30. Pretending To Be Me

More and more lately I’ve been feeling the effects of depression in between the moments of feeling nothing at all. I’m acting a little bit like a pregnant woman right now. I can go from nought to snot inducing crying phase in sixty seconds. And in those moments that’s when the world turns into a dark place. All my fears come rising to the surface, all my pain comes to call and my mind throws things at me which make me feel entirely worthless.

It’s at times like these that I wonder whether I can keep going with all this bipolar nonsense. It’s not as if having an understanding of this condition makes it any easier to live with. It’s not as if talking provides a cure. I’ve come to the realisation lately that there has never been a true moment of clarity in my entire life where I’ve known that the decisions I’m making are mine and mine alone and that I’ll stick with them. I’ve never been happy because from one week to the next something inside me keeps changing the rules. It’s like playing a game that you’re never going to win. And not a cool game like Super Mario or, during the speedier times, Sonic. No, it’s like playing Monopoly over and over again. Or as my husband calls it, Monotony. There is no winning. There’s just hard choices and times when you’re functional and have money and property then times when you can’t function and find you’ve lost everything. But just like the pieces on that board, you’re pretty much alone the whole time.

And the loneliness. Oh how I love that feeling. Not being able to connect to others because you can’t even bring yourself to like what you are. Well thanks for that one, Universe! And what’s the alternative? A ten minute session once every 3-6 months with a trainee psychiatrist, carrying on as best you can, pretending that you are the person you present to everyone, or giving in to it and becoming the insane, vibrating, paranoid, debilitated by OCD fruitcake who needs around the clock care that you know lives just a centimetre or so beneath your skin. There have been so many times in my life when I’ve thought about giving in to that but I’m not sure that giving up would be any better. It seems to me it would take less work to give up than to keep going and from what I understand there are drugs like Diazepam on tap in hospital, which is an incentive, but I’m not sure there’s any coming back from that state. No coming back and no way out.

So I live the lie. The one in which I work to the best of my ability, the one in which I embrace my fate, take my pills every day, wonder quietly about whether I will ever actually make a decision I can live with forever and tell people that I wish there was a cure for bipolar. But even that’s a lie. I don’t wish there was a cure. I wish there was a way to balance the chemicals in my brain so that I was always productive, creative, full of energy and able to do everything in life with ease. I want to be in a permanent state of hypo-mania. Sometimes I wonder whether my constant desire to have the things I can’t reach is born of those times when I’m in a hypo-manic state.

I’m reminded of Tennyson’s poem, ‘In Memoriam A.H.H.’ in which he states ‘Tis better to have loved and lost than never to have loved at all’. And in contrast, Hunter S. Thompson’s quote ‘You can’t miss what you never had.’ That is my life all over, it seems. The polarity of these two statements mirrors the polarity of my entire existence.

Let me explain.

Tis better to have loved and lost. Tis better to have experienced a period of hypomanic behaviour during which you were productive, creative, happy, wild and carefree than never to have experienced one at all. Then, when you lose that feeling, despite feeling as if your wings have been clipped and the ensuing depression which takes over and the reminder that you once had a hell of a lot more control over your life, this is still a better state to be in, than to NEVER have experienced this state.

You can’t miss what you never had. You never experience hypo-mania, you never know that there is any other way of feeling than the normal range of emotions you go through. Your life is generally calm and collected with no dire need for excitement, no possibility of hallucinations and no desire to leave your life as it is and start a new one in a commune in LA.

So you can see which statement I feel more of an affinity with. Because let’s face it, it really IS worse to have experienced something amazing and then have it taken away from you, despite the fact that state also comes with hallucinations and other such novelties.

So will I ever be happy? Will I ever be content with my lot in life? It would appear this is something I should put to the latest trainee psychiatrist and see what they think. I’m sure they’ll have the answer I seek!

29. Would You Like Salt With Your Salt?

Today I’m feeling vaguely victorious and vaguely petrified in equal measure. I told you about my diet, right? The one 0where I have to cut out everything but air, acorns and, if I’ve been really good, I might get to sniff the fridge? Well, when I said that diet and exercise wasn’t good for you, I wasn’t kidding. It turns out that the type of diet I’m on is low in salt as well as low sugar, low fat and low flavour.

Now, I started on lithium 2 years ago. I read the little pamphlet that came with it stating what to do with the little white tablets, when to take them, how many to take and what to do if I accidentally start snorting them like cocaine. But after that I kind of forgot about the little pamphlet and got on with my life. So when I started this diet it didn’t occur to me that the odd symptoms I started getting about 2 weeks in were anything more than dietary pains or the effects of a lifetime of living on sugar.

Last week my lips went numb. Just once and just for about ten minutes and I didn’t really think much of it other than ‘that’s odd and I hope that doesn’t happen again’. But it did happen again. And I was tired all the time. Exhausted to my core kind of tired. And then my right hand went numb which, to my dismay, didn’t stop me being able to go to work and type (I mean, what is the POINT of being poisoned slowly if you can’t get a day off out of it?). And my concentration has been awful. All these things I’ve put down to other issues but it turns out that a low salt diet can really affect your lithium levels, raising them to the point where they become toxic. Yet again I ask you, if you suddenly turned radioactive, you’d want a day off work, right?!

