Wherever You Go, There You Are

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Lately I’ve been thinking about Hawaii an awful lot.

Last November, our family scrimped and saved for months to take a sentimental trip to Kailua-Kona on the Big Island.  My mother-in-law died last spring, and we brought her ashes with us, for she loved living in Hawaii for many years.  My husband Craig knew she would have approved of his scattering her ashes in such a meaningful location.  We also thought our two little girls would benefit from an informal family ceremony in their grandmother’s honor.

So yes, this trip was a big deal for us to take –  we definitely knew how lucky we were to visit such an exotic place.  We stayed at Al’s Kona Coffee  Farm, a rental unit with a kitchen so we could make the majority of our meals and save money.  My husband knew the Kona area well from visiting his Mom when she lived there, and he planned our activities to be mostly free or low-cost.

We had scheduled the trip twice before, but Craig had to reschedule due to my hospitalizations for bipolar depression relapses.  Al was very understanding of my medical situation, and not only was he flexible in our rescheduling; he gave us a good deal.

Look at how spectacular Al’s Kona Coffee Farm is!

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A month before our trip, my bipolar depression had finally lifted due to my trying an “old-school” medication.  I started taking the MAOI (monoamine oxidase inhibitor) named  tranylcypromine or Parnate.  My pdoc added it to the lithium I was already taking, and within two days – kaboom.  My evil, hated, soul-sucking depression was gone.

I located two studies online conducted in the 1970’s that found MAOI’s combined with lithium had a greater effect together to lift bipolar depression than when used separately.  I also read a document that described MAOI’s as the “last-resort” medication for bipolar depression.  When I spotted that, I said “WTF?”   Why no psychiatrist had ever suggested the MAOI class to me before, since I was super-medication-resistant, remains a mystery to me.  There are food and beverage restrictions with MAOI’s, but they aren’t the end of the world, and the restrictions are totally worth it if the depression goes away.

Anyway, three days before we took off on our flight, my depression returned.  Words cannot express the level of disappointment and fear that descended upon me.  I’ll cut to the chase right now and let you know that three weeks later, after we returned from Hawaii, my doctor added Seroquel to the lithium and Parnate.  The depression went away and it has stayed away ever since.

But the entire time I was in Hawaii, my depression was unrelenting.  I contacted my psychiatrist and we upped my Parnate dosage, but it made me feel too wired and didn’t alleviate the depression, so I returned to the prior dosage.  While I was able to appreciate my little girls’ joy as they boogie boarded, and I took in the natural beauty of the Big Island as much as I could, I still felt like a zombie.

I’m attempting to fake being happy in the picture posted above.  Underneath the smile is utter hopelessness.  Despite the beaches with warm aquamarine water, the incredibly tasty Kona coffee, the fresh poke fish, the chocolate-covered macadamia nuts, the dolphins, and the sunsets, I felt beyond horrible.

The lesson I learned was that it didn’t matter if I was in Paradise if I didn’t have the right meds.  Some of you know that’s way easier said than done!

We could have cancelled our trip yet a third time, but  since we were so close to our departure date I didn’t have the heart to cancel.  Plus I was praying for a miracle to happen.  At least Craig and the girls had a great time.  He didn’t hold it against me that I was a less-than-ideal travel companion, and I am very grateful for that.

Someday I hope we get a “do-over”.

When Craig took his mother’s ashes out to a stunning reef on the bay by the Puʻuhonua o Hōnaunau National Historical Park, I was unable to join him.  I sat in the sand, motionless for the most part, unable to even read a book.  I am hoping that some day we’ll have the good fortune to return to that area and I can pay my respects properly.

While there I’d pick a few plumeria flowers, which are flowers that my mother-in-law adored.  I’d walk out on the reef and toss the blossoms in the water in honor of the woman who gave me the best husband I could ask for.   Then I’d walk down to the beach and swim a little, because when we went to Hawaii last year I was so down, I couldn’t even swim in the ocean.

I know that many people in our world could never afford a trip like the one I describe.  Recently I watched the documentary “Happy” that profiles different cultures with authentically happy people.  None of the “stars” of this film were wealthy, most of them lived on small incomes and some were what our society would consider extremely poor.  All of these people truly appreciated their day-to-day lives.  We could all learn from these individuals.  I may never get a chance to return to Hawaii, so I want to appreciate my “here & now” better.  (I don’t know about you, but it’s much easier for me to do this in the spring when it’s warm instead of freezing!)

I wish each of you the trip of a lifetime, wherever your dream place may be.  And I wish even more that your love and appreciation for your here and now grows significantly over time.  It would be awesome if each of us, especially those of us suffering with mood disorders, could not only appreciate the present, but experience some simple happiness every day.

I am sooo not there yet, but I’ll let you know when I’m making some headway.

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Freaked to Meet With My Pdoc

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For those of you who are fortunate enough not to know what “pdoc” means, it’s a shorthand term often used for psychiatrists in the bipolar community.

