Thomas of Cantimpré, Liber de natura rerum, France ca. 1290.
Via Valenciennes, Bibliothèque municipale, ms. 320, fol. 72r

Dear Internet,
The other day I received two unexpected gifts from the same person. The first was the admission that thanks to my writing, this person went on to seek mental health assistance and now treatment on their own. Secondly, in thanks for simply being me and giving them the courage to seek help, this person went to my Amazon wishlist1 and bought me the bundled ebook version of the first four books of George R. R. Martin’s A Song of Fire and Ice series, or as the rest of the world refers to it by its rightful name, Game of Thrones.
Floored by this person’s generosity, I thanked them profusely for being so kind. This person’s gentle heart and reasons for sharing with me paralleled into the increasing visibility of my journal. Daily keyword tracking shows I’m getting a lot of traffic from organic searches by those looking for answers on drug interactions, bipolarism, ADHD, and everything else related to the crazy.
This seems like a perfect time then to write a preface to the blog for if my writing my experiences can help someone else seek professional help, then I need to make sure they are clear on a few things in regards to my own experiences. This post will be in the main nav bar for easy access.
I am Bipolar I/II (depending on which doctor), with ADHD, moderate anxiety, and a side of Borderline Personality Disorder for extra flavor. While I have been diagnosed since my late teens, my most recent professional confirmation came in 2005 and 2012.
I am what is commonly referred to as high functioning, which means that while I exhibit many of the extreme symptoms of my afflictions, I have coping skills that allows me to function, more or less, with little interruption.
In December of 2012, I decided after nearly a decade of being off any kind of medicating drugs, to start the drug treatment again for bipolar and ADHD. If you are a fairly new reader, and you want to see what someone is like within the throes of bipolar, start here and go forward for a play by play look of my last year as I live blogged it all. If you want to hop around, the subjects in the right sidebar gives you the breadth of the crazy as well as my other non-crazy interests.
This journal is not a journal of bipolarism, but I do write a lot about my gifts. Please keep that in mind.
In March of 2013, I decided to stop hiding behind the journal as the only outlet on the discussion and made the conscious effort to being open about my disease.
I am drug free not because I choose to, but it is because I cannot tolerate drugs. I have been on a wide breadth of various bipolar and ADHD drugs on and off for years, all well documented on this site, and none of them work for me. I am what my medicating therapist calls, “a peculiar case.” Simply put, my brain chemistry does not allow for metabolizing of most commercial drugs for anything. For example, most SSRIs take 2-3 weeks to metabolize and for the effects to show up. In me, I metabolize the drugs within days of ingestion. This becomes problematic when addressing doses for stabilization. I also have the unfortunate luck to get all the rare side effects associated with that particular drug.
Drug interactions are typically listed on the drug’s bottle. If not, use a reliable health site such as the Mayo Clinic for more information.
If you are taking medication, take the medication as directed and do not skip a dose. Do not self-medicate unless it’s for an extremely good reason such as when Adderall makes you psychotic like it did for me.
I do not dispense individual advice nor do I recommend you seek your medical treatment from the Internets. Mental health, in particular with afflictions that have cross symptoms, can be triggered by reading others experiences. I also do not frequent forums, while some find them useful and supportive, I find they tend to trigger my anxiety.
Websites that I link in regards to mental health advocacy or support are ones either I have used or have vetted as being legit. There are a lot of schemey sites out there looking to exploit the mentally ill. Using common sense and asking yourself the usual “Who/What/Where/Why” should give you the foundation of whether or not a site is legit. Remember, if you cannot find an about page or if the person is not willing to share credentials about their expertise, keep the fuck away.
Part of managing this disease is creating a supportive network and self-soothing routine for when you go into crisis, whether that crisis is manic or depressive. Make sure your partner, parents, siblings, and close friends know that you are doing this for yourself.
Those who are bipolar tend to also be heavily anxious, so it is even more important you create an on demand self-soothing items / routines in your skill set. This can be anything from having a favorite sweater around, to reading a particular passage from a book, eating a piece of chocolate, and the list can go on. In short: Anything that gives you comfort, bring you down, and give you peace is what you’re looking for AND can be easily accessible. Additionally, when you go into overly anxious mode, also have tools to cope such as TheHusband and I sing the 12 days of Christmas – backwards. Usually I do this when I cannot take Klonopin (the one drug that does work for me) immediately for some reason or the drug is taking too long to kick in. Another routine is five things taste, touch, sense, hear, see. You do a round of each item, finding five that fit the description, and keep going until your calm down.
Almost every encyclopedic entry on bipolar will mention a mind/body connection, that one way to help alleviate the pain of the disease is to eat right, cut out caffeine, and exercise. Even mediating can be boon.
If you think you are bipolar, hie thee to your general practitioner to get a recommendation for a medicating therapist. Bipolar is nuanced enough chemically that almost all those who are gifted with disease will have varying symptoms and medication needs. This should not be treated by your GP.
In addition to a medicating shrink, make sure you have a talking shrink as well — sometimes it can be the same person. You will need someone to monitor your drugs as well as be your touchstone that this is a chemical fuck up in your brain and you’re not a terrible person.
There is no known national bipolar foundation, though some exist in on a state level. If you are unable to get to your GP and are in crisis mode, call the national suicide prevention line at 1-800-273-TALK (8255). I have used similar services in my past which have gotten me to the next day.
Keep a journal of your moods, to track when you’re up, UP, UP UP and down, down, down. Also figure out your triggers and prepare for them. Like, when I get manic, I compulsively shop. Case in point: I own 250+ tshirts.  Putting together a systems of checks and balances in place has helped me from spending thousands. I also know that any caffeine after 12PM means I could be up until 4AM. Keep a list. You will find some friends are toxic, some music sets off your mania, and watching a film about old people will send you into depression for days. Know your triggers and avoid them as much as possible.
And it’s okay to have a terrible day or several terrible days. You know these days will pass and in the great words of Stephen Fry, it will be sunny one day. If you can make it through one day, and then the next, it will get easier.
It does get easier.
I believe in you.

