Forgiveness and recovery

The blog has shifted gears. My writings were sometimes exercises of introspection – reflecting my state of mind during my struggle with depression, anxiety, and bipolar disorder. Other times, I would write about what I thought was wrong with the medical system as it stands today; not seeing the person as a whole or just silencing and over drugging the mentally ill till they slowly lose themselves in an array of side effects and endless adjustments of dosages. I also wrote about misdiagnosis and malpractice, and how our lives could change just by being given one very wrong label or another.

In my last few posts I started sharing with you the lessons taken home. There is no pretentiousness or ‘I know better’ in my words. I try to repeat this one way or another because it is so important!

So here goes…

Today I want to talk to you about a pivotal moment in my recovery.

You know getting better is not linear. If anyone tells you so, then they either don’t know what they are talking about, or they are simply really very optimistic, or just they were super lucky and are the 0.01%.

Recovery has so many elements. Naive, I used to think about it like a finish line. It was actually more of a destination, and to get there you have to take a bumpy ride.

To recover, I of course needed be on the right medication. I was supposed to find stability. Yes little by little I didn’t have anymore mood swings. A small relapse here, a little adjustment there…

I relate to this as trivial compared to what I went through. I didn’t feel depressed or have this huge void eating me up; true. Yet, I felt surprisingly guilty. Probably not surprisingly.

I was not able to feel relief. Why aren’t you happy now? Good question! I was faced with two major problems.

One: the aftermath of what ‘I have done’ to my family witnessing all this suffering. Two: the immense fear of this ordeal happening again. Three: I know I said two but I also had memory issues, self-confidence issues, brain fog, and 20 plus kilograms to lose to fit in my old socks because of all the meds I was taking before finding the right treatment, tapper off a few others, and of course I had to reintegrate into society.

After spending time feeling stagnant in these negative thoughts, I talked to my psychiatrist who suggested that these signs are very well similar to those of Post Traumatic Stress Disorder (PTSD). In brief: the experience of illness is so intense that in itself it becomes traumatic and creates guilt, fear and flashbacks. Are you familiar?

He suggested I undergo a few sessions of EMDR – Eye Movement Desensitisation and Reprocessing therapy. It is non invasive, simple and fast method of psychotherapy. I was skeptical at first but I tried and It worked really well on my trauma. Highly recommend it if you find a qualified therapist.

Relief was not immediate. But at the time I decided that I needed to open a new chapter in my life if I am to recover. Again this does not happen over night. It is a process. You plant the seed.

How can I ask those around me to forget what happened if I am constantly thinking about it? How can I be ‘normal’ if I am living every moment waiting for another attack? How can I expect to be ‘forgiven’ if I cannot forgive myself?

Forgiveness was the magic word. And trust me it is everything but cliché. 

I had no choice. I internalized this and repeated it to myself for the millionth time. Mental illness could happen to anyone at anytime. Mental illness is not a choice. Mental illness teaches you how to be human and humane. This experience showed us all how we are connected and how we love one another and how blessed I am to have my family and loved ones. They also used to tell me the same, but you know guilt…

Before all this, I had to forgive myself for the pain I went through. I decided that I will allow myself the suffering that passed and say it is ok. I don’t judge you. You were hurting and you are fine now. Again, you water the seed.

I gave myself a pat on the back and a big hug for the long road travelled and I said it is ok. I looked at all the things I have learned. How strong I have become. How loved and cared for I was and how things could have turned much much worse.

I looked at my family hoping day in day out that what dwells inside my soul will reflect into my behavior. Little by little, things began to change, and a new normal appeared.

The seed grows into a plant.

My dear reader I decided to be kind to myself because I had suffered enough and I invite you to do the same even if you are not in recovery, or even if you are not mentally ill. We have all suffered one way or another. We deserve to live guilt-free.

Allow yourself the gains you have achieved though little they may seem; for today is a good day and we only hope we replenish the well a little more tomorrow.

The New Business Model in Psychiatry

I checked myself yet again at the hospital. It became my full time job really.

Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?

Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!

My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.

When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.

Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.

I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.

While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.

That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.

My business teachers at university always said a good product or service starts by answering a customer pain.

Very well, mental illness is filled with customer pain; be it the patient herself or her family members.

I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.

Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.

Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…

TBC

Capitalism and bipolar disorder

My illness relates to many many factors. It is my upbringing and my biology. It is society, it might even be fate.

