It's the Blood-Dripping Canary In the Coalmine

I had a point the other day, when talking about anxiety.

Anxiety I feel is insidious. It's sort of like being eaten away from the inside by acid. It hurts and hurts and then it hurts some more. And all you can do it scratch and bite and claw from the outside, trying to get to all the burning happening inside. Anxiety feels like it's in your veins.

And I have found that it's anxiety, and not depression, that causes self-harm. Self-harm is considered an atypical symptom for depression, and I think that's because most people who are seriously depressed don't have the energy or desire to do it. Severely depressed people mostly just want to sleep, or sit, or, did I mention sleep? There's no time in that schedule for cutting, burning, or bruising.

But with anxiety there's a build-up of static energy. It's a welling of acid from within with nowhere useful to go. There's no fissures for release; that is, until you make one. This is where I feel the self-harm happens. All the anxiety manifests as useless, twitchy energy, and self-hatred which somehow transform into the desire to self-harm. It's not suicidality, it's not depression, it's anxiety that's causing it.

This is something that doctors don't seem to grasp. Anxiety and depression infect together and in my experience, medications are just as (if not more) likely to help one symptom as cause the other. IE, antidepressants can often cause anxiety

And worse yet, I'm not sure that people are even aware that it's anxiety that's happening to them when they're medicated and that's what's pushing them towards self-harm. Doctors don't talk about it. And do people even tell their doctors when they self-harm? I don't bother. It's not like they care. If you're not seriously attempting suicide it doesn't seem to matter.

But really it's a symptom of anxiety. And that does seem like something worth caring about. Something to be addressed. Something that at least that speaks of what the disease or the medication is doing. Somebody really needs to care about that.

Anxiolytic Isn't Even in the Dictionary

I grit my jaw. I bite the skin around my nails. I pull at my hair. I bunch my fists. My breaths are shallow. I twitch and clench erratically.

I tell myself not to grit, bite, pull, bunch, twitch, and clench. I tell myself to intake more air. Those instructions are followed. For moments. And then they're not. While I wasn't looking I started gritting, biting, pulling, bunching, twitching, and clenching all over again.

Anxious.

Anxiety.

These are tiny, little words. The barely seem to warrant entries in dictionaries bloated with words like crunk (a type of hip-hop or rap music) and Yogalates (a combination of Pilates and yoga), and yet somehow they have achieved great significance in my life.

Anxiety and depression always come in pairs. The each cover half a sphere. How much you feel of each of them depends on your point of view of the sphere.

I was never an anxious person before. Or at least, I was never inordinately anxious. But then came the meds and so the anxiety. And now I worry. And I'm overwhelmed. Frozen with the fear of things not getting done...leading to the very obvious result of things not getting done. Anxiety. A self-replicating organism.

Insanitarium

Kinkiest sex scene I've seen in a looong time:

Doctor throws nurse into wire shelving unit and ties her arms spread-eagle with medical tubing. She presents her scarred inner-thigh which he promptly slices with a scalpel, producing a thick dark vein of blood. (He should have really lapped the line of blood from her thigh at this point, but I wasn't a producer, so no one asked me.) He's yelling something at her all dominant-doctor like and thrusts himself against her. He slices a piece of her shirt off with the scalpel and shoves it into her mouth as a gag. He fucks her against the shelving while she screams into her gag.

Bondage, and blood play, and domination, oh my!

I suppose such things are only possible in B zombie movies so the sexiness is rather dulled by the bad acting and bad, well, everything. But still. Seriously out-of-the-box kinky. Impressive.

So where did I find this little gem? In an insane asylum, of course. Someone here agrees with me too. And there is a bonus two ex-Buffy-ites in the movie too.

rain patter

I woke up this morning thankful for the sounds of rain outside my window; it's not like we don't get rain here, we get oodles of it, but the sounds of it always comfort me. It's like hearing the raindrops on the top of your tent when you're all snug in your sleeping bag inside. There's something magnificent about that.

It feels like I haven't felt thankful for anything is a long time. It's not that I don't appreciate things, or that I'm not thankful, it's just that the feeling of gratitude has been buried. All the feelings have been.

I don't know that I particularly feel better, or less depressed, but I was pleased, to have a moment of breathing in something positive.

lily-pad chatter

Do you tell people who you are? I do. I don't mean to, but I do. I try to remember the rules, the niceties, the conventions, and the unspoken social agreements, but reality slips out.

