About seven weeks ago, I had a severe psychotic
break. But, I fortunately found a
mental-health care team that promised some hope. However, there were a lot of surprises and concerns
that came along with this, and which are growing.
The first issue is that my diagnosis was elevated to
Bipolar I-predominate manic, and currently psychotic. And, that I had been in a predominately manic
mixed-state for at least a couple of years.
Gee, who says life is a bore!
When I had the diagnosis of Bipolar II, it took me a
couple of years to come to terms with it, and what it would mean for my future. And, it took me about five years
to become, what I thought was, stabilized.
But, even though I did accept it, I still thought that my life events
and decisions were essentially a result of conscious decisions I had made, and that
my “eccentric” behavior was simply part of my personality.
But now, with the new and escalated diagnosis, I’m
reeling. Initially with this diagnosis,
I had, and am still going through, all types of phases in dealing with this, both
physically and emotionally.
Emotionally, I am having a hard time accepting this. I’m realizing that my entire life has been
absolutely out of my control—I feel like the bipolar has robbed me of
everything pleasant and productive that I could have had/achieved. I can’t think of anything in my life that has been authentic, except for
art. At least there’s art.
But the incredible, unconscious spending
sprees, misery I suffered in my teens, twenties, and thirties, all of the
dangerous activities and events I blindly participated in, the self-medicating
with street drugs, the terrible choice of friends (most of them), and not to
mention the even worse choice of men, I now realize was all a result of being
bipolar. And, even though I was able to
work in the arts, I turned down opportunities to work as an artist in favor of
working in art museums (I did find satisfaction working in the museum field, but always regretted that I
never had the time nor headspace to create some spectacular artworks). And, while on the topic of work, I have been
fired from every job (including temporary clerical jobs) since 2000. That’s a long time. I had always attributed it to bad work
situations, bad bosses, bad institutions, bad bosses . . . but never to my own
behavior. See, I thought I was managed.
And, now with the new diagnosis, my condition has reached
the top level of Bipolar Disorder. There
is no higher diagnosis. This shatters and frightens me. This is, to me, a giant slap telling me that
my life is going to get much, much harder.
With every bipolar episode, there is no turning back. This means that any subsequent episodes
(depressive or manic) will be worse than any that went before. After one episode, the next will be
worse. Then the one after that will be
worse than the previous. And so on, and
so on, and so on. I thought it was
hard enough to begin with, and now I’m really having a hard time accepting that it’s much
worse than I had thought. I’m paralyzed by these feelings.
Physically, for the past two weeks, I've been essentially unmedicated. Well, not entirely unmedicated, but
medicated at the bare minimum (I’m still on the Lamictal). This is wreaking havoc with my life.
Day One – 40mg
Day Two –40 mg
Day Two – 80 mg
Day Three – 120 mg
Day Three – 160 mg
Day Four 200 mg
Day Five and beyond – 240 mg.
My body couldn’t handle it. By day four I was so disabled that I was
stumbling as though drunk, sweating profusely, and having to crawl up the
stairs. And, crawling up the stairs, I
had to take a break mid-way and lay down
to rest. Even my cats were worried. They were crawling on me, meowing, and
licking me. Scary.
Day four, with the major jump to 200 mg, I woke up in bed
needing to vomit NOW. I managed to make
it to the toilet, but barely. Scarier.
Day five, with the next radical jump in dosage, I woke up
in bed projectile vomiting. I consider
myself lucky to be alive. The rapid
titration essentially knocked me out, and if I hadn’t woken up, I would have
aspirated. Overdose. Terrifying.
I was taken off of the Geodon and put on Risperdal. Yuk.
That only maintained the mixed-episode, and made me EXTREMELY angry and
aggressive, shaking, and COLD. So, I
decided on my own to split the dosage and take it only at night. Bad nightmares. Really, really bad nightmares, and ongoing
agitation, cold, shaking, irritability, and a ton of invasive thoughts and
ruminating, and a dive into depression.
Hell, sheer Hell.
I phoned in and asked for a Benzo to reduce the anxiety
just a little. My kingdom for a
Xanax! Did I get a Benzo? No.
Instead I was given Gabapentin.
Now, I have had issues with Gabapentin before. A few years ago I had to go to the ER for
uncontrollable and violent shaking of my
limbs and head. After 16 hours being
shuttled between Physical ER and Mental ER, I was dosed with Neurontin
(Gabapentin). It sent me into an extreme
mania. Now, the important thing to know
here, is that my experience with Gabapentin is in my chart. Why, oh, why did she give it to me? Did she not consult the chart?
I knew it was a bad idea.
