Tag Archives: Depression

Thought of the Week: Lithium, One Month In

About a month ago, I wrote about being diagnosed with Bipolar Type I and the treatments I’m undergoing. Specifically, I wrote about adding lithium to my daily pill diet, and being both concerned and excited about this new treatment. I was afraid of the results, afraid of the side-effects; in particular, I was afraid of what it was going to do to me mentally. I was looking forward to the possibility of a more steady life, and afraid that I would become a zombie.

So now it’s a month later, and I’ve been on lithium long enough for the effects to settle in. The overall result? It’s really, really weird.

I haven’t noticed a wide array of different crazy side-effects, but there are a couple of things that are different that I can really only attribute to the lithium itself. The first, most obvious and noticeable effect is a significant tremor in my hands particularly, and in my body in general. Sometimes the tremors become quite violent, although they are mostly more subdued. For example, I spilled tea on myself and my mouse while writing this post because of a sudden shake. It’s even a little more difficult to type on the keyboard (thank goodness for autocorrect). I’ve also noticed a strange phenomena when I’m sleeping. Mrs. Satis has for a long time said that I shake or move uncontrollably when I sleep, but recently when I’m coming awake (that state between sleeping and waking) I begin to shudder throughout my entire body. It’s not painful, but is the most peculiar sensation I can describe. Every muscle in my body, it feels like, starts quivering rapidly, and this continues for several seconds before eventually fading away, leaving me feeling normal. I’ve started to become used to this, and I had something similar (but much milder) before starting the lithium, but it’s a little unsettling.

The second most obvious change is mental. Here, I can almost feel the lithium interfering with the chemical signaling in my brain. I have a constant fuzzy, numb sensation near the back of my head – right about where the cerebellum would be, I’d say – and emotionally I’m simply gone. I can still laugh in the presence of colleagues but I don’t actually find the joke very funny; I can still frown when Mrs. Satis is angry at me for forgetting to do something for the millionth time, but I don’t actually feel upset. I feel steady, certainly; almost like a see-saw that’s frozen in place.

There’s a good side to this. I don’t get nearly so angry, and I especially don’t get so depressed. This is a hard one to explain, actually, because I still feel a great lethargy, which was always one of the key characteristics of my depression. I still want to spend all day lying in bed, sleeping. (I got ten hours of sleep last night, yet I still felt compelled to have a nap all morning.) I can’t bring myself to do anything, never mind the important things that need doing every single day (like cleaning).

And there’s a down side, which is that I can’t react appropriately to anything. If little Satis is happy, I feel a little “meh”. If Mrs. Satis is angry I feel a little “meh”. It’s okay at work – reactions are governed by pre-scripted rules for social interaction, so as long as I respond the way work wants me to respond, I’m good – but at home it’s causing all sorts of problems. Which is ironic, because the whole point of lithium was to improve my quality of life.

It leaves me wondering what the point of any of this medication is. All I’ve done is traded a violent, abusive, depressed and lazy monster for a quiet, monotone, unfeeling lazy monster. And I have no idea which is better.

Do I want to go off lithium? I’m not sure. There’s the part of me that’s enjoying a bit of stability for once. There’s a part of me that hates the relationships this “new” me is forming with his loved ones. And there’s now a big part of me that just doesn’t give a f***.

Sigh. What would you do?

Featured image from http://discoverccs.org/.

Satis Logo with ©

Thought of the Week: The Darkness Burning

And so goes by another week of wasted time and workless nights; no writing, no doing, no thinking. Long evenings of dozing and watching Futurama and eating too many bowls of cereal, waiting to be able to go to bed and fall asleep, to forget the emptiness of yet another day.

I’ve been struggling with my maladies for many, many years, but was only recently diagnosed with (or learned of my diagnosis of) Bipolar Type I. I’ve already written about this, but it just all suddenly makes sense. Look at this graph:

Screen Shot 2013-10-20 at 9.24.49 PMThis is a chart of my mood over the past six months. As you can see, it goes up and down a lot. I haven’t had more than a week or two of feeling generally stable. What’s much more interesting is the pattern of ups and downs. I need more data to be able to see a genuine trend, but I’ve highlighted above periods of time where my average mood remained below a rating of “5”. They seem pretty evenly spaced, don’t they? A month of up, a month of down.

And so the cycle goes. I’m in a black phase at the moment, entering autumn and feeling overwhelmed with the work ahead of me, both in my personal life and with my novel, and although it seems like it’s lasted forever this time, I can see about that it’s only been about three weeks. Another week or two, and I might be looking up again.

