Sometimes I question whether I just wasn’t made for this world. That perhaps I was born defective and unable to survive. Many people are born with parts of their body that didn’t fully form or formed differently; some without the necessary components to function or function fully. And lots of people, who may have these differences, adapt and manage, and do not let their difference stop them from enjoying all life has to offer.
But my “defect” is in my brain, and I can’t seem to find a way to adapt or manage on my own. Often times, there are devices and tools to support and help in this process. I have tried the “devices” for my impairment: medications, ECT, exercise, diet, sleep, and a variety of therapies, to try to work with what I have been given. But for some reason, my brain remains resistant to change, unable to manage and function at a level that is personally acceptable.
It’s been exhausting – the entire process. And since I was in my late teens/early 20’s, I never thought I could make it to 35. I assumed my body would simply get too tired of the pain and stop working, or I would have to help do it myself. But even with these dark thoughts, every so often, there were flashes of hope; moments of a belief that things could get better. And so here I am – three weeks into 35, with a new possibility for change at my chemically-enhanced door.
I have had a good year and a half where I seemed to have found a concoction that made me feel more stable. Not perfect – I still dealt with mood swings, depressive dilemmas, and uncomfortable side effects – but enough to make me hopeful that I could work to form a functional and fulfilling life. Then we changed a medication, and the past three months have been a clusterfuck of mood swings, depression, and a melange of side effects. We hit a road block in terms of options and so a few weeks ago, my doctor conferred with her colleagues to see what ideas they may have for bipolar II medication-resistant treatment.
When I saw her last week she told me about two new scientific advancements that could drastically help me get better. (Please forgive my explanations, as I am still learning.)
The first suggestion is a test for genetic markers that show what medications work best in an individual’s brain. There are five markers and they are able to indicate drugs that will work; some that might work; and others that won’t. I found a website of a company that does it called Genesight. I don’t know if this is the company my doctor is referring to – but the hope is that with this test, we will stop having to do so much guesswork with my meds, and may find out if some are actually decreasing the positive effect of other drugs in my system.
The other suggestion is the use of folate. We all know about folic acid. (Okay I didn’t, but everyone else seems to refer to it like I should.) Doctors encourage women who are pregnant to use it to help with a fetus’ growth and have noted that it could help with growth and rehabilitation of other cells. If I were to just ingest folic acid, it would go through my blood stream and I would pee it out. However, this new folate supplement called Deplin specifically goes into the brain blood stream. Evidently, by delivering the folate directly to the brain, it helps with your body’s ability to absorb medications. So for me, while I have slightly benefited, my medication is still not being fully absorbed, and therefore, I’m not actually getting the full impact of the medications.
After explaining these ideas to me, my psychiatrist asked me if I felt hopeful.
The genetic markers sound interesting, though I feel like it isn’t going to be that helpful. I suppose it would provide me with the peace of understanding that there are genetic reasons why I am resistant to so many medications. And perhaps provide new ideas for medication usage. The Deplin definitely sounds too easy. The idea that a supplement is going to help engage my medications and that would help me feel better – I suppose it just sounds too good to be true. Then again, I know people who take incredibly small amounts of anti-depressants, and it changes their life. I find myself skeptical, but willing to give it a try. However, I would not say I am hopeful.
Hope is a complicated emotion for me. I don’t always have control over my hope – sometimes I can feel it behind my cynicism, trying to push through, small bursts getting by, evoking images of peace and contentment. But through the years, it has become an enemy of my depression – spreading fallacies of possible happiness into my brain, only to be devastatingly wrong.
I remember when I started to feel better after a few weeks of ECT. I was ecstatic because I had finally found something that would allow me the chance to have a life worth living. The short term memory loss was a bit annoying, but at the time, it was a small price to pay to have the heavy pressure of depression lifted. I’d found the “piece” that I was born without, that would make me whole – the component that would provide an adaptation to survive. And then it stopped working. And then I found out it wouldn’t work anymore, no matter how many times I tried. And then I was expected to go back to the medication drawing board and start again.
I would say that’s when my trust of hope died. That’s when I started to wonder if I was just too broken, the deficit irreparable and too impairing for me to ever be able to have dreams again. Hope had hurt me one too many times. So am I hopeful? All I can give right now is that I’m not NOT hopeful. I’m open to being pleasantly surprised, but I’m not running around telling the world to watch out because I’ll be out there soon! I have a feeling even if the Deplin works, I will still need to make changes to my meds, there will still be quite a bit of side effects, as well as possible withdrawal and mood swings. I am not naive enough to think that this is “my piece” anymore. But if my doctor is telling me that my what I was feeling this past year was only a fraction of the medication working and that I could feel better than that, I’ll swallow the pill faithfully, I’ll change the dosages, I’ll try medications again, I’ll do whatever it takes. At this point, what do I have to lose?
While some people believe that hope takes less energy than despair, I think there is a key component to that theory that often gets overlooked. Because when you are in the despair, you have to work to get to that hope, and you have so many factors against you. To reach a place of hope you must push through the exhaustion, find a way to ignore all past failures, and find the strength to block out the despair that radiates throughout your body and mind, draining you, beating you down, offering the temptation of rest.
I imagine myself on the side of a sea cliff, trying to pull myself up to get to safety, knowing that if my muscles get too tired; if I miscalculate one move; or a piece of the cliff simply loosens and drops, I could fall quickly into the dark, depressive water below, possibly being killed on impact. I wait, terrified, for a surge of strength or an outreached hand.
I want to have hope that I can feel better and find a new normal that doesn’t include dire mood swings and hypomanic bursts. I want to believe that help is on its’ way. But hoping for help doesn’t save me. And frankly, I’m getting really tired of holding on to this “sea cliff,” waiting for the moment when I can stand on firm ground.