Friday, July 21, 2006

A Miracle Occurs

I'm posting a picture of me and my brother at a beach. I find the picture uplifting, though at the time it was taken I was seriously depressed. Yes, I'm the brother who doesn't smile. I also post below a poem that's worth sticking on your refrigerator, though I think it's a cut above Blue Mountain Arts:I do this to celebrate the miracle of my mood change that began yesterday.


I will love myself today.
Here are some fuzzy slippers
and a lollipop,
a warm hug and a wet kiss.
Let me tuck this
old familiar blanket
around my shoulders
and read this poem
before I nap.

Whatever I do today,
I’ll approve.
If I spill milk, I’ll clap.
If I button my shirt wrong
it’s a new style.
If I wet my pants
it was on purpose.

My, how well I walk!
How well I speak!
It’s so good to be
good to myself.
Where have I been
all these sad, long years?

(published in Tryst--there's a whole lot of my work in this issue.)

Unbelievable! After suffering a serious depression for nearly four months, I've felt well for two days. Medically I'm sure it's due to my increase in the Zyprexa dosage along with an increase in Wellbutrin. Truly, I was close to calling my old psychiatrist in Orange County for outpatient ECT, though lacking insurance that would no doubt be beyond my means. Even the medications below I can hardly afford. Lamictal costs about four dollars a tablet at Costco, the cheapest pharmacy I know. For me that means eight dollars a day, but I gotta have it. Prior to this depression it was the only medication I took regularly for my condition.

Here's the cocktail that turned me around, though I don't trust my footing just yet.

Zyprexa 15 mg. at bedtime.
Klonopin 1 mg. at bedtime.
Lithium 900 mg. at bedtime.
Prozac 40 mg. in the morning.
Wellbutrin 300 mg. in the morning, 150 mg. in the afternoon.
Lamictal 100 mg. in the morning and afternoon.

All the literature maintains that a manic-depressive's depression is the most refractory of depressions to treat, especially if it comes on the heels of mania. I post this list for the sake of other sufferers.

Them's a lot of damned drugs, but sometimes it takes a big combination to reverse the neurotransmitter deficits. I discovered the synergistic effect of Prozac and Wellbutrin in my last bad depression of nearly a year. My shrink had me on 40 mg. of Prozac, then switched me to Wellbutrin. There was still a lot of Prozac in my blood when he gave me he Wellbutrin. I remember my mood flipping just like it has now. Suddenly I appreciated flowers and the roundness of women's posteriors, something I couldn't do for 11 months prior to. My depression vanished in three days and I resumed taking the Prozac because the Wellbutrin only worked in conjunction with the Prozac in my case. Later I read in psychiatric journals of studies that confirmed this. But my experience predated those papers.

In medical school I was taught by neurologists, in treating seizures, to keep adding medicines until the seizures were controlled. I think the same applies to treating mood disorders. William Styron in Darkness Visible thought depression too mild a word to describe the condition. He thought "brain fever" more appropriate. Thus the model for seizure treatment I think also applies to serious mood disorders. Just keep adding the meds until something breaks. And when it breaks for me, as in these last two days, I go from minus to plus in a flash.


Enduring the depression was soul-crushing, but I've now had two good days, amazing days. When Kathleen sent me to the store yesterday for fruit I had no trouble making decisions. That was amazing. And my anhedonia is poof! gone. I'm back in the wonderful world of color, freed from my black-and-white prison.

May my euthymia continue. Hallelujah and amen!

I should mention my beautiful and compassionate wife, Kathleen, who took excellent care of me during this illness. Having her near helped me endure the snow inside the fire of willful self-abnegation.

Keep your fingers crossed,



  1. CE~

    write-on, man~~

    You've got a fan in NY~

  2. Good to here that you are doing better and better. :-)

  3. Belle--Thanks! My beautiful wife hails from New York.

    Cynthia--you know the depths to which an illness can drive you.

  4. I have been reading your blog for awhile and am glad to here you are on the + side of things. Hang in there. I know it is not easy. My 5 year old suffers from seizures (and maybe a mood disorder) and his father was bipolar. We are currently riding the rollercoaster of medication stabilization (trileptal). My prayers are with you and yours.

  5. Kelly, I don't envy you your burden; one of my daughters is bipolar I and another bipolar II.

    Bipolar illness is often mistaken for ADD in children, but 5 is too early, way too early to make a definitive diagnosis. Worse, as you no doubt know, medications that work in adults often have a different effects on children and adolescents, and you can study this in the psychiatric literature.

    On the other hand, I wish I had been diagnosed before age 30! I spotted both my daughters at 17, when each was subsequently hospitalized. Good luck!

  6. Praise the Lord and pass the Zyprexa! I am so glad you have come back from the abyss. Welcome to Oz in all its Technicolor.

  7. Kenny~ I am happy for your better spirits. My sister suffers from this disorder. She is unable to work and so many other things. I know from my experience with her how difficult this life can be. I wish you the very best.
    Also, I enjoy your poetry.I write, also.
    take care~dale

  8. Glad you are feeling so much better. I was in a manic episode for the past couple of days. I think I'm coming out of it. I spent way too much money, rearranged all the furniture in my house, and slept very little. I think I need more in my mix of meds. Actually, I'm only on one thing right now...Cymbalta. It does a lot, but not enough.
    I too, am living w/out insurance. Hopefully that will change soon.

  9. Thanks, Elisa and Dale.

    And Cheryl, aren't you on a mood stabilizer? Lamictal prevents depression but lithium prevents mania.

  10. Hope you don't mind, but I gave your blog a nickname when adding it to my list 'o blogs: Kilorats.

    Catchy, eh? (grin)

    Two good days sounds like heaven to me. Here's hoping a third follows, then a fourth, then a week.

    I'm the unsmiling brother. I like that. Not sure why, but it instantly conjures Cheever in my head. Specifically, one of my very favorite short stories of his called Goodbye, my Brother.

    Next time I spill milk, or anything else, I swear to god, I'm going to clap. (grin) (it's gotta be a better, healthier reaction than cussing like a truck driver and throwing the milk carton across the room, eh?)

  11. Anonymous6:45 PM PDT

    Laurel, I've been taking your advice and walking an hour a day and eating fruit for snacks. I haven't weighed myself since starting, but I feel better physically. Kathleen says I look thinner, but at my size I can't tell. Kilorats is fine. Above all things, and as my father admonished me, I strive not to take myself serioiusly.

  12. Ah, see? That sounds like something my dear, dead dad would've said. Don't take yourself so damned seriously. Christ, I should have that on a t-shirt or better yet, I tattooed on my body, somewhere where I'd have to read it every day.

    I'm glad to know you're walking every day. Isn't it wonderful? Man, I loved walking and still love exercising if only because it was the single hour of the day that was mine. All mine. A way of forgetting everything except the body. Can you pray with the body instead of the mind? I think that's what exercise is. I don't even believe in god but I swear, when I'm exercising, I feel transformed. I feel closer to fine. Ever hear that song by the Indigo Girls? That's it, exactly. Closer to fine.

    Keep at it, eh?

  13. I only achieve that Zen feeling in exercise in long distance swimming.

    It's a war not a battle, what I used to tell my porker patients.

    And man is America porked!

    We're such a rich country that obesity is inversely proportional to riches.


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