The Spectrum (2)

I've been in what I refer to as an 'emotionally impressionable state.' Essentially, it means that I have very, very little resilience emotionally, and am easily swayed by life events, essentially the opposite of typical bipolar moods, which are rather difficult to budge. If something good happens, then my mood is likely to rise, and if something bad happens, my mood is likely to plummet. Even things in others' lives (e.g. a family member dies, they lose their job, they show inhuman perseverance, et cetera) then I'm likely to empathise and assimilate to their feelings. This, to me, seems very Borderline-ish, especially since it's just not very characteristic of bipolar.

I previously wrote about that little voice in my head thinking I should drop my meds, and - while it's like an alcoholic thinking about having a drink - it wasn't much of a threat. However, when I get in these more rapidly fluctuating moods, it sounds like a better and better idea. Having the moods is like having a beer lying around, and the alcoholic glancing over from time to time, fighting off the urge that haunts them. With it right there, it's harder to deny than when it's at least a bit off in the distance.

Even if I do decide to drop my meds... which would be a sketchy decision... it would be wisest to gradually drop down, instead of go immediately cold turkey. I've heard of plenty of people getting (safely) off of their meds and still... well... living. It can feel as though meds take a person's emotional spectrum and chops it up and cuts out a lot, and then it just doesn't feel right... To represent it more visually, say this is the full spectrum off of meds:

Depression                   'Normal'                            Mania

<===================|===================>

On meds, it feels more like:

                N-Dep                  'Normal'             H-Mania

                <=============|=============>

'N-Dep' meaning 'Near Depression,' or simply not deep depression and 'H-Mania' meaning 'Hypomania.' I put Normal in quotes because it's a very relative term.

As you can see, it's a rainbow that's missing colors. It's incomplete. For other people, the full spectrum probably has all the colors, but different levels (e.g. sadness instead of depression and happiness instead of mania.) So, for a person with a more normal spectrum, cutting out the two ends would essentially be ridding them of sadness and happiness; it would be extremely bland. That's how it feels, to me, with this shorter spectrum. Strangely, that's why I feel better when I can fall into depression and fly into mania. Experiencing the whole rainbow is like nothing else, and is irreplaceable.

I don't think I'll ever be able to adjust completely to a more normal spectrum. I don't know if I'd want to. I know I would never commit suicide and that I would never sporadically run in front of a bus because I saw something interesting on the other side of the road. I'd never do drugs and I'd likely not drink (at least much.) If I could try to manage sleep and learn mindfulness with... probably years of therapy, maybe my meds wouldn't be completely necessary (or I could try to manage my moods to a lesser degree so that I don't crash and fly too low and too high, respectively, but I still get a fuller range. These are some things to ponder. Then again, maybe these thoughts will just start to dissolve until a later time.

Manic-Depressive

I don't think that people quite understand the willpower it takes almost every day of my life to hold onto the little bit of stability I have. I think that I just cover it up to look just casual enough.

There were two parents who made a movie after their child's death (called Boy Interrupted.) He was diagnosed with bipolar when he was just a very, very young child and casually spoke of suicide practically since he could walk. Right before he finally did commit suicide, his parents attempted to get their son to see his psychiatrist because he had previously dropped his meds because he was 'feeling fine,' with worrying symptoms soon after arising. However... just the day before, the boy threw himself out of his window and he died. He psychiatrist later said, they [bipolar people] all drop their meds.

Well... I think that the latter statement is true. Even I have to admit that I once dropped my meds. Felt pretty awful and something I'll never forget. But, despite this, I still often get the urge to drop my meds out of the blue and dive right back into that chaos. Those highs and lows... there's just something strangely seductive about them. The highs are quite obviously enticing, I think. But the lows are, too. The highs make you feel better than alive, while the lows can simply make you feel alive, at least for me. It's like without the lows, life is surreal. I get plenty of bouts of both, but it's just not quite the same - neither in intensity or frequency.

If I were to say that I wanted to drop my meds because I 'felt fine,' then that would be quite true. Feeling fine isn't always the best feeling in the world, especially for someone who craves instability like me. Self-sabotaging, impulsivity, and - especially - doubt and guilt, become regular things for people like me. Some people don't even realise how much they crave instability, yet they still do these exact same things, almost like a dangerous drug.

Luckily for me, I've never taken drugs - at least not illegal narcotics, or anything like that. My drugs are usually just bad habits, video games, and other useless things that simply give me some sort of enjoyment or relief. These can also often turn into impulsive behaviors that are much like itches I just have to scratch. I often feel like I just can't control my body - like someone else was making my every move for me. I stand back, at least metaphorically, and see the things I do in awe and guilt.

