How insulin led to a Lithium overdose and a self inflicted third-degree burn

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This is probably where the trigger warning should go. Most of this post is about inflicting some serious damage onto myself. There’s a quick guide to Lithium overdose at the bottom.

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This post is about more than the acts themselves, it’s about trying to figure out how it made sense to stab my forearm repeatedly with a diabetic testing needle, then to take a red-hot butter knife and burn a trench into my wrist.

In my opinion the insulin I’ve been taking for a few months reacted badly with the Lithium I’ve been taking for almost a decade, causing an overdose and weeks long downward spiral that left me at my desk with a red-hot knife.

The manic depression had been under control for years, two weeks after starting the insulin my numbers had dropped from the mid-20’s, to normal in the morning and the mid-teens in the evenings.

The years of excessive thirst, a major symptom of diabetes, seemed like it was gone immediately. I went from 4L of diet pop everyday, to less than a small can. My milk intake dropped from 4L / day, to 2L. I was also drinking roughly half the amount of water I had been every day.

So instead of drinking two or more pitchers of water over lunch at a restaurant, I was down to two glasses.

As my numbers came down, I was drinking less.

Unfortunately, without water, people taking Lithium can and do go “toxic”. I take a very high dose of Lithium every day, so this is something I know. But I haven’t been monitoring my Lithium levels, maybe not for four or five months.

In mid-September I started noticing two things I believed were unrelated, but turned out to be from the same source.

The first was my blood sugar began to crawl back upwards. The second was I began to shake more often, and a little more violently than normal. I’ve always had the “Lithium shakes”, basically a fine tremor to my hands. But they’ve never been more than an annoyance.

But starting in mid-September the shakes got into a whole new level. Most of the photos I was taking, sometimes over 100 in a day, were being turned into a blurry nonsense

Photography is very important to me. I have very few outlets to rid myself of the frustrations and stress I pick up over a day, week or month. My camera is my yoga and a sensory deprivation tank.

There really is nothing else in my life capable of lifting the weights off.

For three weeks, not only did I have no outlet to relieve the stress building up from my relationship with my girlfriend, and dealing with a rising blood sugar, and from not being able to control my computer mouse, I also had the added stress of not being able to take a decent picture.

Every fucked up photo was another failure. And the shaking got worse everyday. Until it wasn’t shaking anymore, it was jumping and jerking and even bouncing.

I was stabbing my throat with my toothbrush, losing half a glass of pop just by raising the glass. I was waking up in the middle of the night with my arms flailing around above me, or with my fingers furiously slapping each other.

It was also getting harder to stay awake. I was sleeping five or six hours while my son was here. I wasn’t walking anymore, I was staggering. I wasn’t blacking out, but I’d start walking to the fridge and end up lost in the bathroom.

And the frustration of it all kept building. By the end of September my blood sugar numbers were mostly back to the extreme highs of my pre-insulin recovery.

I’ve spoken to my diabetic nurse, and I’ve spoken to my psychiatrist (both before the physical damage), and from what they’ve told me, and what I’ve put together, I believe what has happened to me is a combination of the insulin working, and not keeping a close watch on the Lithium levels.

My blood sugar levels have been rising steadily for more than a month because the insulin succeeded in getting rid of the excessive thirst;

Because my fluid intake dropped by 80% (ish) my Lithium levels became toxic;

Continued toxicity became a recurring overdose;

A Lithium overdose is marked by an inability to concentrate, it becomes harder to stay awake, it made me clumsy, uncoordinated, as well as weak, lethargic and extremely irritable — I was losing my ability to reason through problems;

All of which meant it was very difficult to focus long enough on trying to eat a diabetic-friendly diet. Which means higher numbers.

So, in my opinion, the insulin and the Lithium were driving each other into the dark side of their side effects.

All of it led up to an incident in a local park. My girlfriend and I took our kids so they could play, and so I could grab some photographs of them playing. There would have been some beautiful shots, but everything came out a mess. My hands were jerking in a counter unison, my camera almost flew out of my hands. I almost threw it on purpose.

Eventually I had to sit down because I was ready to cry.

Finally, after trying more than sixty times to photograph a dazed honey bee resting on my hand, only to have every shot come out blurred, I punched a slide. But I felt like I should try to tear the park to pieces, and burn it.

There was also an incident soon after where, out of complete frustration, I lost control and punched myself in the head four times, each one harder than the previous. I had been walking in circles in my apartment for what felt like an entire day, trying to remember what I had wanted to do. The first punch was almost like trying to kick start an engine. The rest were just about punishing myself.

The punches had everything to do with having lost almost total control over my life.

