Monthly Archives: January 2015

Attempting Hormonal Therapy with Mixed Emotional Results

I know I have been somewhat MIA the last couple weeks, but here is a quick rundown of my current situation and how things have been faring.

It looks like some (if not all) of the GI problems I have been having since trying Seroquel (all of which are still present even after almost six months of stopping it) are potentially due to a hormonal problem triggered by the drug. After having an endoscopy (having a camera put down my throat to inspect my stomach) and a colonoscopy (same thing, only in reverse… and with significantly less dignity) the result was that the doctors could find no reasonable cause for the intense amount of pain and other odd symptoms I have been having.

After everyone scratched their heads for a while I did some of my own detective work and I went to see a gynecologist. She recommended hormones. I started taking them two weeks ago… and the result was pretty much exactly what I expected – the same sort of response I have had to pretty much every drug (even the flu shot) the last couple years.

A bad reaction.

You see, not only do I experience a treatment resistant, very sensitive, easily triggered version of bipolar disorder (type 1), most medications I have tried (even something as simple as a nasal spray) have triggered big problems for me either by making my emotional state completely deteriorate and triggering a big bipolar episode, or by triggering significant side effects (which generally just go on to trigger more bipolar episodes).

So on day 5 of hormone treatment when I began crying uncontrollably for an entire day I pretty much knew it was the end of that road, but I kept taking the drugs for two more days (just to be sure it wasn’t my own rapid cycling). Nope, by day seven I had become completely engulfed in suicidality and promptly called the gynecologist’s office to inform them and stop taking the new hormones.

Stopping the hormones suddenly was also a problem. Within two days I was no longer in the throes of depression, but instead I became manic and couldn’t sleep for three days.

I had another appointment with the gynecologist yesterday to try and figure out what to do next. She recommended another form of hormonal therapy (with significantly fewer hormones) which I started last night. Personally, I don’t expect this to end up any different than the last round, but I am willing to give this treatment option a shot because my only other option is surgery… which, frankly, scares the bajeezus out of me a little bit.

Like my continuously evolving trial of medications to potentially treat my bipolar symptoms, after hearing about my experiences the doctor concluded that I am very brave for being willing to try hormones again. It is my belief, however, that bravery and desperation can often look a lot alike from the outside looking in…

At any rate, that would be what I have currently been up to. I am sure the mania was also partially fueled by the fact that it has been summer-time weather (sunshine in the 60’s) in Seattle last week, the total opposite of what normally goes down here in January. It seems weather like this could make for an entirely different kind of winter than I am normally used to (30+ days of rain in a row potentially ending in a depressive hospitalization). Mania has its pitfalls, but honestly there are times (like the winter) where it just feels nice to have a little variety.

I expect I will know pretty soon if I will be able to tolerate this new drug, ironically enough it has the potential to alleviate my lactose-intolerance that started when taking Seroquel, however the pills themselves contain lactose so taking it so far has not been a fun ride. Really, just the fact that I have found a doctor who has found evidence of a diagnosable problem after six months of doctors being unable to give me any kind of answers has been encouraging, even if the treatment options do turn out to be somewhat torturous.

In my life, a little hope can go a long way.

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Mindfulness and Self-Judgment from Another Angle

Thanks for all of your comments regarding mindfulness on that last post, it is a topic that I keep circling back to in my mind because it has been hard for me to grasp the concept.

While some people seem to lean heavily toward the aspect of mindfulness that involves being aware of emotions and their changes, this is the part that I feel completely confident in. Identifying my emotional state is something I have been working on tirelessly for four years now (and I do it 4-12 times per day or as mood shifts happen). Mood charting has allowed me to check in with myself to identify my mood and potential triggers (among other things) so in a self assessment, this is an area where I would give myself five stars.

Having said that, while I have strength in the area regarding identifying my moods and mood swings I am not very good at identifying psychosis. I can sometimes identify this phenomenon when it is slowly gaining momentum (like over a period of days) but when it occurs suddenly and without warning or builds slowly over several weeks it often goes unnoticed by me until I am so irrational I have previously only been able to identify the psychosis after it passes.

This concept (and realization by me) has led to trouble on the second leg of mindfulness; withholding judgment of myself and my emotions.

When it comes to withholding judgment about what emotions I am experiencing, I thought I had that in the bag. For many years I would judge myself harshly and consider myself depraved or inhuman for some of the urges and thoughts I experienced (and still do, some of them daily) but over the last few years I have been able to step back from that and conclude that many (if not most) of these things are a product of my own mind playing tricks on me during periods of depression, mania, or psychosis. I thought that taking the step of realizing that these desires (born of the illness) are not my fault, and that being somewhat burdened by the unwilling desire to do bad things (you know, like homicide) doesn’t mean that is how I am going to live my life and it doesn’t make me a worthless human being.

Having revisited this concept several times in the last few weeks, I couldn’t figure out exactly what was bothering me about mindfulness and why I both seemed to “get it” and not “get it” at the same time. What I stumbled upon the last few days is that even though I am reserving judgment of my emotions in terms of identifying them in a self-deprecating way, I am not withholding judgment completely.

