Traveling

sorrows-mother

I haven’t posted much lately because it’s been scary inside my head.  There’s a fine line between sharing my practice of bipolar disorder and giving voice to the blackest symptoms.  When self-loathing and unrelenting despair become the landscape of my mind, there’s no scenic overlook.  While I strive to be honest here, I also know the scenery will change as my brain rolls on down the road, and that perspective provides a much better photo op.

While I attended Lutheran Hospital’s out-patient program, I stopped taking medication for Binge Eating Disorder (BED).  We needed to see if it was causing my headaches and contributing to the irritability and rage.  Subsequently, all the BED symptoms poured back in—food mania and uncontrollable bingeing.  I gained 15 pounds and hurt all over.

BED creates a downward (outward?) spiral—more weight causes less activity which gives all that food more permission to stick around.  I was already morbidly obese, but was at peace with my body.  Without the Vyvanse, negativity and self-hatred stuffed my head like a Christmas turkey.  The spiral became a hopeless vortex.

Nothing in my bag of tricks helped.  Death fantasies dogged me, but I knew two things would always stop me from actually taking my life—my cats (who are getting old) and the book I haven’t written.  In a weird perversion of logic, I decided that I’d better get cracking on that book if I wanted it to be a party favor at my funeral.  At least I’d have a project to work on.

So, this past weekend, I stayed with my friend, Lily, in Minneapolis and met with another friend, Jinjer, to talk about her experience of self-publishing.

coming-back-to-myselfAnd a very bipolar-ly thing happened.  Being with these friends, who love me unconditionally, traveling out of the struggle of my everyday life and into a few days of watching Netflix in jammies and spicy tea in handcrafted mugs, jolted the positive neuropathways awake.  The hateful Muzak in my head stopped.  My friends’ tender care helped me remember myself.  All the bits and pieces that BED and depression tore off me, fluttered back like Monarchs to their winter home.  Art happened.

And a book will happen.

While I knew Jinjer self-published at least two books, I had no idea one of her many talents was designing books.  So instead of beginning a steep learning curve, I gawked at a path as smooth and clear as asphalt.  She will take my manuscript (when finished) with the accompanying artwork and midwife it through the process.  I started working on the second draft as soon as I got home (and also started back on Vyvanse).

This book is my legacy, not a parting gift.  It’s proof that I lived and survived bipolar disorder, BED, PTSD and whatever acronyms stick to me next.  Like this blog, it speaks to the speed of landscapes passing through a traveling mind.

I’m still on an Adventure.  And I’m making my own Atlas.

sorrows-mothercoming-back

 

Next?

TMy computer is in the hospital, gasping its last, I fear. So I’ll try to create a post with my phone. Technology–heh, heh–ain’t it sumthin’?

I finished the outpatient program and am trying to figure out what’s next. How do I re-engage with the human race? Aside from that being psychologically required, why would I want to?

No more Vyvanse, for one thing. It may have curbed some of my binge eating disorder, but gave me headaches and aggravated an old TMJ  injury. Aggravated seems the operative word here. The general consensus is that it also upped my “All People Stink” core belief, which may have contributed to a crankier-assed attitude this past year.

Mad Maxine

All I know is that it took weeks in group therapy before I could sit through the whole session. It was either bolt or punch some sap in the mouth. Not violent by nature, this impulse scared me a little. But I’d be lying if I didn’t say it also felt good. Which was scary in a whole other way.

Everyone in the group had issues with irritability (a common symptom of just about every mental illness), so we worked with it. A lot. So now I have a folder of “anger management” handouts in my Bipolar Badass arsenal.

Speaking of which, I designed myself a business card for my art show in December. Quite happy with the results.

Business Card 2016

Another “what next” was asking two of my friends who also suffer from depression and anxiety to form a Sanity Support group. We met last week, and the prognosis looks good for more get-togethers. This one stone could kill so many Crazy Birds for me that it’s hard to keep my WANTING in check. Patience, Grasshopper.

