Ryan's Story

EMAIL Ryan HERE
 

Six years ago, I had everything I could ever want—a happy marriage, a good job and we had just purchased our first home.  Amazingly and unfortunately, in less than a year that drastically changed.
 
I was a military public affairs officer in Texas.  My job required long hours and frequent, long trips away from home.  My first Southwest Asia deployment came on the heals of a four-month training stint on the East Coast.  That marked eight months of our second year of marriage spent apart. 


My wife had a very difficult time handling the time  apart.  She was often inconsolable.  Between work and trying to comfort her, I was under a lot of stress. At some point I became depressed.
 

Then while serving in the Saudi Arabia, I began to feel strange.  Everything difficult became easy.  A multitude of sounds, like the wind, fell into a rhythmic pattern.  Colors, light, numbers and language formed exhilaratingly intricate patterns intertwined by connections, or a common thread of meaning.  I was manic for the first time.
 
Despite embarrassing myself with overzealous, rambling emails, my illness managed to go unnoticed until I arrived home in Texas.  My wife noticed the change in me immediately and had me take a self-test for bipolar disorder.  I answered “yes” to almost every question, but yet I denied that there was anything wrong.  Still, I appeased her by going to the doctor.
 
There wasn’t a psychiatrist on the base, so I went to see a general practice physician. This was the worst mistake I made.  He could tell that I had been under a lot of stress and had been down, so he prescribed me Zoloft. The antidepressant sent my mania through the roof.  A couple of days later, at my protestation, I was hospitalized.
 
My first experience in a military hospital was a memorable one.  I was so paranoid that I thought I was part of a military experiment designed to test my loyalty and/or prepare me for advancement.  I thought doctors and the other patients were actors paid to represent abstract inner feelings of mine.
 

I was in psychosis.
 
I was treated with Ativan originally to calm me down, then Zyprexa or Olanzipine was added and Ativan was dropped.  It’s funny to me, I recall  writing a song praising Zyprexa while I was there.  Little did I know what problems it would cause for me.
 
I entered the hospital at 200 pounds.  Six weeks later I was 240.  Depakote was added to the Zyprexa shortly after leaving the hospital.  With the two weight-gaining drugs tag teaming me, I was nearly  300 pounds before the year was over.
 
 Worst of all, during my time in the hospital I was terrible to my wife. Psychosis caused me to believe that my wife and I were not meant to be together. The reality behind that was, I was bitter at her for sending me to the hospital when I had been so supportive of her.  She told me she would stand behind me no matter what.  I told her I wanted a divorce.   We separated.
 

In the months that followed discharge from the military, my thinking cleared enough that I realized I was making the biggest mistake of my life. But I could not convince her that the manic Ryan did not represent  my true feelings. We divorced in late 2000.
 
I went into a deep depression.  I returned home to the Midwest and immediately went back to work, but the depression and combination of Olanzipine  and Depakote dulled my mind and ruined my concentration.  I slept as much as 16 hours a day during that period, often not bothering to shower or shave before going to work.  For hours I would stare at my computer screen and accomplish nothing.
 
A new doctor led me to Lithium for the first time.  He slowly tapered me off both Olanzipine and Depakote, and in a short time I felt like a new man. I lost 80 pounds to begin approaching my old weight and I felt new energy and drive at the office.  Unfortunately, that proved too good to be  true.
 
By December of 2001, I was experiencing full-blown mania again.  The lithium had not been enough to cap my high moods and they bubbled over.  I was hospitalized for a third time.  Risperidone was added to my med regimen.
 
Over the next three years, we tried Quetiapine (Seroquel), Olanzipine again, Depakote again and Buspirone without success.  I continued to experience frequent manias with intermittent depression.  All told, I went through fourjobs in four different states in just a few years.  Finally, I moved home with my mother, and started going to the local VA hospital for treatment.
 
During that time, we have tried Ziprasidone (Geodon) and Topamax, both without success.  Only in the last few months have my moods stabilized for the first time on a combination of Lithium, Aripiprazole and Lamotrigine.
 
