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.

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?

Lately I’ve been having too many ideas to sit down with any one of them and see it through. This includes blog posts, which I compose while trying to fall asleep at night or while pacing around my apartment, but not while actually at the computer. Today I decided that writing something short is better than nothing.

Reading about Reconcile, the doggie Prozac, reminded me of a sentence I recently came across on Borderline Personality Today’s page about BPD criteria:

Individuals with this disorder may feel more secure with transitional objects (i.e., a pet or inanimate possession) than in interpersonal relationships.

I thought it was a pretty poor choice of words. Yes, you don’t have the same sort of relationship with a pet that you do with another human being. I get what they’re trying to say here. But not being a person doesn’t make a pet an object. If a pet is an object, though, then it doesn’t matter to you if you use a quick fix for their behaviour that is convenient for you as opposed to seriously thinking about what solution is best for your pet. Note: I’m not talking here about people who have been diagnosed with BPD, even though this sentence happened to be on a site about BPD. I just mean that people who would refer to an animal as a “transitional object” seem to have the same mindset as people who would drug Muffy for piddling on the rug.

I’m not saying unequivocally that psych drugs for your pets are always 100% wrong, because I really don’t know enough about the subject. I know people who had their cat on kitty Prozac because of its OCD-like behaviour. It actually did physical harm to itself with excessive grooming and biting itself. They were worried about its physical health and obviously couldn’t be with the cat every second to keep it from hurting itself. Medication was not the first thing they tried, and their cat was only medicated on a short-term basis. The cat is now off SSRIs and is fine with only behavioural training. They also have another cat who has never had these problems.

What I am saying, though, is that the Reconcile site scares the crap out of me with paragraphs like this one:

Separation anxiety is a clinical condition in your dog’s brain. Your pet is not a bad dog. Your pet’s behavior is the result of separation anxiety.

Wow, “a clinical condition in your dog’s brain.” Isn’t that just the most specific thing you’ve ever read? What the hell does it even mean? It means “We want to convince you that your dog has a biologically-based medical condition but we don’t have evidence to support this, so we will be alarmingly vague. It is your duty to treat your dog’s clinical condition, damnit. You are a bad pet owner if you don’t get them the medicine they need.”

Does separation anxiety in dogs exist? Hell, yeah. And in cats, too — that’s what caused the excessive grooming and self-injurious behaviour of the cat I mentioned previously. But is separation anxiety “a clinical condition in your dog’s brain”? Umm…

My parents’ dog has very bad separation anxiety, but they’ve never considered drugging her because of it. They just use behavioural training, which works most of the time, and on the occasions when the dog pees on the rug or gets into the garbage anyway, well, then they just have to clean up after her.

I’m glad that Eli Lilly at least emphasizes the importance of behavioural modification in addition to drugs, but I’m sure that some pet owners will just ignore the entire training idea because medication is, you know, easier. For you, if not for your pet. Of course, just like meds in humans, the side effects of Reconcile are often the very things the drug is supposed to treat:

The most common adverse reactions recorded during clinical trials with Reconcile™ were calm or lethargy, reduced appetite, vomiting, shaking, diarrhea, restlessness, excessive vocalization, aggression and, in infrequent cases, seizures.

If you look at the product label or this journal article, you’ll see that some of the side effects were quite common, especially calm/lethargy/depression. I guess if you’re not satisfied with doping up and numbing out your children, you might want to move on to your pets, too.

Well, this wound up being longer than I expected.

After several days back on my medication, my cognitive functioning is finally better. I am able to read books, I am not constantly forgetting things, and I’m not confused about what time or day it is.

I remembered to put the bathmat back in the tub after I took a bath, which I don’t think I have ever done since I moved in with my boyfriend, despite the fact that he reminds me to pretty much every day. I remembered to water the plant. Using these things as proof of my cognitive functioning seems kind of lame, and reminds me of a part in Anne Sexton’s poem “Hurry Up Please It’s Time.”

Interrogator:
What can you say of your last seven days?

Anne:
They were tired.

Interrogator:
One day is enough to perfect a man.

Anne:
I watered and fed the plant.

Although my last seven days were not particularly tired, I have been working extra hours lately, which is vaguely annoying even though I really need the money. Tired in general? No. Tired of working? Un peu.

