All my mental health issues probably deserve their very own blog. Not just a blog post, but an entire blog dedicated to unpacking my emotional baggage and sharing the myriad experiences I’ve had with these issues. My medication journey alone is a complex and long story.
Before I delve into that journey, though, I want to point out an area where I may have misled you in my previous post. I said something about those of us with Bipolar II having clean houses. That was an absolute statement where one should not exist. My place is certainly not always clean. I try to keep up with it because it impacts my mood. But my mood also impacts my cleanliness. When my place is a disaster, I feel terrible. But sometimes those terrible feelings are just not enough motivation to fold the laundry or do the dishes. It is not uncommon for me to give the place what my mother used to call “a lick and a promise”. Put the clean laundry in a basket and put it in the closet. Gather the Paper Pile of Shame and shove it into a drawer. Get all that stuff out of sight so that it’s not spraying gasoline onto the already-hot fire of my misery.
Often I have to rob Peter to pay Paul. I work hard to clean my place, and then I don’t shave my legs for eight days. Or I shower and get myself all dolled up to go somewhere while I leave a trail of domestic destruction behind me. Where I’m at in my professional life has a big impact on things, too. When I am pouring all of my precious energy into a demanding job, everything else in my life suffers. When life is more balanced, I can pay attention to things like dirty floors and personal hygiene.
For a while, I hired someone to clean my apartment. She was a friend from years past and she had a cleaning business, and it just made sense. A few dollars a month put toward that was more than worth it. Because for me, sitting in squalor makes my depression exponentially worse. I get angry that I cannot find anything, frustrated that everything is terrible and the universe is awful and why don’t I just up and die already. As I type this, laundry sits on the coffee table. The only reason it’s folded is that Em took it out of the dryer and folded it. Otherwise, it would have sat there until I either finally got around to folding it, or decided to rewash it. There are cereal boxes and beer bottles on the counter, groceries and mail on the table, dirty dishes in the sink. My house is not always clean. But, as a southern-raised woman, I feel more pressure than men likely experience; in my head, my worth is tied to the cleanliness of my house, and other aspects of traditional femininity.
If I am in a particularly “up” state, I can be obsessive about cleanliness. Hypomania is not all sunshine and great ideas. Instead, it is often punctuated by irritability and nervous energy. I once had plans with a friend, but she had to sit at my place and watch me agonize over cleaning my place and especially making my bed “correctly” for an hour before we could leave. God bless the wonderful people who love us.
I mentioned in my last post that I started with Lexapro. Sometimes, I genuinely think that drug saved my life.
It was the summer of 2007, I had just turned 23 at the end of May—my golden birthday—and I had been in college for over a year. It had been an arduous journey to get there. Having never finished high school, I had to take the GED test at 21 while I worked a full time job and a part time job, and then I moved a couple hundred miles to be closer to family. In the spring of 2007 I finally left the family farmhouse—a little box atop a hill surrounded by cornfields—to move into a 500 square foot apartment near downtown Champaign. Before that move, I was so depressed that my mother sat in my room at times to be sure I did not harm myself. When I got into my own place again, the depression waned slightly, but mostly I was striving to get by at school and work and racing toward time alone. As soon as I crossed the threshold to my apartment, I could peel off my clothes, close the curtains, and collapse onto my couch or bed.
I wasn’t exactly living life; more like enduring it.
Then someone who had been like a brother to me in childhood died unexpectedly and violently. There was a car accident on Good Friday, and suddenly he was gone. My sisters and I loaded up a car with our mother and my newest nephew at the time and drove the eight hours south for the funeral and to just be with the family who had been some of the only family we had in Georgia (remember D, who I mentioned in my last post? It was his brother).
When I returned home that spring, my mood spiraled further and further downward with grief and the loneliness and homesickness that was awakened when I remembered the happiness I felt in the south.
Somehow I finished the semester with a perfect GPA, but I had to take a large financial hit on summer classes when I found I was too depressed to attend. Depression is a monster in that way, among others. It is shortsighted. It convinces you that you cannot get past this moment, and if you do, the next moment will be just as bad. Depression prevents you from even considering the possibility that perhaps you should power through whatever is directly in front of you. Add being a perfectionist to the mix, and your depressed brain creates a damaging binary: if you can’t do it perfectly, why bother doing it at all? Also, you are terrible at everything, and everyone hates you. Plus you’re ugly.
My adulthood has often entailed me just barely starting to get my footing, only to have the rug yanked out from under me in some deeply painful way, usually the death of a loved one.
Back in the summer of 2007, I was sure that if something didn’t change, I would not survive. I was somehow simultaneously completely empty and yet so filled with pain that I was bursting at the seams. I was so depressed my skin hurt. So I went to the doctor and I told her I needed medication. We needed to try something. She wrote me a prescription for Lexapro.
