Daily Archives: May 22, 2012

initial impressions

I’ve had 600 mg of lithium since last night and I’m already experiencing effects like thirst, dry mouth, and frequent urination.  I’ve also got a strange aftertaste that isn’t normal.

I am also noticing some things I didn’t anticipate, like feeling more hypomanic.  I feel restless and distracted.  It’s hard for me to follow my own train of thought, let alone that of my students.  Several times I’ve had to ask them to repeat their questions.  During the student presentation, I just hoped they were getting information right because many times I realized I had no idea what was going on.  I was going to give one of my favorite talks today but I am too disorganized.  I am having trouble forming sentences and sometimes have to correct my words.  Once I realized the disorganization in my thought and speech patterns, I realized there was no way I could lead a discussion.  I am worried: how am I supposed to provide timely grades?  I need to create a study guide for this week’s exam too, but I can’t imagine sitting and focusing on anything.  What about my extra-teaching responsibilities?  Thankfully, I had a backup documentary that corresponded with today’s material, which we’re watching now.  I’m really just counting down the minutes until I can get back home.

This agitated feeling is combined with the strange sensation that I would really like to take a nap.  Sleep for the rest of the day, perhaps.  I got 8 hours of sleep last night, but it was from 7p to 3a, so by the time I had to get up for class I was ready to go back to bed.

Another interesting and unpleasant change in experience that I’ve noticed lately (not just associated with lithium use) is that I am very sensitive to sound and light at times.  Two nights ago, I had to tell my ex-boyfriend to lower his voice.  It sounded like every syllable reverberated in my head and that there was even an echo in the room.  Same thing today: I noticed it right away when I walked in class.  The fluorescent light was on and my students started talking to me right away.  I winced at how loud it sounded.  Even shuffling papers or the tick of the clock seem unnaturally loud.

As the minutes ticked by, quite obviously I might add, my anxiety steadily increased.  So I reached out to ex-boyfriend so that perhaps he could give me some support and relief.  I hadn’t yet told him about my decision to take lithium and I was honestly surprised about his reaction.  In fact, it ended up stressing me out more.  He even just stopped responding mid-conversation.  You may be wondering why I expect my “ex” to be supportive.  We are technically broken up at this point, but we are working toward resolution and getting back together.  More on that later.

I’m so frustrated I’m going so far as to share part of the conversation here:

Ex-boyfriend (XBF): Here
 me: thank you
XBF: But it shows youre offline
 me: yeah
  i’m here
  invisible
  um
  i forgot
  hold
  oh
  so i feel really uncomfortable
  everything is loud
  and i have blurry vision
  and i’m kinda freaking out about teaching class
  i started lithium because my symptoms have been out of control and prozac isn’t helping at all
  lithium at slow doses is also used for resistant depression
  and besides i’m exhibiting hypomanic symptoms
  except
  its dysphoric hypomania which fucking blows
XBF: I am wee aware of lithium
 me: ?
XBF: Well*
 me: why
XBF: One sec
  Phone

5 minutes
me: i can’t follow what my students are saying
XBF: Im back
  Ya thats lithium
  I thought you said you might be bipolar 2
 me: what?
   it’s not lithium this was happening before
  i am bipolar 2
  and you’re stressing me out because it feels like you’re doubting me
XBF: Yes bipolar 2
  No
 me: i am already freaking out
XBF: Im doubting a “doctor” who prescribed lithium as an early attempt to treat bipolar 2
  Thats practically off label
  Ill never doubt you
me: no it’s not
XBF: I just hope you choose to get a second opinion
 me: i am
XBF: Because i care about you
 me: i made calls yesterday
XBF: Ok
 me: i’m waiting for return calls
  ugh
  babe i need your support i’m stressed
why do you know about lithium
babe??

