Hey, student nurse. Yes, you, the girl who recently did a rotation on a psychiatric ward. I don’t think that while you are riding on the bus, you are supposed to be telling detailed stories to your friend about the patients in the hospital. You know everybody else around you on the bus can hear you, too, right? But you don’t care at all, do you? Of course not. Most mental health workers I’ve seen don’t give a damn about patient confidentiality, so why should you be any different, student nurse? I bet you think that since you didn’t mention any names, everything is cool, right? Well, guess what. It’s not. By the way, those were human beings you were poking fun at. I understand that dark humour has a place among health care workers, to help them cope with the things they have to deal with in their work. That place is not on the bus, however.

Hey, guy from the bus a month or two ago. I overheard you when you were saying, “It seems like everybody I grew up with is dying. One guy died of a drug overdose. Another friend of mine killed herself in jail in Ontario.”

I wanted to say, “You were friends with Ashley Smith? Man, I’m so sorry about what happened to her.”

But, of course, I didn’t say anything.

Interesting post at Furious Seasons recently (heh, as if there were not an interesting post there nearly every day!) regarding manic depression as a dangerous gift, as a personality disorder, and as something from which one can completely recover.

I know I am going out on a limb here that someone will likely chop off for me, but I believe that much of what we call bipolar disorder is in fact a personality disorder or constellation of behavioral issues.

I’m not looking to chop off this limb. I view manic depression as a dangerous gift as well, and as something that maybe at least some people can completely recover from. I also understand that Philip is not saying all a person with bipolar disorder has to do to recover is pull themselves up by their bootstraps:

I think bipolar disorder can be a personality disorder–and, nitpickers be warned, I am using the term very broadly–more often than it is a mental illness.

Depression–and here I am not discussing major or clinical depression–is widely known as having a huge personality component.

Mania itself–and here I mean the bad old wild delusions, hallucinations and declarations of Godhead mania–is not a personality disorder. When it’s in full flower, mania is straight-up insanity.

Dysphoric mania is possibly the least fun thing in the world, but there is at least one good thing about it: once you’ve recovered from an episode of psychotic dysphoric mania, it’s really hard to convince yourself that it was a character flaw. You can easily convince yourself that you weren’t depressed, just stupid and lazy, and that you weren’t hypomanic, you were just being a silly, reckless whore… but after having auditory hallucinations for a few weeks straight, once I finally stopped, I realized that something had been really wrong and that this time it wasn’t my fault.

I was aware that most of the time, medication either made me a zombie or made my moods even worse. So sometimes I would stop taking medication, be fine for a few months, and then be much, much worse than before. I learned to do things that sometimes stopped mood episodes, but more often just allowed me to cope with the symptoms I experienced, so that I functioned very well as one of the walking wounded. For quite a long time, I honestly believed that there was no such thing as getting better, there was only becoming a better liar, so that you could hide your pain from others and even from yourself. Or at least I thought that was the only option for me, because I’d read about other people who were asymptomatic for long periods of time, who claimed to experience “growth” and “healing.” I didn’t disbelieve them, but I didn’t think that anything would work for me. I tried CBT, DBT skills, family therapy, couples therapy, group therapy, exercise, meditation, hospitalization, acupuncture, journalling, medication, medication, medication, and other stuff… but the hits just kept coming. I kept getting depressed, I kept getting hypomanic, and I kept getting manic.

Some of those things helped. Some didn’t. (Acupuncture, for instance, was supposed to make me less stressed, but instead it turned me into a stressed person with needles in her ears.) For nearly a decade, though, none of them prevented me from having mood episodes, which I dealt with using a combined method of actual coping skills plus being way, way too hard on myself. I have been essentially non-syndromal for the past year, though, and it seems to be solely because I’m finally on medication that’s working for me.

I am better, and I want this to be an accomplishment. I wish this were something I could take credit for. But it’s not.

The journey to get to this point was so long and arduous that I want the current solution to be complex. (I say “current solution” because although this has been the solution for the past year, I don’t assume it will be the solution that works best for me forever.) It’s not complex, though. It’s not intricate. I-take-two-pills-a-day-and-now-I-am-well. If I am experiencing any side effects, I am not aware of them. I still have emotions. I can cry when really bad things happen, I can take joy in something as simple as seeing furry gray squirrels race across tree branches, and I can write really bad fiction.

Despite how hard I tried to get better, I still can’t take any responsibility for it. It’s true that I learned plenty of things along the way, including just how vast the extent of my own ignorance is (and how ignorant many of my doctors were), but nothing I learned was instrumental in my actual recovery. I tried and tried and tried to save myself, yet I did not.