My illness maybe relates the most to a lifestyle, no; to a mode of being that I am not the only one to have created but surely had to abide to. My illness is so common you would be surprised. My illness is “in” these days. My illness is a mutation, a mistake if you would like. My illness is a blessing as much as it is a curse.

I get to the downs of the deep blue and sometimes I stay afloat. Sometimes I even catch a boat, a sailboat- nothing too fast. I wonder and I ponder about my existence and yours. I shed a few tears and even pop a few pills.

I always end up where I started with mixed feelings about everything. Nothing is my favorite as how should I know? My illness changes my mind as I grow.

Something is constant amidst this storm. I know there is a malfunction, that much is true. Why does it relate to inequality go ahead and ask me. All is a competition, life has become a race. We run around all day seeking a bigger dream. I don’t get there and you don’t either, but why does she? Born in here, studied in there, oh that is her family? Where is my choice in all of this? Where is this leading me? Achieve and fail and fail to achieve. I ask myself why I stopped dreaming. Those images were not mine but yours, so why keep them in the first place? Illusion, delusion, materialistic being. This is not whom I should be. Why wake up and swirl like a mouse? That’s when I decided not to leave the house. I felt immense fear from life; how on earth can I win this race? Exclusion, demotion, gender roles or nationality?

TBC

Raw on hypomania

3:15 Am, four Xanax later, one hour on SoundCloud, about 15 cigarettes, two herbal teas, some half pack of almond thins, an Instagram and a blog post published, and as sleepless as a toddler who just won’t nap.

I wake up nightly between 2 and 4 AM. It is a killer, but it is the period I feel the most creative- unstable but creative.

I can almost smell coffee, its rich and dark brewing aroma inviting me to take a cup. Just a sip. I can also see this gin tonic fresh and calling my name. I don’t want to eat, I want to binge drink! Isn’t that a word ? It is now.

I cannot have coffee or gin as a matter of fact. Doctor’s orders. No stimulation. None. No sports. Mot even hot yogaZ Not that I was your athlete or alcoholic. But still, breaking a sweat, sipping a nice drink…

If I had hold of a car now, if I knew how to drive on the “wrong side of the road” here in London, I would have gone for a cruise. The type of ride you have when you are what 19? Windows rolled down, music loud, singing along, no care in this world.

But am in my pjs, sneaking out in the cold to smoke yo my cigarette with my yogi tea and slippers with my toes freezing like a good girl.

No make up tonight. No tight dress and high heels; first no freakin tight dress would fit now and no heels in the suitcase.

But what is a woman without day dreaming? I have lipstick. I can do lipstick at 3 am or full make up if I want to.

But now the ride is coming to an end. SoundCloud is asking me “how deep is your love?” And am like you have no idea how deep is my love. My eyes are opened and I have devotion and it is bigger than the ocean.

I am making sense, don’t give me this look. Am in Ibiza but in primrose hill and that is totally fine.

Am managing my hypomania which was just suicidal ideation about 5 hours ago. Screw that, I want to be by the beach. Close my eyes, walk on the sand. I am in control of my emotions or not. I can run or swear. Heart rate is my affair. I stimulate and get stimulated as much as I need or wish or both.

Honestly. This is my first hypomanic post. Raw, unedited by my subconscious who wants me to look wise and smart. I just want to party… was it all a dream ? Back to my herbal tea

Please no excuses

Live whitest you can

TBC

Part one: On Guidelines for treating mixed episodes and rapid cycling in bipolar disorder – Beacons Of Hope: Thyroid hormone replacement and rTMS treatment.

My problem with my illness is not my illness per se, it has always been how the medical community thus far dealt with me as a series of isolated symptoms; instead of seeing me as a whole person.

Things have been moving on though. Let me tell you my story with this new treatment am on.

But before that, we have to talk diagnosis. We have to talk guidelines. We have to talk knowledge.

Looking back, the past three weeks seem like months.

My beloved husband researched and researched my condition over and over again. He wouldn’t surrender or admit that I won’t get better. He believed that there is a way out and that I could be cured. At least he told me “let’s have the honor of trying”, bless his pure heart.

Less than three weeks ago I was self admitted to another mental health hospital. I left the very same day. Surprise! Though practically no one understood, everyone accepted, believing I had some internal compass that points to truth. In fact, I was too restless for a single room and too “aware” to stay in a ward.

In a parallel world my husband had found a doctor in London at the London Psychiatry Centre who had very convincing arguments saying that he could treat my condition. In fact he already successfully helped hundreds like me. This brilliant man is called Doctor Andy Zamar. His attitude, bedside manners, and ultimate responsiveness to his patients make him deserve my deepest respect regardless of the outcome of my ongoing treatment. He doesn’t believe in the status quo and he bothers to read what

have written before him.

