Strange Scribbles & Double Vision

Yesterday was a blur. I don't remember going to bed. At work yesterday, I discovered a comment on a student's paper. It said, "Include all your painful nights, but you look good and normal." Was this addressed to me from my subconscious? Had I actually been asleep? I had no memory of the words. I didn't even remember finishing the paper (which is why I looked back at it). Bruce said I should check the other papers. I did, and I have several more odd little notes.Then even last night, I texted nonsense to Bruce.

The only other time I remember writing in my sleep or close to sleep was when I was sixteen, when I think I was having a long manic episode. How can I do my work if that might happen? Josh said I looked awake. I don't remember feeling sleepy then. It scares me. I already had little control of my sleep, but what if I write something inappropriate on a paper and don't realize it? I'll probably have to ask Josh to check for me as I go.

Another weird and awful experience I'm having is blurry vision. This started a few days ago. I can't read. Letters rearrange themselves, stretch, shrink, and turn into other letters. This, too, is making work quite difficult. I hope it will go away soon. It's the same with or without my glasses. Traffic lights and brake lights double or triple.

Apparently, Abilify can cause sleep disturbances (whatever that means) and blurred vision. The pharmacist was unsure about the sleep or trance-type writing. He said that could be the meds or could be the illness itself. I don't like not being able to tell the difference, and it's happening more and more.

Just yesterday, something else started: sudden involuntary jerks, like the kind you might have right as you fall asleep. It makes me feel like something like a piano is crashing next to me. My muscles get hot, and my tendons tense. 

The hallucinations have been creeping back in. Often, I just think something is moving on the floor, or I see movement at the edge of my vision. I saw the red streaks on the road again a few weeks ago. I saw a soldier standing in his ACUs, standing outside as I passed. I turned, and I only saw trees.

The worst one lately, though, was this weekend. I was sitting on the floor in the guest bedroom, getting something from the bottom book shelf. I heard a man's voice from beside and above me, first hushing me and then whispering something I couldn't understand. I thought it must be Josh--who else?--even though it didn't sound like him. I looked up and over. Then, I made the loudest sound I've made since I can remember. It felt like a scream, sounded to me like a shout, and sounded to Josh like a yelp. The fact that no one was in the room with me was terrifying. I got out of the room and leaned against the wall, panting.

On Friday night, I started taking new prescriptions. Dr. N increased my Abilify from 10 to 15. He said that will get rid of the hallucinations. He also gave me a script for Cogentin. This was supposed to calm that maddening agitation and shakiness, which he said the Abilify is probably making is worsening. I don't know yet if the higher A dose is doing much yet, but it may take a while. The Cogentin seems to be working though. I've had almost no physical agitation, and my shaking is better. So I'm excited about that. It makes getting ready for work and being at work and just existing much more bearable.

A few days ago, I felt completely tired of living--exhausted and apathetic. I didn't want to live. I wasn't suicidal, but I had had enough. I couldn't manage to find anything to look forward to, even though I knew that didn't make sense. Every day seemed like something was dragging me through a thick, cold mist. I feel as if I never really rest.

The Truth, at the Moment.

Trigger Warning: This post briefly discusses suicidal ideation with no description or specifics.

I wish a certain word existed: one that means better or improved but that does not mean all better. When people who aren't right in the core of it ask me how I'm doing, I don't know how to answer. Better but not all better? I can say a little better, but that seems evasive.

Anyway, I've been taking Abilify in addition to my lithium (now a slightly lower dose), Wellbutrin, and a beta blocker, for a little over a month. Has it really been that long? I know the Abilify has been making a difference. I sleep a little better even though I still wake up every half hour. The sleepiness has finally started to fade out, and I was afraid the higher dose would bring it back. I just started the higher dose a few days ago.

I'm not sleepier yet, but I have terrible blurred vision .When I try to read (or type!) letters disappear, rearrange themselves, and become other letters. Josh got some artificial tears and helped me use them. I never aim properly when I do it myself, so I lay stretched over the armchair and held open eyelids, so he could put in the drops.

Before I started Abiliify, I was having increasing suicidal ideation. My brain was working on that without my mind's permission. It was just there all the time, at the edges of my mind, with an occasional, "Hey! You should think about this!" Hallucinations came back. After I'd started the Abilify, I noticed that I wasn't hallucinating and that my suicidal thoughts were basically gone. I figured just these two changes (my most alarming symptoms) alone were worth the medication.