My pdoc is wonderful.  Out of the myriad of doctors I’ve seen for bipolar disorder, “Dr. D.” has been the most compassionate, the most capable, and the most “normal” pdoc I’ve ever met with.  Maybe he seems normal because he isn’t clueless, overly detached, arrogant and/or misogynistic like the other pdocs I’ve consulted with over the years.  Even his fees are lower than other pdocs in this county.  He deliberately created lower fees as he wanted to reach people who couldn’t afford the exorbitant psychiatry rates in this area.

Most significantly, it was Dr. D. who suggested the only medication that lifted my severe bipolar depression.  I tried over twenty meds before I met with Dr. D.  He advised that I try the MAOI (monoamine oxidase inhibitor) Parnate and lo and behold, it worked.  Until then, I wasn’t aware that MAOI’s are used for “bipolar medication-resistant” patients, and it baffles me that none of my other pdocs even thought to suggest a MAOI (an “old-school”) medication.

Logically speaking, there is no absolutely need for me to be scared of Dr. D. – he’s anything but the boogeyman!

However, I’ve created my own psychological trip: Dr. D.’s authority as a psychiatrist scares the sh*t out of me.  I’ll admit I’ve done this sort of thing with the other pdocs I’ve encountered.  Every time I meet with Dr. D., I worry that if I seem off or if I say the wrong thing,or if I start to weep, he could *5150 me with his pdoc power!

I feel like I have to “act normal” in front of my pdoc.  It is exhausting and anxiety-producing to place that kind of pressure upon myself.  While I can often “pass” for normal, even when I’m having an anxiety attack, I’m always worried I’ll slip up.

So I try to act normal, and “fake it ’til I make it”.  It’s not a natural or comfortable way to live, to say the least.  Both of my parents were professional performers: Dad played the violin with the Los Angeles Philharmonic and was a soloist with various orchestras.  Mom won the University of Michigan’s first television acting award and she moved out to L.A. to pursue an acting career.  I realized I inherited a little bit of their talent after I won the lead role in a play produced by a professional L.A.theater company, and when my music teacher told my Dad he thought I could make it as a professional violinist.

In an ironic twist, I come from a family of accomplished doctors on my mother’s side.  My mother, who I think secretly wanted to be a doctor, brought me up to revere doctors and she treated them as demigods.  I developed my own attitude towards the medical profession in which I too worshipped them, and I followed whatever instructions they gave me…until I became acutely manic.  (That’s a story for another post.)

My primary point is that I didn’t want to act like a fake at today’s session with Dr. D.  Faking it was getting way old!

I remember how proud I felt when I was selected as the International Bipolar Foundation’s first 2014 *”Story of Hope and Recovery”.  I didn’t want my story be a sham!  The truth is that I am stable, and I’ve been this way for almost a year. (I know a year doesn’t sound that long, but I feel that a year of my mental stability is akin to calculating dog years, i.e. one year feels more like seven years!)

I am happy to tell you that when I met with Dr. D. this morning our meeting went well…much better than I expected.  Right off the bat,  I told him all about my deep-seated fears of his authority.  We spent most of our monthly session discussing how I felt and how to move beyond my fears.

I remember when I first met with Dr. D. he candidly shared how he planned to either be a physician or a therapist, and that many of his friends thought he’d do best as a therapist.  He chose the doctor route because he thought he could be more helpful that way.  I could see the therapist in him as he told me he was grateful I could be honest with him about my fears.  He emphasized that if I kept this information to myself, he wouldn’t be doing a good job.  Throughout our conversation, Dr. D. reiterated several times how well I have been doing, which is always fantastic for me to hear.

We moved on to discuss other topics such as my lithium refill, and blood tests.  We also talked about my sugar addiction of which Dr. D. (he specializes in addiction psychiatry) said must be contributing to my anxiety.  While it’s not pleasant to analyze one’s addictions, I felt comfortable, safe, and supported in doing so with him.  It helps that it’s obvious he knows what he’s talking about!

I know I’ll always be a little intimidated by my pdoc simply because he could dial a number and advise that I be involuntarily hospitalized – all within sixty seconds or less.  But worrying about that is like worrying about an asteroid hitting the earth. It’s more probable we’ll have another big earthquake here than Dr. D. pulling out the big pdoc guns.  I have to learn to…dare I write this “Frozen” phrase?

Let it go.

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*5150= Known as a 72-hour-long involuntary hold in a psychiatric institution

Here’s the link to my Story of Hope and Recovery

http://ibpf.org/story-hope-and-recovery

Bye Bye Benzos, Bye Bye Booze

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This isn’t going to be one of the most politically correct posts that I’ve written.  I hope what I share doesn’t come back to haunt me, and I hope it doesn’t haunt you either!  I’ve found that when I’ve blogged about my deep, disturbing secrets, it has been a positive catharsis.  I also know that I prefer reading about others’ messy lives and how they made it through the chaos, rather than read overly sanitized posts.

What matters most is that I learned from my horrific-sounding experiences, I really did.  I had an enormous wake-up call that I will vividly remember the rest of my life.  These wake-up calls affected me so deeply that I made significant changes in my lifestyle…

It’s common for people with bipolar disorder to become addicted to unhealthy substances/behaviors in order to cope with bipolar’s awful symptoms.  I never truly understood that concept before my diagnosis, but my understanding of addiction changed dramatically after bipolar ravaged my life.

