Bipolar Disorder Part 4

[RonPrice]

8.1.3 Perhaps the one advantage of my wife’s ill-health, if there is any at all, is that it allows me to focus on her problems, to talk about her problems, when the subject of health and fitness comes up in our personal and community life as it so often does, has and will, I’m sure in the future as long as she continues to suffer from her illness. This keeps the focus off of my own disability and I can talk about my need for exercise and diet, sleep or one of many other needs, thus avoiding the reference to my own disability, its stigmatic aspect and generally people’s disinclination to discuss it when I bring it up if, indeed, I bring it up at all. My many years of experience tell me the main reason for people’s disinclination to discuss BPD is an inability to know what to say, among other reasons which I don’t want to go into here.


8.1.4 Consequently, people have little idea of the physical problems I face and much more of an idea of my wife’s problems. I don’t mind this for I am not particularly interested in talking about my disability. After 60 years or perhaps 40, depending on how the aetiology of my illness is defined and described, it has become somewhat tedious in the telling and the thinking. It is well known that people with BPD are disinclined to talk about their problem in public. Such a situation has the disadvantage that people have little idea of the battles sufferers from BPD face. When all is said and done in life anyway, we all face our battles alone—hopefully with a little help from our friends as the inimitable Joe Cocker used to sing over forty years ago in a song written by someone else and now sung by many a modern artist.


8.1.5 This lack of public admission or opening-up can have and has, though, a number of disadvantages. I have a core of friends with whom I can share a broad range of intimacies. Mostly, though, these friends do not tend to inquire and I do not tend to expose these battles, not now nor in the past, except to a limited extent. I have little need to ‘dump’ on people, as we used to say, not after all these many years anyway. On occasion and with encouragement I do open- up. In the last three years I have been ‘coming out,’ as they say, but mostly on the internet at mental health sites. In the day to day round I keep a lid on the subject for the most part.


8.2 Psycho-Social/Family:


8.2.1 My wife has a story here as long as your proverbial arm but to dwell on it, even to describe it briefly, would lead to one of the many possible tangents and their prolix labyrinths. I could go down many burrows as Alice did in Wonderland as I go about writing this statement, but I shall stay with the clinical, the descriptive, focus on my experience of BPD.


9. Creativity


9.1 Writing:


9.1.1 When I finally came to accept lithium without any mental reservations by the early 1990s; when I began, too, to see the end of my teaching career on the horizon by the late 1990s and what I hoped would be a coincidental reduction in various forms of frustration in marriage, career and community life that I had experienced in many and complex ways for decades, at least as far back as the 1960s insofar as my BPD is concerned---I began to write poetry a great deal. One could say I was obsessed; my wife certainly would use that word and I have come to accept that word as a realistic description of my behaviour, especially now that I am retired and now that I devote all of my waking hours when possible to reading and writing. The drive to create never seems to leave me and other activities, domestic and social, serve to provide a useful backdrop, respite, diversion and alternative, coping tools and possibly crutches, to the constant demand that comes from my inner and my psychosocial world.


9.1.2 The demand to create is relentless, obsessive, compulsive and disinhibited, but, on the whole a paradoxically relaxed and energetic activity: "emotion recollected in tranquillity," as the poet Wordsworth once put it. Since the early 1990s until this year, 2007, perhaps a total of some 15 years, the output has surprised me. Again, to go down this track and describe the process in even a cursory manner would take me into another one of Alice’s borrows where I do not want to go and where I would take myself and readers away from the central theme here—this BPD.


9.1.3 Fame and fortune have not come my way, but the act of writing is enough of a motivator. The fluvoxamine, since 2001, has enabled me to work after 11 p.m. and into the early hours of the night, after 2 or 3 and sometimes as late as 4 or 5 o’clock, if I desire---without the black moods. If I wake up at 4, 5 or 6, say, after being asleep for whatever length of time, a low degree of emotional blackness/worry is present. The transition to sodium valproate has had its problems; this proved to be the case after several weeks of one medication and ten days of the other. As I write this latest draft in December 2007 my sleeping patterns have become more regular than they were even two months ago. My sleeping patterns in April and May of 2007 had become more chaotic than they had been since the 1960s; they have altered again and again over the years; the need for regularizing them has not gone away although, as I say, in the last two months sleeping patterns are normalizing again. This new medication, resulting as it did in quite an unsettled sleeping pattern for several weeks, is finally giving me some steadiness, some settling, some routinization of habit and it is my hope that an old normality of sleeping routine will result soon. But this part of the story is ongoing and I’m sure there will be more to say at a later date on sleep patterns.


9.2 My Creativity in a Psycho-Social Context:


9.2.1 My creativity is part of an obsessive compulsive disorder(OCD); but this is only a theory. Whatever my OCD tendencies are, they have never been treated and they have become part of who I am; I accept them, as do members of my family, as a sort of eccentricity. When brought face-to-face with them in an extreme form, as they were in the recent medication shift, when I was only on sodium valproate within this new medication package, my OCD can be an extremity that can be quite frustrating to others. Emptying the garbage many, many times a day, doing the dishes to keep the counter in a pristine state, squaring all the bits of paper around the house are good example of this OCD. These manifestations of an OCD have lessened to a significant extent and are now in the normal range of acceptable social behaviour—well—mostly. I will say no more about it here. Anyone who lives with me is often troubled more by my OCD than other aspects of my poor mental health. Again, this OCD is a tangent to my BPD; my psychiatrist says I do not even suffer from OCD and so I shall leave further comment out at this stage.


