More Whining

About a month ago, after I started taking Cymbalta, I had a week to ten-day lift in my mood. The change made me think that maybe I was going manic - no such luck. Then, beginning last week I began to sink into depression again. By Sunday it was bad - I spent most of the day in bed, unable to sleep, staring at the ceiling. I called off work Monday and Tuesday because I was both physically and psychologically ill and fortunately work was cancelled because of weather on Wednesday. In total, I spent Sunday through Wednesday laying bed staring into space. Physically I'm feeling better, but I'm still very depressed.

I saw my shrink yesterday morning and told him this sad tale of woe. He doubled the Cymbalta and said he was going to talk to the ECT Department about my case in the afternoon. I see him again on Tuesday to see if the increased meds helped and to discuss ECT. Even if we decide to go with ECT, there are a couple of logistical hurdles to get over. First I'll have to get my insurance to pay for it - not an easy trick. Next I'll have to get off Depakote because it's an anti-convulsant and ECT is designed to induce convulsions. Finally, I'll have to complete the course of treatment - whatever that turns out to be - in the next five weeks before Spring classes begin and I have to teach. The short-term memory loss would really screw with lecturing, grading, etc. But then again so would this depression. I talked to my sponsor (an M.D.) about all this and he is really in favor of ECT. I just think he wants to see get zapped on the table. He's one sick fuck! (We don't end up in AA because we're well and doing a splendid job running our lives...)

This just fucking sucks. I'm so fucking sick of being either depressed or on guard for mania. I know mania is dangerous for me and at its worst just as dysfunctional as depression, but Jesus fucking Christ I am sick of being down in the bunker with my helmet on waiting for the next mortar round to land. I NEED a little mania right now. What's more, my wife watches me like a hawk for signs of mania. I know she is doing what she (and the docs) think is right and that she means well, but some times I'm afraid to show any kind of enjoyment of enthusiasm for fear that she will read it as hypomania or mania and freak out.

So the doc is probing me yesterday and it wasn't until he started asking the right questions that I realized how low I've sunk:

"Have you been having suicidal thoughts?" Well yeah, kinda...

"Have you craved alcohol or drugs?" Have I briefly thought about some wine or shooting dope and just checking out for a few hours? Yeah, I have.

"Are you still smoke-free?" No.

"Are you seeing or hearing things that are not there?" Yeah, I think so. I see what seem to be amorphous grey cats running by on the floor and walls out of the corner of my eye. I can hear their claws.

All of my responses elicited bad looks and lots of note taking on the doctor's part. I'm nervous that he is going to want me hospitalized.

On the up side (I'm trying to be positive) I spent yesterday working with a friend at my usual coffee shop and finished the book proposal that's been hanging over my head and sent it out. I meet with the guys who will make a decision about it on Monday. I hope I can fake some enthusiasm by then because I really need that project - both the work and the money.

I do that a lot: take my laptop to the coffee shop and work. A fellow crazy friend of mine also brings his work and we just sit and do our seperate things. There's very little conversation but somehow it helps just to be with someone you know as opposed to all on your own. And, it definitely beats being in my dungeon (basement home office) all alone all day trying to fight through depression to get work done.

This is my last day filling in at my wife's office so I will undoubtedly post again later in the day.

Dr. K

Rambling Overview

I really need to get some work done but I'm just not motivated. Here I sit on a Saturday afternoon at a coffee shop with a couple friends. We've been sort of talking and working/working and talking. I have to finish up this book proposal but it always seems like I've forgotten something at home that I need to finish the next step. I feel like shit.

I think I'll take a cue from Weird Cake's last post and tell a little more about myself:

I grew up in a fairly dysfunctional home. Mom was (and is) an alcoholic, dad was a Valium addict. They divorced when I was two and remarried when I was six (they divorced again when I was 27 – what the fuck?). I'm the youngest of six brothers and we were a pretty violent group - we had lots of visits from the police. I was entered into (and bused to) a pilot gifted and talented program from 2nd through 8th grades after which I was suddenly dumped back into the mainstream high school with my neighborhood peers. In 9th grade I broke my neck in a wrestling tournament, had it fused together (C1-C3), did the whole halo thing and eventually recovered. From then on I drank a lot, started a very successful business, and barely graduated from high school because I was never there. Whether I would graduate came down to my score on one test in one class.

