Withdrawal – Part 4: Unpacking the Experience

Hello again, everyone!

First off, I’d like to wish a very belated happy New Year to all my readers. It’s hard to believe I haven’t written a post on here since May 2018. Last year proved to be a long and difficult series of months, but I’m happy to say I’m in a much better place now at the end of January 2019 than I was at the same time last year.

As I mentioned in the previous post in this series, I was hospitalized for a week at the beginning of February 2018 for a full manic episode, complete with psychosis and all that that entails. Following that, I made a number of posts on here, some of which I have since taken down, since I was still decidedly manic while writing them and now either no longer agree with that I wrote, or they simply no longer make sense to me now that I’m stable again. To be honest, it’s taken a full year to begin fully coming to grips with everything that happened. The idea of blogging about any of it before now was something I just couldn’t face. However I’ve been feeling increasingly prompted lately to start writing on here again. So to start, I will finish of this Withdrawal series with two final posts.

Despite what happened last year, I am indeed completely off all psychiatric medications and have been since December 2017 (setting aside the very small dose of antipsychotic medication I took while in hospital). And believe it or not, I’m actually doing much better now than I was back when I was on medications, though I believe this is largely due to the special supplements I began taking in April last year and have remained on since. I will explain about them in depth in my next post.  I detailed my reasons for deciding to ween off my prescription medications back in the first post in this series. In this post I will give you all a summary of how that process went, and the biggest pitfall I fell into.

As I touched on in Part 2 of this series, coming off my antidepressant medication Bupropion (aka Wellbutrin) actually proved to be much easier than coming off my mood stabilizer Lamotrogine (aka Lamictal). The withdrawal from antidepressants resulted in some mild-to-moderate depression symptoms and fatigue, however I went slowly, breaking the pills into smaller and smaller pieces. From April 2016 to August 2016 I weened myself down from 150mg daily, to nothing, dropping by 25mg increments every few weeks. I took a break from pill withdrawal for a little while before attempting to withdraw from Lamictal, since it’s better not to come off multiple medications within a short period if you can avoid it. I didn’t keep as close a record of my Lamictal withdrawal, since it took most of a year (I was on 250mg daily, if I remember correctly). Each drop in that particular medication caused anxiety, disorientation and mixed-episode symptoms that were mild-to-moderate, so I had to move slowly with it. And when I finally came off the last of it on December 17, 2017, I hit a major pitfall.

Early on in December I could feel the very first inklings of hypoIMG_2584mania tickling the edges of my consciousness–more energy, increased cheerfulness and optimism, much stronger creative drive, etc. However I continued to taper anyway and ignored the symptoms, assuming they would go away. What I should have done, was stopped tapering for a while until I was past the Christmas season (always a troubling time for me when it comes to my disorder). But I didn’t. And I mistakenly believed that because I had tapered off the medication so slowly, I wouldn’t have any sort of relapse upon completely coming off of it. It wasn’t until later that I discovered that it’s common to relapse with a manic episode upon reaching a completely med-free state even if you taper off slowly. In my ignorance of this fact, I slipped into a state of denial over what was happening.

Generally I am quite self-aware with my episodes, but with this particular one, I lost all personal insight. As the hypomania began to escalate to full out mania in late January 2018, grandiosity and delusions took over and I became convinced that I wasn’t bipolar, that I had been misdiagnosed all along, and that I was just entering a new state of consciousness, a heightened level of existence (very similar to some of the delusional beliefs I experienced back in my first manic episode). I was in complete denial that I was manic, so I flat out refused to take any of my antipsychotic medication, Zyprexa. No one could convince me to. I actually had someone slip some of it into my drink at one point, unbeknownst to me, but I quickly discovered it and became utterly incensed and even harder to reason with thereafter.

hospital_hall_by_triller14Looking back, I can safely say my irrational denial sprang in large part from the fact that  having to go through another full manic episode had been my worst fear ever since my diagnosis (worse even than a natural fear of death. I had essentially developed a phobia of mania and psychosis). I couldn’t bring myself to admit the reality of what was happening. Even after ending up in the hospital and experiencing the remission of most of my psychotic symptoms, I remained convinced that I had been unjustly hospitalized, and that I had never been manic in the first place. My behavior was normal enough during my hospital stay that I was able to persuade the doctor to release me after just a week. Looking back though, I can see that I remained manic for months after my release. This, of course, was readily apparent to my parents and close friends, however they felt I was manageable and would be better off at home.