I could barely walk up my staircase. I was lurching around the room. My blood sugar numbers, which had been a rare victory in my life, were back to pre-insulin numbers. I couldn’t think, I couldn’t remember, and my girlfriend was smothering me.

So, early in the morning on October 9, my computer stalled again, something was too loud, there was another sound from the toilet, the fridge was loud, I couldn’t control my mouse, there were eight other sounds to notice, and it made a lot of sense to start banging on my computer desk, screaming “fuck you, fuck off, leave me the fuck alone”.

And that’s when I grabbed a thick but shallow needle, and jammed it into my left wrist thirty-three times.

In the days leading up to my “Stabby Day” I had been thinking about how, when I was in my early-20’s, I’d press lit cigarettes into my arm.

And that’s how it occurred to me to press a red-hot butter knife into my lower forearm. I was just so calm by that point. While the knife was heating up in the stove element, I actually spent time laughing at the stupid shit on Gawker.com. I was also laughing at how little blood there had been from the stabbing.

Ten minutes after turning the stove on I saw the smoke, so I picked up the knife, went back to my desk, laid out my left forearm, held the knife on an angle, and dropped it onto my arm.

The sound freaked me out, so I pulled the knife back, but almost immediately dropped it back. I counted to at least five, then took it off, readjusted it a little, then dropped it again, and then a third and final time.

It’s a third-degree burn, about the size of a Canadian $2 coin, with a $.25 tail. I went almost three days without putting anything on it except Polysporin, which expired in 2008. The indent is deeper on one end than the other.

On the third day I showed it to someone wearing a white coat, and they said to let it breathe for half a day, and cover it the rest with gauze.

Everything seems to be healing well.

I’ve had a Lithium test, I’ll get the results this Friday. I’ve also tried very hard to start eating three meals every day, and not close to bedtime.

I’m drinking a bit more, but not much. But for the past three days my numbers have come down slightly.

I have been doing something that could, in the medium term, be even more stupid than burning my wrist… I’ve cut back the Lithium from 2100mgs/day to 1500/day. Lithium is the reason why I’m alive, it’s the foundation of my recovery from manic depression. But, in addition to everything else for the past few weeks, I’ve also constantly tasted salt.

Of the last 100 photos I’ve taken, most have been in focus.

The shaking is down by 70% from a few days ago, and I don’t taste salt, but that could be entirely meaningless. The plan is to be in an Emergency Room if the healing gets weird. Maybe I’ll get to take photos of a skin graft.

I can almost remember having reasons to be proud.

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A Simple Guide To The Symptoms Of A Moderate Lithium Overdose

unsteady and clumsy motion
inability to coordinate fine motor activities
inability to perform rapid alternating movements
involuntary left-right eye movements
lethargy
weakness
irritability
edema
increasing restlessness
stupor
incontinence
slow and painful involuntary, sustained, spasmodic muscle contractions
sudden, involuntary, uncontrollable jerking of a muscle or group of muscles.
increased deep tendon reflexes
small, local, involuntary muscle contraction
blackouts
confusion

It might seem as though several of the symptoms overlap, or are basically the same thing, like “lethargy” and “stupor”, or “reflexes” and “muscle contraction”. But “lethargy” has to do with energy, and “stupor” simply means too exhausted to function.

Each one of the symptoms involving muscle spasms, for example, attacks different parts of my nervous system. So I’m not being attacked by one or two, but all of the symptoms at the same time.

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...thanks.

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Posted in Bipolar, Bipolar Disease, Bipolar Disorder, Clinical Depression, crazy people with no pants, Diabetes, Health, Lithium, Living With Depression, Living With Manic Depression, Manic Depression, Mental Health | Tagged , | 14 Comments

Without the dolphin taste tuna is really bland

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Speaking of ad campaigns a retarded budgie could think up, Highliner (the fish people) are asking “Wonder why don’t you eat fish more often?” on billboards all over town. Long and painful minutes were spent in coming up with replies:
1) because there’s none left;
2) ask us again in Spanish;
3) very slowly ask again in simple English, it takes the Ministry of Fisheries and Oceans a little longer than most to catch on;
4) because your product has the consistency and taste of flaky wet gyp-rock wrapped in dried kitty-litter;
5) because without the dolphin taste tuna is really bland.

The first Top 5 List I wrote as my college paper’s humour columnist, back in 1995. “Retarded” didn’t make the final edit.

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Almost fifteen years ago, when I was in the second semester of my journalism program, the head of the program asked me to take over as humour columnist for the journalism program’s newspaper.

It was a fairly prestigious position, plus it gave me a guaranteed showcase every two weeks. Editorials, for whatever reason, had no byline at the time. The opinion page columns were shared among the class, and getting a news story into each issue was definitely not guaranteed.

