Posted by greywolf on March 29, 2004, at 22:48:10
After 15 years of this, I'm starting to lose my sense of humor. At the risk of spreading morose, I'm kind of at wit's end when it comes to why things have been bad for so long. I'm hoping some fresh eyes might see things I haven't.
I'm a 40 year old guy, diagnosed as bipolar 5 years ago. I'm in the BP II category, with severe recurring depression, usually of 2-3 weeks duration when untreated, and punctuated afterwards by a day or three of hypomania. During bad depressive episodes, I miss work, skip social engagements, and generally dissociate until the worst passes. At one point a few years ago I lost interest to the point that I became so dehydrated that it took IVs to bring me back to a proper state. It's usually not nearly that bad, but what it normally is is bad enough.
The hypomania is both exhilirating and terrifying. While I remain in reality and don't suffer from the extremes of a BP I, the range is extreme enough for my taste. On the plus side, I'm never more creative or productive. I can write for 2 or 3 days straight with no more than an hour or two of sleep each day. My clients are thrilled with my energy, my house is never cleaner, and my friends are never more entertained.
On the other hand, those few days each month often end up costing me hundreds of bucks I really shouldn't be spending. You name it, I'll do it--need someone to make an ass out of himself in a drinking contest with guys half his age? I'm your man. Impromptu tattoo on a moments notice, even sober? Give me a call. And don't even bother challenging me to pick up the hottest girl in the place; I could look like the Elephant Man and I won't back down from that gauntlet. Success doesn't matter, just as long as things get crazy. My natural shyness and longing for solitude are burned away by this almost out of control energy. It sometimes feels like a physical attack, the drive is so strong. With alcohol or without, the result's the same: I'll work, play, party, or talk until I have nothing left but exhaustion.
Of course, you know where it goes next. Depression descends on its albatross wings, and roosts for far longer than it had been absent. Over the years, I've learned more about myself and BP, so I've been better about not placing myself in situations where my manic drive can be exploited to its full potential. I'll cancel social engagements and sit home, sometimes literally bouncing off the walls. Or my lonely mountain bike will get a sudden and overly vigorous workout that my body remembers for days.
But I've never been able to get a handle on the depression. It's onset is strong, and it's pretty unrelenting during its course. I rarely have just passing unhappiness. It's almost always pervasive, and staggering when it hits. I try to get my butt to work, then I get there and spend the day on the edge of despair, all the while smiling at my colleagues and trying to present a semblance of the outgoing guy they prefer to remember from "that great party last week." And since any sign of personal weakness is a huge defect for someone in my job, the thought of confiding in even my closest friend at work is unthinkable. So I go on with the tightrope gig, maintaining the pretense that nothing's wrong though I sometimes feel like I'm on the verge of a breakdown.
I wish that was the end of the story, but I've been blessed with one other little problem: OCD. From what I gather, your classic type of OCD. Constant intrusive thoughts. Numerous types of repetitive behavior linked to feelings of impending demise or unrealistically disastrous consequences if the behavior isn't performed properly (e.g., turning the light switch on and off until I can turn the light off on a positive mental note; doing the same with the refrigerator door, the toilet, trying to close a book I'm reading; real anguish if my morning routine doesn't happen in the exact same order every time; constantly counting down from the number 20; constantly clicking on hyperlinks when I'm on-line because at the moment I clicked the last one, a negative thought entered my mind and if I don't click on something else with a positive thought in mind, something bad will happen. You get the idea. Some days I look down and realize I have to close on the order of 15 browser windows before I can shut down my computer. The list goes on and on.
Of course, there's a humorous side. My family and some close friends are minimally aware of the OCD problem, but I spend a lot of time masking it every day, so it disappears in the background for them. One of the things I'm most keen to suppress are a repetitive head shake and shoulder shrug that I consciously control when I'm around other people, but let go when no one's around--like when I'm driving alone in my car. Unfortunately, I forget that other drivers can see me, and twice in the past month I must have been shaking my head somewhat strongly while driving because on separate days I had drivers in front of me pull into the right lane, then give me the finger as I went buy. Since I wasn't tailgating or otherwise being offensive, I have to guess that they thought I was driving along behind them for miles shaking my head at them.
Anyway, the OCD is getting out of control now, and it's starting to be as much of an interference as the bipolar. For quite some time I had given up on antidepressants and therapy since nothing seemed to work and I was told the only avenue left to me was ECT. For probably baseless fears, I rejected ECT, and the going has been a little tough without any treatment for a couple years. I used to think I was at least maintaining my position, treading water but at least not getting worse. Of course, that was a lie, and now I'm back to the pharmaceutical gerbil wheel.
The Effexor and Lexapro and Trazodone and Wellbutrin and Xanax and whatever's next on the list will work itself out in time to a likely less than effective but better than nothing state,
so my need isn't necessarily for advice on a drug regimen. Instead, I wonder if there's really any hope. You know, the close at hand kind, not the generalized "everyone's gotta have hope" kind. I've been grasping at straws for so long, hope is starting to feel like a compulsive reaction in itself.Other than my doctor and the good people on this board, I am alone in this. My colleagues don't know, my girlfriend doesn't know, and I caused my family so much pain with these problems in the past that I can't bring myself to cause them such unhappiness again. So constructive advice would be much appreciated. Thanks.
poster:greywolf
thread:330148
URL: http://www.dr-bob.org/babble/social/20040324/msgs/330148.html