And since my computer is likely on its way to the Tech Morgue, I treated myself the day I discharged from the hospital with a 32 inch TV and a DVD player. No more incantations, Reiki treatments and uncomfortable yoga positions to get a disk to play in my wheezy computer. Now, all I need do is push a button. Pure Heaven.

New TV

The final “next” for now is working through the book Seeking Safety: A Treatment Manual for PTSD and Substance Abuse with my therapist. I’m sure the next “next” will rise from that.

Hello, Darkness, My Old Friend

As winter progresses, I watch this long spell of nearly-normal fade in the rear view mirror.  It’s a horrible feeling, watching that image of the real me shrink and shrink as the bipolar hitchhiker takes over the wheel.  I can feel the Vyvanse losing its grip and rolling under the tires.  I worry that I’ve forgotten how to do this—how to manage a life instead of living it.

Hello DarknessAnd, of course, all that is a story.  I’ve promised to guard against telling stories.

So, let’s just say it’s an adjustment.

There is more depression and distorted thinking, more fibromyalgia pain and insomnia, more compulsive eating and anxiety.  But, the truth is we all expected this, even while we hoped Vyvanse could beat back winter (we being my therapist, nurse practitioner/med provider, and me).

Miracle enough that an amphetamine meant to curb my eating disorder also managed to smooth out my moods for six months.  I don’t want to get greedy.  Six months of feeling joy and gratitude for my life, of sitting in the driver’s seat, can’t be minimized.  Ever.

And all is not lost yet.

Vyvanse acted like a screen door, keeping the bipolarness on the front porch.  But as soon as the drug flushed out of my system each day, the rapid cycling and mixed states poked their heads in and wanted coffee.  They’re just pushier now.  And obviously, they’ve been lifting weights this summer.

I couldn’t tell if V was helping at all the past few weeks.  I just knew I was miserable the moment I woke up and couldn’t discern any difference throughout the day.  So, I started taking V as soon as I got out of bed.  Now, by the time I finish at the Y, I can feel a lift.  The depression is still there, but quiet and more polite.  Again, this seems huge.

I’m trying to use these moderate shifts of mood to prepare for the hairier, meaner moods that will crash through the door.  I got groceries this morning and made two quiches (one to freeze).  If this pattern holds, I’ll bake a chicken/wild rice dish tomorrow and stick it in the freezer, too.  I can’t cook when I’m brain sick, so doing this feels smart and kind.  I am nurturing and being nurtured—like being my own grandma.

This is all new territory.  Mental illness tries to keep me from seeing that.  It tells me all is lost and will forever be lost.  But, that’s just a story.

The truth is—

—I’m on an Adventure.

It’s Alive!

I feel a little like Peter Boyle’s monster at the end there.  “Who the hell is the idiot screaming?”  But, the idiot would also be me (less some of Gene Wilder’s hair), bellowing the news to the world.  I admit to ambivalence in making such a bold announcement after being sick for three months. It makes me want to touch wood, spit over my shoulder, or at least wear a hat when I go outside.

Also, I seem to be suffering from a weird kind of amnesia, like not being able to remember what I was talking about after someone interrupts me.  The thought was insightful, choice, but damn if it isn’t gone.  So I just stand and gawp, waiting for the brilliance to return. What was I doing three months ago?  No clue.

Maybe it’s not even relevant anymore.  That’s what I tell myself instead of panicking. Let’s just start by unlocking these steel straps, I tell my mad scientist, and we’ll see what happens next.

So, this week I went back to my water aerobics class, because I remember I used to like the water, and I blew the dust off my journal, and I started to plan.  Because, you know, I gotta have a plan.

Which reminds me that I got a Squatty Potty sometime during the haze of pneumonia.  But that’s a different post.  And, no, that’s not me demonstrating the healthful benefits.  I don’t wear white (But click on the link to the Squatty Potty commercial.  You won’t be sorry).HappySquatter-SquattyEccoStool

Anyway… what was I saying?

