Opioid Dependence and Mental Illness

Pile of pills

I’m not an addict. I’m not! I’m mentally ill. I have Bipolar Disorder. I also suffer from chronic pain in my lower back.

My primary care doctor (PC… PCD? Uhh… let’s go with MD) had been prescribing me oxycodone for the server and persistent (chronic) pain that I’ve had for years. After being active and doing something super strenuous like gardening for 15 minutes I think I’m dying. I’m exaggerating of course, but when I work as hard as Atlas does while holding up the world my eyes leak, I whimper and sit down. Sometimes I end up laying on the floor. The floor is such a very bad idea. If I straighten my legs my whimpering becomes desperate and I realize I’m crying. If I forget myself and straighten my legs I’m done. I can’t move. The pain paralyzes me.

I’m NOT an addict.

When I can think again, I try to find my phone. If I can’t find it right away I feel the panic rising and it triggers thoughts and emotions I thought I’d had under control.

This last time I thought I was managing my mania and depression (mixed state, rapid cycling) pretty well. I haven’t bought piles and piles of books on ducks or Oprah or how to be an astronaut. Honestly, I really haven’t. But please, don’t ask me what I’m thinking about. Also, I’ve been able to get out of bed AND wake-up in the morning and even go for walks. My depression skips through the dandelions with the mania comingling into a mixed state, which is always confusing.

I’m not an addict.

After many months of giving me a legal way to get my the Oxycodone I take for pain legally, and for free. The label on the bottle says I’m to take the little unassuming pills three times a day. They are 20 mg. Currently, I’ve convinced the assistant fellow at the pain clinic to reduce my Oxycodone to 20 mg twice a day.

I’m not an addict.

I’m mentally ill. I have Bipolar Disorder, ADHD, chronic pain, and other stuff.

I was referred to a pain chronic clinic… ah… chronic pain clinic, where my Oxycodone prescription was reissued. A five-minute verbal probe, that’s what it took for the doctor to determine whether or not I needed the narcotic. We didn’t talk about Bipolar Disorder or any potential interactions the Oxycodone might have with drugs that are meant to manage my wild emotions or tame my fantastic panic attacks. I’m not certain she has any record of my current medications. She asked questions, and I quickly tailored my answers to fit what I thought she was waiting to hear. She made a few notes on a paper as small as her palm. I wondered if she was actually making notes that she could refer to later. She thought for a few seconds and then wrote the prescription. I sighed in relief.

I’m not an addict.

A while later, like over a year or maybe two, I’m still taking the narcotic. The clinic has new owners and staff. They no longer asked me questions. Sometimes they required a urine test. Then, they stopped asking me anything at all. We spent my appointment chatting. I started asking if we could please try to figure out what was causing the pain and try to deal with it by correcting the problem. I wanted the pain to stop.

They didn’t listen. They wrote the prescription without hesitation.

I’m telling you, I’m not an addict.

My mental health drug dispenser began paying attention after I updated her about my drugs and included Oxycodone in the list. She stopped talking about whether or not my meds were working to stabilize my moods and started talking about “Black box” warnings.

She had my attention. I started to panic.

At the time I had over five medical people prescribing medications. They didn’t know what the other office prescribed me. They relied on me to tell them the truth. I didn’t have to tell anyone I was taking Oxycodone. That got me thinking.

I’m not an addict.

Later…

I’m still asking the medical folks to figure out the cause of my chronic lower back pain. I’m still not getting results. I’m getting way too much Oxycodone every bloody month.

Because I can, I’ve been researching my of collages of illnesses, disorders, and psychological malfunctions.

Ah ha! Black box warning. Do NOT take anti-anxiety medication (benzine’s) – death may result.

Oxycodone 20 mg

I recently saw Dr. T, my very superior knee surgeon. He saw the condition of my spine when he was looking at the x-rays of my hips. He was making certain that my persistent knee pain, post second replacement, wasn’t being caused by anything running amock in my hips. He was eliminating any possible cause of my knee pain before he even considering using surgery to further correct the inept effort Dr. B made the initial knee replacement. Dr. B successfully replaced my knee, but that’s where the project ended.

It sucked. My leg from the knee down, well, it kind of turned the wrong way.

Dr. T corrected the first replacement. He tried to minimize the damage his surgery could do while trying not to blow up my entire joint… okay, the joint that was already gone.

