two-faced

Impostor. Pretender. Phony. Fraud.

Everywhere I go, I feel disingenuous. I’m always pretending, whether I am at work, or with friends, or even in the mental health community. I’m good at faking wellness; I work hard to seem normal enough on the outside while I am struggling on the inside. However I always feel dishonest wherever I find myself.

I hide my mental illness from my employer, even though by law they are not supposed to discriminate based on health conditions. But because they have designated my job a “safety sensitive” position, I have to be “fit for duty” when working. If I told my employer, would they be afraid I could suddenly snap? Would I be forced off work until I could demonstrate I had recovered (as if that is even possible)?

I don’t tell my coworkers or my few friends about my mental health, and I dissemble when the subject comes up in conversation. Would they not believe me because I act “normal”, or would they overreact because they wonder if I could “go nuts” on any given day? Would people suddenly avoid me for fear of being associated with the crazy dude, or would they tell my employer that I was hiding the truth? I’m not willing to take the risk.

I avoid settings like group therapy meetings, forums, and online communities because I don’t want to face reverse stigma. Would people who are truly struggling not accept me because I don’t seem to be as ill as they are? Would people judge me for being “high functioning” and feel like I was just looking for attention? Even in the hospital mental health ward, someone told me I seemed the most normal out of everyone, and that bothered me.

In the past I have wondered if my psychiatrist takes me less seriously because I’m not as sick as his other patients. I think that was the case several years ago with Dr. PrescriptionPad and his 7-minute appointments. [Fortunately, I think my current doctor does take me seriously and seems to listen to me when I describe how I am feeling.]

I guess this is why all my mental health issues come out in my blog, because I have an outlet where people can come or go, read or not, and I never hear about it if they think I’m only doing it for attention. I can be honest here, even though I am doing so under a fake name in the hope no one in real life ever finds me (which is a story for another day).

Note: here’s a post by Meghan which discusses similar feelings.

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that was unexpected

Every so often, something happens when I am least ready for it, and it unleashes a torrent of negativity and self-loathing that is usually restrained. I think that’s what happened the other night when a backlog of frustration and mental fatigue burst forth all at once.

Negative things seem to affect me more than “normal” people, and this is one of those instances. Some people would simply solve the problem, where I turn it into a metaphor equating one event with all the negative feelings I have about myself. I don’t react well when events happen that I’m not prepared for. I turn temporary setbacks into catastrophes.

I am truly worn down by a lot of things. I am very dissatisfied with life right now for many reasons. At the same time, my life is not all bad. I need to remember to even out my emotions when I am capable; try not to get too high or too low when events affect my mood.

up, down, sideways

Life has been up and down and a little out of control the past couple of weeks, like an old wooden roller coaster that is falling apart and miraculously hasn’t maimed or killed anyone yet..

Several negative events: a rough conversation with my daughter resulting in her hating me; bad health news; depression; procrastination and laziness; giving up on something I would love to do for myself; back and neck pain; cancellation of best-laid plans for my wife’s birthday; and the ever-present exhaustion.

On the plus side, the LA Dodgers are out of the playoffs, and I hope the fans feel miserable. The other thing that brought a smile this morning was the story of the Tennessee goalposts. Google it or search for videos; you’ll be entertained.

I’m trying to find something interesting to write about, but it’s just not there. I should go for a walk, shower for the first time in a week, and then try to accomplish something before going to dinner with Annie and her parents. Instead I feel like wallowing for a while and taking a nap.

off the spectrum

I wrote previously that my new therapist asked me to do some research about autism, and see if I thought I might have it. I looked at multiple reputable sources, and after reading many lists of symptoms and presentations, I don’t seem to fit the overall autism profile. I suppose some of the criteria could apply to me, but it seems like two general patterns of autistic behavior are a lack of understanding of social norms, and difficulty with communication. I don’t feel like those two conditions apply to me at all, currently or in the past.

I know autism is a broad spectrum of different abilities and limitations, and it expresses itself in different ways with different people, but it just doesn’t feel right to me the way other diagnoses feel right. My actions and behaviors seem to be better explained by a combination of bipolar, ADHD, and personality changes resulting from years of emotional abuse in childhood. Even if my therapist and I decided I was a little bit autistic, what good would it do for me to have another label? There’s no treatment, and having that diagnosis doesn’t help me solve anything.