I just barely got into college and completely fucked up my first year chasing women and beer. After sitting out a year (at the university’s request) I re-entered classes and maintained at 3.50 GPA and above thereafter – which didn’t really matter because my GPA from my first year permanently fucked my overall GPA (though I guess it did show “improvement”). I majored in Asian Studies and graduated with a B.A. Somehow I wiggled my way into grad school at the same university and did a M.A. in history. All during college and grad school I was traveling back and forth to Japan.

After that it was clear that I would have to do something major to distinguish myself if I was going to have a career in academics, so I went to Japan and did a M.A. there (I sat for the entrance exam, took regular classes, and graduated with an earned degree). While in Japan I met, courted, wooed, and married my lovely wife (now of ten years).

I applied to many, and was accepted at several, Ph.D. programs in the U.S. and finally settled on one program – based largely on the advisor I would be working with. But, as fate would have it, two weeks before the beginning of my first quarter there he received a fellowship to do research in Japan for two years. Oops. So, I had to change gears and I picked up a different advisor in a different field of history – military history. Now I am a military historian focusing on early modern global history, with a dissertation about Japan.

However, to back up a little bit: I got through my coursework and comprehensive exams while teaching and doing research without much trouble. I finished my dissertation research and started writing in good order. That’s when the trouble began. I took a job as assistant director of a large research center at a ridiculously high salary (for a grad student) and that was effectively the end of my writing. I was working 12 hours 7 days a week. My drinking really picked up, and then the big bomb dropped: I re-injured my neck. I was prescribed painkillers (oxycontin etc.) and within a few months I was addicted and abusing them. I seesawed between pills and booze for a couple years until I was no longer able to work and resigned my position (and salary).

For the next several years I was a living vegetable. All I did was sit in the dark smoking, popping pills, washing them down with booze, and letting my wife support us and take care of the house and me. There were periods when I wouldn’t leave the house for as long as a month. There were never enough drugs (I would supplement by buying them off the internet) booze, or cigarettes. I was always either high or going through narcotic withdrawal (which if you’ve ever seen or experienced is very nasty – the worst physical state I’ve ever been in without exception).

Then about two years ago I started hanging out with a guy that introduced me to heroin. I started out snorting it, which lasted all of a week before I was shooting up. At first I was in heaven – it was the answer to all my problems. But that manic drive kicked in and my habit grew exponentially - I was like a machine. Before I knew it (about six months later) I couldn’t get high anymore. I had to shoot a ton of dope just to not go into withdrawal. I was 30 lbs under weight, looked like a corpse, had shot up my whole 401k, and basically ruined my wife’s life. I just couldn’t imagine living with drugs any more or living without them. And, by this point I was too much of a coward to take my own life (or so I thought at the time).

Then, like flipping a switch, I decided to take myself to a treatment center. I spent 10 days in-patient, and 3 weeks out-patient. I went to meetings, got a sponsor, did what he told me, and started to heal.

At the age of 35, after I was sober for a few months I had an extremely manic episode that ended in hospitalization. I was diagnosed 'Bipolar I' and kept for ten days of observation. Without the haze of drugs or alcohol it became clear for the first time that I had been bipolar for at least 15 years, and probably since my teens. I (and my wife) could clearly identify periods of depression and mania going back years. In fact, about 5 years earlier I was told by a shrink I went to (only for sleep problems mind you) that I was bipolar and I completely blew her off. (What the fuck did she know anyhow? Just give me the sedatives lady!) Also, I was diagnosed as a teenager with borderline personality disorder, but my folks blew that off.

In the last year and a bit since going to treatment I’ve been medicated, reunited with my advisor, finished writing my dissertation, and graduated with my Ph.D. I've returned to research, writing, and teaching, and have some good projects going. I'm eeking out a living writing here and teaching there. My relationship with my wife, although not perfect, is better than it’s ever been. I’m in AA, she’s very active in Al-Anon, and we go to couples meetings together.

I guess right now I have two major problems: 1) My bouts of depression are still crippling and I need to get these meds straightened out (as if it were that simple); and 2) I need to find a tenure-track job.

That’s a hell of a lot more than I intended to write, but oh well.

Dr. K

Just What I've Been Looking For

Mood Tracker

I really don't have the patience for handwritten or spreadsheet style mood charts. Luckily, over on "Weird Cake" I found a fantastic link for this on-line mood chart. It's free, easy to set up and maintain, and printable for doctor visits. You should really check it out if you are bipolar or depressed. What a great tool.