We first had a FaceTime consultation during which he made me read some research he had gathered regarding bipolar disorder. Specifically, he wanted me to read in black and white as he said how wrong it is to take antidepressants when one has a mood disorder. He made me read out loud the Maudsley Prescribing Guidelines in Psychiatry for those suffering of rapid cycling. It said loud and clear to “withdraw antidepressants in all patients”.

That my friend is an interesting finding. I have been given antidepressants by the medical community that treated me in the past three years. In 2017 Effexor led me to the emergency room trying to quit it as it was impossibly painful to deal with its withdrawal symptoms. Mind you it was done under medical supervision. But that is another story.

Later on in 2018 I began self medication when I quit lithium by myself – which interestingly I discovered does not work on its own in my particular case as per the guidelines. It has also lots of side effects I could not deal with. So I self medicated and started Prozac 20 mg for 7 months. I did that because I thought it would be a safety net that won’t let me fall into deep depression.

I was wrong, I couldn’t have done myself more harm unknowingly. I did rise into hypomania which inevitably led me to deep depression. When I went to see doctors just before meeting Dr Zamar, they advised and prescribed an increase in Prozac to 40 mg and this is when hell broke loose.

Doctor Zamar diagnosed me then with ultra rapid cycling bipolar disorder otherwise unclassified. I had hypomania turbo charged, as he explained with depressive content. Talk about suicidal thoughts!

Again I read during our call what described my state. Doctor Zamar was not reinventing the wheel. The paper is called Melancholia Agitata and Mixed Depression [Koukopoulos et al. Acta Psychiatr Scand 2007: 116 (Suppl. 433): 50-57. The paper is more that 10 years old!!

So on page 52 here is the “clinical picture of agitated depression” – it was describing me in a nutshell …

Melancholia Agitata and Mixed Depression
Melancholia Agitata and Mixed Depression p.52

So people someone was saying why I was committing suicide in ink…

Check this out

Melancholia Agitata and Mixed Depression
Melancholia Agitata and Mixed Depression p 53.

The last time Doctor Zamar prescribed antidepressants was in 2004. Say what you may. But isn’t it a million percent better to be safe than sorry?

This is a heavy post I know.

My final words are those of hope. Now that we know what not to do, the action he proposed is derived from new research based on thyroid replacement therapy and rTMS.

The treatment combo am doing is that I take on one side Olanzapine known as Zyprexa which is an atypical antipsychotic that is supposed to calm my hypomania.

Secondly I do rTMS or Repetitive Transcranial MagneticStimulation; a treatment that not only has enormous success rates for treating depression but it is virtually side effect free.

Last but not least, Doctor Zamar is using Precision Medecine Nd treating me as a person. We do weekly ECGs and blood tests. He takes my side effects seriously and he doesn’t brush them under the table. He listens. Mind you this post could sound like praise to him, which it is. But listen my friend, it is to everyone of us working with people. Stop being an ear and nose doctor and look at true bloody person you are treating.

At this clinic they do take swabs to send for genetic testing to stop wasting your time. As their website says there is no “one size fits all”. Genetic makeup therefore is very important in deciding treatment, knowing what works and what won’t and also knowing what would be tolerated. In psychiatry this saves light years.

I will be staying explaining in my following post the thyroid replacement therapy.Meanwhile I urge you to read this beautiful hopeful article published on their blog: Bipolar News – Millions could benefit from bipolar breakthrough #worldfirst

TBC

I am committed

I am committed to coming back to this very hospital

I am committed to receive every form of therapy there is under the sun

I am committed to doing whatever it takes to raise our children, see them graduate and organize their weddings

I am committed to loving and honoring my immediate and extended family in every possible way

Meanwhile I am finding my happy middle

It is a mirage

But I need to keep on looking

I will check out tonight if it is the last thing I do

I will come daily as an outpatient

I am committed to heal

I am committed to survive

I just checked myself in a few hours ago and now I want to run through the iron gates and never come back.

I cannot deal with my thinking, my needs, my wants, my moods.

Is this a magic spell?

Get me in here

Get me out of here

My patience is nonexistent and my insight is blurred with my tears.

End this torment for I am at the end of my rope

This song is on a loop and it won’t stop

TBC

Worry of hope – rapid cycling

It’s 5 am and I cannot sleep.

