The big picture

It's 11:30 pm and in this slightly dark and judiciously cropped tree selfie, Christmas at our house looks postcard-perfect. But in reality there are boxes and bills and blankets and coats and wet shoes and easily 20 bottles of meds and folding tables and stuff to clean up sick-cat barf and plates of half-eaten cookies and basically something that needs time and attention on every counter, table and square foot of floor space in sight. It's exhausting and defeating just to look at. And none of us is sure how it got this bad.

But in the big picture, it's small stuff. And it really doesn't matter. I moved home two years ago in part to take care of my dad. And I'm thrilled to do it. I drove him to two doctor appointments today and helped get him changed for an X-ray and we drove to the hardware store to get him a rubber tip for his cane and we had lunch and got some Christmas stuff and took our kitty—who is actually pretty sick—to the vet, where he proudly told the doctor that HIS dad had been a vet, and it was an honor and a joy that I'm here to take care of him. And tomorrow we start all over again with two more doctor appointments and more Christmas shopping and probably lunch and I'm going to remember and savor every moment of it because when he's no longer here I can look back and say "I took care of my dad. And we had lunch. And we laughed at dumb stuff. And he told me stories about my relatives and what cool old buildings used to stand where in the city and where he and Mom lived before I was born and which of his friends who've died he really misses and how he hates to be blind and I took care of my dad."

And that street runs two ways. I've been on a two-year emotional roller coaster of bipolar highs and debilitating lows and lengthy hospitalizations and miserable, crushing side effects of taking and withdrawing from maybe 30 psychotropics (which, all things considered, I still think is a really cool word) and quite literally sleeping my life away as we try to find a med combination that doesn't make me unstable and embarrassingly fidgety and relentlessly, overwhelmingly drowsy. And my mom and dad have been my super-advocates all along, organizing my ever-EVER-changing meds, making up a bed for me on the couch on the days I can barely crawl home from work, making sure my insurance is up to date and I'm not missing a dizzying array of doctor appointments with a dizzying array of doctors and making me pot roast and Jell-O with fruit in it and in general just being awesome.

But we're not special; millions of families are facing millions of medical problems, some easier than ours and some crushingly harder. And millions of families also have messy houses, especially around the holidays. And there's a glaringly obvious metaphor in there that can be interpreted in positive or negative ways. For me, it's all good. We'll get the house picked up and back in order soon. My mom will eventually forgive me for announcing to all of Facebook that we live in pestilence and squalor. I'll get my meds—and my brain—straightened out. Mom and Dad will or won't get sicker or better and I'll be right here to take care of them.

And my slightly dark and judiciously cropped tree selfie might not show our struggles and messes, but it totally captures all the warmth and joy and love and—I'm sorry—really ugly ornaments in this house, in this family, in this world of uncertainty and unfairness and hope and fierce, unbreakable devotion.

My nephew brought his dog over to bring me back to life tonight!

Bridget (the dog, not my nephew) is the best medical dog in the world except 1) she has no accredited nursing degree 2) she keeps asking to borrow my stethoscope and I'm beginning to suspect she doesn't even have one of her own 3) her scrubs are decorated with little superhero kitties, which—I'm sorry—is COMPLETELY implausible for a dog nurse 4) she is way too fidgety to just lie down and snuggle 5) she's even worse when you try to get her in a picture, like this tender loving emotional nursey one of us both sitting upright and attentive and side by side in front of the lit tree.

So I swear my bloated woe-is-me ramblings on here every time I spiral out of control aren't thinly veiled solicitations for love notes in the comments. In actuality, they're not even veiled at all. I know I have a vast support network, I am humbled by its size and sincerity, and sometimes getting lengthy lists of Facebook comments reminding me you're all out there does more good than you could ever imagine. So thank you. Between you, my parents (who are the fiercest, most devoted advocates a crazy bipolar man could ever hope to have), Bridget the dog (who at this moment is selfishly in the next room not doing a damn thing on behalf of my mental health), a workday highlighted by two Diet Cokes, a bag of Famous Amos cookies and my favorite shoes, a 500-hour nap and a bowl of store-brand Jell-O that was so deliciously limey that no other lime in my past or future will ever measure up, I am exponentially better than I was when I started typing my unfocused manifesto 24 hours ago. I'm not out of the fog yet and I'm gonna spiral out of control again sometime but I learn new ways to cope each time and when I brain-dump on here again to organize my thoughts, my Facebook support army will come out of the woodwork again and make me feel able to keep on keepin' on.