Just weeks earlier, at the end of the first semester, I had actually been targeted for expulsion. For months I had been on a bipolar roller coaster — I was late by hours everyday, I missed the same morning class for six weeks in a row, and I failed several projects.

When he offered me the column, he told me the only reason he allowed me to return for the second semester, was the quality of a feature I had written on a local, legendary, radio personality.

It was the feature, plus a throwaway but irreverent story I wrote on what students were planning for March Break, that made him decide to hand the column to me.

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“Students have a hard enough time finding the money to travel to the corner store let alone Disney World. So if you’re stuck in the Ottawa area trying to pay off the Valentines Day bills, try wandering over to one of the multitude of museums, take a tour of the parliament buildings, or spend the Doritos money and take a bus tour around town, it beats watching [OJ Simpson] sit and stare on CNN.”

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From what I remember, the guy I was replacing had gotten lazy, or he was just overwhelmed by being in the last semester of a very tough program. I do know he owes me $10. His column was titled “Truth, Lies and Innuendo”, which I thought was cute.

When I sat down with a friend to brainstorm titles for my column, his idea was to call it “A handful of pills and a bottle of Jack Daniels”, which was shot down pretty quick. The program head, who also taught first-year journalism, came up with “From the edge”, which I thought was lame, but “Standing on a ledge” was cool — but only because I couldn’t get away with “Falling from a ledge”.

I managed to get away with my (kind of) subtle reference to suicide for the first few columns… pretty much right up until I told the program head I had a case of the Bipolars.

I actually only had an opportunity to write four columns before the semester ended. They were dark, sardonic, and pretty much random with regards to who I targeted — except for the college’s Students Association, I went after them every column.

But those four columns generated more letters to the editor, and direct calls to the program head, than every other piece published that year. I think there were only a dozen, but the letters were mostly positive. The calls, however, weren’t. I wrote something about an ad campaign for the number one local radio station, so they called asking what they had done to piss off the college.

Then there was the night when a bunch of us were taking advantage of the free Internet access to finish off some school work, when the president of the Student’s Association walked in, sat down, and spent twenty minutes alternating between anger at something I wrote, and desperately trying to be our friend.

He turned out to be a really decent human being.

Then, with only a few days left in the semester, the program head took me into his office and told me I was being kicked out of the program, but for really real this time. I had missed most of my classes, and some of the classwork I had submitted was definitely infected with the Manic.

He had already spoken to the head of the screenwriting program and, if I wanted, I would have a place there in the fall. Or, he said, I could take a full semester to get my Bipolar shit together, then come back to the journalism program in next year’s second semester.

I’m still not sure if it was the right choice, but I went with what I knew.

But either way the problem was, I had no idea how to find treatment for the problems I had. I had been living in a room at the YMCA, and they were also kicking me out for not following their rules. So, after three weeks of near starvation and looking at imminent homelessness, I moved back to my hometown where my parents paid for the first month’s rent for a small bachelor apartment.

After the first month I was back on welfare and sleeping 16-hours a day.

Six months later, having learned nothing about my recovery, I moved into Ottawa’s Youth Hostel and bought some ties and a few nice shirts.

My first day back, repeating my second semester, I was twenty minutes late. When I walked into the class the program head introduced me to my fellow — and much younger — students as the “best writer” he ever had.

He also told me to immediately take over the humour column. I renamed it “Life of the Times”, a play on the name of the paper. It was mine for the next three semesters, and a year later I won the Ontario Community Newspaper Associations award as “Best Humour Columnist” in all of Ontario.

In the awards magazine they called me “brilliant”.

But, during the school year, I fucked up every personal relationship I could create, I missed major projects and tests, I spent a lot of time drunk, there were teachers who wanted to toss me out of the program, and about half the students — who all worked on the paper — hated my column (mostly because they wanted it).

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When I filled out my college application, I had to list three choices. Journalism was my third option, but I missed the “Mature Student” tests for the other two.

The reason I filled out the application in the first place was because my girlfriend of three years had finally tossed me to the curb. The bipolar was untreated the entire time, so my behaviour was… erratic, plus, except for a few jobs lifting heavy stuff, I had been on welfare the entire time we were together.

I’ve never held a grudge. She was supposed to have a boyfriend, not a patient. But she was magnificent, and I was deeply in love with her. And I was a completely devastated wreck for a long time afterwards.

Going to college was supposed to be a way to get back at her, or get her back.

I think the columns I wrote, with their bite, anger and sardonic humour, came from what I was feeling about her. I had other reasons to be bitter, angry and sardonic, but she left a gaping wound in my chest that I lacked the ability to heal.