The suicidal thoughts returned for a couple of days, but at least they weren't a totally random flare up. I was highly stressed, suspicious (which, interestingly enough, is common to people with BSD--bipolar spectrum disorders--and is their version of paranoia), humiliated, ambivalent (the mind and emotions getting yanked in two directions at once), intermittently angry, guilty, and terrified. Still, I had no plan or intention. 

Unfortunately, the hallucinations started popping up while I was on 10mg of Abilify. They're still around after the switch to 15mg, but I hope that will change soon. At work last week, I looked out through one of the glass doors and saw a soldier in his ACUs. I looked closer, and he was gone, a tree in his place. In the shower, I saw a shadow on the wall waving at me. Movement happens in my peripheral vision so often (probably even more now with the vision problems). I've seen, for split seconds, old pets on the floor by my bed or watching me while I get ready or do something in the kitchen. Objects so easily turn into something else.

The scariest, though, was yesterday. I was sitting on the floor in the guest room, organizing my stickers (massive collection) when I heard a hissing exhalation like a man shushing me. It was coming from a spot next to me but up, as if he were standing right over me. I thought it was Josh, even though the voice sounded nothing like his. The voice said a word or a few words, but I couldn't understand. So I stopped and looked up to see what Josh wanted. No one was there. Some straggled scream/yell tore out of my chest. I got out of the room and had to breathe hard for a while. I told Josh about it. Then, I went back inside. Without the weird mini hallucinations, I'm afraid to be alone. I don't know what I'll see or how I'll react.

Probably with all this and work stress and other stress, I began feeling hopeless. Well, not began really; I've always had pockets of hopelessness. But last week, I had no desire to live. I wasn't suicidal; I didn't have a desire to die. I just didn't want to go on with my daily life. And I have started inadvertently  collecting reasons that people I love would have better chances at happiness without me. I never really understood people's thinking that way, but I do now. And I know that my thinking that way, whether or not I indulge it, is not a good sign.

So I hope Abilify will take all that way--at least that much. My doctor also prescribed me Congentin, which is for Parkinson's disease and now to combat side effects of psychiatric meds. I've had much less shaking, restless and exhausting agitation, and inability to get comfortable. It was becoming really noticeable, and more importantly, it was maddening. I think some of it, at least, was the illness itself--a manic thing. But the doctor thought the Abilify was making it worse. Either way, I'm relieved something is working on something!

The last couple of days, I've felt okay. I know that could (and will) just in a week or a minute from now. But I try to use the gifts of calm while I can. The internal landscape of the moods makes me think of the beach. Sometimes, a storm is raging. The water is dark and ominous, crashing and tossing. Deafening thunder.

Other times, it's sunny, and people are laughing, brightly colored towels and tents are everywhere, and the Italian ice cart just came by. But that doesn't last long. The sun turns to a glare and starts to burn me. My swimsuit straps are driving me crazy. Everyone is talking talking talking, and they are everywhere. Even the water scratches and irritates me. But when I get out, I'm too cold. I try looking for pretty shells, but they're all broken along with bottle glass that the sea hadn't had time to soften yet. I come to a washed up jellyfish that is dying. A cluster of little boys are poking it with sticks. Only one boy comes over, tears in his eyes, and dumps a bucket full of salt water onto the jellyfish. We catch each other's eyes for a moment; I don't know what to do either.

And other times, the sky is bright, but I can still see the lightning in the distance, and a rhythmic devil rain is tapping me on the head and shoulders incessantly. We have an idea: we'll use the sticks to get that jellyfish in the bucket. I carry it, not wanting the boys to get hurt. I walk out up to my knees and toss jellyfish out ahead of me. I walk back, and seemingly moments later, the jellyfish is washing back up toward the sand. I don't know much about jellyfish, but it’s clearly dead. The bucket boy and I just stand there and watch the waves push the jellyfish farther and farther out of the water. We just stand there. It died anyway.

And the weather could change at any moment, for any duration, to any extreme.

The Ink of It.

I wrote this in my work notebook during a writing exercise in class. I think it shows my disintegration into something. The self-talk gets desperate as I tried to keep it together. 

September 4, 2014

I got sick last night. I hope I can get through this day. Standing is difficult. I need to be better to Josh. I’m so often frantic or sick. 

I want to know when. Spontaneous is nice but only if it’s extra. Oh. I can focus on so few things at once. The house is slipping completely. I’m always behind with work. I want to sleep and to go, move, find new bodies of water. Splash. Meditate on water. I feel like a slightly different person. Is this a phase, or it this me under the layers of cycling and sickness? I loved swimming as a child, so maybe I pushed it away. 