Astoundingly, I managed to go back to work right away and continue “functioning” in daily life without any of my coworkers or students picking up that anything was amiss with me (at the very least, no one ever commented on it). Though internally, I was still fluctuating between various mild delusions and paranoia. For instance, I firmly believed the RCMP were following me around and spying on me for several weeks, and could not be convinced otherwise (this was not helped by the fact that the RCMP did in fact show up at the college where I work and kept undercover surveillance on the place for a week, though this was due to an incident caused by some unruly students and had nothing to do with me. It just happened to be very bad timing) . Thankfully, I kept all of these beliefs to myself, only occasionally mentioning them to my parents and close friends, which is likely why no one else in my life noticed.

It wasn’t until April that my family discovered the supplements that I subsequently began taking. These had an immediate effect—my previously high levels of anxiety and agitation almost completely vanished. For the next month and a half I remained in a hypomanic state, still more extroverted, enthusiastic and impulsive than I usually am, but grounded once more in reality without any lingering delusions or paranoia. Thankfully I was able to direct my extra energy into studying for my RCM music history exam, which I took and passed successfully. Within a week after the exam, my hypomania vanished entirely, and I dropped into the inevitable depressive episode that always follows my manic episodes.

The Advantage of Suffering cover photo resizedThis particular episode reached a moderate-to-severe intensity by the end of May, beginning of June, though it was no worse than episodes I had experienced while on medications. It lessened to a moderate level throughout most of June and parts of July, then eased off further to a lingering mild depression that continued into December, when it finally lifted completely. The episode lasted a total of 6 and a half months, by far the longest episode I’ve ever had, though that probably isn’t surprising considering the 5 month hypomanic/manic episode that preceded it. December was actually my only month of stability in 2018, which is ironic since that’s usually my most unstable time of year. That stability has continued throughout January this year. It’s a real blessing to feel normal again. I’ve been told that as long as I stay on my current supplements, I am not likely to experience any future episodes of mania. I would very much like to believe that, but only time will tell for sure.

I did learn a number of important, if painful, lessons last year, which I will unpack in future posts. In particular, it was a time of much spiritual growth. Jesus and Mary were both very much beside me, guiding my steps the entire way, thoassumptionugh there were times when I felt entirely cut off from them and in the dark, and I backslid to a large degree in many of my devotions for an extended time. That, in and of itself, was a learning experience (a strong blow to the spiritual pride I’d been falling into prior). There were times I felt as if I’d gone completely astray and was right back to square one spiritually, my relationship with Christ and my trust in him reduced to tatters. I will delve into that much more in a future series. Suffice it to say, by the grace of God I am back on my feet again with a reinvigorated spiritual life, and a restrengthened desire for growth in holiness. I can safely say that the process of renewing my 33 day consecration to Mary that I began on December 31 and will finish this Saturday, February 2nd (Candlemas, the feast of the Presentation of the Lord), has had a large part to play in my spiritual recovery.

I’ll leave it at that for now. In my next post I’ll explain the supplements I’ve been taking and discuss my plans/strategies for the future. In the mean time, take care, and God bless you throughout the coming year!

Kasani

(Click here for Part 5)

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Self-Harm: For Parents

I was recently having a conversation with a concerned parent who was thoroughly puzzled as to why so many of her daughter’s close friends are cutting themselves. She couldn’t fathom what would drive a person down such a path. This isn’t the first time I’ve run into an “adult” (by which I mean people in the age-group of 40 and upwards) who doesn’t understand the phenomenon among young-adults that has come to be known as “self-harm” or “self-injury.”  I’ve already done a three-part series on this subject, which I encourage you to check out if you haven’t already. But those posts were mainly directed at people who are dealing with self-harm personally. It’s different for people who are “on the outside looking in” at a loved one who is struggling with such a problem. So this post is for all of the parents, siblings and friends who don’t understand self-harm, but want to help somehow.

The first thing you need to know is that it’s not your fault.

It’s a horrifying thing for a parent to discover that their child is self-harming. It prompts a million questions and self-torturing emotions — how did I miss this? What did I do wrong? Am I a failure as a parent? What should I do?

