T Visit; Interesting Observation

I saw my T on Tuesday. We had a nice visit, and of course he had a few words of wisdom for me.

I was telling him about my stress about work this year. LOTS of paperwork that just pisses me off and stresses me out. He reminded me that I have a choice about how I think about that paperwork (and other things that piss me off). He has to remind me of that every few months. The paperwork is what it is. No reason to get bent out of shape about it. Just do it as a routine task and choose not to fret about it. I DO have choices about how I view things in my life; I just have to remember to choose wisely.

We also talked about my meds. I am really very stable right now and have been for about 5 months, so I'm in that spot that is so common to those of us with bipolar disorder where taking meds just doesn't seem necessary and I wish I didn't have to take them. T says what we need to start doing is videotaping patients with chronic, recurring mental illness when they are at their worst. Then, they should be required to watch the video every time they start thinking they don't need the meds. Yikes! That would be awful to watch, but it would probably do the trick!

I mentioned that when I think about how I was, for instance, in my last episode/hospitalization, it doesn't even seem real -- like it wasn't even me. I mean, I realize I was manic, hospitalized, hallucinating, racing thoughts, the whole nine yards, but it doesn't seem like that was me at all. He used the term "depersonalization" to describe that phenomena in me. Not the full-blown disorder, but that sense of seeing things from the outside/being detached from that experience. I know that I experienced my abuse in a very depersonalized state when I was young. I guess I've kind of learned to use it as a way to cope with the trauma of my bipolar episodes as well.

It was a good session. Nothing too terribly earth-shattering, but he did a good job of reminding me of my reality so I can stay on target.

That sounds like a lovely helpful session.
Good going! The video thing would freak me out too!

Yep, we do have a choice how we react to things. I have to remind myself of that fact, but it does definitely help.

I am curious why you wish you didn't have to take meds. My anxiety is fairly stable right now and I do tend to forget how I felt off the meds, but generally I don't mind taking them. Is it the expense? Side effects? General PITA-ness of having to take pills?

I actually do have some videos - but only recent ones. The worst of the lot is when I got put on sertraline and it drove me into probably the worst hypomanic episode I've ever had.

The video scares me to watch it! Like... I've seen drunk videos of myself before and I am way more coherant when drunk. I couldn't get half a sentence out, couldn't stop laughing, and had a really weird head-tick going on (I am guessing I was trying to shake my thoughts out?)

So.. yeah... I'd agree with videos being a good thing.

Honestly, I find this fascinating. And familiar.

You say, It Didn't Seem like it was Me at all.

Isn't that your Ts point with the film? To capture evidence of that "other you" so you recognize that there are times when the "You" who acted a certain way does, in fact, exist, even if you would prefer to believe otherwise?

Man, I sure get that one.

The very distance from the now-so-alien behavior, the de-personalization that helped me cope with past trauma, can also create so much distance that I start to think, well, THAT'S not going to happen again. THAT wasn't me with the seasonal blues and the greasy hair and oversized wool sweater with the crusted yoghurt on it...

In summer, when everything is peachy, I can't imagine feeling as lost and blue as I do during the dim days of fall. It's as if a "different me" has taken the stage for a bit part that is sluggish and crabby. Later, that Me is a distant embarrassment, one I hope will never emerge again, and would certainly not be recognized or acknowledged.

It's as if my "emotional memory" doesn't serve me as well as my "factual memory." And I need the help of the film to remind me that it simply is true.

Lights! Camera! Action!

Sorry for taking your post in unknown directions.


Gah!

The issue with bipolar disorder is that it is cyclical, and when I am stable, I am really, really stable even if completely off meds which I had been for 4 months. My pdoc urged me to take meds preventively as I am bound to cycle again. It just hard to actually "remember" how bad it gets for me during an episode. Very common problem for those of us with bipolar disorder. I think the meds are that constant reminder that my mental illness. Hard to see myself as "ill" when I am as stable as I am the majority of the time. The other issue is that I do worry about long-term side effects.