I have not felt well. Yesterday, I became exhausted and unfocused during a conference call, tapping my fists on the table without meaning to. Bruce said that I looked like I was crumbling and running out of time to be human. Today, I’m worn out, and my limbs have a low, sickly electricity. I need the day to end. I need the drive home. I need help. I’ve been feeling kind of angry—not about anything or toward anyone in particular. Music helped a little. 

I feel a little like I may not handle this class. Like I may fall and turn into a million twisted paperclips with a crash. 

Oh. I’m hurting too. I need…help. And more water. And a chair. 

Halfway. Eating didn’t help with the weakness. Help. Sun. Water streaming down my back. Water in my shoes, on my wrist. Kisses in excess. Like stitches. Out of these clothes. Quiet! And for that engine to leave my body and my water bottle. And a hand that does not shake. And tiny metal beads in a bucket with a little water—sink up to my knees. An open mouth. The. Slip tissue. Something that wiggles and isn’t gross. Banana candy that invades the sinuses.

Triggers.

Triggers are events, places, things, or situations that spark symptoms of a disorder such as post-traumatic stress disorder or depression. In my little spiral work notebook, I worked on a list of my triggers. I don't necessarily know what state they trigger, whether they are related to panic disorder or bipolar disorder, or whether they're really just things I don't like, but I want to be as aware as possible.

Triggers

Meetings before class

• The rush this creates is intolerable. I feel utterly panicked and trapped, and I question everything. Xanax in advance helps, but I still feel this. 

Breathing trouble
Preparation for car trips
Loud, rhythmic noises (barking, alarms, loud crying)
Lack of sunlight or access to sunlight

• Josh has seen me nearly lose my composure over broken blinds. Gloomy days usually prompt depression. 

Getting interrupted

• This one is mostly because I feel like the person wasn't listening at all. If he or she interrupts and then says, "Okay, so you were saying this...," and can actually repeat me, it doesn't really bother me. 

Not being able to talk when I need to

• I'll bounce my leg and tap my fingers or just collapse into myself.

Impersonal nicknames

• I react badly to innocuous names like sweetie, honey, and such. These make me feel I'm just like everyone else. And I'd rather be nothing. I love nicknames, but they have to be uniquely mine or somehow unusual.

Lack of water access
Hunger
Jealousy

• The slightest thing can spark this, anything that makes me doubt or question my place, my identity with a person. How ever mild, and how ever much I know it's all fine, this usually creates something like rapid cycling over the next minutes or hours. I don't even have to feel jealous.

Upset plans
Busy restaurants
Spiders

• My terror defies logic. It's almost heart-stopping. 

Lost items (shoes, jackets)
Being tired in public
Checking work E-mail

• I have to set my inbox so that I can only see two or three messages at a time. Still, I often avoid my work E-mail, which of course helps nothing. 

Grading
Counter service

• I can bear table-service restaurants most of the time now (and that's pretty new), but counter service stresses me horribly. I'd just as soon sit down and not eat. 

Prolonged cold

• I've always been cold-natured, but now, cold leads to painful shaking and muscle spasms. I think some of this is because of lithium, but it's also how heightened (positively or negatively) the senses are in mania. 

Others' mistakes on the details of my preferences

• This is obviously one that reveals how difficult I can be. I build everything up in my mind. So if I don't get what I expect, even if it's a sandwich without mayonnaise, I feel myself spinning into irritated despair. 

Lack of repetition and reinforcement

• My mom used to say I had a hole in my love bucket. I do need constant refilling, even in a secure relationship. 

Mess
Missing essentials (socks, cups)
Changed decor in a familiar place

• I can feel a change, but I don't usually recognize it right away. That feeling of change makes me feel I'm losing my grip on safety and sanity. 

Twisted or uneven blankets
White noise

• Fans, noisemakers, static from the monitor, and other background sounds that soothe many people are maddening for me. They feel invasive and threatening.

Side Effects.

Side effects are supposed to be one of the main reasons people with bipolar disorder stop taking their meds. And no wonder. In some cases, I can't tell the difference between side effect and illness. But these are what I've noticed.

Wellbutrin

• It switched me into mania, probably what should have been my first highly recognizable episode, so I'm not sure what to call a side effect. I don't notice any side effects of it now, after almost three years. 
• I wonder if it has contributed to my near-total inability to cry. 

