Researching my condition online and talking with my parents and psychiatrist revealed that the gold standard treatment for bipolar disorder was Lithium, yet I was fearful of the regular blood tests because I had always hated needles.
Read moreMy Last Visit to the Psych Ward
I noticed that the flowering plant on the counter of the open nurse's station had withstood my incessant plucking, as it still had about a dozen blooms, by some miracle.
“She loves me. She loves me not. She loves me.” I debated, pulling at the tender petals of a flower I had stolen late into the night on my evening of admittance. “I know it’s going to be a girl. But what will she name it?” I mused to myself out loud, lost in the psychosis which my pregnancy had spun me into.
Later that night, or maybe it was the following morning, one of the nurses tried to get me to eat. “You need to eat something, sweetheart. For the baby. Here, try this,” she urged, shaking the small box of Apple Jacks she had brought from the kitchen down the hall. We were in my sterile little patient room, a desk between us. She sat in a chair across from me, attempting to coax me into taking a few bites, as I sat in another chair, shaking, sweaty and weak from exhaustion. A small container of milk was ripped open on one side to form a drinking spout, but hadn’t been touched. I felt a little like Alice in Wonderland, staring at the items in front of me labeled "Eat Me" and "Drink Me."
I may have taken a few bites, a sip of milk, but my mind told me she was trying to poison me. I made sure not to eat or drink too much, for fear of never waking up.
Eventually I did decide to lie down and rest on the stiff single bed with the scratchy white sheets in the far corner of the room. No one slept in the other bed in the room. I had my own private room. Good thing, too. I needed to just sleep, to dream off the mania. It had taken two days of the nurses pumping me with antipsychotics until I finally relaxed enough to sleep.
I emerged a day later, after a long, hard sleep, to “meet” the other crazies in the day room. I might have met them a day or two earlier, but my memory was a slice a Swiss cheese when I was manic, so I didn’t remember. Two did stand out, though.
Tony was a big, burly Italian guy who chain-smoked and had the cough to show for it. He was warm and engaging, and I liked him immediately. He made me smile with his obscene jokes, a welcome escape from the situation we had all found ourselves in. Tony was constantly searching for a number in the phone book. When he wasn’t in the smoker’s lounge, he was on the phone pleading with the person on the other end to come pick him up.
Mary had left the day before. She was young like me, and claimed she was also very early pregnant, although I didn't believe her. Hell, I didn't even believe I was five weeks along. We had promised to keep in touch, but I knew there was no way I’d live up to my end of that deal. I didn’t like to take hospital memories home. Art therapy projects were an exception. Nothing like a glimpse into a mad mind for old time’s sake. So instead of giving her my number when she wrote down hers for me, I hugged her goodbye, telling her it would be too painful. She understood.
The exercise lady arrived in the afternoons, swooping in to lead the patients in yoga or dance sessions in the day room. She’d turn on 80’s pop music and we’d bop around, forgetting about the frustrations attached to having lost touch with reality. During those moments, everything seemed to disappear and for three minutes I was okay. Hips swayed, eyes closed softly so I could really feel the music. But as quickly as her sessions began, they were over, and we were back to waiting for our next activity to pass the time until we’d see the outside world once again.
Held for forty-eight hours of insanity, twenty-four for the meds to really start kicking in, and another forty-eight and I was good to go. A final meeting with the staff psychiatrist and I was given my ticket out of that joint. It had been my fourth stint in a psych ward, and it was a house of medicine I was hoping not to have to visit again for a very long time, maybe even never.
Ready to get back to my own home, to my family where I’d be nursed back to complete health so I could get back to being the kick-ass mama and wife they loved. This last visit to the psych ward solidified my commitment to staying well. For myself, for my husband and for our son and the unborn baby I was carrying. Not another day would pass without that little salt pill sliding down my throat before bed. My family deserves this promise. And they’ll get it, forever and ever.
