I’m back…

[Started on December 9th]

“I’m back, baby doll…”

-one of favourite quotes from How I Met Your Mother

I’m baa-ack. It’s been a month, apparently. It felt a lot longer! I only know this fact of it being a month since I was here from opening my blog today for the first time since … so it tells me … the 9th of November.

Wow.

And during that time I actually thought up zero topics, had zero inclination to write anything and was pretty much happy to climb into a hole and be a hermit for the rest of my natural life. But the light has broken through and here I am.

It’s been a very full month. I’m trying. A trip away to Werribee, days out of the house doing stuff, hanging out with girlfriends, some actual real live housework. There were, surprisingly, some pretty great times.

And then there were days when I wore my pajamas until 5pm and only left my bed to eat. But you know, looking for the upside!!

There was one amazing week where I thought I’d finally broken through the depression glass ceiling into what normal life could be like, and I loved it! So did my GP: ‘Imagine if this is how life could be from now on? That would be f*@%*^# awesome’. His words, not mine! Just to clarify. But yes, why yes, yes it would.

Sadly for me and anyone my life bumps up against, it was mania.

Oh mania, you heartbreaking devil you. You get us so excited and hopeful and relieved and let us sniff “normal” for 5 minutes, before depression overcomes us again and we all sink back into the swamp!

Normal, or a bit more overdone than normal; either way, it’s a nice change from blergh, uff and erk!

But it wasn’t devastating when mania went this time. Well not as devastating. This time. I’m getting more resilient gradually.

[Updated from here in later December but the computer wiped all my additions and made me so angry I gave up on it! Then I vowed to complete it on January 9th but when the date came around I was staying in a motel without WIFI…ahh the horrors of modern life! So here I am, Feb 9th…and finally I’m back! And saving my draft after every word!!]

Thankfully, bit by bit, episode by episode, high by low by high by low I am taking it less personally, getting less excited and less distraught when my brain chemistry flicks the switch and lands me somewhere I wasn’t prepared for.

So says my mouth, and my head. So I wish, so I hope. And maybe sometimes that’s the case, that I’m less wrung out over it. Maybe.

But actually now that I’m slipping down the slidey slope again I find myself not so okay with that. I don’t want to go down there again. I don’t want to be like that again. But it seems that I’m not being consulted in the matter of what goes on in my own head.

Ironic, isn’t it? My own head, taken hostage by chemicals. Chemicals that don’t even have brains or thinking power or motives – but they pack quite the punch! We’re doing all we can to oppose them but it’s turning out to be more of a war than just a battle.

I’ve been told over that I have tricky brain chemistry. At first I thought it was one of those placating remarks all doctors make to help ease you through the rough period between the diagnosis of depression and the onset of full medication effect, which can be up to 6 or 8 weeks at times in some people.

Although I guess I didn’t hear it said first until I was trying the 5th antidepressant; but I definitely needed to hear something at that point to convince me that I should still hold hope that this one would work! My doctor told me that every time an antidepressant didn’t work, we were one step closer to finding the one that would; we were one step closer to getting better; the depression was one step closer to showing us how it was working and what we could do to oppose it.

That’s a lot of talking for a chemical to do!

Time and experience have unfortunately proved the fact to be true. I have tricky brain chemistry. It’s difficult for the medications that we have available to match the chemicals that are lacking from, but should be in, my brain keeping me from becoming anxious, depressed, manic or a swinging monkey between all three moods!

I’d love to be one of those people who gets diagnosed with depression, gets prescribed whatever antidepressant their doctor has on their mind that week, tolerates it well and after a year or so with successful treatment and other supports, undertakes a careful withdrawal of their medication under supervision of their doctor and continues on with their life drug/medication free. Not trivialising their sufferings, just envious of their rapid and successful long term improvement and freedom from medications.

Of course that doesn’t happen in bipolar disorder; only in depression. Bipolar is not a condition that remits; it’s a life sentence. It’s not going anywhere, and it’s quite unlikely that I’ll ever be free from taking medicines.

But it’s the dream, isn’t it? To be medication free, drug free, not drug dependant; isn’t that the dream of any person tied to medication?

As a pharmacist I have to ask every person/patient I deal with if they take medications. Apparently this is the most annoying question that a person could possibly ever ask! Or maybe I’m just asking it wrong; that’s always a possibility.