Abilify

• I'm having a lot of agitation lately, which I think is a disease symptom but Abilify may be irritating. 
• Extreme sleepiness, to the point that I think I may fall asleep standing up in class. This has gotten slightly better, and it's supposedly rare, so I hope it will disappear or nearly so.

Lithium--oh, boy.

• Frequent, urgent urination. It's so extreme that it would be funny if it were someone else's story. The kidneys work overtime to flush out what they must perceive as poison. 
• Digestive upset, start and stop. 
• Extreme thirst. I have never consumed so much water in my life (including pregnancy and breastfeeding) or longed for water so deeply. I'll need a whole post for that. Apparently, I have to drink to replace what my kidneys flush out so eagerly. This side effect, though not terrible in itself, has really changed my life. I must have water in large quantities with me at all times. 
• Dry mouth and cracked lips, to the point of bleeding.
• Interrupted sleep. A lot of this is due to needing to drink water and needing to pee. But I wake up about every hour. 
• Dry skin, sometimes extreme. The webbing between my fingers is always wrecked. My hands are rough on everything, and they have aged from the dryness. 
• Dry, brittle hair. My hair, long as it is, was so healthy. Now, it's dry and broken. 
• Decreased sexual and even sensuous interest. Touch affects me less, and I seek it less.
• Nausea and food aversion. At my highest dose, which I'm now just below, I threw up most nights. This was horrific, and only desperation to get better kept me on that dose.

Xanax

• None I've noticed.

Dr. N says that if the Abilify works, I may not need the lithium at all. I would not mind dropping some of those side effects. I know the meds are worth all this. But it's hard to believe that sometimes.

Stay with You.

My favorite song lately has been "Stay with You" by the Goo Goo Dolls. I think of this song more as a duet. For me, the promise of it is about a lot more than staying in relationship with someone. It's a promise to stay on earth, to keep breathing, to stay as present with the person as possible. To stay alive to some degree, and not just clinically, though sometimes, that may be all that's possible.

Every time I listen to the song, I make that promise again. I know it's not a lifelong or even long-term promise; it's the kind of vow I have to renew continuously, every fistful of days, every day, even every minute.

And if it's a duet, the other person in the song is acknowledging how utterly impossible that promise will sometimes seem. That "stay with you" is about staying inside all that as much as possible ("I can feel the storm inside you"), facing it, holding the other as he or she changes face and form, and still seeing something worth having, "sweet and warm."

The song is momentous, like a double-virgin wedding night, like a first kiss, like tattooing names, like becoming blood brothers. We're in this. We're doing this. No matter what happens, this joins us forever. And we're staying. The song challenges me, scares me, and gives me hope all at once.

Musical Confessions Part 1.

I've always had a strange relationship with music. For a long time, I didn't know it was strange. Under age five, I remember hearing my parents' music and going into a kind of trance. Images, video, and word associations exploded in my mind. They often had little to do with the lyrics (probably a good thing). I remember a certain red and blue swirled, thick glass vase I used to see on a tall square stand in a minimalist house when I heard Richard Marx's "Right Here Waiting for You." I remember seeing intricate laces, probably like those on a rented roller skate, when I heard Def Leppard's "Have You Ever Needed Someone So Bad." 

The music videos were more complicated in my mind, but they did conjure certain images and objects. Those have changed at various points of my life, but one song still hold layers or at least echoes. Maybe this is normal. I don't know; I've never talked about it in-depth. Now that I can look at it with a little objectivity, it reminds me of synesthesia, in which sounds might have colors and colors have scents. Sometimes, what music held was a tumble, a crash, and other times, it seemed carefully formed with chip by chip of colored glass.

It's one of my greatest treasures. I've been careful to keep it hidden because I couldn't bear the thought of anyone teasing...not me, but it. The slightest insensitive comment would be a burn from which I wouldn't recover, or at least from which the relationship wouldn't recover. I'm surprised I'm trying to write about it now. This is only a little of the story.

Cherry 7-Up in a Champagne Flute.

It's too long but still has a good sound.

I'm home sick today. Sick is complicated. Last night, I had what seemed to be a panic attack. The shortness of breath I've been experiencing got much worse, so getting through a sentence was a yanking fire in my chest. My heart was racing. I couldn't stand, but sitting was no relief. When half a Xanax didn't make much difference, I turned on the space heater by my bed and went to sleep in almost perfect darkness. Sometimes, that's the only cure.