I've been asked more times than I can count, 'Is this really how you want to live your life?' and I always respond, at least one way or another, 'No.' Of course it isn't. Or, at least, the logical side of my mind doesn't want that. But it happens anyway because the irrational side always manages to have more power. And so... with every day, I think, 'What if I stopped taking my meds?' I know it would be catastrophic, but I just can't shake the urge. I've managed to muster all of the willpower I can to keep it from happening, but then I have just about no willpower for anything else.

My life is exhausting, but people can't even see that. And then you add fibromyalgia and anxieties and it's simply catatonic. It's disabling. I'm getting nowhere fast. And, the faster I run, the more nowhere I get.

Vertigo

'Fool me once, shame on you. Fool me twice, shame on me.' What about when you do something with a bad result, but then do it again? Well, in my case, the bad result was pharmacological. I took my normal meds a while back, which - at least on the average person - have some major CNS (central nervous system) depressing effects. Basically, it 'slows' your body down, and it's the prime reason I can get to sleep... just about ever. Well, I've been 'doped up' in the past - lots of meds being needed causing lots of CNS depression. But I haven't been that way in a long time. If anything, I've had more trouble getting asleep than staying asleep. It's been somewhat of a theme, and so I've piled on a couple other things - melatonin, occasionally clonidine, namely. I raised my Seroquel to try and control my more recent (i.e. within past several months) hypomanic episodes, and while I've noticed the episodes lower in frequency, now my overall depressive episodes have surfaced a bit more here and there, and I still have a sleep problem.

So, the first incident, I took my Seroquel, Lamictal, melatonin, and a Norco (hydrocodone/acetaminophen). That night, soon after taking the combination, I was flickering in and out of consciousness, having memory lapses, stumbling around, having severe vertigo, and eventually just went out like a light bulb. While, sure, the goal was to get to sleep, at least eventually, I do remember one thing very, very clearly - I went up the stairs and into the kitchen, suddenly out of the haze in a moment of clarity, and I started worrying for my life that I was too overly medicated, that I might never wake up should I go to sleep, and would die in my sleep. For a little while after that, I sat on the couch just trying to keep my eyes open so that I none of that would happen. Eventually, I got to the previously mentioned destination - 'out like a light bulb' - and obviously woke up several hours later. While, when I woke up, no problems seemed to have occurred, I clearly remembered what had happened just before going to sleep.

Last night.... (by the time this will be posted, the night before, really) I did the same exact thing. I had been having a flare up that just wouldn't go away, and so - in my mind - there was no decision to be made; I took a Norco. I think a few hours later, I took my normal, nightly meds. Virtually the same thing happened to me. I - embarrassingly enough - dozed off in the bathroom, and when I was just conscious enough to get up and out of there, I headed for the kitchen. The vertigo seemed even worse, and I was essentially having a flash back to the first incident. In seconds, I got this horrible nausea and raced (or, rather, drunkenly stumbled) to the bathroom and spilled my guts.

So... if I don't learn that my meds in combination with a Norco is a bad idea by now, I'm probably pretty stupid. I checked drug interactions on Drugs.com (admittedly, there's no guarantee on the reliability or completeness of their database, but it's not a bad idea), and... sure enough, there were two, and they both involved hydrocodone. Hydrocodone in combination with both Lamictal and Seroquel, according to their database, can cause serious CNS depression (each given a 'Moderate' alert.) If each one is moderate, then I just wonder what both of them together makes.

I don't want to take Norco within even several hours from my nightly meds, anymore, but I don't want severe, persistent pain while I'm waiting for my meds to kick in, or while I'm trying to sleep. Normally, once my meds put me to sleep, I'm out, and few things fully wake me up and keep me up. But once I'm up, or if I'm still trying to get to sleep, it's hard to get back to sleep. Pain can keep me from getting to sleep, and if I get up, be troublesome when trying to get back to sleep.

Seems a bit like a dilemma to me; perhaps it's a crossroad where I need to figure out how to deal with this. During the day, Norco has no problematic side-effects, and during the night, I'm more vulnerable to problematic pain, but I need to get to sleep and stay (as) stable (as I can), so ditching my normal meds isn't an option. NSAIDs and regular, over-the-counter meds like acetaminophen (Tylenol) just don't do anything, and those are typically the 'safe' avenue for pain relief. Although, the Piroxicam does seem to have a marginal, beneficial effect, and I definitely noticed I'm worse off without it, it doesn't actually solve anything. Even with Norco, the fibromyalgia pain can pierce through, though make it tolerable.

I'm gonna have to talk to my doctor. I've been rather safe and careful with Norco so far, but I possibly could still be a bit safer. I'm gonna actually try to learn from this, rather than stubbornly dismiss it. It's not good for me, and it's honestly pretty scary. I don't want to ever feel like my heart is just gonna stop all of a sudden anytime in the near future, that's for certain.