1. Yes, I do indeed have nearly 20 wishlists under the main wishlist title, neatly sorted out by categories. TheHusband thinks I’m insane and Beth thinks I’m adorable, but I did this because I needed to separate out various works based on topic. So this organizing is for my own edification, not for people to peruse at except for TheHusband who shops from the Holidays and Lisa-mas Gift Ideas Wish List to get ideas on what to get me for gifts.

This day in Lisa-Universe:

la princesa de los Ingenios

Dear Internet,
It’s the 272nd day of the year or the end of September, whichever is easier to remember. As I quipped to TheHusband today, my favorite time of year for it’s one of the few months we’re not running our boiler or the central air, ergo the electric and gas bills are down.
And here I bet you thought I was all seriousness and no fun.
I’ve been purposely withdrawing from a semblance of social life as I meter down on the Lithium. I’m currently taking 900mg a day (I started out at 1500mg), and have found that this particular dose is working well for me. At the advice of Dr. H., who suggested if I found a level that worked for me to stay there so I’m heeding his request.
Most of the problematic side-effects from the higher doses have gone, which has been a tremendous amount of relief. As I don’t know how I am going to respond on the lower doses, I thought it best to curtail anything I don’t need to be actively involved in. This includes but was not limited to withdrawing my volunteer work with a few local comic cons happening this fall, my application for a part-time job at a new local comic book store, a few classes I was going to take, sponsored by Grand Rapids recreational department, and a few more things.
If my absence around town before was due to mobility, before that to some sort of depression, this time for a fairly sensible reason: my mental health. Some of the scariest moments this year was going on a new ADHD drug and having it take over my life. When I sampled Adderall and Focalin, I was living in emotional hell and the strain of being “normal” for everyday things took its toll.
I became a sketch of a person who only seemed to exist in novels or on a television show.
This is always the part that never seems to get discussed: the ramifications of going on/off controlled substances and how if done wrong, can fuck with your life in many serious ways. This is the reason why I write about because I want others to know they are not the only ones going through this particular hell. I also noted to my small support circle of those who also were gifted with being Bipolar my tactics and plan and they also agreed what I was doing was sensible.
This entire year has been exhausting. And I feel incredibly vulnerable, tender, and weary of the world at large.
My session with my talking therapist, Dr. P., have been ramping up pretty well. A year into our therapy and I’m finally revealing more about the inner core of me than before. I’m realising more so than ever talk therapy may be one of the few drugs I have left in my arsenal and I don’t want to waste it on discussing stupid things. I need to get rid of the burned husks and lay it bare.
I’m still solidly working on my archives, bouncing through different back-ups to add back in here at EPbaB. TheHusband often reminds me the back-ups I pulled from former SQL tables, still chock full of injected code, can easily be cleaned up by him. I then explained there is something Zen in the grabbing the data I need and cleaning it up myself. It can be so automatic but at the same time, soothing. There is sense of accomplishment to the act his fancy scripts cannot give me.
I’ve been spending a lot of time in 2003, mainly working through the entries where I found my high school sweetheart when I moved back to GR and what happened after. In 2008, he would track me down to my place of work to try to rekindle something, and follow up with the same move in 2011.