Dr. T showed me the x-rays he’d just had taken and explained where and why he left Dr. B’s “efforts,” while replacing the replacement. A month ago we tried a shot to relieve the pain and keep from having to have surgery again.

Nope. I’ve had no relief from the pain. In fact, my brain was overjoyed and thought that my knee was doing awesome. Holy cow! I should NOT have knelt down like that! Looks like surgery is probably what our next conversation will be about. I’ll need to be on pain medication again…. I intend to be off Oxycodine ASAP. I would really like to have some kind of painkiller to take after surgery – assuming I have it. Always be prepared! Sigh…

I’m not an addict.

After my constant complaining about my back pain that happens every time, I do regular human type activities involving the lower back. I’ve finally had x-rays of my back taken. Holy heck. Next stop is at a spine doctor.

The online personal information provided by my medical organization includes this: Opioid Dependence.

My chronic pain clinic instructs me to continue taking the Oxycodone. I haven’t been able to identify any specific relief from the pain in a long time. I have never felt any “fun” results from taking it. It has never made me feel sleepy.

I have found that taking Oxycodone at bedtime with the medication I take for Restless Legs Syndrome (RLS) helps me to get to sleep and not wake up in agony caused by the RLS.

Am I an addict?

“Taking opioids over a long period of time produces dependence, such that when people stop taking the drug, they have physical and psychological symptoms of withdrawal (such as muscle cramping, diarrhea, and anxiety). Dependence is not the same thing as addiction; although everyone who takes opioids for an extended period will become dependent, only a small percentage also experience the compulsive, continuing need for the drug that characterizes addiction.”*

I’m mentally ill. In my opinion taking any medication, especially one that alters my brain chemistry (opioids do this), should be thought about and discussed with other medical personnel who are also responsible for my continued living – and to live my best life.

Am I an addict?

No.

I have Opioid Dependence.

Dependence. I can live with that, but look, let’s get rid of that too. Okay?

{I have Bipolar Disorder. I’m a little manic now. I’m using it to write and post while I can. So, for now, I will post often because tomorrow, I may be depressed and unable to say what’s on my mind. I may not have anything on my mind.}

* https://ghr.nlm.nih.gov/condition/opioid-addiction

Frankenstein – Bipolar & ADHD

Frankenstein-tumblr_ovgh5egVdd1wzx3t8o1_1280 I’m aware, that when given the chance, I will, without question, talk until the air has been sucked out of the general area and everyone has passed out. So normal.

Anxiety – After I graduated, and a few weeks had passed I could tell I was under stress from that. My anxiety has gone down. It did get better, for a while. I got to the point where I didn’t quite feel like my brain has been stuffed full of raging bees. Awesome!

ADHD – I was under the assumption that I was taking Ritalin to help me focus my attention so I could do well in my classes. I was always confused when my med provider asked me if I felt the Ritalin she was prescribing was helping me to focus better. I always said, and continue to say, “Um… I guess so.” I’m manic! What does she want me to say? I work very hard when I meet with her to sit, shut up, and answer her questions honestly. She terrifies me. What if I answer wrong and she changes my meds again? I’ll say something than think, “Crap! Why did I say that?” I always say that I guess it was working well. I suppose. Now I think that I was wrong.

More ADHD – I accepted the diagnosis of having ADHD because it was about not being able to focus on one thing at a time and I knew I couldn’t do that. But, being Bipolar was always the main objective of both my counseling sessions and appointment with the med woman.

Bipolar 1 – I assumed that my Bipolar was worse (or more dangerous to me) than ADHD could be. Wasn’t it?

You know how a doctor will sometimes leave a small tube that goes through an incision so that the area can drain and heal properly?

Yeah, I don’t know where I was going with that—

Switch – I have some ideas that I think are pretty good. I’ve done one or two or three big projects that have come out great. The other 45 ideas that are going around in my mind appeared to be stuck in orbit. I remember the video I watched on YouTube yesterday about ADHD and I was shocked. Frankenstein!

FRANKENSTEIN – I’ve come to think of Bipolar/ADHD as a Frankenstein type of symbiotic relationship. I can’t imagine why my diagnoses has always focused upon Bipolar Disorder. In counseling I talk faster and faster and cover an impressive variety of topics.

