Monday, April 6, 2009

And my diagnosis is...

The DSM IV has various stratifications of this term, "Bipolar Disorder". I happen to be Bipolar Disorder II. It's not what you think. It's much more than the new and improved version of plain old manic-depression. You see, Bipolar Disorder I are the crazies that scare the world shitless. They are the guys that try to bankrupt the casinos after watching Ocean's Eleven, they're called upon by God to serve a higher purpose and throw of the chains that enslave humanity by breeding the platypus, sometimes they go on killing sprees with smiles on their faces, their motor skills are so fine tuned that they can walk blindfolded down the interstate and move out of the way of cars traveling at speeds of 80mph, they're the crazy women that happily go skipping of cliffs, champagne bottle in one hand while donning their wedding dress. Ok, you get the point right? They're the ones that make the news.

You don't hear much about the people like me. I'm Bipolar Disorder II. I'm not prone to flights of fancy and your delusions of grandeur brought on by Bipolar Disorder uno. My highs aren't so high, but my lows go much deeper. My highs only get to what is called "hypomania". Think of this as mania lite, "now with 30% MORE sleep!" There's not really any middle ground for me. I'm either a little bit higher than I should be or I'm way down depressed. With typical BPD, doctors are afraid their patients are going to "become a threat to themselves and others" so they over-prescribe a myriad of mood-stabilizers and anti-psychotics to suppress these dangerous, selfish, and compulsive thoughts and behaviors. I have been on such drugs: Depakote, Zyprexa, and Seroquel. All of these robbed me of my creativity, independent thought, brilliant memory recall, and drive. I became the world's happiest vegetable. I went from an A- student who never went to class because I was too depressed or too "activated" to becoming a B+ student who went every day and had to struggle to grasp the most basic concepts. I also gained so much weight so quickly that at 19 I got stretch marks on my sides (hot imagery, I know).

I was first diagnosed with Major Depressive Disorder when I was 18, almost 19. I was having panic attacks, trouble getting any work done, could barely function socially for fear of the next panic attack. I was too depressed to get out of bed most days. I made my doctors aware of my past drug indiscretions and he prescribed Celexa. Celexa at this time was the mildest of the SSRIs (Selective Serotonin Reuptake-Inhibitors). It was meant to increase levels of serotonin in my brain and stave off the depression and anxiety. It did just that and it worked rather well for about 4 months. Then it just stopped working. I experienced side effects with it that were pretty common: dry mouth, sweating, persistent yawn without being tired, insomnia, increased energy, and I had a little trouble getting off. At this point I could fuck for hours and not get off. My dick was bruised as was my girlfriend's ego. Being that I don't lie to my parents, doctors, or lawyers, I told my doctor. He suggested we switch to Lexapro. It was *NEW* and shiny, and it was an isomer of Celexa, could be administered at lower doses with higher efficacy. It wouldn't have all those nasty side effects. He assured me...

Two weeks on Lexapro and I was noticing some strange effects. I was able to get off during sex, but I was really distressed. I would break down into tears at things which ordinarily I wouldn't find disturbing. While running the meat slicer at work I thought, "I wonder what it would feel like to run my arm down the blade?" What the fuck? Where did that come from? Odd... While looking off the balcony, across a field, I looked down. I thought, "I wonder what kind of design my body would make if I jumped off and became a splatter paint on the concrete below?" and I would chuckle. Then while driving I had equally disturbing thoughts about driving into the support pillars of an overpass. I shared these thoughts with my girlfriend. I told her that lately things like that had been crossing my mind. I wasn't suicidal, I assured her, but these really weird thoughts kept passing through my mind. She did not laugh. She was mortified. Then as CK was prone to do, she broke into histrionics.

"WHAT? How often do you think shit like this, J? That's just not fucking healthy! That's not normal! We're taking you to my doctor. Dr. Klein is a good man and he'll get you straightened out. Lexapro is not working for you. Besides, your doctor's name is Steve Martin. Didn't that tell you something? I'll call him and make you an appointment or you can just go with me on Thursday. Jesus, now I have to worry about every time I go home, coming in and finding your dead body."

My doctor's name was in fact Steve Martin, but he was a nice guy. We go to see Klein, CK was the 2nd of my girlfriends to have seen him. He knew me by reputation already. Apparently The Good Reverend had opened her mouth about every instance of ecstasy taking and pot smoking we had done. After a little interrogation of Katy and I, he was kind enough to give me 3 months worth of samples of Wellbutrin XR and told me it was a cure all for the kind of depression I was experiencing. Boy, was he right. I began taking Wellbutrin and the effects were immediate. I was full of energy and creativity, I found myself smoking fewer cigarettes, and I wasn't prone to raiding the fridge, something I frequently do when I'm depressed. Instead I was only sleeping for 3 or 4 hours a night, all of my class work was finished before deadline, and I felt very confident.