I have a similar interaction with people over and over; I seemingly, unable to change it. I allow my mouth and throat to form words and sounds that frighten. They speak of death, and pain, and sadness. They speak of my desire not to wake up tomorrow morning. There are so many days, so many days, so many days when I don't want to ever wake up. So many days that some of those days, even a tiny percentage of those days, scare too many people away.

Don't get me wrong I have a huge inventory of witty banter constantly at my disposal. I know how to flit and skip from one lily-pad moment to another. And coupled with my practiced laughs, smiles, and movements, I'm charming and wonderful.

But in my brain, there are never daisies. I my brain there are daggers, and dangers, and rough seas, and jagged slices, and closing-in-walls. And I'm deep and meaningful. I don't mean to be. But I am. Unfortunately that drowns others or gives them a concussion.

And today I talked to a girl I shouldn't have about a subject I shouldn't have, and I just didn't see in her face how wrong it was early enough to fix it. I hit her and hurt her by making her brain think about things she really didn't want to think about, for really good reasons. I forget how traumatizing it is to think about this horrific things. I think about them all the time so they have no shock value left. Yes, I want to die, so what?

Mistakes. Yes, I made an error. Who I am is decidedly, an error. Or at least thinking about it is. Talking about it is. Telling other people about it is. I know.

I'm simultaneously beyond aggravated at the requirements of typical shallow human interaction and the weight of loneliness. Only professionals can stand me. And I really don't want to stand them. They have outlived their usefulness. Paying people to hear me talk. Not helpful.

I'm really tired of myself. Tired of my brain. Tired of my thoughts. Tired of my mouth for saying them. Tired of the humans for being so fragile.

I wish conversing didn't feel like failure.

Quote of the Day

It is a mania shared by philosophers of all ages to deny what exists and to explain what does not exist.
Jean-Jacques Rousseau

Yes, I awoke hypomanic again. On the upside I thought of a story idea of an ascent from madness during the treatment of a schizophrenic.

Verapa-Cycle

So I was hypomanic, then I was depressed and now I'm hypomanic again.

I'm fatigued. Anxious. Jittery. Unclear. Unfocused. Jiggly. Cluttered. Messy. Itchy. Nervous. Twitchy. Confused. Discombobulated. Distinct lack of time perception and hunger.

Like, seriously.

And this is after being seriously suicidal a day ago. Ow. My psyche hurts.

This, is due to the Verapamil. Verapamil, as those of you who waded through my paper know, is a calcium channel blocker. This turns down the calcium in your brain. Which is complicated. But it's just one of the things that lithium does. And some anticonvulsants, for that matter.

Verapamil is actually a treatment for mania. So it's unlikely to cause it. But as always seems to be the case, if a drug can treat it, it can cause it, and in rare circumstances, a calcium channel blocker can induce mania.

Oh, I'm so rare. And special.

This did not happen with the formulation I was taking in the US, but having switched now to a Canadian formulation it's happening. At 40mg, I became hypomanic. Then I crashed nastily, maybe due to stress. Then I increased the Verapamil to 80mg (still very low) which is the amount I took in the US, and again I'm hypomanic.

Just to be clear, both in Canada and in the US verapamil is a generic, but they're made by two different companies. This shouldn't make a difference. But I've written about this before: the generics manufacturer does, indeed, make a difference in some cases.

I know that I was supposed to be on the immediate-acting version in the US and here, but honestly, I'm just not sure. The information on this drug just isn't that clear as it's old and rarely used. (It was originally used for heart problems, I believe, but there were some side effects found with this medication in that population.)

And also to be clear, the studies that have shown a positive effect with verapamil have done it with the immediate-acting version, but as any crazy person will tell you, a bolus of medication (a big chunk entering your blood stream all at once) will cause a spike, which is usually not so fun. But it's what's indicated here. Oddly.

And of course I don't exactly have a doctor right now. I'm still waiting to be processed through the "system" so that I'm allowed to see one. They have to assess that I am still crazy enough to see a psychiatrist. A doctor referral isn't quite enough. There's a crazy bar to pass too. Did they think I got un-crazy in my 3 years in the US? That's just silly. The Borg doesn't reverse the crazy, it induces it. Ask any of the drones. They almost need to put lithium in the water there.