Searching for Clarity

I've had a few hostile comments complaining about me whining on this blog, but that's just too fucking bad because this is my on-line journal (of sorts) and I'll write what's on my mind - that's the point. To that end, I'll fucking whine if I need to.

I've been thinking a lot about going off my meds. It's so tempting to do it and see what happens. I'm taking Depakote and Seroquel to keep the mania in check, but now I'm taking Cymbalta to lift the depression. In other words, some drugs to keep me down and some to keep me up. The visceral part of me asks, "Aren't they just cancelling each other out?"

I know that non-compliance is a major reason for relapse - and I don't want to end up in the hospital again, not to mention a zombie, but I have this urge to dispense with the meds. I talked to my sponsor (who happens to be an M.D.) about it and he suggested I call my shrink and tell him about it. He said, "Who knows, maybe by this point you're right: maybe you are over medicated." Sounds like good advice, so I'll call him today.

Other than that, I'm busy and confused. I'm having a hard time cognitively (focus, concentration, etc.). I can't seem to clear my mind. I almost kicked some guys ass in the grocery store parking lot this morning. I was backing out of a space and he looked right at me and pulled into that lane anyhow. We were in a situation where someone had to back up and I was almost completely out of the space. I sat there for a few seconds and then got out of the car and asked him what his problem was. He just sat there so I started walking over to his car door and all of the sudden he started backing up.

What the fuck? He was like 50 and I'm 36 and a big guy (6'3" 270 lbs). What, he didn't know what kind of unstable character he was dealing with? Doesn't the rest of the world know that I've got some serious psychopathology going on here? In addition, where I'm filling in at my wife's job they are trying to screw me out of two hours of vacation time. I know it's only two hours (maybe $30 after taxes) but it's the principle of the thing. It's especially irritating because the HR woman here has always - over the course of three years filling in here on and off - fucked with my pay. It's a constant struggle just to get paid what you are owed from this place.

Lately, half the time I feel like bursting into tear for no reason and crying my wittle (as a friend snidly put it) eyes out, and the rest of the time I feel like ripping someone's head off. I'm pretty violent when I'm drinking, but not usually when I'm not drinking - though I do have my moments... I've got so much work going on, which is a great thing - I'm excited about all the projects I've got going, I don't want to lose any of them - and I'm terrified that a relapse, which may be coming, would put it all in jeapardy. On the other hand I often feel like throwing up my hands, giving up, quitting the meds, and giving in to psychosis and ruin. Anybody else had that urge?

That's all for now,
Dr. K
(Prophylactically: That's Dr. as in Ph.D. not M.D. for fuck's sake.)

Just for the Record

I have been asked repeatedly if I'm really a doctor, so just to clarify, AGAIN: I am a Ph.D. For those who don't know what that means, see the entries from Wikipedia below:

Doctor of Philosophy (from Greek Διδάκτωρ Φιλοσοφίας, meaning "Teacher of Philosophy"), typically abbreviated Ph.D., for the Latin Philosophiae Doctor or D.Phil., for Doctor philosophiae, is an advanced academic degree. In many countries it is the highest degree awarded in most disciplines.

At American universities, students undergo a series of three phases in the course of their doctoral work. The first consists of course work in the student's field of study and requires one to three years to complete. This is followed by preliminary or comprehensive examination and/or a series of cumulative examinations where the emphasis is on breadth rather than depth of knowledge. Finally, another two to four years is usually required for the composition of a substantial and original contribution to human knowledge embodied in a written dissertation that is typically 250 to 450 pages in length. Dissertations generally consist of (i) a comprehensive literature review, (ii) an outline of methodology, and (iii) several chapters of scientific, social, historical, philosophical, or literary analysis. Typically, upon completion, the candidate undergoes an oral examination by his or her supervisor and a committee of academics with expertise in the given discipline.

Doctor of Medicine (M.D. or MD, from the Latin Medicinæ Doctor which means teacher of medicine) is an academic degree for medical doctors. In the United States, the M.D. degree is the most common degree in Medicine. Medical doctors are trained in evidence-based Schools of Medicine and are regulated by the American Association of Medical Colleges. An M.D. is one of the two first professional degrees, either of which is required to practice medicine, the other being the D.O. degree (Doctor of Osteopathic Medicine).

Hopefully that clears things up.

Dr. K, Ph.D.

Busy, busy, busy...