Pressured Speech (Bipolar) – Thought very little about ADHD or how to deal successfully with it. I’ve been taking medication for it for three years. In that time no one has talked to me taught me to handle it. Why not?

FRANKENSTEIN – Why hasn’t anyone explained how the two disorders interact, and how the medications for each may also affect each other. (“Do you think that the Ritalin is making your mania worse?”)

I have been primarily a mixed state, high functioning, Bipolar type 1 for years now. I always thought that my constant mental zooming about was just my amazingly stunning mania. (While I mostly talk about my being manic lately, let me just say that depression has played a big part in my mental health too.)

My daughter went with me to my last counseling appointment. We talked about my inability to stick with one thing and see it through to completion and how it was impacting her. Basically, I’m driving her bonkers. These are some of the things that I do: TALK CONSTANTLY NO MATTER WHAT WE ARE DOING, change topics as fast as I talk, pick up a pile of laundry in the living room to put it away, stopping to talk to our beta fish (Victor and Batman) and feed them a few dried wormy things and set down the laundry, forget that I had a mission with the laundry, see that the dog/cats water bowls are empty and fill them, read 1.75 pages in a book. What was I doing? Let the dog out to do her business. Hours later I discover the laundry next to the fish… you get the idea.

My new counselor, my daughter and I decided that I need to focus on being able to focus. Yes, my Bipolar mania hops it up like jet fuel in a race car, but with knowledge and tools to help me with my ADHD and settle on one thing, even for an hour, I might just begin to get a handle on my anxiety/stress and even mania.

Maybe. This is stressing me out. Bothering my daughter this bad is building an anxiety that is part of everyday life. Sigh…

Who knew that pressured speech and mania aren’t the same thing as ADHD? I really don’t understand what the hell is going on. I feel like my brain has been sewn together with blue and green colored twine and slip knots.

One final thing: It has taken me three days and four hours to type this. Just kidding. Two days. Honestly, I have no idea. I need a time-out.

Bipolar – Days Racing Up, Down, Up, Sideways Right, then Left… It Never seems to End.

There will always be days that start well.
After they go along for a while…
Then the ground begins to frighten me.

train_crash_for_blog_imagedddddd(It says, “Somedays, This is how we feel…..””

I find that this is very true. At least it is true for me.

Is it ever true for you?

Today started out slow and exhausted. I was up almost all night with restless legs. It eventually became so horrible… that I cried in frustration and pain. I think I slept an hour. I was so tired. my goodnesss. Sleeping right nwooo dddkkk,,,,,,,,,,,,,

<I keep falling asleep. Sorry if this all comes out weird and confused… well.. that’s what you get. LOL. Pardon my language but this is crap””””””’>

There were other good things that happened throughout the day, but this was the best I think. I had a business meeting at a resturant! Isn’t that awesome!? I’m publishing a second edition of a book that I published 27 years ago. I’m so proud of how I wrote it, and the amazing artwork. But, it is time to update it and publish it in different editions and to update it as well.

I’m very excited because my meeting was an amazing. The woman I met with completely understood what I wanted to do and she caught the project and my passion for it really fast.

Then I got home, and stepped on the kitten, again. Sigh….

I’ve had enough of my day. So, I’m going to sleep. I usually do a lot of my work at night. I’m too tired.

I wanted to give you a look at this train photograph and share with you that I feel like I’m on fire and out of control.

Control. That’s hard to achieve when I’m being full on manic, have my ADHD surfing around everything I can possibly think of and somehow finding more, ever more, to add to the intense way I zoom. And finally, there is my always and every seemingly anxiety.

Anxiety – ADHD – Bipolar MANIA. Oh exploding stars that’s enough! Insomenia from restless legs. Oh I keep falling asleep and my fingers press the keys on my laptop and the strangest things get typed up.

I’m going to sleep now. aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaazzzzzzzzzzzzzzzzzzzzzz. Oh rere… ug. Whee are my fingers supposed too bee on the deyboard? I think I’m sleeep. Yes. dd

Nite my friends,

Robin

Pressured Speech – Bipolar Symptom

Descriptions of Bipolar Disorder are pretty standard across books and websites. The symptoms seem easy for anyone to understand. Unfortunately, they are not. I will be looking at each of the significant symptoms and will show what they look like on a real person. It is essential to understand them. To give you an example, what does it mean when I say that one of my most persistent symptoms is “pressured speech.” “Pressured speech,” this is not something I’d ever heard before.