When I was working, a distant memory just now, I’d get 50 people a day saying “I’m not the kind of person that takes medication”, “I’m not the type of person who takes tablets”, “I’m not some kind of druggie”! Or my personal pet favourite hate: “I don’t like taking pills”.

Really? Well who does like taking pills? And what exactly is the type of person that would take medications? I guess having to take medications to get by makes me more sensitive to these types of comments spoken from ignorant minds. It’s obvious that they’ve just never given the issue more than a seconds thought, or they’re basing it on inappropriate pill popping they’ve seen on TV.

But just a suggestion, if you ever come across me actually working as a pharmacist in the indeterminate future, please just answer no or pass me a printed list of all your meds with doses, thank you so kindly!

 Moving on.

Tricky chemistry, multiple antidepressants, additional diagnosis of bipolar on top of depression and anxiety.

The diagnosis of bipolar disorder, after the initial shock and rejection of the idea as stupid and crazy (oh the irony of calling it crazy!), was actually not that surprising, looking at it rationally. The failure of antidepressants to work or to work fully is actually an indicator of bipolar disorder, which I knew somewhere in my mind from when I studied mental illness as half of my post graduate studies. Another irony!

What if I’d had the clarity of thought to see it that way back when? To look inside my brain in a rational, systematic, logical manner. But that’s not how mental illness works. It takes a regular brain and clouds it with so much doubt, fear, hurt, pain, sadness, hopelessness etc that you just can’t see.

I’d go to my doctor and say, I was so bleak and black yesterday I nearly couldn’t stand it. And he’d say, how many Valium did you take?

Valium. Brand name of diazepam, used in my case as a sedative and anxiolytic, remover of anxiety and worry.

And every time he said it, it would be such a revelation to me: oohhhh! RIght! I should have taken a Valium! That would have made me feel better. Of course, how did I not think of that? I say every time because there were quite a few times he had to say that to me!! And I’m a pharmacist! Turns out being a good pharmacist doesn’t always extend to yourself! Luckily my husband is happy to jump in and now whenever I’m complaining of my mood he puts on his doctor voice and asks me, did you take a Valium??

I had this sanctioned stash of tablets capable of taking a stressed-to-the-eyeballs or suicidal girl and transforming her into a warm, fuzzy, calm girl ready to take a nice comfy little sleep to get her through the hours until her chemistry improved or she crawled into the doctor’s office, totally empty and out of ideas and ready for the next injection of hope, help and medication changes.

I had it. I still have it. 13 months later! I think I’m getting better at remembering how to render psychiatric first aid to myself when the complicated muddle of meds I’m on just isn’t cutting it, or the depression is just a bit too strong, or the mania is making my limbs dance a jig of agitiation. Or everything is just all too much and the circuit breaker has to be activated to prevent the whole place from burning down! Metaphorically, not literally.

 Because there are still those days. Bleak days. Blank days. Flittering days. Storm in a teacup days. Meltdown days. Frustrating days. Agitated days.

There are less of them. They come less often. They do less damage. They don’t get full control of me. But they do come. They’ll always come.

The key, as they always say, is management. So here we are, my and my team, managing. We’re managing. And that’s pretty great!

Thank you for taking the time to read my great big long shambles and hope to chat again soon x

Unwilling or unable?

Unwilling, or unable?

This is a difficult call to make.

It’s so subjective.

All that we have to go on is my opinion versus your opinion, with whatever evidence each of us has gathered plus whatever balancing knowledge we have at the time the call is made.

It’s something that I’m still battling with, and because I’m battling with it, I assume that there are others out there fighting with themselves over this. I don’t know for sure if there are, but I’m writing this anyway, for me and for anyone else who gets it.

Before I got sick. Such a statement! Also hard to define but I’ll use it anyway.

Before I got sick, I found this line easier to determine.

I’d get home from work, tired out and ready to relax and the thought of having to get together the where withal to get up and going again seemed impossible. Everyone has felt like that at some time.

So it comes down to a battle of the will.

I know I’m tired, will I allow myself to sit down and relax or will I get myself up and going to an exercise class I love and know I will enjoy/the supermarket for groceries to make a better dinner/the week night Bible study meeting which I’ll feel so refreshed after?

Will I, won’t I, will I, won’t I? It was a mental battle. From experience I knew that if I pushed myself I would get through whatever it was that I had planned on doing. It wasn’t physically impossible despite my tiredness. It was a matter of setting my mind to it being a non-negotiable task and doing it! Like work. You don’t wake up in the morning and think will I, won’t I go to work. You just get up, do what you have to to get organised and go!