This is the face of near-catastrophic bipolar depression

This is also a brain dump of a blog post that may or may not be a shameless plea for affirmation or an embarrassingly disjointed documentation of my current inability to generate linear thought. I haven't decided yet. Because I haven't written it yet. And I don't know where to start.

I fell over getting out of my car this morning at work. I opened the door, grabbed the frame to pull myself up and immediately lost all sensation of the direction of gravity, spinning to my left, rolling against the rear door and hitting my head on the door frame on my way to the ground. I've felt a little off-balance all week since my doctor doubled one of my meds on Monday but this was the first time I went full-pavement.

My right hand is slowly losing its ability to function. Last week I couldn't push the button on the key fob to unlock my car door. Last weekend I couldn't hold on to a tube of chap stick hard enough to pull the cap off. Last night I couldn't pick anything up with my chopsticks at the restaurant where we celebrated my brother-in-law's birthday. This morning—after realizing I was plummeting faster than I could manage to control at work—I couldn't pull the key out of the ignition when I got home.

I have no idea if any of this is related to being bipolar, changing meds or something entirely unrelated, but it's the easiest to explain.

My depressive episodes are mostly about fogginess (I get lost physically and mentally, I forget stuff like things I promised to do or why my parents are gone for the night) and abject despondency (everyone I know hates me, I don't care if I live or die). Fortunately, I've been doing this a long time and I can look at it all objectively—no matter how acute or systemic or visceral or urgent the feelings are—and know with slightly foggy certainty that none of it is real and it will all pass and if I can just find a blanket and a dark corner and a couple of uninterrupted hours I'll be emotionally drained but highly functional.

I'm a 48-year-old man who after a 15-year advertising career in Chicago moved home to Iowa ostensibly to care for his blind father but more as it turns out to be cared for as a mentally ill person by his parents. On paper, I hate everything in that sentence. In reality, I'm currently sitting in the glow of the Christmas tree with both my parents and Bitch Kitty and I'm so thrilled I get to share so much of my adult life with them and that alone helps me rebound when I spiral out of control.

It has taken me over two hours of intense concentration to write this. But I'd already napped for five hours and writing this gave me something relatively constructive to do instead of stewing in self-pity. I know I probably spend way too much time on social media talking about being bipolar but it helps me clear my head and organize my thoughts and in some ways make myself accountable for my own mental health. And it's even helped me bond with a number of you who have confided in me about your own struggles with mental illness. You call me brave. I call myself unfiltered. But if any of us finds value in my ramblings, it helps compensate for the fact that I've probably scared away every eligible gay man in Linn and Johnson counties.

600 paragraphs ago, I said I didn't know where this post was going. Almost three hours later, I don't have a clear recollection of where it wandered to wind up here. And I'm not going to proof or edit it so when I emerge from this episode I can maybe see how the depressed me kicks through the brambles and strings together thoughts. In the mean time, I have my blanket and dark corner and I'm finally sleepy again. For those of you still with me, thank you for your friendship and support and kind words. And good-night.

YESTERDAY: Perky, engaged, productive, awake, normal

TODAY: Foggy, confused, slow, buried in mud, unsteady on my feet ... and I seem to have lost the dexterity in my right hand

Whoever told you that bipolar disorder is all cupcakes and kittens sliding down rainbows forgot to tell you the cupcakes sometimes have bugs in them and the kittens sometimes fall and break their legs. Sorry to sound like the black hole of emotional need but I had to tell someone I'm crashing in new and profound ways and you 1,500 people were the closest by.

