The Power of One Pill



Pills.  Ah, pills.  “Pill” is such an innocuous-sounding word, but anyone with bipolar disorder who takes medication knows that pills are anything but harmless.  However, unless you depend on medications to keep you stable, and unless you’ve experienced a med horror story, it’s hard to understand why someone highly sensitive to meds would TOTALLY freak out at missing just one dose.

(***Trigger Alert: suicidal ideation***)

Over the past year I’ve become used to taking my MAOI med Parnate (tranylcypromine) three times a day.  That hasn’t been a big deal – I’m incredibly grateful for it since this drug brought me out of bipolar depression when twenty other meds did not.

But as ridiculous as this may sound, refilling my Parnate has been problematic. Here’s a little backstory…please forgive me for it being tedious!  It’s difficult for me to spice up the topic of medication!

When I first started taking Parnate, my psychiatrist wasn’t willing to arrange refills.  His rationale, which he explained to me rather apologetically, was that he wanted to keep close tabs on me.  While I was frustrated with his philosophy (and I told him so!) I understood where he was coming from.  Eventually I asked him to arrange refills and he complied with my request, which was great.

Last week I noticed my bottle of Parnate was getting on the low side and I called Costco to refill it. (Unfortunately, I didn’t think to ask if their pharmacy offers an “auto-refill notification” system so I could be contacted when my medication was ready.  CVS has an auto-refill system that I use with my lithium, and it’s awesome.) In any case, I thought I would be able to get my Parnate without missing a dose.

I forgot that a holiday was coming up, Memorial Day, and that the Costco pharmacy would be closed exactly when I needed to pick up my medication.  That meant that I was going to miss at least one dose, which sent me into a panic.  I was furious with myself because it was my fault for what happened!  Furthermore, I was also mad because I hadn’t thought to ask my doctor if he could prescribe me a few extra “emergency pills” in case this kind of situation happened.  (BIG DUH!)

My husband Craig was in the same room when I flipped out about my error.  We’ve been together for sixteen years and this poor man stood by my side after I was diagnosed with bipolar disorder.  He has been to hell and back in helping me with all my emergencies, care taking, my seven hospitalizations, you name it.

As I threw my tizzy fit, he casually said, “Don’t worry about it.”

What?” I screeched, just shy of a yell since the kids were outside.

Then I angrily muttered,”You’d probably feel differently about it if you were hospitalized seven times in the nuthouse!”

I could sense the hairs on his arms raise in aggravation.  He said nothing and walked away.

At that point I knew I needed to calm down, so I tried thinking rational, soothing thoughts such as:

“You won’t go off the deep end just for missing a dose!” and:

“It’ll all work out!” and even:

“Let go and let God!”

Lo and behold, my mood actually started to level out.  I released my anxious fears because there was absolutely nothing I could do short of robbing Costco.

I felt contrite for blowing up at Craig, and I tracked him down.  I told him I was sorry; luckily he accepted my apology and gave me a hug.  I know he’s burned out from having heard about my medication woes for so many years.  Anyone, even Mother Theresa or the Dalai Lama, would be tired from my numerous complaints, emergencies, and years of seemingly never-ending depression.

While I blame myself for not creating a good medication refill system, I do give myself a break regarding my feelings about missing doses.  I give myself another break for how powerful a pill can affect my system.  The following tale is why I’m letting myself off the hook for my tantrum one last time.

One, itsy, bitsy psychiatric pill made me suicidal.

My former psychiatrist prescribed me an antidepressant medication called Elavil (amitriptyline) and after I filled the script, I took my first pill. Literally two hours later I wanted to hang myself with my bathrobe belt and Craig, thank God, was home.

I told him I felt suicidal and he rushed me to the hospital. There is no way that anything else but that pill that made me feel that way.  I know the subject is so morbid to think about, but up to that very afternoon I knew that if I would ever actually take my own life, I would *never* use that horrific method.  I think that my brain played tricks on me, triggered by the medication, because someone I had cared about had hung himself just a month before that awful day.  I suspect my brain synapses wanted to do a copycat action in reaction to the medication. Who knows? Again, thank God Craig was home.

Because of what happened with Elavil, I’ll never underestimate the potential consequences of missing a single pill or taking a single pill.  I’m paranoid, yes, but now don’t you understand why I feel that way?

So there you have it.  “What’s the point of this post?” you may be thinking.  (I know that’s what I would think!) Well, if you have bipolar disorder and take medication, I implore you, don’t wind up like me.  See if you can arrange an auto-refill system with your pharmacist.  I know CVS does it and I’m going to call Costco to see if they offer the same program.  I’m also going to check in with Dr. D. about having an emergency supply of Parnate – at least a few days worth.  I’ve been wisely advised in this comment section by Rob to buy a weekly pill dispenser to give me more notice when I’m getting low on meds. (Thanks Rob!)

