Lithium



well, i'm in a new orbit.

the Lithium is definitely having an effect...
and i'm still trying to articulate just what,
exactly, or even approximately, that effect is.








i talked with my new pdoc about why i had vetoed
Lithium as a possibility years ago when i was first diagnosed. in my mind, Lithium was the proverbial chemical
lobotomy, the ticket to zombie-ville.

i envisioned myself shuffling around the house in track
pants and slippers in my bathrobe, guzzling coffee to
stay awake and sitting in a chair, staring off into space without a clue of any kind going through my head...







Lithium - the only rock that floats




kind of funny really, because that's what i was
doing anyway before i started taking it.
which is why i was open to his idea of giving it a try.

i'd been feeling so awful lately that i was open
to anything that brought the possibility of feeling
less this way. if he'd suggested ECT, i probably
would have shrugged and said "sure. what the hell..."






oh look - it's Lithium!





i didn't then/don't now think it's bad thing
to have mixed feelings about ingesting a substance
used in batteries, baseball bats and pottery glazes.

it might even be a sign of mental health.
despite all my reading, and what i've learned
from others' experiences, there is still a dark
shadow on the edge of my consciousness
about this particular drug.

but so far, it doesn't seem too bad.










when my Muse asked me how i was liking my new
lithiated brain, i said "it feels like somebody has
moved out of my head, but i'm not sure if i'll miss
them or not".











it's definitely not as dark inside my head
as it was a month ago, and that's a good thing.

what was a sense of absence when i talked
with my Muse now feels more like a distance.
like "things" can't get as close to me as they once did.
my boat is not so easily rocked.



am i getting over myself?



... or am i snuggling up to my lobotomy?








Worth Lithium Storm HyperLite



















how should i know?





one of the strange gifts that comes with living
la vida medicado is this keen awareness of just
how flexible... how fragile... how curiously arbitrary
the whole "reality" thing is... really.






John Cade, who discovered Lithium's
effect on humans



my biggest fear was my creative energy would dissolve,
fade away, whatever and it's a big fear.
it's the one true enduring joy of my life
and if that candle did flicker or fade away,
my world would be dark beyond redemption.




so far, that doesn't seem to be the case.





Lithium - the pill




i'm pretty diligent when it comes to work.

some of this is probably that bipolar tendency to get fixated on something, but some of it is my upbringing.
my parents and grandparents were very clear about
pulling one's freight and honouring the one's
commitments to others.




my pills look like this



i don't expect my meds to do all the heavy lifting
when it comes to my brain and my moods. i know
i need to "do stuff", like get some fresh air, eat,
hydrate and apply myself to my 'work'.
such as it is.





"Lithium" - the 3rd single
from "Nevermind"



in the past year, i've written about a hundred
"little stories", created about a thousand comics
and taken several thousand photographs.

my discipline in sticking with it helps with my self-image, and i've become better at all of them than frankly i ever thought i could be.

but it still adds up to nothing...





















... no income, no new doors opening, not even
any real sense that it's possible or likely.

hence, the lithium... i guess.

...and for now, i'm taking my meds,
like a good little head case and trying
to "do stuff".




i'm also wondering. it's often said among the mental
that "you are not your symptoms". so who am i now?

am i my medications?





MORE ABOUT LITHIUM











*

Electroconvulsive therapy








A patient lays on a table, surrounded by people in starched white uniforms. They open their mouth and something is put in their mouth. Electrodes are applied and they begin
to convulse, violently, their face a map of agony.

Repeated in countless films over the years,
it's a popular image for mental illness.

It's Electroconvulsive Therapy.




*


ECT was introduced to the therapeutic world in 1938
by Italian neuropsychiatrists Lucio Bini and Ugo Cerletti.
Dr. Cerletti became interested in the electrical shocks applied to the temples of pigs being prepared for slaughter. The electricity left the pigs unconscious, but not dead.


At the time, it was that believed that epilepsy and schizophrenia never appeared in the same person
at the same time. Since epilepsy caused seizures,
it was thought that by artificially inducing seizures,
one might cure schizophrenia.