My mom's secret alter ego

is Mega Super Awesome Pill Figure-Outer Lady with Pillbox Thumb Opening Action(R) and Micro Pill Splitting Power(R). Seriously. You should see how fast she can calculate and portion weeks of simultaneous weanings up and down in separate am and pm boxes without running out of refills for me.

I don't know how she does it all without getting her cape caught in the pillboxes but that's part of her superpowers and we mortals don't question anybody's superpowers. Mostly because it's impolite. But also because we secretly want to try on the cape but it's considered the height of rudeness to ask.

Go, Team Jake!

Here's me and 4/7ths of Team Jake, who are on call 24/7 to provide wake-up calls and remind me to take my meds and send me random texts to remind me I'm loved and provide courtesy laughter for (most of) my dumb jokes and refuse to let me feel like I'm broken and give me big hugs out of nowhere and to tell me gently and respectfully that I have too many shoes, which, of course, I don't because there's no such thing as too many shoes but I play along with our little charade because it makes them feel appreciated and I genuinely appreciate every one of the things—both little and big—that they do for me. Because some days I really need to feel loved and every day they remind me that I am.

The therapeutic benefits of ice cream

Misery is feeling so shitty at work that you have to admit defeat and come home early from the job you love and never want to jeopardize.

Cozy is getting home to find your folks have made up the couch like a bed so you can climb in it the second you get your shoes off.

Happiness is being awakened in time to have a home-cooked dinner with your folks.

Frustration is choking down the newest mountain of evening psychotropics in the hopes that this cocktail will finally—FINALLY—be the magic bullet that promotes social confidence and friendly comfort and eliminates embarrassing side effects like wiggling and grunting and face touching and hair swirling and eye rolling and knee shaking and foot tapping and diminished motor skills in my hands and fingers and time-sucking distractibility with Facebook or rubber bands or the shoes I'm wearing or how many 5 Hour Energies or Diet Mountain Dews I can nurse before lunch.

But there is a mighty cloud of joy amid all that complicated emotional mess: the unbridled happiness I get from slurping up a giant chocolate malt my dad made for me (with extra malt because we're not savages) and enjoying it along with my parents as we discuss the news of the day interspersed with attempts to fix my mom's perpetually broken iPad even though none of us has even a modicum of a clue what we're doing. It's a small gesture of love and goodwill for what I often feel is an irreparably broken man.

Don't cry for me

So I made it through two and a half Evita performances over the weekend without even a hint of the grunting and twitching and wincing and eye rubbing that have been my constant companions on my current cocktail of bipolar meds. But they started to flare up in the second act of our closing show on Saturday night, and by the time I got to my car after the show I was a full-throttle circus clown of grunting and twitching and wincing and face touching and eye rolling and invisible gum chomping. So I regretfully skipped our cast party and came home to hide under the covers. Today at work I was thankfully a few clowns short of a full circus, but I compensated with hand tremors and a pronounced loss of dexterity in my fingers when I tried to open and close shoe boxes so I could write about them or press the button on my key fob to lock and unlock my car. Plus my face is now chronically red and raw from involuntarily rubbing the fuck out of it whether I'm asleep or awake. Plus my left ear has the on-and-off sensation that I've successfully driven a railroad spike in it. I'm frustrated to the point of never leaving the house again, but there are shows I want to be in and people I want to meet and uncling I want to do and acres of shoes I want to wear and maybe another marathon I want to tackle and family happiness I want to enjoy. And thanks to an after-hours call with my psychiatrist tonight, I have a new med to get my hopes up over. So I'm heading to bed with a new psychotropic joining my existing army of four and wondering which Jake I'll be in the morning. Good night to all of you who managed to slog completely through this endless manifesto. And thank you to everyone who calls or texts to see how I am. I may not have a coherent answer every time but your friendships mean the world to me.

Here's some friendly midnight advice from your crazy Uncle Jake:

If any doctor tries to prescribe a psychotropic drug for you, the FIRST thing you need to ask about are the withdrawal side effects you'll endure when you stop taking it, which—trust me—you eventually will. The ramp-up and day-to-day side effects of taking psychotropics definitely come with their challenges, most of which are a welcome trade-off for eliminating the mental-illness symptoms they were prescribed for. But eventually something in your head will change for the worse and your doctor will start to tinker (rather blindly) with the drug or cocktail of drugs you've been having success with. And the fallout can be unpredictable and devastating.