When I was diagnosed with bipolar, it explained everything that had happened up to that point in my life, and I finally got the treatment I needed. After being diagnosed with anxiety disorder, I am working on ways to finally deal with childhood traumas in order to help cope with my anxiety. I have also been diagnosed with avoidant personality disorder; I haven’t researched it extensively, but it seems to describe my thoughts and behaviors related to social interactions. My psychiatrist and I discussed OCD, and it seems to fit pretty well, but we didn’t really dive deep into that rabbit-hole. And although I haven’t been officially diagnosed with ADHD, I am very sure I meet almost all of the criteria for the inattentive type.

the cost of bipolar

I’ve had bipolar disorder since I was a pre-teen, and the costs of my illness have been eye-opening. I have lost educational opportunities and had instability in my career, resulting in a loss of many tens of thousands of dollars over the years. There have been the financial costs due to unnecessary purchases and moving to different places. There are significant costs for ongoing mental health treatment. I have lost or damaged several important relationships, and I nearly lost my life on a few occasions.

There are also the physical health costs associated with bipolar disorder. There is the weight gain associated with the meds I take, which causes me problems such as high blood pressure, the potential for heart disease, and lack of mobility. I have sleep problems, decreased libido, and ongoing gastrointestinal problems, all of which decrease my quality of life. Bipolar medication may one day cost me my intellect, if the potential for early dementia becomes a reality (I wrote a previous post about memory problems).

My bipolar has inflicted harm on the family as well. My wife has stayed with me despite over 30 years of instability and unpredictability, and it has cost her emotionally, including unhappiness, fear, and anxiety. She had to be responsible for raising the kids while I was unable to help due to my illness. She has felt like she has to work harder to make more money to pay for the medical bills (she doesn’t at this time), so she continues to work at a physical job and often has debilitating aches and pains.

My son and daughter grew up in an unstable home where I wasn’t mentally present for long periods, which in my opinion caused ongoing mental health issues. My son has battled depression, but seems to have dealt with it pretty well. My daughter has been diagnosed with bipolar, schizoaffective disorder, and anxiety disorder. Her illness has cost her most of her friends, dreams of a normal life, two potential career paths, and many thousands of dollars in medical bills. She struggles with emotional issues in addition to her other physical and mental problems.

rear view

I was looking back at my posts from early 2021 that followed the arc of a long manic episode. The posts from that time aren’t scary like some of the deep depression posts from the old blog, but they are interesting to me.

My episode started with the side effects of starting on Latuda in November of 2020; I felt pretty good for a few weeks, but I started climbing the hill in December. By January 2021, I was frequently staying up in the middle of the night, my anxiety was climbing, and my OCD symptoms became overwhelming. I couldn’t concentrate at home or at work, I was having panic attacks, and I almost left my job out of frustration. After quitting Latuda and returning to Abilify, there was a long downslope where my symptoms were decreasing steadily, but were still there. I was afraid something had permanently changed in my brain. It wasn’t until May when a solo mini-vacation brought some relief from the storm.

Looking back from a year later, I am reminded how much I was struggling. This manic episode seems odd because on one level I knew what was happening and how dangerous it was, but at the same time I was very much caught in its uncontrollable grip. I didn’t think I could fly, but I believed that my life would be better if I tore everything down at work and at home. Had I followed through with my late-night schemes, it could have damaged my family relationships, cost me tens of thousands of dollars, and jeopardized the continued treatment for myself and for Nicole. I think I escaped the episode just in time, because I don’t know what I would have done if I had remained manic for a longer period.