A Plan.  Right.

All I’ve been able to do so far is babble in my journal.  What’s important to me now?   What needs my attention?  What’s happening?  Where am I?

Getting my strength back and building my immune system came up a lot.  So did paying attention to how winter seems to be sapping Vyvanse’s effectiveness. And maybe I should see if I have any money in the bank.  So much more to consider now than whether I can sit at my table and sort beads for a half hour.

And speaking of those beads… I sure had fun making zodiac cards for the friend who sent me the Bead Box—so much so that I made some for myself.

Capricorn Odor

So, maybe Fun should be part of The Plan, too.  I’ll put it in the hopper (no Squatty Potty humor intended).

Drama, Magic and Miracles

In Their DNA

It seems almost sacrilegious to not have any drama in my life.  I’ve even lost count of how many weeks I’ve been symptom-free—six or more I’m thinking.  And to not worry about what I eat, or even think very much about food.  It’s that darn Vyvanse!  Not only does it curb my binge eating, but has kept my mood at this nice, even place with a clear mind and plenty of energy.  What the Hell?

Winter is still the real test for this magic pill.  But even if my mood is a little better than usual this season, it will still be magic.

So, if I’m not constantly managing my illness, if I’m not on alert for distorted thinking and the Big Fat Liar in my head, if I’m not The Bipolar Bad-Ass Warrior, who the heck am I?

Honestly, I have no idea.  Survival has been my entire existence for the past ten years.  It has changed me, honed me, made me fierce in ways I never expected.  I’m not the same person I was ten years ago.

I like this version of me.  I like it a lot.

That has to be the biggest miracle of all.

The Adventure Continues!

My Life on Speed—An Update

updates

Almost four months ago, I started treatment for Binge Eating Disorder.  Basically, that consisted of taking an amphetamine, journaling about the changes in my compulsive thoughts and eating, visiting my med provider (Sarah) more often, and fighting with insurance.

I’ll start with the ugly and work toward the beautiful.

Gorey1. Dealing with insurance is a nightmare of Edward Gorey proportions—decoding the telephone directory-sized formulary, shuffling piles of contradictory paperwork, making my pharmacy do what the insurance company tells me to tell them to do, stopping Sarah from following the pharmacy’s incorrect instructions, filing forms for an exception to the formulary, filing an exception to the prescribed dosage, discussing the exceptions with non-English-speaking Call Center schlubs who have no authority, resubmitting forms, getting Sarah to resubmit forms…

It took all four months to get it straightened out with me double-checking everyone else’s work.  This process would make a sane person stark raving (and has.  I’ve discussed this with lots of neuro-normal people who ended up screaming on the phone or curled up in a puddle at their pharmacies), so I had to tackle it one little piece at a time.

I’m well aware that insurance companies try to get customers to give up.  They don’t want to pay for anything.  But, I survived filing for disability.  I know this game.  And while it was stressful, and I used a lot of colorful language, I got the exact drug I needed and gained even more respect for Sarah.  She and my (new) pharmacy—these worthies—stood with me on the battle field.  Their loyalty and integrity will earn them a place in Valhalla.

Yield2. There’s a reason amphetamines are contra-indicated for people with bipolar disorder.  Luckily, Sarah and I both did our homework about how they might cause mania and insomnia.

When the zip I got from my pills crossed over into agitation, I stopped taking them.  Since I’ve never been very clear about that line (it feels so good to feel good), the symptoms got scary sometimes before I recognized them—like forgetting appointments, or tearing my apartment apart to find a photo I wanted to use, or getting completely overwhelmed by a movie, or driving too fast while texting.

