Tuesday, November 24, 2009

Plan Ahead, or Abilify Is a Hell of a Drug

Author's note: sorry if this rambles, but it will get somewhere eventually...

For a change, I thought I'd post an update within 48 hours of a change in my situation/psychiatrist visit/end of the world/etc., while it's all still relatively fresh in my mind.

To recap: I'm rapid cycling. This was pretty much confirmed by my doc yesterday. The short definition of rapid cycling is three or more depressive or manic episodes in a 12-month period. Currently, that's definitely me.

As I mentioned in my last post, I was running a bit manic. I had tons of extra nervous energy. There were several days in a row where I walked 5-6 miles a day, and still had energy to burn-- definitely abnormal for me. And for the first time, ever, in my life, I was having hallucinations. Nothing major, mind you, but some minor annoyances that caused me some concern and made life awkward. I never heard voices, but was always hearing music-- bad music no less.

My doc took me off my last remaining anti-depressant medication back in October, (Lexapro, 5mg-- a very low dose), as anti-depressants often cause mania in bipolar patients. In fact, that's often how doctors (at least, good doctors) distinguish between bipolar and major depression, but more on that later. Within two weeks of going off the Lexapro, I noticed that things were moving, ever so slightly, downward. My energy was a bit lower, my concentration got worse, and I got more irritable than usual. I was sleeping 7-8 hours a night again. The audio hallucinations got fewer and farther between, and I noticed that my hearing was not nearly as acute as it was when I was manic. Back to "normal" then. Good enough.

But as usual, "normal" was entirely subjective, which is why it's one of those words that is always used in quotes with me. Very soon, there were less "normal" days, and more days where I didn't feel quite right. I quit walking after work, and I noticed that even the smallest noises in my condo bugged me-- especially the sounds of the upstairs neighbors walking across the hardwood floors in their shoes and the out-of-sync noise from the furnace, which sounded like a boom car on mescaline as it rattled throughout my condo.

I had this sneaking suspicion, given how my episodes wind out, that I'd be feeling about knee-high to a grasshopper around the end of Novembeter. I planned ahead, and asked for the week of Thanksgiving off from work. If I was sick during that time, I could at least work on getting well. If I wasn't, I'd have my first full week off in over five years. I even moved up my appointment with my psychiatrist for Monday the 23rd of November, just to be extra safe.

Needless to say, planning ahead has definitely paid off. This latest depressive episode, while still difficult and painful, has been one of the easiest I've had in several years. And being prepared ahead of time has made all the difference.

It's taken several years, but I think I've finally learned to listen to my body, and my mind. This time around, I recognized that I was running a bit manic: difficult tasks at work became "too easy" for me, as did making music. I had tons of nervous energy. I was easily distracted by small things. I kept my spending under control, for the most part, but I had urges to make large purchases (*cough* new Gretsch guitar *cough*). After so many episodes, I knew what my signs were-- and because I knew they were signs, I followed them.

And whatever goes up, must also come down. I knew that I was going up, even if it was fairly small when compared to other episodes. Consequently, I got ready for the inevitable crash. I talked to my doctor. I made appointments. I took time off work, and arranged to spend the week at my mother's house, because I didn't know if I'd be able to take care of myself when I crashed.

And it has paid off.

Yes, I am still pretty depressed right now. I can't get out of bed before 9:00 a.m., and am in bed well before 10:00 p.m. I feel lethargic, and it has taken me two attempts and five hours to write this blog entry. I haven't gotten any exercise in almost a week, and feel like I've got a hangover (which is probably due to the side effects of starting Abilify, more than anything). However, I am able to get out of bed each day, I am able to feed myself, I am able to leave the house and spend time among humanity (I'm in a coffee shop as I write this). So yeah, things kind of suck right now, but they are bearable.

The moral of the story? Hell if I know. But what I do know is this: us bipolars needs to pay attention to what our brains (and our bodies) are telling us-- much more so than normal folks who don't have to ride this roller coaster. We need to be ever vigilant of the signs that we're having an episode-- manic OR depressive. We need to be pro-active, hyper aware, almost to the point of being hypochondriacs (better safe than sorry when it comes to having an episode, I say. Besides, we're the ones that pay the doctors' salaries).

We may not have asked for this condition, but we can learn to live with it. And make no mistake, it's very hard work sometimes. Sadly, our brains do not speak English. But we can understand them, if we only pay very close attention.


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The Diva's Guide To Fabulous Living said...

My mom was M/D before they had drugs for it. It was hell on wheels at our house 24/7 It took me a decade of therapy to figure out simple stuff like "am I sleepy?" At one clinc they gave me Rorschack tests & then no meds, so, ergo I must be "normal"
as I read your column I started to wonder if some of your problem is that you're psychic? I'm not joking. Good luck & I think walking helps.

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