Monday, August 12, 2013

Manic Depression

How did I know that someday — at college, in Europe, somewhere, anywhere — the bell jar, with its stifling distortions, wouldn't descend again?- Sylvia Plath

Eight days ago, the worst depression in years arrived. Perhaps I'd been a little too optimistic that I'd beat the odds and managed to side-step the real pain and discomfort for a while. I'd experienced brief periods of depression three or four times in the past five years, but nothing like this. Depression arrived, stealthily, and before I knew it, it had me under its control. 

One of the most troublesome aspects of mental illness is how little psychiatrists truly understand about it. An analogy I've often heard compares psychiatry to alchemy. In other words, it's all about proportion. The medications prescribed often take weeks to work, and their effectiveness depends entirely upon the person taking them. A drug that works exceptionally well for one patient may be completely ineffective for another. I've known patients who discovered a successful cocktail within a few years and others who are still searching. 

Trial and error is the rule of thumb. I've taken somewhere between twenty-five and thirty medications since this endless cycle began, when I was in high school. Bipolar disorder is successfully treated by very different classes of medication. Lithium is the gold standard of mood stabilizers, and the drug that most people unfamiliar with mental illness recognize, but can be entirely ineffective for some. Fortunately, it works well for me. Drugs used originally to treat seizures like Lamictal and Depakote are another option, but they haven't done much for me.  

The proverbial silver lining does exist. I am on the right combination, finally, but I must be patient. Diagnosing my illness is more guesswork than it is hard science. The day these feelings lift and I feel normal again cannot be accurately predicted. It could be three days from now or three weeks. This is what keeps me frustrated. I don't know when the discomfort will leave me alone. Depression contains a component of both psychological hurt and physical pain. In tandem, I feel exhausted by the end of the day.   

I've learned the hard way that I have to continue to take an antidepressant, possibly forever. The side effects are significant, particularly the sexual side effects. I'm not going to go into too much detail here, but suffice it to say that we're all inherently sexual beings. Having decreased urge and desire makes me feel hollow and sub-human. I enjoy my sexuality and for now, it doesn't exist. I pray every day that a new breakthrough will be discovered and more effective pills will eliminate many of the problems I'm dealing with this very minute.  

One doesn't have to look hard to observe and experience the drawbacks of the medications currently available. In addition to treating my symptoms, they bring with them other problematic issues. I know that, because of the length of time I've taken prescription drugs, my body has been changed irrevocably for good and for bad. I've gotten addicted to antidepressants, and have realized recently that I might never be able to stop taking them. Every drug, even a legal, necessary drug, is poison to some extent. Side effects cannot be eliminated completely.

Each day is an improvement upon the day before it. Psych meds do not work quickly. Psychiatrists give me approximations, not specifics. I hope to feel better by the end of the week, but full recovery may take a week longer than that. In the meantime, I keep myself busy the best way I can and try not to worry about missing out on my life. This is a time for rest.    

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