Whenever I woke up to being scattered or dangerous, I stopped.  I made myself safe or quiet.  I notified Sarah.  And I waited.  The mania always receded.  This is one of the benefits of rapid cycling.  I can always count on my mood changing.  I just had to take my brain-skillet off the fire of the amphetamines to let it happen.

Double AhThose are the ugly parts of My Life on Speed.  The rest is pretty darn lovely.

3. I’ve experienced very little depression since May.  Historically, I suffer less depression and more hypomania in the summer, but not to this extent.  I checked my old journals to make sure.  I expected the Vyvanse to flick me into mania at times, but did not expect the overall shift up in mood.  Sarah and I are cautiously hopeful that this trend might continue into winter.

Oh!  I don’t want to pin any real hope on this, but what if the Vyvanse could keep my mood from sinking into that suicidal basement come February?  Since I’ll also have a caregiver for the first time in my life (from Lutheran Services of Iowa) to help motivate me to keep my apartment clean, this winter could be very different.

4. When I take the Vyvanse, all the compulsive thinking about food goes away.  Small amounts of food give me a sense of satiety.  I don’t need more.  I don’t want more.  There have even been times this summer when I forgot to eat.  I can’t express how weird that is.  I know there are people in the world who lose their appetites when stressed—I thought they came from Pluto.  I have wanted to eat while I was puking from the flu.

Brain That Wouldn't DieI’m seeing now how much space food occupied in my head.  The absence was unnerving at first—like walking into an abandoned house with just a few sticks of furniture left behind by the previous owners.  But, I’ve come to love all this room.  And I’m taking my time redecorating.

Whenever I stop the Vyvanse to let manic symptoms settle, the compulsive thoughts return.  I feel them crowd in—pushy, rude, overbearing.  But I can remember what their absence feels like, and somehow that helps keep me from bingeing as much as I used to.  And even then, I don’t punish myself anymore—for being weak, or gluttonous, or just wrong.  I have evidence now.  Binge Eating Disorder is real, not a character flaw.

5. The final sweet treat is that I’ve lost 30 pounds.

I’ll just leave it at that, because… you know…

I’m on an Adventure.

Life on Speed

CrackheadSay No to Drugs.  That’s been my mantra for the past five years.  After trying every psychotropic pharmacology had to offer, which either had no effect or made my bipolar symptoms worse, I chose to manage my illness drug-free.  I take a sleep-aide when insomnia pops up, because that can mess me up fast and hard, but that’s it.  I had to get over my dream of a Magic Pill.

A year or so ago, I also gave up the dream of losing weight.  I’d used every kind of diet and non-diet (learned genius things at birthorderplus.com), mindfulness training and behavior modification, but compulsive eating always won in the end.  I felt it was time to shake hands with that old nemesis and accept it in the pantheon of players.  Better to accept all of me, I thought, than keep bullying the parts that didn’t behave well.

I’d never talked about my compulsive eating with the nurse practitioner at my psych clinic, but this spring I did.  It was part of my bi-annual check-in, a commentary on my relationship with myself.  But she had a different take on it.  Sarah said I was a poster child for Binge Eating Disorder, and that there was a drug that might help.

Was I leery?  Yes.  Skeptical? Of course.  One of the things I love about Sarah, though, is how conservative she is about medication.  She’s my loudest cheerleader, and our brief sessions usually consist of her grilling me on what new tools I’m using to manage drug-free.  I know to keep an open mind when Sarah makes a suggestion.  So, we talked about Vyvanse being a “clean” drug—it’s in your system or it’s not, no lingering effects, no weaning on or off it like the psychotropics.  Any side effects should present themselves right away (source: http://sideeffectsofxarelto.org/current-xarelto-lawsuits/).  We would start with the lowest dose and work our way up to find a level that would (ideally) curb the compulsion without throwing me into mania or insomnia.  I said, yes, let’s give it a try.