Wouldn’t it be nice? What if I could predict my depression, prepare for it, set things in place to ease the way for myself and my family? “Well sweetie, in about two weeks I’m going to start making your life miserable again; we’d better prepare.”

It probably won’t work out that way. I’m unpredictable, and that’s part of the problem. Ignoring the averages, look at the variation in the above graph: I can go from a 9 to a 2 overnight, and back up again the next day. It’s not easy, believe me.

Unlike typical bipolar disorders, I don’t have especially manic phases. I don’t spend money compulsively, I’m not promiscuous, and I certainly don’t feel like I can do anything and everything in the world. On the best of days it’s a struggle to force myself to do even the things I want to do. However, I do have extremely difficult depressive phases. I’m on four different drugs to try and combat this. And as of this week, I’ve added a fifth: lithium.

That’s right – the dreaded lithium. The certain and dreaded proof, if any was needed, that I truly am bipolar. And I don’t know how I feel about it. If it works – if it softens the downs – I’d be very pleased. The side effects are worrisome, though. I have a mild hand tremor as it is from my existing drugs; lithium may make this worse. In my work I need to have pretty steady hands, and this could definitely cause problems. Weight gain? I gain weight when I’m depressed anyway – my nightly routine usually includes several bowls of cereal. I certainly don’t need to get any fatter.

Worse, I’m both looking forward to and worried about just simply feeling numb. At its worst, my depression nonetheless warms me, a kind of comfort in solitude, in trusting in a known quantity. I know my depression, it is me in the most basic of ways. It’s as much a part of me as my own hands. Drawing back into it is like curling up by the fire in the dark. What am I going to do without it? Will I be able to carry on working, writing, living without as much difficulty? Or will like become even more intolerable without even the escape of withdrawing into the dark?

We’re going to have to see. My doctor hasn’t exactly started me on a low dose of lithium, though there’s plenty of room for increasing it. Part of me wants it, just to see what it’s like – and part of me is terrified.

Which will win?

Featured image from http://quenya101.com/ainulindale-quenyanna/page-5-§§14-8/.

Satis Logo with ©

 

A Gothic Symphony: Chapter Six – Steve

Date: October 12, 4:00 PM.

General topics discussed:

• Relationship with parents

• Self-harm

• Suicide/death

• Past worries/fears

• New job

Amy was more responsive this week than most. In general was willing to discuss matters at length, with accurate descriptions of events/feelings etc. Certain topics are still off-limits, including the circumstances surrounding the onset of her depression. She still struggles at times to verbalize thoughts:

”The words never come out right. I can’t ever say what I actually mean.”

She spends a significant amount of time thinking before speaking, although parent-relationship topics appear to frustrate her, and as such is prone to rapid, defensive responses.

Amy brought up the relationship between her and her father spontaneously at the start of the session. She described an incident in which her father got angry when she questioned him about doing the dishes:

“Some shit about money and how he works all day.”

Said her father’s response was to ‘get drunk’. She has referred to her father’s drinking on numerous occasions, but signs do not implicate alcohol dependence. Alcohol may be a coping mechanism.

She also expressed a reference to sex, which is extremely unusual for Amy:

“Then he fucked mom.”

She appears to be extremely sensitive about this topic, although this is not unusual for teenagers her age. Her phrasing and tonality were extremely negative, but it is unclear whether this is in relation to the act of intercourse itself or the general anger she feels toward her father.

She has referenced a ‘distance’ between her and her father on several occasions. The repetition of this topic suggests that there is a desire for closeness that she is not receiving. Her father appears to have been emotionally distant for most of her life. Possibility: Amy was an unplanned pregnancy?

We spoke at length about death and suicide. She initially described a state of being she refers to as ‘numbness’. She finds a lack of emotion/sensation to be comforting. This was brought up reference to self-harm, which she is continuing to do. She claims that she does not self-harm for any sensation of pain, but instead to ‘see the blood’. She appears to find the sight of blood emotionally releasing. There is a strong sense of shedding negativity.

Bring up leech metaphor if appropriate.

Amy likened her numbness to being in a grave. She seems to find a sense of protection, of safety in this state. However, this led to the first roadblock of today’s session: probing about this sensation of safety triggered a shutdown with regard to perceived threats.

It is possible Amy sees death as a place that is safe. However, at the moment the risk of completed suicide is not high:

“I want to be dead, but I don’t want to die.”

For the moment this ideation seems to suffice. She referenced contemplating multiple scenarios of death, though most seem to be taken from the canon of ‘urban myths’, including cyanide poisoning and injecting air into the venous system. She also suggested wrist-cutting, though it does not appear that she has done any significant research into effective methods. This is something to monitor closely over the next few weeks. […]

Read the full chapter here.