Some Days Are Easier Than Others

 

I have to say I am struggling at the moment. Not in terms of depression or mania. Not in anxiety or stress. But from pure exhaustion.

I’m struggling to understand whether the exhaustion is mental or physical. Medication induced or cumulative from the hell last year was. All I know is that I crave my bed at times of the day when I shouldn’t. The early morning enthusiasm I have always possessed has deflated into a bleary eyed being going through the motions. Sometimes, and I know this is bad, I choose not to eat because the very thought of preparing lunch exhausts me.

I’ve tried experimenting with my medications. The anti-psychotics are my biggest suspect. Naturally, though, when I skip my dose I end up awake all night. My insomniac ways back again. This I could put up with, but the symptoms of dissociation the following day I can’t. So I take the pills again, and continue wading through my days.

This just wont do though. Despite the fact that I have an active toddler to care for and a house to run, I also have a thesis to write. Yet I stare at the page, immersed in a cloudy brain fog, wondering if I will ever possess the mental strength to finish it. It annoys me. All that time spent researching, waddling into uni eight months pregnant to meet participants, meetings, leaving behind my eight week old baby to run classes and collect data at uni, hours fighting with my statistical software, ….all that goddamn dedication, and now I can’t find it in me to do the best, easiest, most rewarding part!

“You” my supervisor said a few months ago, “have worked so hard on this. You have put much more work into this than the average student. Now you just need to get your act together, write the darn thing and get the mark that you deserve”.

Ok, so she didn’t tell me to get my act together, but I’m sure she was thinking it. 😉

I’ve made a start I suppose. I sat down today, reread the 19 pages I have already written. I read a few key journal articles. Corrected a few mistakes. Forced myself to sit at my desk, put on my glasses (because that surely means business!) and just get on with it. I haven’t achieved much, but it’s more than yesterday, and I suppose that is what counts. I’ll chip away at it. A bit here, a bit there, and hopefully one day I will be surprised to find a finished product.

 

Over the last few years I think I have tortured those around me enough with my thesis. “It’s hideous! I actually think it may kill me”, punctuated with a dramatic flop onto the floor (much to the alarm of the family dog). An epiphany three hours later where I talk with great excitement about “the most interesting thing I have learned all week. Potentially all year. But let’s not get ahead of ourselves yet.” Yes, it’s a love hate relationship. A bipolar state within itself. I’m not the first and won’t be the last to feel this way. Enough is enough, and I must get it done.

 

As for the exhaustion, it’s still here. I’m hoping it’s merely a medication glitch that can be dealt with at my next appointment. If it’s a psychological thing – I guess I just have to keep riding this wave.

Lithium

 

I was against Lithium for a long time. I suppose I was tired of being pumped full of medications that never worked. Maybe I was scared of the side effects, and the risk of lithium toxicity. Perhaps refusing the medication was the last source of control that I had.  Whatever the reason, each time the doctors wrote it up for me, I would refuse to take it.

Lithium, to me, was a commitment that I wasn’t sure I wanted. Everything about Lithiu seemed to revolve around ‘Do’s’ and ‘Don’ts. Do: have regular blood tests, drink enough water, monitor for symptoms of lithium toxicity, take the medication with food. Don’t: stop taking the medication suddenly, take the medication if you have gastro, take other medications without checking to see if they interact, get pregnant.  And even if I did do all of this there was no guarantee it would work anyway. As it was, every single mood altering medication I had been prescribed during the past decade had been a dismal failure. I had lost a great deal of faith in the psychiatric profession and in psychoactive medication.

But more than this, I think  Lithium represented my last chance, a lifeline that I was scared of giving up. Every time things got bad, a part of me would think “well…there’s always the lithium..”. But if I used it up, if I took it and it didn’t work, then what?

But one day, of course, things did get really bad. I fell to the ground in front of the other patients and howled from the core of my being. I was quickly escorted outside and medicated. “I can’t do it”. I whispered to my nurse as she held my hand. “I just can’t do it. I’ve tried. I can’t keep going anymore”. I howled again, clutching my stomach in physical pain.

The nurse gently steered me into the doctors office. Emotional pain became physical paralysis.  They helped me sit down. I stared blankly into the distance. They asked me: “What is the doctors name? What is the day of the week?  What is the prime ministers name?” The first question I knew. The second I had to think about – every day is the same in hospital. The final question I struggled with. Was the prime minister still that woman? Who cares.

