wanted: real discussion of insight vs meds

It's funny, in that not really funny sort of way, but I keep screwing up some part of this entry/posting process, and when I go back, it's all blank. In starting over so many times, my whole post is becoming sort of anxiety fraught. I'll try to be clear. I'm in that down cycle, where it's still descending, each day a little lower that yesterday, with the abyss yawning just "there," too close for comfort. I feel like I need communication, can't really go out and get it, and yet, even in this mode, ie email etc, feels like I'm pushing a car up a hill.

But that's not even what I want to talk about. The discussion I'm looking for really would be about others' experiences with meds and without as far as coping with symptoms of Bi-polar, PTSD, and various "features" (don't you love that term?) such as mild psychosis.

I'm 47. When I was 40, I started a manic cycle that went on for about 8 months. I had experienced bouts of depression all my life prior to that but had always attributed it to some imagined lack of character on some level. Several winters in a row before I turned 40, the depresions becames sort of frighteningly catatonic so I diagnosed my self as seasonal affective and tried using lights and L-tyrosene and st. John's wart type things. Everything I tried, I suppose because I was so hopeful for improvement, would seem to work for a few days, but then not. I think placebo tests show similar results but I'm not sure. Now, I still had no idea I was bipolar, so when one winter I started feeling good, and needing less and less sleep, I never questioned it. I was just glad to finally realize my superhuman nature. I gave up sleep like a former bad habit. I could not fathom why I had wasted so much of my life in sleep, when it was so much more incredibly stimulating to sit up and watch the dark of the night. Pretty soon, it was as though the lights of heaven shone directly upon me at all times, the mystery seemed revealed. Fifty thousand dollars, 8months, thousands of miles, and an entire lifetime later, I found myself destitute, utterly alone, sobbing my guts out on a beach in Puerto Rico. I cried like that for two straight weeks and became skeletally emaciated.

My parents had been aware of my calamity even from afar, and tried to dissuade me from my course of ruin many times, but I so "knew what I was doing" there was no reaching me. Fortunately, I called them at some point and they rescued me. Again. (While I had never "broken down" before, my life has had it's ups and downs.)

Prior to that, and fluctuations notwithstanding, I'd done a great many things in a variety of endeavors. I did well in school, enjoyed college rather too much. I read voraciously, am very creative and artistic, I had a construction business, did disaster inspections for FEMA, worked in a variety of fast paced clerical jobs, and went to extraordinary lengths seeking spiritual enlightenment. (some hilarious conversations could come out of that alone.) Anyway, all that to say, no more.

So I got into psychiatric care and the whole meds program. It wasn't very nice. I tried though, for almost four years, the antidepressants, lithium, and l'm not going to try to name them all, it just was, in the end, not a fair trade in my estimation.

"My estimation." OK. That's neccessarily flawed, I get that, I really do. But at the same time it isn't "nothing" either. I have a certain amount of insight into myself, my condition(s) and my behavior. I find that I observe myself in a whole new way armed with the awareness that I am (list of dx's here). Fortunately, I know when I'm depressed, I know when I'm triggered, I am able to monitor and enforce my sleep schedule, I'm aware of the statistical improbability of being uniquely singled out by the Universe to receive the supreme illumination. (I should insert one of those smiley things here, but I can't be bothered this moment to try to learn another feature of this site, tech isn't my forte.) I realize that not everyone affected by, or carrying the same or similar dx's neccessarily is at all able to reasonably audit themselves apart from adhering to med. program.

Without bogging down in the whole list of side effects and other disappointments about my med's experience, my main point is that there seems to me to be a "frontier" aspect to life which when obscured, renders life so flat to me as to seem not worth the effort. By frontier I suppose I mean cutting edge, or the horizon, the next veil, the continuing penetration of the "mystery" as much as is given to mortals, the inquiry, the wonder. In art it's the creative impulse, and the inspiration. In love it's empathy. For anything I could name that matters to me I could name a corresponding point of some nature that is vital to the experience and which is carelessly anihilated by the meds.

I've got a strong hunch that is why suicides occur on antidepressents. They're also anti feelings. For me. I'm talking about my own experience, not holding forth on the evils of meds in general. If I couldn't live outside of a hospital setting without medication, I would sing a different tune.

I can't find much usefulness in any of my PTSD symptoms, although I suppose in the grand design it has to do with self preservation by being hardwired to avoid reinjury. But being bipolar isn't all bad. I can't talk about this aspect within my current psych care system. I'm on welfare, and waiting for my SS disability hearing. I'm afraid to ever admit to a good day for fear of diminishing my chances of prevailing in my claim. I'm so mistrustful of gvt agencies. But in all but my worst states of depression (which no drug was able to prevent) my mind crackles with delight just to contemplate something meaningful to me.

I saw a who's who list of some sort once that listed famous people who are or were bipolar. Aside from the astonishing number of suicides, I was struck by the fact that so many of my own "heroes" were there. So many brilliant artists, writers, musicians were/are bipolar. I'm not saying bipolar makes me brilliant, but what brilliance I have, is erased by the meds. Ever see that movie "MR Jones?" Richard Gere's line about being unable to live without the high rings in my ears. I can live without the full blown mania, and being careful with my sleep seems to accomplish that for me. But I can't live without the spark itself.

