Taking Medication for the First Time

31 October 1997

I’ve taken medication (Tegretol) for the first time and it is like…

A bucket of cold water thrown on an overheated footballer

Being able to think now!

Putting on shades to blank out the glare

Sanity after years of insanity

A 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!

Imagine 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. Put on your left sock, but can’t decide whether to put on the right shoe next or the left sock next. 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.

I’ve been living like that for years and years and accepting it as a normal part of life. It’s only when I took the Tegretol (carbamazepine) and my coordination and speech improved and my thinking became less scattered that I realised perhaps how I’d been living was not normal and perhaps my life could be different, could be better.

1 November 1997

I’ve been depressed for the last three days. But now that I am on Tegretol, which seems to be doing something for my depression, I’ve had to develop new words to describe how I feel.

Normal is that elusive state of being, well, normal like other people. However, 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 moving inexorably down a railway line, or feel compelled to do the sensible thing, or fall asleep at eight o’clock in the morning.”

But I do my work calmly. Hence stable.

In this state I feel like the victim in a B-grade thriller movie, where everything around me feels slightly out of kilter, but I can’t put my finger on quite what is wrong. Nevertheless, I got all I wanted 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 romanticism to.

In any case I need the energy to monitor myself.

3 November 1997

I’m not sure if the medication is working properly. Today I’m hypomanic or something. It can’t be; my depression cycles are supposed to last 5-9 days. I’ve gotten used to one week manic and one depressed. If this changes, it will wreak havoc with my ability to predict my moods – not a good thing.

The Tegretol doesn’t actually stop the mania. What it does is calm me down and connects my thoughts to my actions so that I am not forever trying to decide what to do next. There is something to do and I do it – no fuss, no confusion. I am calm, so I can be aware of myself and take corrective action if things start to go wrong.

As a result I can work, I can behave, I can get things done. But I doubt that it is normal that each action that my body tries to make, each odd thought must be monitored and compensated for. The Tegretol makes it possible to do so, unendingly, with a clear head. I doubt that this is how others live their lives.

I’m not sure that this is better than just collapsing into depression or being manic. It is tiring to be endlessly compensating; my mind should have collapsed in fatigue, should have given in to tiredness already. But the Tegretol supports me, gives me the ability to continue, in spite of how exhausted I feel. This is just a different nightmare from my mood swings.

But I am functional. I suppose I can go back to being without medication, but I want to be able to do things. I’ll stay on medication, but I don’t know how long I can keep paying this price of eternal vigilance.

Anyway, am I manic now, or normal? How do I tell? What does normal feel like?

In this state in the past, my physical reactions were frantic, uncoordinated, unable to choose between signals (this book or that one, this action or that one). Now my thoughts are sensible. I can choose, I can do things. But… is this the real me or is this just me all drugged up and happy and functional?

What are the drugs doing to me! I’m scared.

6 November 1997

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 was mistaken all these years. It wasn’t that I didn’t like shaving, it was that my thoughts were so roiled up on mornings that I couldn’t concentrate enough to shave.

Today has been an upsetting day. By my new “able to get things done” standard, I have been unproductive. But at least I have done some work. Feeling a little antsy all day, not too focused. Able to calm myself, but only by focusing very strongly on one thing (like this note I am writing). My weight lifting 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 at 8 am and at 2 pm. Otherwise, I fall asleep. Four cups a day seems to be the minimum.

7 November 1997

I’m on medication, so I should be normal, right? However, my thoughts are trying to get away from me and a frantic anxiety of things left undone is gnawing from the sidelines. Still manic, I suppose. I’ve started doing stupid things again. Making less than good decisions. And trying to do four things at once, because they are in front of me. I can control it, but it takes a lot of effort, and the effort is less than perfect.

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

Isn’t the medication supposed to fix all this?

14 November 1997

I’ve been microcontrolling all my behaviour. I’ve had to, because I’ve been having mad uncontrollable racing spurious thoughts, which probably means I getting somewhat manic (hypomanic) again.

The uncontrolled thoughts are a real problem. 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 letter at work or make a telephone call. Or try to write the letter and think about how to solve the street vending problem downtown.

And being anxious about each task to the point where each is a mountain of difficulty and you give up because each task feels 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 the secretary about sending the messenger to get some items photocopied but being unable to do so because somehow the thought doesn’t connect to the action. 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 okay 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.

My 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 structures can take over from the medication.

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. In time I may forget what crazy was like, but I won’t ever be free of 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.