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Wednesday, May 01, 2013

BEING BIPOLAR, Part 7: Taste The Rainbow

Being Bipolar, The Knight Shift, bipolar disorder, mental illness
This is the latest in a series of articles that The Knight Shift and its strange proprietor is glad to present about what it is to have bipolar disorder.  As always, I am attempting to chronicle and document my journey through a life with mental illness thoroughly, with honesty, and at times with a healthy dose of humor!  If you are new to this blog (hey, stick around!  I  try to keep things interesting around here :-) then you may wish to read the previous entries of Being Bipolar.  Whether you have kept up with the series or are just now discovering it, this new installment takes us into the wild and unpredictable realm of medications and mental illness.

Let's talk about... drugs!

One Flew Over The Cuckoo's Nest, medication time

I've had five possible installments for the next Being Bipolar sitting on my desktop for the better part of a year because I hadn't been able to figure out where to go next.  But finally I decided to go with the one about the chemical carnival that is finagling with pharmaceuticals.  Why?

Bipolar disorder brings a lot of pain, confusion and frustration into one's life.  And treating it with medication plops an entirely new layer of frustration on top of that.  There are a very few fellow strugglers with bipolar who've had the grace to never have to "juggle drugs" to reach a place where their condition can be better managed.  I however am not one of those people.  Sometimes I find myself thinking that I could have had a much better life all along already even with bipolar disorder, were it not for what I've gone through doing what I can to get the meds figured out.

So that's why I'm writing about medications for mental illness.  To share my tale of woe and occasional wackiness that has come from using them.  Not just as a kindred spirit for others with bipolar but also for those who must live with a bipolar person.  Because they are just as affected by this condition as those at ground zero and too many times there is intense suffering that must be endured because of the rigmarole a bipolar person goes through to "get it right".

That’s certainly been the case for me and the people in my life...

"Climb in the back with your head in the clouds, and you're GONE!!!!!"

I have literally lost count of the number of variety of meds that I have been on since early 2004.  Okay, for longer than that.  My first hospitalization was in the spring of 2000, because of extremely severe depression following the death of my grandmother.  I was put on Paxil and remained on that for more than two years until I realized that it wasn't doing me any good. That's not to say that the drug itself is ineffective, but that it wasn’t effective for me.

It was one particular incident which led my wife at the time to compel me to see a medical professional about my... "problem", which by this point was clearly something well beyond mere clinical depression.  At the time I had not yet been diagnosed as having Bipolar Disorder I (the more severe kind).  I think my doctor, after she heard about all the stuff I had been going through (death of family members, loss of a job, discovering I had inadvertently been working for a swindling operation... I wish to God I could tell you I'm making this up) wanted to "play it safe" and I can't fault her for that.  I mean, it could have been bipolar.  It could have also been a lot of other things, too.

(As an aside, in retrospect I can see that I've had bipolar for most of my life but it can get seriously triggered by anything from the trauma of a loved one's passing to as insignificant an incident as hearing a certain song, and there's no real predicting which way my mood will swing or how hard. Until January of 2004 however I was just seeing the "spikes", and not paying attention to the "valleys". But back to the story...)

The doctor put me on two drugs: Wellbutrin and Risperdal. I will never forget the return to my apartment later that morning. The doctor had written prescriptions but she also provided samples to help get me started. I got home, took each as prescribed and laid back on the bed and thought to myself: "This is the first day of the rest of my life and it really is going to turn into something beautiful.  Thank you Lord for the knowledge and the wisdom that went into making drugs for people like me!"

'Course, in the end it didn’t turn out that way.

Wellbutrin is an antidepressant. Risperdal was prescribed to treat anxiety. And that combination worked pretty well... for a few months anyway.  And then as summer approached I sensed an increase in manic thoughts and behavior.  At the time I thought that perhaps it was just my system developing a tolerance for one or both of the drugs.  Much later I discovered that Wellbutrin, in some cases, can heighten the probability of having a manic episode for those with bipolar. And that's what was happening to me.

There were two other things that I was experiencing as well: an inability to have a solid night's rest, and being unable to focus my thoughts for very long.

It was the summer of 2004 that I was working on Forcery: that parody of Stephen King's Misery, about George Lucas being held hostage by a crazy Star Wars fan.  I now wonder how much better that first movie could have been if I "had my act together".  During those months of filming whenever we could all get together I felt driven by a need to get it finished and out the door and... I put Chad and Melody and Ed through hell at times.  The very first time we shot at my parents' house (which was the main bedroom set) I tried to film it all in one day.  I don't know what’s the more miraculous: that I didn't burn the house down (seriously) or that Chad, Melody and Ed didn’t walk off the project then and there.  Was I that manic?  Hell yes!

