Tag Archives: bipolar

A couple of things

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Sorry if the pic bothers anyone. It’s just a relief to see so many more in such a short time. If you’d rather not see it, just comment and I can remove it.

For a long time I’ve called this 30-something guy’s journal – mostly about bipolar II. In less than a month I’ll no longer be in my 30’s and I don’t write mainly about Bipolar II anymore, so I need to come up with a new name for this little space on the net’.

On another note, my wife and I have been trying to conceive based on her fertility tests and we’ve been doing pretty regular checks to see if I have any sperm with the microscope. Tonight was the first night I didn’t need to hunt to see sperm, but they were all dead. I’ve read up on it, and this apparently isn’t unusual. If I were to guess, in the 11 minutes I looked at the slide, I saw well over 200 sperm, which is a huge improvement from a week ago when 20-40 minutes of searching showed only a few. For proper lab testing we need a centrifuge and an incubator. Neither of those items are cost prohibitive. I’ll talk with my wife and see if she’s willing to wait long enough to just decide to go the IVF route to make the extra lab equipment worth the investment. It’d get used after this.

If someone did a tag search and found this blog about having a vasectomy reversal, please feel free to contact me to talk about the process. I did have one of the top surgeons in the country perform mine, even after 18 years of the original vasectomy. I can tall you about recovery times, pain, other things to expect and at least what the cost was for us (it was not covered under insurance and required general anesthesia). I know when I was researching online most of everything I found was very clinical in nature, but didn’t get into the actual reality of the procedure and recovery.

So, this is real. This is going to happen. Even if I can’t produce naturally, the surgeon that performed the reversal said as far as production and quality of sperm I may as well be in my 20’s. Extracting it would be less than pleasant, but nothing I’m not willing to endure to move the process forward. This is really happening, and likely within the next year, barring any complications. I’m equally excited about it and terrified at the same time. The terrified part is mostly the reasonable things people that are going to have a first child have. To summarize; I just don’t want to fuck up too much and to be a good father. The other part that scares me though is the crippling depression that I go so very often. I’m high-functioning when I’m depressed and to help with focus I have Adderall which has been a godsend. Out of the group of 20 of my position in the country, only two other perform consistently at my level with errors being extremely rare and missing deadlines being unheard of.

I’ve been researching online again to see if I can find a therapist that we kind of hit it off as far as being a good fit for working together that can allow me Skype sessions when I’m traveling. Our health insurance will cover it, but there’s a specific code that needs to be used and I need to see the therapist in person every so often as well. It’s the suicidal ideation and urge that I need help with. It’s a constant. I’m used to it. I’m in no danger, but it’s a constant thing running through my mind. I feel guilty about it. How shitty would it be to everyone around me if I were to check out early? How shitty would it be for me now that I’m living a life that I never thought possible? Why won’t this constant nagging desire..no..need, go away?

I go through the mental gymnastics centering around that and starting a family. I can live with the depression. It’s tolerable with medications. I’ve no doubt I could endure well into old age. But would having a depressive parent be selfish, even if I’m good at compartmentalizing it? I don;t know.. It’s late and I put in 70 hours this week. There are things I should work on this weekend, but I think I’m going to go do some photography with an old friend. If time allows for work I’ll do it, but I need downtime. I’ve earned it.

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Today

Here it is, 3:00am and I can’t sleep. I downed to sleeping pills and two klonopin with a heavy could shots of liquor, which I’m feeling the effects of now. I know.. I know better. I need to wrangle my liquor consumption under strict control.

So.. What’s keeping me up? Horrible depression. Worse than it’s been in the last few years. I’m at a loss. Thoughts of suicide plague my mind every few seconds to every few minutes. It’s not about anything specific. No triggers that I’m aware of. I’m just exhausted.. Physically and emotionally. I’m tired.. I’ve been worse off than this before and I know I can endure through it, which I will, but this suffering seem like cruelty at this point. I’ve been over self-medicating with alcohol.. Strong alcohol. Take a small drink glass, fill it half with vodka, add to Kahlua and some Baileys to top it off and you have my version of hard chocolate milk. I down about a glass a day that’s filled to the brim. Tonight’s poison was about a 1/3 of a glass of B&B – packs a punch with very little consumption. Equivalent of three shots. I’m hoping tonight’s choice with a couple of klonopin and a couple sleeping pills will knock me out because I need to be online for work at 8:30 and have much to do.