I knew it was the wrong prescription. But I took it anyway. And, sure enough, it sparked a mania.
I was up for four days. But it
wasn’t a “fun” mania. I was shaking,
anxious, and terrified about what was happening to me. And I was constantly
cold (still). And, of course, I soon
crashed into a deep depression.
I went to visit the doc again. And, as referenced in a previous post, she
wanted to check me in to a Mental Health Residence. “NO.” So, she decided that she was at a loss
as to how to medicate/stabilize me, and that she couldn’t help me any
further. She handed me off to a
Department of Health Services Community Mental Health organization. Great, government care. I took myself down to a lower dose of the Gabapentin, and took it only at night, but it was still giving me problems-I
was sleeping, but still shaking and extremely anxious. And, the depressive episode was becoming
worse, and worse, and worse. And I was becoming more and more paranoid. More Hell.
It took more than a week to meet with the intake process
for the new team, and I didn’t get to meet with a Psychiatrist for a week. Since he was going to be on vacation for two
weeks, he decided to not start me on a new regime. He did, however, prescribe Ativan 1 mg, daily as needed, to last until he returned.
I tried the Ativan . . . nothing. So I started making calls. First to the new team, explaining that the
new doc had prescribed Ativan, but that it was ineffective, and to please
prescribe something else to reduce the anxiety.
Nothing doing. They don’t know me
well enough, and the Psych is out, so no prescription. Well, I went back on the phone and called the
original team to ask for something.
Nope, I’m no longer in their care so they can’t prescribe anything. “You should contact your new team”. Grrrrrrrr.
So there I was, anxious, depressed, hopeless, and paranoid. The case manager from the new team called,
“How are you doing?” “Awful, life is
terrible. I have no hope, and no faith”
“Gee, that’s too bad, but hopefully there will be something to help you when
the Psych returns. Have a great day!!” Have a great day? Who is this person!!???
I had one more chance, slim, but a chance. I called my general practitioner and explained
what was happening. He’s seen me for the
last five years and agreed to double the Ativan dose and gave enough to last
until the new Psych returns. Now, I’m
doped, stumbling, brain-dead, and moving further and further into the
depression. Just get me through the
three more days until the new Psych comes back, and please let him have some
good news.
Did I say frightened, yet? There are not many drugs left for me to
try. I’ve been on the following, none of
which worked:
·
Depakote -- Anticonvulsant
·
Lamictal – Anticonvulsant
·
Prozac -- SSRI
·
Celexa -- SSRI
·
Paxil -- SSRI
·
Propranalol – Beta Blocker (used for high blood
pressure and tremors)
·
Cymbalta -- Serotonin-norepinephrine reuptake
inhibitor
·
Abilify – Atypical antipsychotic
·
Geodon – Atypical antipsychotic
·
Risperdal – Atypical antipsychotic
·
Gabapentin – Gamma-aminobutyric acid
So, what’s left to try?
The Anticonvulsants, SSRIs, and SNRIs don’t seem to work, but I’ve still
included them in the list of everything else I can find:
·
Seroquel – Atypical antipsychotic (I’ve heard
sooo many bad things about Seroquel, I
really do not want to go there).
·
Latuda—Atypical antipsychotic (I’ve heard of
this, and have heard good things. But,
it’s used as an anti-depressant. Maybe
it will figure in with whatever other med combinaion they decide to give me)
·
Saphris – Atypical antipsychotic
·
Vraylar – Atypical antipsychotic
·
Iloperidone – Atypical antipsychotic
·
Paliperidone – Atypical antipsychotic
·
Zyprexa –Atypical antipsychotic.
·
Lithium – Miscellaneous antipsychotic (This is
completely old-school medication and requires monthly blood checks. I REALLY don't want to go to there)
·
Topamirate Systemic -- Anticonvulsant
·
Levetiracetam – Anticonvulsant
·
Symbyax – Anticonvulsant
·
Venlafaxine – Serotonin-norepinephrine reuptake
inhibitor
·
Desvenlafaxine -- Serotonin-norepinephrine
reuptake inhibitor
·
Sertaline – SSRI
·
Escitalpram – SSRI
·
Bubpropion – Antidepressant/Smoking Cessation
·
Clonodine ----Antiadrenergic agent, centrally
acting
·
Verapamil – Calcium blocking agent/group IV
antiarrhythmic
·
Armodafnil – CNS stimulant
·
Tiagabine – Gamma-aminobutyric acid reuptake
inhibitor
There's not a hole or cave deep enough for me to crawl into and hide, and I’m afraid of my future.
Very, very frightened.
