Hoss is working really hard at being in control, even dropping his afternoon ADHD dose on days when he is just hanging out. His meds have been steady for some time, his appointments are now spaced out more than before, and we are not dreading the return to school. The administration stacked the cards in our favor this year- the fifth grade had a vacancy, so Hoss’ fourth grade teacher rose to fill it. And, in a totally unexpected move (and by ”unexpected” I mean “totally expected,” a la Professor Doofenschmirtz), Hoss was assigned to Mr. G’s class again this year. Hmmm, a teacher who my boy totally connects with and loves more than anything, and a special educator who gets his humor. What more can a mom ask for?

This, I think, is the year of Little Joe.  The quirks and routines are starting to become more noticable.   I forsee testing, and am going on record with a prediction of PDD/mild Aspergers with a touch of OCD. I hope that any issues can be dealt with by behavioral measures, since the possibility of Little Joe swallowing even the tiniest of pills or anything liquid that is not milk is…let’s just say it would be a challenge.

My goal for the school year? No hospital stays. It’s not so much to ask.

More from Joshua Walters.

By now I know the answers the nurses and doctors need to hear. I rattled off the history of the previous visits and hospitalizations. I identified her current and previous medications, by name and dosage and treatment schedule. The terminology is almost second nature now- she is not in active crisis, but is unable to ensure that she is fully capable of maintaining her own safety at home. The bipolar tendencies were first diagnosed in September, and her brother’s mood disorder (the ever popular “NOS,” which in layman’s terms means “your kid’s brand of crazy doesn’t fit the current DSM definition”) was diagnosed about 20 months ago. There is no diagnosed history from parents or previous generations. Note that I don’t say there is no mental illness in the parents or previous generations; I firmly believe that there has to be something on both sides that we just don’t have on paper. I can’t accept that I ended up with two children with such significant mood disorders just by the luck of the draw.

The transport to the psychiatric hospital came at 7:30 on Wednesday. We were ready to leave. 24 hours of hospital food and sleeping on a the chair that pulls out to a cot took its toll. I survived the the 35 minute drive, as I followed the ambulance, without significant incident. The blowout I got during that same drive in September remained in the back of my mind.

We got her checked in without a snag. A couple of the nurses recognized her name when the paperwork was handed to them. They checked her bag, noting that everything was acceptable (I learn from experience). She hugged me goodbye and asked if I was coming to visit every day. I promised that we would try to visit, and would call if we could not be there in person. No one cried.

I feel numb and empty. The experts tell me what to do, I do those things, and yet we are not being able to help her. I have come to believe that she needs a specialized school situation, one which provided the cognitive behavioral therapy that she needs to combat the irrational thoughts before they become emotional actions. The medication is not enough. But the specialized school will require many, many hoops to be jumped through. I am in the process of the educational evaluation that has the potential to put her in this type of school without me needing to go bankrupt. But I am scared to admit to my husband or my parents or my friends or the current school that the special school is what I really want for Princess. They fear a stigma, or an inability to re-assimilate to the life we’d planned for her (e.g., attendance at the private school at which her dad is the band director). I fear that the adjustment to a new group of students and a new school will be more anxiety-provoking than returning to her current situation, although she reverts to the harmful behaviors when she is back at school for more than a few weeks.

The more I research and the more I learn, the less I really know about any of this.

(Cross posted on Band Back Together)

Tonight was back to school night at Princess’s school. It was not an easy night, since I didn’t know what to expect from other parents or from the teachers regarding Princess. Many of the parents seem not to know that anything has gone wrong. The only parents with whom I talked about her recent hospitalization were the parents of one of the girls who reported to the counselor that she was talking of stabbing herself. I thanked them, and their daughter, for starting the process to getting better. I tried to hold back the tears, but…well, that isn’t so much an option for me sometimes. I apologized for putting their twelve-year-old daughter in such a tough spot.

My tears brought some tears from this girl’s mom. She and her husband admonished me for apologizing, and said they are keeping Princess in their prayers. They wanted to pass along to their daughter our appreciation for having done the right thing. She told me that her sister had struggled with depression and talked of suicide, and that her husband lost a friend to suicide.

I still feel like a shell of myself. I’m sleeping more than typical yet not feeling rested. I eat because I know I must, not because I have a taste for it. Our priest, the school staff, Princess’s therapist, the executive assistant for my department are keeping a close eye on me, I think, not sure if I may shatter at any moment. But for Princess I am holding it together, I take deep breaths and I focus on how to move forward. One small step at a time.

