Never forget that you are my hero

Save this for a rainy day

For new readers, hello and thank you for joining.

To put you up to speed, I was diagnosed with bipolar disorder back in 2017. I documented my long and raw journey of fighting this illness here in Happilydepressed.blog. Despite repeated hospitalisations and endless cocktails of psychotropics, I was getting worse. Luckily, in 2019, my husband stumbled across a new approach to treating bipolar, a mix of rTMS sessions (repetitive transcranial magnetic stimulation), and life long high-dose Levothyroxine. If figures, bipolar patients suffer from a lack of Thyroid hormone due to a gene mutation that is compensated by high-dose thyroxine. Slowly but surely, and thanks to this treatment, I was able to regain my life back. For more information on this treatment approach and to better understand the link between thyroid and mood disorders, you can refer to this research article published in 2021 by my treating psychiatrist Dr Andy Zamar.


Last week, I tried reducing for the second time this year my dose of levothyroxine (from 700 to 650). My idea was that I might be able to function as well, now that I have been stable for a long time.

It started fine, I was ok. All of a sudden, hell broke loose without any warnings. I was bed-ridden, crying, not eating, and suffering tremendously. My negative thoughts were spiralling. Nothing seemed right. I even doubted my previous stability and all what I had achieved fighting bipolar for 5 long years.

I was aggressive, repulsive, talking in monologues and saying hurtful things. Three days in, I agreed to shower and listened to my dear husband, who was trying to convince me to increase my dose to the initial 700.

Soon enough, the dark cloud began to disappear and I found myself regaining the confidence I had lost.

I made a list of what I learned and what I should remember if I ever have another relapse. I try to give meaning to my suffering, and perhaps if I do, I will manage to avoid it in the future. So here you go, you might want to save this for a rainy day:

  1. NEVER UNDERESTIMATE BIOLOGY: As much as bipolar disorder is defined as a psychiatric disorder, it is really a genetic illness with psychiatric symptoms. There is so much one can do in face of a biological deficit. Ask yourself, am I fighting the right battle?
  2. HEALING IS RARELY LINEAR: Growth, development and healing are not linear phenomena. You do need sometimes to regress to move forward. I am not telling you anything new. Look at the big picture, not just at an arbitrary snapshot.
  3. REMEMBER YOUR PAST TO APPRECIATE YOUR PRESENT: Never forget where you are coming from. Be humble and grateful. Have you been worse? If your answer is yes, then try to get up.
  4. MENTAL WELL-BEING IS NOT A FAD DIET: Fast results fade fast. With perseverance you will reach your goals. When has it been any different? So hang in there and get back on track.
  5. LOVE YOURSELF WHEN YOU ARE LOW AND PLEASE DON’T CRINGE: Be kind to yourself. Being harsh, unrealistic, and idealistic won’t help you one bit now and you know it. Don’t make it harder than it already is.
  6. REMISSION IS NOT A RACE: Why compare to others? When was this a reason to move forward? Did it ever make you a better person? No? So, give yourself a pat on the back and praise what you know how to do best. There must be something you do well. Now, go do it.
  7. BE GRATEFUL (DON’T GRINGE): Count your blessings, and recount them. You should count them again, especially if you are feeling low. Imagine if the little (or plenty) you had disappeared? Believe me, it can always get worse. So be grateful and get up.
  8. BE HOPEFUL: As long as we are alive, as long as there is a place for hope. If you have been to the other side (no need for me to be more explicit to avoid any triggers), then you know that today is better than many other days you have managed to live. No one is telling you this, you know it in your bones. So get up.
  9. NOW GO COMPARE YOURSELF TO THOSE SUFFERING FOR “REAL”: If you think you suffering has reached its peak, and that you are in intolerable pain, get up and go see some real suffering. Visit a hospital, hospice, an orphanage, special needs school, or just walk in the streets of the less privileged parts of your town. Get up and go help others.
  10. YOU ARE A SURVIVOR: Ultimately, you are a hero. My hero. Waking up for some of us is already a huge achievement. So for my sake, get up. You have done it so many times before. I love you too much to see you not doing what you do best: When you fall, you get up again.