(I’m declaring here and now: Melody Hallman Daniel is an INCREDIBLY beautiful, sweet and strong woman and immensely talented actress.  She not only drove as far as she did each time to film Forcery but far more than that, she put up with me for the whole crazy time.  I’m always going to be thankful to have her as a friend, along with everyone else who I have been blessed to have met during my filmmaking projects.)

It was around this time that the diagnosis for Bipolar Disorder I was handed to me.  My doctor suggested that I go off the Wellbutrin and give something else a try.  That turned out to be small doses of Lorazepam: in larger amounts a strong sedative but it has also been used as a mild sleeping aid and relaxant.  Instead of daily doses I was only to take it "as needed".

Lorazepam isn't meant to be used long-term, because a person does tend to develop a tolerance to it pretty quickly.  It helped to get me back on a normal sleeping schedule.  However my thoughts running too fast remained a problem.  So I went off the Lorazepam and was put on Adderall.

Of all the experiences that I’ve had with meds, nothing... and I mean nothing... comes close to what began in the fall of 2004 and my time with Adderall.

The medications I had been taking were having a very blunting affect on me creatively.  We were wrapping up filming Forcery and then right as we had got all our footage together… my mind went every which way but loose.  I wanted to edit the film but couldn't get myself together for the task.  And I was feeling excruciatingly desperate for something that would get that creative side of me flowing again.

Well, Adderall worked.  Oh bruddah did it work.  My thoughts and feelings became tightened and focused again, and along with that came a return of my passion and creativity.  A huge chunk of Forcery got spliced together.  The holiday season was going well and I was already thinking about what I could do as a film project next.

I had Christmas Day in North Carolina that evening my then-wife and I drove to her parents' place in Georgia.  And for some reason or another while cruising south down I-85 in the darkness of Christmas Night, my mind wandered onto the subject of God.

That was the real beginning of one of the craziest periods of my life.  Something which I hope and pray will never happen to me again.  It was when my mind became so fast and so powerful and seemingly so capable of anything that I felt as if I had become omnipotent.

It started innocuously enough.  I mean, for most of my life I’ve pondered theology.  Wondering if there is a God and after accepting His existence, contemplating how and why it is that He chooses to work in the ways that He does.  Things like that aren’t new to me.  Except that during that drive I found my thoughts focusing with startling circumspection on God and His place in the universe.

I'm going to do my best to describe what was happening to me: what began as a passing musing about God and His relationship to the world around us, began to grow at a geometric rate into an unceasing process of analysis, theoretical supposition and uncontrollable thinking about not just God, but about mass and energy and the speed of light and space and time and angels and the concept of free will and sin and what sin really is and how it correlates with the entropy of the universe...

It could not be stopped. Not by my own choice. When it finally did stop, my mind had conceived of a personal theology about God which fit perfectly within what I had known and have come to know about the physical universe and its laws.  There is nowhere else that I can really take that subject matter: it's been played out in my mind and I don't see how it can go further.  My mind knew that too...

...so it decided to focus on other things instead.  Which turned out to be anything at all.  Practically overnight I found myself capable of understanding some higher mathematics, which should have been impossible for a guy who hasn’t been able to do much past comprehending square roots.  A passing fancy about genealogy turned into a weeks-long study of my family history going back to the time of the New Testament.  For the first time in my life I could conjugate verbs in Spanish (bear in mind that I flunked Spanish in high school... twice).

Darkseid, DC Comics, New Gods, Jack Kirby, Fourth World
Artist's rendering of Chris Knight when he was taking Adderall(tm)
Then there was what really did nearly drive me over the brink of insanity.  My mind began trying to comprehend the scale of the cosmos, from the Planck length (considered the shortest possible distance between two points) exploding outward to the megastructures we see in the patterns of distant galaxies.  That particular phase went on for months, well into the summer of 2005, long after I had gone off the Adderall.  I would sometimes lay awake at night, only able to think about that vast, vast darkness punctuated by mere iotas of matter and light.  Wondering what my place in all of that was.  Wondering, even, if I should want to be dead and not having to think about it all anymore.

It was a video game franchise that I had just begun playing which gave me a new terminology for what I was going through.  In the mythology of the Halo series, characters like Cortana and other artificial intelligences can only function for seven years before they go "rampant": their neural structures become so developed and hyper-active that they literally "think" themselves to death.  Before that happens however comes a period of psychosis and instability.

That's what I was going through.  Rampancy.  Because of a prescribed drug interacting with my bipolar in a very unpredictable fashion.  My mind was becoming too much more powerful than one mortal being should ever be.  “Knowledge is power”, it is said.  The Bible also teaches that with much learning and wisdom, there also comes grief.  I had to learn that the hard way.  In fact, my experience with Adderall taught me that there is such a thing as too much understanding, and that there is a bliss to be known when one chooses not to fixate on the nuances of things we aren’t meant to fully comprehend.

