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.