In a few hours we’ll be seeing the fertility clinic to discuss our options. I had a vasectomy 18 years ago and the chances of a reversal working after 15 years is 2%. I don’t care for those odds, so we’ll explore the more invasive techniques offered by the clinic. I don’t mind 2-3 weeks off with an ice pack on my nether regions. It’s part of the goal. I had that vasectomy because the depressions were so bad that I was certain I’d not make it to 30 by my own hand. Turning 40 within the next year, priorities have changed and it’s a step my wife and I are ready to take. I’ve no expectations. If they say it’s simply not possible, the adoption is the next option. I don’t need a child to be part of my own genetics to love them just the same. Some guys get hung up on that, but I don’t. It’s not blood that make a family, it’s the ties that we make.

Here’s the dilemma, though. I suffer from deep and debilitating depressions. I’m in the midst of one of the worst in years. Every minute of every day have visions in my mind of piercing my carotid arteries and bleeding out as quickly as possible, probably taking some aspirin or alcohol beforehand to reduce the chance of clotting with thin blood. Please pardon the graphic nature of that, but after considering many, many options, this seems like a sure-fire way off success. Too many things can go wrong with pills, gunshots aren’t always successful, jumping ha a good chance, but it’s not guaranteed, getting hit by a car or a train at high speed have likely outcomes, but there’s no guarantee. The list goes on.. The last thing I want is a botched attempt and my loved ones having me on life support in an ICU or my being in a vegetative state being a lasting reminder and a constant source of grief by simply being alive, if only physically. Why the urge? I don’t know. All I know if I’m mentally and physically exhausted. I take my meds religiously. I see the therapist weekly. I do the homework in trying to find the root cause of this, but all things point to a chemical imbalance.

At 39 and having dealt with this pretty much the entirety of my life, when is it acceptable to say that we fount the good fight, but it’s time to call it? Doctors can do this with resuscitation attempts. Oncologists can help the patient and family decide when the fight has reached a futile point. Even we can choose when a pet is suffering to the point that their quality of life has turned to one of suffering. Why can’t humans do the same? I know some miracle drug may come along that will over me peace and a sense of well being in my lifetime , but that’s a hell of a gamble.

So, onto the choice to have a child. It’s a conscious choice. It will cost a boatload of money to do so since it’s all elective surgery as well as the IVF. I don’t mind the money part. I’m prepared for that. But.. Is it selfish to want to bring a child into this world knowing that I feel this way more than 60-70% of the time? I can put on the good act, but kids have a way of picking up on things. I don’t want to pass my instability onto our child.

Life goes on… If we have a child, then I’m locked into surviving no matter what for a minimum of 20-24 years. I don’t want to hurt anyone. I don’t want to hurt my wife or our child. I love my wife dearly. I loved my best friend who took her own life many years ago. I loved her as a friend and more than a friend. It took me a decade to just begin to process her death. How could I possibly do that to someone else that I love? The endless questioning of what could have been different.. What could I have said.. Could I have been a better friend.. All of that comes up regularly, even after so long ago. I don’t want that for her. I like my life with her. When she’s around I feel some semblance of peace. Some days that’s all that keeps me going.

So.. Is it selfish having a child with me being a train wreck of a human being? I’m ready for the challenge and am high functioning even when I’m extremely depressed. I can do the necessary parenting things regardless of mental state. Maybe this will give my life some sense of purpose as opposed to just waiting for the clock to run out.. Maybe not. I have to work through that with the therapist.

Hmm.. 3:47am. Time for sleep, I guess.

5:30 A.M.

Long post ahead – feel free to skip.

