Monday, April 13, 2009

What doesn't cure me can only kill me

Yes, finally, another update. My apologies again for taking so long between these things, but it's been a crazy past few weeks.

First, some good news: as of today, I have been off of Lexapro for a week. So far, so good-- mostly. I had a few withdrawal symptoms (headaches, "brain shivers", muscle aches, nausea) but nothing that didn't go away, or couldn't be treated with a couple of ibuprofen. So far, so good.

And unfortunately, some bad news: a couple weeks ago, I had a nasty cold. I treated it with OTC cold medication and herbal remedies. Both of these together (along with my daily dose of lithium) dehydrated me, and caused additional problems. I managed to get a mild case of lithium toxicity, which pretty much wiped me out for five or six days. I exhibited most symptom associated with it: tremors, diarrhea, thirst, drowsiness, nausea, blurred vision and weakness, and spent a week in bed or on the couch until I could get re-hydrated and get my medication levels back to normal.

Of course, this is not a frequent occurrence, but because lithium is a drug where the window between therapeutic and toxic is so small, it's still a possibility. And because it's still by far the most effective therapy for bipolar disorder (not to mention the cheapest, and most well-proven), there's not much choice about taking it (or not taking it).

If I take lithium, I can live a somewhat normal life. I can hold a job. I can live on my own. I can take care of myself. I can do the things that everybody else takes for granted every day. If I am off my meds, things go downhill. It may not happen all at once, but within a few months I have usually wrecked my life.

If I'm depressed, I don't leave the house. I sleep most of the day. I feel sad all the time. I can't concentrate on anything. I don't go to work. And I don't want to live. If I am manic or in a mixed state, I am constantly angry. I drive recklessly and get tickets or even have car accidents. I spend money that I don't have on things I don't need and will never use. I do things that I know are not good for me. I use people to get what I want and push them away after I get it, and then hate myself for doing so. I drink, a lot, all the time. And I don't want to live.

The choice for me is simple: either take my meds and live, or don't take them and destroy myself. When I was younger, I would have chosen the latter without hesitation. I never planned on living to be 40. But now that I'm four months shy of that date, I know what I want to do. I want to live. And because I want to live, I will take those three capsules of lithium every evening at 8:00 p.m. for the rest of my life.