Thank goodness for Lithium!

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The treatments for bipolar disorder were initially discovered serendipitously. Lithium for example remains one of the most frequently used and effective treatments for bipolar disorder, but lithium has a number of different targets in the brain and so we haven’t learned very much specific information from lithium’s effect. Some of the things that lithium does are now targets for a great deal of research. One of those things is that lithium will decrease the function or change the function of some second messenger systems. And so it will give a way that you could have multiple neurotransmitter systems affected or damped-down by just the one effect of lithium. Another thing that lithium does is that it has very robust neuroprotective and neurotrophic effects. It’s thought that lithium may partly have its effect in the brain by restoring the structure, some of these structural abnormalities that occur in bipolar disorder. For example, the reductions in grey matter volume that exist in the hippocampus and the medial prefrontal cortex, there is now some evidence that suggests lithium can actually reverse those changes. Similarly in those experimental animal models where you’ve got repeated stress causing atrophy in the same structures, lithium has the capability of reversing those atrophic changes. So, one impact of lithium might be on the neuroplasticity of the brain.

http://www.dnalc.org/view/2085-Lithium-how-it-might-protect-the-brain.html

At 25 years of age, bipolar disorder got me.

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1984, My brother was diagnosed with this wretched disease. None of my family knew whether we were coming or going. My poor mother was devastated. This was her favorite child, her precious baby Farooq, who was 20 at the time. We were all under so much stress, that my mother went into a severe depression and I too, started slipping into a depression. My depression became so severe that I felt like I had completely lost myself. There was nothing of Samina left. Not her laughter, not her interest in life, not her love of music or books, nothing at all. I didn’t know what was happening to me and I kept thinking “How do I live without myself?” I started thinking about swallowing a whole bottle of my mother’s tranquilizers which I had hidden in my room. I thought about it daily for weeks. No one was paying any attention to me, we were all totally involved in the disaster that my brother’s life had become. He did not want to see psychiatrists, he did not want to take any medication. He went into a full blown manic phase, so much so that he was out of touch with reality. He had to be hospitalized with a 3PC (a three physician certificate, used to hospitalize a mentally ill patient by force.) In the hospital, they gave him lithium and major tranquilizers and he became totally his normal self. Once he was discharged, he threw away all his medication and of course started to get sick again. He went to my step dad’s office and told his secretary to tell him to “call off the dogs.” Classic paranoia in the psychotic (out of touch with reality) phase of mania. Again he had to be hospitalized. His doctors worked with him, trying to explain to him that he could not control his own brain. He must stay on his meds. As soon as he was released, he again threw away all his meds, insisting he could control his own brain and didn’t need any medication. We all tried to tell him he needed to keep taking lithium and other meds his doctor prescribed. But he wouldn’t listen. I was steadily going downhill, and one day told my mother and step dad that no one was looking out for me and that I didn’t feel well. I was put on antidepressants (without lithium) because no one knew at that point that I too had bipolar disorder. I had, at any rate, decided never to attempt to take my life. It was amazingly because of a song I’d heard on the radio by Wilson Phillip, called “Hold On For One More Day!” I literally took that song to heart and in a way it stopped me from doing anything to myself I would later regret. Once on the antidepressants, without lithium, I started to become manicky. Talking a lot, listening to music very loudly, shopping, driving extremely fast. And, in the middle of all this, I a job in New Orleans, I drove my car down there. Nejat, who was my boyfriend at the time, was doing his postdoctoral fellowship in New Orleans, and I went there to work and join him. Once I got there, the antidepressants pushed me into a full blown manic phase. I became out of touch with reality. I thought everyone was trying to prove that I was schizophrenic. I thought the shower was bugged and people were listening to everything I did. Again total paranoia. I thought there was an under world gang of people who were following me to harm me and Nejat. I thought everything that anyone said was just dialogue for my benefit. I once called Nejat’s boss, telling him to leave Nejat alone. I told hime I knew about his designs on Nejat. I also, bizarrely, told him about the sweet olive bushes and how good they smelled… Needless to say, the man had no designs on Nejat and was married with kids! Nejat didn’t know what was going on with me, and I was pretty