So I can stop the medication, but I'm hoping it'll even out. Honestly, I'm hopefully because I've had any reaction at all. Usually for me, I take a drug, I feel like crap, it has no benefit. The idea that I can take a drug, and I feel something other than crap, is kind of extraordinary. I more than prepared to wade through some cycles with the possibility of actual improvement.

And, of course, I don't feel, good, per se. People have this picture of mania being good. I'm sure that it is for some, but all those words I used above, they aren't exactly good. But I do feel energetic, which is good, even if I can't seem to focus that energy very usefully.

But of course I also can't come anywhere near sleep and so need to take oodles of drugs at night to sleep. And then I'm really hungover in the morning from everything I had to take the night before. That is even more fun. Bleh.

But for now, still here, still hanging on. Unfortunately I've bitten off all my fingernails nervously twitching, but I'm still hanging on by my toenails. They're considerably less convenient to bite.

New Blog Layout

OK, I have made a discovery, using a free template from the web is bad. Bad, bad, bad. It seems no matter what I can't get things to show up in IE/Chrome/Firefox - all at the same time. Firefox seems happy but the other two are like feuding family members.

So, what we have now is something that should work in all three, although Chrome seems to have issues. But seeing as almost no one uses that, I'm not going to worry about it.

What we have here is a design care of Blogger's new advanced template designer. It's pretty cool. I really hope it doesn't spontaneously stop working. Beta products, you know, can't be trusted.

Blog Changes

Hi all,

I'm updating the blog template and so things might be a touch disheveled. Please bear with me.

...this template is a bitch...working...

OK, everything is here and should be working. There will be a few changes over the next few days but it's basically all there.

Remind me not to try to edit some free template again, K?

Anticonvulsants as Calcium Antagonists in Mood Stabilization

This is a paper I wrote for a psychology course I am taking so the level of discourse is quite high, sorry about that. I promise though, it is comprehensible. What I'm basically talking about is calcium-channel blockers and other calcium antagonists (they turn calcium down). This refers to calcium in your brain and not calcium in your blood. I'll probably write up a layperson's version of this later.

Because inadequate response, poor compliance, chronic recurring symptoms, and functional disability are constant challenges is the treatment of bipolar disorder, (Gitlin, 2006) efforts have been made to search out new mood stabilizing medication and determine new methods of action. There has been an effort to treat bipolar disorder with a class of medication termed “mood stabilizers”, most notably consisting of some anticonvulsants (also known as antiepileptics) in addition to the traditional lithium.[1] While anticonvulsants are widely used in the treatment of mood disorders, their method of action in mood stabilization is mostly unknown.[2] Recent research has indicated that disrupted calcium homeostasis is present in bipolar disorder, and that anticonvulsants and lithium effect calcium channels and concentration in the brain (Amann, 2005). The mood-stabilizing effects of calcium channel blockers like Nimodipine (Levy, 2000) further add to the evidence that calcium antagonism is useful in the treatment of bipolar disorder. I will show that these “mood stabilizers”, anticonvulsants, stabilize mood in bipolar disorder, at least partially, through their ability to act as calcium antagonists.

A review of hypercalcemia and hypocalcemia shows links from calcium blood levels to depression, irritability, delirium, and psychosis – symptoms that are similar to a bipolar disorder. Additional to calcium’s powerful abilities in the blood, it also plays a vital role both as primary and secondary messengers in the brain and according to Gargus (2009), is known to regulate “physiological systems at every level from membrane potential and ion transporters to kinases and transcription factors”. Calcium also plays a role in long-term changes to the architecture of a neuron (Amann, 2005). Disruption of intracellular calcium homeostasis is now thought to underlie many diseases such as Autism, Migraine, Seizures, and psychological disorders like bipolar (Gargus, 2009). Additionally, atrophy and glial death now found in mood disorders may be avoided by increasing cellular plasticity, accomplished through reducing intracellular calcium concentrations (Landmark, 2008).

In some studies, the bipolar population has been found to have abnormally elevated intracellular calcium, elevated basal platelet and lymphocyte calcium concentrations, and elevated B-lymphoblast calcium (Silverstone, 2005). Found more consistently the bipolar population, both in the manic and depressed phase, is an enhanced calcium response to agonist stimulation (Silverstone, 2005). This may partially be explained by the enhanced platelet intracellular calcium mobilization found after stimulation by serotonin in bipolar disorder (Suzuki, 2003). This research suggests that not only are calcium levels elevated, and calcium activities dysregulated, but this may become worse if the patient is treated with a selective serotonin reuptake inhibitor (SSRI), which is often the case.

