On My Chemical Dependency
Lined up beside my mirror, my pill bottles stand out among the carefully-curated collection of trappings on my dresser. In contrast to the beautiful bottles of perfume that catch the light so perfectly, the trinkets from my travels that transport me to my favorite places, the stack of my most beloved books that bring me joy, the stale orange and blue prescription labels are more than just not aesthetically pleasing— they fill me with dread and existential agony. I hate them. As I struggle to grasp the lid at exactly the right angle and still can't figure out the child-proofing after two years, I'm filled with sadness, anger, and inadequacy. My moods still wax and wane but no longer overpower me. Despite this, I'm ungrateful. These chemicals are marvels of modern science and, in ways, represent some of humankind's greatest accomplishments: to tame the exceptionally unfathomable mystery that is the human mind. To triumph over an illness we still know so little about. I don't care. I don't want them.
When I was diagnosed with Bipolar II almost exactly two years ago, I was initially filled with relief. There was finally a name for the madness welling inside me. Briefly, I didn't care about the stigma. I was just glad to know I wasn't alone. I found an odd peace in being a statistic. The brief period of reassurance was shattered when I was handed my first script for a drug called "Abilify." I'd be dependent on it but it would bring me some sort of stability. I was exhausted and tired of fighting so I let my ego go and headed to the drugstore to receive these life-changing dots. The cost of mental clarity was $200 a month and piece of my independence.
My relatively brief time on Abilify was like a fever dream of sorts. Nothing felt real. I was elated for some time then I just sort of leveled off. Spring of 2016 was a good time for me. After a tumultuous January in which I quit my job in TV abruptly (an odd case when I made a good impulsive decision during an episode) and nearly drank myself to death, I was sober and had mental clarity for the first time in a while. Looking back, it was the calm before the storm. When I quit my job, I was completely in denial of the reality that I faced not having a backup plan. I had my startup, GoBabl, but, as all business owners know, it takes a while to get a paycheck when you're working for yourself. I was ignoring the warning signs all around me and embraced the numbness. I continued living the way I had been before, racking up massive amounts of debt and slowly ensuring an explosive end to this seemingly pleasant time. Certified letters began arriving in the mail and I began to come back to reality as I leveled off. Life turned into a nightmare overnight. Still reeling, I started moving at a thousand miles an hour trying to get myself right. I made cuts, I stopped living outside my means. This meant letting go of the $200 a month I was spending on meds.
I ignored what everyone says about people who have bipolar disorder. "They go off their meds when they're feeling good then they lose control." Not me, I reasoned. I'm of sound mind. I'm not like the rest of those feeble, socially inept people. I'm on top of my shit. With that, I stopped my meds cold turkey. I was alright. For about three days. Then I began to unravel.
It happens so suddenly. One moment you're on top of the world. The next, you're scraping pieces of yourself off of the ground after failing so spectacularly that you begin to dissociate as a means of survival and self-preservation.
Being in the midst of an episode is a terrifying experience, one I can best describe as an out-of-body one. I'm still aware of myself but see all control slip away. As I watch my Mr. Jekyll overpower all ability to reason and make decisions for myself, I stop fighting because fighting against myself in such a way is exhausting, and I succumb to the madness raging inside me. It starts off slow. I'll dwell on my anger for a moment too long. I'll allow myself to suffer in sorrow for the sake of feeling SOMETHING. Then, I turn on myself, and there's nothing that I can do to stop it. It happens so suddenly. One moment you're on top of the world. The next, you're scraping pieces of yourself off of the ground after failing so spectacularly that you begin to dissociate as a means of survival and self-preservation. The person acting out, making irrational decisions, headed at full-speed towards the abyss is not you. You'll wake up. It isn't real. Nothing is real. Life is an illusion. Paranoia begins to make sense. The world is plotting against you. You're in the for yourself and can trust absolutely no one else.
I began experiencing uncharacteristic fits of rage. I destroyed a precious relationship and so many aspects of my career because of them. Flags and large pieces of furniture were rearranged in my room to cover the holes I'd left from punching the plaster, throwing objects through the wall in anger and hopelessness. I specifically remember one night when I took a swing at the door jam after a screaming match with my roommate. I slammed the door before losing myself and collapsing to the floor, knuckles bruised and bloody. Face down on my dingy Ikea carpet, I sobbed for what felt like only a moment, but upon checking, was closer to 40 minutes. Lifting my head, hair matted and pieces of floor mess stuck to my cheek, I looked at myself in the mirror. I did not recognize the bloodshot pair of eyes looking back at me. My anger turned to fear. I was absolutely terrified. My terror turned to shame, and I crawled into bed, where I stayed for two days.
I remained in this cycle for months. I would feel alright, then I would develop the same sadness. I would lose myself in the sadness before inexplicably feeling better. Then I'd feel great. Then I'd feel too good. Then, the euphoria would turn to irritability. Then from irritability to paranoia. Then to full-blown rage. Then... sadness again. I was doomed to repeat this, until the end of time. I convinced myself that life would not be better with medication though. I lied during therapy as to not alarm my psychiatrist. I thought there was nothing the meds could do. I sacrificed my well-being for the brief thing resembling autonomy. In reality, I was willingly losing control of myself.