This morning, I didn't feel panicked, but I felt the after-effects. I was exhausted. I also had a sore throat and was starting to cough--not surprising since Oliver seems to be fighting off the same respiratory infection we passed around a couple of weeks ago. Showering was more of a challenge than it has been lately. Josh brought in a chair, so I could sit while putting on my makeup, but I didn't get that far. When I feel near tears about it, desperate to fulfill my responsibilities or whatever it is, it usually means I need to stay home. Josh called my boss and sent me back to bed.

Later, I woke up and knew I needed steam in my throat and lungs. I plinked two big ice cubes into a champagne glass and felt a cold Cherry 7-Up in my palm. The berry-pink liquid fills with perfectly suspended and surfacing bubbles that look like decorations for a combination of a roaring '20s bash and a fairy ball. I watched them as the tub filled around me with Bath and Body Works Aromatherapy Eucalyptus Tea bubbles, my favorite.

I think one of the challenges for someone with bipolar disorder (this person, at least) is doing something nice for oneself that does not involve spending money. Spending comes naturally...more on that later. But self-kindness...not so much. I'm wrong. I'm a burden. I'm--everything that deserves nothing. I'm sure I'm not the only one who experiences that. Not the only person in general even. But I know that kindness (not indulgence. Well, maybe sometimes indulgence) is a large part of what will help me get well, as well as I can get. And that kindness cannot only come from the people who love me.

Eleven.

Eleven is my favorite number (along with sixteen, the date of my anniversaries and the year of my best time). November 11 was a few days ago, and this reminded me of how my childhood friends said one could make a wish at 11:11. I loved that: the thought that twice a day, I had the opportunity to wish for anything. If I notice the clock at 11:11 now, I still feel a thrill. So on November 11, I wrote,

11/11. Can I make wishes all day?

• Easy standing up in class
• Even speaking in class
• Elimination of the agitation that keeps me awake or uncomfortable
• No more almost falling asleep while driving
• No more driving unless I want to
• Unlimited Dr. Pepper with no weight consequences
• No more need for lithium
• A second counselor who specializes in BSD and can help me build a life plan
• Absence of anger, mistrust, and humiliation
• More time with Buddy [Bruce]
• Time and money for family activities
• A real vacation
• A warmer indoor pool and building
• No more criticism at work
• Time, desire, and energy to write in my long-abandoned journal
• More intimacy interest and opportunity
• A clean room
• Time and energy for my little creative projects
• No more upset stomach
• Healthy hair again
• No more cracked mouth corners
• No more painfully dry hands
• No more credit card debt
• No more student loans
• No more getting out of breath in class
• Enjoying makeup, clothes, and jewelry again
• Better sleep at night
• Less sleepiness in the evening
• A couple of reliable babysitters
• Cooking ability and interest
• Hope

Beliefs.

One of the classes I teach is critical thinking, and one of the assignments I give is for the students to write down one hundred of their beliefs (which we examine later). These can be simple beliefs, such as that the sky is blue. I usually write the assignment along with them. These are some of the beliefs I wrote on September 8, 2014: 

• I believe I have a BSD [bipolar spectrum disorder].
• I believe that Li [lithium] helps me. 
• I believe that some of the side effects won't go away.
• I believe it's still worthwhile.
• I believe I need much more water than most people.
• I believe I can't get enough affection. 
• I believe that I may be exercising too hard, but I don't want to stop. 
• I believe I will have to do the same level of work next semester.
• I believe I am stuck & lost right now.
• I believe I still have bits of madness that slip through. 
• I believe I'd feel better if I could sit down. 
• I believe I'm lonely--whether or not I should be.
• I believe the end of this day will be a massive relief.
• I believe I'm close to a fissure, but I don't know why.
• I believe I can get through the last part of this class.
• I believe I like people projects, and this affects my relationships.
• I believe I'm not naturally very loyal.
• I believe I'll never feel a strong enough, lasting connection.
• I believe I'm running out of ideas for how to take care of myself.
• I believe my sleep patterns are almost incurably screwed up. 
• I believe I need more attention than I'll get in my current situation.
• I believe I have much stuck strength, creativity, love...and it's choking me.

The Council, Part I.

Most mental health resources talk about some form of support team. Initially, I heard about this in hospitals after other people's crises. I thought it was a recovery technique. In a way, I was right: I like how most books, web sites, and people I consult refer to living with mental illness as a process of recovery, whether or not one has ever attempted suicide or abused substances or had a psychotic break.

My support team is an interesting assortment of people. Of course, many people care about me, and now, many people know about my diagnoses. But five are the sort of primary caregivers. In a session with my therapist, Nancy, I jokingly referred to them as the council. I was talking about having consulted The Council before making some decision.