Because of the combination of the psychosis factor and the, well, less than desirable “socially unacceptable” thoughts and feelings I have put up with on a regular basis I have a track record of inexplicably doing things that I wouldn’t normally do. There have been times where, let’s face it, I have not had control of myself or my actions, and during those times I have done some things that have scared the bajeezus out of me.

Things like running away from home, or plotting to murder someone (hello hospital), or attempting to harm very cute, innocent, furry creatures (hello again, hospital). What I have learned from these experiences (and others) is that I shouldn’t trust myself, and that I am capable of doing things that frighten myself and others.

Even though I might be reserving judgment about the origin of these thoughts or actions today, my judgment is taking place in a different way; through fear.

And, well, we all know how that story goes. Fear leads to anger, anger leads to hate, and hate leads to suffering. (Thanks Yoda)

Personally, given my track record and the notion that any one of my swings could suddenly bring the overwhelming, incoherent madness of psychosis, it doesn’t seem unreasonable for me to feel terrified when my mood starts to shift or deteriorate. With every additional layer of emotion my reaction becomes more complicated, I begin jumping to conclusions out of a place of fear, and quickly go tumbling down the rabbit hole.

I find myself in the age old riddle; which came first, the panic attack or the anxiety about having a panic attack?

At this point I am not looking for answers from any of you, just thinking aloud. What I do know is that this fear is something that I need to address, and hopefully with enough applied reasoning (or voodoo) the fear and I can reach some kind of understanding.

No cute, innocent furry creatures were harmed in the making of this post.

Exploring Mindfulness; Anxiety and Bipolar Rage

I have a new therapist. So far I haven’t decided if I like her because we are total opposites in terms of our beliefs and methods. While this has been pretty helpful in terms of learning new things (like mindfulness techniques), it can also be entirely exasperating when it comes to explaining my point of view.

The first day we spoke she seemed confident that the practice of “mindfulness” would help solve a lot of my problems.

For those of you who haven’t come across this technique, mindfulness comes from a Buddhist practice involving keeping your focus on the present, including “regarding your emotions in a non-judgmental way” (that is a direct quote, I can’t say I totally understand).

The mindfulness meditation I took on takes about five minutes and involves taking deep breaths, focusing on relaxing my body, looking at my surroundings and finding 3 things that are pleasing to me (colors, textures, etc.) and then formulating an appropriate emotional response.

What I found was that after a week of using this technique (several times a day, sometimes 10 to 15 to 50 times as needed) my anxiety was somewhat responsive. I say somewhat because I often found a bit of relief after the exercise, but it wasn’t uncommon for the relief to last about five minutes and then I needed to do the exercise again. I could see how it would be easier to continue doing the exercise for someone who is seated much of the day, however when walking down the street or overwhelmed at the supermarket I was having a really hard time dropping everything to breathe and relax.

At the same time, I also was curious about using this technique to combat bipolar mood swing reactivity, but the results I experienced were somewhat catastrophic.

If you’ve ever seen the episode of Seinfeld (yes, I know, a common theme lately in this blog) George’s father begins using the mantra, “serenity now!” to help combat his rage. What we find out at the end of the episode however is that this practice was only bottling his rage up to a critical breaking point.

However comical, this is actually fairly similar to what happened to me when I was trying to use the mindfulness meditation to address (primarily) bipolar reactive rage. At first it seemed like it was working great and I felt quite pleased (less like breaking things or shouting or hurting myself), but within a span of four or five days the rage suddenly exploded out of me, and I leapt off the couch, threw the remote control in one direction and my glasses in the other and made a mad dash for the hallway where I very seriously expected to throttle whoever was on the other side of my door.

It wasn’t as if this was a situation that had gone on all day and I had been “stewing”, I felt perfectly fine one moment and then within two or three seconds (literally) I was ready to break someone over my knee like a piece of kindling. All I can say is thank goodness for my boyfriend, because if he hadn’t been home to divert me… well I am still shuddering at the notion of what might have happened. Instead I just stood in the bathtub and screamed and cried for a solid half hour.

I have a couple theories about why this happened.

The first involves George’s father from Seinfeld screaming “serenity now!” The thing about rage that I find makes it so difficult to deal with is the energy that comes with the feelings. For me, it has never felt like the emotion builds up if I don’t express my anger, frustrations, and rage, it is the energy. Since childhood my methods of expressing rage have all been physical because they allow me to address and release the energy that is overwhelming me. Unfortunately, they also have all been more or less unhealthy.

With this mindfulness technique I used, I was addressing the emotion I was experiencing, but not the energy that came with it. Once it built up it only took the tiniest moment to trigger it and… kaboom.

My second theory involves PTSD as I have encountered several situations where very minor things have seemingly flipped an invisible switch in me. Frankly I find this to be less likely in this situation because it did not involve any of my typical triggers (being in close proximity of a stranger, the bus, etc) but I can’t discount this as a possibility.

Finally, one could suppose the incident and meditation were not related. Frankly, I can’t say with absolute certainty that they are, but I am nervous to try again given how close I came to, well, certain incarceration.

At any rate, being able to try new “treatment options” that don’t involve pumping my body full of chemicals has definitely been a welcome change. And as frustrating as my new therapist can be, I think a little change can do me good.

At this point we are brainstorming ways to potentially address that rage-energy in conjunction with mindfulness meditations so stay tuned, I am sure there will be more to come on that topic!