I ended a seven-year relationship with Abilify over a week ago because within the last year I'd developed a hefty case of tardive dyskinesia that made my legs shake involuntarily, uncontrollably and—most important—embarrassingly. And my current doctor was pretty maybe kinda sure Abilify was the culprit. And at first it seemed she was right. The leg shaking started disappearing almost from the moment I started tapering my dosage.

But.

The leg shaking seems to have been replaced with a three-ring circus of embarrassing side effects: involuntary eye rolling, power squinting, face rubbing, scalp swirling, nose pinching, beard rubbing, chomping, grunting, hyperventilating, spasms down the back of my neck, and an increasingly obvious sense of fogginess and confusion—all of which started manifesting themselves since I took my final tapered dose of Abilify. I'm so miserable I can hardly stand it. And my face is raw from the constant rubbing.

I have two choices: Go back on Abilify and (maybe) trade back my new side effects for my old ones, or stay the course and endure the withdrawal side effects until they (hopefully) go away. I have NO intention of reliving the withdrawal side effects I've survived to date so I'm going to stick with the plan and hope for the best. But I can honesty say that if the doctor who first prescribed Abilify for me could have impressed on me the degree of severity and misery I'd have to endure in my eventual withdrawal, there's no way I would have started taking it. There have been entire days over this last week where depression seemed exponentially easier to endure than withdrawal. Hands down.

You know that fogginess and confusion I mentioned two paragraphs ago? And you also know how in real life I'm a professional writer with (if I may indulge in some immodest immodesty) a quick wit and some mad typing skilz?

It took me almost two hours of intense concentration and multiple fits of intense face rubbing to write this, what should have been a 20-minute post. And I'm beyond the capability of proofing it.

Sleep study redux! This time with superhero headgear!

How to keep your friendly neighborhood pharmacy solvent:

I mean seriously. And I take just as many meds in the mornings as well. Granted, about a fourth of my daily pill pile—which is a totally awesome band name—is OTC stuff with purported powers to control the side effects of all this pharmacology. But none of any of it seems to be working for shit. I'm still shaky and chompy and chubby-tummied and chronically, relentlessly exhausted. I'm still struggling to claw my way out of deepening pits of depression on an almost weekly basis. The unnerving and sometimes terrifying symptoms of my Cymbalta withdrawal seem to be escalating. And I'm weaning myself off of Abilify next. BECAUSE NONE OF IT SEEMS TO BE WORKING. Despite my many plans to the contrary, I pretty much slept my way through this entire weekend. I didn't go to a play I had tickets for. I didn't help my brother-in-law paint his house. I didn't do any half-marathon training. I didn't go to our neighborhood block party. I didn't even take a fucking shower.

But I have hope. And the greatest support network a bipolar person could ever ask for. And the ability to sit back objectively and make fun of the absurd and ridiculous stuff. And the delusion that I can stubbornly will myself to get better. But not, unfortunately, the ability to swallow two daily handfuls of pills without violently gagging. And clearly I don't have the self-control—or maybe just the self-sufficiency—to shut up about it all on social media. Which, on some levels, makes all of you part of my support network too. Which I suspect may be my subconscious goal with all this whining. So sorry to drag you all into my mental drama here. But thanks for playing along. I'm going to sleep now. Which I'm really good at; I practiced all weekend.

Cymbalta withdrawal is a bitch. Bitch Kitty is a bitch.

Cymbalta withdrawal gives me brain zaps, which are like blackouts with extra dizziness and lip tingles and confusion and disorientation but no actual blacking out. Bitch Kitty gives me the come-pet-my-soft-warm-exposed-tummy fakeout, which is like a real come-pet-my-soft-warm-exposed-tummy invitation but with growling and hissing and swatting and running away as fast as her waddly soft warm tummy will allow but with no actual soft warm tummy petting.

