Hormones & Irritability
K took me away for a surprise birthday weekend over the past few days. It was great getting away, but I kept combating a low-level (and at times, not so low-level) irritability. I wasn't able to place it and determine the source, but it was an all too familiar feeling of late.
I've written about struggling a bit with my menstrual cycle, ever since I turned 30. K's reaction to it has also made the cycles more challenging. In response, I went onto
Seasonale, a birth-control pill, which reduces your period to 4 a year. I've been on it about 3 weeks and during that time, my irritability has increased. The irritability may be only that it's January, it may be that it is the pill, or it may be a general blah mood.
On Saturday evening, K and I received a surprise, when she started her period (or extremely heavy spotting) for the first time in over 14 months. Admittedly she is young (42) for menopause, but there wasn't any other reasonable explanation. She's even been on the estrogen patch (after begging her doctor for months) to alleviate some of the depression associated with menopause.
Result: Our hormones are off in some strange way. I hope that's all that's causing my irritation. A biological explanation is better than any other. K's not too happy with her situation and she's confusion. Also, in pain, as the lithium prevents her from taking any advil or ibuprofen for cramping, and Tylonel does very little for the muscle aches.
My other gripe is work, as I've been spending my day juggling three complex projects and waiting for one of the eggs to crash on my head. It will fall on me first, since I'm responsible for the completion of all three. Urgh!
Birthday
As I said in my last post, I realize that I've been bad about updating my blog of late, but things have been busy. Then Friday was my birthday. K had been giving me riddles all week about what my gift would be and I was unable to figure them out. But, she finally told me on Thursday night. 2 nights in Philadelphia!!! We headed out on Friday and have been having a wonderful time despite the cold weather.
That K had the ability to plan a trip away like this is a big improvement. She picked out the restaurant for us last night and did all of the research. Normally, she leaves planning to me and goes along with whatever I choose. I'm happy to see her take the initiative. Things are good.
Bad Blogger
I've been slothful in the past week and haven't managed to work up any energy to blog. It may be that the cold is seeping into me and even as I type the fingers of my right hand feel as if they froze some time ago. In addition, problems in the house have taken time and energy. No house project ever goes smoothly, regardless of how much you pay.
The short report is that things are good. K's having a bit of a down time, but it isn't anything that would even be a blip on a mood chart. It may be that today was labeled the most depressing day of the year, according to this
article.
After some of the comments regarding bipolar remission that were made last week, I realized that I was confused about exactly what remission entailed. With that thought, I began actually doing some research as to what K and I should expect from a remission diagnoses. I stumbled across the DSM-IV additional treatment guide for bipolar disorder, thanks to
McMann's Depression and Bipolar Web.
John McManamy does a better job than I could of discussing 2002 changes to the DSM-IV regarding the possibilities of bipolar remission. But, the short version is that in 1994 the best hope for a patient with bipolar disorder was to have fewer episodes. In 2002, the opinion has been revised to say "Treatment is aimed at stabilization of the episode with the goal of achieving remission, defined as a complete return to baseline level of functioning and a virtual lack of symptoms." Check out his
article if you are interested. Suffice to say, the study and understanding of bipolar disorder continues to evolve.
After finding this article, I turned to the actual DSM-IV
Revised Guidelines for Treating Patients with Bipolar Disorder
It was fascinating in that K's treatment plan was described almost to the last detail, along with lengthier descriptions of symptoms, implications, and impacts. It didn't say anything fundamentally different than what her psychiatrist told us, but he gives us quite a bit of information. There are definitions of the different states of bipolar disorder, manic, depression, and mixed. The treatment alternatives as well as cautionary notes are included. It is worth investigating.
The surprising thing is that the understanding and treatments for bipolar disorder continue to evolve. It's very good, but somehow I expect the doctors to have already gotten to the root of the problems and not continue to work on it. I realize that my thoughts make no logical sense, but I still was surprised that in an 8 year period the prognosis for bipolar moved from trying to reduce the number of episodes you live with to an expectation that the episodes can be fully controlled through medication. Very different impacts on the patient's life.