Another movie that struck me deeply on this subject was "A Beautiful Life" with Russel Crow? About that scientist who was so schizophrenic. He couldn't handle the meds, and despite the severity of his symptoms, has lived a better life without than with medication. I identify with his pragmatic vigilance over his own state.

I hope I have introduced myself and what I'd like to explore sufficiently to at least make contact with someone. I'm going to post this now and see if it works. I've lost track of how many attempts I've made now, starting to feel pretty dumb about it.

From what I understand, it is common for people to think about not taking meds because they feel like they would lose that sense of creative inspiration that comes from the high of mania, not to mention the general feeling of fabulousness. I have said to my self when manic, "I wish I could feel like this EVERY DAY!"
But the crash afterward always makes me realize that my down is not worth the up, and if I were more balanced it would actually be easier for me to complete the projects I start. I can be really enthused about a project or idea when I'm manic which will be tossed aside when I crash and may never be finished. I also tend to take on too much when I'm up, which also keeps me from finishing what I start. Especially for an artist, one feels that they may not be able to express them selves as creatively, that they may lose they spark, as you say.
But wouldn't you rather have the focus afforded by emotional stability, and continue to pursue your creative passions without fear of a downhill slide that will take you away from your art, not to mention a stable lifestyle?
I understand what you are going through because I've had those same thoughts, and for me, right now strugling to get treatment, I'd rather risk losing my all night painting and writing expeditions for a manageable lifestyle, and continue to pursue my creativity in a healthy way. I may even get more accompllished.
I thought I could deal with it without meds and for years now I've been self medicating and destructing, even now that I understand what's happening, and I'm in a heap of trouble trying to get help because of the way I've dealt with it in the past. Because I decided I could handle it my self, I'm now stuck without help. I, and the people close to me, now recognize the behaviour and moods associated with bipolar, and it helps me to realize when I've done something wrong and fix it ASAP, or remind my self that I'm high or low and it will pass and I need to wait it out without acting destructively to my self. But it doesn't end there.
Another reason for treatment is that it's kind of unfair to those around you, in a way. I can't speak for anyone else, but part of my reason for seeking treatment is that I realize how hard it is to be around me sometimes. When I'm high I can run people ragged and make them feel terrible. When I'm low I can bring them down and wear them out. I don't want to do that to the people I love, which is why I'm trying to get help. Your parents must have gone through an awful lot watching you self destruct before you understood what was happening to your self. My poor room mate understands when I'm running him around the apartment with a mop and organizing his dresser drawers. He knows why it's happening. It ALMOST excuses my behaviour. But it doesn't mean I don't have to appologize when he's fed up with my bad attitude because I'm Miss World. Now that you know, you know what to expect and your parents know what to expect, and that makes it a lot easier for you to monitor. But it is still an illness that can be treated, and no amount of willpower or self control can change the way it makes you feel. The only control you've got, if you are lucky, is your actions in response to the symptoms of the illness. I had to admit it was beyond my control in order to seek help.
You mention the list of famous people who are/were bipolar. I was just thinking about that today, how many artists we have lost because they were untreated, and what a contibution they could have continued to make if only they had lived through that last crash.

Wow ... you mean there are people out there who are actually productive while manic? When I get on the upswing I get so flooded with fifty billion brilliant things at once I couldn't focus on concretizing even one of them if I tried. It's all too bedazzling.

Hi jeff,

You're Puerto Rico beach thing was magnificent, but pretty costly!

The meds are a real problem for many people. The aim for sufferers in all areas of mental health seems to be to get off the medication and 'go it alone', maybe we relate that to being healthy somehow.

I 'go it alone' and have done for many years, despite phasal depression, panic attacks, and generalised anxiety. I don't know why I do it, except maybe that I want to feel the illness and deal with it straight rather than feel insulated. I have two friends on prozac etc and they are definitely not the same as they were before, they have a fuzziness, a lack of attention about them.

I think the meds thing with bipolar is more pressing due to the extremity of the swings. I remember watching a programme about the English comedian Spike Milligan and when he got to the point of giving is secretary a loaded gun and asking her to kill him I think the point for medication was well made.

Medication issues come up so often in support groups that there must be something interesting going on in the psychology, apart from the obvious side effects with drugs like lithium .

No answers I'm afraid, but I can see where your coming from.

Good luck, and stay with us if you can.

Myzen,

Ok. First, I'm NOT bipolar, so this might not apply.

I feel that I have BETTER attention and can focus more clearly on solving my problems than when I was NOT on medication. The meds took me out of the desperation enough to help me start working on me.

For those important things, the medicine helps. Then I can STOP obsessing and start to live. However, for trivial memory stuff, it suffers a bit.

But I have OCD.