Actually, Nancy is on The Council. She and Dr. N, my psychiatrist, are like outside directors. They aren't directly involved, but they have important objectivity and expertise that the inside members don't have. Those outside directors certainly don't show up for all the meetings though.

The three remaining members are the people who have been in the middle of all this with me, even before we knew what it was. They're the ones who decided to like me anyway. They decided to stay with me even if I tried to push them away, hard. They know me best, and they know my illness (maybe not in general but as it is as mine). They know me intimately at various points as they time I've known them ranges from always to nine years to two years. I think that spread is an advantage.

Mom is able to see the whole stretch of my life. She knows who I have been since I was a child, a baby. She's seen my terror, my rebellion, my heartbreak, and my performances (in every sense of the word). I'm sure incorporating my diagnoses into all these memories and her nearly three-decade concept of me has been and is incredibly difficult and complex. But she knows how I got here.

Josh met me when I was twenty, working hard (to the point of figurative limb-breaking) to leave adolescence. He witnessed my best writing years. He's watched me face horrors both around me and in my own body. He's seen me earn degrees and fight for what I wanted professionally. And he's stood right next to me as I've crumbled, rallied, soared, crashed, spit sparks. He sees the range of me as an adult. I don't think he's had a chance to add bipolar disorder into that perspective, though I imagined he suspected panic disorder or something like it.

Bruce has known me for two years. He saw me deep in my career before we got close and my illness got worse. We've worked together and commuted two hours together every week day. We've shared work stress, and we've talked for hours. Though I've pumped him full of stories, he knows the current and most recent me. That's whom he sees and whom he's most likely to protect. 

They bring in these different perspectives. Though they don't communicate with each other much, they still seem to work together. Thank goodness three people can love me at such close range and with such continuous energy.

Filtering.

I got my diagnosis six months ago, in April. 

I think I've always had bipolar disorder, and I can point to specific symptoms and even states. These will probably become clearer over time. But my most obvious depression episode came when I was fifteen, and my most obvious manic episode came when I was sixteen and seventeen. 

I think the full onset was after my son,  Oliver, was born. His birth was a traumatic one. In the deliver room, I found out that I had severe preecclampsia with HELLP syndrome. I couldn't have an epidural, Oliver's heart rate was dropping rapidly, and even once I managed to release him, the doctor tried to remove the placenta with her hands (without pain medicine) but had to do surgery anyway. For the first few weeks afterward, my mood was fine. Then, I plunged into the deepest depression I'd yet experienced. I remember very little of Christmas. I had no idea how I ended and started semesters. I slept any time I could. 

After two or three months of this, I asked my friend Melissa when she began to feel like herself again, like she wouldn't shatter at a touch. She said she felt fine again basically when she got home from the hospital. I told her I still felt so fragile, and she asked if it could be postpartum depression. This hadn't occurred to me, but it made perfect sense: a cause for this contained, intense darkness. I struggled but called my OB, who started me on Wellbutrin. 

It had a dramatic effect, one that I didn't know was called switching: throwing bipolar disorder into the opposite state. Suddenly, I was recognizably manic. But who was going to recognize it? I felt bright and capable. Eventually, I felt almost supernatural. I taught a heavy and varied load of courses. I stayed late most days. I stayed up far into the night writing proposals and idea lists for new courses I wanted to teach. I put together a thick literary magazine with only one student's (tremendous) help. I didn't mind the resulting attention. I breastfed and pumped at all hours, ensuring that Oliver wouldn't need formula even with my long work hours. I got thin quickly. I was chatty and charming. My husband, Josh, noticed my increased interest in and energy for sex, but who would worry about that? I shopped. It was almost always work clothes, so even though it was excessive and beyond our means, it at least made some sense. The only part I hated was the feeling of a low current of electricity in my body, how I could sit still at my desk and feel my heart pounding, my body shaking, and my thoughts exploding so quickly that I couldn't catch a good glimpse of any of them. At those times, I couldn't even begin to think of what to do next, even turn on my computer. 

This continued for months. The charm and ability eventually shifted into extreme anxiety, paranoid thoughts, and a general imprisonment. I was teaching an interactive television class for the first time, and this terrified me. Something about the cameras or the screens or the sense of more people watching would have me sick the whole day of the class if not the day before too. I was fairly certain I would lose my job though I had no basis for that. The idea of getting fired has always been extremely frightening for me. I think that at some point in my childhood, I came to think that getting fired would ruin me, make me unlovable, much as I thought of smoking. My brain grabbed some story or movie, probably, and did wild things to it.