Lithium has long been the standard therapy for bipolar disorder both for acute and maintenance treatment due to its quality and quantity of supporting evidence (Gitlin, 2006), (Levy, 2000). Part of lithium’s biological effects is to both inhibit the entry of calcium intracellularly acting as a calcium antagonist, and to block calcium channels directly. This, in turn, inhibits other cellular responses of subtypes adrenergic, serotonergic, and cholinergic (Levy, 2000). Moreover, adding Verapamil, a calcium channel blocker, to unresponsive lithium treatment, improves outcomes, (Mallinger, 2008) suggesting that both calcium itself and calcium channels benefit from antagonists.[3]

A number of calcium channel antagonists have been studied with varied results likely resulting from their specific affinities to different calcium channel subtypes and their individual ability to cross the blood-brain barrier. Verapamil, one of the most studied calcium channel blockers, is not the most lipophilic and is likely not as effective as other calcium channel blockers like nimodipine (Gitlin, 2006), although Verapamil has been shown effective in some studies and does work on calcium ions in a way similar to lithium (Levy, 2000).

Nimodipine is not only a calcium channel blocker but has also been shown to have anticonvulsant properties and has shown great potential as a mood-stabilizer particularly for cycling forms of bipolar disorder (Goodnick, 2000). While its efficacy needs further study, there have been positive results shown for bipolars in manic, depressed, and rapid cycling states.

Anticonvulsants spawn a broad range of medication and methods of action. Useful actions for treatment of psychiatric disorders are thought to be: increases in GABAurgic transmissions, decreases in glutamate, inhibition of voltage-gates sodium and calcium channels, and interference with intracellular modulators (Landmark, 2008). For the treatment of bipolar disorder, specifically mood stabilization, carbamazepine and Lamotrigine, have been identified, and accepted as treatments through their inhibition of voltage-gated sodium and calcium channels (Landmark, 2008). Carbamezapine and Lamotrigine have also been seen to positively affect mood while GABAurgic transmitting anticonvulsants have not. The general decreased excitability found with Carbamezapine and Lamotrigine may also be responsible for their role in preventing affective episodes (Landmark, 2008). Valproate is also considered an accepted treatment although likely functions more from the combined actions mentioned above, making it an anti-mania treatment as well as possibly useful for mood stabilization (Landmark, 2008). The effects of anticonvulsants are compared to the therapeutic effects of lithium on calcium, calcium channel blockers, and inositol concentrations, another secondary messenger indirectly acting on calcium signals (Berridge, 1993). Anticonvulsants that work on calcium channel blockers are also known to be helpful in the treatment of neuropathic pain (Landmark, 2008), which some researchers believe is closely tied to psychological pain, here in the form of bipolar disorder.

Lithium acts in the body as a complex agent, making it difficult for scientists to specify exactly how it stabilizes mood in the bipolar population, in spite of its being used for decades. It is clear; however, that part of its biological action is to antagonize calcium concentrations as well as calcium channels. This action is shown to have positive mood stabilizing effects as proven by successful treatments with calcium blocking agents like Verapamil and Nimodipine. These same mood stabilizing effects are seen with some anticonvulsants which also act as calcium antagonists. Therefore, it is reasonable to assume that part of the reason why some anticonvulsants stabilize mood is because of their ability to work on calcium, calcium channel blockers, and inositol, as seen in Lithium and calcium channel blockers.

_________________________

[1] There are several antipsychotics also in this list but are outside the scope of this paper.
[2] Treatment of bipolar disorder and mood stabilization in this paper will refer to non-acute treatment, although some of the drugs mentioned can be used in acute treatment also. No distinction will be made between types of bipolar.
[3] It should be noted that Mallinger (2009) posited that the positive effects of combining Lithium and Verapamil may also be due to the inhibition of protein kinase C (PKC) activity provided by the Verapamil.



 
References
(I apologize for the departure from APA style, but Blogger just wasn't having it.)