I’m not a walking list of the common symptoms of Bipolar Disorder. Since a large part of mania seems to consist of going excessively fast I’m going to start right off with it. Get ready – The following information is critical to understand precisely what Bipolar Disorder is so that you can live life to the fullest. Ignorance of my condition left me without defenses and practically begs for things to go wrong. Now that I understand more about the disorder, I generally deal with it more successfully. Well, some of the time. Other times, it seems to slap me upside the head before I ever see it coming. Despite the seemingly inevitable setback, I feel like I have a fighting chance. For once, I even feel hope.

Mania – Pressured Speech

Bipolar Disorder is a mental illness where a person’s moods swing wildly from severe depression to reckless mania. Pressured speech is one loud symptom of Bipolar Disorder. I’ve repeatedly been told that I do it, but no one ever stopped to explain what it means. I had to research on my own to figure out what “pressured speech” means.

Knowledge – For me, a key to coping with any illness has always been understanding what’s wrong with me and how I can fight it. I hate seeing the same look on people’s faces when I realize that I’m my speech seems pressured. It freaks them out. It freaks me out too. It makes me realize that I’m talking crazy talk again and again and again.

“Pressured speech” is my “crazy talk.” Everyone deals with the disorder differently. Labeling pressured speech as my crazy talk is a way that I like to think I’m stuffing thoughts of being crazy into a specific behavior. When I can resist doing pressured speech I feel less crazy. I suppose that’s weird, but it seems to help me cope with it.

Some illnesses can be detected by looking at x-rays or surgically investigating a problem area. No medical test can be used to determine if I have Bipolar Disorder. I was required to meet with a medical person that I knew nothing about so that she could decide if I was eligible for disability status. She asked me some questions, and then we were done. I was labeled as disabled and given medical care. Since it only seemed to take mere minutes to determine that I have Bipolar Disorder, I wondered if I had acted excessively crazy. I tried to answer her questions honestly and without spending time trying to use wording that would influence her decision.

Whenever a person assesses me (which they regularly do to determine if I’m still eligible for mental health care), I hope that they are well versed in identifying the signs of the illness and are confident in determining if I have it or not. The first behavioral clue that screams that I have Bipolar Disorder appears to be my speech. I talk all the time. And fast. My kids tell me to stop and take a breath. Talking. I have so much to say. Okay, that isn’t a mental illness. It’s irritating, but it isn’t a mental illness. However, pressured speech can be evidence of it. Pressured speech is something that I do all the time. Even when I’m depressed, I still manage to have pressured speech. So what the heck is it?

Pressured speech is different for every person. Just about all the lists of symptoms of Bipolar Disorder will have it on them. Let me explain what it looks like in me.

People may wonder if I have Bipolar Disorder when they hear me speak too fast and sound like there is some crisis that I feel compelled to tell others about it. I can sound erratic and talk without stopping or even noticing that someone else might want to speak. I am not easy to interrupt. Often what I say is irrelevant or strange, and the person I’m talking at doesn’t know what I’m talking about. When I have pressured speech, I may not stop talking when I usually would. I act like what I’m saying is urgent and essential and it doesn’t matter whether or not the person trying to listen can follow me or not.

I seem to speak like I’m leaning into a wind, a mighty wind, and I’m bent over trying to stay standing. You could say that I am pushing a car up a hill that never ends. The pressure I apply to keep the car moving is just like the way I talk like I am pushing forward faster and harder all the time.

My speech is pressed out of me with an urgency that doesn’t even come close to the situation. It is as though I’m waving a flag in a frenzy announcing to the world that I have delusions of grandeur. What I say is of great importance even though it is often fragmented and random. I speak with urgency thinking that what have to say is so important that I have to be listened to right this very second and I have to tell everything to you all at once. All at once may mean that I’m going to talk at you for as long as I can unless someone stops me. Occasionally I can stop myself, but that’s usually when I see the listeners face and it registers with me that they seem to think that they’re being faced with listening to a crazy person.