"Rampancy" was the word that I used to my doctor.  When I explained where it came from she said she thought that was a good word for that kind of condition.  She took me off the Adderall.  It remains however the one drug which I know I have developed an addiction to... and I went through a hella withdrawal as a result.

But for a few weeks and months, I really did feel like I had become a god.

I never want to feel like that again!

"…A whole galaxy of multi-colored uppers, downers, screamers, laughers…"
Fear and Loathing in Las Vegas, Johnny Depp, Doctor Gonzo, Raoul Duke, Hunter S Thompson, Benicio Del Toro, drugs
"Not that we needed all that for the trip,
but once you get locked into a serious drug collection,
the tendency is to push it as far as you can."
 Then is where I began to lose count of the kinds of meds I was placed on and off.  Let's see: I know Strattera is in there somewhere.  So was Abilify.  And Xanax.  Yeah I'm pretty sure Xanax came and went at some point.  There was trying Zoloft, and that worked for awhile before it started to have no effect whatsoever. Was I ever on Pristiq?  I can’t remember. Somehow I totally missed being on lithium. Yeah they put me on everything else but I didn’t get lithium...

I would guess that there have been between a dozen and twenty different medications that have been prescribed to me during most of the past ten years.  I can't remember all of them.  It literally strains my memory to try to recall every single one of them.

But I remember their side effects well enough.  Indeed, one of the reasons why I don't remember them all is because of the side effects. Not "loss of memory" in the clinical sense, but rather how I lost track of the variety of drugs amid the swirls and chaos of my mind veering this way and that, trying to compensate for how it wanted to go in the opposite direction instead.  I know when I went off Risperdal. It was the summer of 2007. And I thought... I thought... that I was losing my hair because of Risperdal.  I wasn't at all. But that's what I was perceiving and that I had read about Risperdal causing hair loss didn't help matters at all. "Imagination running wild"? Give "deduction in overdrive" a try sometime and come talk with me.

And then there is Seroquel. Something which I have come to call "that rotten shit". Very, very few things in my life have merited such harsh vernacular. Seroquel is one of them.

I was involuntarily placed in a behavioral health facility in September, 2008. The doctor I had been seeing all of this time decided that we should try Seroquel.  What with everything else that crashed down onto me at once, I became very glad to be taking it.  For a while, anyway...

Okay, I know and accept that Seroquel is a "big gun" in the treatment of bipolar disorder.  That it has worked wonders for many people.  In those first few months following my hospitalization it went a significant distance toward helping me manage my mind.

But I'm not like most people.  Come to think of it, I don't like the idea of anyone being like most people.  Each of us is an individual and it's not only going to be impossible to apply one "fix" for a problem on everybody, it should be impossible.

I'll run down the grocery list of what Seroquel did to me: dulled thoughts.  Lethargy.  A loss of creativity.  A loss of interest in things I had long been fascinated with.  Tremors in my hands and fingers (predominantly with my right hand, for reasons unknown).  Chronic heartburn and acid indigestion.  More of an appetite than I was used to having.  And with that came a horrid gain in weight.

How bad was that?  When I was first brought to the hospital my weight was about 170 pounds.  By the end of that year a few months later, I was up to 220 pounds.  And it kept going up until my weight crested at 270.

I will confess: there were other factors that figured into my weight gain (the most significant was depression from my wife’s departure) but none of that... none whatsoever... would have led to my being overweight without the Seroquel.

Yeah, my bipolar was becoming more manageable all right.  Unfortunately the rest of me was getting in piss-poor shape because of the very thing that was making that possible!

I decided on my own to quit Seroquel cold-turkey. Now that's something which a patient should NEVER do without consulting his or her physician.  But in my case I had come to a point where the Seroquel was more hassle than it was worth.  And by that point I was on another drug (more about that soon) which seemed to be having a more positive effect than anything I had taken previously.  And also, I had a new girl in my life: she fast became the best encouragement God had ever put into my life on this earth, and I decided to take a chance and trust in the support system He has blessed me with.  Also, I did want to get in better shape for her (y'know, being a guy and all...)

That was in November of 2011.  By the time Mom passed away the following month, I had already lost a lot of weight and before she left us Mom told me that I was looking much better.  I am now 4 pants sizes less than where I was before quitting Seroquel.  I lost 50 pounds within the space of a few months and today my weight hovers around 200 pounds.

And now I'm torn between losing more and maintaining what I have now.  Because at the risk of coming across as immodest, this is the most buff that I've looked in my entire life!  A lot of people have told me that my appearance is the best it's ever been.  And my girlfriend certainly has no complaints :-)

The Mistake We All Seem To Make

But going back to something: I cannot reiterate enough how a person considering stopping a medication should NOT do so without first consulting a doctor.  That goes for any prescription drug but in the case of a mental illness like bipolar it is especially so.  I admit and thoroughly acknowledge that I wasn't being that responsible when I quit Seroquel. That was an awfully big risk that in the end proved was worth taking.