Amann, B., & Grunze, H. (2005). Neurochemical Underpinnings in Bipolar Disorder and Epilepsy. Epilepsia (Series 4), 4626-30.
doi:10.1111/j.1528-1167.2005.463006.x.
Retrieved from EbscoHost March 14, 2010 AN = 17118993

Berridge, M. J. (1993). Inositol Trisphosphate and Calcium Signaling. Nature 361, 315-325.
doi:10.1038/361315a0
Available online: http://www.ncbi.nlm.nih.gov/pubmed/8381210

Farooq, M., Moore, P., Bhatt, A., Aburashed, R., & Kassab, M. (2008). Therapeutic Role of Zonisamide in Neuropsychiatric Disorders. Mini Reviews in Medicinal Chemistry, 8(10), 968-975.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost March 15, 2010 AN = 34436130

Gargus, J. (2009). Genetic Calcium Signaling Abnormalities in the Central Nervous System: Seizures, Migraine, and Autism. Annals of the New York Academy of Sciences, 1151133-156.
doi:10.1111/j.1749-6632.2008.03572.x.
Retrieved from EbscoHost March 14, 2010 AN = 35830926

Gitlin, M. (2006). Treatment-resistant bipolar disorder. Molecular Psychiatry, 11(3), 227-240.
doi:10.1038/sj.mp.4001793.
Retrieved from EbscoHost March 14, 2010 AN = 19892243

Goodnick, P. (2000). The use of nimodipine in the treatment of mood disorders. Bipolar Disorders, 2(3), 165.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost March 15, 2010 AN = 6500123

Landmark, C. (2008). Antiepileptic Drugs in Non-Epilepsy Disorders. CNS Drugs, 22(1), 27-47.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost March 15, 2010 AN = 28088990

Levy, N., & Janicak, P. (2000). Calcium channel antagonists for the treatment of bipolar disorder. Bipolar Disorders, 2(2), 108-119.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost March 14, 2010 AN = 5788405

Mallinger, A., Thase, M., Haskett, R., Buttenfield, J., Luckenbaugh, D., Frank, E., et al. (2008). Verapamil augmentation of lithium treatment improves outcome in mania unresponsive to lithium alone: preliminary findings and a discussion of therapeutic mechanisms. Bipolar Disorders, 10(8), 856-866.
doi:10.1111/j.1399-5618.2008.00636.x.
Retrieved from EbscoHost March 14, 2010 AN = 35323933

Silverstone, P., McGrath, B., Wessels, P., Bell, E., & Ulrich, M. (2005). Current Pathophysiological Findings in Bipolar Disorder and in its Subtypes. Current Psychiatry Reviews, 1(1), 75-101.
doi:10.2174/1573400052953574.
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Suzuki, K., Kusumi, I., Akimoto, T., Sasaki, Y., & Koyama, T. (2003). Altered 5-HT-Induced Calcium Response in the Presence of Staurosporine in Blood Platelets from Bipolar Disorder Patients. Neuropsychopharmacology, 28(6), 1210-1214.
doi:10.1038/sj.npp.1300159.
Retrieved from EbscoHost March 15, 2010 AN = 22436847

Entropy Swallows

I made it thought another day without cutting any more vial pieces of myself. I told him that I was not OK. I am not OK. Stupid tiny words with large thorny meanings.

I haven't cut myself in a long time. I can't remember the last time, exactly, probably because the last few times were burns and bruises. Burn scars I have found do tend to fade over very long periods of time, slices never really do. But it takes years either to look unhidous.

So I cut myself for the first time last Sunday. It was the first time in so long I couldn't even find the knife I wanted to use. I had to go searching for the magic tape to sew it back together. And I cut myself, while cleaning the knife for use. I tried not to bleed on my incision site.

No one made me do it, of course. No one can make you do such a thing. It did coincide nicely; however, with a piece of literary criticism I received. It wasn't so much that it was critical, because, um, criticism generally are, it's that it was _so_ critical, on such a personal piece, with zero positive feedIback, from a person whose opinion mean a lot to me. "Whining" "Clunky language" . Felt like daggers. And then he wouldn't talk to me. He wouldn't give me examples or suggest how to make it better, just told me it was a failure and to try again in a year.

I was devastated.

I looked again at the piece and I think I saw where some of this comments came from. I still consider it brutally unfair to declare failure a wait a year. Apparently all her first drafts are perfect.

And so I spiraled. Quickly. He didn't talk to me. And I had things to do. And I had to do them. So I couldn't afford to wallow in my failure and have it sit on my shouldn't, nothing good to balance it out, and tell me that I am nothing. Failure of writing is devastation of person for me. The only good thing to come out of ECT is to write about it, after all.

So there's the cutting to try to snap me back and keep me functioning. It doesn't work. My body...my body...so used to that pain. The cutting pain. Tolerance builds when you're not looking. My body, tolerant of the clearly so intolerable.

And from there is a spiral. Benzos with gin chasers. Working and working and working. Research on mood disorders and calcium in the brain. Truly interesting research that I will post here, but painful to read over and over about your own disorder. In research they are always talking about their failure to help us. I know. I know.

Crying on campus, crying in class, just like being 14, 16, 20, 22 again. The infinite entropy of my disease and my life. I despise feeling like I am going nowhere except that I can't seem to stop feeling like I'm going no where. I talk this pill and that pill and get zapped and get an implant and talk to this person and try that therapy and I still end up with a pain and darkness so infinite as to swallow cities whole. Stuffed inside my tiny brain, my tiny body. I can actually watch someone's psyche wish to escape me if I talk of such things. Talk of like, talk of cancer of the mind. I don't blame them. They don't want to know. They don't want to see that their city could be swallowed they don't want to know that it could all be over with the blink of a tear. But I have to know. There is no one to save me from this pressing knowledge. There is no one to save me from being swallowed.

You know what I wish I didn't know?

I wish I didn't know how to glue flesh back together.

Quote of the Day

If a man comes to the door of poetry untouched by the madness of the Muses, believing that technique alone will make him a good poet, he and his sane compositions never reach perfection, but are utterly eclipsed by the performances of the inspired madman. - PLATO (428/427 BC- 348/347BC)

the squealing of brains

I hadn't planned on discussing my ECT experience with many people. I found it terrible, scarring, not to mention futile and immensely embarrassing; those aren't generally feelings I like to talk about. I still find the idea of shock therapy, well, shocking. Incomprehensible. Absolutely impossible.

The problem with being a writer is that you write what you know, and you're driven to write what plagues you most. At least I am. I can't write about fluffy bunnies and sparkling rainbows, because these aren't the things that occupy my conscious mind. But ECT. Ironically it erased pieces of my brain only to seemingly permanently occupy others. I'm acutely aware of its happening and yet find it completely unbelievable.

For me there's a dual issue. At least. There's the ECT, and all that implies, then there's the failure of the treatment, and the fact that going through the treatment with me seems to have caused someone I love to abandon me. I feel like I've been stabbed in the brain, told it was my fault, and stabbed in the heart. It's hard for me to forget about her. Now I live in her town. Too many things remind me of the loss.

Almost before I realized it I had written seven pages about my ECT experience for my non-fiction class. Six hours flew by as I tried to find the best words to express the anguish that I didn't want to talk about. I was scared of every syllable. I was terrified the truth would hurt me even more than it already has. Accuracy seems so sharp.

I suppose it's because I went through ECT only a few months ago and I don't have enough distance and perspective on the experience. Intellectually I can say that it really wasn't that bad, but somehow I can't convince my intestines of that. I can't convince my hind brain that I'm fine and I'm over it. It doesn't matter.

Compulsion. I had to write it. I couldn't write anything else. Even now, it seems so difficult for anything else to enter my consciousness. It's obsessive. I've written for six hours about it today and I'm here, writing about it still. Sick little graphomanic mind of mine.

And then the seven pages and I made it to English class. I realized I had to give copies of the story to other people and I had to hear their comments on it. The story's so sad. The tragedy is so clear when its echoed in the faces of other people. My life so deeply painful. I know. I try not to think about it. And now strangers are thinking about it. I read a story about a guy who loved stuffed animals. And he read about a girl whose brain was electrocuted. It's an embarrassment of riches I have to talk about.

The voice in my head is screaming to be heard. It defies logic, reason, and common sense. And tone. It's screeching. It's making my brain vibrate.

the words aren't easy

People say I'm a good writer, primarily on what I write here. (There are other words, I have written, but so few have read them few have the power to make a determination based on them.)

People think that I write about impossible subjects eloquently. I bring the reader into a painful reality. I say what others cannot. Others identify with exactly what I'm saying. I bring clarity to the foggiest of subjects. I am mercilessly truthful about my own flaws and the suffering I experience.

These things are mostly true. And it gives people the impression that this is easy for me. Like somehow bleeding into words is like breathing. Like talking about suicide and self-harm and bleak hopelessness is somehow a talent I've mastered and become accustomed it.