7 minutes
me: …
fyi this is a really bad time to bail in the middle of a conversation without any freaking warning
well f you too
:(

Any words of guidance or support would be welcomed–about the lithium, not the ex.  :)

PTSD and isolation

One of the classic traits of PTSD is isolation.  PTSD sufferers often feel unable to relate to other people.  Sometimes this results from a feeling that others can’t possibly understand them, and sometimes it’s not a conscious thing at all, just an uncomfortable or even aversive feeling around other humans.

I say “other humans” because people with PTSD often feel comforted by animals.  Animals will love you unconditionally, and often will protect you during an episode of symptoms.  The mere presence of an animal can sometimes be comforting enough to head off a full-blown episode.

One problem with isolation is that it is self-perpetuating.  Who the hell wants to be around a touchy individual who tends to disappear off the map for reasons most people cannot fathom?  And if concerned individuals ask why, they are not likely to get a straight answer, because who wants to go through the whole “I have PTSD” explanation to somebody who is not on the “need to know” list?

As for people who are on the “need to know” list, their job is so difficult that many of them bail out.  Here you are with this lovely person, going along just like usual, and something you do sets them off, and all hell breaks loose.

Granted, the triggering behavior often resembles the original wounding behavior itself: aggression, threats, or actual acts of violence. And there are, unfortunately, individuals who thrive on the power trip of controlling a person with PTSD, as is seen in domestic violence, and in the pimp-prostitute relationship.

Among returning veterans with PTSD, the rates of divorce outstrip the rates of marriage success, among preexisting marriages. Likewise, the rates of homelessness among vets with PTSD are astronomical. Much of this is due to simply being unable to reintegrate, unable to relate to civilian society.

Other groups that show similar social isolation patterns are domestic abuse survivors, rape survivors, and survivors of prostitution and human trafficking. Much like combat veterans, these people find it hard to integrate into a society that not only has never had to deal with the traumas they have been through, but also may look at them as pitiful, dirty, or damaged people. In addition, survivors of domestic abuse and sexual trauma have difficulty knowing who to trust. Repeated experience of betrayal of trust erodes the foundation of the ability to trust, making isolation preferable to being abused once again.

Suicide is the ultimate act of social isolation. I don’t have the numbers handy at this moment, but the relative risk of suicide is much higher in people with PTSD than in the general population. This is greatly multiplied if the person with PTSD also has an additional psychiatric diagnosis such as Major Depressive Disorder or Bipolar Disorder.

I’m breaking my head trying to come up with a good closing sentence, but I’ve depressed myself writing this post such that I can’t think of one. So that’s the way it odds, today.

Copyright 2012 Laura P. Schulman all rights reserved


Respect Your Fellow Sufferers

There are three types of BiPolar; BP1, BP2, and BP Not Specified. We all suffer the swings, but our experiences vary. I once had someone explain to me what mania was… as if I didn’t know. Because obviously, if I am BP2 I certainly don’t know what mania is! I can appreciate the ignorance, but it also really offended me, because I was just told this recently. And I have been diagnosed for about 7 or 8 years. There was a whole scene to this, but I’m not going to rehash it because it’s the past, and I’d like to move on… But I thought it was important to say this: We have all been in different levels of this hell. You can not assume that no one understands what you are going through. But you also can not assume that people don’t understand. There must be a healthy level of respect and compassion.

I try my best to be sympathetic of other people. I try my best to help. Sometimes I’m not in my right mind. Sometimes I’m just completely out of my body and have someone speaking through me. So really, you just have to take it all with a grain of salt like everything else in this world.

I guess I really need to learn how to let go of things….

Passivity, Sanity

I have always done my best to hide just how fragile I am. ‘They call me Mr. Glass’ – besides the fact that most of M. Night’s movies are crappy shambles, that line from Unbreakable always summed it up for me. Except for the shattering of bones, it was the shattering of psyche, the shattering of stability. That’s not something you can ‘toughen up’, per se – you can only hide it and hope you look menacing enough that nobody is inclined to take a swing.