I'm ultra busy right now. My wife took a three week vacation from her job to do some interpreting work (Japanese/English) for big bucks and I'm filling in at her office for her. So we are quadruple dipping for a while (her vacation pay + interpreting pay + my pay for filling in + my research pay). But being at her job 8 hours a day really puts a dent in the other projects I'm working on. I pretty much get up at 5 am, feed and walk my two huge Akita's in this fucking weather, get to her office by 7:30 am, work until 4:00 pm, go home and walk the dogs again, go to a coffee shop and work until 9-10 pm, and then go home and pass out. She is also working 7 am until 8:30 or 9 pm every day so she's exhausted too. We've been a little grumpy around each other lately...

In addition to working at her office I've got a good research gig going (research for an hourly rate), I'm putting together a rather lucrative book proposal (the funding is already there, I just need to negotiate the details), and I'm fleshing out my lectures for Spring quarter (I'm teaching a huge class of 240 students).

Last night I got a new prescription and picked up the starter pack to begin, again, taking Chantix. You take it for one week and it slowly builds up in your system. Then, when it's at a therapuetic level you quit smoking. So for me that will be next Tuesday. Until then I'm trying not to go over the deep end and smoke too much, but it's tough not to. A friend of mine can either smoke or not smoke - it doesn't seem to phase him. He can smoke for a week and then not smoke for two weeks and then pick it back up. I can't do that: If I smoke, I SMOKE; If I done, I DON'T. Marlboro Reds, Baby - Marlboro Reds.

The other thing is that I had pretty much de-smokified my house, car, clothing etc. Now my car stinks again, but for the sake of my wife and the house I've been smoking in the garage despite the fact that it's literally 10 degrees in there (lower at night). And, I was just ready to begin the process of repainting the inside of the house and ripping up the carpet which would have really gotten the smoke smell out, but now I have to wait until I've quit smoking for good, again.

Smoking again is also definitely fucking with my health. When I do sleep I don't feel as rested. I'm tired all day. I'm coughing shit up again. This just sucks. Oh well, it's a fucking drag, but I've got to start over again. If you can't tell I'm rather pissed off about this smoking thing.

More as the mood strikes...

Dr. K

Life's Little Headaches

Holy fuck have I had headaches the past few days! I'm sure it's at least in part to my renewed smoking, which like a good bipolar drug addict I dove back into full force. I am also exhausted - but that's understandable given that I've got four major projects going and I'm not getting much sleep. Plus, this fucking weather is about enough to do me in: the temps in the Midwest have been below zero with ridiculous wind chills down to the teens and twenties below.

Yesterday I guy I sponsor in the program came over, we talked about the steps, and just generally talked for a while. Then we ordered a pizza and watched Jack Ass 2. I have to admit it was hilarious. I should note, that I used to shoot up heroin with this guy - I cleaned up, but he kept going. Now he's getting sober and I'm his sponsor (funny how the worm turns, isn’t it?). Well, my lovely wife came through the door, took one look at us sitting on the couch watching the movie and eating pizza and it was too much for her: the memories of when the two of us used to shoot dope came flooding back and she got really scared and pissed off. She tried to blow off her anger as upset that we didn't save her any pizza (she doesn't eat pizza) but it was clear something else was wrong.

Later on when I returned from the meeting that my sponsee and I went to, she had calmed down and we were able to talk about her fears. I also suggested she call her Al-Anon sponsor - which is something I know I shouldn't do. I shouldn't interfere in her Al-Anon program and she shouldn't mess with my program. Anyhow , my wife called her and they are meeting tonight. I think she's alright, it was just the sight of us together again that threw her for a minute. On the lighter side, my sponsee is doing really well - his head is in the right place. Plus, given the fact that we used to be scumbags together, he's going to have a hard time lying to me.

Right now I'm at a coffee shop and I better quit screwing around and get some work done.

As ever,
Dr. K

Sleep Less

This could be a very bad sign: I couldn't fall asleep until 2:00 am this morning and was up at 7:00 am despite 600 mg of Seroquel and 2500 mg of Depakote. I usually maintain good sleep discipline: 10:30 pm to 6:30 am. I don't know if taking up the smokes again effected my sleep or the fact that I forgot to take my Cymbalta yesterday morning and took it at 5:00 pm had something to do with it. In any event, when I don't sleep it's something I need to watch because I may be sliding into mania. I don't feel manic, though I don't usually recognize it too early because I enjoy the lifting of the depression and the elation of hypomania.