I stopped my meds this summer (lithium) after my husband suffered kidney failure, had dialysis, was in the ICU, and completely psychotic due to lithium toxicity. Pdoc is working with me on an alternative to lithium right now, but bipolar meds are very potent and potentially problematic. It's a bit of a catch-22.

The hospital always takes a picture of each patient on admission to place in your chart so staff can remember who's who. I remember once that the nurse showed me that picture at the end of my stay, and it was pretty awful. Amazing how much improvement can be seen just in a still photo over the course of a couple of weeks. Seeing live action video would be really painful to watch, but again, probably very effective in reminding me of the reality of how bad things get for me.

I have the same cycling problem...when I'm good, I'm great and can't remember what it felt like to be so out of whack. I see a lot of patients with a lot of different problems who have the same issue...."but nurse, my blood pressure is fine so why do I need to take this blood pressure medicine?"

I think your session sounds very interesting...lots of food for thought there, thank you for sharing!!

it doesn't even seem real -- like it wasn't even me. I mean, I realize I was manic, hospitalized, hallucinating, racing thoughts, the whole nine yards, but it doesn't seem like that was me at all. He used the term "depersonalization" to describe that phenomena in me. Not the full-blown disorder, but that sense of seeing things from the outside/being detached from that experience. I know that I experienced my abuse in a very depersonalized state when I was young. I guess I've kind of learned to use it as a way to cope with the trauma of my bipolar episodes as well.

I experienced the exact same thing during my worst episode. I still don't remember much of it, though this is probably a blessing.

I've been there with the meds. I've said on the bipolar forum how I've tried now 3 times to lower the Seroquel when feeling well, I also go through long periods of being very stable. Worked out very poorly each and every time. And then the frustration and shame, even, that I have to take these, and deal with the side effects, that I can't, in fact, entirely control this without meds. And I worry too about long term effects --who knows, long term, what it will do to the brain....

I agree, a video to remind how awful it can be! It's very easy to forget and especially with the 'depersonalization' which I have experienced as well; I feel like I've morphed into an alien being, that I've crossed over into another dimension. It's not me. I don't want to go back there and I know you don't either. Medication is such a constant struggle...

Have you tried Lamictal? It's been hugely helpful for my depression, though not mania. Seroquel helps with mania, but it's a sledgehammer and the side effects are awful. I wouldn't actually recommend it, though it's been very helpful, all and all, with me. Especially since I can increase it PRN if I feel (or have been told) that I'm going into an episode.

Lamictal is what he's trying with me right now. I've taken it before without any problems, but in conjunction with lithium, not alone. I rarely go manic, although that was what happened in April. Usually I'm on the depressive end, so hopefully the lamictal will work alone well for me. I'm about to hit 100mg and he may let me sit there for a bit since I've been holding stable for quite awhile. Last time I was on lamictal I was not stable at all and it took going up to 375mg to get to that stable point, so we'll see what he decides.

Generally, if I go manic or mixed like I did in April, he'll add an AP for awhile. Last time he put me on Saphris which worked like a dream for me (literally overnight).

I could have written what you wrote myself! I can very much relate to feeling stable and wanting to go off meds, and even though I know that I shouldnt, I still find myself thinking that I dont really need them. Logically I know I do, its really strange.

And the depersonalisation - I dont remember hearing that term before (but my memory is terrible). It must be what is happening to me too. When I talk to my pdoc I find it increasingly hard to remember what was going on for me during an episode. I feel so distant to the person I was when I was unwell. I feel it has helped me not to remember so intensely because I went through some truly awful times and having that in my head is only damaging.

I loved lamictal, it is a very good medication. I hope that it helps you.

Thanks so much for sharing your story, I got a lot out of this.

Chris, thanks for sharing... I've found that my T2 is very good at helping me see things from a different perspective and to help me see my choices in my thoughts...