TBC

The importance psychiatric empathy and engagement in patient /doctor relationship

Today I had a routine FaceTime appointment with my psychiatrist. I wasn’t expecting much. We were just going to discuss the usual.

Yet, the first thing he told me

was “I read your blog”.

I was taken back for so many reasons. I had no idea he would have such interest in his patients, or have the time really.

What is interesting is that I had written my last entry on how I am suffering from the side effects of the meds I am taking, especially how I have lost hope, and how I feel disabled mostly because of the antipsychotic quetiapine of which I take a significant dose. Although I had shared this with him before, reading my words seemed to have had a different impact on him I would discover.

Yes. My doctor told me something I would have never ever have imagined any medical practitioner to ever say. He told me I have failed to treat you.

I could not believe what I just heard. First of all we are far from being done. I am still being treated. And I am a thousand times better my dear doctor than the first time I saw you. I cannot even find words to describe the state I was in when I first talked to you and you said yes I will take you as my patient. I could barely speak, yet you were able to translate my pain and understood me.

Today my doctor showed me how he truly listens to his patients. I had talked to him over and over again about reducing the dose of my antipsychotic. He had refused categorically on many different occasions and told me if I did I would relapse. He told me I had to bare the side effects and be patient. He was extremely worried about me.

Today however, he told me that he thought long and hard about my blog piece and decided to change the treatment plan.

He decided to change it to accommodate to my needs and because he had already increased during the past weeks my levothyroxine. [My treatment is based on three pillars: levothyroxine, quetiapine, and rTMS]. I had also a few sessions of rTMS as a back up before this new treatment plan. He also told me that if I don’t respond well to reducing the quetiapine, he would shift me to another antipsychotic. This was all I needed to hear. Hope is the most powerful medicine of all.

I am sharing this story today because it is really a breakthrough on so many levels. I rarely hear of anyone admitting or alluding that they are wrong or even questioning themselves really- especially if they have any kind of authority over you. Two, who has the time to read or listen or care about their patient outside of the 15 minute appointment slot they have? Who cares what they feel, like or dislike? I have seen my share of psychiatrists and usually when I start slightly feeling uncomfortable it means that the relationship is going south and the end is near my friend.

I have all the respect and admiration to you Dr Andy Zamar, a great man, extremely bright and sensitive.

Mind you this is just the top to the iceberg. My admiration for this great doctor has no limit.

I only hope that he has the opportunity to train other fellow psychiatrists.

Thank you for your humanity.

TBC

Bipolar – my disability

My illness is flagrant. It is clear as sunshine. Bright as a star. Big as a 10 cart diamond ring. Obvious to the naked eye…

Yes it is when I have an episode.

But when I don’t…

It is dormant. Blends with the background. Goes unnoticed. Quiet common. Just like the flue. It is a John Doe..

I tend to forget, for am human. And we humans tend to do so. A lovely quality we have. Makes us able to live, to turn the page.

When my illness strikes back, am always surprised. It takes me a few days to adjust. As if it is the very first time am experiencing the symptoms. All fresh.

The pain is new, yet the depth of the scar is familiar. I remember the fear of falling into the abyss of mental illness with all what it means – more meds, more symptoms, more side effects, hospitalization, days in bed, fear of losing my mind, fear of losing control, fear of finally giving in to suicide…

Yet I know I can’t. Something tells me this cannot be the end. I recall the conversations I had, the notes I wrote, specifically for these moments to remind myself not to give in.

I try to summon my strength, the strength I have and the one I don’t, and pretend to stand up. I rise in my dream above myself, above my tears, above my hospital bed and tell my doctors to let me live some more.

But if you are ill like me, you will soon learn that living isn’t the point really. So what is the point of having a life with such an illness that makes hell a walk in the park? On average I get two good weeks a month and if am lucky we can stretch them to three.

I am heavily medicated, but at least the meds I take do work.

I got PTSD. I am being treated for it, but I feel mostly guilty all the time for how my illness affects my loved ones.

That’s where am at now with my bipolar. I cannot always embrace it. I don’t rise above it. I wish I could say it differently, bipolar is my disability…