Mania · Medication

The medication miracle

I was told a lot of things when I was started on lithium. One of them being that only around a third of people respond well to it. A third would respond quite well, but would need another medication in the mix or would experience breakthrough symptoms, while the last third wouldn’t respond at all. (I hope I’ve got that information right, it was almost a year ago and it’s something I was told rather than something I’ve researched).

Within a few weeks of starting it, I’d come down from my high and was ‘stable’. I was told that those who respond well to it in the first few weeks are likely to continue to respond well.

Excellent!

And so lithium was my medication miracle. For months I experienced ‘stability’, my mood wobbling only with the type of things that would bother anyone- a 44hr week at work, a tough therapy session, the return of my best friend from Australia. My ups and downs were in the confines of ‘normal’. Between a 4 and 6 on the blessed mood scale.

Arguably, I was more stable on lithium alone than I was on the lithium/olanzapine combination (where the side effects coupled with the stress of moving to a new country had me worrying I was slipping into a low).

So I’m scratching my head and wondering why it doesn’t seem to be working this time.

I’ve been in hospital five weeks now. Which means five weeks back on meds. I was put on aripiprazole and lorazepam to bring me down from the high/mixed episode and restarted on lithium at the same time. Last week, the aripiprazole was swapped for quetiapine to see if that would help my sleep, after promethazine, zopiclone and lorazepam still left me awake. It did. So I’ve had maybe 5/6 nights of some sort of sleep (before I was getting next to none).

So I should be well down, settled, stable, on an even keel. I should be grand, home, back at uni. But I’m not. My mood is still swinging. The past few days/week has been a lil up, a bit buzzy- not overly, but high enough for the doctors to ask if I could see how it was too good, for the occupational therapist to comment and for my mum to symptom check over the phone. High enough for me to want to climb back onto the hospital roof.

So I am panicking that the medication isn’t working. That this time the lithium isn’t quite so miraculous, and I am worried that that is my fault, for stopping it, that now I’ve had to start it from scratch, I’ve somehow raised my tolerance to it. In fact, my outpatient psychiatrist warned me that for every time I stopped it, my recovery would be reduced by 2-3%. So technically, it won’t work as well. But it kind of feels like it’s not working at all.

And I am worried about what will happen if it doesn’t, if the medication miracle doesn’t kick in and sort these bloody chemicals out and put them back in their place. Because I can’t do this, I really can’t. I really do want nothing more than to be back at uni, back with my friends, away from this hospital and my head.

And there’s that, too. It’s still hard, messy. I’m still crying at meds time, with my favourite nurse cheering me on, telling me I need the pills to get me stable. I still sit in the fishbowl (quiet room) on the ward and sing Frozen at the top of my lungs (and subsequently have nurses charging in and telling me to shh), while simultaneously wanting to cry. I still badger staff and ask them for walks, trips into town, a new brain. I have been tasked with writing a list of pros and cons for taking meds and for being on meds. I sit down on my bed and put pen to paper. Jump up, flit around the dorm room, up the corridor, outside for a cigarette, back to bed. I throw my pen down in frustration. I am hot and flustered and I am confusing myself, and to be quite honest, this whole damn exercise is s t r e s s i n g m e o u t. It is making me want to scream and cry and punch the air and holler that IT’S. NOT. FAIR.

Today one of my favourite nurses is on. She is hilariously grumpy today and tells me that I need to get it into my head: I need meds. The same way some people might for cancer or diabetes, I need medication for bipolar disorder. Tough shit. That’s just the way it is. Well, she doesn’t say that, but she might as well.

It’s all a big jumble. I both want to be still and don’t want the medication. I recognise that the medication is what will make me still, yet I am still fighting it, trying desperately to cling to the high, crying as I swallow the dixie cup of pills, speed walking past the nurses station in the hope of sneaking into bed before they remember I haven’t taken my meds. I know I’m fighting it, but I don’t know how to not fight it when the meds both leave me with unpleasant side effects and the lithium miracle doesn’t seem to be working anyway.

So it’s all a bit shit, really.

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