On a more personal note, it's been a good four-day weekend for us. We got irritated with each other a couple of times over the past few days, but nothing particular stands out as a problem. The week will be short, as we also have Thursday off for the coronation.
Personality Test
K just showed me the results of a personality test, Strength Deployment Inventory. She initially took it four years ago and retook it today. Her strengths and approach towards conflict has dramatically changed over the years.
Four years ago, her approach towards conflict was basically to fight and if pushed hard enough she would give in.
Now, she is listed as choosing her battles. She will make a concious decision as to whether the conflict is worth taking on or if she should give up.
Previously, she would give in and then be angry. I see the choosing conflicts as a good thing rather than conceding and harboring anger.
I'm the type (though mine is five years old and I may have changed), who meets conflict with caution, waiting for the facts before committing to a position. If no important principle is involved, I'll defer, but otherwsie I come out fighting as a last resort. My initial reaction is that this is no longer accurate, but I'm not sure I'll bother to retake the test.
Busy, busy, busy
Work has been keeping me very busy and somewhat stressed this week. I have ended up on the lead for three projects, all which need a lot of attention over the next six months. The good thing is that I can concentrate on work and am no longer having to suddenly leave in the middle of the day, because K can't be home by herself. She's also back in the office and working full time and being productive. As I'm sitting at the dining room table typing this, K is sitting next to me reveiwing materials for an exam in project managment tomorrow.
What this means is that we come home and collapse. No desire to play with the dog, barely any energy to cook dinner (though we have been managing to do so and cut back on eating out), and barely able to stay up more than three hours after making it home. In other words, we're leading a normal life! Put in those terms it somewhat sad, but the result isn't. Bipolar disorder is no longer running our lives.
That's not to say that I'm thrilled about the exhaustion and being tired to the point of being unable to think, but that's something for me to work out. No longer are we solely in the hands of the psychiatrist and therapist relying on them in order to be able to change things. It's not a question of medication in making changes, it's K & I deciding what we want to do and making the changes. (I fear my exhaustion is making me babble.)
I still need to review a presentation that I'm supposed to give tomorrow afternoon, but I'm glad I took a few minutes to reflect.
Technical Note
Blogger doesn't support Safari, yet. Nor is there any word on when they will begin to support Safari. So. . . I downloaded
Firefox to regain some of the editing functionality without resorting to using IE on the Mac. I've gotten some of the editing buttons back. I guess if I were even mildly versed in HTML, I could avoid this entire problem, but I'm not.
Accomplice
This morning, our first stop was the new Dunkin Donuts walk-up kiosk. I feel a bit like an accomplice taking K there. She certainly would have been able to get there without me, but I encouraged her as a treat. I especially feel like an accomplice as I read all the blogs bemoaning the weight gain that goes along with the bipolar meds. But. . . it's her decision, and she is upstairs thoroughly enjoying them, while watching an episode of
24.
Sunshine
After days of rain, fog, and streetlights on at noon, the sun is shining today. Am I out taking the dog for a walk she desperately wants and deserves? No. Rather, I've been sucked into blog world and been reading. However, once I finish writing this, I'm heading out the door, with the dog on the leash.
Things are better with K. She's facing some changes at her job, since her organization was suddenly deprived of 50% of their funds. It looks as if at a minimum, her office will be moved under another executive and her manager may take early retirement, if buy-outs are offered. The good thing (yes, I have irritatingly positive viewpoints on things) that this didn't happen last year. If it had, K would have probably taken a medical retirement, due to her inability to handle the change. She's struggling with it now, but she's handling it very well.
This morning though, her mood was black. Today was her therapy appointment, her first one in about 3 or 4 weeks. It was clear that she didn't want to get up, she didn't want to figure out her breakfast, and she didn't want to go to therapy. After being snapped at, I withdrew any offers to cook her breakfast and left her alone to figure it out. I did offer to drive her to therapy to make it easier. I fear that I am too eager to jump in and try to solve her problems, when I ought to step back and let her work through them on her own. I'm been trying to do that and hover less. It's difficult, but it's the right thing for us both.
The dog woke up from her nap and is now beginning to lobby for a walk by staring at me with deep brown eyes, which plaintively beg for attention.