Having said that, I don’t much like being in positions of leadership. I tend to disguise this fairly well too, insomuch that I didn’t have a choice growing up. I was the eldest, I was under strict orders to ‘be an adult’ and help out from age four. I don’t begrudge my parents this – I still had plenty of play and fun, and have even more now that I’m in the somehow less stressful job of being a parent and wife on my own steam. But because of that young experience and the fact I am (supposedly) charismatic and confident, I tend to find myself in leadership roles in spite of myself. I try to not bemoan it even if I VASTLY prefer to ‘lead ‘from the shadows (where you can avoid the PR and get real work done) because of that old saw – the best leaders are the ones that probably don’t want the damned job in the first place. So I do my best to set a good example, because leading by example is a fantastic morale builder. If the people working under you see that you’re busting your ass too, then it’s much easier to say that we’re all in ‘it’ together.

With that in mind, it is not my style to be an active volunteer for things. If someone asks for help on something, I’ll usually voice up easily – this is passive because it doesn’t require me seeking out things to do. It’s being handed a task, and (fingers crossed), being able to take it back to my dark cave to work on it by my lonesome. So trying to set up a support network and having to proactively pester people to spread the word and consider joining up to The Bipolar Blogger Network is totally outside of my comfort zone. That’s equally blamable on the anxiety that’s been comorbid with my biploar for long years now, and the whole introvert thing. I’m not shy by any stretch, but anxiety of being a pest combined with not enjoying extroversion makes the task unduly stressful. I managed to drop a few notes this morning before caffeine kicked in, but now that I’m alert, I’m ridiculously nervous about considering poking people. Add in the fact that I’m finding people now who already have little groups of their own in place, and I’m incredibly worried that they’d find me super-annoying, or who knows what from the list of made-up ‘you’re a jerk’ things that is suddenly in my head. Since I have been having this period of insanely amazing random stability, I am definitely hesitant of doing things that could rock the boat, so…

Still, I’d not do these things if I didn’t think they were making the world a better place somehow. And while I have no interest in making my mark by being some rich person or some sort of august careerist, I am glad to take my gift-flaws (“Meg, I give you your faults.” – Mrs. Whatsit, A Wrinkle in Time) and use them to make me better, and to make the world better. It might not be the fanciest legacy, but it’s one I’m glad I’m willing to keep trying in spite of the non-stop war with my emotions and thoughts.

<3

5:10am, 8 hours of sleep

I passed out sometime around 7pm and woke up at 3am.  I spent the first hour dividing my attention between my three animals, each of which was curled up next to me in some fashion.  Little Dog C was nestled in my arm, Big Dog A stretched over my leg and looked up at me with big puppy eyes, and Meow Cat A came to stake her claim on my other arm.  I love my animals, and it occurred to me that when people had been asking about my support group, I completely neglected to include them.  They are my biggest support group and I am certain my animal family has buffered some of the negative effects of my recent experiences.

Now only if I could train them to bring me breakfast in bed…

I’ve got a lot of mixed emotions today (imagine that).  I’m a bit scared, and definitely anxious, but just slightly optimistic.  It’s definitely an aroused state, and kind of antsy.  I wonder what the next few weeks will hold.

Will lithium be all that my psychiatrist said?  Or will I have the experience of countless others who need revision after revision of their prescriptions?

Will lithium take care of my anxiety, my PTSD?  Will I be diagnosed with another disorder once we rule out the effects of Bipolar?  Will I soon be taking pictures of my pharmaceutical breakfast?  I have already balked at my daily dose case when it had Zoloft or Prozac, Buproprion, Valium, and a Multivitamin.  It looks like that will just be the start.

How soon will I be able to clean my house?  Go to the store to get toilet paper and shampoo, which I’ve been out of for what seems like forever (don’t panic, I at least have had wet wipes and paper towels at my disposal)?  Walk the dogs every day again?  Make real progress on the myriad projects I have going?

Will I get fat?!  I should really look into starting my healthy diet asap.  Time to check the bank account, which is something I’m never fond of, to see if I can even afford the super healthy diet I want.  Why?  Because it entails mostly “perimeter shopping” – all fresh foods that can go bad quickly if not consumed right away, and virtually no processed foods.  Will I get back to making food from scratch and freezing?