When I picked Princess up from her aftercare program on Tuesday, I had a message that the school counselor wanted to see me. Princess and I gathered her things and sat down in the counselor’s office to talk. The counselor relayed that another student came to her to say that Princess had indicated that she was planning to bring a knife to school for the purpose of stabbing herself or cutting her throat. She’s never articulated a plan before, and never expressed thoughts so boldly violent. The counselor advised me that she would need written confirmation from some mental health professional regarding Princess’ abililty to return to class.

We made an appointment with the therapist, and Princess was vehement in saying she did not want to go back to the hospital. She later had an outburst that culminated in her locking herself in the bathroom, refusing to speak to me, and I told her through the door that if I could not get the key to work, I would call 911 and have them break the door down and take her to the ER in an ambulance. She came out, and finally admitted that her thoughts were too overwhelming to handle alone, and she thought she needed to go back to the hospital.

We arrived at the pediatric ER around 2:00. We met with the intake nurses and pediatrician and social worker. We waited for word about which hospital had a bed and would accept her into the program. I called and texted my husband (who was home with the boys) and my parents and my siblings with updates through the night. The food service people delivered Princess’ dinner to the adult ER, so it was cold by the time we hunted it down, but she ate it anyway. They fixed another dinner for her, so I ended up getting to eat something, too. The ambulance transport came just before midnight. I took my car and agreed to meet them at the hospital.

About halfway to the hospital, my car blew a tire. I sat at the side of the highway, sobbing so hard I thought I would vomit. My  husband called the pediatric ER staff, who called the transport company, who contacted the ambulance driver to  have him come back to get me. Another bus from the same transport company arrived a few minutes after we did, so the drivers kept me distracted with their chatter. I barely remember filling out the paperwork for the intake. The coordinator on the unit asked me if I had a ride home, and I asked her to help me call a cab. She did one better- she arranged for a transport voucher for me, since I wasn’t sure I had enough cash on me to pay for the 40 minute ride home.

I got about 3 hours of sleep before taking the boys to school and coming into the office. My boss is wonderfully understanding and supportive, and is allowing me to make my schedule day by day depending on what I feel I need. I don’t know what it is I need, though.

I am still standing, and I know that Princess is getting the help she needs. This is a different hospital than the one she was in during May. That program seemed to work then, but the doctor’s willingness to dismiss my suspicions of a biploar disorder bothered me. This hospital seems more open to the possibility that there is more going on than her anxiety/depression. And we will once again find our light at the end of the tunnel

You’re going along, not thinking about how things are getting incrementally harder because you’ve always had days that are harder. And then get better. And then harder again and then better again ad nauseum until you are pretty much used to the ride. You don’t consider it remarkable anymore because it’s your “normal” life.

But the black hole is sneakier. The days get harder and harder. You’re waiting it out. You know if you just get through another day, things will get better again. So another day passes where you’re holding on with both hands. Then one hand. Then a few fingers. Then you notice your fingernails are torn and bloody stumps and finally, FINALLY, you realize you’re not going to be able to get back up. You are losing your grip completely and it’s too late to take precautionary measures. Way to late for that.

It becomes a life of lying under the water, looking at the world through goggles and trying not to think about all the ways you could die. Accidentally, of course.

And then it becomes a life of trying not to think of how to die on purpose. And you can’t even see out of the water anymore. Someone turned out the lights. You can’t hear or see or feel anything but extreme sad and bad and guilt.

“I’m trapped!” I yelled at the psychiatrist yesterday, “I can’t stay here and worry everyone while my mother-in-law has stage4 cancer and I should be taking care of her! I can’t go see family because they would worry the whole time I’m there! I can’t stay alive because this is how things will be the rest of my life – up, down, up, down – I can’t do it anymore! And I can’t kill myself because my kids would never get over it!”

It feels like I’m trapped in hell.

A med change is underway. I don’t feel better, I feel weird. Even more distant from my surroundings and I care even less.

I can write this because I’m a writer and this is what I do. I can’t change anything in my brain because this is how I am. I haven’t stopped crying for over 2 weeks and I shake all the time. I don’t want food. I only want to drink and fall asleep. But I don’t. I just think about it. Because maybe I won’t wake up. That would be nice.

My husband says, “There are lots of people who want you around, and alive. I love you Leah. You are valuable and precious.” I hear it but I can’t hear it because it feels like a lie. I didn’t think I would get married again after my divorce in 2002. I figured no one should be married to the mess that is me. But, I did marry. And he’s wonderful. And I fill his life with stress and drama and worry. In loving him I’ve ruined his life. If I really loved him, I would leave him.

This is the black hole talking. In this flash of sanity, I know it. But, sometimes the black hole just takes over everything and reason and sanity are nowhere.

Originally posted on Leahpeah

A new antidepressant being tested in Canada appears to do what no other drug can — increase connections between brain cells within hours to swiftly improve symptoms.