Eventually, I couldn't bear this, and I went to my regular doctor with a complaint of anxiety. He added Zoloft at a medium dose. For a couple of months, this helped. Last spring, the depression got worse. My doctor doubled my Zoloft dose after talking to Josh on the phone, so Josh must have been worried. Again, this seemed to help for a while. 

Near the end of last year, my thoughts started racing. As I often have when my thoughts and irritation reach a fever pitch, I cleaned. I cleaned and organized, all the way down to decorative labels and color-coding. Cleaning is not my thing. At this time, I needed to be focused on finishing grades and ending the semester. I couldn't. I was also researching relationships and creating a bizarrely complex assessment that had no practical purpose. Around Christmas, I deemed a relatively new (and deeply necessary) connection unworkable. My mom remembers thinking this was skewed logic. Maybe my brain was trying to pitch anyone who might take notice and help.

By March, I was sick enough to take my doctor's advice and try Viibryd, a fairly new and strong antidepressant, to replace Zoloft and to take a referral to a local psychological services group for testing. Bipolar disorder runs in my family, and I'd begun to think it might explain my situation. 

One evening, I was leaving my friend Bruce's house, and I saw a man in my car. He was young, Indian, handsome. He had glasses with thick black plastic frames. The light inside the car was on. This didn't bother me; I thought I must be looking at the wrong car. But I looked up and down the row and didn't see another car that looked like mine. When I checked the car again, the light was off, and no one was there. I walked over and checked the backseat. Nothing. Apparently, I'd had a hallucination. I still wasn't really disturbed, except that I worried I'd see something else while I was driving, and I'd wreck. Nothing happened. 

I had a long talk with a PsyD, and she scheduled testing that would focus on executive functioning and other aspects that bipolar disorder would affect. She and I did a quick overview of my whole life, including all (or most) of the rough events. I had a feeling that she would base a lot of her diagnosis on that talk rather than any tests. I was worried, though, because I knew I seemed a lot more stable than I felt or would feel at any moment. That night, I cried for the first time in two months or more. I wish I could cry more than I do.

Two days later, something happened that upset my expectations and disappointed me. I didn't feel able to express how much it bothered me--it didn't seem normal. Suddenly, I was crumbling. I was both disoriented and hyper-aware. I couldn't speak. Bruce came to talk to me, and I couldn't look at him. I didn't want him to look at me. I didn't want the comfort or presence of any of the most important, safest people. I had a photo of Josh, Oliver, and me on my desk. As I looked at it, I realized that the girl in the photo wasn't me. She looked like me, but she was someone else. When the same started happening to Josh in the photo, I turned the frame face down. I went to a reading, and the place and people seemed vaguely threatening. An administrator had a painful-looking, peeling, scabbed burn all over his face. It disturbed me much more than it should have. It seemed sinister. Later, maybe days later, I asked Bruce what he thought could have caused the burn. Bruce didn't know what I was talking about. 

Bruce drove me home. He said, "I don't want you to think about anything but getting up the stairs to your apartment. And if you can't do that, I'll carry you." I don't think I was vocal at that point, but I felt a little less anxious. I also realized that, even though he was scared, maybe he really could handle whatever came.

Josh had read some of my texts to my doctor. I had said that I felt like fire behind glass. Josh spoke to my mom too. The doctor wanted to switch me from Viibryd to Abilify, and Mom was ready to take me to the hospital. Once I got home, I calmed down and avoided both actions for the moment, mostly because I agreed to see a psychiatrist. 

Josh got me an appointment with a psychiatrist in the same practice, so the doctor had access to the PsyD's notes. We talked for ten or fifteen minutes, and he diagnosed me with Bipolar II Disorder and with Panic Disorder. It seemed so easy and obvious to him. As I told a few people, I felt stunned about having answers, but the answers themselves seemed right. I was mostly relieved. Now, I had something I could learn about and maybe learn to manage. I started lithium that night. 

Later, my testing paperwork showed that the PsyD had diagnosed me with Bipolar I and Anxiety Disorder NOS (not otherwise specified). It made sense to me that some of my symptoms might seem like mania or panic. I was just relieved to have confirmation of the general diagnostic categories. Now, though, I think the psychiatrist suspects Bipolar I too.