So, here it is, 5:30 A.M. in a random hotel room in Pittsburgh. In spite of me taking enough Klonopin to knock over a small horse to get to sleep last night, I’ve been laying awake for about 45 minutes now. I’d ask my doctor for Ambien, but I used to do strange things on Ambien. For example, I’d get up and write really dark stuff, then leave it up on the computer to be found. I’d have full conversations with my ex girlfriend, and later my wife after we married. I was totally honest while on it. If there is such a thing as truth serum, that’s it. I was also completely uninhibited. I finally stopped taking it after I got up in the middle of the night, drive 5 miles to the nearby 24 hour grocery store and purchased 10 frozen pizzas, drove home, placed them on the counter and went back to sleep. The fun part about Ambien for me? I’d not remember anything from about two hours before going to sleep or anything that I’d do while on it. So.. No Ambien for me. Lunesta kind of works, but I get dry mouth from hell. It leaves me with insatiable thirst throughout the day. Trazadone kind of helps, but I feel like my heavy drinking days the next morning that I’d experience in my 20’s.

What’s on my mind at this hour? Aside from planning out my work day and all of the stuff I need to somehow get done, I’m thinking about my wife and I having a child or children. I had a vasectomy at 22, so a reversal at this point is unlikely to be successful. Surgically though, they can extract sperm, I can take a few days off from work afterward and sit with frozen bags of peas on my nether regions to keep swelling down and to dull the pain. A vasectomy is a pretty simple procedure. Extraction of sperm is far more involved.

Here’s the thing.. I have health problems. Some of which are definitely genetic. My wife also has some genetic health problems. It stands to reason that if we were to have a child that some of that would be passed down. I also have the carrier gene for hemochromatosis, which isn’t something I’d want to pass on. My main concern would be though, that my wife and I both suffer from horrible depression. On one hand, we get it, so there’s no fights about it. On the other hand, it’d be terribly selfish to risk having a child that might get whatever chemical imbalance we have, mainly mine. Since bipolar is chemical in nature, it’s kind of unavoidable if it’s passed on. We’ve gone round and round about all this and still do at times.

I’d be totally fine with adoption. I have no preference of race or gender. The child wouldn’t necessarily have to be a newborn, either. I’m not one of those guys who wants a kid to be his own genetic lineage. If we were to have a child, regardless of natural birth or adoption my wife would likely stop working to take care of the child until they reach school age, then likely return to work part time. We can afford to live off from my income, so it’s a viable option. My fear is that I’d be the father that’s not there with all of the work travel. Also, both of us grew up in abusive or neglectful homes, so we don’t know how parenting should work. We’d be winging it.

Decisions, decisions..I think I’ll bring up the topic this weekend. She made a passing comment that having a child is on her mind constantly of late last week. It’s something we should talk about. If we decide to go the route of trying to have our own, I’ll have to make an appointment with a surgeon and a fertility doctor as it’d be in vitro.

Living versus Existing -being on psychotropic medications long term

Since I was a young child, I had always suffered from depression. At the time, it was likely situational. I’ll spare the details, but there was a lot of alcohol involved, a lot of violence and a lot of terrorizing pretty much everyone in the household. My parents split when I was 5 and I stayed with my mother. She dated a few men here and there, but overall they were decent or indifferent toward me. She met and married my step father when I was 9. He was a horribly abusive person, mostly along emotional lines. Again, I chocked up the depression and suicidal ideation to it being situational in hindsight.

I moved out when I was 17 and did whatever I could to make ends meet. I was lucky to start in the industry that I still work in when I was 19. I had pretty bad PTSD at that time; it seems I didn’t know how to exist without constant conflict. I married the girl I had seen all through high school at 20 and we divorced when I was 22. Shortly thereafter my best friend lost her battle with depression and took her own life which sent me into a downward spiral that would last most of my 20’s. I’m still affected by that to this day on some levels.

So, the question for me always was if the deep depressions I felt were merely a product of experiences, or if they were more chemical in nature. I never did quite feel like myself, though I didn’t really know who that was. I just felt like I was wearing someone else’s skin for the most part. Sometime around 30 I figured out who I was, shed the past and started living my life on my own terms. I then started to see glimpses of the real me from time to time.

Throughout the years though, I had been on such a mix of medications and in and out of therapy with all sorts of approaches. At some point with therapy, there are no more secrets to tell, no more hidden truths to discover and no more techniques to learn in order to cope. As for pharmacology, that’s a tedious process of starting a medication, upping the dose until it’s maxed out, giving it time to work if it’s going to, then tapering off before starting the next one. When single medications don’t work, then the combinations start.