It was not the only shock therapy on offer. People were being overdosed on insulin to induce convulsions or perhaps a brief coma. Shock and convulsion experiments were being done with strychnine, metrazol and other substances, as well as inducing high fevers via malaria.
I'm not making this up.


When Dr. Cerletti tried it on his patients, he found
the shocks rendered obsessive and difficult mental
patients meek and manageable. ECT caught on,
and became a common form of treatment in the
1940s and 1950s in Europe and North America.












100 to 150 volts of electricity was applied to the brain,
via an alternating current. This is fired through the brain
for anywhere from a tenth of a second to about 1 second, inducing a seizure.

The current travels from temple to temple (bilateral)
or from the front of one side to the back of it (unilateral), depending on where the electrodes are applied.














It was later found that epilepsy and schizophrenia can appear in the same person, but ECT remained in use as it clearly was having an effect on patients.

It is especially recommended for patients who do not respond to drug therapy or whose depression has led them to seriously consider suicide.



























It has long been a controversial therapy. Some swear by it, including Carrie Fisher who has regular ECT sessions.Others see it as a form of torture and note it was often
used to subdue troublesome patients, by giving
them several shocks a day.

Public figures who experienced ECT include Paul Robeson, Lou Reed, Peter Green, Yves Saint Laurent, Gene Tierney, Roky Erickson, Vladimir Horowitz, Judy Garland,
Cole Porter, Oscar Levant, Dick Cavet, Ernest Hemingway, Sylvia Plath and Frances Farmer.









 

As always, there are studies- studies that point to it's good effect and studies that show it as high voltage snake oil.
What is known is that ECT on its own does not usually
have a sustained benefit. Half those who remit then
relapse within six months.

And also as always, when it comes to mental health treatments, there are side effects. The most common side effect of electroconvulsive therapy is memory loss. 

It's implicated in the suicide of Ernest Hemingway.
He became extremely depressed, was medicated and ultimately given ECT; but he became even more depressed and complained about the effects of the electroshock -

   "Well, what is the sense of ruining my head
     and erasing my memory, which is my capital,
     and putting me out of business?
     It was a brilliant cure
     but we lost the patient...."

In 1961, after a second series of ECT, Hemingway
used his shotgun to commit suicide.












Two years later, Sylvia Plath would publish The Bell Jar, based on her descent into mental illness and treatment including ECT and insulin shock treatments. Her ex-husband Ted Hughes has suggested The Bell Jar may have been
a response to years of electroshock treatment
and the scars it left.

Soon after it was published, she committed suicide.




*





To this day no one is really certain quite
why ECT works for some patients.





Neuroscientist Christian Schwarzbauer at the University of Aberdeen suggests that depression may be caused by an overactive brain, where there is so much internal communication that the brain becomes preoccupied
with itself and less able to process information coming
in from the outside world.

There is a growing interest in repeated transcranial magnetic stimulation (rTMS), where a magnetic field
is passed over the scalp above the brain. It may offer
many of the benefits associated with ECT with less
risk of cognitive dysfunction like memory loss.

The development of more effective drugs for the
treatment of depression and other mental health
issues has been key to the decline in the use of ECT,
but it is still in use today around the world.

The process has evolved to minimize the negative
effects and ensure to some degree that patients
are undergoing the procedure of their own free will.
The closest most people will ever get
to Electroconvulsive therapy aka electroshock
aka ECT is the scene in the movie
One Flew Over the Cuckoo's Nest....

















Based on the novel of the same name, the film
was informed by Ken Kesey's experience as an
orderly working graveyard shifts at a mental
health facility in California.



     "The Shock Shop, Mr. McMurphy, might be said
       to do the work of the sleeping pill, the electric chair
       and the torture rack. It's a clever little procedure,
       simple, quick, nearly painless it happens so fast,
       but no one ever wants another one. Ever."

                                       from One Flew Over the Cuckoo's Nest








Here is a look at the history and current procedures
for administering ECT.

The Wikipedia entry on ECT.

