Archive for the ‘alcohol’ Tag

THE BIPOLAR PERSPECTIVE: BEARING THE BAGGIE OF BURDENS   Leave a comment

PISSED

The other day I finally went to the urologist.  I wanted to find out why at fifty years of age I started wetting the bed three nights a week.  As I walked into my sparse HMO Plan’s Doctor’s Office, I was prepared for news of a cancerous growth in my manhood, a renegade testicle or an untreated progressive tropical sexual disease I picked up eating Cuban Food in San Francisco’s Mission District.  But I got even worse news… There was nothing physically wrong with me.  The emotionless managed care physician even managed to look at my prostate, which apparently gave him the “OK” sign as well.  I wonder if it was a “thumbs up” or it just “winked”at him like a Cheshire cat?

RESTRICTED FLOW

 If my member is not sick, that means my night-time urinary incontinence must be in my head.  Or at least that was my first conclusion.  After all these years in therapy trying to keep my Bipolar mind afloat, now I had sprung a leak down below.  And, the treatment was as vague as the apparent cause.  So the vanilla urologist gave the tasteless advice not to drink fluids three hours before bedtime and see what happens.  He also emphasized no alcohol.  I knew this was implausible. My Bipolar medications make my mouth extremely dry.  I have to keep drinking liquids or suffer from such bad cotton mouth my lips stick together when I speak, causing annoying suction sounds.  Plus, the thought of restricting the flow of alcohol prematurely during an evening on the town is out of the question.  I prefer to drink with wanton abandon.  Why should I once again have to add another limitation to my already restricted existence?

HI-HO!

And then it hit me… This was just one more annoying annotation to my treatment schedule I will have to endure due to my Bipolar Disorder.  Just like the cadre of pills I have to take twice a day, now I must regulate my liquid intake.  Another hurdle to clear, inconvenience to negotiate and regiment to be saddled with in order to remain ready for prime time.  I feel like I am in an 1800’s horse-drawn wagon, piled high with pills and their side-effects, barely inching across the baron plains of the old west.  Hi-Ho Effexor, Lamictal and Topamax! Git!

MANAGED MEDICAL INCONTINENCE

However the thing the Managed Healthcare Professional said that bothered me most is he felt the assortment of Bipolar medications I take are probably the cause of my night-time incontinence.  I’m well aware they cause dry mouth, nausea, severe constipation and weight gain, among other things.   But because my nightly dose of the anti-depressant Seroquel makes me sleep quite deeply, I may not be waking up when I have the urge to urinate.  Consequently, I go in my sleep.  And, the doctor made it clear he did not think I should discontinue any of my medications.  So in essence, he was saying it was best to continue wetting my bed.  That way “at least I have my sanity.”  I call this Managed Medical Incontinence.

BEARING THE BAGGIE OF BURDEN

One time a friend who I met in a Bipolar Chat Room came to visit me in San Francisco. When I helped her get settled in her hotel room, she pulled out an identical Zip Lock Baggie to mine filled with pill bottles containing her personal mixture of Bipolar elixirs and poultices.  I suddenly felt a strong commonality with her. I realized all Bipolar sufferers carry their own “baggie” full of unique prescriptions and medication induced limitations like mine, everywhere they go in life. I take a handful of assorted pills twice a day. Some people take theirs three times daily. Some have to take meds with food. Mine make me too nauseous to eat right away.  A number of people can drink alcohol with them, but others get violently sick or depressed and can not combine the two.  Each baggie contains a mixed bag of burdens specially formulated for that individual.  But we all bear the same baggie of burden.

MY BAGGIE IS BIGGER THAN YOUR BAGGIE

Wetting the bed is a pretty heavy burden for a baggie to bear.  You can learn to keep your shaky hands in your pockets, and take your midday dose of medication out of sight from your co-workers.  But if you are ever going to have an intimate relationship, you can’t hide the fact that you are irrigating the bed.  Or, you can wear a diaper to sleep at night and call it an “undergarment,” so it sounds more like Mormon underwear. However I’ve come to the realization that everyone’s baggie seems equally big in their own eyes.  Different people with Bipolar Illness have different medication regiments.  It’s not as simple as just popping a Prozac.  And consequently, we all have our own set of annoying side-effects. Moreover, if they are your annoying side-effects, they are bigger than anyone else’s.  When I first started taking a once daily dose of the anti-depressant Elavil in the mid-1980’s to treat my Bipolar, I didn’t even need a baggie. Conversely,  I thought taking that single pill at night would be a massive intrusion on the rest of my life.  Now I carry a heavy duty Zip Lock Baggie, and yearn for the days of simplicity that came with only needing one pill bottle.  These were the days when my side-effects could be counted on one hand, not amplified to a roar and punctuated by constantly having to change my bed sheets.

