The manic symptoms have almost all subsided, probably due to pushing the Lithium dose up. And so far, no signs of Lithium toxicity. I am now waking up every 3-4 hours for more medication instead of every 1-2, which is a huge relief.
So where does that leave me? Fixed? All better? If only it were that simple.
In the first instance it leaves me absolutely exhausted. The energy credit card the manic symptoms racked up with insomnia, over-exercising, not being able to sit still or shut up, and thoughts firing for 23 hours a day, is demanding payment.
Payment usually occurs in one of two ways. If I am incredibly lucky, I may recover from the exhaustion with just some rest. Or I will pass from merely exhausted into a rebound depressive episode, which will take longer to recover from and may require further medication changes or a course of electroconvulsive therapy if it turns catatonic.
I often compare this stage of the illness to my psychiatrist and I piloting a jumbo jet. The cargo is my life the way I like to live it: being at home with my family, well enough to read and write, do my veterinary work, throw dinner parties and catch up with friends for coffee. There’s another hundred things I like to do, but those are a good start.
Moving from mania to stability is like trying to land that plane. We’re aiming for a smooth landing, not a crash with explosion on impact, which would signify an immediate descent into depression. The medication and our combined experience with this jet give us some guidance and an educated guess at where the ground is, but there is no air traffic control, and the runway is cloaked in mist. So, there’s a lot of just crossing one’s fingers and hoping it works out all right.
Assuming we land all right ie I get to the 60%-70% level of stability I need to leave hospital – we are still not home free. Sometimes we land that jet perfectly. I disembark holding my breath, dare to exhale, and then a month or so later the sinkhole of a delayed rebound depression opens up directly underneath where I’m standing, and swallows me, and all my cargo whole. And by the time I’ve climbed my way back out I have to start everything in my life from scratch again.
To end on a mildly optimistic note though: It has only taken just over two weeks for mania to emerge and be controlled, which in the scheme of past experience is a short time.
Keeping those fingers crossed and my seatbelt fastened as we continue our descent.
For a fascinating Conversations interview about the accidental discovery of Lithium as a treatment for Bipolar Disorder, click the link below: