There’s Nothing “Hypo” About It

Four or five weeks ago a wave of hypomania hit me so abruptly I felt like I was suddenly caught in the midst of a hurricane. It was in fact the beginning of a mixed episode more intense than any I had ever experienced before. I had read and heard that bipolar disorder has a tendency to get worse with age, that for some people each episode implies that each concurrent episode may be more severe than the last. And so, I had experienced with bipolar depression, but never with the flip side.

I was feeling so angry, irritable, and upset. There were some situational things going on in my life that would explain being upset, but that couldn’t explain my desire to put my hand through the wall. After a few days of feeling progressively worse, I realized that it was more than situational. I was furious all the time and the only thing getting me through the day was a particular fantasy. When I started to feel my anger spiraling out of control to the point of feeling violent, I would imagine myself holding a sledgehammer, walking through various buildings, and breaking everything in site. It was a very therapeutic fantasy and it got me through the most difficult periods.

My nurse psychiatrist put me on trileptal at first, but that almost immediately may be significantly worse. Within twenty-four hours I felt maniacal and didn’t take more than two doses. During the several days without medication while I was struggling with this furious anger and maniacal energy, one day I got up, put on my sneakers and went for a run. If you know me, you know that this is completely out of character. I think the last time I was able to run more than ten feet was at the age of sixteen. So this in and of itself gives you some idea of what it’s been like. At the end of that first run, I finally felt normal again for the first time since the whole thing began. I’ve been running a few times a week since then. It’s the only thing that pretty reliably makes me feel normal.

The sledgehammer fantasy led to the idea to go the batting cages, which is something else that my husband and I have been doing about once a week since this whole thing started too. It’s been very therapeutic to just get all my energy and aggression out. It’s also been a way for my husband to help and support me through this process.

Incidentally, hypomania is an eminently misleading name for this phenomena. Mania is a much more fitting term, though I appreciate that there is a big difference between mania and hypomania. The prefix “hypo-” makes hypomania seem so much quieter, calmer, less disruptive than it is in reality. I wish there was a better name for it. I really like the descriptor maniacal, although that really makes me sound crazy, doesn’t it? I mean, it feels pretty crazy in the moment.

My nurse psychiatrist switched me to lithium now, which I’m not thrilled about. It makes me really tired and I think it turning the hypomania into depression, which I don’t think I prefer. Honestly, I’d rather not be on any medication and just run off the energy. But the reason I went on the medication in the first place was because of the violent anger, because of feeling like I wanted to put my hand through the wall all of the time. That was not a good feeling at all. So, it’s an evolving situation. I’ll let you know how it goes.

I hope you are well.

Anesthesia Anxiety

For me, anesthesia is the worst part of having surgery of any kind. For some reason, whenever I wake up from anesthesia I start crying and sometimes have a panic attack. I know this about myself. It happened for the first time after my first serious surgery when I had my ankle repaired in 2004. I woke up from this outpatient surgery in a curtained off “room” by myself. My mom had come with me so I called out for her and as soon as she was by my side I was able to calm down. Ever since then, when I have any kind of anesthesia I warn the doctor’s and make sure that whichever family member is with me can be there when I wake up from anesthesia.

This time I told every doctor, nurse, and tech I was introduced to the morning of my surgery. They told me Erik probably wouldn’t be with me when I woke up. Their recovery area is very strictly controlled, we were told. Family members are not usually allowed in there. The staff of the acute care unit (ACU) would not let him in, but would notify him when I was out of surgery. I wasn’t happy about it, but there was nothing we could do.

anesthesia
Inevitable Mental Health Consequences of Anesthesia

As expected, when I woke up in the ACU with only strange faces above me, I started to cry. The nurse stood over me telling me I was fine, the surgery was over, and that I was in recovery, but I was confused and traumatized and she only made it worse. I started to have a panic attack and instead of bringing my husband to me, they gave me drugs to calm me down.

Now, don’t get me wrong, I am not above anti-anxiety meds. I have used them in the past and I’m sure I’ll use them in the future. What I am opposed to is using meds when there is something else that can be done to mitigate symptoms. All I needed was my husband to be the first face I saw when I woke up, but that wasn’t allowed because of the ACU’s policy’s. In this case, policy was put above patient care.

As I mentioned yesterday, my experience at St. Joe’s was fantastic. Everyone we met (almost) was kind, compassionate, and accomodating. This was the one glitch in their patient care system.

On the best of days, anesthesia can have mental health side effects for anyone. For people who experience mental health challenges normally, anesthesia is much more likely to cause bouts of anxiety and depression. This has always been my experience. In addition to the trauma of surgery knocking me off my game, anesthesia always makes it more difficult for me to recover.

Advocate for Your Needs

Even though advocating for my needs didn’t work out this time, I will continue to do it in the future. As I have mentioned before, it is so important for those of us who struggle with mental illness to be our own best advocates. We need to know more about our illness than anyone else, and especially know more about what helps us when we are struggling.

How To….We Interrupt Your Regularly Scheduled Programming

There was a plan for today’s post. More about our trip and how it may have changed the course of my life. No really. But more on that tomorrow.

Instead, a rant. On how holiday hangovers are made much worse when you are on a medication that makes your brain foggy for a couple of hours after taking it and which you are required to take both morning and night.

I’m sitting here, having finished my breakfast, trying to figure out what’s next, only to realize that I almost literally can’t get my brain to move. Do you know what I mean? It’s the same experience, I think, as when you’ve been up for almost 24 hours and you’re so tired you can hardly make yourself move. Maybe it’s also the same way you feel when you’re way past drunk and someone helps you to an even remotely comfortable place to lay down. Any effort to stay awake only results in you feeling sick. That’s how I feel.

Despite having gotten more than enough sleep – 9 1/2 hours or so, and having been awake for only two hours, I think I need a nap. This is the part of taking medication that I hate. How can it be helping me if it’s putting me to sleep? That’s all I wanted to do before I started taking the medication.

Side effects are a %&*$#. Do you ever feel like the side effects of your medication might outweigh the benefits?

Oh yeah, Happy New Year.