What I need: meds and sleep
My poor husband. Being married to someone who has Bipolar Disorder has got to be a teeny bit nerve-wracking at times. Take last week for instance. I contracted Baby Girl's lovely stomach bug and on Wednesday night (really, the wee hours of Thursday morning) was up puking my guts out from 1am until 4am. It was horrendous. I swore up and down that I don't think I want to have another baby because throwing up is the most awful thing in the world and I know I'd have morning sickness if we decided to go for #3.
The next morning I tried my hardest to get the kids up for Mom's Morning Out but I could barely walk ten feet without my head spinning. My husband had a 9am meeting that he HAD to be at, so I decided that I'd just keep the kids home and would let them watch TV all day until he could come home early in the afternoon.
And then I remembered my wonderful Mother-in-law. She's retired and she loves the kids and they adore her. I called and she said she would of course come over to watch them so that I could catch up on my sleep.
I couldn't even make the kids breakfast. My husband gave Mister Man a bowl of cereal and Baby Girl a sippy cup of milk and he was out the door. They were distracted with the TV until my Mother-in-law arrived and I crawled back in to bed. I didn't even come out until almost 2pm.
By then I only had a few hours until my husband would get home. I hadn't been able to eat anything, but was able to drink apple juice on ice. It tasted like pure heaven but it was bad news for my blood sugar. My husband got home around 4:30pm and I went straight back to bed. He made me a piece of toast and I was able to keep it down, but my body still ached from the heaving the night before and then there were the chills. I couldn't get warm despite two layers of clothes, socks, and a fuzzy bathrobe. Under covers. Eventually I fell asleep again.
I woke up at 9:30pm and picked up my phone next to me in bed to text my husband so he would check on me. He came up and when I was so delirious in the way I was asking him to get my phone charger, he started to get concerned.
Not about the stomach bug I had. He was concerned that I may be manic. I could hear it in his voice.
He tried to force me to take my Lithium, but I refused. I got angry. I called him names for trying to force me.
I realized I had forgotten to call his mom back about the next day and whether she should come help me again, so he offered to call her. He'd stay home with me and the kids.
When he came back up with another piece of toast for me, I took a bite and apologized for my rant. I was just so afraid of the medication making me throw up again like I had the night before. I promised to take it the following night. I know how much I need it.
Just not when my stomach is rejecting anything that goes into it.
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Sleep is my #1 trigger. I know this after years of managing my illness. As much of a night owl that I am, I cannot pull all-nighters like I did in college anymore. I can't even take care of multiple newborn feeding shifts (lucky for me). Because of this, I do everything I can to protect my sleep. If I don't, my health is at risk. Same thing with taking my medication. I may just need a small amount of Lithium every night, but if I go a week without it, I am most-likely going to become manic.
I don't blame my husband for trying to get me to take my medication and for worrying that I could have been becoming manic. He is just doing his job of looking out for my well-being and our family's well-being. I am very thankful that he realized that my irrational behavior was due to my frustration in him not being able to find my cell phone charger and also my haywire blood sugar levels from surviving on nothing but apple juice and a piece of toast all day. He is a wonderful, loving partner and father to our kids who has done a tremendous job of helping me to manage my illness.
Within a few days my sleep was back to normal and my stomach is almost back to normal. I was only off my medication for one night do to this nasty stomach bug (which I wouldn't wish on my worst enemy, btw). This week I am preparing for Daylight savings by going to bed a little earlier each night starting tomorrow. The following weekend (St. Patty's weekend!) I am heading to a memoir writer's retreat in Seattle and this will be a bit of a challenge for me, sleep-wise. But I am well-prepared and I have my trusty sleep-aid to use since the time change will definitely disrupt my sleep. When I get home on the 18th I'll have a good week of work to do on my sleep to get back on schedule, but I know I will be okay.
I am a fighter. I monitor my sleep and take my medication because it is my responsibility to my self, my spouse and my family.
And it's getting to be past my bedtime, so I need to wrap this post up so that I can log some quality ZZZZ's.