The finding by Yale University researchers may explain how one dose of ketamine can reduce symptoms of depression within 40 minutes among the hardest-to-treat cases, and could help spur development of quick-acting antidepressants.

Mathematician and Physicist Percy Paul is afflicted with severe Bipolar Disorder. He believes that his manic states allow him access into creative thought patterns. The curse is the resulting depressions that endanger his life.

Watch a 2 minute preview here.

Funnier, yes—and talking fast, loud.  I can barely get a word in edgewise as he quips, his words darting faster and all around me.  He pulls faces, laughs, then stops.

I feel stupid, because I maybe wouldn’t have noticed if he hadn’t said anything about it.  Quieter, now—“I’m going to go see somebody, one of the counselor’s at school.”  He talks about how he’s fucked things up, how he lost his girlfriend of more than a year by being stupid.

He’s the same age I was when I fucked things up.  21 and change.  The age where everything starts to come together, when your body feels electric with the burden of the future and the prospects of freedom and responsibility start to wind themselves around your ankles.

And I envy him, if only a twinge, before I am suddenly scared for him.

***

(remember)  What it’s like to be told in a room by a man that you have a chronic illness that will never go away.  And it’s something that’s inside you—it’s something that you’ve always thought is you.  Because it’s in your head—in your brain—it’s hard to separate out the sick part.  You start the never-ending data-mining, the perpetual jump through funhouse mirrors—you decide what to keep and what to put away in a box marked “other.”

You are stricken by two dual forces.  One.  You would never wish this fate on your least favorite person.  Think about childhood bullies and mean bosses.   You may wish for them to die, but you’d never wish for them to feel this way.  Two.  There’s a genetic component.  A much higher likelihood than you’ll admit that someone you love will do this too.

These forces get inside you and they explode your heart.  Pieces of it go everywhere, flying into all of those they love.  You understand that quote about your heart walking outside of your body.  You live with it every day.

***

And still, I dare to dream about a normal life, ignoring the fact that I took a left turn from normal years ago.  Once upon a beautiful time, I had a coherent line of sight.  I was engaged, had a wedding planned for June 14^th, 2008.  I wanted to go to school, get married, start thinking about children.

The words “bipolar disorder” make everything so fucking complicated.  When they find out that we’ve been dating for seven years, even casual acquaintances ask about a ring.  I laugh it off.  I say that we’re taking our time.  I don’t mention that we were engaged.  I don’t tell them that we’re not engaged now because I contracted a case of the crazies and went about fucking schoolboys while my fiancé worked at 5 AM on Saturdays to pay for my ring.  When I think about it, my jaw starts to hurt from the clenching of my teeth.  My lungs are filled with air that won’t be pushed out.  I take a look at the path at the fucked-up path of burnt-out bridges that lay behind me.  How do you explain this?  How do you make sense of something that feels so senseless?  How do you do anything but move forward, blindly, spouting platitudes and bullshit about taking your time.  Taking the long way.  Going the whole distance around your ass and still, somewhat improbably, coming out ok.

***

In the review session for my neuroscience final in my first year of medical school, the question is posed: “What is the heritability of Bipolar Disorder?”

The answer I’ve learned to parrot is:  “Autosomal dominant, but with partial penetrance.”

In my head, it sounds more like: “You are playing Russian Roulette with your future children’s lives.”

In these moments—among others—I am forced to contemplate the ghost-children who will someday tumble out of my womb, with so much potential for brilliance and pain lying latent their skin.

In the dark, I will whisper to them that my genes do not determine their fate.  Then—and now, even now—I will whisper it to myself.

I see myself as scatter-brained but loving. And loved.

If I thought you cared and you were listening, I would tell you I have a bipolar depression and anxiety disorder diagnosis. Sometimes I wonder if the drugs are working, or if it’s a misdiagnosis because I feel pretty good these days. Then I forget to eat or take my meds or I drink too much and I fall down the hole again. Some days I want to do so many things, and others I want to do nothing but sleep. I can’t focus on getting good at one thing, or getting one thing done well. Why can some people manage and lead well but other struggle?

I am struggling with so much distraction. And I eat too much to soothe my anger and frustration. I want to get unstuck and feel untrapped.

Something I have been keeping a secret is how upset it makes me that I don’t have a child, and how I am so frustrated with my husband. I would like to adopt a child but he has said that is a deal breaker. I have examined, at length, why I want a child so much. Is it selfish to want a kid? Is it selfish to not want to raise a child? I’m not right with this. I put on a happy face to make my friends feel comfortable, my husband happy, and my parents satisfied.

I am trying to think positive and something I’m good at is connecting people. And I love learning new things and meeting new people. Pretty simple.