Finding out gave me a way to find some answers. My whole life, whether actually or only in my perception, people (including me) had said, "What's wrong with you? Nothing's wrong with you!" I seemed to have all these strange symptoms and qualities but no valid explanation for them. I should have been able to snap out of it, but I couldn't. Now, I knew why. Of course, learning about my disorder also meant learning that it would never go away. I can treat it, but it's a part of me (and therefore a part of everything I do and everyone I love) for life.

Brume.

I recently finished reading The Dark Side of Innocence: Growing up Bipolar by Terri Cheney. Though I read An Unquiet Mind shortly after my diagnosis, reading the remembered perspective of a child felt important. It might help me address a few of the questions that are so dense in my mind that I can only decode some of them.

• When did I "become" bipolar? 
• Did I have the disorder before the actual onset? 
• When was the onset? 
• Was I born with this or only with the tendency or possibility? 
• Can my diagnosis explain any of the childhood experiences that I've only recently begun to recognize as strange? 

But that isn't what I'm going to write about now. One of the most fascinating aspects of Cheney's book was that, even at age seven, she referred to her experience of bipolar disorder as "The Black Beast." This surprised me because I'd never thought of it as a separate entity, as something that pushed me or taunted me, as something whose appetites I had to endure or satiate.

But I've since realized that this is much more accurate than I thought. I think in part, I'm beginning to separate myself from the disease. Of course, that's difficult, confusing, nearly impossible...because the disease is me. It is a part of me, and it colors who I am and every aspect of my life. It always has. That's part of why I find myself trying to re-frame every memory, every trait, as it returns to me.

But. Something shouted numbers at me in 10th grade math class. Something was desperate to do, find, grasp what I didn't even think I wanted. Something pointed out my enemies. Something made me struggle to act appropriately. Something also made me stronger, braver, more competent, and more confident than I ever would have been alone.

I think of my brain and my mind separately. I first thought this way when I began to realize that medication was not going to heal me; medication might help fix my brain, but it wouldn't help fix my mind. The disorder lives in my brain. My mind usually lives there too, so my mind is damaged. I don't know how I'll ever untangle it. The body is involved too, and of course, it's directly under the brain's influence. I can't necessarily trust the body to tell me the truth or to help me.

So. Bipolar disorder does not seem like an animal or a person, even another version of myself. It's not that clear and concrete. It's only recently taken any real shape at all. Maybe it will solidify eventually. For now, though, it's fog.  A fog. The fog. Sometimes, it's thick and choking and ghostly. Anything could be in it. It keeps me from seeing and concentrating. It throws me off course. It subdues me. Depression is a traditional fog.

Other times, it's the kind of fog from a fog machine. It makes everything more dramatic and exciting. It can have the perfect lights or pyrotechnics in it. It's fantastic, really, like a fantasy. But then, it can become too much. The strange fog machine smell is overpowering. The fog is full of neon flashes, strobe effects, dissonant music. No clear air exists, and the fog itself seems laced with heart-pounding, head-spinning drugs. Mania is gorgeous and then horrific, and I trample myself trying to escape it. The doors are locked.

And sometimes, I don't know where I am. The fog spills off a black-lacquered stage in the middle of an ice-crisp field. It all happens at once, or it switches rapidly. This is the mixed state, or the state with mixed features, which is where I think I spend most of my time.

It's not particularly original. But I always find names comforting or validating. I needed a name, a technical term, for how others categorize what happens to me. And I need my own name for the changes, the ambushes. Okay. Fog...or maybe the literary version, brume. Naming something is the first step to defeating it. Or to loving it.

Pour.

A metaphor: A small volume of something vital, pure, beautiful, and surprisingly powerful is hiding in a fragile vessel--one that can slice if chipped or shattered. 

A reminder: One way to combat this, or perhaps negotiate with it on an ongoing basis, is to establish rituals that elevate the ordinary. These embroider tiny ties to earth, people, sanity, and self.

A rule: The goal is to move away from coping mechanisms (automatic, thoughtless, and potentially desperate and harmful) and toward coping strategies (deliberate, constructive, and healthy). This includes a continued commitment to avoiding hazards I've already identified. Safe equivalents exist.

I write this in a spirit of hope greater than what I feel. But that is why I'm doing this. I need a place to grieve, to scream, and to wrestle with this through (often mixed) metaphor and art but also to synthesize information and to begin drawing a map for myself. It won't be a map out of here. I have to learn how to travel and travel on as the terrain and weather change. Right now, I'm cheekbone-deep in rain and mud, and I'm too wet, tired, and wind-sliced blind to climb. If I don't start some kind of swim, I will drown.