It’s been a long hard road.  After six hospitalizations, lost jobs and damaged relationships, it can take quite a toll on a person.  But I’m on a military pension now, and I have the opportunity and time to find something I want to do.  It’s an opportunity to find real meaning again.  I hope to resume my  career writing and  editing.

 

 

 

I first experienced the depressive symptoms of Bipolar II disorder the summer before I started an Ivy League college.  Symptoms waxed and waned-anxiety, fears, social maladaptation, gastrointestinal disorders, that bad feeling and depressive thinking. Yet I was able to do well enough to get into medical school after my junior year. (What my true potential was I’ll never know). The first two years of medical are normally hellish but my situation made it marginally bearable.  I felt like leaving a few times during those non-clinical years. But the last two years and internship seemed much easier although there were some residua of the illness. My tour of duty in Vietnam was marked by a profound depression and I was barely able to persevere. I saw a psychiatrist during medical school, in Vietnam and after returning to the States.  They all felt I had an anxiety disorder.  Today psychiatrists would be more attuned to the Bipolar Spectrum given all the information that has amassed about this common disorder.

After starting practice I had periods where I needed little sleep and effortlessly worked 70 hours a week and was exuberant.  Then years later over a period of weeks I felt awful again. But I never suspected a mood disorder even though I took pride in my treatment and care of seriously depressed patients. By fortuity I chose a psychiatrist who was himself bipolar.  He advocated lithium and I felt this was a rush to judgement Eventually a few months later the pain was so great I started lithium which at first I took reluctantly and sporadically and started an antidepressant, doxepin(this was over 20 years ago) mostly because of the insomnia. I weaned off of this slowly over the next 18 months.

Since being on lithium I have had two mild depressions. About 15 years ago with the first breakthrough depression I visited an expert in bipolar illness who gave me such sound advice that I have not had any breakthroughs until a few months ago.  He advised taking all lithium at bedtime, suggested supplemental thyroid as a mood stabilizer and told me to increase the lithium levels some should I get breakthrough depression.

Recently there has been an article in the Journal of Clinical Psychiatry which purports to show that multivitamins, multiminerals and amino acids seem to help Bipolars normalize. I have been taking these types of supplements for many years. Most recently I have added Omega 3 fatty acids to my regimen purely for cardiovascular health.  With my recent depression I increased my dosage by 50% to no obvious avail.

As a child in grade school I used to get the blues in the fall and winter, while in the summer I was outdoors all day long and was ecstatic.

My cousin who attended all of grade school with me clearly remembers my mood swings.

I realized I had seasonal affective disorder (SAD) when the work first came out NIMH. I purchased a light many years ago and used it mostly for fatigue and hypersomnia rather than depression per se.  I didn’t seem to need it anymore and gave it away only to purchase one again several years ago but hardly ever using it.  It is rare not to have yearly or biennial episodes of SAD. Perhaps my regimen protected me.

Six months ago my mother died and three months ago I went into semi-retirement.  At Christmas I sensed the depression that had been chasing me for some time.  I ascribed it to life events but about two weeks ago the hypersomnia approached 14 hours a day and this wounded healer realized that SAD was back. I got Dr.  Rosenthal’s books out and re-read parts of the them and the depression abated within three days of starting the light.  The negative thinking is gone, the thoughts of death have evaporated.  I got to be careful not to induce a hypomania.

Would that there were a medication that worked that fast for depression(Some day!).

Even if I had been diagnosed in 1960 not much could have been done as there was no lithium treatment available in this country until 1970.

Nonetheless with lithium I have been able to work 60+ hour weeks and not lost a day of work.  I have taken great pride in helping seriously depressed patients as a primary care physician, especially the ones who have told me after they improved that they were seriously considering suicide before coming for treatment.  Almost all serious mood disorders are biologically based and stress from numerous causes can  activate the underlying disorder.  We must all be aware of any recognizable change in our mood and evaluate it with a health professional because there is an ever-growing armamentarium of mood enhancing and stabilizing medications.

 

 

 

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