Well, it isn't.

Writing isn't easy. Well, writing is easy, but writing honestly, writing brutally, writing beautifully, writing poignantly, that's tough. I have to scrape the words from my soul. I have to look at myself with such a cool, analytical eye that "I" almost cease to exist. It's hideously difficult, and sometimes the words do nothing but torment me.

I choose it, of course. No one makes me write. No one makes me write about painful subjects. I could go on about how cute my cats are and the odd purple pouf one of the girls wore to psych class today. But I don't. Those things don't add value, in my mind. Not No value to me, and not value to you. (Whomever you are.)

Now though that I'm playing at being a "real" writer, I have to take on writing challenges. I don't get to pontificate endlessly on anything I want, eschewing all grammar and written convention. Now I have to think of what to write. Make it Good. Somehow. So there's the difficulty of the subject matter, and the difficulty in trying to produce quality. A double whammy. Really.

And being a writer I have to look at myself, constantly. Which means looking at bipolar, constantly. Not passing the buck. Switching the channel. Pretending the pretty pills are Pez. But watching. To see what happens. To see what I feel. To see what I do. To see what I consciously think, and what I unconsciously know is true. It's fucking exhausting.

And I'm honestly not sure why I'm driven to do it. You'd think with all the watching I would thoroughly understand my own motivations but I don't. I like to write. I like the words. I like the sounds. I like how they look. I like how they taste. But the drive to write about pain? Not sure. One might think that it would help me work thought it. For the most part I would disagree. Mostly that's something said to make me feel better. Mostly that's something said to make people believe that I can work through it. That you can work through it. That anyone can work through it. It's bipolar, it's not a thick African jungle: you can't just "work through it".

And yet I'm driven. Like other artists, I suppose. What drives anyone to create anything? I don't know. Some deep-seeded need of expression. To be heard. To matter. To be remembered. Lord knows my strings to other humans are tenuous, at best, so maybe all I'll ever have are the words. The words are my kids. The words are my legacy, such as it is. I guess that would drive a person. A person as lonely, isolated, hurting, with as much to say as me. I guess it makes sense. But it isn't easy. This much I know.

No! Don't go down to the basement!

I'm writing about the ECT treatment from the perspective of my friend who joined me for the futile pain and chaos. I wanted to write about it because my friend broke up with me over it. I have barely spoken to her since. She just wants nothing to do with me it seems. And yes I'm hurt. Broken-hearted actually. Feels like I've been stabbed. And I hate her. And I miss her. And I love her.

I'm at the part of the story where the ECT actually begins and I'm terrified. Not in the story, in reality. I'm terrified now. At my computer. Writing. I feel like the words are going to jump off the screen and eat me. I can talk about this girl, and how she felt, and how she left me, but the words about the ECT feel sharp and serrated. I wrote about it before. I know I did. And yet now, I consider the description, the idea, still to be verbotin. Maybe I would feel differently if it had worked. But as it stands, even though I've had it done, I still consider a doctor attaching electrodes to your head and electrocuting you a nightmare, a horror, bone-crunching fear, no matter what. It's a voice screaming in my head not to let it happen. Not even to talk about it. Lest it be invoked. Like in a horror movie where they're saying "Bloody Mary" and you can't stop holding your breath. Waiting for the ax-murderer to arrive.

bubbled

I've been told that I'm a woman of appetites. It's true, I am. The problem is that my appetites are extreme and so terribly difficult to sate.

I like a day when I don't _have_ to do anything. A day off. A day free of work, or homework, of running around, of answering the phone. These are the greatest days. I can sit, and think, and write, and fuck, and lay, and drip, and gasp, and scream. All selfish and pointless and hedonistic.

Haze and delirium.

If I'm really good, and work really hard I can create a bubble. A bubble where my brain doesn't exist. I bubble where my disease is, less. It's never gone, or even mostly gone, but it is a little less. It is a little suppressed. It is a little controlled.

It's imperfect and temperamental and limited and when the bubble pops it rather bites and stings but for a moment it all holds together. Appetites reign. Nothing but hunger to be felt or expressed. A great need to be clawed. Bled, marked, bitten. Striped.

It seems that breathing makes me hungrier. Oxygen further opens the blood vessels for need. Extraordinary. Delicious. Such panting desires. I ache.