far gone by then to help myself. Finally, one day at 3 in the morning, I called my psychiatrist. His answering service said it was too late to speak to him. I unloaded a barrage of insults and pretty bad language on the woman who had picked up the phone, because I was sure she was in cahoots with the people who were trying to prove that I was schizophrenic, when in fact I had bipolar d/o. She must have realized that I was very sick and had my psychiatrist, Dr. Roniger, call me back immediately. I told him how people were hounding me and trying to prove I was sicker than I was. He asked to speak to Nejat and told him to take me to the emergency room IMMEDIATELY, as I was in a full blown manic phase. I packed my things and I even packed all of Nejat’s things, including his toothbrush, (the poor guy had no toothbrush the next morning) because I had to protect him from all these nefarious people who were trying to hurt us. On the way, I saw a man fixing his car, with his hood up, and I was sure he was trying to give me messages! Once I got to the hospital, they signed me in, and of course told Nejat to leave. I looked for him until they gave me huge doses of major tranquilizers, and put me in a group ward. I kept trying to get up and find Nejat. They had to put restraints on my arms and legs and tie me to the bed, I remember all this. Then I must have passed out from the meds. In the middle of the night, I awoke to find myself in a strange place with strange looking women. One woman, Myris, had tried to slash her wrists and they were all bandaged up, it was quite frightening. I had no idea what I was doing there. The next morning Nejat came to visit me and he said he cried when he saw me in restraints and looking as white as a ghost. I was in the hospital for one month. 30 days. For a while, I started thinking I was Alice in Wonderland. Dr. Roniger and Nejat were both the white rabbit. There was a young guy there, he always wore red tee shirts, he was the Queen of hearts. There was a male nurse, Albert, with red hair and a wide smile, he was the cheshire cat! Once, I went into another patient’s room, and it was such a mess that I cleaned it all up!!! Not something I was really supposed to do… Slowly all that started to pass as the meds worked. However, the major tranquilizers gave me, among many other side effects, a mask like face, and akathisia, which is a distressing sense of restlessness. So that when Nejat came to visit me, which he did everyday (!) I looked like a rigid mask and could not show him how happy I was to see him. Because of the akathisia, I must have walked about 500 miles around the floor where I was hospitalized. I used to have a dress that apparently looked like a nurse’s uniform, because Mr. White, another patient, always said to me when I was marching “Nurse, you do your rounds really fast!” There was Rachel, a very troubled teen, who actually tried to attack me once. There was Mr. Bartley, whose wife had abandoned him because, I think, he suffered from dementia. George, the Queen of Hearts, wrote beautiful poetry and went to high school everyday and had been in foster care and was sad that he didn’t know who his parents were. There was a young boy, Joseph who was a troublemaker. There was a young man Guidry, who though Nejat was my father and always called him “Sir” and apologized to him endlessly, saying he hadn’t touched me!!! Damn straight he hadn’t touched me, I would have clocked him if he’d tried! So I got better and finally 30 days after I’d been admitted, and after daily begging to be released, I was released. And I just took up my life where I’d left off. I went back to work, started cooking and having friends over for dinner. No side effects, no remaining symptoms. This was in March 1986. The next time I was hospitalized was in December 2009, and this was because my psychiatrist took me off lithium and put me on a drug that is totally ineffectual against bipolar 1 (the more severe form which I have) called Lamictal. I was on it for about 6 years and finally it pushed me into a full blown manic phase. And I flew myself down to New York City and admitted myself into the Psychiatric ward of Columbia Presbyterian. But not before being held against my will in CPEP (Comprehensive Psychiatric Emergency Program). A hellishly depersonalizing, awful, prison like place. But that story, another time.

GRACE

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Grace.

Last night in my dream, I saw you

You were there, in my sanctuary, my idyll, where the sun shone bright and there was the sound of sweet birdsong.

You were there in my shelter, where the storm clouds had passed, and the day, bright and sweet, newly dawned.

Flowers with adorable faces of children here grow, throwing playful glances your way, you are free to rest and play, to let you know.

Here my father sun’s golden rays warm me, they caress my face as a mother’s hand caresses her child newly born.

Here Mother Earth supports me with her gentle, quiet, sustaining strength, so I can rest my bones so careworn.

Here, in this place, where a peaceful, gurgling river flows, I came last night to see if I could find you full of hope.

I had been looking for you for so long, yet till last night, you had eluded my grasp sure and strong.