A promise
There have been many ups and downs in my life since being diagnosed with Bipolar Disorder six years ago. Thankfully, the past few years have included significantly more highs than lows, mainly because I've been stable and have made a commitment to myself and my family:
I promise to always take my medication, see my doctor and therapist, and get good sleep.
This promise stemmed from the fact that, at 5 weeks pregnant with my daughter, I spent almost a week in a psych ward to bring me down from the most extreme psychosis of my life. It came about because I was so incredibly happy - over the moon, really - that we were pregnant after trying month after month for almost a year that I didn't make sure I was getting enough sleep. I remember the nights leading up to the hospitalization where I would just lie in bed wide awake, my mind racing with baby names while my husband was sleeping soundly beside me. You see, when I knew I was ready for another baby, I wanted it like, that second. To have to live my life in two week increments for so long, and to have waited almost a year to see those two pink lines, both of those realities had driven me mad. Quite literally.
I count my lucky stars that I was able to get help. I took the medication I needed with my doctor's close supervision, in order to make it through the pregnancy. And my wonderful husband took over many a night feeding during the first month or two so that I could get the sleep I needed at night and the naps needed to catch up during the day.
In the waiting room before my trial to be released from the hospital {yes, there was a trial due to the fact I was involuntarily committed}, my husband and my dad sat with me. I was in handcuffs. Don't ask - we have no idea why they would cuff an almost 6-week pregnant woman who wouldn't hurt a fly - but we think it was because they had to treat all the patients the same. My hair was a disaster, I had on mismatched sweats and the sticky-bottom hospital socks and I was just dying to get out of there. I can't remember why I didn't have shoes on.
This is where the promise occurred. My dad took a picture on his phone of me sitting on the small sofa in that tiny room. With cuffs on.
So I would always make good on my promise to keep taking my medication.
That was two years ago. And I have no intention of ever breaking that promise.
My family means too much to me to ever put them through that again.
Thank you to my dad, for thinking to take that picture. Now, Dad, it may be on your old iphone which has a shattered screen, but maybe you could find a way to email it to me so that I can crop it and Instagram-it so that I could add it to this post?
{Don't hold your breath since he's not that great with computers and he's presently on a golf trip in South Carolina. But I'll try to add it. For posterity.}
Postpartum psychosis - how it happened to me (Part I)
I was online this afternoon and came across a story in our local online newspaper about a woman who had experienced postpartum psychosis after the birth of her second child. She stopped her car in the middle of DC afternoon rush hour traffic, took off all her clothes, and was running along the shoulder of the road towards a bridge over the Potomac River. She was convinced that she needed to be baptized in the water because the world was ending. The details of her story are eerily familiar to me. I feel for her that she had to go through something as embarrassing as stripping down naked in public. Could you imagine?
But at the same time I am so incredibly proud of her for standing up and telling her story - publicly. She is a brave woman and I truly respect her. She is not afraid of speaking out about this rare disorder that affects only one to two women out of 1,000. It doesn't sound like many at all, but when you do the math, that computes out to 4,100 to 8,200 women in a year based on the average number of annual births.
I think it's about time that PPP gets a voice. There is so much information out there about postpartum depression, but if you ask anyone if they know anything about postpartum psychosis, I would venture to bet that they'd bring up Andrea Yates, the Texas mother who killed her five young children by drowning them in the bathtub in June of 2001. But only five percent of women with postpartum psychosis commit suicide and only four percent commit infanticide.
Those numbers could be so much lower, if the general public were aware of the signs and symptoms of postpartum psychosis so that they could intervene before a tragedy could occur. When a woman finds out she is pregnant and begins reading the various pregnancy books out there, there is always a chapter on postpartum depression. I wish those authors would cover the other side of the spectrum too. There are lives at stake.
