Trying To Get Stable:
The First Year

When you get that comment, and you will,
what exactly do you tell them to make them understand...

31 Oct 97 – Diary

I’ve Just Started Taking Medication and it is like a...a...
Bucket of cold water thrown on an overheated footballer
Being able to think now!
Like putting on shades to blank out the glare
Sanity after years of insanity
Space of calm in the ocean with the sea raging just outside

I can hear myself think calmly now. I can coordinate my physical actions now. I can focus on one thing and remain with it now. I can...I can finish my sentences now.

Image a day like this. Get up in the morning. Can't decide whether to brush your teeth or bathe first. Can't shave because you get caught in the back and forth thoughts of shaving/bathing that eventually you give up and not shave. After bathing, can't decide whether to put on the shirt or pants first. Can't decide which shoe to put on first, or whether to put on the right shoe now or put on the left sock now. Can't remember where the car keys are, and have a foreboding, every morning, that you are forgetting things, important things to do.

Imagine if every day was like that.

When I'm on the Tegretol, I am not like that. But I only now realise that I have been living like that for years and years. And accepting it as a normal part of life.

1 Nov 97 - Diary

I've been depressed for the last three days and I'm on Tegretol (carbamazepine) and I've had to develop new words to describe my condition.

Normal is an elusive condition, occasionally attained by accident. I've started to use stable to distinguish from being normal, as in:

"I feel stable but probably not normal, because normal people probably don't have pressing headaches or feel as if their thoughts are on a railway line, or feel compelled to do the sensible thing, or fall asleep at 8:00 in the morning."

But I do my work calmly. Hence stable.

In this depression, the world around me has been endlessly mutable and I feel like the victim in a B-grade thriller, where everything feels out of kilter. Nevertheless, I got all I want done, so I've added functional to my vocabulary. As in:

"I'm not normal, and I don't feel particularly stable today, but I am functional."

Got it?

When I was young, I used to think it would be romantic to have an illness. That way I could show the world how much courage I had and how well I could succeed in spite of the handicaps. You know, the way they show it in the movies. Now I don't feel that way at all. This is too terrible to attach any sort of romanticism to.

In any case I need the energy to monitor myself.

3 Nov 97 - Diary

The depression lasted three days from last Wednesday through to Saturday night. Sunday was nice. Monday I'm hypomanic or lonely or something. Or maybe depressed. The depression cycles are supposed to last 5-9 days; this one can’t be over yet. If I'm in a manic phase, this means the cycles are closing in. I'll never survive this.

The Tegretol stabilises me but it isn't perfect. I can't sustain cycles like this. Up now, down later. Fighting to stay aloft but not to fly. I can't.

Worse yet, I can. The Tegretol stabilises functionality, connects thought and action. Stabilises emotion in some odd way I don't understand. I can work, I can behave, I can get things done. I don't know how others do it, but I doubt that it is correct that each response that the body makes, each nausea, each stagger, each thought must be monitored and compensated for. The medicine makes it possible to do so, unendingly, with a clear head.

Which is the worse torture, collapsing in depression when the mind goes crazy or continuing along by endlessly compensating, calmly knowing that this should not be, that the mind should have collapsed in fatigue, should have given in to tiredness. I can choose to go back without medication, but what I want is more precious. But I don't know how long I can keep paying this price of eternal vigilance.

Am I manic now?

How do I tell?

What is it like to be normal?

How long is it before I go insane, calmly and logically?

In this state in the past, my physical reactions are frantic, uncoordinated, unable to choose between signals (this book or that one, wavering, between the two). But now....now they are sensible. I can choose, I can do things. Does this mean I am sensible. Can I be sensible. I'm scared. What is happening to me!

6 Nov 97 - Diary

Subtle changes. I need to cut my fingernails now. Funny. I never had to do that before. I always bit my nails. I can shave on mornings now too. I lied all these years even to myself. It wasn't that I didn't like shaving, it is that my thoughts were so roiled up that they wouldn’t allow me to shave on mornings.

Today has been an upsetting day. I, by my new standards, have been unproductive - although there wasn’t much to actually do. But at least I have done work. A little antsy all day, not too focused. Able to calm myself, but only by focusing too strongly on one thing (like this note I am writing). My weightlifting has started back, which is good, but I am simultaneously invigorated and tired. This does not help in trying to remain stable.

Coffee is no longer just a good morning drink, it is a requirement, both at 8 am and at 2 pm, or else I fall asleep. And four cups a day seems to be the minimum.

7 Nov 97 - Diary

I seem either to be in my "normal" phase or my manic phase. My thoughts seem to try to be getting away from me. And a frantic anxiety seems to be gnawing from the sidelines. This is much worse than being depressed. Much worse. I've started doing stupid things again. Making less than good decisions. And trying to do four things at once, because each is in front of me at that time. I can control it, but it takes a lot of effort, and the effort is less than perfect.

Unlike my depression, where functionality is unaffected by my feelings, at present, my functionality is being affected. Not greatly, but enough to prevent me from realising a full, fully productive life.

At this very moment, all I want I want to do is to make telephone calls, even though they can wait. This is hard to control on a moment to moment basis.

14 Nov 97 - Diary

I've been microcontrolling all my behaviour. I've had to, because although the danger signals for depression onset are relatively clear, the signals for mania, or just mad uncontrollable racing spurious thoughts, are quite vague and subtle. The depression bothers me, but because the onset, passage of it, and upswing are so clear, it is easier to deal with. In fact, it is less of a personal problem than a social problem. Reconnecting to other people and explaining why I wasn't available for the last two weeks is the problem - not the depression itself.

The uncontrolled thoughts (hypomania) are a real problem though. They happen continuously, and thoroughly disrupt every little thing that I do. I tell people that I have distracting thoughts, that I can't control my thinking or behaviour, and they say, doesn't that happen to everybody all the time. And I ask them, well, do you have problems deciding whether to butter your toast or close the back door, or deciding what to take out of the fridge first, the milk or the bread. Or which to do first, write the four line letter or make a telephone call. Or try to write the letter and think about how to solve the street vending problem downtown.

And be anxious about all of these to the point where each is a mountain of difficulty and you give up because each task is absolutely impossible. Or going to a social gathering and being loud and noisy and being unable to stop your actions, even though you really want to. Or knowing that you should talk to secretary about sending the messenger to get some items photocopies but being unable to do so. Imagine knowing that the stuff in your car requires two trips to take out, but trying to carry everything in one trip anyway because there is this urgency to do everything NOW.

Imagine knowing what you are supposed to do and being unable to do it. Imagine knowing what you are not supposed to do and doing it anyway. Imagine having no control at all, no choice, just riding with the actions and hoping you can put a spin on them so they look ok to other people. Imagine assuming this is normal.

Imagine living that way every day every hour every action. I tell people that to get through the day I spend ninety percent of my energy fighting myself and ten percent being productive. On good days. On bad days I spend all my energy and all my reserves just being present and appearing socially acceptable. If anything gets done, it is a godsend.

The medication creates a circle of calmness that allows me to think rationally, to act, to be calm. I have been able to use the circle to set up structures that act as a barrier to irrationality. I am hoping that over time, these can take over the medication. But the fear at the moment is that I can't tell if I'm being lazy or procrastinating. Or being crazy.

Normal is not a word that will ever come naturally. It has only been a few weeks since I started taking medication, so I still remember what it was like before. I suspect that I'll soon forget what crazy was like, but I don't think I'll ever forget the terror that I may slip back from where I am now to what I was before.

Someone asked me what it would be like if the medication stops working and I return to how it was before. I have an answer now.

It would be like going to Hell.