Tuesday, August 16, 2011

Mania, Defined.

maniac [ˈmeɪnɪˌæk]
noun
1. a wild disorderly person
2. a person who has a great craving or enthusiasm for something, i.e. a football maniac
3. (Psychiatry) Psychiatry obsolete; a person afflicted with mania
[from Late Latin maniacus belonging to madness, from Greek]

That terminology bothers me. "Afflicted" with mania. Granted, the psychiatric definition of a maniac is archaic and not blanketed upon patients with bipolar disorder anymore. Hell, the label "manic-depressive" isn't widely used anymore either, clinically *(unless you're Dr. Lips, one of my bosses, who, along with his fashion sense, is still in the 1970's). I don't consider myself afflicted with bipolar disorder. It's just a facet of my personality that is generated by a chemical imbalance in my brain, a treatable disorder that is currently in a pharmacologically-induced remission.

I was talking about bipolar disorder with TOC (my middle-aged soul brother/boss/doctor)yesterday after my cardiac checkup, and discussed the same with my mom later last night. I admitted to both of them what a delicate dance it is to keep me sane. And how hard it's been. How bipolar people function and relate in the world. This chemical imbalance in my brain...a lot of people want to know who I used to be and what I used to act like. Thus, an vivid illustration:

Apart from the fact Dr. K and I have been oil and water since the day we met, I must give credit due to him figuring out my mental malady. He tried multiple combinations of antidepressants (Celexa, Lexapro, Zoloft) with antidepressant boosters (like Abilify) when I insisted I wasn't depressed all the time. Not a good, compassionate listener, our Dr. K. (I'm in the market for a new psychiatrist, if for no other reason than that creepy poster of Icarus Dr. K has in his waiting room, but I digress.)

Just the opposite, typically. I described to him what my life was like over the last several years: frequently paranoid, often suicidal (2 veiled, failed attempts), cutting my right inner forearm with a steak knife regularly, overspending, over-sexing, over-drinking, over-drugging, overeating, weirdly creative, full of grandiose ideas that got shelved, able to function on 2 hours of sleep and get a crapload of shit done, but unable to concentrate my full attention on any given responsibility. I gained a fuckload of weight and was 216 lbs.

Before Luke was born, I'd spent a year, 1998, lying on the couch, drinking Kool-Aid, watching reruns of "ER," smoking cigarettes and taking a shitload of narcotics, on disability from work. A whole year. My husband was dumbfounded and didn't know how to help me, even after coming home multiple nights from work to find me virtually catatonic and unresponsive. By the grace of God, I kicked narcotics cold turkey in February of 1999 and, after a miscarriage in August of '98, I got pregnant with Luke in May of '99. After Luke was born in 2000, mania was still there but was coupled with short bursts where I was literally just too tired to roll out of bed and take care of my son. When Luke was 3 or 4, I started drinking, quickly becoming a full-blown alcoholic. Whatever it took to numb the insanity.

Giving no thought to the ramifications of a life-altering decision, I impulsively and drunkenly left my husband in March of 2007. I was pulling all kinds of batshit that had been going on for upwards of a decade, in reality, starting in my early 20's in dribs and drabs. An unstoppable fucking crazy train. And no one fucking recognized it, stepped in and dragged my ass to a doctor or rehab. For that, I tend to blame my ex-husband, as he was in the thick of it and just watched me destroy our family. (But I'm a forgiving person and that's water under the bridge. Craig just didn't know WHAT to do. And in hindsight, that's ok. I went through all that for a reason, God knows.)

After my divorce, though I was finally clean and sober, my (former)boyfriend wanted to break up with me because he was (rightfully) convinced I'd gone insane. I was convinced he wanted to chop me up and throw me into Lake Michigan. Seriously. (Which now makes sense given who he is, but that's another story for another time.) My behavior was too erratic for him to handle. I was incapable of working a job. I forgot nearly all of Luke's obligations, where to be when, et al. I was drumming, and would make up great fills and awesome parts, but was unable to remember my parts no matter how diligently I practiced my art. Everyone around me was growing increasingly frustrated with my behavior.

I was untreated that whole time, not seeing a psychiatrist until I got out of alcohol rehab in February of 2008, when I was assigned to Dr. K. I got very good at hiding my crazy from my family and friends but inside I was rapidly crumbling into pieces. Living in side my head was a bitch.

Go and visit some of those blogs from 2008. They're really creative and well-written, but they MAKE NO SENSE. They're a cacophony of disjointed thoughts rambled on page after page. They all made perfect sense to me at the time, but in retrospect, holy crap.

It took Dr. K 2 years and countless medication combinations to arrive at the conclusion that I was indeed bipolar, when he settled on a successful combination of a mood stabilizer and an anti-psychotic (Lamictal and Geodon, newer drugs) with an antidepressant booster (Zoloft).

True, getting clean and sober helped out a bit, though I was still cutting (and wearing long sleeves a lot). Once the Geodon and Lamictal kicked in, and with some cognitive behavioral therapy, I stopped cutting. (I don't think I've cut since around February of 2009, though that's all sort of foggy.) The urge to cut is still there, as is the impetus to abuse drugs and alcohol. But nowadays, I function on a relatively even keel, though I'm prone to manic episodes every now and then, which are few and far between. I've been working for the medical practice for 2 1/2 years. (I think I got my job literally a month after I started taking bipolar meds.) I'm a really good mom. And daughter. And friend. And musician.

I'm keenly aware when I'm manic, and I usually tell Dr. K and we adjust my meds, and it goes away after a few days with no lasting complication. In the interim, however, my co-workers tease me, my mother worries frantically, and Luke just rolls his eyes. I still have intermittent delusions of grandeur and crazy ideas that never make it to fruition.

I'm writing again, which makes me happy and is a positive coping mechanism for my mental illness, though what used to take me 15 minutes to write now takes an hour, which is frustrating, and I find myself editing a lot, more sensitive while putting my thoughts out in public.

I'll always be the neighborhood psychotic drumming junkie, but I've grown to accept that as just part of what makes the whole Andrea, who is not delusional in saying that she's awesome. I am med-compliant; I still need pharmaceuticals to calm me down (a point of huge contention with Dr. K and I right now) and I live life with little abandon.

Andrea. Mania defined.

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