 
Cymbalta withdrawal brain zaps hit me then fade away then hit me then fade away until I'm exhausted. Bitch Kitty swats at me then runs away then swats at me then runs away until I'm tired of her bullshit.

Cymbalta withdrawal brain zaps will eventually go away and I will dance on their grave. Bitch Kitty will eventually go away and I'll actually kinda miss her.

Today was day 10 of s l o w l y weaning me off Cymbalta ...

... the act of which gave me seizure-like blackout thingies when we did it rapidly last spring. I should be completely Cymbalta- (and seizure-like-blackout-thingie-) free by the beginning of October, at which time we start weaning me off of Abilify. Because I'm on five psychotropics right now, and while saying “psychotropics" is fun and all, five (plus my thyroid medication) is a bit much.

Every time we change my meds (I mean psychotropics!) I get my hopes up that THIS TIME will be the magic bullet and I'll finally stop sleeping through life/binge-buying shit I don't need/growing an enormous gut/hearing noises in the other room/deciding nobody likes me/shaking like a hoochie mama in a bathtub with a toaster. And every time, my symptoms seem to shift around a bit but never totally go away. So now instead of adjusting/introducing meds, we're taking them away entirely. And s l o w l y. But like everything related to psychotropics (there's that word again!), results (or complications) take time. And we have to map out when those results (or complications) might manifest themselves so they won't interfere with things like vacations, projects at work, family events, theater commitments and Disney half marathons. 

Speaking of which, the Disney half marathon I'm running is the first weekend in November, at which time who the heck knows where my meds (and my brain) will be. But once again, I choose to think that by then I'll be clear-headed and focused and energized and bedecked in my red running shorts with huge yellow buttons on the front and—aside from the aforementioned shorts—perfectly normal. Just like all of you magically wonderfully perfectly normal people. (You'd tell me if you weren't normal, right?)

The natural progression of bipolar disorder:

Depression > deep depression > despondency > recovery > fogginess > exhaustion > functionality > public panic attacks > Oreos

How to survive a bipolar crash:

1. Ride it out. Sleep it off. Which I've been doing since Sunday afternoon.
2. Walk through a spider web and do the frantic spider-web dance. Which I did this morning. Bipolar depression is no match for the absolute mathematical certainty that there's a giant man-eating spider somewhere on your body. Or crawling into your shirt. Or down your underpants.

There's no real way to "fix" bipolar depression

You just have to ride it out. But sitting around with your parents, eating a malt made by your dad and listening to Widor's organ Toccata sure collectively go a long way toward making you better.

Beware the Withdrawal Effects of Cymbalta

I've been sailing along for months and months on a cocktail of four bipolar meds and one thyroid med with only two problematic side effects: unceasingly shaky legs and all-but-debilitating chronic exhaustion. So my doctor decided to wean me off of Cymbalta over the last week. Which, in retrospect, was probably not the smartest decision to make at the confluence of tech week for one show, early rehearsals for a second show and the week before I start an exciting new job. Throw in a dreamy new boyfriend and a paternity suit with a traveling stripper and I'd be Maury Povich GOLD right now.

Anyway, I've been off and on more meds than I can count with zero noticeable side effects ever. Until today, when I started getting hit by wave after wave of what I can only try to describe as shivery hot carbonation under my skin. It's like the waves of nausea you get with the flu … only there's no nausea. Plus it's like the prickly head rush and the near blackouts you get when you stand up too fast … only it happens no matter if I'm sitting, standing or lying down. A little Googling of Cymbalta withdrawal tells us this is actually a common side effect, but I was never warned about it. And after a conversation with the on-call psych doctor and a trip to one of the only 24-hour Walgreens in Cedar Rapids, I'm now back on a lower dose of Cymbalta for the time being. So the shows and the job are saved. And if you're a potential dreamy new boyfriend, you know where to find me. I promise that the traveling stripper meant nothing to me.