One night in September, all of this changed. I grew tired of the constant, seemingly endless shifting of my moods and gave up. I walked out to the living room in the middle of the night and made a plan. I wrote the notes. Then, in a moment of bravery that still baffles me, I ran to the bathroom and forced myself to throw up. Hugging the base of the toilet, I felt real for the first time in months. I climbed into bed again and embraced my husband and my dog. I was back to my baseline. I was home. But I was far from okay.
I know it sounds irrational, like, "if you don't want to be that way, just stop acting like that." But that's the thing. In the moment, it not only makes sense, but seems like the only way to protect yourself.
After a conversation with my psych, I was put on new meds. This time, rather than depression medication, she prescribed Lamotrigene, an anti-convulsant that also happens to work for Bipolar II. For some, the side effects outweigh the benefit of the medication but for me, I was willing to put up with them because my depression could finally be controlled without mania being triggered. It took a while but after easing into them, I found they were a perfect fit. After about a year of treatment, I felt like myself again. In early 2017, in the midst of this sudden clarity, I wrote this, which still sums up the cruel, overwhelming feeling of a bipolar episode the best that I can:
For those of you who do not have bipolar, think of that heart-racing, short-breathing, sense-of-impending-doom feeling that happens if you narrowly escape a car accident or see a cop in your rear-view mirror after speeding by the police cruiser without realizing. Try to imagine a time when your sense of survival kicked in and staying alive was the only thing that mattered-- if only for a second. Now think of feeling that way nonstop for a week or more at a time. Mania isn't always this blissful unawareness that leads to irresponsible decisions like impulse tattoos and unfathomable credit card debt. (Though it can, and it has for me in the past.)
It's exhausting. It's easily to become irritable and even delusional. Every motion you make is an effort in self-preservation. Words from others are infinitely magnified. Their actions are misconstrued, regardless of the intent. At my best, I alienate myself and at my worst, can be hostile. I know it sounds irrational, like, "if you don't want to be that way, just stop acting like that." But that's the thing. In the moment, it not only makes sense, but seems like the only way to protect yourself.
Now, think of how you felt after a night of heavy drinking: that sudden sober clarity leaves you feeling embarrassed, stressed out. You're reeling, attempting to make sense of up from down while trying to blink the unshakable sleepiness from your eyes. Once I snap out of the episode and start to stabilize again, I get what I call the "apology panic." I have to back track and figure out who I've gone and hurt or pissed off then sheepishly apologize. It's rarely well-received and has often been met with responses such as, "yeah your illness shouldn't be an excuse." That, of course, drives me right back into the arms of depression and the cycle repeats itself again. (Read more about this here.)
Still, I found the shame was better than the fear of losing myself. If I ignored the hopelessness, I could function in a more human way than I ever had before. I survived, and, dare I say, thrived on Lamotrigene for almost a full year. Sure, sometimes I felt numb. Sometimes I would miss the unparalleled ambition and productivity that came along with small bouts of mania. When I was feeling alright about myself and my life, I considered going off the meds again just so I could fully feel again.
In January, I experienced a medium-sized trauma. I'll get into it at another time but it was an event that led me to the (oddly comforting) familiar arms of depression. Even on meds, it can happen. I stopped taking care of myself, and, as a result, stopped taking my medication. I came out of the depression alright. I got a new job, started getting better. It wasn't long before I began to lose myself once again. Fear overcame me. Depression snuck up. Irrational anger began to rear its ugly head once more, I became unbearable to myself. I watched myself argue points that didn't even make sense with those who meant most to me. Grudgingly, I began to take my meds again. I'm getting adjusted to them, and let me tell you something: it sucks. I hate it. But, I understand its necessity.
If you've stuck around this article this long, you may be struggling with mental illness yourself, which is why I'm writing it. If you're been diagnosed with Bipolar, I implore you: take your meds consistently and earnestly. There are ways to mitigate the infamous numbness that comes along with being medicated for Bipolar. Initially, you go from feeling everything, to feeling nothing at all. It's uncomfortable, especially when we get so used to these overwhelming emotions that become the impetus for every decision we make. How do you trust yourself? You basically have to learn who you are all over again. Or, in my case, for the first time.
If you're not mentally ill and you're still reading this, I hope you'll understand the importance of checking in on your mentally ill friends and loved ones. I understand how difficult this can be but please stick around.
Mental illness made me an enemy of myself. I doubt myself more often that not, and though therapy is a great way to mitigate the tragedy that comes along with doing so, mental illness, at its core, is just that: an illness. There is so much stigma surrounding it, even now but it's a sickness, and, like all sickness, requires medical attention. There is no shame in being dependent on heart medication, what makes a disease of the brain much different?
It's a struggle to open my bottle of pills and ingest the chemicals I need to get through the day without harming myself or others. It's painful adjusting after not doing so for a while. It's difficult to keep in mind what can happen when I'm not properly medicated but I thankfully have people looking out for me, keeping me accountable, and making sure I practice kindness to myself. If you don't have these things, I've left a few resources in the post script. If you think you need help, please get it.
Treat yourself with respect and take care of your body: it's the only one you have. Much love to you, dear reader. Wishing nothing but the best for you.
National Suicide Prevention Lifeline | Behavioral Health Treatment Services Locator | Depression and Bipolar Support Alliance | Health Resources and Services Administration | National Institute of Mental Health