I can’t answer those questions for you. What I can tell you is that self-harm is a personal decision that your loved one decided to make because they were/are going through serious psychological/emotional pain. The cold, scientific reason behind self-harm is that it releases endorphins which distract from the internal anguish the self-harmer is experiencing. It creates an “afterglow” of sorts that offers a sense of relief. And this effect is highly addictive. It creates a pattern that is very difficult to break out of. And the more often you’ve done it, the harder it is to get away from. It’s no different than alcoholism or drug addiction — except on one very important point: breaking free of the addiction is not as “easy” (I say that with irony) as resisting the urge to go to the liquor store, or not making a trip to your local drug-dealer. Self-injury comes in many, many forms, and short of cutting off your own arms and legs, there’s really no way to “remove yourself from the source temptation,” as one would be normally advised in Christian circles.

So what is one supposed to do?

Therapy is a good place to start. Another option is getting the person in-question committed (voluntarily or involuntarily) to a psychiatric institution. There are a few things you need to keep in mind, however, if you make that choice:

1. There are psychological consequences to a person spending time in a psych ward. You are likely going to face some backlash later on as the person tries to cope with the serious wound to the self-esteem that spending time in an institution creates. Like it or not, there is a stigma around mental illnesses and psych wards, and the people inside them are just as vulnerable to it as the people outside them.

2. People can still self-harm in psych wards. The staff do their best, and if the patient is there voluntarily and cooperating, it can be a good and safe environment. But if the person is there involuntarily and is angry/depressed, they will still find a way to hurt themselves, regardless of what the staff do. I’ve seen this first-hand.

3. Regardless of where the person is, a measure of trust is required on the part of the family and friends of the self-harmer. The worst possible thing you can do is turn into a “hovering helicopter” that refuses to leave the individual alone. While it’s important to keep up regular, positive interaction with them and make sure they know they are loved, smothering them is going to have the opposite effect you want. It will drive their already damaged self-esteem even lower into the dirt, which can lead to angry outbursts and an increase in self-harming behavior.

You will have to sit down with your family and decide the best course of action, because every family is different. Just know that self-harmers deal with a great amount of shame and disgust over their own condition. Criticizing them, or demanding answers, even in a “nice” way, is not helpful. People who self-harm don’t “do it for kicks.” It is the result of deep psychological pain, and it will take time to heal from it (in more ways than one). Prayer, patience, and emotional support are the best things to surround a self-harmer with. Recovery is guaranteed, just so long as the self-harmer themselves has the personal desire to break free, and the outside support necessary to make that desire a reality.

Until next time, take care and God bless!

Kasani

My Story – Part 2: The Aftermath

After the ship of my old life had been shattered on the rocks of hospitalization, I was dragged aboard a new, unfamiliar vessel, and I wasn’t sure how to feel about it. Fully coming to terms with my diagnosis would end up taking several years.

But I’m getting ahead of myself.

While still in the hospital, after medications had grounded me once more in reality, my doctor tried to explain to me that in bipolar disorder, what goes up must come down. A depressive episode almost always follows on the heels of a manic one. But I was still hypomanic (the term for mild mania), and thus cheerful and optimistic and feeling great. I assured him that I was overall a very happy person and I was sure I’d be fine. And I wasn’t deluded in thinking this. I was going on experience. For most of my life I’d been a happy, well-adjusted person. Happy was my norm. I had no way of knowing just how radically that would change.

Not surprisingly, I did experience a depressive episode a couple weeks later. At the time, I thought it was the worst experience of my life, mainly because it contrasted so drastically with the euphoria of the preceding manic episode. But looking back, I can see it was pretty mild. It only lasted a little under two weeks, and I didn’t end up needing antidepressants. After that episode, God granted me 7 months of almost total stability. This allowed me to get back on my feet and start trying to live my old life again, but it did nothing to prepare me for the reality of my disorder.

d6uhuht-d7e8ebca-0a65-4cc5-9640-179e1bc594b1By the time August rolled around, I was completely adjusted to my disorder (so I thought) and not the least bit embarrassed or uncomfortable talking about it. It was a bit like a cool new label that put me in a separate category from most people– like a weird sort of bragging right (boy, did that ever change over the next several months…). My best friend, who had been diagnosed with ADHD within the same month that I was diagnosed with Bipolar (funny how these things work out), was amazed by my nonchalant attitude towards my disorder. She had been having a difficult time coming to grips with her own diagnosis without it completely destroying her self-esteem.