Finally, I saw you in this place to which I go, where only days of pure goodness and joy surround me.

Where night blooming jasmine, and a wondrous, precious rose so rare, their perfumed garlands weave around me.

Here I am enveloped in safety and warmth and no one can hurt or harm me.

Even when dark night comes to this place, it comes gently, with promises of sweet rest and repose.

it is a silent night, full of restful sleep and such fantastic dreams, you can inhabit them all night long.

The full moon shines it’s calm, serene, white light here at night, lights your dreams as with a fairy orb.

Here, I am protected by the very trees that watch over me like strong, stalwart, silent sentinels.

And the stars glitter like jewels, winking playfully and teasing, laughing with their playful, little faces.

Last night, when I curled up in bed and came to this my magical place, you were there!

I saw you and said ” Hello. How are you? Where have you been? It’s been so long.”

And you said “Hello. I’m fine. I’ve always been right here. I was waiting for you to cast away your fear and look for me with your beautiful, big eyes, so fearless and bright. I have been here, waiting for you the whole time.”

And I knew you were telling me the truth.

And I knew we’d meet again… soon.

I am sorry.

One of the worst things about bipolar d/o is that when you’ve been in one of those phases and then come out of them, you feel as though your mind has betrayed you. Your illness took you on this path without your consent. You were simply dragged along without any recourse, at least for a while. The manic phase you were in caused you to act extreme and in an illogical and very emotional manner. You may have said and done things which you would never have done in your normal state. This costs you friends and relationships you valued very much. How do apologize in a meaningful way so that they will forgive you? How do you make friends and relations understand that that wasn’t you, it was your “evil twin”? Some people understand, some don’t. And some understand, but perhaps choose to stay away from you because they don’t want to have anything to do with a “crazy” person. I understand this. But it is extremely sad that because of an illness, you lose friends who are important to you and whom you would never hurt in a million years.

Just feeling sad that this happens because of mental illness. It’s already difficult enough to live with bipolar d/o, to lose precious friends and relations is almost too much to bear.dec31_2013

Depth.

Depth of beauty.
Depth of sadness.
The deep folds of a flower.
The folds of a rose.
Deep not shallow.
Deep not fallow.
Seeds sown too deep never flower.
Too shallow, eaten in an hour.
Lost in my feelings.
Life passes by.
Tear stained eyes.
 
 
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“In the hope that you may understand”

January 27, 2011.

In the hope that you may understand

Again I am drowning in it suffocating in it.

Again the shroud of darkness is upon me.

Hypomania, mania, depression.

They all play with my life at will and leave me listless as a dead drooping flower.

I have no control, when the hellish inferno of anger envelops me, I have no control.

When the bottomless, empty, deathly dark well of depression swallows me I have no control.

When fear overcomes me as though I am lost in a long abandoned ruin where there is no sight or sound only little rodent feet scurrying.

When I shed a million tears of sadness from the inexhaustible stores that are in me.

Yet they don’t understand, I know everyone loves me but they say “Oh get over it”, “You’re stronger than that”, “It’s not important”

Would I not get over it if I could? Do you think?

It is important, I am not stronger than this illness is, I fight it over and over yet the blighted thing always comes back.

Lithium brings me out of it yet it damages my kidneys, makes my hair fall out, ruins my skin, causes GI damage…

Seroquel brings me out of it yet makes me go from mania to an empty, horrifying depression, where the emptiness is so painful that I cannot get out of bed…

My muscles ache, my hands have tremors, my eyesight is shot. If I was on Trilifon I’d have a mask like face as well with no expression whatsoever and tardive dyskinesia and massive restlessness.

Do I just get over all this, does it sound easy to do?

In everyone’s eyes I may be a failure or a mediocrity, but I know what I have gone through and what I have overcome and it has not been easy.

This is not a complaint, it’s just out of my need to be understood, it’s just in the hope that you will understand.