Reliving that extremely short period of 2003 has been much more painful than I would have imagined even a decade removed. I was so absolute and sure about our relationship even though he failed me over and over again. I was smart enough in 2008 and again in 2011 to recognize the bridge he was trying to sell me was never, ever going to materialize. It also didn’t help matters after 2011 connection, I found out he was still living with his girlfriend of many years and has a long rap sheet for various offenses. Politically, we’re so far apart it’s laughable and his various social media streams indicate he’s one step away from writing a manifesto while solitary living on the mountain.
In 1989 we were not an ocean apart. By 2003, no matter how much our hearts begged to be joined, our differences outweighed us. By 2008, I had no idea who this man calling on me was for he was not the man I had fallen in love with 20 years prior. By 2011, I was just tired of the ping ponging and the lies.
It is like a bullet has been dodged multiple times. The 17 year old me weeps for the death of someone she had loved, who had died many, many years ago and instead now sees just the shell of a person she used to know.
But it is finding those lost moments of time, which are ripe in their honesty and candor, so appealing as I go through my archives. They remind me I would not be here today without these events happening, the decisions and sometimes the regrets I have chosen. My personal history may not have world changing moments, but there is a richness to the layers of my struggles, pain, and happiness that helped define me as a person and charted the course of my life.
And it helps to remind me, as I come off the drugs, all of that is inside of me. That life, no matter how monochrome it may feel, can always randomly burst into technicolor.

This day in Lisa-Universe in:

The Drugs Don’t Work

Now the drugs don’t work
They just make you worse
But I know I’ll see your face again
The Verve, The Drugs Don’t Work

Dear Internet,
Ritalin, Concerta (32mg and 54mg), Adderall, and Focalin.
To give you a brief idea of the foray into my brain has been like, in the last five months, I’ve cycled through the above and received well documented and undocumented side effects for my efforts. Focalin, the latest drug, pushed me to the edges of paranoia, anti-socialism, and rapid/cyclic impulse thoughts.
I would not classify myself as being an introvert or extrovert, I seem to be fluid between the two, but on Focalin in social situations, I was always scamming to get a way out. I would wall myself up internally so that even the most banal small talk would be difficult. I would come off as standoffish, an asshole, or just plain weird.
People in my space made me nervous. People taking up time I had allocated for another task, irritated me. Music, I realized today, was not listened to because of depression, but because it moved the focus to something I didn’t deem as being important instead of allowing me to work on the task at hand.
I was sharp around the edges.
We could have the most innocent of conversations and I would take great umbrage at any perceived slight I felt thrown in my direction. Then I became hyper-sensitive to this behavior and had to monitor all written and verbal conversations to make sure I didn’t fuck shit up.
All of this defense and protection is exhausting.
Being crazy is exhausting.
Tonight I told my medicating therapist I took myself off of Focalin, and as of the Tuesday, I’ve been free of legal meth for 5 days. I’m still on lithium and will remain on lithium for as long as I live, but for now I need a break from the ADHD drugs. At least not take them on a regular basis.
He agreed.
The medicating doctor thinks this is all rapid signs of over stimulation. I am not going crazy, well not at least yet. The doses I was on for all of the drugs were of the lowest dose available. Ritalin works, but on occasion and for a few hours, and any attempt to prolong the drug doesn’t work. Good when I need to work at home or want to sit down and write, but I don’t think, at this time, I want to be on an ADHD drug permanently.
Since I’ve built my own coping skills on managing ADHD all these years, although haphazardly, I’m going to research for resources of tried techniques to help compensate so that the Ritalin will be last case use, not first in hand. I’ve also started my meditation in the morning to calm my mind.
In the last five days, the amplified symptoms have calmed and started to leave. Now I hope to find only peace.