Combinations.. That’s where I’m at right now. I have a high dose of Lamictal, Wellbutrin and a moderate dose of Lexapro. Limictal saved my life. Hands down, that’s the only medication that ever gave me a sense of levity to get through each day without being on the edge of using whatever was near me to take my own life. The thing is though, it dulls my nerves. It takes away that creative spark that’s set me apart professionally. I don’t feel things with nearly the intensity that I used to, good or bad. In essence, I’ve been numbed. The other meds are to help with the depression, but I’m a bit dubious of how effective they are. So as to not rock the boat or start another cycle of trial and error, I’ll just keep taking them as prescribed and see how things go.

So, on to the meat of what the title of the post is about. I’ve been on psychotropics for so long, each altering my mood in one way or another, I feel like I’ve lost whomever it is that I would be otherwise. Maybe that person is gone forever. Maybe this is me and I’m just underwhelmed. I’ve always thought I had pretty good potential to do something important in my life. Not grandiosity or anything, but I’m fairly intelligent, can see patterns in things that most overlook and I’m able to stick with something longer than most if I believe there’s more to be found or gained. Do I like the current me? Sort of.. There’s an emptiness there that I can’t ignore. It’s not that I believe that it can be filled by having a child or some other profound change, but rather it’s just a hole left from life experiences. Would I be willing to take some medication that would make me not feel, or at least not feel sadness or emptiness? Absolutely. Would I be willing to give up whatever must be given up in the way of side effects for such a drug? Yes. I think that would be worth a hefty price. The thing is.. I don’t know who I am anymore. I don’t even know who I’d be if I were to try to become someone else or a better version of myself for that matter. I’m not alone in this world. I have a wonderful marriage. I have friends and some family. Even with those people that love and care for me, I feel like I’m a million miles away and have no real way of reaching them, or them reaching me.

Where do the meds drop off and I begin? How much of who I am is a product of medication versus whatever part of me is left?

Here is is Monday night and I already feel beat. In other news, after talking with the psychiatrist, we’ve decided to double my dose of Lexapro to try to battle the depression that’s seeped in. I’ve been mostly honest with her about how I’ve really been doing, but I should probably come clean about how strong the suicidal ideations are. It’s logically and objectively making sense to me, which isn’t a good thing.

I know there’s more than this.. Than existing, I mean. It’s not as bad as it can get, but I see that coming in the coming in the near future. Every time I think I know how bad it can get, it seems to surprise me by finding a new low. I’ve been self-medicating with alcohol some nights, which I really shouldn’t do, aside from the obvious, but even for health reasons alone. It’s not a regular thing, at least. I hadn’t had a drink in a couple of weeks, and tonight I’ve only had some. Not even enough to get a buzz.

I’m conflicted about telling my wife how I’m really doing. I owe her that much.. For the hell I’ve put her through with my mental illness, I owe her that much. On the other hand, for what I’ve put her though, I feel I owe it to her to keep it to myself. I’ve burdened her with this too much as it stands.. I don’t know what the hell to do to be honest. Part of me thinks I should leave so that she can find someone else that’s in a much better disposition than me. I know that’s the depression talking, but it’s how I feel either way. To be frank, if it weren’t for her, as cliche as it sounds, I’d not be here at this point. The lows have hit bad enough that I’d not just think about giving up, but would have, or would act on it. I couldn’t do that to her. Other people, yes, but not her. So, I have to figure out a way to push through. Since I have to push though, then I need to figure out a way to make that less miserable. Right now, chemically is about the only option that I see. It’s that, or ECT, or TMS, or Katamine, or whatever else is out there. All of which I could try, some of which would likely cost me my job, which would enter in a whole host of other fucked up problems that would likely make me even more depressed which wouldn’t be good for anyone.