I wish that I had been a bit more with-it the last time my boyfriend and I went grocery shopping, because today I opened the freezer door and was very surprised to see a box of Thick & Juicy Bison Burgers inside. I kid you not. Wow, I guess I wasn’t paying any attention at all to what he was putting in the cart. Not that I’m necessarily saying there’s something wrong with bison burgers, not ever having tried one before, but I can’t believe I didn’t even notice that we had acquired them.

I got my prescriptions filled tonight, so I am hopeful that my stupidness from medication withdrawal will go away soon. Seriously, it’s not good when you’re sitting in the doctor’s waiting room reading a poster on the wall about signs of Alzheimer’s disease and realizing that you currently have most of them. If my attention span improves soon, then I’ll be able to post more, as well as read other people’s blogs and respond to their posts. You would not believe how many times lately I have read other people’s posts, clicked on “Post comment,” and then completely forgot what I was doing and never got around to actually posting a comment.

There’s a Wired article called Anakin Skywalker: Borderline Personality, Bipolar or Narcissist? that I found via stir-crazy, they found via Mind Hacks, and they found via Omni Brain. I’d especially recommend reading both the Wired story and the Mind Hacks post.

I only have a few comments to make:

1. Hee.
2. Hey, I’ve been told I have bipolar disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder, just like they’re saying about Anakin Skywalker. This can mean one thing, and one thing only: I AM DARTH VADER!
3. The article reminded me right away of a humorous article I’d read years ago in the Canadian Medical Association Journal, “Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne”, so I was extremely happy to see that the Wired story linked to it.

Admittedly, though, I don’t actually think I’m borderline, and I know I’m not histrionic or narcissistic.

According to the authors, who reported their findings at the American Psychiatric Association’s annual meeting in San Diego, Skywalker meets the criteria for the condition: He has difficulty controlling anger, stress-related breaks with reality (after women in his life die or leave), impulsivity (dangerous pod racing), obsession with abandonment (those women again) and a “pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of ideation and devaluation” (hello, Obi-Wan).

In another sign that he’s borderline, the authors argue that Skywalker suffers from an “identity disturbance.” After all, he did become Darth Vader after being “very unsure of who he was and what he wanted.”

I don’t have difficulty controlling anger, obsession with abandonment, an identity disturbance, or a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of ideation and devaluation. I am impulsive and have had stress-related breaks with reality. Well, I can live in hope that those two things are enough to MAKE ME DARTH VADER, can’t I?

What is the best treatment for one who has been drawn to the Dark Side of the Force? The opinions of professionals are mixed:

Study co-author Bui said psychotherapy — “long term,” he added with a laugh — would be the best treatment for Skywalker, although he might prescribe a drug to help him sleep.

Bui had mixed feelings about prescribing an antidepressant like Prozac and said he’d avoid tranquilizers like Xanax that could leave Skywalker addicted or send him into “disassociation” (a rupture with reality).

But would Skywalker even go into therapy? “Because of his narcissistic tendencies he would perceive himself as ‘above’ that,” said Sultanoff, who thinks Skywalker also suffers from narcissistic personality disorder, at least in Star Wars Episode II.

I’m going to assume that by “disassociation,” Randy Dotinga means “dissociation.”

Not that there’s much point in trying to help Anakin at this point. He’s dead, yo. Remember?

thememoryartist recently made an excellent post, A new proposal for the DSM, which “outlines and categorizes the features of Mental Health Professional Personality Disorders.” It’s funny because it’s true. Which also, of course, makes it sad. I’ve seen plenty of mental health professionals whose behaviours and attitudes are outlined very well by those criteria.

In a comment, Gianna mentioned that the post might be educational for mental health professionals. I’ve met some MHPs who would appreciate it very much… but they’re not the ones who tend to exhibit any of the listed behaviours. I think the ones who actually exhibit the “symptoms” would see that piece of writing as an example of a patient being narcissistic and overly hostile, and would never recognize themselves in the criteria.

There are also a lot of interesting comments on this post about PTSD misdiagnosed as BPD.

I am doing okay physically with the Zoloft and Epival withdrawal. I didn’t even have any of the brief dizzy spells yesterday. I was, however, staring at a word on a computer screen when I saw it suddenly jump several inches to the left, even though this did not really happen. I am hoping that this is just a regular hazard of the twenty-first century, as opposed to a withdrawal thing.