Better living through chemistry, round two: Sunday

Dear Interent,
8:12AM: Took 10mg of Adderall XR
9:24AM: Still waiting for something to happen. Take my morning lithium dose. Ask Kate, who is also on Adderall, how long it takes to kick in.
9:42AM: Low grade headache, still haven’t had breakfast yet, TheHusband has brought me a caffeine free Coke.
11:13AM: I’ve researched buying Nintendo 3DS’s and Manic Panic hair color; I’ve checked my bank balance, chatted with friends on Twitter and IM, but I can’t singularly concentrate on completing a a longer task. I have not had breakfast at this time. And I still have the low grade headache.
13:36: TheHusband had started taxes, food has been consumed. I’ve taken Tylenol to combat the headache but it keeps popping up and saying, “Hey.”
15:38: Called Dr. H. Waiting to hear back. TheHusband and I get frisky in the basement when we begin laundry cycles. Libido not completely squashed by all the drugs. Yay!
17:04: TheHusband and I have been going back and forth on our taxes today. Bottom line is that we can’t write off $10K in my student loan interest or my nearly $8K in medical expenses because we’re slightly over the threshold. Time to get an accountant.
17:16: Dr. H. calls back and says to up the Adderall to 20mg tomorrow. I’m to call tomorrow afternoon. Dr. P. returned my text and my appointment has been successfully moved to 12P tomorrow.
20:25: TheHusband made dinner (third night we’ve had some variation of Mexican food) and he’s now on an after hours call due to network troubles.

