Garden Variety
My whole life I've thought of myself as a garden variety neurotic guy. You know, high functioning but with a lot of crazy noise in my head (and the occasional leap into OCD lunacy) that I could handle by staying busy, or venting in therapy, or, for the last twelve years, those twenty magic milligrams of Prozac. Last summer I decided there was a level of anxiety and self doubt the Prozac wasn't getting at and went off it to see what would happen. What happened is a head full of broken glass and a sense that nothing in my life is any fucking good at all and, worst of all, never will be. There is always the possibility that that is simply an accurate perception and not depression talking. I don't really know right now. Look at it all one way and the guy has a great career, great wife, great kids, house full of books and music and friends and pets. Look at it the other way and the guy has a list of TV credits he's more inclined to apologize for than brag about, a wife whose interest in sex has long been on the wane, a house full of clutter, friends he would be fine never seeing again and pets that only pretend to like him so he'll feed them and take them on walks. (The kids, thank God, look the same through both lenses.)
Is my despair causing my dissatisfaction or is my dissatisfaction causing my despair?
And then there are the all too brief vacations in the land of elation. I'll have a wonderful night of lovemaking with the wife, or a script will get picked up, and for a few days the world shines like the first day of creation--and then they turn the lights down again. So last week I thought "enough of this shit" and went to see somebody about getting back on the meds. With typical OUTRAGEOUS snobbery I went down the list of doctors on my health plan and chose the one who did MIT undergrad and Harvard med school. And got pretty much what I should have expected: somebody reasonably smart and unreasonably stuck-up--rather like myself. Anyway, Dr. Harvard listened very closely and asked many questions and then said the last word in the world I wanted to hear.
He said bipolar.
I said great, when do I get the manic phase?
Ah, he said, Bipolar II. Smaller manic component. And all that elation you feel after sex, the elation that crashes after a few days? There's your manic phase. No, I'm thinking, that's afterglow. But then I thought: he's absolutely right. I use sex as an antidepressant. In fact I was going to do a post on my blog about that! How did he know!
Then he said another word I truly didn't want to hear. I wanted to hear Zoloft, Wellbutrin, Lexapro. But he didn't say those words.
He said Depakote.
I took the second 250 mg dose tonight. Possible side effects include weight gain and hair loss. If you see the fat balding guy in the robe that ties in the back shuffling down the corridor in his slippers, that's me.
The operative wisdom of the moment is: can't hurt to give it a shot.
But does the hair grow back?
Is my despair causing my dissatisfaction or is my dissatisfaction causing my despair?
And then there are the all too brief vacations in the land of elation. I'll have a wonderful night of lovemaking with the wife, or a script will get picked up, and for a few days the world shines like the first day of creation--and then they turn the lights down again. So last week I thought "enough of this shit" and went to see somebody about getting back on the meds. With typical OUTRAGEOUS snobbery I went down the list of doctors on my health plan and chose the one who did MIT undergrad and Harvard med school. And got pretty much what I should have expected: somebody reasonably smart and unreasonably stuck-up--rather like myself. Anyway, Dr. Harvard listened very closely and asked many questions and then said the last word in the world I wanted to hear.
He said bipolar.
I said great, when do I get the manic phase?
Ah, he said, Bipolar II. Smaller manic component. And all that elation you feel after sex, the elation that crashes after a few days? There's your manic phase. No, I'm thinking, that's afterglow. But then I thought: he's absolutely right. I use sex as an antidepressant. In fact I was going to do a post on my blog about that! How did he know!
Then he said another word I truly didn't want to hear. I wanted to hear Zoloft, Wellbutrin, Lexapro. But he didn't say those words.
He said Depakote.
I took the second 250 mg dose tonight. Possible side effects include weight gain and hair loss. If you see the fat balding guy in the robe that ties in the back shuffling down the corridor in his slippers, that's me.
The operative wisdom of the moment is: can't hurt to give it a shot.
But does the hair grow back?
posted by Tom at 9:04 PM
6 Comments:
I love the emotional rollercoaster I live on. All the ups and downs. I wouldn't change it for anything. Sure the downs suck, and the ups are amazinly great, but it's all worth it. It's these changes that help inspire me to think the way I do and to enjoy life. I can't imagine trying to force myself to "mellow out" by taking pills. That takes the living out of life. I don't want to be another programmed robot. I don't want to feel "just ok" all the time. So I roll along through life and wait to see what each new day will bring along. I'm sure that some people have real mental issues... but most people take pills because they don't have the spine to deal with real life. This corporate image of what life should be like is a bunch of crap and is what inspires people to become normal. Your perception of reality is a gift unto yourself and wiping part of it away through taking medications is nothing more than writing yourself a prescription to not fully enjoy life.
Be careful, bi-polar 2 is becoming a very trendy diagnosis. I've been labelled that two, and in a way it makes sense, but then again it doesn't. Sometimes, they guess, but don't go off your medication until you get a 2nd opinion.
Tom, I apologize for the cross-talk...
Jason, I admire your conviction. I do have one question. Do the other people in your life enjoy the rollercoaster ride as much as you do? My family and friends don't enjoy my drama and I would rather have them around than my cherished ups and downs.
I love elation. I love drama. Sadly, I love self-pity and wallowing in misery just as much if not more. That's my unmedicated reality.
I've got a lot I want to do in life. Medicine helps me focus on people around me and things I want to accomplish rather than just on myself. I love that. But certainly I have no harsh judgment for those who don't find medicine aligned with their goals.
Tom, I think the diagnosis matters a lot less than finding the right combination of medicine and therapy that helps you achieve your goals in life. Be patient. And don't forget the prayer of St. Francis. It is paradoxical but the concepts seem to work for a lot of people.
I'm just jealous you guys get to go to therapy.
On the medication discussion, psych meds are a blessing to those who need them. Trust me on this. As a nurse, having to tie people down with 4 point restraints because they decided to not take or stop taking their meds, isn't any fun. For them, their families or those of us who have to fight them off in a hospital.
Now, where's my Prozac?
Hey Tom....if the new meds help to smooth the jagged edges of that glass..we will LOVE the bald head!!
Tom:
I have been on Depakote for a number of years, and I have at least as much hair as I ever did. In fact, lots of hair is as much a sign of low testosterone as of anything else --- manliness = bald. Go figure.
Here's the scoop, though. Since the day I went on Depakote about seven years ago, I have not had more than one episode of grinding my teeth, pulling my hair, or hitting myself, with one... minor... exception, which led to a immediate increase of dose. Nada since then. I am now on 3 x 125 mg a day, and am as grateful as the day is long for it, Effexor and Amitriptyline, which have kept my keel even-ish since 1996.
Who are you doing it for? For the people who share your life, who will sooner or later bail out if you remain completely unpredictable.
It's an art, not a science. If the big D doesn't do it for, wade back in there and get Dr. Feelgood to find something else. Fuck the Physician's Desk Reference -- find something that works, even if it's approved for kidney disease. Depakote is an anti-seizure medication; I have a brother who is/was epilectic...
It's all in the mind...
The Troll
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