Bipolar disorder case study

Riding the bipolar rollercoaster

Not the First Time, Not the Last

About three weeks after I started taking antidepressants for depression I began speaking in tongues. My speech had become impossible to understand. My mind and my mouth were moving just short of the speed of sound. Had my speech been any faster I would have emitted a loud sonic boom.

I slept less then an hour a night. My work began to suffer as I passed the point of manic-related efficiency. This wasn't some fine print side effect of the medication; I was experiencing a full blown medication-induced mania and I was out of control.

Being whacked out on medication was the last thing I thought I'd be dealing with. I mean, at twenty-three I was being responsible for the first time. I was going to a "head doctor" for three months. I couldn't figure out what had gone wrong?

When I first showed up on my psychiatrist's couch (ok, it's really just a comfy chair but that doesn't sound as fun) I was in the throes of depression. To an outsider my life seemed to be going fairly well. I had just started a new job and a new relationship and was living in Manhattan. But for some reason I still could not seem to pull myself together.

So after several sessions, talking about the normal psychomumbojumbo my doctor decided to put me on Zoloft. He was confident about placing me on an antidepressant and expected my depression to clear within in a month or so.

However, during our time together I had neglected to mention that along with suffering periods of depression I sometimes swung way to the other side into states of mania. All my doctor saw was a sad shell of a person and since I wasn't exactly revealing too much to someone I had only known for a short while, I was ultimately misdiagnosed. Oh boy, was I misdiagnosed. So, after the "Zoloft Incident" my major depressive diagnosis quickly became bipolar 1.

Can I interest you in a cocktail?
Getting control of my bipolar hasn't been easy. I see my doctor regularly and have used the services of a psychopharmacologist at times to further refine my medication routine. My mood swings haven't disappeared but rather occur less frequently and less severely. My mind still operates in cycles but the peaks have been scaled back and the depths have shallowed. I have been on an ever-evolving litany of medication for nine years now. That first episode led to me being placed on the father of all mood stabilizers, lithium. At other times I also take Abilify, Klonopin, and Ritalin. And that's just what I'm taking now. Over the years I've subjected my body to the SSRI's like Prozac, the tricyclic Elavil, Desyrel, the atypical antipsychotic Geodon, benzodiazepines like Dalmane and a host of others - all in search of the perfect cocktail. Keeping my medications strait and keeping my head strait is chore. It's a lot to remember and it sucks. Forgetting a dose here and there will sneak up and bite me in the ass. In 1998, for instance, I became lax with taking my pills and soared into a manic state that culminated in my lock-down in mental hospital. It was a hard and demoralizing lesson. But I'll get back to that later.

Relearning how to live
I often find it hard to remember how ill I used to be. Especially, considering how ill everyone else seems to be. I mean, am I really that different that I need to be a human chemical repository?

Despite the obvious improvement in my mental health I still have to convince myself that I need to be on medication. It's my biggest challenge. Anyone who has ever had to take antibiotics understands my dilemma. Just peer into most people's medicine cabinet and you're bound to find a partially used bottle of antibiotics. That's because even though their doctor insisted that they finish all the pills, once they felt healthy again they felt no need for the prescription and stopped taking it.

For me, when I am lucky enough to experience long stretches without suffering a major emotional glitch, I often find myself no longer believing that I need medication and want to stop taking it.

It's a cruel trick that my mind plays on me, like I'm being controlled by some evil Jedi. I have been on medication for so long now, that I often feel as though I have been misdiagnosed as bipolar and I don't need to be medicated at all. Thankfully, my doctor points this out to me if I talk about wanting to be 'prescription clean'.