I wish I’d fixed it. I know I should be careful what I wish for. I’ll say that I wish I’d slain the dragon myself and the next thing you know, the meds will poop out and the dragon will pop back up, all scaly and fire-breathing, saying, “You called? Here I am, bitch. Come and get me.”

But still. I wish I’d fixed it.

I just spent over two fucking hours writing a post about Howard Hyde, a man diagnosed with paranoid schizophrenia who died in a jail in Dartmouth, Nova Scotia thirty hours after he was Tasered by police, when Wordpress ATE IT. Or my computer ate it, or something ate it. It just disappeared while I was working on, I swear, the last sentence of it. It should have been autosaved, of course, but somehow it’s still gone.

How about you read a couple of news articles while I curl up in the corner of the room and cuss at technology in general for a while?

• Police informed of tasered man’s psychiatric illness - widow
• N.S. orders Taser review after inmate’s death: Halifax police reluctant to link 45-year-old man’s death to weapon
• Man jolted with Taser needed help, widow says: ‘I really don’t want this to happen to anyone else’
• Panel urged to include mentally ill person: Taser review report will be examined by experts: province

My original post had actual opinions! And more links! And quotes from articles! But I’m not going to bother trying to reconstruct it, because that would just annoy me.

I’ve also been working on a more personal post on an entirely different subject, but it’s been difficult to write because it’s painful for me. Luckily, the draft of that one is still intact. Don’t expect it to be an insightful work of art when it’s finished just because it’s taking me so long. It’s hard enough for me to write it; it would be impossible for me to write it well.

Although my brother finally more or less accepted that his girlfriend needed to work this summer, when she took a trip elsewhere just for fun, he freaked out because she was having a good time instead of being with him while he was miserable. He stole my parents’ car a few weeks ago so he could drive across the country to her, but came back after driving for two hours when he realized that this plan was not actually going to work. He said his mind wouldn’t stop racing, but none of the people who were supposed to be treating him considered that it might be related to the fact that he had just started taking two different antidepressants and had gone nearly three weeks without follow-up treatment. A few days after that, he wound up in the hospital for the second time. He “escaped” once (he was on an unlocked ward, so it’s not like it was hard to escape) and the police brought him back, but he’s been out again for a while now. He was on Seroquel for a while in the hospital, but even the doctors admit it probably made him worse, and took him off it.

His ex-girlfriend, if that’s what she is, has cut off some forms of communication with him, but they’re still emailing each other, and every time he gets an email from her, he gets upset. A few days ago he smashed the glass door of a cabinet. I know this girl has problems with depression, but she’s always seemed much more stable than my brother throughout their relationship, even though they’ve always fought a lot. Now, though, she’s seeming nearly as unstable as he is. She keeps telling him that she loves him but can’t be with him, and mixed messages are the last thing he needs right now. He’d prefer if she were supportive, of course, but I think he could even handle a breakup better than he can handle what’s going on right now. Not that I’m saying this is her fault — I know he’s not easy to deal with, but she’s really making things worse, even though she’s not doing it on purpose. Apparently she has also been sending weird emails to my parents.

Previously, my brother had planned to attend a day programme soon. Now he says he doesn’t want to bother trying to get better unless his ex(?)-girlfriend is supportive of him. That’s just him being completely pigheaded. His shrink, though, did say that nobody can help him “until he gets over that girl.” Um, his main problem is that he doesn’t know how to get over “that girl,” and if he knew how to do that on his own, he probably wouldn’t need a shrink.

Apparently I was wrong when I said that my brother was staying out of the hospital. He was actually back in there at the time, just my parents hadn’t told me yet. He’s still there. It is not going very well. He says some of the nurses are mean. And there’s not anything I can do to help; I can’t even visit because I’m way too far away. I don’t really want to write about it any more right now. I did have a good weekend, by the way.

Stumbling back, blinking confusedly and wondering what happened to the past week.

My brother was released from the hospital after nine days there. My mom says he is doing okay, but she worries about him all the time. She is worried about what he’ll do the next time he and his girlfriend have a fight. They’re always fighting. He told her that if she took that job this summer, he’d kill himself. She took the job, he didn’t kill himself or try to kill himself, but he did have to spend nine days in the hospital.

I’m a bit hypomanic. Nothing extreme, mainly I’m kind of hypersexual and I’m also feeling like it’s stupid to be taking my medication. Usually, if I’m not taking my medication properly or if I stop taking it altogether, it really is because of the side effects. I am not the stereotypical “she stopped taking her pills because she thought she didn’t need them anymore” manic-depressive. (Almost nobody is, by the way. People just think that we are because they don’t actually believe us when we tell them how bad the side effects are.)

But I am that stereotype right now. Or at least I would be if I actually stopped taking my pills, which I have not. I want to, though. I feel so good right now. How could there possibly be anything wrong with me? Why would I possibly need drugs?

