-naps.
I forget that music can help.
I snap at my husband.
Noises irritate me.
I can force myself to work.

Floundering
I don’t want to eat.
I turn off my phone.
I sleep up to 14 hours a day.
Attention span is one hour (or one average book chapter).
I can trick myself into working.

Going Under
Can’t sleep.
Can’t work.
Can’t read.
Attention span: 15 minutes max.
Thinking “Maybe the plane will crash and I won’t have to deal with this anymore.”
Regretting I flushed my stash of pills.
Urge to cut.

Fortunately, I am well-medicated enough that category 3 doesn’t happen nowadays, though I remember it clearly and am appalled. At that point, the only things I can do are keep seeing my doctors and taking my meds. And remember to thank my husband when I come out of it.

(The title of this post is from a poem by Stevie Smith. The last two lines are: I was much too far out all my life / And not waving but drowning.)

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mental health, Uncategorized

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