Breathless

The light that shines through the window into the dark room is cold blue-grey. It once was a warm, sandstone orange like the Tuscan sun. The walls are hardly illuminated, full of shadows and shivers. When did it get so barren and bland? When did the life get so sucked out of the light? The sun's no longer yellow, but pure white. The sky's no longer blue, but pure white. The clouds are the only ones who stayed true during the day, already having lacked color, but during the evening... too, are bleached. And as the sun hides behind the hills, they become gradient until utter blackness.

I'm tired. It's tiring. Slow days of lulling grey, mixed with humidity and birds chirping, and the fatigue of merely living. I feel the pain in my bones, the tears that want to come out, but can't — the onslaught on my body drives me down into the ground. I lose my breath and it flees from me. Why can't I catch it with my net and nestle it back within my lungs where it belongs? I sigh, and sigh, and sigh, shallow sighs as desperate attempts at ensnaring breath. But it's not enough.

My eyes become heavy, difficult to hold open. My body wants to fall into a coma and I'm almost willing to abide. Electric pain courses down and throughout my body in unbearable waves. Each bolt drains the life out of me until there's nothing more to take. My eyes water, but I still can't cry. I moan, trying to let out the demon's in vain attempts. "Kill me now," I pray to Azrael. "Take the life from my bones, give mercy on my soul." But no voice answers in return. I lie in total silence... I lie in wait... I lie in slowly... waning... hope.

A semi-fictional vignette about fibromyalgia and the closely intertwined depression.

Manly Men

I've never liked them. Manly men seem like an evolutionary relic that ought to be thrown away. Then again, I'm not one for feminine men, either. How about... toned down men? Men who don't base everything in their lives on being a man. It seems women often say, "Half of your thinking is from your other head." I've never wanted to be one of those men; I've always condemned those kinds of men. But women can be similar; it's just not as  cliché. Men can also be vulgar, competitive, aggressive, and many other adjectives that you often don't want to be downwind of. These things I've hated and hated for so much of my life, and even worse, seen in myself.

And now I hear that I have very low testosterone. Not just low testosterone - very low testosterone. Average testosterone for someone my age is probably 600-800 ng/dL (I'm just guessing), and 300-400 is on the problematically low in most men. So what's very low? 200 is at the bottom of average for a guy in his forties. Is mine 100? Less? What's very low, and should I be worried? I have a lot of 'female' disorders - fibromyalgia, bipolar, my suspected borderline (yet to be confirmed)... Could this be due to low testosterone? If I get testosterone replacement therapy, will I be like the guy on House and start having aggressive, angry outbursts (aside from the times that I do that already)? I mean, I'm not as chipper and unrealistically happy as the guy on House... but doesn't that mean that the possible outcome might be worse? What caused the low testosterone?

Testosterone... I've always disliked it... It's what makes men all of the aforementioned things I just... get a headache to think about. But then I'm told that it's a big problem not to have it. It's unhealthy with it, and it's unhealthy without it. But then it can be healthy with it, and occasionally healthy without a lot of it. I'm not healthy. I don't have a lot of it. So that must mean that I need more of it. Or maybe I'm screwed up regardless. Not trying to get more testosterone just seems stupid, though. Not trying a possible avenue that just might help with... something, seems stupid. I hope I don't need it - or that it isn't the cause of a problem - but the truth is... I just don't know. Maybe I'm just stubborn with my views (actually, I know I am.)

I can't imagine my life without problems, and to think that something that might be wrong with me could be solved... it makes my mind go, 'Cannot compute.' It's like a glitch. A brain fart. It's ironically scary to me. I told my psychologist that I often desire chaos. I think about dropping my meds and falling back into that chaos, but I never do it. I come back to reality and think rationally - I won't do it. I remember how unbearable it was, and how much better my life is without that chaos (even if it's still most certainly far from ideal.) But perhaps I'm still in some of that chaos - or a new chaos - and hearing about this low testosterone - very low testosterone - might threaten that chaos. That second paragraph really shows it. Those thoughts - cyclical, long tangent of thoughts - are characteristic of anxiety. The run on sentences, parenthetical dashes, scattered thoughts. Most people would probably hear about this and feel relieved in some way that issues they had been having could potentially be solved. Perhaps I just have to wait a bit longer to let it kick in.

Testosterone... Maybe I should just stop thinking and wait and see what happens. So... we'll see, I guess.