As I have stated, K's therapist is amazing. She entered the office with a furrow between her eyes (always a danger sign) and exited with a smile on her face and an apology to me for being grumpy. The woman is basically able to work wonders with K.
K believes the continued, though diminished, chaos of our household is bothering her. The work on the basement continues, but the majority of the upstairs work is completed. Unfortunately, the few things that remain keep us from fully setting up the living room and dining room, as we would wish. Regardless, it is still a great improvement. K may also be struggling with PMS, since I haven't started the blood flow yet.
Quick update as to the pheromones and like that I've discussed before. My doctor gave me Seasonale to go to the 4 periods a year. She claimed it works great and there won't be any problem. She also agreed that my cycle could be having an effect on K's mood. I took the samples with trepidation, as the thought of only four cycles a year seems somewhat unnatural. Convenient, but unnatural. I haven't started on the pills yet, so I have no opinion as to their effectiveness.
Dog is continuing to lobby, so I need to go before the gloaming sets in.
Good News
K's back in the office this morning. She still had a rough night, with a Xanex moment at 3 am, but she was able to get up and make it to the office. Yippeee!
I'm hoping we'll be able to meet for an early dinner out tonight, as a bit of a treat. And with luck, I'll be able to fit in an hour of shopping beforehand, as I have an afternoon doctor visit. I'm planning to ask if putting me on the pill will reduce K's PMS.
The Return of Doom & Gloom
K's been struggling again. We had hoped with the diagnoses of remission that these bad days would go away, but they haven't. After being off work for two weeks, she was unable to return to the office yesterday or today. She says the bad thoughts are invading her head and making it difficult for her to think clearly.
The challenge is that she and I believe that her current mental state is due to PMS. As I've said before, she's susceptible to my cycles, despite having reached menopause. The good part is that her depressed state of mind will only last a few days, and she has the Paxil to help combat it. She began taking the additional drug on Sunday, but it doesn't seem to have fully kicked in.
I struggle when she has these moods, as well. I hate seeing her sitting in the dining room looking as if everything is caving in around her. I hate that I can't help her regain her self-esteem that she's losing by not making it to the office.
Instead of being a support, I have a desire to flee the house, because I don't want to know about the bouts of rage and self-hatred, which occur around now. It's not a good feeling that I want to, not abandon her, but keep my distance. I fight it and try to remain supportive and get through these struggles with her.
The bruises in my psyche from the past two years feel bone deep. The kind that don't really hurt any longer, but they remain painful when touched, and appear to take forever to heal.
Yesterday, I lost my temper with K. Two doors down, the developer, after 3 years of not doing a damn thing, including cleaning the lot, has decided to begin building without notifying anyone. K hates the developer, who is slimy. Before the bipolar diagnosis, she would get worked up and obsess about "wrongs" and that slimy individuals (said developer) will make money from their sliminess. I'm fearful that she will obsess over every irritating thing done by this developer for the next year, while the building is being built.
I can't face the thought of her getting worked up every night when we come home from work. It isn't something I'm interested in dealing with and to be blunt, I don't truly care what the guy does as long as our house doesn't collapse and we can reach our parking spot. (The developer has talked about closing the alley during part of the construction.)
When K got upset about the work yesterday (yes, the house did shake dramatically when the backhoe began to dig and we are not finished the work on our foundation), I freaked out. She didn't obsess, she didn't go off the handle, but I could envision all of those things happening. I lost my temper. I apologized and we worked through it, but it didn't help her feel better and be able to go to work today.
Today, I'm fighting to keep my own irritation with her mood in check. I probably have mild PMS and am tired. She feels that I'm angry with her and I'm not. But we don't seem to be communicating well, for whatever reason. Urgh. I keep hoping things will improve for us both and remind myself it's only been two days of bad tempers.
Bad Mother
I mentioned this blog recently more among the entertainment blogs, but tonight I realized that Ayelet Waldman, owner of the Bad-Mother blog also suffers from bipolar disorder. I keep intending on purchasing her books, because I thoroughly enjoy her writing on the blog. Any case, here's the blog site.
http://www.bad-mother.blogspot.com/
The post and link where she mentions bipolar disorder is below.
