It seems that I’m a bit of an enigma to my current psychiatrist. I say current because his coming Monday I am seeing yet another doctor at the request of my current doctor. The pattern and intensity of my bipolar episodes have become so erratic that my medication regime is failing to control or at the very alleviate my symptoms. My last appointment review letter indicated I was in a ‘mixed state’, which comes as no surprise to me, but something of a frustration to my current psychiatrist who has pretty much thrown the kitchen sink (or least the ceramic, minus the taps) at me to see whether something will stick. In the meantime, I have been up and down and up and down and increasingly distressed. And he is struggling to know how to treat me. My cycles are ultra rapid now, but maintain some consistent features: perhaps two days of laser-guided hypomania and then the rest of the time in a whirlwind of desperation, agitation and, as is my state over the past week and a half, intensifying depression.

I like my most recent psychiatrist. He is unfailingly sympathetic and tireless in his approach to excavating some kind of pattern of mood and corresponding treatment regime. But even he is at a loss as to why I am still oscillating so dramatically. Neither of has discussed admission, mostly because he knows that being professional with regard for my university job is paramount. We have until the 3^rd of December to come up with a new plan, in conjunction with the consultation with the specialist, after which I am off until term starts again in late January and perhaps a window where more intense treatment might be necessary.

But Monday seems farther and farther away. The ‘complex nature of [my] illness’ is starting to have a significant impact on my work and ability to cope with all facets of my life. Practically everything upsets me at the moment: charging my laptop overnight, choosing clothes to wear, or ordering a coffee. Trivial things. I have a tremor that mostly affects my left hand and interferes with typing (the key skill of a note-taker) and my stutter is often incredibly disruptive – it is likely that both these things are the result of my intolerance to the lithium I am taking and this is probably going to be phased out as of next week. The stuttering is made worse by the continual anxiety and stress that I feel all day. In the night, the agitation and crippling depression has space to take hold more intensely. My sleep is disrupted even when I try to calm things down with zopiclone and diazepam. Poor sleep leads to confusion and panic. And then I have to contend with the other side-effects of the medications I diligently take: quetiapine upsets my ‘stomach’, the lamotrigine gives me twitches and the aripiprazole gives me blurred vision. The lithium has been a total failure and will be the first thing to go, alongside the aripiprazole most probably. If I can’t type and I can’t see properly then I most certainly cannot do my job.

Last night I got home and the darkest of suffocating waves washed over me. I tried to alleviate it by watching a film, a film I enjoyed very much when I went to see it at the cinema (X-Men: Days of Future Past), but I couldn’t keep still and I tried very hard not to cry. I managed to see the film through to the end. I went upstairs and took my nighttime medication (the great pile of pills in different denominations) and lay in bed with a whirring mind full of despair and self-hatred. I looked at the clock and it was 10.30, which isn’t late for me, but I started to calculate how much time I had to get effective sleep before getting up early for a 9am lecture (which in the event did not happen and I got up at 7am for no reason). Then I began to panic: I can’t sleep, my life is so painful, I can’t take these hours and minutes that drag me along, my bones hurt from the psychic darkness infecting them, I am a heavy, dragging sack. I took some zopiclone to help me sleep, but by half-past midnight I was still awake and still in a state. I took some diazepam and then promptly started to cry, the intense crying where your whole face feels agonizing and you screw up your face against the pain. I received some supportive tweets from people who I have come to consider close friends and felt slightly less alone. Thank goodness for my twitter companions.

I looked at the clock and discovered it was now 1.15a.m. and I had to get up at 7a.m., which seemed unbearably close. So, I began to consider whether trying to force myself to sleep, and risk waking with a diazepam/zopiclone hangover, was a good idea. I went and got my iPad – Netflix it is then! I watching a couple of episodes of House (M.D. if you’re American), but then I started to search for the episodes that I knew were particularly depressing. Well done, brilliant idea. Oops, now I was crying again. Perhaps a book then? Nope, I can’t read with these blurry eyes, and certainly not at that time of night.

I looked at the calendar on my iPhone to confirm that my referral appointment was indeed on Monday and not any closer. Of course, I knew it hadn’t moved all by itself just because I willed it to. I took some more diazepam. I then wondered whether my lodger was awake and if she’d want to just chat for a few minutes, at what was now nearing 3a.m. I left my room and stood on the landing before going downstairs to disturb my cats instead. They were asleep and grimaced at me when I put the light on. Bad human. So I went back to bed, this time feeling a little calmer thanks to the extra diazepam and, after about ten minutes, I had dropped off to sleep.

This morning I awoke with a gargantuan medication hangover, made worse by the taking of my a.m. medication. I dragged myself into the shower, dragged myself out of the shower, dragged on my clothes and dragged myself out of the house. And this is where I’m at, dragging myself around like a sack of rocks. Attending lectures for my students is difficult today and my brain simply is not working. And so I wait. Waiting for this appointment that seems as if it is next year. Waiting in the hope that something positive will come of it because I am putting all my eggs in this basket. And so I clock watch and clock watch – I wait for the specialist with the keys to my salvation.