It happened to me after the birth of our first child in September of 2008. He was a healthy 6 pounds, 12 ounces, delivered via emergency C-section. (He wasn't tolerating the contractions since his heart rate was taking a nosedive with each one, and I wasn't dialating past 5 inches, so the decision was made and at that point I was so exhausted I just couldn't wait for him to be out.) I was absolutely determined to breastfeed him, yet had no clue what I was doing. I just felt all of this outside pressure to make breastfeeding work - all of my friends had breastfeed their children, the books and magazines you read all say that "breast is best" and of course all the literature at the doctor's office was the same. Even the formula company's marketing materials pushed breastfeeding. So of course I put a ton of pressure on myself to make it work. It made those first few days and weeks with baby boy so grueling, draining, and sad. Due to the C-section, and the added stress I was putting on myself to be successful at nursing, my milk took almost a full week to come in. I was breaking out in hives up and down my legs every night because I was so stressed out. Instead of enjoy my baby, I was feeling like I was failing as a mother because I couldn't feed him. The pediatrician had us start supplementing with formula at his 2-day check-up because he had lost too much weight. I was barely sleeping at all. That is how the mania started to spiral me into psychosis.
The days and nights started to mush together as I started to live life in 2-hour increments. The baby would nurse for 45-minutes, then we'd do a diaper change, then he'd nap, but in the hour that he napped I felt as though I had a million things to do so I never napped myself. And it wasn't as if I didn't have help with me. My parents stayed for a week after the baby was born and my husband was off from work for two weeks. So I did have times when I could hand over the baby, but yet, things still had to get done.
It was about seven days after he was born that I remember breaking down in tears in front of my mom with the phone in my hand, outstretched to her, pleading, "Please call my OB and ask her what med I can take that will help me sleep! I can't sleep!" My mom called and they said I could use Tylenol PM while nursing, and so I did that afternoon and slept four hours straight, the longest stretch of sleep I had gotten since having the baby. The next day my mom changed her flight so that she could stay a few extra days to help out.
I remember feeling as though my mind was starting to race uncontrollably at times during those first four weeks after my son's birth, but somehow I was able to hide it from my husband and my parents. I wanted to be able to breastfeed my son and I knew I couldn't do that while taking medication. So I continued to fight the racing thoughts, but they quickly caught up with me in a big way.
We had our son baptized when he was four weeks and two days old. My parents flew back into town for the ceremony, and stayed with us for that weekend. I drove them and my brother and sister-in-law to the airport on Monday morning. On Tuesday morning I had become manic to the point of psychotic, and had to be hospitalized because I refused to take medication.
I spent a week in a psychiatric facility where the doctors stabilized me using a combination of anti-psychotics, sleep medications, and the mood-stabilizer Lithium. I could not believe that I had missed out on my son's fifth week of life. Completely.
The insomnia was the first and most prominent symptom for me. The delusions and hallucinations are a close second. I refused to eat at times. Each and every sound I hear is amplified one hundred percent. These are the symptoms that I experienced every time I had been hospitalized. Which up until that point had been twice.
The common theme that I experience when I become manic to the point of psychotic is the feeling that the world is ending. Let me tell you - it has got to be the scariest feeling in the world when you are absolutely convinced that it is happening. The time I lost touch with reality after our son was born, I remember that I had been sleeping upstairs since my husband said he would take care of the baby so that I could get some rest. I woke up at some point in the middle of the night and went downstairs to find him asleep on the couch, the gas fireplace blazing, with our son snoozing peacefully on his chest. For a split-second I thought about grabbing my camera to take a picture, but I had no idea where it was or else it seemed like too much of an effort to find it, so I didn't bother. I just woke my husband up and we went upstairs to bed, putting the baby down in the bassinet by our bedside.
A few hours later I couldn't sleep because I kept thinking I heard the baby crying. But he wasn't. My husband kept telling me to go back to sleep. But I couldn't. When he woke up an hour or so later to get ready for work, he knew right away that I wasn't right and he needed to call for help.
(To be continued...)