THE CAT IS OUT OF THE BAGGIE

Now that the cat is out of the baggie, do I accept my predicament or search for a solution? If you suffer from Bipolar Disorder, you are forever trying to do one thing to compensate for another.   Am I willing to discontinue the Seroquel, become sleepless, depressed and dehydrated, so I can awaken dry just in time for another miserable day of suicidal ideations? Personally I am not ready to accept the Meaningless Managed Medical Memorandum on my nocturnal incontinence. So I will go forth seeking solutions that may or may not materialize.  Will I end up adding to my baggie or shrinking it?  I don’t know. But I do know I am not alone. Because Bipolar babies all have baggies.  No matter how big or small, they are enormous to the bearer.  And all of us in the Bipolar Community anticipate with bated breath a cure for their individual intolerable side-effects just around the corner.  Side-effects are the price we pay for being alive and sane.  However they can also drive you insane.

HALF IN THE BAGGIE

I thought the only way I could write about this was if I were “half in the baggie.”  It’s an embarrassing thing to do sober.  And nobody except the person “sleeping on my bottom bunk” really has to know.  But so rarely can you showcase a Bipolar medication related side-effect that makes the non-afflicted truly realize how gruesome this business can be.  There is no free ride.  Moreover, in most cases Bipolar medication only works to a point.  It does not completely wipe out deep depression, anxiety or mania.  Just enough to get by.  But the side-effects are full strength and show no mercy.

 

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Take a Drink in My Blues   Leave a comment

The other night a friend commented to me that I drink and smoke pot every evening. She questioned, in a very nice way, if it may be in excess.  I think she was taking a mental inventory of how many wine bottles were in the trash and “roaches” in the ash tray at the end of the week.  She said so out of concern because I am Bipolar II and alcohol is not a recommended additive with anti-depressants and mood-stabilizers, of which I have both taken for years.

My friend is a mental health worker, so I gave her concern more weight than if the elderly Chinese lady who scours our trash for bottles and cans made the comment.  And as a writing-hack, I sat down to construct a blog justifying why it’s actually healthy for certain people with Bipolar Disorder to drink and smoke in moderation, visa vi there was no reason for my friend to be worried.

It took me days to write the blog.  I just could not get the wording right.  And then I finally realized it was because I was full of shit.  I was not being honest with myself and that’s why I was unable to summon the appropriate words.  So to coin a stupid phrase, “let’s get real.”

Alcohol is a depressant.  The reason people with Bipolar Disorder are told not to drink when taking anti-depressants is because it’s counterintuitive.  It will make the drug work harder or render it ineffective.

It’s the same thing with mood-stabilizers, prescribed to people on anti-depressants to make sure they don’t become overly happy.  They are meant to keep you somewhere in the middle where you are devoid of emotion, or at least that is my experience.  You won’t hit rock bottom, but you also can’t summon up a whole lot of excitement about anything either.  And of course adding alcohol into the mix can destabilize the entire situation.

Marijuana.  Who the hell knows what that does to people with Bipolar Disorder?  Some say it helps their mood, some say it makes them more depressed.  There really isn’t much information that I know of on how it interacts with anti-depressants and mood-stabilizers.   Plus with pot, even if you buy it from a legal California Dispensary, you really never know what strength and properties you are getting with every purchase.

With all this information, why would someone on anti-depressants and mood-stabilizers drink and smoke?  Well imagine a life built on a base-coat of depression with suicidal thoughts and side effects that range from constant nausea to sexual dysfunction.  Shaking hands to extreme dry mouth.  Short term memory loss to irritable bowel syndrome.  And this is all courtesy of the best medication cocktail I have ever been on.  Without it I am positive I would be dead.

In light of all this, I just can’t see anything wrong with coming home and having a couple of glasses of wine and smoking a joint over the course of the evening if it makes me feel good.  It’s nothing that many non-afflicted people do on a daily basis.

Am I addicted to drinking and smoking?  No, but I would be very unhappy if I had to stop.  And if it doesn’t affect my work or other aspects of my life, I don’t see the point.  Even if I were alcohol dependent (pot is non-addictive), at my level of consumption I would not really care.  I’m already addicted to anti-depressants and mood-stabilizers.  Take those away and it would be like withdrawing from heroine.  It’s much easier to stop drinking.

Please don’t misunderstand me.  I am not recommending the consumption of alcohol and marijuana to people on psychotropic drugs.  Everybody has to make their own decisions.  I know some Bipolar people who drink, some who drink and smoke pot, some who just smoke pot and others who do nothing.  And if I were prescribed a drug that makes me feel wonderful, I would stop drinking and smoking in a heartbeat.  Why rock the boat?  Not many people with Bipolar Disorder get to sail those pristine waters.

I make no excuses for my alcohol and marijuana consumption.  Just like everyone else, blessed with Bipolar Disorder or not, I like the way it makes me feel.  I enjoy the taste of good wine and micro-brewed beer.  Pot takes away my nausea and has almost eliminated the sexual side-effects that have plagued me for years.  And for a little while I can relax and stop constantly worrying about whether I’m heading for a cycle of depression or not.

So I will say to my good friend, thank you so much for your concern.  I appreciate your vigilance.  And I hope you’ll keep looking out for me, as I will for you.