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

divine-mercy4

Withdrawal – Part 3: Joyful People Suffer

It’s been a long time since I posted anything. Or at least, it feels like a long time. Realistically it’s only been a few months, but that might as well have been a lifetime ago. A lot as happened since then.

I’d like to start with the good news: I successfully came off of my last medication (Lamictal/Lamotrigine) mid-December last year. It was, in a way, the most freeing experience of my life. It precipitated a manic episode that ended with me in the hospital, but that’s all right. I learned a lot from it. Christmas 2017 was beautiful for me. So many blessings. I had a strong re-conversion experience in which I gave my life to Jesus again to do with me what he willed. Admittedly, if I’d known doing that would end with me in a hospital, I probably would have hesitated. But God knows our weakness. He hid from me how things were going to turn out. He wanted my complete and unconditional trust, and he was there for me every step of the way. He and His mother, Mary.

I plan to write a blog series explaining what happened. For now, though, I’m still processing everything and picking up the pieces (i.e. catching up on everything I’m behind on after two weeks out-of-commission, and praying to discern God’s will moving forward). I just wanted to send a shout out to my few followers that yes, I am still alive! And I’m doing great. Just decidedly worn out after everything. I look forward to writing more in the future.

Until then, take care and God bless!

Kasani

 

 

Sit Down, Buckle up, and Hang on Tight: Riding the Bipolar Roller Coaster

(If you’re curious about the cover picture, it’s a self-portrait I drew a few years back with mania and depression anthropomorphized into fictional characters. I’ll let you figure out which is which.)

What is bipolar disorder?

To quote Wikipedia:

“Individuals with bipolar disorder experience episodes of a frenzied state known as mania, typically alternating with episodes of depression.”

It’s a teeny-weeny bit more complicated than that (<– please note the sarcasm in this statement). I’m not going to launch into a full, in-depth explanation, because plenty of books have already been written on the subject (for an excellent, highly entertaining book check out Welcome to the Jungle by Hilary Smith. It’s the first book I read about bipolar disorder, and it’s by far the best. I guarantee you’ll get a laugh– something you won’t be getting from most other books on the subject. Instead, I’ll just walk you through the terminology I make use of:

Manic episode – You’re bursting with energy. Sleep is impossible. You’re either euphorically happy, alarmingly irritable, or paranoid, or some combination of all three. Some people fly into rages (thankfully I’ve never had that problem). Your thoughts are speeding along at roughly a million miles per minute, which starts out exhilarating, but it gets old very quickly (just staying focused on one conversation is difficult, let alone trying to read something or plan your day). The speeding thoughts can enhance your creativity, but you have the attention span of a gnat, so you might start a dozen new projects in the course of a day, but you won’t ever finish them. Your judgement goes out the window. You do stupid things: driving recklessly, maxing out your credit cards on spending sprees, breaking up friendships, quitting your job. Hypersexuality is another symptom. Ordinarily you might be a very chaste, conservative wall-flower, but in the throws of mania you are liable to get into a lot of trouble if you’re in the wrong place with the wrong person (or people). You aren’t in your right mind, so you aren’t morally culpable, but when sanity returns you might end up facing some devastating consequences (this is something I’ve never had to deal with, thank God). If things progress far enough you can become psychotic. You have delusions of grandiosity that leave you convinced that you’re a celebrity, or that you’re Jesus (this is actually a very common delusion, even among non-religious people), or you’re on a mission to save the world, or you’re invincible, can control things with your mind, can fly, etc. Hallucinations are also a possibility. The symptoms of psycho-manic episodes are very similar in some ways to the symptoms of schizophrenia.

Hypomanic episode – This is another way of saying “mild mania.” Take manic symptoms and turn them down a few notches. It still interferes with your life, but you’re able to function at least semi-normally. Sometimes hypomania can actually be a positive thing, since the extra energy and creativity isn’t compromised by incapacitating racing-thoughts. It can also be quite enjoyable if euphoria happens to be a symptom.

Depressive episode – In other words: depression. Anyone who has ever experienced it probably doesn’t need an explanation. Bipolar depression is very similar to major depressive disorder. Symptoms of depression include utter misery and despair (that’s not an exaggeration), crying, lethargy, exhaustion, apathy, loss of interest in formerly enjoyable activities, inability to feel pleasure, morbid thoughts and suicidal ideation, excessive and irrational guilt, intense self loathing, insomnia, loss of appetite and weight loss, and withdrawal from friends and family. There are three potential differences in bipolar depression: firstly, antidepressants usually kick in immediately and have the potential to shoot you over the moon into mania, so you have to be very careful with them. Secondly, some people experience hypersomnia rather than insomnia. They are unable to get out of bed for days. This is not due to laziness, but rather absolute exhaustion (the intensity of it defies description) and apathy.  The third potential difference is an increase in appetite, rather than a loss, which can result in impressive weight gain (eating a whole tub of ice cream every day, for example, or sitting down and eating spoonfuls of sugar straight from the bag. It doesn’t help that a number of medications used to treat bipolar have weight gain as a side-effect). When someone experiences hypersomnia or increased appetite  it’s considered an “atypical depression.” I’ve never had either of those problems. My depressions are pretty typical. Unless they’re mixed episodes.

Mixed episode (also known as Dysphoric Mania or Agitated Depression) – You’re depressed and manic at the same time. I’m not joking. This happens rather frequently (in my experience, anyway). Take the emotional anguish of depression, along with its self-loathing, guilt and suicidal ideation, and mix it with the energy, impulsiveness and racing thoughts of mania, and you have a very dangerous cocktail. According to the stats, about 40% of people with bipolar disorder attempt suicide at least once in their lives, and roughly half of them are successful. In other words, 1 out of every 5 people with bipolar disorder end up killing themselves. Mixed episodes are the main reason for this. In straight depression, exhaustion and apathy make suicide less likely. Exhaustion and apathy are probably the only two depressive symptoms missing in a mixed episode. Energetic impulsiveness + thoughts of suicide = dangerous. In my experience, mixed episodes are also the time when self-harm urges hit you the hardest (if you’re someone who has that problem).

Rapid Cycling – In ordinary bipolar disorder, a person doesn’t get more than 4 episodes per year (that doesn’t sound like much, but one episode can last anywhere from a few days, to months). But it doesn’t always work that way. If you have more than 4 episodes over the course of a year, you are considered to be rapid-cycling. It’s a common problem in bipolar teens, and antidepressants can play into it in a big way as well.

So there’s your brief overview. If you have any questions, drop me a comment.

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. There was a tree in the courtyard and some benches.I can see these things in my mind’s eye now, 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 to it 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 much to me at that moment. What I wanted to know, as I eyed the marks with a certain amount of 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.

Some of my memory came back to me in bits and pieces as the mania diminished, but the first few days of my stay there 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 of my room. What little else I remember is both cringe-worthy and amusing. For instance, I have a vague memory of being locked in a padded room in 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 emerge 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.

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 uncomfortably intense, but I chalked it up to hormones. “Moody” and “teenager” go together like “peanut butter” and “honey.”

It was my riding instructor, of all people, who rang the first alarm bell. I had been horseback riding for about 6 years. My riding ability, once cemented at a slow but steady rate of improvement, had begun to fluctuate between skilled, and 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 swallow 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 (which, oddly enough, has been an inside joke in my family ever since. Whenever I become unusually cheerful and giddy, my father invariably asks me “Do you get it yet?”). 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 emerge. I had gotten the idea into my head that the key to 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 emerge 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)