Twice in the past, I went off all of my meds without telling my doctor. I didn’t think that I wasn’t manic-depressive; I just thought I could handle it better without the drugs. Both times, I felt fine for a little while. Both times, things changed. The first time was a bit more gradual. It started out as mild paranoia, then moved to severe paranoia and delusions, and then added auditory hallucinations. Now, that was a fun six months. The second time was much more sudden. A case of severe insomnia turned overnight into serious suicidality and helped set off a chain of hospitalizations. All of that funstuff is why I decided that although I would try taking lower dosages of medication, and although I would stop taking Dope-a-max and atypical antipsychotics, I probably shouldn’t take no medication at all.

Right now, though, I feel like I’m talking about someone else. I have a hard time believing that I was ever ill. It feels like it was all a dream. I am fine. There’s nothing wrong with me. Why would I need pills?

Since everyone else is doing it, I might as well. Not jumping off a bridge (I think about that often enough by my own damn self), but the meme that CL Psych posted about giving film-like ratings to blogs.

This rating was determined based on the presence of the following words:

* hell (4x)
* drugs (2x)
* rape (1x)

I never knew using the word “hell” was such a big deal. Well, I’m going to use it all I want, and we’re going to live like kings. Damn hell ass kings!

I wonder what I have to do to push it to an NC-17 rating. Talk more about rape flashbacks? Talk even more about meds, since I’ve never even mentioned illegal drugs on this blog (until now), but apparently the word “drugs” in any context is scandalous enough?

Update on my brother: nothing to report, really. He’s still in the hospital. They might let him out this weekend. Or after this weekend. Or something. They’re not telling him a whole lot. He is bored. I would be, too.

My younger brother is like the poster boy for borderline personality disorder, but since mental health professionals seem to be looking only for BPD poster girls, none of them had ever considered this diagnosis for him. No, I’m not sure whether I think BPD is a useful construct, but he does fit the criteria to a T (except, as far as I know, the last one, “transient, stress-related paranoid ideation or severe dissociative symptoms”).

Last week, I kept mentally writing a blog post in which I would describe all the ways he fit the criteria for BPD, but refer to him as “she” until the end of the post, where I would say that there was one major lie in the post and to switch all the pronouns, I’m actually talking about a guy, not a girl. My brother can be awfully exasperating, but what really bugs me, and what that post would have really been about, is sexism in the mental health profession. About how I, a girl, have been called personality-disordered simply because I used to cut myself or because sometimes I’ve disagreed with doctors’ opinions about something, but someone who very obviously fits eight of the nine criteria for BPD isn’t diagnosed with it because he’s a guy. I’m not really interested in amateur diagnosis of anybody other than myself, but it seemed appalling that behaviour that would get a female slapped with the BPD label was ignored in a male. I never did write that post, because 1) it would have wound up being awfully long and I’m lazy, and 2) it seemed malicious to write a post delineating all of my brother’s very worst qualities when he is one of my favourite people in the world and one of my best friends.

Now there is another reason to never write that post, which is that a doctor has finally considered that he might have BPD. Until the other day, my brother’s official diagnosis was generalized anxiety disorder, but he’s been in the hospital for a couple of days because of suicidality. One doctor is saying bipolar spectrum disorder and another is saying borderline personality disorder.

As for how he is doing in there, it varies. He went voluntarily, but then when he said he wanted to leave and it was stupid and he should have just killed himself instead of going to the hospital, of course they changed his status to involuntary. For a while he was really mad that he’s stuck there because he wants to go online and see if his girlfriend is terribly worried about him, as he wants her to be. He was doing a countdown online to the day he planned to kill himself and dramatically telling his friends that it would be his “last day on Earth.” His girlfriend has a good summer job on the other side of the country and he is upset about that because he would prefer that she come home to her apartment and work at the part time waitress job that she had before she found the better job. He thinks that her wanting to make money to pay the rent for her apartment, where he sometimes lives with her for free as he has no job, means that she doesn’t really love him. My mother said today, though, that he is feeling less angry about being in the hospital now because he thinks he should stay until he feels safe.

Feelings can shift so rapidly in the hospital sometimes, can’t they? Most of the time, it’s very boring, so when anything at all happens, sometime it seems monumental and you can overreact.

This is not an anti-BPD post. My brother behaves like a stereotypical, worst-case-scenario borderline, and of course I’m going to vent about that. I realize that most people diagnosed with BPD aren’t actually like him, and I’m hopeful that whatever the hell is wrong with him, whether it’s BPD or something else or BPD and something else, he will soon get some appropriate help and will feel better and not be such a pain in the ass. Even if he is bipolar without BPD, I’m glad that somebody has finally noticed that something other than GAD is going on.