The difference between her and me was that she had been struggling with the effects of her illness every day of her life without fully understanding it, and now she was still having to deal with it every day but with the added bonus of having a label slapped onto her that essentially declared her “defective” because of it. There was no way to deny the reality of it. It was part of her life 24/7. The fact that she was a straight-A student, whom her friend’s thought the world of, did nothing to ease the initial sting of the diagnosis. She did eventually come to grips with it, and even met and befriended some fellow sufferers of the disorder, but adjusting to the diagnosis of a mental illness takes time.

For me, the fact that I had a mental illness hadn’t yet sunk in. While the events surrounding my hospitalization had been very dramatic, the disorder seemed to have vanished into thin air after a month had gone by. Once I stabilized, it was as if it had never happened. The only changes in my life were that I was now on medication and I had to monitor my sleep and stress levels to avoid triggering another episode. Other than that I felt normal. It wasn’t compromising my ability to function like a normal person. I didn’t feel the least bit embarrassed about it.

In the fall, that changed.

Part-way through September, 2012, I crashed into a depressive episode. I didn’t know it at the time, but it was the start of what would turn into nearly two years of rapid-cycling. After September, I went on to have 12 more episodes over the course of the next year, and 6 the year after that. The first year of that very nearly killed me. From December 2012 to May 2013, I went straight from depressive episode, to hypomanic episode, to depressive episode, to hypomanic episode, with only a day or two of stability here and there. The depressive episodes typically dragged on for close to a month, while the hypomanic episodes usually lasted a couple weeks. If I hadn’t had an antipsychotic medication (Zyprexa) on hand as a PRN, the hypomanic episodes would almost certainly have progressed into full-blown manic ones, and I likely would have had to be hospitalized again. Thankfully that didn’t happen. But most of the hypomanic episodes were dysphoric. In other words, they were mixed episodes. So to say that they didn’t lead to euphoric happiness would be a very impressive understatement. I was miserable.

It was around this time that I began to feel very insecure about my disorder. When I was Disabledstable,  I had successfully taken several university correspondence courses and passed with flying colors. In 2013, I failed a university course because I was hypomanic for my midterm and depressed for my final. I began to think I would never be able to attend an actual university. If I couldn’t handle just one correspondence course, how could I possibly handle a full-time course-load on a real campus?

I withdrew from all my friends except my previously mentioned best friend (most of my friends at that time were not a very positive influence anyway). I muddled along putting one foot in front of the other, and stumbling into a number of pitfalls along the way. I came to have a very intimate understanding of why people self-harm, and thoughts of suicide were rarely far from my mind. As far as I can remember, my faith life did not deteriorate, but it certainly didn’t improve either. To be honest, I’ve forgotten large chunks of that period, especially some of the depressive episodes, and what I do remember is foggy at best. The only reason I know most of what took place in my head in the years of 2012 and 2013 is that I kept a journal. It was one of the coping mechanisms I latched on to.

The year 2014 marked the beginning of my recovery. It was a much stabler year, thanks to changes in my medication. The first mood stabilizer I was put on when I was diagnosed was Lithium. It didn’t work, and over time it began to give me alarming muscle weakness as a side-effect. Any muscle strain at all caused me to shake like a leaf. I looked like a caffeine addict whenever I so much as raised a tall glass of water to my lips, and walking up a single flight of steps left me gasping for air and utterly exhausted.

Thankfully those symptoms went away when I was taken off the drug. The next mood pills  picstabilizer I was put on was Lamictal. My doctor slowly increased the dose until I stopped popping regularly into hypomania, the process of which involved some strange side-effects until I adjusted to it (disorientation, lightheadedness, panic attacks). I also wound up on a constant dose of Wellbutrin (an antidepressant), which my doctor would increase whenever I got depressed, and would decrease again as soon as the increase popped me up into hypomania (which it always did). I also kept the previously mentioned antipsychotic Zyprexa on hand to take whenever hypomanic symptoms appeared. This combination seemed to work, and I was much more stable over the course of 2014 and 2015. However, at the end of 2015, my mother found out some very disturbing things about the medications I was on and after much research and debate, I decided to start weening off all my medications in 2016. You can read about that story here. (As that series details, I am now living completely med-free with the help of some wonderful supplements, and doing far better than when I was on psychiatric medications.)