My bipolar experience has been mostly depression, with very brief manias or mixed episodes followed by a deep spiral. This episode was different in that it had a long buildup and a long letdown, and I didn’t crash in the same way I had in the past. Since that time I have had no mania and a few depressions, and not with the abruptness and intensity as in the past. I know mania will happen again in the future, but I think having been through this most recent episode makes me better equipped to deal with it.

broken

You can only beat your head against the wall so many times before you crack, spilling your hopes onto the floor. You struggle to pay the price of existence, and the costs are staggering. Damaged and broken, you barely survive the day, and get no relief from a fitful sleep before waking up again. The cycle of hopelessness is not a circle but a downward spiral, a black hole from which positive things never escape. Your carefully constructed life is shattered by a disease with no empathy. The beast is not satisfied until its victims lie on the floor, crushed by its destructive power.

thanks for the memories

My daughter and I both have memory problems, and I believe they are directly related to bipolar disorder. We were talking about this recently, and she said she has forgotten lots of things, but it also feels like she never made the memories at the time; there is simply nothing there to remember. I never thought about it that way, but when she said that, it completely made sense.

I’ve given this more thought since that conversation. Looking back at what I remember and what I’ve forgotten, it seems like my ability to make and retain memories correlates to how severe my bipolar mood swings were at the time, and the depressive moods in particular.

I remember some of the depression “highlights” over the years, but during the times I was severely depressed there seem to be large blank spaces in my mind. School happenings, kids’ milestones, and my own work life just blend into a grey fog. I also have some memorable manic or mixed moments, but I seem to remember mental images from those times rather than the context of what was happening on either side. These memory snapshots don’t do anything to help me remember the life events surrounding the moments I do remember.

The memory loss feels strange, but just as odd is my ability to retain many events from times when I was alone. For example, I can remember locations I delivered or picked up from while I was a truck driver. I can remember places I’ve been hiking or exploring or just driving around by myself. I can remember vivid details about places I visited many years ago. In addition, I can remember lots of useless information and trivia (people always told me I should try out for Jeopardy, but I never wanted to).

My memories are often triggered by something else, whether it is music, a photo, or a geographic location. If I can associate a moment in time with a particular song, I will remember it for many years. For example, I recently listened to some music by Wham! for the first time in a long time, and it triggered a memory of driving through the Sierras in the dark when I was 18. A Hall & Oates song reminds me of a railroad crossing on a main boulevard in San Jose. A Tears For Fears song reminds me of a girl I liked in 9th grade, but also specifically of one part of a highway in Sacramento when we were on a school trip together.

I guess the part that bothers me is that I don’t know what is normal and what is not in my bipolar-addled brain. I think most people make memory associations from photos or music. I realize that normal people don’t remember everything about their lives, and usually just the highlights are what they remember. But I don’t think people typically have long years of time where they forget virtually everything. People have told me I had a great memory because I can tell them obscure details from events long ago, but I feel like my memory is getting worse all the time. I don’t know if it is caused by bipolar brain chemistry, long-term effects of psychotropic drugs, or early dementia coming on.

running to stand still

Up. Down. Sideways.

Hopelessness. Defiance. Acceptance.

Spinning wheels, hit the brakes, stuck in first gear.

Restlessness. Depression. Mania. Fear. Anxiety. Psych meds with a whiskey chaser.

I don’t have a center right now. I can’t find balance. My brain is all over the place.

My doctor called me back tonight, and he is going to try a couple of things. My faith is wearing thin.

Work piling up, waiting for me to stop feeling overwhelmed and make my brain work properly. The forecast doesn’t look good for that at the moment.

I’m also calling a therapist tomorrow. Without help, I’m a train wreck waiting to happen, and I can’t crash right now. Actually I can’t ever, but that’s another discussion for later.

panic! at the home office

So Friday afternoon I may have had a little panic attack. Apparently I posted something here and then trashed it immediately. Then I started drinking.

I was trying to email a request form to someone for a project, but I didn’t know just what to say. But I got stuck thinking about it, and it never got sent. Then the 10 am department meeting happened, and the department manager started demanding more output than we have been producing lately. Just what I needed to hear. After the meeting, I froze up again.

I took a long lunch, thinking I would take a break and calm down, then get back to work. The getting back to work never happened, and instead of producing more, suddenly I’m producing less. Thinking about this made me start freaking out, and I gave up around 2 pm. I literally got into bed and covered up hoping I could calm down, but it just got worse. I briefly thought about calling my psychiatrist, but I don’t think I could have made it through the phone call, and I didn’t want to get sent to the hospital involuntarily.