A poem about someone who hates themselves…

Find me find me
I am not going to make it easy
If you find me you’ve won
If I hide I will be wanted more
I want your obsession
I want you revenge
I want you to care about me more that you care about yourself
I want you addicted to me
Because I have this black hole inside me that I cannot fill
So I must whip you and enslave you to make myself feel better
No matter what you do you will not be successful
You will always be wrong I’ll make sure of that
But go ahead and try, bang your head against the wall of my despair
I’ll make sure you know how stupid you are and how you lack any skills
Just like Mommy Dearest did to me
Nothing you do will be good enough
And I’m clever enough to make it seem like it’s all your fault
That you are the one who has no skills
I am not ready to love myself so I hate you
IN FACT I HATE MYSELF
So you cannot love me.
I see love as weakness and I pounce on weak people like a cat does to a mouse
no one will win, every one will lose, I don’t care if I have to destroy myself to destroy you, I will destroy you.
You come to me as if you really care for me hahahaha
You are only in it for yourself.
I have to beat you before you beat me
I don’t love myself so I must hate you
IN FACT I HATE MYSELF
Please love me even if I am impossible
Take me out of this hell hole
I need you I want you I’ve got to have you baby
But if I let you find me you’ve won and you can never win
I love you
I hate you I will not embrace you
You must be whipped for loving me because I am so unworthy
I love you I hate you
I HATE MYSELF

“Tiger” again in manic phase.

December 29, 2009

feeling forlorn and lonely
I have been to hell and back so many times I’ve lost count

feeling restless and agitated

every time this happens I lose days and days of my life

why me?

is it really fair that most other people waltz through life while I do a tortured dance in hell?

what’s the good in it?

nothing that I can see

words and deeds that hurt everyone come out of my mouth and my hands

losing myself, oneself is what most people take for granted, while I cannot, I can lose myself; lost in the dark at the precipice of a steep cliff

falling would mean only pieces of me would survive

not being able to take even myself for granted is a bone chillingly frightening thought

yet I live with it and every time it happens I hope it is the last

however it never is the last, there is always the next loss of myself waiting, silently, stealthily in the wings

I tell it to let me go but it won’t

it has me by the jugular like a tiger does its prey and it drags me and thrashes me about just like a tiger does to its prey

will I ever be free?

Is freedom only in death?

I have days and years to live yet

how can I appease thid cruel, unfeeling tiger god

what must I take to the shrine to so it will be appeased and let me be

where in the world is the shrine even located? 

“I am still here, I am still here.” Again Manic phase… but Sheer Strength!

I am still here, I am still here

November 18, 2013.
Oh my beloved ones, I am still here, not gone and out of your lives, just a little farther away, but I am still here for all of you, for each and every one of you, I am still here

Not exactly where I want to be
If home is where the heart is then Buffalo is my home
Soon I will be stronger and I will be back with love and grace
This loss, this heartbreak, this ripping and shredding of the fabric of my life
will only make me stronger, will only make me glue all the shreds back with a stronger bond. I will never give up despite the agony and the fear and pain I have felt, this immense discomfort is a gift to me, making me realize what is important to me, I am stronger and more focused because of it. I will heed the message my pain has delivered to me
and I will return, shining like the internal star that guides me
I will return to my home, to my son, my nephew, my uncle and all my beloved friends
Life leads me down strange new, unknown paths, makes me quake and scream in fear and pain, but it will not beat me
It is I who will choose which path I walk on, nothing else, no one else will choose it for me
Not many understand how this upheaval has affected me, me with an affective disorder
How my heart is broken into shards of glass that cut me and make me bleed and cry tears of blood and make me scream like a banshee hurling insults and epithets at people I love
My little house, where my heart still lives, abandoned and empty not understanding where all the people who loved her are gone
Fear and loss are my companions now but only for a little while, soon I will smile
Hope dawns and the sun shines bright on my face and tells me I am alive and have hope and grace
I will get over this and be strong and vibrant and alive and I will make a life for myself that is of my own choosing and no one else’s
Even now I make it

Fight

Fight

February 24, 2012 at 1:37am

I will not go gentle into the night

I will put up as courageous and valiant a fight

though my battlements are worn

and my armaments, to others, a sorry sight

I will not go gently into the night

Many friends I have lost, many kith and blood tied kin

I grieve over them never losing sight

of their towering value to my life

many days I have struggled, seemingly carried the burden Atlas did

many nights have I lain awake and conversed with Sisyphus

Easy to give up and say good night?

Yet my hand flies out and catches the ashes as they flutter to the floor

as of its own free will, no gentle Ophelia it is not yet time

the river you must swim in is one of life

You cannot go gently into the night