Apparently, what happens is your kidneys process both sodium chloride (common table salt) and lithium chloride (not to be confused with table salt. Doesn’t taste nice on your chips… apparently) in the same way. Ie, if you’re dehydrated or don’t have enough salt in your system your kidneys will hold onto what it has got, and invariably that will mean holding on to the lithium too. Your body doesn’t flush these things away in your urine like it normally would and you end up building up a little store. One thing is relatively harmless although again, wouldn’t recommend you put it on your chips after extraction from said kidneys, while the other thing starts to build up to toxic levels. You notice it most when you get the shakes, numb bits of your body, your concentration goes, etc etc. (there’s a much better explanation here: http://bipolarworld.net/Phelps/ph_2005/ph1350.htm).

You’re supposed to speak to your GP before you go on a diet of any kind when taking lithium but this is where things fell down for me. Neither myself, nor the GP or nurse put two and two together and that’s how I’ve ended up with lips like Mick Jagger and no feeling down my right side. Ok, I exaggerate, but I wouldn’t be me if I didn’t.

For those of you in the same position as me (not walking around like one of the undead, just considering dieting is what I mean by that) you might like to read the following guidelines from the National Institutes of Health Clinical Center:


These diet guidelines will help you keep your lithium blood level stable:

• Drink 8 to 10 glasses of water or other liquids every day.
Drinking plenty of fluids is important while you are taking lithium. Not drinking enough liquids may cause lithium levels to rise. You may need even more liquids during hot weather and during exercise when you sweat heavily. To avoid weight gain, select water and other non-caloric beverages.

• Keep your salt intake about the same.
Do not begin a low salt diet without first talking with your doctor or pharmacist. Do not suddenly increase the salt in your diet either. Less salt may cause your lithium level to rise. More salt may cause your lithium level to fall.
Try to keep your intake of these salty foods about the same from day to day: luncheon meats, ham, sausage; canned or processed meats and fish; packaged mixes; most frozen entrees and meals; soups and broths; processed cheeses like American; salted snack foods; soy sauce; smoked foods; olives, pickles; tomato juice; most fast foods; salt, salt containing seasonings and condiments like ketchup and meat sauces.

• Keep your caffeine intake about the same.
Keep amounts of coffee, tea, cola, and other soft drinks with caffeine about the same from day to day. Less caffeine can cause your lithium level to increase; more caffeine can cause your lithium level to decrease.

• Avoid alcoholic beverages.
Check with your doctor or pharmacist about this issue and any questions you have.

• Take lithium with food or milk.
This will reduce possible digestive side effects like nausea, vomiting, diarrhea, and abdominal pain.

25. What’s Wrong With Wiping Your Nose On A Nun?

A few people have mentioned to me now how lithium has affected their weight and that they find it harder to lose that weight once it’s on. I don’t know if this is because the medication affects metabolism or perhaps makes you crave certain foods. I know I have recently been told my entire diet revolves around eating sugar. It’s in everything I drink, eat, snort… just kidding. You can’t snort Smarties. I’ve tried. And the doctor has put me on a really strict diet to help reduce my risk of diabetes and other nasty symptoms.

Oh believe me, I fought it. I argued that I get enough exercise jigging about during my manic episodes and that I suffer from rapid cycling, which sounds far too close to a form of exercise for me to want to take part voluntarily.

But I lost that argument. So I’m sitting here typing next to a bowl of something green (that can’t be natural, surely) and the prospect of a dinner of aromatic lentils which even the cat wouldn’t go near the last time I prepared them. I’ll let you know if I actually lose any weight. I’ve been on the diet for nearly 2 weeks now and I complained to my colleague yesterday that I’m sick of eating tasteless salads. He told me that dieting is a journey of discovery. That I should look at it as a way of enhancing my self-discipline (how can you enhance something you never had in the first place?). As far as a journey of discovery goes, I’m quite looking forward to discovering just how many chins nature intended for me to have.

http://www.dailymail.co.uk/femail/article-2602630/I-pooped-like-freaking-clockwork-What-happened-one-family-went-sugar-free-diet-one-year.html - Check out this article on how one family managed to get through a year on a sugar-free diet.

I’ve also started writing a bit more lately, which is nice. I think. I’ve actually found that when I try to write from the heart I usually end up writing about childhood. I had a rough time as a kid, as do a lot of people. But it would seem that if I start to dig deep it’s always that time that pops up and grabs the pen.

It’s been emotional writing about events I had hoped I’d put behind me but in some ways the fact that I’m an emotional wreck (crying on the train, in the supermarket, on that nun, etc) is good because this time I have a reason for it. You know what it’s like, right? Being down, crying for no reason, feeling like life is just too hard sometimes. And usually that’s all down to the chemicals in your brain. So when you have a REASON for reacting that way, it’s almost comforting! I’ll let you know how it goes. It may be my big break into writing and this time next year I’ll be collecting my BAFTA (I’ve already written my speech. Hey, writer’s write).