So when my shift ended at 3:30, I poured a glass full of scotch whiskey and started drinking with the intent of knocking myself out as quickly as possible. After an hour I was successful, and I slept until about 8 pm.


I fear the manic episode from January has permanently damaged something in my already defective brain. I can’t organize tasks, I can’t follow through, I can’t regulate my mood, I can’t control the anxiety. I can’t stop thinking that I will no longer be able to do my job, and that I will have to find something less stressful for much less pay and worse benefits.

Before the manic episode I was relatively unhappy at work but I was able to cope with the stress and managed to produce work in a timely manner. Now I am completely unable to deal with my mental state. I have no coping skills; I have nothing in the toolbox that I can use to improve my situation. My fight-or-flight instinct has been engaged, but I have nothing to fight with. The urge to flee is overwhelming.

The only thing that helps me relax is when I am doing something new, like yesterday when I drove new roads for a few hours and walked at a park for over an hour. But there are only so many roads within a reasonable distance, and I can’t do that every day. Eventually I have to come back home to my life, and start thinking about everything again.

I will call my doctor on Monday when I am relatively calm and explain the situation, and see if he can recommend something.

instability

I’m used to my brain throwing curveballs now and then, but since the most recent manic episode something seems to have permanently changed for the worse. I’ve lost whatever stability I had in the previous year, and it has been replaced by rapidly changing highs and lows.

Since quitting the Latuda, I have had significant OCD and anxiety problems (see this previous post). I started taking Klonopin a week ago, just a small dosage, and I don’t think it has helped very much. Most days I have been edgy and frazzled, like I am just barely in control of things.

I have slept okay some nights, then not so much on other nights. There have been a couple of days where I was so tired I was falling asleep at my desk (one benefit of working from home). I had to nap during my lunchtime to feel better. Then I wasn’t tired at bedtime, and I had to self-medicate with a little whiskey to fall asleep.

On two days this past week I have been so wound up at the end of the day that I have to get out of the house. I ended up driving about 2+ hours both times. Friday night I just had to get on the freeway and go fast; yesterday I wandered aimlessly through Amish country before finding a freeway and coming home.

Another thing wrong with my brain is my reaction to caffeine. Apparently I can only drink decaf coffee, because when I have regular coffee the tics and shakes increase within an hour. Soda seems to have a lesser effect, but I still feel it. It fucking sucks because I love coffee, and decaf usually tastes bad.

I’m glad I am dealing with this now and not at an office full of people (another benefit of working from home). I don’t have to hide my daily roller-coaster from everyone and pretend to be “fine”, whatever the fuck that is. My wife knows I am abby-normal right now, and she’s concerned, but is mostly just trying to stay out of my way. I have been telling her I’m not in any danger, which is true.

I don’t want to admit it, but maybe I should go back to the meds I was taking six months ago and see what happens. I was stable, I was sleeping, and I felt like I was mostly in control. However, I was depressed most of the time, so that wasn’t good. Now, I’m just feeling exhausted and hyperactive at the same time.

Sorry if this is rambling; I’m just spewing this out and not editing at all. Just like my thoughts right now. It’s bedtime, so I’ll see if I can get some sleep. Bye for now.

tics

I’m not talking about blood-sucking arthropods, but the little movements and rituals that are the major symptom of OCD or maybe Tourette’s. I’ve had little tics and quirks since I can remember, but usually they were only present during stressful times. The rest of the time, they didn’t have control over me and I could ignore them.

During the most recent manic episode brought on by taking Latuda, I started having uncontrollable “tic seizures” where I would be lost for seconds to minutes at a time, then only by force of will could I stop them for a few moments. I could maintain calm stillness if I really concentrated (which is the opposite of being calm), but eventually I would surrender to the urge.

I tap or flick things repeatedly with my fingers. I blink my eyes forcefully, way more than necessary. I blow air on my fingers. I tap my mouse on the desk over and over. I click my teeth. I scratch my chin or my head. I wiggle my feet or my toes. All of this is fueled by the need to “get it right” – the right sound, the right amount of force, the right number of times, or the right rhythm. If I don’t get it right, I feel like I have to keep doing it until I succeed, and I never do. These rituals are not involuntary, I’m doing them purposefully and I’m fully aware I’m doing them.