December 23rd, 2015 marked the end of the fourth year since my diagnosis. A lot happened in those 4 years that I’m not going to try and summarize here. Some of it appears my other posts if it’s relevant to the issue I’m discussing. To wrap up, I am finally adjusted to my disorder. I’m back to living a relatively normal life. I’m happy again. Whether that will last or not is in God’s hands, and I’m content to leave it there.

One of the most important lessons my disorder has taught me is that we have to live in the now. The future is impossible to predict. Life is much less stressful when we let go of the illusion that we’re in control and instead trust God to take over the navigation of our vessel. He knows where we’re supposed to be heading, and he will give us all the grace and support we need in order to get there. We just have to be willing to accept it.

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Take care, and God bless.

Kasani

 

 

My Story – Part 1: The Diagnosis

When I woke on the morning of December 24, 2011, the sky was cloudy. I could tell this, not because I could see the sky, but because the light coming in through the metal grate over the window was a cold, grey shade. The window looked out on an enclosed courtyard covered by a large dome of honeycombed skylights. A tree stood in the courtyard and some benches.

I can see these things in my mind’s eye now as I write, but they were not what initially captured my attention. What I first noticed, as I raised my head, were the claw marks on the walls. Someone had dug their nails frantically into the drywall over and over, and perhaps had applied their teeth as well. The first question that came into my mind was not why am I in a child psych ward? I recognized that I was, but it didn’t matter in that moment. What I wanted to know, as I eyed the marks with horror, was whether or not I had been the one to make them. In my drugged haze and the scattered confusion of the still prominent mania, I couldn’t remember any of what had taken place.

My memory came back to me in bits and pieces as the mania diminished, but the first few days of my stay at that child psychiatric facility have remained a fuzzy blur to this day. I do remember being profoundly relieved to learn I had not made the marks on the wall. And what little else I remember is both cringe-worthy and amusing. I have a vague memory of being locked in a padded room on the unit–the one saved for unruly patients when they threw fits–not because I’d been violent but because, as a fellow patient later explained to me with great amusement, they hadn’t been able to get me to stop singing. I hope the nurses in Emergency had a similar sense of humour, because I sang Christmas carols at the top of my lungs for the majority of the nine hours that I spent waiting there, my exhausted mother at my side having long since given up the task of quieting me.

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I don’t remember being told I had Bipolar Disorder. I must have been told at some point, because I remember sitting in a room with my parents as the doctor gently explained to them why they assumed I had the condition. Then the doctor took me aside into another room to discuss the matter with me. I have no memory of what he said, but I do distinctly remember asking him why he sounded like Darth Vader and feeling convinced he was breathing oddly just to see if I would react. I remember his laughter and his assurance that he simply had a cold. And I remember remaining convinced that he was lying to me.

Looking back at my level of paranoia during those first few days of treatment is quite comical.

(For an explanation of the symptoms/terminology I use in reference to bipolar disorder, check out my post on the subject)

My parents received my diagnosis with a certain amount of relief. Whatever was going on, they hadn’t lost me forever. It was treatable. And it wasn’t, as my mother had feared, schizophrenia. But none of us really knew what the diagnosis meant. It was close to a year before I began to really understand what I was dealing with. In those first few weeks, all I knew was that I had been through an incredible ordeal and my life would never be the same. If I had known at that point just how true the latter statement would prove to be, I’m not sure I would have survived it. But as humans, we are blessed with not knowing the future. It’s a greater mercy than any of us realize.

But how had I gotten to the extreme point of needing hospitalization in the first place?

To continue with the boat analogy from the homepage, my little boat had been sailing along without too many glitches for most of my childhood. As I grew into my teens, the waters grew rougher, but what teenage-hood isn’t rough at times? As the waves grew higher and the troughs between them grew deeper, I struggled to keep my little vessel from capsizing. I didn’t understand why the moods I was experiencing were so painfully intense, but I chalked it up to hormones. “Moody” and “teenager” go together like “peanut butter” and “honey.”