I do make a point of carrying an extra dose of Parnate in my purse in case I find myself away from the house unexpectedly for a chunk of time. These are all little things that can make such a big difference in my peace of mind, and yours.  Take care and may all your script refills go as smooth as silk! 😉


imgrescat pills(Hope this cat photo doesn’t offend you – I thought the expression was hilarious!!) 😉


My Freaky, Malodorous Urgent Care Life Lesson


Dyane’s Disclaimer:

The contents of this post may be a little much for some of you.  Good writing is full of details and I try my best to write descriptively.  While I was tempted to add even more graphic detail to this piece, I held back for reasons you will understand if you read on. 

Here I’m following writer Natalie Goldberg’s advice:

“Write what disturbs you, what you fear, what you have not been willing to speak about. Be willing to be split open.” 

― Natalie GoldbergWriting Down the Bones: Freeing the Writer Within  

A couple weeks ago I was finally hitting my stride.  I was writing daily, exercising regularly, enjoying time with my family and sleeping pretty well.  I still had a doomy and gloomy “other shoe is about to drop” feeling behind it all, but it was not that bad.

Then I let the other shoe drop.  I cannot blame anyone else for what happened.  (Damn!)

I began noticing that when I responded to the call of nature, an unfamiliar, icky smell emanated forth into the toilet basin.  I had no other symptoms – no pain, no infection, no signs of anything wrong.  It was a 100% “olfactory symptom”.  This started happening when our decomposing rat’s smell was strongly wafting throughout our house, which grossed me out to no end.

Between the “eau de decomposed rat” and my own stench (which was almost as bad), I was on the verge of gagging all the time.  One fine day Craig finally located the rat’s remains and cleaned them up.  One fetid smell down, one to go.  Each day my smell grew worse.  I was not only more and more worried, but I was embarrassed.  My family could smell the odor too; it was lingering on my clothes.

I’m sure you’re thinking, “Well, why didn’t you go to your doctor right away?”

Good question.  I was utterly terrified to go to a doctor.  I didn’t even have a current general practitioner at the ready.  I only had my psychiatrist.  I emailed him about my problem and he, along with my husband, advised me to get a urinalysis test at Urgent Care. I knew that they were both right.

I resisted seeing a general practitioner for a couple of deep-seated reasons.  First, I was burned out on all doctors.  I had seen so many of them for bipolar, and I had such a bad association with the medical establishment that I wanted to stay far away from them.  Second, I was frightened that once I met with a doctor, there would be lots of drawn-out tests and then catastrophic news.

I searched the internet to see what others with my problem wrote about it, but I couldn’t find anything conclusive.  My thoughts turned to what would be the worst outcome: cancer, specifically ovarian cancer.  A sweet, young friend of mine had died from ovarian cancer leaving a beautiful little girl behind. Maybe I had ovarian cancer too, even though bad smelling pee did not seem to be a symptom.

I shut down emotionally, unable to think rationally about the situation.  It had been ages since I went to bed during the day, but that’s what I wound up doing on that Saturday.  I became hysterical and I started to shake and cry for hours.

It was a nightmare.

My husband offered to take me to Urgent Care.  In my stubborn panic I refused his kindness. Because of my decision, I prolonged my agony of not knowing what the hell was wrong with me.  The next morning I woke up at 4:00 a.m., and ruminated for hours.  I finally decided to haul myself into Urgent Care.  I arrived at the office forty minutes early to ensure that I’d be first in line.  That worked out well because a long line of people showed up soon after I got there.  The doctor on call that day, Dr. K., was awesome.  I had seen her in the distant past, and I remembered I had a good experience with her.  The medical assistant tested my urine sample and got immediate results: they were completely normal.

Dr. K. seemed a little baffled at first, but then she said, “Let’s take a look.”  I felt really sorry for her.  I was humiliated at how much I reeked, and apologized to her about it, but she told me not to give it a second thought.

While examining me, Dr. K. exclaimed “Ah ha!”

I had left a tampon in.  It had moldered there for way too long.  Sorry to be so explicit, but we all come from the place where tampons are used.

The relief I felt at Dr. K’s news was extraordinary.  After I put my clothes back on and she threw away her putrid medical gloves, I gave her a big hug.

If I had done a more thorough internet search I could have found the answer to my problem, as the “lost tampon” subject exists on many websites.  But by the time I began to do my internet research I had become unglued, and my search skills were sorely lacking.

As I left Urgent Care, I realized that I really had to slow down and ground myself much more than I had been doing.  The lost tampon was a metaphor for my needing to pay better attention to myself and to my life in general.  I lost not just a tampon, but over three days of my peace of mind that I will never get back.  I don’t mean to sound melodramatic, but I’ve lost too much time in this life already to illness.

Life is scary sometimes…we all know that to be true, unfortunately.  However, if I can be proactive with my health and prevent needless stuff like a lost tampon from happening, then I’ll be happier.  Speaking of scary, a lost tampon could have had a much worse outcome, i.e. infection, fever, chills, and the worst case scenario: Toxic Shock Syndrome which can result in death.  I am so grateful it didn’t go that way.  I lucked out this time.  I also will be using pads instead of tampons for a while until I feel a little more present.