I tried not to have any expectations.  I turned down the volume on The Song of the Magic Pill.  I didn’t want to set myself up for another round of disappointment and failure.  Sarah encouraged me to focus on changes in the compulsive thinking and my feelings, not weight.  I created a chart for the back of my journal to keep track of those parameters.  I was ready.

Three weeks in and I’m cautiously, furtively whispering, It’s a miracle.

The first thing I noticed was the sensation of fullness.  I never felt full when I ate, not even after bingeing for hours at a time.  What allowed me to stop was a weird click in my head, like a timer that said I was done.  Feeling full was a totally alien concept, and I was astonished at the minuscule amount of food that produced the effect.

I also noticed when the Vyvanse wore off and the compulsion returned.  It was like fire ants scuttling over my brain, a swarm of nattering food-thought—What do I want? What do I need? Where? When? How much? What else?—that hadn’t been there a moment before.  It was fascinating.  And it helped me identify the compulsion more clearly.  I could see the difference between the frenzied drive and habit.

Habits are the things normal people deal with—popcorn at the movies, a snack with TV, a trip to Dairy Queen to celebrate.  I found that without the engine of compulsion pushing my habits, I could brush them aside.  I spent a couple of hours reading without eating.  I watched a movie without a snack.  Habit carries its own power, so I have to be intentional and mindful, but now mindfulness actually works.  I still overeat and make crappy choices otherwise.

With time and attention, habits can be changed.  This is my hope.  I went to Starbucks the other day and stopped before I ordered.  I thought my regular Venti latte might make my stomach uncomfortably full.  I was perfectly satisfied with the Grande I ordered instead.  I can’t adequately express how weird and wonderful that little triumph felt.  With nary a fire ant in sight.

I’m on an Adventure.

Something New For My CV

Louis CK

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The DSM (psychiatry’s Bible) came out with a revised and updated version in 2013 with oodles of controversy.  Along with weird restructuring, the Powers that Be (think Nicene Council with prescription privileges) dropped some diagnoses and added others.  One that gained full blessing of the Holy Order was Binge Eating Disorder (BED).  It came with criteria and suggested treatment.  No one paid too much attention.

But in the two years since, more and more providers are taking BED seriously.  Drugs used to treat ADD and ADHD have been somewhat successful in treating the compulsive/impulsive aspects of BED.  Cross-training has always been the drug companies’ bread and butter.

In a casual conversation last week with my nurse practitioner, I mentioned how I gave up trying to lose weight this year.  She asked a few questions, then said I met every single criteria in the BED diagnosis:

  1. Recurrent and persistent episodes of binge eating
  2. Binge eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal
    • Eating until feeling uncomfortably full
    • Eating large amounts of food when not feeling physically hungry
    • Eating alone because of being embarrassed by how much one is eating
    • Feeling disgusted with oneself, depressed, or very guilty after overeating
  3. Marked distress regarding binge eating
  4. Absence of regular compensatory behaviors (such as purging).

She knows I’ve managed bipolar disorder without medication for five years, but she wondered if I might want to try Vyvanse, the current darling drug for BED.

Vyvanse is, basically, Speed, so we both knew mania and insomnia could be side effects.  Great.  But, since I’m sensitive to medication, I’d probably know right away if the spin was more that I could handle.  We also talked briefly about self-monitoring and keeping charts (I’m boss at keeping charts).

So, what the NP and I decided was to wait until I was out of my Mean Season and more stable, then start Vyvanse mid-May.

All my life I’ve dreamed of a magic pill.  I doubt this is it.  But, what have I got to lose besides a few nights sleep and some mad spring cleaning?  At least I get official credit for something I’ve known all my life—I have little to no control over what I put in my mouth.  No diet, motivational bestseller, or cognitive therapy ever touches that wild and mindless drive.

Not that I’m looking for more craziness to add to my resume, but there’s comfort in being recognized.  I’m not lazy or lacking in willpower.  I’m not weak.  My brain just works differently than most people’s.  Funny how that keeps coming up.

I’m on an Adventure.

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