Backpacking and Bipolar II. Taking Manic Depression on tour.
I recently visited with a friend for three weeks. I was beginning to feel depressed and confused before I left for the trip. The obvious and predictable conclusion came to fruition in three quarters of a month of near-suicidal behaviour. I sank into a very confusing and miserable hole. I didn’t want to kill myself but it was there as an option of dealing with pain. I was a ticking timebomb as all other options were gradually being proven redundant or ineffective.
Upon my return to civilisation I saw my doctor. He had, three and a half weeks prior, given me 50mg/day of Sertraline. Sertraline is an anti-depressant used to treat Major Depressive Disorder, also known as Clinical Depression. This medication can potentially have adverse effects when ingested by someone with Bipolar. My only thought concerning this presently is: “No shit”
At 50mg/day the medications positive effects cannot be felt as it is a sub-clinical dose. The doctor’s hypocratic oath says “First, do no harm”. Unfortunately in the case of medecine designed to combat depression – this translates in real world terms to “Do no harm to yourself” and, consequently, doctors are likely to issue a dosage that will test for side effects without having any efficacy with regards to combatting the illness itself. In my case this proved an effective litmus test for Bipolar as the medication sank me into a deep, dark depression.
I told my doctor of the everpresent suicidal thoughts and, thankfully, he had the cojones to put me on a significant dose of an antipsychotic caled Quetiapine (Trade name: Seroquel). The dosage I am on is 600mg/day. The medication for the first two weeks almost rendered me unconscious approximately twenty minutes after taking it. I felt a general increase in appetite, particularly after taking it in the evenings. As for positive effects – I couldn’t clearly identify if the medication was helping me or if the fact that I was busy all day with work and had constant support was the reason I became more stable. Thoughts of suicide gradually dissipated.
Whilst away from my current home, I had begun to have paranoid thoughts that my friends that I live with were happier without me in their home. I dwelled on this thought and it matasticised into the idea that I couldn’t stay where I was, I couldn’t return to my friend’s house and I couldn’t go back to the U.K in disgrace as a broken, mentally ill person. In short I felt as though I was out of options. These thoughts were not of my making, I know that now. This disease is like having a random negativity generator constantly set to “TURBO FUCK UP” deep inside my brain. It only took three days of constant remonstration about this, and convincing from my friends before I realised how my illness had held my hand and taken me for a walk into very dark territory.
For the last few days I have spent a lot more time in bed as I felt my mania slipping away from me. Thankfully I can identify this happening now, and correctly attribute it to illness. I remind myself to grit my teeth, rest as often as I need to and wait out the problem. Undoubtedly I can spot this now because of the sessions I’ve had with my friend. He, as acting-therapist, has given me advice on how best to cope with depression and has pointed out thinking subroutines of mine that I wasn’t even aware of.
The exciting thing for me now is that only three days into what would have been a major bout of depression only a few months ago, I can see the light at the end of the tunnel. I am constantly on my guard against my O.C.D ruminations and whenever I have felt overwhelmed for the last few days, I’ve simply gone to bed. I believe these drugs are working because I’m doing the mental aerobics I need to in order to allow them to work. It feels good.
Today I still don’t feel manic but I’m not absolutely miserable either. I believe that beauty, rather than being an attribute of individual objects or people, is a state of mine occupied by the observer. Beauty is in the eye of the beholder they say. One of the elements of my life most conspicuous by its absence in my depressed state is being able to really revel in, celebrate and be bowled over by beauty. When manic I can be brought to tears by the sheer beauty of a lot of things. An interesting development is that, while depressed, I have begun to show a meloncholic streak whereby tragedy has become beautiful to me. This may seem morbid, and self indulgent, but to find beauty in noble suffering or in the horror of some peoples’ lives actually makes depression more bearable. It allows me to still think creatively and it gives me access to that mental state of Beauty. Depression’s spear is blunted by this and whilst it may not be the case in the vast majority of sufferers, in my case I take this as direct evidence that the medication might be starting to really work.