Another charming characteristic of my chemical makeup is that I tend to be very susceptible to the side effects of psychotropic drugs. When I first began taking Lexapro, it made me exhausted. Not just oh-I-only-slept-a-few-hours-last-night-I’m-kinda-tired exhausted. This was a tiredness that I felt in every cell of my body. The thought of how badly I needed to sleep RIGHT.NOW. was sometimes so consuming that I struggled to interact normally.
Yet somehow in that, my mood changed. When I was functioning, I was happy. Like, actually HAPPY. Not a faked good mood, not a quest to make people laugh so they wouldn’t stare at my eyes too long and see the endless wells of sorrow there. It was not ideal to have to rush home so that I could sleep for twelve hours, but it was better than the alternative when I rushed home to lie around in unshowered semi-wakefulness, binge-watching Netflix (this was when streaming had just started and for some things I had to actually get DVDs in the mail; they were dark times) and eating ramen noodles for every meal.
Later that year, we tried Effexor. It was on the heels of all kinds of steroids to bring back my eyesight, and its side effects were untenable. I cannot remember what all the side effects were, but the important one is the constipation. Again, I’m not talking about oh-I-ate-a-big-meal-last-night-and-I-feel-full-and-I-haven’t-pooped-yet-today. I’m talking about days and days and days where your bowels refuse to move an inch. A distended abdomen because I was literally full of shit. There were tears. There were hours in the bathroom. There were hours of lying around, groaning in misery. The truth is, I have no idea whether Effexor improved my mood because I could not see past the agony of not pooping for a week.
Digestive problems have plagued me my whole life. When I was a teenager, after having my gallbladder removed, my doctor put me on a low dose of Paxil, which is one of the most dangerous and volatile antidepressants out there. Something about the way it releases serotonin supposedly helps the digestive system. I knew no better at the time, and I was on my own. My mom had moved to live in Indiana more than 90% of the time, my dad didn’t really “do” childcare things, and my sisters were working and being kids themselves.
So when the doctor put me on the drug, I happily took it without questioning her. She did not caution me to never just stop taking it. So when I packed up and left Illinois to stay with my sister in Virginia for a while, I thought nothing of it that I may not have enough Paxil to carry me through. I also knew nothing of how to navigate the public aid system of which I was a part, or how to get a prescription refilled in a different state.
When I ran out, I was just out. And then, even at a low dose, the absence of it in my body caused a brutal reaction that might have killed me then were it not for my oldest sister carefully navigating the situation. I was a trainwreck, a shattered and sobbing mess. I’d had no idea that the drug impacted my mood so significantly and I especially had no idea that its absence would send me nose-diving into the ground. Ultimately we got more of the drug, and when I eventually went off it a few months later, I did so more slowly and carefully supplemented it with a lot of pot smoking.
We have also tried the mood stabilizer Lamictal, which did stabilize my mood, but it also made me unable to feel anything at all.
You got straight As! -__-
You just got a new car! -__-
You’re the president of the United States! -__-
Someone in a Nixon mask robbed the bank, and all your money is gone. -__-
Sorry to tell you this, but the dog ran away. -__-
You have died of snake bite. -__-
Becoming a flat line is a major difficulty for those of us with mental health issues. Feeling everything so deeply is challenging. But feeling nothing at all? No sadness, no fear, no happiness, no joy? Literally nothing? That can sometimes be worse. Your creativity slowly dissipates until only only a haze lingers in the air. You essentially become a robot. A functional robot.
I shall do the dishes after eating this tasteless, joyless meal. Now I shall lie supine for several hours while my body recuperates during my brain’s unconscious state. Tomorrow I shall meet up with a friend and interact pleasantly for a reasonable amount of time.
Eventually we settled on Trazodone, a tetracyclic antidepressant, which makes me think of a dinosaur on a unicycle for some reason. I took that drug for something like two years. It turned me into a semi flat line. I was productive. I was functional. I was a high-achieving student and did well at my jobs and maintained a romantic relationship and made new friends. But I also couldn’t cry. Not even a little bit, not even in situations that absolutely warranted tears. I felt the ghost of the feelings that should be there—semi-sadness and semi-happiness. But mostly I went through the motions and lived life that way, assuming I had gotten it right because my emotions no longer ruled me.
Eventually, I couldn’t take the lack of feeling. I wanted to create. I wanted to feel. So I took the only logical step: start drinking. As you might imagine, alcohol mixes poorly with psychotropic drugs. But I found my feelings again. Even if the happiness was fleeting and artificial, tied to the booze, it was there for a moment. And then I would crash down hard. But somehow the familiarity of the sadness was comforting. I knew how to be miserable. I had lived in that place for so long, recognized my surroundings, and I knew how to exist there, even if it was terrible. The devil you know.
