Thursday, October 25, 2012

"I dwell in possibility -- " *

In the early 1990s, I started what became a two decade wrestling match with depression that took me into dark places of my mind that I never knew existed. I fought back with prayer, counseling, and medication. When those failed to deliver me, when I developed psychotic hallucinations and delusions, I fought back in psychiatric hospitals. Seven times I was admitted to a psych ward between 1996 and 2005; six times I thought I had conquered the darkness. Today, I know that the depression was due to bipolar disorder. Today, I know that I do not conquer it once and for all, but continue to overcome it every day for the rest of my life.

My long battle with the depressive part of bipolar began in 1992 at the end of a difficult pregnancy which resulted in miscarrying twins. Following closely on the heels of that was a major move and change in lifestyle. From 1992 until 1996, I sought help through counseling within my church and talking with friends and family. There were times when the fog lifted, but for most of those three and a half years, I was bathed in despair. I always felt I was a failure as a mother, wife, and Christian. There was nothing I set out to do that I felt I accomplished with success. That those thoughts were untrue never occurred to me. Part of the delusion that bipolar depression brings about is that of abject failure.

I often thought of ways to die; frequently envisioning violent, gory images involving knives, claws, and other sharp objects. I then spent lots of time alone in my bathroom, sitting in the tub and running water to drown out the sounds of my crying. I was also trying to wash away the things that made me so objectionable to others, though those things were not at all the thoughts or intentions of others. I had many of the classic symptoms of depression: feelings of hopelessness and worthlessness, inability to sleep all or sleeping all day by turns, difficulty in accomplishing everyday tasks, irritability, and fatigue.

The first time I was admitted to a psychiatric hospital was in 1996. The mental images of drastically hurting myself were at an all-time high. I constantly saw images of bloody knives and scissors. I worked with scissors at my job, as well as an industrial sewing machine, and I fought an overwhelming onslaught of imagery involving slicing myself or ramming my hand under the needle. Work became impossible.

One day, I left my machine and called a friend for help. My plan had been to run naked down a busy street in the next town in the hopes of being arrested and locked up where I would be safe. Instead, my friend took me to see a psychiatrist on an emergency basis. By nightfall I was in a locked ward with a dozen other women all dealing with some form of mental illness.

Over the next eight years, I continued with bouts of depression and was eventually started on a years-long course of anti-depressants. Because I never presented to a hospital with problems other than depression, no other diagnosis was entertained.

I started back to school in 1997 and excelled, pulling a 4.0 in spite of dealing with serious stress at home. I landed a job from my externship and did well, but I was having more and more difficulty concentrating, couldn’t sit still, and would behave in very unprofessional ways at work. One of my bosses wondered if I didn’t have adult attention deficit/hyperactivity disorder. I wondered, too. I also wondered if I might have bipolar because I would start the day depressed and end the day feeling super high. I never did drugs or drank alcohol, though substance abuse is often co-morbid with bipolar. Other hypomanic behaviors were there: starting projects and not finishing them, a sense of invincibility, no apparent need for sleep, and a constant feeling of being “up”.

The cycling between depression and hypomania should have been something that my doctors and I “caught” early on. But, like most bipolar people, I only sought help when the depressive symptoms were interfering with my life. Including the doctor that arranged for my first hospitalization, I saw eight different doctors and counselors before learning that my true problem was bipolar disorder. Like many bipolars, I was always initially diagnosed with clinical or major depression.

At the beginning of 2000, I became a reporter/ editor for a local newspaper. I was functioning pretty well and not dealing with much depression. The anti-depressants I was on had me in a state of constant hypomania – one of the problems bipolar people have with that particular class of drugs. I worked long hours, stayed up late, covered everything that needed covered in our small town, and rarely had a “stringer” to help me get everything done. I was the sole news reporter.

The long hours and constant lack of sleep, coupled with the deadline stress and problems at home, resulted in a full blown panic disorder. I’d been prone to anxiety and had suffered what I now know were panic attacks, but the job stress brought everything to the fore. Anxiety and panic disorders are also frequently co-morbid with bipolar disorder. I spent many evenings in ER with dangerously high blood pressure and chest pains. I underwent scores of cardiac tests. Everything was always negative for heart disease. Having the diagnosis of a panic disorder allowed me to get counseling and medication to treat that, but the bipolar continued undiagnosed. Again, I was only seeking help for symptoms that were troublesome to me.

At some point in 2000, the anti-depressant I was on quit working and I started having problems with depression again. A new anti-depressant put me into a full-blown mania that lasted for well over a year. During that time, I married an ex-con I’d met online and had moved to Indiana. I was spending more and more time online and losing all contact with my teenage daughter and my other friends. I was working more hours at the paper, but risked my job with some bizarre behavior outside the office. Finally, it all fell apart.

The year 2004 saw the beginning of what would be six hospitalizations within a 15 month period. All the psychotic features of the worst depressions were back. Now I saw my hands as werewolf-like, capable of ripping my throat out. I would close my eyes and see demonic images full of fury and hatred. I became depressed again and suicidal.

What started happening was severe rapid cycling. The more my depression was treated with anti-depressants, the worse the manic and psychotic features became. I would go to the hospital to get help with the suicidal ideation and difficulties sleeping, get counseling, and still end up back in the hospital several weeks or months later.

It wasn’t until sometime in 2005 that my psychiatrist finally pegged me with bipolar disorder and started a course of medical treatment that included anti-psychotics and mood stabilizers to lower the highs while maintaining the anti-depressants to raise the lows. Since that time, I have been on various “drug cocktails” as we work to keep my symptoms at bay. I left the paper, quit several other jobs, left the ex-con, moved back to Texas, changed psychiatrists several times, and have been on more medications than I can count in my effort to put my life back on an even keel.

Bipolar is never something that one “gets over”. It cannot be cured like cancer, but it can be controlled like diabetes. For now, everything is mostly under control. With counseling and finessing the meds, I have been able to return to school where I maintain an A average. I will be graduating next year with my first bachelor degree. From being at a point where I couldn’t function in a normal job or in any normal capacity, I have now held the same job for five years. From feelings of hopelessness and despair of ever having any success in life, I know now that I live a life of endless possibilities.

* Emily Dickinson

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