While growing up I abhorred alcoholism and drug addiction.  My father, who had bipolar disorder, was alcoholic, and my first boyfriend became a drug addict before my very eyes.  Dad and Mark were both my personal cautionary tales, but I threw caution aside when my anxiety soared sky high and my depression hit rock bottom.  I looked for something, anything, that would take the edge off my extreme anxiety after bipolar disorder entered my life.

I asked my psychiatrist if I could take an anti-anxiety medication, and he prescribed Xanax.  Up to that point, I never thought I’d take a benzodiazepine.  I was well aware that class of drugs was addictive.  But I had become consumed by anxiety so badly that I couldn’t function, and I felt desperate.  The Xanax did reduce my anxiety, but it didn’t completely wipe it out by any means.  While it helped me, one massive drawback was that Xanax affected my judgement and my driving to a dangerous degree.  I caused two separate car accidents, one minor and one much more serious, due to Xanax.

The first car accident didn’t involve anyone else but me, thank God.  It happened in a church parking lot.  I found it ironic that the lot was where my accident took place because I was there to meet with the minister.  He had generously offered me the use of their meeting room for a women’s bipolar disorder support group I created.  Because of Xanax, my depth perception was off, and I gently hit the fence bordering the parking lot.  My car bumper knocked down a couple planks of wood.  When I told the minister I hit his church’s fence, I was humiliated –  it wasn’t the ideal way to start our meeting.  I was relieved that he was gracious about the small damage.  (I didn’t breathe a word about why I hit the fence.)   No one questioned me about my little “tap”, and my husband fixed the fence a few days later.

My next car accident was a total nightmare which could have been disastrous.  I had taken Xanax that morning, as usual.  I was driving with my four-year-old daughter in the back seat. I waited at a stoplight and I thought the light had turned green, so I entered the intersection.  But the light had not turned green.  A SUV sped towards me, hitting the front of my car on my side, missing me and my daughter by inches.

An angel must have been looking out for us all because no one was hurt.  The SUV pulled over into a lot by side of the road, as did I.  An elderly husband and wife got out of the car and I stepped out of mine, with Rilla safely locked into her car seat watching all the commotion. I was in shock and I lost control of my emotions.  I started bawling because I knew what I had done was grossly wrong.  Even though I was at fault, the man looked guilty as well and he admitted to me he had been speeding. He hurriedly said that they were on their way for his wife’s surgery appointment, and they were already late. He didn’t even ask me for any insurance information – I suggested it.  My crying distracted the couple, and by the looks on their faces, it was evident they felt sorry for me.   I wrote my name and phone number on a slip of paper, gave it to him, and off they went to the hospital.

After this accident happened, I knew without a doubt I needed to taper off Xanax and I tapered successfully over a period of months.  Quitting a benzo was one of the toughest things I’ve ever done, but after I almost killed myself and my child, and knowing that I could have killed others too, I couldn’t deny the gravity of my problem.

Regarding alcohol, I never got into an alcohol-related car accident, but my dependency upon it grew worse as a couple years passed by.  Trading one addiction for another, I became a daytime drinker.  I hated the taste of alcohol, and I literally wouldn’t taste the red wine that I gulped in my oversize coffee mug.  I felt gross.   I had gone from being a health-conscious, certified personal trainer who only drank water (before I was diagnosed with bipolar disorder) to an overweight, depressed, anxious alcoholic who had bipolar disorder.

A blessing in disguise took place thanks to a medication called tranylcypromine, also known as Parnate. Parnate is in the MAOI/monoamine oxidase inhibitor class.  After I tried over twenty drugs for bipolar disorder, my psychiatrist suggested the MAOI Parnate.  I didn’t realize that Parnate was known as the “last-resort” antidepressant used for bipolar depression.  Not a single one of my numerous other psychiatrists thought to suggest this old-school medication to me.

MAOI’s are controversial because they require a fair amount of food and beverage restrictions.  One of these no-no’s is alcohol.  If you drink alcohol while on a MAOI you could potentially die, so it’s a very convincing way to give up alcohol. When I took my first Parnate pill, I relinquished alcohol cold turkey. I haven’t had a drop of alcohol since because the Parnate (in combination with lithium and Seroquel) worked to lift my depression.

The fact that medications finally worked for me was nothing short of a miracle.  While I do miss the numbing qualities of benzodiazepines and alcohol, I don’t obsess about them anymore.  I am back to exercising regularly again.  I’m researching holistic methods for anxiety such as meditation and flower essences (as long as they are compatible with my meds).  I belong to mental health crusader Meagan Barnes’s Facebook page and website called  “Anxiety Angel – Women Conquering Anxiety”. (http://anxietyangel.com/).  I take advantage of the great resources Meagan shares with her many followers – she really is an angel on Earth!

I know how lucky I am that I got several “second chances”.  All it takes to remember what I could have lost is a glance at my two daughters’ faces.  I’ve become much stronger in knowing I’ve been able to “just say no” to the benzos and booze.  If you are struggling with either of these addictions, or both simultaneously, please remember that if I can do it, you can do it too.

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