I bet you didn’t know that pressured speech was such a  complicated symptom. That’s cool. It’s also a written example of me with pressured speech. <Deep breath, sigh>

Sometimes, when I’m finally taking a little break, I realize that I’m getting tired. Pressured speech can be hard work. Listeners should try to be more understanding. Don’t you think so?  <Heh>

<This is unedited and is a demonstration of pressured speech as I experience it. It may be different for another person, and it is different for me each time that I do it, which is a lot, all day long. It is meant to illustrate what people mean when they use the term “pressured speech” when talking about Bipolar Disorder.>

Bipolar Parent

Greetings friends, how are you doing in these wee hours of Friday morning?

Me? I’ve been both better and worse. Thursday had hours I enjoyed… then it crashed and burned as only the day of a parent can do.

When my three kids were young I had impressed even my ex-mother-in-law (let’s call her Kathy) with how well behaved and just good all around people my children were. Now, we are being stalked by rough and naked emotions that have always existed (that would be me, Bipolar parent) but are now beyond my own mind and have grabbed hold of my youngest.

I thought I was a good person growing up. I felt as though I were a likable person, yet I didn’t have many friends. I was lonely much of the time and kept my own company out on our small ranch with my horse, dogs, cats, chickens, pigs, cows and the occasional ducks.

I was a shit.

Seriously. I was a short, freckled shit. Today my mother and I can look years back and point to much of my careening and completely out of control behavior and emotions and say, “That, that right there!” And recognize it as full on Bipolar Disorder presenting before I even had my drivers license.

In short – I was angry all the time and blamed everyone one else for everything. My depression and anger were crushing me and the only name I could give it was – sin. I was a practicing Christian and all those “evil” emotions were clearly not of God… but that’s a topic for another time.

My youngest and his regular doctor decided that he does not have the highly genetic Bipolar brain that I’m still learning to embrace. Anxiety. Depression. Mania. Mood swings. Irrational behavior. That’s Scott, my “I’m a psych major. I already know how to deal with anger and anxiety.”

Scott is transitioning from my second daughter, Sydney, to my second son, Scott. (Incidentally my father’s name was Scott.) Scott is undergoing hormone treatment. He wasn’t always easy to talk to about things that he felt “attacked” him. Now he’s so much more difficult.

I despair.

He turns 21 this Saturday. He’s angry and bitter and is working so hard to make people not like him that I just want to sit down and breathe like I’m having a baby all the time. He and his wife are both psychology majors who it seems aren’t studying behavior.

Odd.

Scott sounds just like I did. If transitioning changes him into the sex his mind believes him to be, then I will continue to try to learn and gain deeper understanding. However, he’s a grown man (he says) and I expect him to at least respect me.

§ On Father’s Day Scott thanked me for being both his mom and his dad growing up. §

What I will not do is accept from him the same behavior at 21 that I had at 14. He has tools around him to teach him about what’s running loose in his little grey cells. Me – religion, animals, and hypnosis.

The weight of his relentless ill-will and violent anger crushed me at dinner. It was like fighting with my dad, but I was the reasoning one (yeah, no. My dad wasn’t good at being rational when angry either.)

Top the whole bloody mess off with a leaking red cherry on it and you have a self-entitled disrespecting second son.

I’m not having it anymore.

Being a parent with Bipolar is terrifying literally every second of that child’s life for me. With Scott acting like the individual (did I mention pressured speech?) that he clearly isn’t I have no clue how to even begin to help him to stop yelling into my face that I should shut up because I’m not listening.

Huh?

Parenting the twenty-something kid today is a massive challenge for this Bipolar mom. I have been charged with the crime of trying to build good family memories. I have felt despair and anger towards Scott. These are not the memories I want to build. We’re going to work this out, but I realize that I will very possibly react like I have Bipolar Disorder while we do it.

I can do this. I can figure out my part in healing our relationship. Be loving and kind… and forgiving.

However, Scott is a grown man and if he does not have Bipolar Disorder or some other explanation for his behavior, then he’d better watch out. I corralled the three of them through their teens by myself and while not properly medicated for my illness.

Respect me as your mom.

Respect my illness.

Respect yourself and get help if we just can’t talk it out.

I really wanted to go old school, like back to when I was a kid, and wash his mouth out with some nasty bar of soap like Dial or Lava and spank him with a wooden spoon. Two if the first one breaks.

Sigh….. parenting never ends, not really. My mom is still my mom. Who else would she be?

Scott, baby? YOU! It’s time for YOU to shut up and listen.