1915446_212680410920_4665233_nIt was my horseback riding instructor, of all people, who rang the first alarm bell. I had been riding for about 6 years. My ability, once cemented at a slow but steady rate of improvement, had begun to fluctuate from skilled to utterly incompetent, right alongside my moods. It was infuriating and disheartening, and my horse was none too pleased with me either. My instructor was at her wit’s end. How was it possible for a student to excel at challenging manoeuvres one lesson, and fail miserably at even simple warm-up exercises the next? Having worked with horses for over 50 years, she had developed what I can only describe as a sixth sense. She could see what was going on inside me just by looking me in the eyes, and what she saw concerned her. She spoke to my dad about it.

“Have you ever considered that your daughter might have some sort of disability?”

My father was utterly taken aback. How could someone suggest such a thing? I was a high functioning, capable individual. There couldn’t be anything wrong with me.

Things continued along in this way for several years, a storm brewing secretly beneath the veneer of my everyday life. Then in December of 2011, a month shy of my 17th birthday, the storm broke. I had no way of knowing I was in dangerous waters. I didn’t feel normal, but I didn’t feel bad exactly. I began taking on more than I could handle in commitments and failed to feel stressed out by it. I began to feel I could accomplish anything I put my mind to, regardless of the challenge. I was invincible and life was my oyster. Those of us who have been diagnosed with bipolar disorder recognize such feelings of grandiosity as a major warning sign. In type 1 bipolar, when you reach that point, there’s nowhere to go but up. And I kept going up— much, much too high.

My riding lessons began to turn into rodeos. My horse was highly sensitive and intelligent, and whatever it was he sensed going on in me, he was not happy about it. I was unable to get through a lesson without him trying to throw me. My guardian angel was definitely looking out for me because my horse employed nearly every trick in the equine book to get me off: from bucking and crow-hopping, to rearing and bolting. My riding instructor was floored. My horse and I had gone through a lot of ups and downs together in the preceding months, but he’d never behaved anything like this before. Something was wrong. But we didn’t know what.

That was when my ship finally crashed into some rocks.

My parents didn’t initially recognize that I had become delusional, but they were getting concerned by my increasingly erratic behavior and they kept me home. I knew something was wrong with me, and I had crying spells in which I sobbed out all the various things that had bothered me over the years. This alternated with ecstatic excitement over the belief that I was reaching a whole new level of existence. I had numerous bizarre insights into books and other things that my parents couldn’t make any sense of. I exclaimed “Oooh, I get it. I get it!”  with alarming frequency. Finally, one evening, after telling my parents good night, going to bed, closing my eyes for several minutes, and then leaping out of bed and skipping back into their room declaring “Wow, I had such an amazing sleep!” with total sincerity, my parents realized I was no longer living in reality.

They rushed me to the nearest hospital, an hour away from our small town. By the time we arrived, I was conversing amiably with my guardian angel, convinced I was a prophet from God and that I had the cure for cancer. I was also at some level aware that my behavior was not what it should be, and decided it must be because I had a brain tumor. But, of course, I had the cure for cancer, so everything would be okay.

We spent the entire night in Emergency. I had gotten the idea into my head that the key pexels-photo-236380to moving on into a higher level of existence was demonstrating that I was able to breathe correctly. I spent the night making repeated trips to the reception desk to earnestly inform the nurses there that “I can breathe!” and then returning confusedly to my bed after receiving their forced smiles and nods.

Morning arrived without me having slept a wink. My poor mother had spent the night keeping track of me while my father grabbed a bit of rest so as to be fit for driving the next day. We were sent to another hospital in a larger city, another hour away. A nine hour wait in emergency later (during which time I began to hallucinate and my delusions grew even more convoluted) I was finally admitted to the child psychiatric unit. After going for nearly 72 hours without sleeping, the cocktail of medications I was given kicked in and I slept for most of two days. December 25th found me still in the scattered, confused grip of mania, but my delusions and hallucinations had ceased and my parents were able to come and attempt to celebrate Christmas with me, bringing me a number of presents that would make my stay in the hospital more comfortable.

But the largest, most life altering present had already been delivered to me: I was Bipolar.

(Click here for Part 2)