Finn: We’ll figure it out. We’ll use the Force

Han: [irritated] THAT’S NOT HOW THE FORCE WORKS!

Doctor: We’ll figure it out. We’ll use medication.

Me: [irritated] That’s not how wellness should work!

***

Yes, I know, gratuitous use a Star Wars quote, but the premise still stands: if in doubt, throw medication at it; if in personal doubt, ask for medication. But maybe it shouldn’t work like that?

It seems like an eternity since late September when I decided I’d had enough of burying myself under a veneer of medication and wanted to try going it alone (supervised, of course, but un-medicated). I’d been enduring an ever-increasing regime of medication, many of which did have some effect, but mostly they made me feel absolutely dreadful – and definitely not myself. I value my identity and I value even higher my intellectual faculties. If you diminish those, well, this is untenable to me: I simply could not see any life stretching out before me. If medication had any effect at all, it was most certainly on my body. Those of you ‘in the know’ understand that mental health and body image are intertwined. It is excruciating to look in the mirror to see a wide and squishy body, a good stone heavier (clothes not fitting like they once did, sudden allergy to the scales). And the heaviness of the mind. The sedation and confusion constituted the greatest challenge. I stumbled into things. I found words harder to capture, writing more confusing to decipher. This was terrifying and frustrating. More so when I had to get others to translate or make decisions for me, which was humiliating.

The hardest part above all, was the sense that it wasn’t medication at all that had dulled my senses, but that I had become stupid and incapable all by myself. I’ve always oscillated between extreme self-belief and debilitating self-doubt (as is not surprising as this is an intrinsic part of being bipolar), but as the years and medication have progressed I’ve begun to believe strongly that I was far past my ‘best before’ date. My fear too was that people hadn’t actually caught on to this fact and I would suddenly plummet in productivity and esteem, seemingly out of the blue. I would then lose my job and this would be the final nail in the coffin. This had happened before: losing one’s self to illness and deteriorating to the point of incapability, and losing the respect of most of my colleagues, has been the most upsetting of consequences. Thankfully, thus far, my illness has not had a detrimental effect on my current employment, but I keep thinking the penny is about to drop (especially as I am part-time and not earning enough to even touch my mortgage). Asking for personal and financial support has been mortifying and my family has been crucial to keeping me afloat. I know that I’m a terrible drain on their patience and income. I shall forever be grateful for their unwavering love and devotion.

So, it is now late January. I don’t usually name and shame medication, but for the purposes of this post, I think it is needed. At the end of December I realised that I could no longer cope with the mood shifts and chaos that was starting to creep up on me; I was particularly concerned that depression was starting to bed in. I thought long and hard about whether medication was once again needed. I was cross about this because I had gone through withdrawal from my mood stabiliser (lamotrigine) and anti-psychotic (quetiapine), both of which had been at the top of the recommended dose range. A number of other trials of other medications had failed, either through their lack of effect or due to the disruptive and unexpected side effects. I still had diazepam in my arsenal and this was being deployed more and more, which was a definite alarm bell. I reluctantly broached the subject of medication with my psychiatrist who was very supportive and had been so during my ‘experiment’ to go without. What would be the new plan? First of all, I had to concede that lamotrigine had been beneficial, so I agreed that I’d add that back in, eventually tapering it back to the top dose. Next we discussed reintroducing an anti-psychotic, but I was extremely reluctant to agree to this – after all, I had dropped back to what I considered to be an agreeable weight and was anxious to see this continue. So what about trying lithium once again? This I had been thinking about myself; the only thing that gave me pause was the fact I’d had a pronounced tremor the last time and, after several months of the usual blood tests and waiting to acclimatise, it was clear that I couldn’t tolerate it. What about if we tapered it incredibly slowly and tried some “creative” ways to adjust the dose on different days? OK, perhaps this might work. So, that was back in the mix once more. By the beginning of January I was back on lamotrigine and back on lithium. Defeat.

The past fortnight has been what I can only describe as a nightmare. For whatever reason, I’ve felt as if fissures have started to open up in my mind. My sleep has been terrible – most nights I have been getting no more than around 3 hours and even that has been broken and light. I do have sleep medication and I agreed to up this to try to break the cycle of sleeplessness. I suspect my brain has become wise to this medication for the most part and it did not have the required effect. I sloped off back to my psychiatrist feeling now that I was failing him as well as myself (and my family). I explained that I could not sleep, that I was agitated and anxious all the time and that I felt like crying about practically everything. The looping music had started again also. The music looping was made worse as the earworms have always had a very distinct playlist – David Bowie songs. In short, I was desperate. I was exhausted by having to keep it all so tightly contained so that I could keep a grasp on productivity. We added in an anti-psychotic – this time an older one with less chance of weight gain. Begrudgingly, I sighed and agreed – we’ll try this, on a PRN basis. What followed was unlike anything I’d ever experienced with any medication…

On Day One, I took half a tablet. And I didn’t sleep. I couldn’t think clearly. I wasn’t sedated as I had been warned about. I was quite the opposite: where I had felt fissures opening up, now they were huge cracks and I was sure I was going completely mad. I was shaking in every molecule of my body. My eyes felt huge. My jaw was clenching. It was like I was being electrocuted. But. But I told myself that perhaps this was just psychosomatic. Maybe if I get used to it and stop being so anxious about it, this will be a passing phase? On Day Two, a couple of days after Day One, I took half a tablet again: the chaos resumed. The next night I took my usual sleep medication and eventually got about five intermittent hours of sleep, but promptly experienced four hours of supraventricular tachycardia (which does happen from time-to-time anyway). I was then so strung out, I thought (who knows what my logic was at this point?), Maybe if I take a whole tablet, it’ll calm me down and knock me out? Day Three, or Night Three, was like entering a pit of snakes. I went to work in the morning and I could hardly type; my arms hurt, my eyes could hardly focus, my hands shook uncontrollably and I felt otherworldly. I told myself there would not be a Day Four – I shall never take this drug again. I got home and tried to ride it out. I took a hefty dose of diazepam (‘splamming’ myself) and went to bed. I did not sleep. I had trouble with my bladder. I was still shaking. I couldn’t eat and my blood sugar levels plummeted. My electrolytes went haywire. And then thing I had feared the most: I realised that I simply could not go to work the next day. So I emailed in and explained, in more vague terms, that I had had an unexpected reaction to medication and was in no fit state to be at work – they were wonderfully understanding and said that if I needed to take another day off, just to let them know and they’d sort it out. No one would think any worse of me. I did take that extra day. And I have since been back at work and have taken on a couple of extra hours (smart thinking *rolls eyes*).

I have this horrible fear. Now that medication has proven to be problematic once more, what lies ahead of me? I have lived with this illness for too long to endure it much longer. I don’t trust medication to do its job. I certainly don’t trust my mind to play its part either. I am a crippling whirlwind. So I end this post with trepidation and dread. What does wellness mean to me anymore?

Doctor: We’ll figure it out. We’ll use medication.

Me: [irritated] That’s not how wellness should work!

Maybe I should use The Force?