What about exercise?  Will I have the energy and motivation to get back into boxing classes?  I am wasting so much money on that membership as it is…

So much to think about…


DSM-IV-TR criteria for PTSD – NATIONAL CENTER for PTSD

http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp This is a good link to check out if you want to refresh your memory about PTSD. It’s geared toward veterans, but it contains the DSM criteria, so it applies to everyone unfortunate enough to live with this crippling illness. There are three major classifications or groupings of symptoms. A person can have symptoms that cross groups, too. If you’re one of my regular readers, you might notice that my writing style is not its usual sparkling self. That’s because my personal PTSD demon got let out of its cage yesterday, and I haven’t managed to get back into the world enough to get it corralled. My PTSD falls mostly into the avoidant group. I get numb and totally leave my body, even as I scramble to try to grab onto something to keep it from happening. This time, I felt myself slipping, tried to stop it, and then got totally knocked off my pins by a second, larger trigger. When I was younger and had fewer resources, I would ends up depersonalized a great deal of the time. I had a lot of severely traumatic experiences, running the gamut of childhood abuse to multiple rapes to multiple trauma from being hit by a car while riding my bicycle. But the worst was being the helpless target of childhood verbal and emotional abuse. I’ve done a huge amount of work on this stuff, and got a lot of it under control. From my own work as a pediatrician I have observed that abuse that happens to preverbal kids just does not get integrated and has little hope of being erased. Prior to language development, a kid just has no way of processing what happened. So when they’re confronted by a similar situation, even as an adult, boom, you’re right back there in that same place of no-escape terror. For me, the only way out was to leave my body and let the chips fall where they may. So yesterday I got triggered. I’m still trying to find my way back. My dog helps, but I think I’m even freaking her out a little. Time is the only healer for this.

Copyright 2012 Laura P. Schulman all rights reserved


Hot,Humid & Rainy!

We arrived back here in CR last night after our long weekend in Panama. I was so very surprised with Panama city……it is very large, modern & clean! Not one speck of trash was to be seen, they even had some street cleaners out. And the Bay & Canal were very cool to see, so many large ships waiting and coming through it. Unfortunately it rained the whole time we were there, so we didn’t get to do as much sightseeing as we would have liked, but we did get to go shopping. They have some amazing shopping there, upscale malls and regular type as well. I was not prepared for all of the new construction and the very amazing skyscrapers that dot the city, and many of them had ocean views. Our hotel was only 3 blocks from the Bay of Panama, and it is very pretty. There are some very exclusive hotels that are right at the beach, further away from the bridge & the mouth of the Canal, they have private beaches and are all very lovely. I would like to go back to Panama and do some more exploring, the City has a really great vibe about it, and the people are reserved, but friendly once you get them talking. The one thing I was not prepared for was how Hot & Humid it was! I live in the Tropics, but Costa Rica has much nicer weather, especially where I live……our town was named by National Geographic as having the best climate in the world, and after visiting other places here in the tropics, they are so right!!! I do love the heat, and the humidity gave the whole place a sultry sort of feel, so it wasn’t awful. I love wearing sundresses and light skimpy whispery clothing, so I wasn’t too bothered, and my Husband and Son didn’t seem to mind it that much, it was just a different kind of heat for us. They have excellent Beer there, Balboa Beer, and the brewery was opened in 1910? It was incredibly refreshing, I admit to drinking quite a few over the long weekend, and our son just loves fresh Pineapple juice, so we were all able to get refreshed and happy.

I am glad to be back in CR though, it is so peaceful after the hustle & bustle of the Big City, and our son was very happy to go back to his Little School. He just loves School, and his Spanish is getting really good! I am so happy that we were able to find a great Private Bilingual School right in our neighborhood, and it is worth every penny when you ask your child every day when you pick him up from School how his day was and his answer is always “Great!”  Man. I just love it here, and so does my family. Pura Vida!