Better living through chemistry, round two: Saturday

Dear Internet,
It was a little over two months ago I started taking my ADD/ADHD medications or  as my friend Liz calls them, legal meth.  I live blogged the first weekend diligently, and the experience convinced Dr. H. Ritalin was not the drug for me. Additionally, I needed medicinal help with my bipolar so the legal meth of any flavor could work properly. I was then started on to lithium and switched over to Concerta.
Ritalin is short acting and could be taken over the course of the day to keep the strength up. Concerta 36mg, on the other hand, is longer lasting but it needs to be taken before 9AM  in order to allow me to sleep at night. On the weekends, if I woke up too late, I would take one 5mg of Ritalin  instead of Concerta to get me over the hump I needed to get tasks done in a timely manner.
In the beginning of the Lithium/Concerta combo, it was fucking glorious. I was productive, I was focused, the quirks about my personality I always attributed as just my personality, turned out were actual symptoms of both diseases and were tempered with the drugs. That small period from end of December to early January was a golden age. Sure, there were some kinks in the process like no caffeine as it made me feel like I snorted 10 lines of speed  even if I had caffeine in small doses and my anxiety would sometimes get out of control, but who cares? I was feeling really fucking good and I was productive.
Work started  back up on January 9 and things were hopping. I could complete tasks, organize myself better, I wasn’t short with co-workers,  and if a difficult situation arose, I could handle it with aplomb. Everything was awesome.
During the initial period of Lithium/Concerta, I was super productive with my writing because it was all done during the day when the Concerta was peaking, ergo it makes sense I was super productive at work because the Concerta would be peaking during those same prime hours.
Then, the downside.
When I came home from work, however, I didn’t want to do shit. No matter what time I got home, once the pants came off, at most I could handle was reading on the Interent or watching TV. Anything other than that was either too taxing, too long, or required absolute concentration from me which I couldn’t give. This also allowed
I kept up the Collectioun of Cunnynge Curioustes because that was an easy thing to do. Open a post, format, set the post date, and save the draft. Anytime I found something that fell into a CCC post, I just had to open up that week’s post and add it. Friday nights, I would verify everything was in order before it posted on Saturday and be done with it. Very little work was involved on my part.
I returned to work on January 9th. January 16 was my monthly follow up with my orthopedic doctor, who decided I needed to have surgery two weeks hence to explore the still open wound to find out why it was not closing after seven months. During that two week period, I was a frenzy of productivity at work but at some point the Concerta stopped working as effectively, so lithium was upped. The general idea is the more my mood stabilizes, the better the legal meth works.
Other signs started to illuminate the drug wasn’t working such as I was getting easily irritable and short with people again. My productivity at at work was beginning to slow down considerably and my former bad habits started to appear. I was staying later and later in the belief I had to do the work NOW and not that it could wait until the following day. This obviously effected my home life.
Dr. H. and I were in contact either via phone or appointment during all of this. If I was metabolizing the 36mg to the point of non-effectiveness, then it was time to up the dosage to 54mg and see what happens. The catch is with the 54mg dose, I’d need to take it at 6-7AM. He thought my recovery period would be good time to experiment with the 54mg to see how I do.
A week before my surgery, all extraneous medications were stripped from my regime except for Concerta and Lithium. On the day of my surgery, January 29th, I did not take my morning doses of either drug and when I came home that evening (it was outpatient surgery), I only took my evening dose of lithium. I stayed off of Concerta for the rest of the week because I didn’t want to interfere with my antibiotics and my pain meds (sweet, sweet Vicodin). I decided the second week to stay off the legal meth as well and gloried about in the ability to drink caffeine. I spoke with Dr. H. via phone on February 8 and he upped my lithium to 1200mg and I was to start back on the Concerta the following the week.
During that week, Concerta and anxiety wrecked my sleeping. Some days I would get up early enough to take 36mg, and others it was a Ritalin kind of day. Every day was always in flux.
I went back to work on February 20th and started the morning with 36mg of Concerta, my morning lithium dose, and half a Klonopin. While this combination worked well mood wise, not so much for the focusing and concentration part. At least, not as well as I had hoped. I had still not taken the Concerta 54mg because I was afraid if I did, I’d never get to sleep.
After  a month of  all over the place mentally  and being laid up physically, I finally got to see Dr. H on Friday to go over my therapies and talk more about what was going on. The ramped up anxiety, the heightened ability to not sleep even when sleeping aids were produced,  were driving me crazy. I knew as I was on/off drugs for the better part of the last month had much to do with the problems since there was no consistency, but even attempting at consistency became problematic.
So we try another experiment, this time starting with the Concerta 54mg.
I woke up on Saturday at 6:30A to take Concerta 54mg, and then napped for a bit. At 8AM I became wide eyed and bushy tailed and started writing this post. I had a hair appointment at 10AM that would end up lasting five hours. I spoke with Dr. H. in the afternoon and he suggested I try Adderall on Sunday depending how the rest of the day went.
TheHusband and I rearranged some afternoon plans to get my Adderall script filled. Dinner was had. Shopping was done. We were home by 19:00.
The way I explained it to Dr. H. earlier was Concerta 54mg was giving me alertness for several hours, then it ebbed for a few hours, then picked up again, so when I spoke to him at about 15:30, I felt pretty together. But by 18:00, I was crashing pretty hard and falling asleep at the dinner table. I was not expecting the crashing or how hard I would much so that I needed to drink a can of Coke just to keep going for a few hours before falling asleep around midnight.
I started this post early Saturday morning and finishing it late Sunday night. Perfectly illustrating even a simple task can become highly complex when the drugs don’t work.

Exit mobile version