The drugs are still working. It’s been over ten months, and I am still largely asymptomatic. This is not the day to pontificate about that, though.

I had a cold for about two months, or possibly several colds in rapid succession. Then it (they?) went away for a few weeks, but now I have a cold again. I’ve been tired lately, too. It’s easy for me to work insane hours in the spring and the summer. Not so much in the fall and the winter. Cyclical seasonal patterns and all that. I’m still going to be busy in the near future, but I shouldn’t be as busy. I’m about to make some changes in my life. They’ll be good changes, but that doesn’t mean they’ll be easy ones. Oh, and my relationship with my boyfriend is still great, just in case all my vagueness sounds like an illusion to “trouble in paradise.” It’s other circumstances that are going to change, one of them being that the working fifty-some hours a week thing is coming to an end. That change is necessary if I want to stay healthy. Yeah, I was totally wrong back in August when I said that I’d only be working extra hours for a few more weeks.

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.

I don’t even know why I tried this again so soon, as I wasn’t expecting it to have changed already, but it has. My blog has moved from an R rating to an NC-17 rating. For completely ridiculous reasons, I might add.

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

* hell (7x)
* kill (4x)
* rape (3x)
* ass (2x)
* hurt (1x)

I have no idea why it is no longer keeping track of the amount of times I’ve used the word “drugs,” since that’s the one word from before that I remember using a bunch more times since then.

In news of things that are not fast, my brother was released from the hospital five or six days ago but no one has yet contacted him regarding follow-up treatment, although of course they were supposed to. I have no idea why this surprises me. It really shouldn’t, at this point.

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.

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.

It’s been a year since I was in the hospital. Although there were nearly five years between my second and third hospitalization, last year, in the space of six months, I had two brief inpatient stays and spent seven weeks in a partial hospitalization programme, which I completed last June. I’ve also gone exactly sixteen months without cutting myself, which doesn’t really seem like a big deal because I pretty much quit and have only cut myself three times in the past six years, anyway.

My mood has been fairly stable lately, and, for a change, it is holding steady at “Very Well, Thank You” rather than “Rock Bottom.” So of course I’m being dogged by insomnia again. You know that saying, “It’s like putting an octopus to bed?” As soon as you’ve got one thing under control, another tentacle pops out from under the covers. It’s always something, isn’t it?

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.