Thank you all so much for such thoughtful responses. I'm ecstatically overwhelmed to find myself in "conversation" with peers. Not something that springs naturally out of my life these days, as it usually implies going "out" in some sense. Winters are the worst, and this one is a doozy so far. But as bad it feels, I'm still ok with not hurting myself.

My brother has a harder time with that part. He and I have many similar aspects of illness. His primary dx is borderline personality, major depression with bipolar features, and psychotic features. My primary dx is bipolar with some of the other features. "Features," you want fries with that? My brother's medicated state is a pretty dismal looking existence. He's only a thin facsimile of his former self, but he no longer stabs himself, or feels suicidal. He stays on his meds, aware of the trade off, but counting it fair trade for being alive. Fair enough.

In my own med experience, I never achieved a level of improvement in symptoms that would have allowed me to return to work, or resume almost any of my pre-break down life style. Not only did I not get the benefit of improvement but instead, become host to a variety of side effects which generated RX's which generated side effects which generated rx's, you see where i'm going with this? At one point when the sexual dysfunction, never mentioned to me as a side effect, was in full bloom, my shrink rx'd a pill to counteract the anti depressent long enough to have sex. Maybe it's just me, but that struck me as, well i can't find the right word for it, but it didn't feel "sound" at the core.

The med program quickly escalated into this gigantic regimen I could barely manage, with out any effect that I could say was helping me. So if with meds and without meds, I'm a fluctuating, up and down, nut case hearing voices, afraid to go outside, but who doesn't kill himself, what is the difference to anyone but me?

Lest I give the impression that I'm just thumbing my nose at even the idea of meds, I could also explain that I would be interested in talking extensively over time with a shrink to really dissect this pantheon of symptoms and see which meds are really appropriate. I was dx'd on my very first visit to a psych, and what did he have to go by but what was freshest in my mind on that day? But then of course, that's it, the dx, it stays, it's never challenged or reexamined. Or at least, mine hasn't been. The mental health systems are all so overloaded in relation to public assistance as to be unavailable.

A writer named Phillip Dawdy has been publishing a series of articles on mental health in the Seattle Weekly news paper. In a letter to the editor in response to one of the articles someone articulated the observation that it was due to Dawdy's "insight" ability that has enabled him overcome his own psychotic illness to the point of being a successful writer. I don't know where I got it, but I have insight into my illness. I didn't always. Before my breakdown, I never examined how I felt about the world and myself in relation to it. Or I never challenged it for reality checking. How I felt just was because of how things were. The epiphany of understanding that the only change in the world was my own brain chemistry has had a profound effect on my whole understanding of life. It's down right humiliating to recollect the naivete with which I so utterly presumed my perception of self to world to be true.

I tend toward tangents and could quite go off on just that single experience. Another time.

I'm running out of gas for now, but would like to be sure I have thanked each of you for your responses. This is a whole new level of contact for me and I feel good about it. Thanks.

After finally being diagnosed after 10 long years that I was bi polar 2, i am thankful for the meds. I was initially diagnosed at 18, but that diagnosis was reversed by another psychiatrist, who told me I just have a hard time dealing with stress and I should look for other outlets. I looked alright...and crawled right into the bottom of a vodka bottle. During the manic times, I felt unstoppable. But a few days later after the mania wore off, I sunk so low that i didn't care about anything, and it has cost me a lot - jobs, friends and homes. When I decided it was too much, that there has GOT to be something else wrong here, I moved back home and asked my family doctor for help. He referred me to a psychiatrist and it was re-confirmed: Bi-Polar 2 with underlying panic disorder due to PTSD.

I was terrified...the prospect of being medicated for the rest of my life was not the answer I was looking for, but I was open to anything. Unfortunately, I got a doc who liked to over-medicate to treat other symptoms rather than tweak the dosages of the necessary meds. I asked my clinic to find me a new doc on the advice of my counselor, and my current psychiatrist is wonderful. He reduced my meds from 8(!!!) to two everyday, and one as my 'safety net'.

My life has a new clarity that it never had before. Sure, its a pain to remember the meds some days, and using other meds to supplement when i go into a hypomanic episode isn't a thrill, but I know that I need the help of those meds so I can finally be happy and well-grounded. The way I look at it, there is a reason for everything, and God doesn't make everyone perfect. This is just my glitch, and I think it has made me a stronger person just to realize all of this.

Sure, I still get manic now and then, but don't we all??

Well, having just had a great talk with sqrlb8 in the chat room, I can tell you I am forced to agree, at least to a degree with him. I'm honestly not sure which is worse. The depression, the horrible decisions I make when I'm up, or the zombie meds make me into. But I can honestly say that when taking meds, I'm just an automaton. No emotions whatsoever. To me that's just as bad as the lowest of lows that I have experienced. Admittedly, my symptoms appear to be less severe than most. I only recently just began to understand that I am bipolar at all. But when on anti-depressants, each day just goes by without meaning. I don't know what to do about this, whatever you may call it. But for me, anyway, medication doesn't seem to be the answer. Now, having said all that, I should also mention, I am here because these, not-so-severe symptoms do seem to be getting worse, so I am open to any suggestions whatsoever, and frankly, right now I am willing to try anything.