Never underestimate the power of bipolar depression

A relatively low dip brought me to my knees at work yesterday morning and—aside from a brief rally at dinner last night—I've been sound asleep for more than 24 hours. Full shutdown notwithstanding, this is actually progress; as little as six months ago, my shutdowns lasted around five days. This episode, however, comes with flashes of deep, excruciating pain from my right hip to my right foot. Diagnosis still TBD.

Here ends my boring medical update. To thank you for your time, I leave you with the conversation I dread having with my trainer:

I'm really tired of the tummy my bipolar meds gave me

REALLY tired of it. Cutting back on pop and sugar and fatty foods hasn't changed it. Taking HydroxyCut hasn't changed it. Adding a brutal abs workout to the end of every workout hasn't changed it. So I just hired a trainer. We meet for the first time in 10 minutes. And she's a girl. A girl covered in tattoos and piercings and filled with the kind of badassery I need to whip my midsection - and everything else - into badass shape. And I can't wait to get my ass kicked by a girl!

Pro tip:

Never clip your nails when you're jittery from your bipolar meds.

My shrink just put me on an 8th bipolar med that by far has the prettiest name

Introducing Latuda, a sassy girl with a heart of gold who just may end up being my drag name. I can't decide if she should have a last name—Latuda Pillpopper? Latuda Justment?—or just have an iconic single name like Cher or Jake.

Thank you

As anyone who spends more than a few seconds on social media every month probably knows, I'm bipolar. As probably nobody knows, my bipolar depression got so acute and so scary that I spent the week of Christmas in a psych ward. It was there that I decided I needed to move home to Iowa to help take care of my dad—who has lost his sight to macular degeneration—and where my family could take care of me. It was also where I told myself if I really did move to Iowa I'd get involved in the theater again. Now fast-forward four months. I've already done one show, and tonight marks the point where I am for the first time in my life doing two shows simultaneously. I start rehearsals for A Chorus Line tonight and I open Barefoot in the Park this Friday. Plus I have a kick-ass job. Plus my meds are working so well I forget what it's like to be manic until my increasingly rare manic waves hit me. And I honestly can't remember the last depressive episode I had. (Then again, huge chunks of my manic episodes are a blur too. Which is both a blessing and a curse of being bipolar.) I owe A LOT to so many friends and family members and social-media acquaintances who have believed in me and given me encouraging words and friendly hellos—and parts in theatrical productions—and I don't even know how to begin showing my gratitude. Which is a lot to say for a professional writer who usually can't shut up. So I'm showing my gratitude by living my life and enjoying what it brings to me and believing in myself even when I don't really believe in myself. I love my family, I love my friends and I love my life. And I send an epic thank you to everyone who's helped get me here.

I'm thankful to be home and cozy and safe ...

after a 300-mile adventure today with snow and sleet and beautiful hoarfrost and huge trucks barreling down the highway and stops to see my ex and pick up the last of my crap that had been lingering in Chicago and buy some shoes and celebrate the staying-awake properties of my new meds (yay, lithium!) and all the while sharing the day with both my parents, who remain my stalwart supporters and I'm so grateful for them.

Not to belabor the fact that *I Have Bipolar Disorder* ...

but my depressive crashes are usually marked by an odd compulsion to grunt repeatedly like a damn circus freak. Usually I produce just a simple beat—it's not catchy and you can't even dance to it—but sometimes I get caught up in an endless cycle of some snippet of a song, making my grunting doubly embarrassing. Or at least frustrating. The songs can come from anywhere—usually they're show tunes, natch—but tonight I can't get that damn dum da-DUM baseline from the theme to CSI out of my head … or out of my grunt cycle. 

Bipolar disorder is NOT for the weak. Or the unrhythmic.

I'm thankful for family and friends who believe in me fiercely, even when I don't

I'm thankful for new opportunities to participate and stretch and thrive. I'm thankful for productive dance rehearsals and honest sweats and meds that seem to work better each day and 5 Hour Energy when they need a boost. I'm thankful my mom cries when I have a good day and my dad hugs me freely, which we never seemed to do enough in the past. I'm thankful I have a safety net in my family when so many others with illnesses like bipolar depression don't. And right now I'm this close to being thankful for a deep deep sleep after an awesome day.