I am angry of myself. I am angry of the world. I am angry of hope.

I am supposed to try a new treatment soon. My mood changes more than I can handle. I am up and down at the same time.

I put on my trainers and went down for a walk.

Am writing and waking while listening to music. That is how restless I am.

I am worried it will fail

I am worried I will fail

I am worried I will fail them

I am worried they will fail me

End up my post with the usual

God grant me the serenity to accept the things I cannot change

The courage to change the things I can

And the wisdom to know the difference

TBC

In the world of rapid cycling

Hello everyone. Bla bla bla yes I haven’t written for a while, miss you, etc.

You know it is not me who is inconsiderate or rude: am rapid cycling.

Say what? Say one day am high as a kite (a small kite since am bipolar 2), and the next am digging a tunnel to the the after life (does that even make any sense?)

You get the picture. Am a yo-yo, I am a roller coaster, a bullet train with bad breaks.

I enjoy my ups and do accomplish a lot; especially if you count shopping as an accomplishment. I spend hours without eating (big high five since I tend to feed like a newborn every 2 hours). I even live on 5 hours of sleep and I am Eeyore on any other day.

Woke up at 6 am today (weekend here on my side of the world) and hoped into my trainers and on to the kettle and to my smokes.

Am sociable, am pretty, am smart and talkative. I love it.

I wrote this down to me Nour. Yes to me, for in a few hours I will feel like dirt is better than me. I will feel empty and useless and I will become a burden. I will get back to staring at the ceiling and doing nothing but dealing with suicidal ideation.

Today however I will kiss my kids, a lot and lots more. I will go for a long walk like the book says. I will have lunch with my beautiful loving family and I will dress to impress. I will put on my make up and my new earrings. I will take a selfie or two and hashtag them to mentalhealthawareness.

Meanwhile my rapid cycling friend; I freakin feel you. You are my hero.

Remember, for every down there is an up coming and heck yes we shall ride the wave and rise to the moon.

Bless

TBC

Call for interviews

As part of a bigger life project, I am conducting (anonymous) interviews on how to live/cope with bipolar disorder. Send me a message here or through my Facebook page if you are interested in participating.

Bless

https://m.facebook.com/happilydepressedblog/

Choosing to live with the side effects of psychotropics – a life changing decision…

I saw my psychiatrist yesterday.

I told her about my “attacks” and she explained.

She told me that hormonal changes in female bipolar patients tend to send them over the moon sometimes. So what I am going through is not surprising. It is not a hormonal problem per se, it is just a confirmation that I have a mood disorder.

I asked if there is any biomarker that would tell us if I need a hormonal treatment to fix my mood. She said that there is currently no information on this. Surprise? Not really. So the only marker hormones wise is that of the thyroid gland functions. My numbers are not perfect, but not alarmingly different to cause such an imbalance.

My session was important despite the “negative” results. I now know that I need to make a big decision.

My doctor asked me about whether stopping lithium was due to hypomania and I said it was not. I would do this over and over again. The changes, the personality changes that most psychotropics cause me are just unbearable- to me. Again, this is such a personal matter that it would be straight stupid to advise anyone to quit or not. I am not preaching anything. I am just sharing my own journey, which might or might not be similar to yours. What is sure though, you might have gone through similarly difficult choices to make.

We agreed that my life as it is now is not fulfilling. The unpredictability of my attacks renders my illness a disability to me and to those around me. We are unable to plan anything. I struggle to be an adult, an independent person who requires little or no maintenance. I struggle to be there for my children as a full time mother. Career? What is that sir! Sometimes having a shower is already a challenge to me.

Having said that, my worst fear is hurting those around me. Till when can they deal with my unpredictability.

Till when will my husband take days off work, or leave the house with a feeling of apprehension not knowing if he will find me home when he gets back.

Till when will I have my father leave everything and stick around to be here just in case I cannot deal with the children. Till when will he hop on and off plans to come to an emergency situation beyond his or my comprehension? Till when?

So fact one; we know this cannot go on.

Fact two; there is no clear solution.

My dear doctor whom I respect so much suggested that I add a new psychotropic to my daily dose of Prozac.

Psychotropic drugs are medications that affect your central nervous system, changing how your brain processes information, such as altering your mood, thoughts, perceptions, emotions, and behaviors. Most psychotropic drugs are prescribed by your therapist or health care provider to treat a diagnosed mental illness, such as bipolar disorder or borderline personality disorder.

https://www.verywellmind.com/psychotropic-drugs-425321

You see I don’t have a conscientious objection against drugs. No, I don’t. The thing is with most drugs I feel alienated, weird… I twitch, I get nightmares, I get lethargy, restlessness, anxiety, and sometimes I even have suicidal thoughts that unfortunately led me to the emergency room more than once.