After the third day of taking Wellbutrin, I was making a lot more money selling cocaine. I attributed this to the fact that I wasn't sleeping very much, but I didn't care. I was happy. CK noticed that my ego was becoming a little inflated, that I was a little more hostile to people, talked down to them, and was really mean. I didn't care if they didn't understand. They were stupid, slow, and just another inconvenience. They couldn't go fast enough and they were always in my way, slowing me down. I hadn't noticed that I had stopped smoking, but I did notice that I couldn't stand to be in the same room with a lit cigarette. The smell made me nauseous. I tried smoking one for fun, because I genuinely enjoy the way they taste. It felt like sand paper was being rubbed against my throat and that something acidic was filling my lungs, my head spun, and I threw up in my mouth a little. Definitely effective at getting me to stop smoking.

After the first week, I had to force myself to eat. I would only eat when I felt my blood sugar was so low that I was going to pass out. Usually this happened after class while working at the deli. Doing all the prep work, I would just make myself a salad wrap and devour while doing counts in the freezer. Also, the freezer was the only place where I didn't feel like my skin was on fire. It was the only place I could be where I wasn't sweating profusely. It was nice. I started isolating myself from people as I saw them merely as sources of frustration. I was surrounded by people who couldn't think or move fast enough. My tongue was getting sharper and my temper shorter. Poor CK, she endured a lot. Mostly she endured me fucking her, all the time. No drug on the face of the earth has skyrocketed my libido like Welbutrin.

After two weeks of Wellbutrin the good doctor recommended I go from 150 to 300mg. I did as were his orders. The 150mg is the starter dose just to get you used to it. The 300mg is the maintenance dose. Things became stranger and stranger. Everyday seemed to get longer and longer, all the while my patience got shorter and shorter. I looked in the mirror and noticed that I looked very thin. Even I could see where I had lost weight. I stepped on the scales and had indeed lost weight. I was no longer 215lb, I was a solid 200. I had lost 15lb in two weeks. I weighed less than I did when I graduated high school. In the time since graduation, I had developed and kicked a cocaine habit and had stopped smoking. How is it possible that I had lost weight? The next two weeks were a blur to me. I know that I stoped sleeping in the conventional sense. I would just take the occasional power nap. I was staying up all hours of the night, associating with other drug dealers. I gained connections for any drug I could have wanted, although, I had no desire to use any of them.

After two weeks of a 300mg dose regimen, I stepped on the scales. I now weighed in at 185lb. I had lost another 15lb in two weeks. My manager at work mentioned how thin I had become and asked me if I was using cocaine. This really took me back because I fueled that deli with the cocaine that made its workers competent. She made me particularly uneasy with the questioning. I had in fact, not been using cocaine, but when I lifted up my shirt, I could count my ribs. I looked pretty sick. I had dark circles under my eyes, and my cheek bones protruded from my face. I took a physical exam at the university. My resting heart beat was 93bpm and my blood pressure was 133 over 85. They told me this was not healthy for a 19 year old. I believed them.

The next 5 days were a complete blur to me. I do not really remember much other than becoming completely delusional, going from no money after having paid bills and in a single night, I raised $500, used that money to buy a quarter ounce of methamphetamine, bagged it up into quarter grams, still not using any of it, attended a party, turned that $500 investment into $800 and left the party with 2.5g of meth, used that money to buy a quarter ounce of cocaine, went on a shopping spree, and still had $200 in my pocket. I was riding with Sarah and CK and they told me we were going to go to CK's mother's house to house-sit while she was out of town. I remember the drive there because Sarah and CK were terrified at my erratic behavior. CK kept asking me if I had been blowing coke or smoking meth. I answered honestly that I had not. She eventually put 2 and 2 together and recognized that I was having a full blown manic episode. Upon arrival to her parent's house she noticed how I was very agitated and couldn't focus. The details of that night are very blurry to me as I don't remember much. Some how, even though I whole heartedly disagreed with her, she convinced me to take a sleeping pill. I took it and nothing happened. I took another, nothing. After 3 hours of delirium I became stark mad. I was completely delusional, having hallucinations, and talking in complete nonsense. 45 minutes after my third dose of trazadone, I fell out. I woke up 4 hours later and had that same energy. CK had taken the liberty of scheduling an appointment for me. After we arrived, she explained the details to my doctor. I was very quickly diagnosed as Bipolar Disorder and given a prescription for Zyprexa and Celexa.


  1. whoa. i definitely wouldn't say i opened my mouth about every instance of our drug use. i was rarely seeing klein at that point; maybe once every 6 mos. so i'm sure i couldn't have remembered every instance, even if i tried. of course, i don't remember what i did or didn't tell him, but i can say that i'm thoroughly unimpressed with his confidentiality policy if he was willing to tell YOU (or anyone!) things i'd shared with him in private sessions. shrinks aren't even supposed to admit that a specific person is their patient.

    also, i thought we agreed on "reverend" as my pseudonym?

  2. I completely forgot about that Reverend... I'll make a change on that and while Klein didn't say anything about you having been a patient, he asked me if I knew you, how I knew you, and his next question was directed at CK, "Tell me about your recreational drug usage. Any ecstasy or marijuana?" Then he cut his eyes back at me.