9.2.2 The issues of career, various frustrations and anxieties, problems in relationships that we all have in one way or another, the difficulties involved in moving from place to place as I have done over the years, stresses and strains in marriage, dealing with the ill-health of my wife and others, while important to me and to my story in a wide variety of ways are somewhat tangential to the central theme here of my BPD. They are all tangents to the main story line. I do not want to underemphasize or overemphasize these other and important aspects of my life in this statement. They are important, but as I have often said above, they are tangents to the theme, however important they may be. They have all been, each in different, complex and mysterious ways, contributing factors to my outburst of creative writing in the last 15 years(1992-2007).


10. Concluding Comment: The Road Ahead


10.1 General:
(see next instalment #5)

[RonPrice]

This account is far too detailed for many readers. Just click me off your radar when my story is for too detailed for your general interest--it goes without saying.-Ron Price, Tasmania
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10. Concluding Comment: The Road Ahead

10.1 General:

10.1.1 This brief and general account, at least brief in contrast to a whole book that some people write on the subject of their bipolar experience, summarizes both the long history of this illness and where I am at present in what has been a life-long battle. I think it is important to state, in conclusion, that I possess a clinical disorder, a bio-chemical imbalance, having to do with brain chemistry. There is an upset in the balance of different neurotransmitters known as excitatory and inhibitory neurotransmitters which are involved in sending signals in the brain. This lack of balance is seen as central to the disorder. Lithium and valproic acid work by restoring the balance of these neurotransmitters in the brain.
Increasing medical and diagnostic skills and knowledge since the 1950s have helped those with BPD so that they are being treated better than at any time in history. With an increasing range of mood stabilisers, anti-depressants and anti-psychotic medications on the market the perturbations of BPD have been more effectively treated.

10.1.2 I feel I am a success story inspite of any tendency to gloom and doom that occupies the content of this long essay. Everyday one makes progress or goes backwards, although often what we sense is stasis. Every step we take may be fruitful or retrogressive but, again, so often it seems like nothing has happened at all. Whatever stretches out before you—and I—is an ever-lengthening, ever-ascending, ever-improving path whose journey will never end. Churchill said that it is this process which, far from being discouraging, only adds to the joy and glory of the climb. Of course, not all of us can be a Churchill and even that Old Battler had to fight the Black Dog and it was not always with success. It seems to me that, however unfortunate it is for you or I to be discouraged and however dismal the outlook appears, labouring serenely, confidently and unremittingly is a useful goal to shoot for—little by little and day by day.

10.1.3 Depending on what study you read some 3 to five per cent of the population suffers from this illness. The extremes of this illness as I had experienced them before 1980 were largely treated by lithium carbonate from 1980 through the 1990s to 2007. But in the 1990s and into the new millennium new medications and, indeed, other treatments became available. The story of all these medications and treatments that have become available is not included as part of this account. I tried many alternatives in my efforts to obtain healing in the years from 1962 to 1980 but, by the time I retired from full-time work in 1999, I was not inclined to experiment with alternative treatments.

10.1.4 The prescription of lithium(1980) and the addition of fluvoxamine(2003); the changeover to sodium valproate(2007) and venlafaxine(2007) in April/May 2007 each had its own story and its problematic for periods of time in the main for less than two months each. By June/July 2007, after 7 consultations with my psychiatrist in the January to July period of 2007, it was obvious that the new medication package was giving good results. My psychiatrist and I agreed that, unless some problems arose, I would not come for any follow-up visits. This is, then, my latest medication package, my most recent cocktail, as it is sometimes called in the psychiatric vernacular. In 1980 I had settled on lithium, just the other day it seems in retrospect, although it flowed through my veins, was part of my brain chemistry to put it more accurately over some 28 years ago. And in the last 18 months I have worked out—thanks to my psychiatrist--a new and quite satisfactory alternative package.

10.1.5 Finding the right combination of meds can be a discouraging process but, thanks to the professional expertise of a psychiatrist, a clinical psychologist or, perhaps, a psychologist, assistance is available to sufferers from BPD. In my case I had a psychiatrist who has specialized for over three decades in working with people who have BPD. I feel I am on the right meds, as medications are often called colloquially. I am not inclined to tempt fate and try some other package, at least not yet. Trust and confidence in one’s psychiatrist, one’s specialist, is a critical variable in this whole exercise.

10.1.6 The story of the history of my medication-regime change is not over yet, even after 18 months of the shift. In November 2008 I reduced the effexor level from 75 mg to 37 and ½ for two weeks and then nothing at all on 10/12/’08. These most recent changes in the quantity of anti-depressant medication, that is of effexor or venlafaxine, has produced no change in my behaviour or symptoms. I will remain on NAVAL until some advances in chemotherapy and psychiatry come my way or until I feel the need for a change due to some symptoms raising their head again. As the story unfolds and my experience under this new regime advances I will document it here as succinctly as I can. The major side effects of mild diarrhoea and drowsiness.

10.1.7 Other factors that describe my personal situation I have outlined above and they need to be taken into consideration. These factors provide a thorough overview of my present medical, social and psychological context. This overview will help others in various ways, ways I have also outlined above. I have gone into the detail I have above because I wanted to give readers some idea of the extent of this illness, its subtle and not-so-subtle affects and provide a longitudinal study, the kind of study one rarely sees except at a few internet sites and in books written by people who suffer from BPD.
---------------------Part 5 To Come At laterDate---------

[RonPrice]

This is enough of my story. If in the next year or so there is some feedback to indicate more of the story would be useful, I will post the4 next instalment.-Ron Price, Australia