I’ve spent countless hours trying to figure out if what’s going on with me is psychological or chemical. When I look at the world, I think there’s a mix of good and bad in the world. I don’t know what the balance is, but objectively, I think there’s considerably more good in the world than bad, but the bad gets most of the attention so it seems worse than it is. Overall, I am optimistic about most things. If what I experience is indeed mostly chemical, then it stands to reason that there will be breakthroughs within my lifetime that would offer relief. Approaching 40, barring anything unexpected, dare I hold on to hope that some relief can be found within a reasonable time in the next 35-50 years? Will I be so far gone into darkness that I’d even know how to handle being good, much less just ok? I don’t know.. My mind isn’t in a good place tonight. I’ll probably watch a show or something and then go to sleep. That seems to reset my mind pretty well.

Fuck me, this shit gets old..

Homesick

I’m feeling pretty down, still. Being sick isn’t helping matters, either. I need to get many bloodwork redrawn as I’ve been extremely tired lately. Even when I’m down, 6 hours isof sleep  usually plenty for me. Lately I’ve needed more like 10-12. It’s likely my vitamin D3 bottoming out again, but I need to verify that.

So, I’m writing this from my hotel room in Pittsburgh. I’m here so often that I’m on a first name basis with the staff and we know the names of each other’s spouses, kids, interests outside of work, where they are from, etc. Though it’s nice to see familiar people, I miss being home more. My new manager who started a little over a couple of months ago is trying to help by traveling in my place to other cities, but I’m still pretty swamped and home usually only on weekends, save another day here and there. The week before lady was 5 days in Pittsburgh, followed by a 5 day trip to Rhode Island for a wedding last week, Pittsburgh this week, Cincinnati next week followed by Pittsburgh for the second half of the week. Hopefully this lets up soon..

Being sick while traveling is hard.. You’re exhausted to begin with from either hours in the car, or stuck in the airport for delayed flights (I’m looking at you, American Airlines and United Airline), layovers, etc. Once I finish at my customer tomorrow I’ll travel home and likely go to an urgent care either about midnight, or on Saturday morning. I should have gone today, but I laid down to nap as soon as I finished for the day and didn’t wake until a little while ago. This has all the telltale signs of a bad sinus infection and some sort of upper respiratory thing. I had hoped it would resolve itself, but it’s been over a week and is getting worse. I should probably cancel my flights for Sunday night now, then drive to Cincinnati Monday night, provided I’m on the mend by then. At least that way, if I need to head home early or can get away early I can head home. Maybe I’ll keep my Pittsburgh flights.. That’s a brutal dive when you’re tired and not feeling well.

Missing Monday wouldn’t be a big thing as I’m taking care of internal company tasks, but missing any more than that screws everything up. I’m booked out for weeks, and I can’t simply reschedule with a customer and put them at the end of the list. It usually takes 8-10 hours to contact everyone and reschedule accordingly. That just puts me behind another day or two.. That’s 4-5 different customers, one day rack for every week until mid November.
I’m also feeling guilty. I’ve been irritable with my wife and have snapped at her a could of times. Both times were completely unwarranted. She’s about the only non-stressful part of my life right now. It’s not fair to her, and it’s not righ. I need to apologize and try to make it up to her when I see her on Saturday.

Still wanting to give up. It’s edging on needing to give up. I’m not sure what to do at this point. It’s not situational. Has nothing to do with that. It’s just the soul crushing depression. I don’t want to mess with medication changes. That could make things even worse. I’ve been self medicating lately with alcohol, which isn’t healthy on a number of levels. I’d see about finding a therapist I could Skype with after hours, but frankly, there’s nothing to talk about. I know about self-care, positive thinking, CBT techniques, distractions, mindfulness, reframing my perspective, etc. I’ve been through all that and practice it. The only thing I can’t do is have a regular routine. What do you do when there’s nothing left? ECT? Finding a doctor that will do ketamine injections on the regular? TMS? That all requires being in one place for long enough to do the therapies. Since I’m in Pittsburgh so much, maybe I can see if I can see someone at Carnegie Mellon university.. I’m really hesitant about ECT as it can have rather bad cognitive effects, both in the short and long term. My intellect is me. It’s what makes me who I am. I don’t want to risk losing that. It’s not a statistically large risk, but large enough to give me pause.

Time for sleep. I need to be in the middle of frigging nowhere in Ohio tomorrow at 9:00 a.m.