National Pregnancy Registry
My daughter turned 8 months old yesterday. About two weeks ago she started crawling and just yesterday she started babbling non-stop. I am continuously amazed at how quickly she is growing and changing. And I am intensely grateful that she is a happy, healthy baby. I was hospitalized for bipolar mania when I was just five weeks pregnant. My husband and I had been trying to conceive our second child for seven months and it had finally happened, only to cause me such excitement that I couldn't sleep which lead to my mind racing beyond belief forcing him to sign me into a psych ward for four days. I had been working closely with my psychiatrist to come off the Lithium for the first trimester once I found out I was pregnant and then once the mania took over from the excitement of finally becoming pregnant, I continued to refuse medication because I thought I was doing what was best for the baby growing inside me.
Looking back now I know how very wrong I was.
The main risk that the baby faced if I stayed on Lithium was Ebstein's anomaly, a heart defect. The general population has about a 3% chance of this particular congenital heart condition, and the risk increases to around 6% for a person taking Lithium during pregnancy.
In my case the benefit of staying on medication greatly outweighed the risks of me becoming manic and needing hospitaliztion, and I definitely knew this having done a ton of research beginning back before I became pregnant with my son. But with his pregnancy I was able to somehow stay medication-free throughout those nine months and one month after his birth. And I think I was feeling some mommy-guilt in wanting to give this second baby the same drug-free environment in which to grow and thrive. It only seemed fair.
After spending four nights and five days in a psychiatric facility near our house, I was finally released to the care of my regular psychiatrist after being stabilized on Haldol via injections because I was very resistant to oral medications at the beginning of my hospital stay. They also used Zyprexa since historically I responded so well to it. Of course I was scared to death about how these medications were affecting the baby's development, especially because there is so little research out there on the use of a-typical antipsychotics during pregnancy.
This is what lead me to find the National Pregnancy Registry via an online search. They are collecting information from women who have taken certain antipsychotics during pregnancy and after childbirth to hopefully shed more light on the safety of these medications during pregnancy. They also need women who are currently pregnant and NOT taking these medications, to serve as the control. If you know someone who is willing to participate in this on-going study, please direct them to the site to sign up to join.
It is easy to participate - just a series of brief phone interviews and some completed paperwork releasing medical records is all it takes. They do a baseline interview during the beginning of the pregnancy, a 7-month interview, and a postpartum interview. Simple. Once you finish it will give you a good feeling knowing that you are doing something to help improve the quality of healthcare for pregnant women in the future.
A little history - the first half
In writing my blog posts, I'm not planning on going in chronological order, because that would be kind of boring, don'tcha think? The first half is about my first two hospitalizations which occurred within two weeks of each other and were before it was determined that I was Bipolar. The second half details my second two hospitalizations which occurred after the birth of my first child and during the first trimester of my second pregnancy.
However, I do think that it would be helpful to give a quick little summary in order to kick-off the launch of my blog, so here goes. Back at the end of 2005 I suffered my first mental break when I became manic beyond belief and had to be taken via ambulance, screaming and strapped down to a stretcher I might add, to the hospital because my poor husband had no clue whatsoever as to what was happening to me. I had barely slept a wink that entire week and it all came to a head on Sunday night. Two nights in the psych ward, a week off from work to recoup, my first visit to a shrink who attributed the entire episode to sleep deprivation and told me I could discontinue the Risperdal I was taking, and yes folks, believe it or not, I was back at work the following week.
Two weeks later when I relapsed and suffered another manic episode, it was clear that something really was wrong with me and it wasn't just sleep deprivation. But with no real history of mental illness in our family, we didn't know where to start to begin seeking answers. My parents spoke with some close friends of theirs who were able to find a recommendation for a psychiatrist in Florida and got me an appointment while I was there with my husband visiting over Christmas. Spending Christmas Day and the two days after in another psych ward was not my idea of a holiday. In fact, that Christmas was probably one of the worst days, if not the worst, day of my life.