As I mentioned in a comment on my last post, medication withdrawal has made me kind of stupid lately, though. I can’t remember anything, my attention span is even worse than usual, and… um, I already forgot what I was going to write in the last part of this sentence. Oh, yeah, I’m constantly almost late for stuff. Since none of this has been interfering with my work performance, it’s not really all that important. It just bugs me.

Tomorrow I get to see my GP and I hope I’ll get my prescriptions. I have to pay forty freaking dollars for the cab ride there and back, because there’s a shortage of family doctors here, no bus service to the neighbouring town where my doctor is, and I don’t have a car.

The main annoyance that is occurring since I am currently off my meds is that I’ve been having very brief dizzy spells. I also have even less of an attention span than usual. It’s hard to settle down and read books or web sites. Disorganized, forgetful, etc. My mood is very good, though. Except for when it isn’t. It happens suddenly, without warning, and goes away suddenly, too, and the rest of the time I am quite peppy.

It turns out I shouldn’t have been sulking about my one-day weekends, because next weekend I personally get a zero-day weekend. It’s not as if I have to work eight hours every day, but still, it’s just nice to have an entire day where you know you don’t have to be at work for any of it.

I am thinking that I should be more Organized and learn how to Manage My Time, so maybe this will be my newest obsession that I will research, and maybe I will try systems and labelling and colour-coding and be very gung-ho for a month and then forget about it. Or maybe it will work. You never know.

I haven’t been around for a while. I’ve been trying to use my scant amounts of free time lately to do things like reading, crafting, and interacting with people offline. I am bummed that most people around me just had a three-day weekend and I had a one-day weekend. I am not physically tired, but I still wish I had some time to relax lately, which I don’t. I am also so disorganized that I didn’t really notice that I was running out of my medications, and I won’t be able to see my doctor and get my prescriptions until next Thursday. I am used to having doctors who will phone in prescriptions, but since my current GP doesn’t, calling my doctor when I had three days’ worth of medication left was as useless as calling after I’d run out completely. I’m on such a low dosage of Epival that I don’t know if it’s possible for anything horrid to happen to me if I abruptly stop taking it for a bit, but I’m taking those last three days’ worth every other day instead of every day, just in case that will lessen my chance of suddenly having a seizure or something. I don’t have a seizure disorder, but stopping Epival cold turkey can make people have seizures even if they’ve never had one before. Whee.

I have to take my Zoloft with food. If I don’t have enough food with it, I get this horrible feeling in my throat, like choking to death, only I can breathe okay. I realize that this description makes no sense unless you’ve had the same feeling yourself, but that’s what it’s like. It’s not exactly pain, but it’s extreme discomfort. This particular discomfort feels a lot worse than some things that cause actual pain, and when I experience it, it’s all I can think about until it goes away, which usually takes about two or three hours.

The first time this happened to me, which was over eight years ago, I didn’t know what was going on and I was terrified that I was going to stop breathing and die. Luckily, when it happened again the next night, I quickly figured out that I should probably eat more food when I take my Zoloft. This was a completely random guess, a shot in the dark, but it turned out to be correct.

Occasionally, the amount of food that is generally enough to prevent the choking feeling will not work, and I will still be in extreme discomfort, despite having eaten the same amount that I usually do before I take my Zoloft. Tonight, I ate more than I usually eat before taking my Zoloft. I ate more today than I’ve eaten on any other day in the past two months, without throwing any of it up, and I was all proud of myself for my progress with the eating disorder thing. I ate lunch. I ate supper. I ate a good-sized snack and then took my Zoloft and Epival. And I still feel kind of like I’m choking. It’s not as bad as it usually is when it happens, thank goodness. Moderate discomfort as opposed to extreme discomfort — if it was the extreme choking feeling, there is no way I would be able to type this right now.

When I have a really bad night with the choking feeling, then I really don’t want to take my meds the next day. Or any time in the near future, really. There’s all this trepidation and uncertainty. Usually, I eat something and take my Zoloft and I feel fine, but other times, I eat something and take my Zoloft and feel like there’s a giant hand closing around my throat.

Does this happen to anybody else? I once had a doctor tell me that this side effect that I was experiencing did not exist. If he traded esophagi with me and took some Zoloft without food, he would never say that again.