Well at that stage I did. As the stress of my last job accumulated and compounded I did find myself waking up with a feeling of dread (hello anxiety!) and thinking do I really have to go? What if I just don’t go? What if I say I’m sick? What if I just stay in bed instead?

I guess I should have known that that was something else. That this was more than usual reluctance to get out of bed. I’ve always been a mid-morning person. Getting up has never been easy, but then again it had never been like this. Lying in bed watching the clock tick around to when I should be leaving. Feeling dread and stress and fear with a little smidgen of hope build up until I thought they could physically burst out of my chest.

But in our house growing up, the words “lazy-bones”, “wuss”, “sook” were tossed about like “hello”, “goodbye” and “how are you?”. As a consequence of those terrible words being acceptable to apply to children, I always question my own judgement towards myself, and wonder if indeed I am being a “wuss”, a “sook”, “weak”, “lazy”, lacking in having a backbone or courage or dedication or commitment or appropriate drive?

I think I’m learning these days to give myself more credit. To remember that I am a dedicated, committed professional who knows her responsibility in the workplace and fulfills her duties creditably; who wouldn’t “slack off” or “be lazy” or “not pull her weight” unless there was a solid decent reason. All words that no one else has used against me by the way, except for my old inner voice that I’m slowly chipping away.

I’m learning to know my limits and to communicate these to others. Not with the phrase “sorry to be a wuss but…”! With the phrase, “I have done x and y and z today and I’m pleased that I have accomplished so much. That is all that I can manage today. Thanks for your understanding”.

I think it’s called being assertive. Having been terrified of confrontation all my life I never really got the practice of asserting myself. I knew the theory but that only gets you so far. These days I’m realising that I am a person with valid opinions and thoughts. I’m finding that communicating this directly to others results in a better outcome for everyone. And I’m not so fearful of confrontation anymore. Because now I know that I am an equal part of the conversation/discussion/interview. I’m not the weaker part having to make up to the stronger part anymore. These are truly great days for my personal development!!

But it still comes down to this: what and where are the limits?

When is it enough without being too much? When could I push myself more? When am I taking it too far and risking exhaustion? Do I have more energy than I think I have? Could I maybe do just a little bit more, or should I call it a day?

How can anyone know the answers to these questions?

And then there are the other factors: I just don’t feel like talking to anyone today so I don’t want to go, I feel very anxious about going so I think it’d be better if I stayed home, I just can’t get my head together to go today, I’m too drowsy/sleepy/exhausted/tired.

I’ve been told to push myself, but to be careful not to exhaust myself. I’ve been told to learn to know my own body so it will tell me when enough is enough.

Who teaches these things? How can I learn these things? How can I know the difference between my body being tired and my mind being tired?

My body tricks me all the time. I’m sitting here an hour after a good dinner and my body is telling me it’s hungry. I know its not, but that’s not how it sees the situation! So how can I be sure about my body telling me when it has had enough? It feels like a marathon getting up, showered and dressed some days; my body tells me that it enough but surely that can’t be the limit.

If I can’t tell the limits, how can anyone else? I suppose this is my main point after all. Here’s me: I’ve got these limitations of conditions, medications, recuperation. How, considering all the variables, can any other person tell me what or how much or where or when I should be doing what I’m doing?

Not that many have tried, to give credit where credit is due. Most people have been endlessly helpful, patient with me in my disability, considerate of my limits and thoughtful of me in the middle trying to make me work.

I really do appreciate that!!

I guess it’s always a work in progress. The fact is that I can’t do everything that I would like to do; that’s just how it is right now. I am learning to accept these facts as they are without judging them or myself; that’s huge progress!

With the energy and motivation I do have, I do what I can. I get tired and worn out faster than I’d like. I don’t have the stamina I want. Some days I wake up and it’s just not my day. Then after a nap suddenly I’m firing on all cylinders again. And tomorrow, I might be rearing to go! I just don’t know, and can’t tell. It’s a trying, sometimes frustrating game trying to figure out my agenda for the week, or even the day, not knowing when or how or what I’ll be like with any definite prediction.

Another thing that it is very hard is to differentiate between what the condition causes and what the medication causes. Am I suffering from a side effect, or is this just the part of the condition that we haven’t got under control yet? I think only a trained doctor could answer that with any certainty, and maybe not even then.

So, in the meantime, I hope I’ll do what I can, but not too much, and hopefully figure out just what that is!!