A Thousand Steps…

If we take a thousand steps, we’ll have travelled some distance whether we’ve reached our destination or not.

Woman descending steps on a mountaintop

Three months ago, I relapsed into a mixed mood state, having symptoms of depression and hypomania at the same time.  This took me by surprise since I had been psychiatrically stable for the past several years.  Why I slipped into this destabilized state, I do not know.

Losing myself

In response to this, the recommendation from my psychiatrist was to double the dose of one of my medications and within a few weeks my mood symptoms resolved and I felt back to my usual self.  Or so I thought.  Sometimes, it’s only in retrospect that I realize that all has not been not so well.  It was only after a month of being a good patient and taking the elevated dose that it was obvious that something was wrong.  I wasn’t having mood symptoms but I was lifeless without any interest in doing anything at all.  I’d just lay around all day not writing, cooking, exercising or otherwise engaging in my life.  This wasn’t depression, it was a side effect of the medication.  I made the decision on my own to return to the lower dosage and a few days later, emerged from my deadened state.  I was alive again.  I know that despite feeling better, on this current regimen, my mood symptoms are going to express themselves and I will become ill again.

The half or zero dose guy

If halving my medication caused me to re-awaken, how could I be sure that the remaining dosage wasn’t having some deleterious effect?  If I stopped taking it all together, might I become even more alive?  Who am I? Am I the half dose guy or the zero dose guy? Am I still trapped beneath the weight of this smaller pill I take everyday?  I’m tempted to experiment and stop all my meds and find the answer.  I understand non-adherence to recommended care.

A thousand steps…and more

I continue to face what many who have psychiatric disorders face.  Still searching, after so many years, for that combination of medications that will stabilize my mood yet won’t suffocate the real me.  As a psychiatrist, I understand the challenges of this delicate balancing act.  That said, I’m rather frustrated and pissed off that I’m forced to continue this wearying journey.  It seems, at times, that there is no end in sight but I have no option other than to soldier on in this (so far) elusive search. I don’t think my feelings arise from a place of self pity. They are instead a sober realization that a thousand steps hasn’t been nearly enough.

13 thoughts on “A Thousand Steps…

  1. Dear John, I love the honesty and humility and vulnerability of what you have offered here … mood-altering drugs alter your mood, there is no doubt about it, and it is a delicate balance between taking drugs that make you more ‘functional’ and suppressing the essence of who you are. Thank God for doctors like you who honour the essence of the person and support people to live from that essence.

  2. This is the first of your posts I have read. I am currently, with the aid of my doctor, moving through a huge taper/takeaway process in my psychiatric medication.

    I am now down by six medications. This change was made over the course of about 7 months.

    My thought, as I read this, is, “Exactly how much of my song can you sing?”

    Thanks for telling me *for sure!* Someone else is out there.

  3. Hello John, I viewed Physician Living With Bipolar on YouTube and I was immediately captivated. To know that there is a Physician with the courage and moxie to embrace his diagnosis and to share his lived experience with the world caused my faith to increase and brought great joy inside my tears – THANK YOU!..

    I am unable to fully express the impact that your testimony is having on my personal wellness journey. You have gained a friend and a brother. You are NECESSARY!!!!. 👍

  4. Hello John. I viewed Physician Living with Bipolar Disorder on You Tube and I was immediately captivated. To know that there is a Physician who has the courage and the moxie to share his testimony of lived experience with the world is so impactful. You increased my faith and brought some joy inside my tears – THANK YOU!

    Know that you have gained a friend and a brother – YOU ARE NECESSARY!!!

  5. Ah John, at times not really sure where you are at here however you definitely seem to know which is the most important factor in my view. I suppose psychiatry in general can be objectively hit and miss anyway but I can imagine applying your own knowledge to yourself becomes more subjective and so all the more harder.
    From reading various topics on i.b.p.f it seems access to a psychiatrist is an easier process than here in the u.k. Of course National Health Service is free (so far) and more recently I have considered paying for a private referral after Covid priorities just for a trained person to ‘refresh’ things if they need refreshing. Being in a ‘no man’s land’ of remission for the past 17 years with an annual General Practitioner review with a bipolar label on my records somehow doesn’t sit right. Each review seems to be a tick box procedure and at the last appointment he asked me what would I do in a crisis because he didn’t know. Sodium Valporoate seems to keep me ticking along & I had 9 e.c.t sessions.
    Enough about me, I wish you all the best John and thank you for sharing your insights.

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