I quit taking Latuda two weeks ago, and my psychiatrist tells me it should take no more than a week for the drug to wash out of my system, but the tics remain worse than ever before. I find them in control much of the day, every day, and only when my brain is fully occupied can I really prevent them from happening. I have had difficulty with concentration and focus over the past year or so, and when my mind is spinning or drifting, the tics are more difficult to control. They get worse with stress, and my anxiety is feeding them. They get worse with caffeine, which is bad because I need my coffee in the morning.

Between the manic episode and the increasing control of the tics, It has been mentally exhausting for the past three weeks or so. My work is suffering, and because I am working remotely it is too easy to take time away from the computer to try to relax. It has been difficult to work a full day every day, I am taking too long on projects, and I am struggling to meet deadlines. After work I just want to drink myself to sleep, but I have (mostly) avoided that so far.

My p-doc wants to put me on Klonopin or Ativan to calm down a little and hopefully reduce the tics, but my employer’s safety requirements and drug policy might be a problem. We are randomly tested to federal standards for opioids, marijuana, PCP, cocaine, and heroin. In addition, I’m not supposed to take any drug which might affect my “ability to perform” safety-related tasks. Klonopin is on that list, so if I do take it, I have to demonstrate to the safety police that it doesn’t affect me during work hours. Hopefully I can work with the company on this problem. I won’t ask my p-doc to be untruthful, but I wonder what will happen when they find out I have bipolar and anxiety disorders.

I don’t know if the manic episode or the Latuda triggered something in my defective brain, but something has changed, and I hope the effects are not permanent. I’m actually concerned for my future because of this. I am worried that my mental health problems will cost me the best job I’ve ever had, and send me into an uncertain future of trying to find a new job at my age. I’m not that old, and I can do good work when things are under control, but age discrimination still exists. I hope I’m just overthinking everything.

In the meantime, I’m exhausted, and I’m struggling.

manic word dump

I wrote this in about two minutes last week when I wasn’t sleeping. I think this stream-of-consciousness rant sums up what was going on in my brain at the time. Thankfully, I’m feeling more calm now, and I’ve been sleeping all night for past three nights.

===

I might be a little manic I don’t know why well maybe I do it’s because of fucking chemistry my brain is a mess I’m not wired right I listen to my doc I take my meds like a good patient but they make me even worse depression sucks but being manic sucks a little harder and not in a good way billy joel said too high or too low there ain’t no in between and that’s how I’m feeling this month get on the roller coaster riding the colossus spinning off to every extreme I was in this state once and tore apart all my computers just for fun now I am up all night reading blogs and doing word searches and disturbing the cats who wonder why the fuck I’m up every night one moment I’m asleep and then my eyelids open and my train of thought is like the japanese bullet train the shinkansen I think and there’s no going back to sleep now and it’s fucking exhausting so I have to wait for the offending drug to clear my system and then we’ll see if I get depressed again it’s the great circle of bipolar and what comes around goes around the block and down the freeway and out of town until one of these days when I crash

withdrawal symptoms

Latuda is marketed as a treatment for bipolar depression, but they don’t tell you that it prevents depression by placing you into a constant manic or mixed state. I had to stop taking it last week because I had been manic for about three weeks.

The withdrawal symptoms of Latuda are significant and apparently long-lasting. I got more sleep last night, but I’m still waking up in the middle of the night for extended periods. In addition, my brain is still restless even though my body is tired. I sat all day yesterday and fidgeted because I wanted to do something, but I didn’t know what to do and I couldn’t concentrate on anything. Finally, the akathisia effects continue; the “twitchyness” is still causing me to blink my eyes and tap on things with my fingers repeatedly and shake my feet almost constantly. I’m hoping these symptoms will decrease this week.

Several years ago I had bad luck coming off a high dose of Effexor, but those effects were completely different: auditory hallucinations, nausea, and dizziness. I’m not having any of those now.