Did you know that the Frank Zappa song Camarillo Brillo refers to a hairstyle resembling that of a mental patient who has recently received ECT?
In Canada, ECT is used more than 15,000 times
across the country every year.

There is a lot of news and background information
about the use of electroshock at Mindfreedom.


There's a fascinating summary of the treatment
and a nice list of links for further reading here.


If you'd like to purchase a unit yourself,
Welcome to Somatics, the World's Leader in ECT Innovation and Sales




*

Are You Nuts?


are you demented?

take the

Saint Louis University Mental Status (SLUMS) Exam

test and find out!


























http://aging.slu.edu/index.php?page=saint-louis-university-mental-status-slums-exam




*

Bipolar Alt Meds



i've never tried Dr. Miles NERVINE...



























but reading these ads












... it sounds like it was pretty good stuff.





























*

That's Just Crazy Talk




Since being diagnosed as bipolar, there are words
i don't use as easily or that no longer mean the same
thing to me as they once did.

neither am i as confident as i used to be that my understanding of them is the same as anyone else's.

one of those words is "reality".




















"I became insane with long intervals
of horrible sanity."

                                                                                           Edgar Allen Poe 





















I like nonsense, it wakes up the brain cells. Fantasy is a necessary ingredient in living,
It's a way of looking at life through the
wrong end of a telescope.

Which is what I do, and that enables you
to laugh at life's realities.

                                                                            Dr. Seuss



































Sometimes the appropriate response
to reality is to go insane.

                                                             Philip K. Dick























"Insanity -- a perfectly rational adjustment
to an insane world."
                                                                RD Laing

















































*

Steady Nerves


what do i want?

steady nerves.


when do i want them?

now.




















*

Just Say No to Drugs




If a great slogan is one that finds its way
into the language, and takes on a life of it's own,
then Nancy Reagan's "Just Say No"
is a great slogan.






























This does not preclude in any way the possibility
that it's a stupid slogan, or like so many things
that came out of those halcyon days,
of very dubious utility.












For a significant number of people, of course,
"just saying no" to drugs is not an option.

Cancer patients.
Diabetics.
The mentally ill.
And so on. 


















the kinds of minds behind these kinds of fatuous,
simplistic cliches about "drugs" are, naturally,
the same kind of people who think that a "war
on drugs" is not just a good idea,
it's a "can-do" situation.

it's a war that can be won!














Thirty years and how many billion dollars later,
there aren't as many true believers.

People are still dying, by the thousands.
Lives are still being ruined, by the thousands.
And in a time when we are being told there's not
enough money for schools, or old people, or justice,
or freedom, there are still billions of dollars to piss
into the wind for a "war on drugs".

Because as it turns out, a significant part
of the population just says "yes".















Like so many things on Planet Neo-Con, it's a rerun.
As so often happens when people who are willfully
ignorant and deity-challenged make policy and
execute it, the results span the spectrum-
from the ridiculous to good old fashioned evil.

And then there's the collateral damage.
The "unforeseen" consequences.
The things we of the pharamaceutically-engaged community know as "the side effects"













side effect #1

crack, meth & oxi

take pot out of the picture and these are the drug choices of a lot of people. or to look at it from another perspective, for a lot of people, this is the wine list.

if people don't have good choices, only an idiot would blame someone for making a bad choice. which not to say an idiot can't get elected, because they obviously can...


*

when i was young and experimental, there were options.
schooled by information widely and freely shared among other mental astronauts, one could plot a course embarking from the gentle and benign and going as far, as fast as one wanted to. or not.

there were maybe 20 kinds of marijuana, a dozen kinds
if hashish, hash oil, mescaline, mushrooms, peyote,
"pills", LSD, speed, heroin  and oh, so many more...

















now, it's pot that got way strong because gangs in a rainbow of ethnicities make even more money that way...

it's the easy bust, so it works for the warriors on drugs,
but it's so economically important now that nobody
thinks it's going away, and they're all thankful.


from there, it's crack, meth or oxi.

a and b are all ganged up, and oxi's legal.
FDA, government approved smack.