Anyhow, I've got a full day for a Sunday: I've got to feed and walk the dogs in single digit temps, finish some painting at my mom's condo, go to the library and exchange some books, do work on a research project, put together a proposal for another project, spend some time with a sponsee, and go to a meeting. That should pretty much fill up the day I think. And, no matter how offensive some may take this: I couldn't care less about the superbowl - what a waste of time.

Sleepy,
Dr. K

Relapse

OK, this sucks, but I have to admit that I relapsed on cigarettes today. As of this morning it had been over a year since I'd shot heroin, nine months since I had a drink, and over two months since I'd had a smoke. I don't know what did it - I've been Jones'ing for a smoke all week and somehow today at the gas station I just couldn't take it anymore: I bought a pack and had one. I've had three so far today. My wife is not happy, but she's dealing with it pretty well.

I used that new drug Chantix to quit. It's a partial nicotine agonist and worked very well. However, three weeks ago I stopped taking it because I thought I was free of the smokes. About the same time I started taking Cymbalta. So, I don't know if it was stopping Chantix, starting Cymbalta, or the combination that got me, but I definitely think there is some brain chemistry at work here because I went from not even thinking about smoking for a month and a half to huge cravings over night.

Not that this is an excuse, but I've been doing some interesting reading lately that suggests that bipolars and schizophrenics tend to smoke, and smoke heavily, because the nicotine alters brain chemistry in a way that lessens symptoms: in other words, we are self medicating. That's not a free pass to smoke! In fact I hate smoking and I was so happy being off them. The cost, the smell, the fatigue, the headaches, the freakin' inconvenience (you can't smoke anywhere these days). Not to mention it makes you a social pariah - it's the new scarlet letter.

Anyhow, Monday morning I will call my doc and get a new prescription for Chantix and start all over. In the meantime I'll be smoking with the rest of the outcasts banished to the great outdoors (despite this cold snap in the Midwest).

As ever,
Dr. K

P.S. To clear up any confusion from earlier posts and comments: 1) I am not responsible for any other "characters" in the blogoshpere; 2) Everthing it says in the sub-header above is true; 3) If you take special note you'll see that I'm a Ph.D. (in a discipline in the humanities) and hence cannot write scripts for you miscreants out there; and 4) Everyone is welcome to leave comments, but I reserve the right to delete anything that is overly long.

Thawing Out

Kansas Sunflower kindly asked where I've been since starting this blog. The truth is that except for a little burst of energy behind the set up of this blog, I've been in the depression deep-freeze for the last couple months. I finally insisted that my doc do something about it. He's reluctant to try anti-depressants on me because they've thrown me in to mania in the past, but I told him something HAD to budge. I just couldn't live like that anymore.

His response was that we should try an anti-depressant one more time and then move on to ECT. The problem with ECT is I really can't tolerate short term memory loss and do my job. "Gee class, I have no idea what I lectured about on Tuesday so I'll just take a shot in the dark today..." I have to be able to teach and do research.

I've been on Cymbalta for over two weeks now and I've felt a very noticable difference, physically and mood-wise. Physically I feel like I'm ramped up quite a bit; my muscles, especially in my face, jaw, and neck feel very tense. My mood has improved quite a bit, though it's still not where I would like it to be. (Will it ever? I doubt it.) I fear, however, that I am sliding toward mania. I'll let myself whine to the crowd: sometimes I get really tired of keeping all the plates spinning and I'm so tempted to give in to the illness, addiction, desires, and sundry monkey-chatter that fills my head most days.

Will anyone out there who has been through ECT please leave a response and let me know how it went for you? Thanks again for your inquiry Sunflower.

Getting Started

I had a hard time finding a name for this blog because anything having to do with bipolar disorder, drug use, or anything else I find interesting is already taken. I picked Emil Kraepelin's name for the URL because for one thing it looks fun to pronounce (undoubtedly he was a Kraut, but is it the Old English Ae ligature as in "Crap-elin" or is like the French breakfast food "Crepe-e-lin"?) and for another he coined the term "manic depressive psychosis." In any event, no one else had taken the name. However, I did NOT take my 'nom de blog' from Kraepelin - I am in fact a Dr. (although I can't write scripts, so don't ask) and my last name does start with 'K' - hence Dr. K. That's all the time I have for now.