That night my nurse came to give me my night medication. Two lithium tablets were sitting in the little plastic cup. “I don’t know if I can do it” I said. She sat down next to me “Look Rachael, I saw you this morning and it was absolutely horrible. It was awful to see someone in that amount of pain. It must be awful to feel like that, and yes – all medications have their risks, but surely anything….anything… is better than feeling that way”. I knew she was right. I knew I needed to take a leap of faith and trust the people who were trying to help me.

So I took the pills. I think I was expecting some kind of revelation to occur as soon as the white tablets touched my tongue. The heavens to open. The stars to collide.  But no. It was just like taking any other tablet, and life went on as normal.

 

The thing about Lithium is that you feel like crap when you first start taking it. Even worse, my first blood test revealed that my blood level was below the therapeutic dose, so much to my annoyance my dosage was increased. I was prescribed Maxalon for the nausea, but it didn’t help much. Another girl at the unit had just started her Lithium too. We bonded over shared side effects, and fantasized together about refusing our doses (Anarchy in the MBU!) I honestly didn’t ever believe it work. Nothing ever had.

 

But that’s the thing about bipolar. Standard SSRI anti-depressants don’t work, not alone anyway. Best case scenario you have wasted your money. Worst case scenario they make you a whole lot worse – or even trigger a manic episode. I had been a worst case scenario.

 

To my utter astonishment only a few days after taking the lithium at the therapeutic dose I started to feel better. A whole lot better actually. At first I thought it was a fluke. But my depression fell away, my mood lifted, my agitation lessened, my anxiety disappeared. I stopped crying. I started laughing.

And then I had to sheepishly inform my doctor that she had been right all along. To her credit she never said ‘I told you so!’ 😉

The major lesson I learned from this experience is to never give up. I had come to the conclusion that nothing would ever work to help me. That I was unsalvageable. I had given up on myself, and I had lost all sense of hope. Yet the thing that helped me was staring me in the face all along. I’m not going to proclaim that Lithium was a magic cure. It’s far complicated than that. But it did help stabilize me to the point where I could begin to use the psychological strategies that I had been taught. And for now I take those little white pills each morning and evening. But only for now 🙂

 

 

Hospital Diary Entry

Today I thought that I would share one of my more coherent diary entries from when I was in hospital. This was written on the 10th of April, 2012.

3:30am and I’m wondering, yet again, if I can do this.

You don’t know what it’s like to be a psychiatric patient until it happens. Here everything has the facade of being a friendly family oriented institution. But if you look past the queen size beds, comfy couches and children’s play equipment, it is still a psychiatric institution where they have control, and you do not.

You have ask to shave your legs here, so eventually you stop bothering. You have to ask to dry your hair here, so eventually you stop caring. Every time you go out you have to complete a ‘risk assessment’ form, where the person accompanying you is referred to as your carer and has to take full responsibility for your actions (because you are not deemed responsible enough to take care of your own actions). Your room has a low water temperature, a peephole on the bathroom door, and a window on the door. And don’t forget the locks.

In two days I will have been here for four long weeks. Four weeks of waking up alone, without Hubster there. Four weeks of crying every single day. Four weeks of strong medications…yet not being able to sleep. Four weeks of being cocooned from the outside world.

I felt ‘stoned’ yesterday. That’s the only way I could describe it. My pupils are huge. Everything is overwhelming. The colours. The brightness. Sometimes I look around and feel I will physically collapse because there is just SO much. Doctor said it’s a medication hangover. Bloody Zopiclone. I refused it tonight….which is why I’m awake. It’s a no win situation. I don’t sleep, I get worse. I get worse, I don’t sleep. I take sleeping pills, I don’t sleep. I take Zopiclone, I sleep but feel awful the next day.

Diazapam, Lorazepam, Olanzapine, Quetiapine, Phernagen, Lexapro, Desvenlafaxine….this is my language now.

Hubster keeps telling me to take my time. That he would rather I stay another week than come home prematurely and be re-admitted a month down the track for another three weeks. I know how hard it must be for him. He goes from home to work to the hospital then home every single day. Some days he doesn’t even have dinner. But he never ever complains.

The thing is, I have been trying hard, I really have. I WANT to get better. I’ve done the meditation, the CBT, the medication. Yet something is just…..not right.

God, I’m so sorry.