who'd a thought that would ever catch on?.










they were barely on the menu when i was young
and given the other options, sales were not have
been brisk. everyone knew speed (aka meth) kills.
even the guys who sold it were skanky.

which differentiated them from the people
who sold heroin, who were scary.

in general, these was an awareness that certain drugs
would take over your life and they would do it faster
than you might imagined.

no one chose to do chemicals or needles out of naivety.

which is not to say they didn't need something.

which is not to say they didn't want to die.















crack, meth & oxi.
excellent selection!

nice one, drug warriors.















side effect #2



among those of the "i'm saying yes to drugs because
my other option is death" crowd, i'm intimately familiar
with the mentally ill.


no matter how mental and proud one might be,
one will probably also be occasionally angry,
upset and/or confused by the cognitive dissonance
inherent in "you need to take these" and "users are losers".
























one of the side effects, for me anyway, of la vida medicado is a different perception of the role of drugs in life.

another is an understanding of "reality" that is nothing
if not flexible.














but hey, what do i know?
i'm on drugs.





































***

Even More Side Effects?



yes, side effects go on and on...
fortunately, we the maladjusted often come
with a good sense of humour...






















*

33 Things not to say to a Head Case











i created this graphic a few years ago. i forget what the incident was that made this little truth clear to me, but
i have never forgotten this thought. why? because it's
a fact of my life, and the lives of many people who
have been diagnosed as bipolar.

it's on my mind now because an interesting thread came up this weekend in a online mental health group i'm part of -  someone asked what comments by others people were upset by/sick of hearing and/or angry about their health issues...

there were a lot of responses, including a few from me.
it was interesting how many of these remarks were familiar to most of the participants and reading them, it seemed to me that a few themes began to emerge.

i've compiled them here in the order they appeared...

*




"Everyone has highs and lows, that's normal"


"I know people who are bipolar,
    you aren't bipolar"


"you have nothing to be depressed about"


"you need to pull yourself up
      by the boot straps"


"There are a lot of people
    worse off than you"


"You have so many things to be thankful for, how can you be depressed?"


"You’d feel better if you got off
       all those pills"


"What doesn’t kill us makes us stronger"


"I know how you feel"


"We create our own reality"


"I've never really noticed
      anything wrong with you"


"don't be so over-dramatic"


"Yeah, I get depressed like you"


"It's all in your head"


"You're ALWAYS sick."


"when are you going to grow up?"


"You just have to work harder to control it"


"you read too much"


"You just refuse to accept reality,
       there's nothing wrong with you"


"just leave her, ignore her,
       she'll get over it"


"I get depressed too - thinking positive
    and being active helps me a lot"



naturally, there were comments people had heard
       from those i call "god crazy" ...

"depression is lack of dedication to God"

"you need to go to church"

"you need prayer"


and then it was back to 'non-denominational'...


"Are you crazy?"


"get over yourself"


"Its not that bad, I get depressed too"


"You take way too many meds"


"Stop being so negative, think positively"


"Everyone goes through stressful mental times"


"You are not trying hard enough"




but by far, the gold medal, most-often-said comment people mentioned was the classic...


"Snap out of it"

















The level of condescension implicit in most of these remarks
is incredible and - i would suggest - inevitable, given the awesome sense of superiority that the speakers have endowed themselves with...

It's difficult to imagine a similar list coming from a group
of diabetics, or people with MS. Would people say things
like this to someone with Crohn's disease or arthritis?
i think not...

Yet people feel completely justified saying all this and more (and worse) to anyone with a mental illness. Why?


There are a lot of reasons, and i wouldn't pretend to
know them all. There is a very strong tendency in this culture to blame the victim. It's virtually the default in many situations. A woman gets raped? She shouldn't have dressed so provocatively. Someone gets mugged? What were they doing in such a bad neighbourhood?

The list is endless. The habit is probably as old as time.
It's a primitive urge - the need to dissociate ones' self
from 'the unclean', the 'defective', the weak of the herd who will probably attract more predators.













- to be continued -









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