After emerging from that second hospitalization, and sitting down for just an hour with the psychiatrist we were referred to, he was able to determine that there was a very strong likelihood that I was suffering from Bipolar Disorder and that I needed to start taking an anti-psychotic medication immediately to bring me down from the mania that I was still apparently experiencing. That evening I began taking Zyprexa.
Once back in Virginia and back at work, I started having anxiety attacks on an almost daily basis. The feeling of waves of panic coming over my body were so intense that it became impossible for me to be effective at work. I was forced to resign from my job as a successful employment agency recruiter and in turn felt like I had lost part of my identity. Crying spells then became part of my daily routine, in combination with the anxiety, and I remember wondering if I were going to be feeling that way for the rest of my life. It was a scary time for me. I don't ever want to go back to that. Ever.
I remember back in the fall of 2006 when I was incredibly against going on Lithium, but yet, at my wits end with the way I was feeling I was ready to give in and try anything with the even the slightest probability of helping me feel like my old self again. For pretty much the entire year I had been depressed and anxious and thus I had reached a turning point. My psychiatrist at the time had been suggesting Lithium for a few months, but it just seemed so final, so imperative. But who was I kidding? It was obvious to the three different shrinks I had seen, one being a renowned specialist in the field, that I was bipolar and that a mood stabilizer was what I ultimately needed to function at a normal level.
So fine. I caved into going on a Lithium regimen the day after my husband and I had a consultation with the specialist. He didn't even see patients any longer, only did continuing research in the field. So when my dad's friend was able to get us an appointment as a favor, we jumped at the chance. At the time I was on Prozac and Zyprexa, along with Ativan for anxiety and Ambien for sleep. Nice cocktail of meds, right? The Prozac caused some suicidal thoughts, though nothing I ever remotely was going to act on. So my doctor had cut that dose back quite a bit. After seeing the specialist I started on Lithium and my regular doctor began to wean me off the Prozac and Zyprexa one at a time until I was eventually just on Lithium.
Within a matter of four months I found myself feeling like the old me again. I was ready for a fresh start and finally felt more confident. It was what I needed in order to launch a job search and in a few short weeks I landed a job as a corporate recruiter for a Fortune-500 company and I couldn't wait to get started.
My inspiration for this blog
Bipolar I is my diagnosis but I try not to let the label get to me too much. I definitely think about it on a daily basis, but I'm not embarrassed or ashamed of it anymore like I was back when I was first diagnosed. Sure, the stigma is still there, but it's beginning to fade. I hope that by putting it out there and by telling the world that I am living with this illness, and living a very fulfilling life I may add, I may inspire other women to seek the help and support they need in order to be able to have a family of their own if that is what they are wishing for. I was at an extreme low and was so devastated by the state of my mental health that I had convinced myself that I may never get the chance to become pregnant to start a family with my husband. But once I found the right medication and the right doctor, I was able to make my dreams of an amazing family come true and it was worth all the struggles and heartache, the four hospitalizations and the recovery time, to get where I am at this moment right now. Lately at night when I am drifting off to sleep, I find that I am reminding myself how lucky I am to have an incredible husband who loves and supports me, two beautiful healthy children, an amazing family surrounding me in my parents, brother and his wife, and in-laws and sister-in-law in addition to an extended support system of loving friends whom I trust so much. It sometimes doesn't seem real. But I am living proof that just because a person is living with a mental illness doesn't mean they can't work hard to manage it well and this blog is my way of giving back. I want to take the past six and a half years and share what I have learned from my journey to somehow help other young women who may have been feeling the way I was feeling back at the beginning of when it all started for me.
If you like what you are reading, and know someone who could benefit from my experiences, please, pass on the link to my blog. Over 5 million Americans live with this illness, so chances are within your family, friends, work, school, or church you probably know someone who may be suffering. They may find comfort in reading a story of someone who is doing better than average at managing it. I know I always do.