I ended my romantic relationship, and jumped right into another one where we could booze together with abandon. We held jobs and functioned, despite the binge-drinking. I stayed in school, but my grades plummeted. I carried a 4.0 GPA for all of my college career until my last semester, when I got a C. I was off all psychotropic drugs. I drank, and I fought with my live-in boyfriend. Tearful screaming matches became the release valve for my misery. I let myself feel every feeling in every direction to its fullest. He drunkenly locked me out of the house, so I drunkenly pounded on the door for ten minutes at 3am before I drunkenly broke the window latch to crawl in behind the TV.
Eventually, I moved on from that lifestyle and got back into my own place and started living more healthily. I stayed off psychotropics, and I continued to drink. But I reduced my intake to a couple of (large) glasses of red wine at the end of the stressful day. I was functional, I was finding meaning in the work I was doing, I was content in my little space with my dog and my simple life.
When I met Em, I had been off meds for nearly two years. Something about him drew me in, and I later recognized that it was his simple spirituality. He is a wonderful, warm, personable, compassionate man who leaves a positive impression on everyone who interacts with him. When we started dating, I was at one of the most stable places I had ever been in life. In the six months prior to us getting together, I had unpacked an enormous amount of personal baggage and I had carefully and meticulously set up my life to be riddled with coping mechanisms and other things to offset my issues.
Around the time that we began dating, I slowly started to redefine my belief in God, which had been absent for a few years. In another six months, I would find myself begging the God I wasn’t even sure existed to just take my ailing mother home, whatever that meant. When I finally prayed it out loud, that God listened and the life finally left her frail body.
For eight months, I wandered through the aftermath of my mother’s death with no medication. She died in July. By the following March, I was so depressed that I frequently went to bed for the night shortly after arriving home from work just so I would not have to think about what to feed myself for dinner. I laid in bed for hours and hours and hours, not awake and not asleep and barely alive. I saw a therapist. Em urged me to ask about trying medication, as talk therapy did little to cut the anguish.
So we started Wellbutrin. I was no longer crying and sleeping constantly. I was slightly more functional. But, as folks who have played the depression/mania/hypomania/anxiety/panic/medication game know, sometimes being functional comes with a high price tag. In this case, I could not feel anything when I landed what should have been my dream job. Instead, I just felt a sense of foreboding at the thought of how much pressure I would be under in learning a new job. And then when I actually started the job, it was precisely what I had envisioned. Crushing pressure. Uncertainty.
To make matters worse, Wellbutrin made my own thoughts inaccessible to me. Where I had once been a formidable leader and professional, I was a tongue-tied, semi-lobotomized shell of my former self. Something about Robin Williams’ death sent me into orbit. A tidal wave of hypomania washed over me, and I thought if I uprooted my existence maybe I could make sense of life and the world and be capital-H Happy. Turns out, it doesn’t work like that. That “break” was necessary for me in some ways, and I needed it to right the ship. But it was also a difficult period with consequences that make me shudder at times.
Today, we have reduced my dose of Wellbutrin. I still do not feel like my brain has returned to normal, and I may never again be as professionally dogged as I was in my previous position. If I do not settle into happiness with this job, I will move on and find a way to survive elsewhere. Sometimes the things we want desperately turn out to be less lustrous than they seemed from afar. I will not give up searching for the right drug or the right combination of circumstances, habits, and behaviors to help me enjoy life.
Even with the professional difficulty, I am happier now than I have ever been. And by cutting the Wellbutrin dose in half, I am at least able to access my thoughts enough to write again.
Nearly everyone who has tried medication for their disorder has tried more than one. Some have disabling side-effects like extreme irritability, tiredness, nausea, constipation, headaches, and sexual dysfunction. Others just don’t work for the symptom(s) they are supposed to be treating. Unfortunately, it is rare to simply take some meds and be good to go. Instead, everything is a balance and the levels need constant adjusting. I stay away from alcohol for the most part, I strive to get enough sleep, I try hard to listen to my body and to recognize signs that I may be on the verge of a meltdown or a major depressive episode or whatever else may come.
Everyone’s journey is unique.
In my personal life, I have found the people and things that are most right for me, my “calling” if you will. I have not yet found that professionally. Maybe I will and maybe I won’t. One of the most important ways to be kind to yourself with a disorder like this is to recognize that happiness isn’t always just around the corner. Instead, it is where you find it, cheesy as that sounds. Forcing yourself to be awake and aware, finding even the smallest meaning and most minuscule reason to keep trudging forward, is as important as anything else.
If we could all have an honest discourse about our issues, I think I would ask everyone, What medications have you tried? Did you find your silver bullet? What do you recommend avoiding altogether?
Because community, connection, fellowship, just the ability to relate to someone else who has also faced these dragons alone, is sometimes more powerful than any drug.