If you’re dying of thirst, it’s too late to dig a well. ~ Chinese Proverb
The key is to write even when you don’t feel like it. To be consistent, when you want nothing more than to be inconsistent. So, tonight although I’m struggling with a mild flu and tired due to a string of insomniac nights, I’m going to write anyway. Actually, I consider the topic of tonight’s post one of the most important since starting this blog. I know it will help me to clarify things moving forward and could actually be of use to others learning to manage a mental illness. For me, it’s Bipolar 2, and the hypo-manias, insomniac nights, agitation, and deep depressions that come with it. While I’m just starting to feel that I can manage this illness, I had a recent experience that showed me I still have a ways to go.
Last week I forgot to take my medications for at least three days. It sounds crazy, although that’s not a word I’m fond of for obvious reasons, but it happened so easily. Following several nights of insomnia I got up one morning and just didn’t take my medication. The same thing the next day. And by day three, not knowing that I was skipping my medication, I began to think, “Maybe I don’t need to be on so many pills.” In retrospect, the signs were there that things weren’t right. I was irritable and impatient with my family. I was judgmental and very pessimistic about the future. Although I didn’t act on them, I had some moments of internal rage when thinking about the past. There were also physical symptoms, such as, what can only be described as an electric sensation in my head when I exerted myself physically. My wife later reminded me that my psychiatrist had explained this sensation can be a symptom of withdrawal. I did notice these things as they were happening, but as my body chemistry shifted, I started down the same path of denial that led to a recent hospitalization.
Fortunately, my wife noticed that there were two pills left in a bottle that should have been empty, and she brought it to my attention. “Have you been taking your medication?” she asked. My initial response was “Yes, of course.” But as we spoke further, I realized I was wrong and that I had been without medication for at least three days. It really scared me as I began to put the puzzle pieces of my untreated Bipolar 2 symptoms together. I realized how easy it was to stop taking vital medications and the serious consequences of doing so. I became immediately grateful for my wife’s attention to detail and for the medications we’ve worked to get just right. They do work when I take them.
There’s an ancient Chinese proverb that says, “If you’re dying of thirst, it’s too late to dig a well.” It popped into my head as I thought about the very real possibility of a relapse. As many mental illnesses are cyclical, the chance of a lapse is probable. The key is to have a plan in place, “a well”, if you will, to get things back on track, to prevent the inevitable lapse from becoming a full-blown relapse. So, I’m taking this opportunity to review my relapse prevention plan and document the process.
First, I got one of those “old guy” pill boxes. Actually, I got two. One for the pills I take in the morning (the green one) and one for the pills I take in the evening (the blue one). Second, I’m going to sit down with my wife and review my behavior during the three days without medication. In retrospect, I know that I was showing some manic signs and other symptoms. I want her to know, unequivocally, that she can call these symptoms to my attention at any time. Third, I have a great therapist who I see once a week. I’m going to tell him what happened and get some feedback. I used to hide things from my therapist because I didn’t want to disappoint him. However, I’ve found that the more honest I am with him the more I heal. Fourth, I’m also going to speak with my psychiatrist about forgetting to take my medication. Even though I’m back on track, I’ll tell him. I’ve found so often that things I consider insignificant, to my psychiatrist, actually matter. Although it doesn’t always feel good, I have to tell on myself. Finally, I’m fortunate to have a large support system, and I’m going to let them know as well so they can help monitor my behavior and give me feedback. There’s no point in hiding my illness. In fact, hiding it can be dangerous, even fatal.
Probably the most important part of any plan is to have at least one person who can be your advocate. Whenever possible, I take my wife to appointments with my psychiatrist, especially when we discuss medication. It just helps to have another set of ears. A trusted friend or parent could do the same thing.
Just don’t do it alone. It’s too damn hard. Take any help you can get and be grateful for it. You would do the same for your loved ones.
May we all safely manage our mental illnesses and be in the presence of those who we love and who love us unconditionally.
Thanks for reading.