Medication

As I already mentioned, I have rapid cycling bipolar disorder. On the downswing, in addition to intrusive thoughts and self criticism (including replaying of events and situations from many years ago), this leads to deep, dark depression – even as far as suicidal thoughts. On the manic upswing, symptoms include obsessional behaviour, emphatic (even strident) tone in conversations, suspicion and jealousy, magical thinking and intense narcissism. Unchecked, very little time is spent in any kind of level middle ground, the switching between the two poles being sudden and unpredictable.

Unfortunately the mania, jealousy and rage (or even just obsession and magical thinking) often form a self-amplifying feedback loop, pushing higher and higher until I actually flip out into a full-blown psychotic episode. When spurred by jealousy and rage, this can be a particularly dangerous situation; one time, I got so angry and convinced my wife was cheating on me that I pushed her into the road in the path of a double-decker bus. Fortunately the driver was already pulling in at a stop and was able to halt the bus in time; but still, the intention was there. Away from that insanity, I feel so lucky that things turned out how they did.

I’ve broken bones, my own and other people’s, in this state.

It was the bus episode that finally convinced me that I couldn’t control this by diet, exercise and shutting myself away from the world. I got an emergency referral for psych evaluation and was diagnosed as schizophrenic. After listening to me babble and rave for nearly two hours, the psychiatrist started me on a strong dose of Risperidone (Risperdal).

Risperidone really didn’t agree with me: life was “letterboxed” (as Richard Dreyfuss once said about Lithium). The high mania and deep depression were gone, but so was any chance of reaching a state other than the bleak, flat middle ground. I found it very difficult to enjoy anything – I went to a Reel Big Fish gig and just stood watching as the band rocked the room, I couldn’t even get my feet to move. Later that summer I went on holiday with my family and everyone noticed that I wasn’t my usual self. I decided that there had to be something my psych team could do, because I certainly couldn’t face life like this.

I got in touch with the mental health unit, who transferred me from the care of my original psychiatrist and put me with a specialist in bipolar spectrum disorders. She was great. She quickly recognised that I was seriously over-medicated and started me off on a low dose of Quetiapine (Seroquel). The change was pretty much immediate. Whlie I did begin to cycle again (hitting manic and depressive states), they weren’t as intense. We very quickly pushed the dosage up in stages until we came to a sweet spot at 600mg per day. Gone was my rapid-fire babbling, sleeplessness and unpredictable state-switching. In its stead was a calm, centred version of me who was able to enjoy the simple things in life: being a dad, my work as a goldsmith, even getting out into nature with the dogs. When people say “a new lease on life” it’s exactly this.

That’s not to say that the aberrant states have been completely cured, but they are now confined to the very extremes of my being. Getting particularly intoxicated or in the grip of serious rage are still risky for me, but day-to-day life is much steadier and more enjoyable. I’m actually glad to be me and grateful for my family and career.

Looking back on the twenty years I spent under the yoke of an uncontrolled mental illness, I see the pain, fear and violence that I have put people through, but I also see the peak experiences I have lived while strongly in the grip of mania and psychosis. I wouldn’t swap any of that for the world… but I wouldn’t go back there either.

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