Bipolar Link
2. Pharmaceutical Companies. Why can't they invent a mood stabilizer that doesn't make you both fat and stupid? I'm actually not so much mad at them as I am at the body chemistry that makes me need a mood stabilizer in the first place. Don't get me wrong, I actually think there is a certain benefit to having bipolar disorder. Hell, I wrote three novels in the past year. Try doing that without hypomania. Still, I'm dragging around at least ten extra pounds that I lay squarely at the feet of my drugs.
This echos many of the writings of Tidal Moods and Blondzila as well as K's own comments regarding her drugs. The drugs make you gain weight and then self-esteem becomes even a greater problem. K continues to struggle with her weight gain, despite the fact she lost 15 of the 30 pounds she gained. Once the basement's completed, we'll be able to set-up her rowing machine for her to workout and start to regain her own image.
Technical Note: We purchased a Powerbook as a Christmas gift, so I've been using that. The downside is that Blogger appears to offer none of their editing functions for the Safari browser. Thus, my posts are slightly less pleasing from a graphical sense. My writing remains the same, be that good or bad.
Susan Sontag
Susan Sontag passed away from leukemia on Tuesday, December 29. K and I heard excerts from two interviews with her during our drive home on Wednesday, which articulated many of our feelings regarding the past two years.
During the 1970's, Susan Sontag was diagnosed with breast cancer. After receiving experimental treatments, she made her way to a full recovery. In 1989, she discusses the impact of the illness on her life and her approach towards life. She reached a point, where she believes that the illness had a positive result on her life. As we drove down the highway, K commented on how articulately and elegantly Susan Sontag expressed her views and how closely K identifies with Sontag’s perspective.
"NPR : Listening to Susan Sontag, One More Time"
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*Order a text transcript of this story*
Happy New Year
My writing seems to frequently address various anniversaries and today marks another one. K's heart attack and the beginning of our slide into illness and darkness began two years ago today. She woke me at 4 am New Year's Day and asked me to call an ambulance, as she was having a heart attack.
The heart attack began a cycle of illness, depression, and culminated in the hospitalizations for bipolar disorder. After reading about people's experiences with the disease, I realize that she was exceptionally fortunate and worked very hard to achieve full remission 13 months after her hospitalizations.
Today is the two year anniversary of the beginning of it all.
We're better off than we were before this all began, albeit somewhat more fragile. My psyche still feels bruised from the experiences, but I'm healing. K is less volatile and better able to manage her emotions and reactions than she was prior to the heart attack and bipolar diagnoses. Her relationship with her family has improved greatly over this time. And K's therapist has helped her work through some of her experiences, which have proved to be stumbling blocks for her. If I were forced to give a list of how to credit K's caretakers, it would be as follows.
1) Her therapist has been amazing. Even with the right drug cocktail, K needed the assistance working through her past and learning how to unburden herself of her daily guilt. The therapist has convinced K that she doesn't have to be perfect to be successful.
2) Her psychiatrist. He is excellent with the pharmacological side and with his bedside manner. When we needed him, he was there with a phone call. During K's hospitalizations, he made sure to visit or send a representative if he couldn't make it.
3) K's manager at her office. This woman protected K and allowed her to take almost an entire year off without placing undue pressure on her to return to work before she was ready. She completed the paperwork for K to continue to receive her health insurance and fought with her senior management to protect K from political infighting.
4) K's internist. Another woman, who was always available whenever she was needed. She acted as K's advocate throughout the hospitalizations and made sure she took the time for both of us. For example, I would run into her in the hospital elevator and she wouldn't give me K's status for the day.
Actually, each of these doctors made time for K and me. They freely shared information on K's status and listened to my concerns regarding K's health. Never was I cut off from information and they always welcomed my input. When we went through the worst times, I was able to use them as consultants to determine the best course of action for K. Each one of them is a role model for the medical profession.
My memories of the past two years have begun to fade. I don't want to forget what we went through. But I also don't want to remember in stark terms. Better than the pain is softened by the passing of time.
We've reached 2005 and celebrated the arrival of the New Year by attending the same party, where K had her initial symptoms two years ago. Now, I'm looking forward to a year happy, fun, and wonderful year with a healthy K.