But I'm not going to write about this and deny that I have tried doing that before and got burned bad as a result of it.  Not just me either, but several other people.

When I went off the Risperdal, I thought that I was "better". That I didn’t need it or any of the other drugs anymore.  I was feeling so much more improved that I honestly believed that whatever this bipolar was, that I had conquered it.

Big, big mistake.

Whatever happened to me pharmacologically in the months after that, I was definitely going through a sense of elation and euphoria... but in reality I was getting worse.  Downright dangerous, even.

It's something that I'm still not comfortable with writing about on this blog.  But I'm okay to share this much: I became a danger to my wife, to friends, to family, to myself.  Because I stopped taking the medication.

It wasn't the absence of the drug itself that caused all of that so much as the shock to my body trying to compensate for it.  But I didn't know that until much later and by then it was too late for too many of my life’s most cherished aspects.

I had no idea what was going on or what I was doing, and I could not have known at all to begin with.  But my mistake cost me very, very dearly.  In fact, there isn't a day that goes by that I have some lament for what happened because of my loss of judgment.

And unfortunately I'm not alone.  It seems that many if not most of those who suffer from mental illness in whatever form, have also abruptly halted their intake of meds. Sometimes it's because of perceived physical effects.  Others, because a person feels that the meds are having no effect at all, or that they have magically "cured" that person.

Let this much be clear if nothing else I've written so far is: there is no cure for mental illness.  It can only be managed and controlled, but never fully rid of.  The meds are part of that management, and you can't go by "feelings" about that. Bipolar disorder wrecks havoc with your mood and your feelings but when it comes to the drugs you’re prescribed, you absolutely can NOT trust your feelings about that!  It could result in serious injury, or worse.  Potentially even being driven to commit suicide.

I don't want that to happen to anybody.  And if you're bipolar or have some other mental illness, I don't want it to happen to you especially.  Do the right thing and call your doctor in the morning instead.  Or tonight if ya wanna (hey, you're paying him for this anyway, right?).

Stability(?) At Last!

It took from the earliest days of 2004 until the summer of 2010 before I finally, finally found something that worked and is still working.

How did I realize it was working?  It was a turn of events nearly three years ago that dropped me hard out of the fog of disease and denial and brought me to the realization that things had gone terribly, terribly wrong in my life and that I had to do what I could to make up for it all.

I’ve tried to do that.  Some things worked out.  Others, never did.  But God has a way of letting things turn out for the best even if you can't possibly imagine how. And I like to think that is what has happened to me...

Currently I'm on a daily regimen of Citalopram (also known as Celexa) and Lamectal (also called Lamotrigine).  I'm not a doctor and I don't play one on teevee (or the Internet for that matter) but Citalopram has become the one true wonder drug which I have needed and benefited the most from all this time.  There have been no deleterious side effects from it. Lamectal is for treatment of my depression and it has likewise proven extremely effective. After some trial and error I am now taking one 150 mg of it daily: one-half a tablet in the morning and the other half at night.  I've found that it’s the best way to manage the depressive episodes if they happen throughout the span of a day, and it helps me to sleep better at night.

That's two teeny tiny tablets I'm taking every day.  The total cost for them per month is less than $20.

I won't lie: I had to go through hell to find those meds.  To find anything that would let me live some semblance of a normal, productive life.  And a lot became lost along the way.

But I've a real chance now.  I have real stability for the first time in my life.  A lot of things to live for and look forward to.  I’m going to keep taking the medication.  It's a very small price to pay for being able to enjoy so much.

My life is finally my own.  And there's no turning back now.


Stefani said...

That couldn't be easy to write Chris. Thank you for putting yourself out in the open to talk about your condition. And you made me laugh while reading it! Love the image and quote from Fear and Loathing in Las Vegas :)

Derek James said...

You did an informative and well written article Chris! It's not one I could have written. And I've been diagnosed bipolar disorder 1 for longer than you.

100 pounds extra weight from Seroquel. I got 50 from it. That couldn't have been a good time. Good to hear you're back down.

Please write another one soon! It's been too long between articles :p

Chris Knight said...

It wasn't 275 pounds the entire time. There were some pretty wild fluctuations. I was in the lower 200s in the summer of 2012 (pics at the time show hardly any at all) then it went up again toward the beginning of fall.

I weighed myself earlier today and I was at 197. Ever since going off Seroquel the tremors in my hand have ceased.

This is one entry that I possibly could have written better. Something seems missing and I don't know what it could be. There was a *bunch* of stuff that I would not and *could* not write about. But, it is what it could be for now. I'm still examining myself and my condition and that understanding will undoubtedly deepen as time goes on. Maybe someday I'll write another essay about this :-)