Exhaustion

I'm not 100% certain if my current med setup is mostly to blame, my fibromyalgia, or both... but I have simply had no energy lately. I'm now on three Neurontin (the med that's supposed to treat the fibromyalgia, itself), a Piroxicam (NSAID pain reliever, most likely wouldn't produce any somnolence, and hardly seems to produce any effects whatsoever), and a Norco (hydrocodone opioid pain reliever, is seemingly ineffective), and I raised my Seroquel (atypical antipsychotic/sedative) a little while ago. While some of these things would typically cause increased somnolence, the lethargy has been increasing more proportionally to my fibromyalgia pain.

The pain's been getting persistent and increasing in intensity. Tramadol became utterly ineffective and I stopped feeling its effects totally. I got an increase to hydrocodone (about six times stronger) which I've taken almost once a day for several days... I still haven't really been feeling the effects. I could almost swear they were merely placebo pills... without the placebo effect. Then again, there's a thing called the 'anti-placebo effect.' It's doubt about a drug reversing or negating the effects of said drug. It's been too little time, I think, to start building up a resistance to opioids and we've been pretty careful about dosage and how often I take the pain meds. The Tramadol I noticed was supposed to be working when the signature itchiness and slight dizziness kicked in. With the hydrocodone, I haven't noticed any effects. I can't tell when it kicks in after taking it. I just don't 'feel' it. I'm afraid that I'll have to keep on increasing the strength and dosage of pain meds and I'll become House. Actually... House takes Vicodin, a.k.a. hydrocodone. If I take something stronger, and more often over time, I'd be worse than House.

The pain's no longer dull. It's sharp, stabbing pain, wincing pain. Sometimes it's so sudden and so bad that I have to let out a moan or a groan. I can't hardly do anything before the pain starts to grow and grow and I just get completely drained of my energy. Lately, I've been having to take sudden deep breaths like I'm low on oxygen. I slept from about 4:00 a.m. (normal, if not a little early for me) until 10:00 p.m. (much, much later than normal.) I woke up more refreshed than the day before, but that doesn't say much. I was still exhausted, achy, and with stabbing on again off again pain. I just don't know the next step to this. The fibro's getting worse instead of better. It's not as bad as before taking Neurontin at all, where I was in total agony as if I were dying, 24/7. But it's climbing back up that way. It's like a race between meds and symptoms, which will prevail.

A month... Hopefully in that time something will be better and I'll be able to give a positive report to my doctor. Hopefully.

The Spectrum

I decided to make a spectrum depicting the different levels of moods I can be in. In the past, I typically wrote: very depressed ← depressed ← neutral → hypomanic → manic. This was exceptionally simple and lefts a few gaps. So... I made a new spectrum with one particularly special add in: very depressed ← depressed ← negative ← emotionally impressionable ← neutral → positive → emotionally impressionable → hypomanic → manic.

Everyone can be in a positive or negative mood. Usually, we aim for positive, and sometimes we achieve it. This spectrum, however, stretches from a central point to the extremes, not necessarily the 'base point.' I probably tend to lean more toward the negative part than the neutral or positive part, but I think that 'emotionally impressionable' is less extreme than 'negative' on the negative branch, whereas it can be more extreme than 'positive' on the positive branch. One example of being emotionally impressionable is having mood swings because of the things around you. For instance, sometimes my mood can be like clay, and every event in my day molds and morphs that clay into constantly fluctuating shapes. It's not always bad, it's not always good, but it has a consistently unstable behavior. Negative is more concrete, so that's the reason why I think that emotionally impressionable can be considered less extreme, but it's instability is also the reason why it's more extreme than the more solid positive.

For the last half year or so, I've had a great deal of being emotionally impressionable. I've identified it fairly well - almost immediately - but never quite found the right words to describe it... until now. Today... I went from crying at every little thing on Parenthood to laughing hysterically at Community to feeling like crap because of my fibro flare-up (that Tramadol simply isn't dealing with effectively.) I can't list all of the constant changes in my mood and behavior from this past day - there's just too many to remember! However, I do know that I slipped from the emotionally impressionable state to the hypomanic state. I had accelerated energy, accelerated mood, accelerated reactions, accelerated irritability... you get it - accelerated! That's hypomania.

Having this new spectrum now to identify all of my states... I could probably analyse my issues better. I can try to link the states to events or to specific behaviors (e.g. emotionally impressionable on the negative branch can cause sudden angry outbursts or quickly swing to the whimsical, careless, strange, and extroverted positive branch [though being on the positive branch doesn't always mean it's good, and the opposite with the negative branch.])

So, once again, hopefully this will help me better identify my different states to analyse and learn to cope and deal with each state as it comes along - after all, you can't simply ward off certain feelings with 'feeling repellant' or some sort of talisman of warding. They're inevitable, so instead of trying to expel these moods and feelings, I simply need to learn how to handle them. It'll be a long uphill battle, but it's a battle that needs to be fought.