This week has wiped me out, mentally and physically. I stay on a knife’s edge between functionality and nonfunction, largely with the aid of the Five Medications: Lithium, Lamectil, Seroquel, Ambien, Ativan.
When I lived in Israel, 2007-2010, I was down to 50 mg. of Lamectil daily: practically a homeopathic dose. I was on Lithium when I moved there, but the dry heat makes it very easy to get dehydrated, and that can be lethal on Lithium. So my shrink had me very slowly and carefully wean off of it, since I had been very stable for several years by then. I found that I felt no different at all without it, so I had nearly a four year vacation from Lithium.
I attribute my stability to the wonderful network of friends and advisors I had in Israel. I have never felt so loved and cared for. For the first time in my life I felt that I had family. Lots of family. Where else in the world can you walk down the street on the evening of a holiday or the Sabbath and have people you hardly know invite you to come and share their festive meals?
I had several extended visits back to the States during that period of time, for a few weeks or a month, keeping tabs on my aging parents. I am the only child, and they are getting precariously old and poorly functioning. Usually these visits were precipitated by some crisis or other: my father had a stroke; my father had surgery. My father.
To say that my mother and I don’t get along would be a gross minimization. The truth is, we are oil and water. Actually we are more like gasoline and a match. My mother knows how to devastate me with a look or a gesture. Five seconds in her presence and I am once again a cowering child hiding under the covers hoping to become invisible to her rages.
I have lived my entire life trying to find ways to appease Mom, so that she would love me and not tear me apart with tooth and claw. And wonder of wonders, none of it has worked more than briefly.
So each visit took its toll: on one three week visit I became so depressed I had to go to Canada afterward for 30 rTMS (Repetitive Transcranial Magnetic Stimulation) treatments. This is the best thing since sliced bread for treating major depression, PTSD, and a growing plethora of other neurological and neuropsychiatric disorders. (I plan to write a future post about rTMS, so stay tuned.) Sliced bread or not, it’s really not what one wants to have to do in order to cope with a family visit.
In January, 2010, two months shy of my fourth anniversary of moving to Israel, I returned to the States on an open-ended visit, since my father’s health was declining rapidly and I wanted to spend as much time as possible with him before he became totally out of it.
I’m glad I did, as he is now at the stage of dementia where he is in another world most of the time. He still recognizes people, but sleeps on and off all day, and can’t perform any tasks more complex than eating. I am grateful that he’s still able to feed himself and do most of his activities of daily living. I can see those decaying, too, though. Soon he will be totally dependent on others. It breaks my heart to watch it happening.
The price tag of my leaving my support system in Israel has been brutal. In order to keep myself from going stark raving mad, I’ve had to work with my psychiatrist here to find a cocktail that will keep my bipolar stable while helping me to control the symptoms of PTSD that threaten to rage out of control every time my mother looks at me.
Sleep is a constant struggle. Sleep is essential to the stabilization of bipolar disease. In fact, one of my neuropsychiatrists treated hypomania or mixed episodes by inducing sleep for 24 hours. It’s like hitting the reset button. As we know, one of the huge bugaboos of PTSD is the eyes-wide-open-like-dinner-plates horrible sleep disorder. So the combination of PTSD and BP is deadly.
Hence the addition of drugs: more Lamectil. Back on Lithium (hydrate, hydrate, hydrate). Ambien for sleep, except that’s not enough to quell the PTSD horrors, so Seroquel to deliver the knockout punch. Oh, and a benzo to keep the Mom jitters down to a dull roar.
Why do I do this to myself?
Copyright 2012 Laura P. Schulman all rights reserved