She said the new drug- Abilify– could help regulate my mood. The idea is to take it at 5mg – a super low dose – to keep my curves from skyrocketing or dropping at the speed of light. Sounds good yes. I would have to wait a few months to monitor the effect of Abilify on my mood and on my menstrual cycle.

Will it work? We have a fifty percent chance it does. Ok, side effects? For starters, it is prescribed to children. How bad could it be?

Then Surprise surprise, they said when they put it in the market that it does not make you gain weight. Oups! Mistake, she said it does in many patients and my readings confirmed a nice 10 to 20 kilograms of extra weight per year. Maybe at different dosages, but still. I won’t be able to tie my own shoelaces by 2020.

Ok. What else? Oh it varies greatly she said from one person to another. Reading suggests that the worst is in the beginning; like vomiting and the like. That does not scare me. What really scared me is that patients on this drug would complain of very low energy and of restlessness or need to move.

According to the official site of the drug,

ABILIFY may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop receiving ABILIFY. Tardive dyskinesia may also start after you stop receiving ABILIFY.

https://www.abilify.com/important-safety-information.aspx

They might get also compulsive behaviors such as gambling and binge eating, cholesterol and anxiety.

How are you supposed to fight depression with all this extra weight and without any energy, with twitches and compulsive behavior? Don’t tell me stop searching the Internet. I did differ from a wide spectrum of side effects before. They are as real as it gets.

Her idea is that my Prozac would have a counter the side effects of Abilify and things would balance out. Perhaps…

So my dilemma is simply the following:

Should I risk living with these unpredictable cycles and watch myself and my family losing our minds slowly; or should I take the drugs and lose myself little by little and become a deaf note floating around in a soundless world?

Can you relate? Did you go through the same? Can you throw me a bone here? What did you do? What would you do?

God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to kno
w the difference.

TBC

Solace, where are you?

I would like to shed my skin like a snake…

I would like to change colors like a chameleon…

I know that personal growth is not always linear.

I know also that sometimes you keep on suffering until you learn the lesson.

Things are more bearable during the day. Yet, when the sun sets, and as the sky becomes darker, there is little left to be done. The few chores of the day end one by one.

I sneak back to my corner in bed. I hold my phone and do nonsense. Minute after minute, tic toc. It is past midnight already. I count the hours I have left in bed, and dread facing the next morning. I will myself to sleep but know to well that this is not how it works.

Someone else got into the control center in my head and took over. I am equally lost between trying to fight and surrendering. They are the same.

I’d do anything if I could. Like walking on shifting sand I lie on this side then on that side seeking comfort.

I finally fall asleep but my dreams are no solace. Of course they are vivid. I stopped trying to know what is true and what is not. They are as real as it gets, and also as fake as it gets.

I usually fixate on things in my dreams. Small details, they keep on coming back. I wake up without any memory of what happened. Just a feeling of weirdness and abnormality. Too much brain activity or too little. All the same.

I find small feet cuddling next to mine. They are seeking comfort and safety in me. In me…

I wake up to the sound of the alarm and hit snooze. I wish I could escape from the responsibility of being me.

I wish I could let go.

I worry about my family and how they will react – again. Pity, love, empathy, boredom, anger, what again will they feel.

I can see my temporary paralysis turning beautifully into a handicap. Will I need to be taken care of again? Till when I wonder… Will I ever be an adult?

I don’t know what to do with every single second of my day. I listen to this song then forward to another. I watch this show and then another. I go out for a smoke then decide it is too cold. I want cookies and cheese at the same time. What the hell is going on.

You know I wish I had a timeshare at a mental clinic. How cool would that be? Hello yes, this is client 44087. I am calling for room 13. Yes, is it time already. Is it empty today? Sure, like last time yes. I would like to start with the locked up package first. And I insist, don’t let me out even if I beg you too. That’s it then. See you later. Oh yes, I know the drill. No sharp objects of belts. Thank you.

Perfect customer service.

A few weeks after, my skin would have shed. Yes I am a reptile after all. Why? Oh am also a chameleon and I change colors all the time. Only difference is this is not for adaptation like reptiles. It is a malfunction, a mutation if you prefer.

At the end of the day, survival is for the fittest…

TBC