And that was the foundation I built myself when I was twenty-four. Left entirely on my own, I used a tragic yet inevitable ending to a love affair as an excuse to prematurely enrol into a program I didn’t want to take, and which I was kicked out of, only to succeed beyond my wildest dreams, while failing nearly every course not directly associated with the school newspaper.

This is the rope I’ve been hanging myself with my entire life.

I spent years afterwards trying to live up to the words of the program head, and the awards people, but kept failing because I was constantly fighting the bipolars. People would hire me to work on their magazine, or newspaper, based on words like “brilliant” and “best”, only to find out months later that I couldn’t live up to the most basic of schedules.

Left untreated, the manic depression took away every opportunity I was able to create for myself. Finally, in 2002, I was left homeless, unemployed, banned from social assistance, and rapidly burning through whatever goodwill I had with the people who wanted to publish my book.

It took me seven years in recovery to learn the ways and means to control the manic depression, seven years before I could understand, every time I started to succeed, I’ve killed myself. Whoever I was at that time, I put a gun to that person’s head and pulled the trigger.

And it’s still going on. For a few years I had two very successful blogs, but now I only update this one once or twice a month, and in the past six months the other one has dropped from a PR5 to a PR3.

I was approached a few weeks ago to write a column for a good newspaper, the paper received letters praising my first column, but now I can’t focus on getting the second one done.

I impress someone with what I can do, then spend months proving them wrong.

And I do not know how to fix this.

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...thanks.

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Posted in Bipolar, Bipolar Disease, Bipolar Disorder, Clinical Depression, crazy people with no pants, Health, Living With Depression, Living With Manic Depression, Manic Depression, Mental Health | 10 Comments

Ten years ago my brother stood at the White House and watched a low flying plane turn away

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Ten years ago, on September 11, 2001, my little brother was standing in front of the White House speaking to our mother on his cellphone.

He was preparing for an early morning tour, and my mother was trying to tell him airplanes had hit buildings in New York. My mother could hear the loudspeakers telling people to leave the area. My brother said he had to go, and that was the last mom heard from him for seven hours.

As my brother was leaving he saw a plane, flying very low, and banking away. He could see the windows, and the flaking paint on the plane’s tail.

A few seconds later, as he and the crowd moved away from the White House, he heard the explosion as the plane hit the Pentagon.

Either Flight 77 or Flight 93 had the White House as its intended target. The whim of a demented madman changed the target of the former, the sacrifice of forty normal yet extraordinary people made sure the latter would never get to its target.

We both thank Todd Beamer, and all the other passengers on United Airlines Flight 93, for making sure my brother didn’t die that day.

He spent the rest of that day safely making coffee for the Australian Prime Minister, and the other refugees who had made it to the Australian embassy.

My brother was in shock for a long time after that day. He considered it not only to be a near death experience, but also a shared near death experience. He saw a planeload of people seconds before they were all murdered, he believed another planeload of people had to die so that he could live.

Unfortunately, after he finally got home, there really wasn’t anyone around who could relate to what he went through. So, for a few years afterwards, there were some dark depressions, some self-destructive behaviour. But, thankfully, there was also a recovery.

Since then my brother has lived a very normal life. He has an interesting job, a fantastic wife and a baby boy. He is also Godfather to my son.

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...thanks.

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Posted in crazy people with no pants, Health, Mental Health, Politics | 2 Comments

The surprising role of insulin in my recovery from depression

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Known best for its role in the body as a regulator of blood glucose levels and fatty acid storage, insulin also acts in the brain to aid memory and thinking. Thus, when insulin regulation is disrupted, as it is in many common medical conditions including obesity and diabetes, the risk for cognitive impairment rises.
M. J. Friedrich, ‘Insulin Effects Weigh Heavy on the Brain’; Journal of American Medicine, 2006

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Vanderbilt University Medical Center researchers, working with colleagues in Texas, have found that insulin levels affect the brain’s dopamine systems, which are involved in drug addiction and many neuropsychiatric conditions.
The results are some of the first to link insulin status and dopaminergic brain function and hold several implications for human health and disease.

Vanderbilt University Medical Center, “Insulin’s Brain Impact Links Drugs And Diabetes”; ScienceDaily, 17 Oct. 2007.

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…diabetes causes a narrowing of the arteries and makes the brain more susceptible to gradual damage. People with diabetes are more vulnerable to depression and are more likely to suffer a decline in mental ability as they age.
The Franklin Institute, “High Sugar Intake Over Time”; ‘The Human Brain’.

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I’ve known for a while that diabetes can cause depression, but I didn’t know how. It was just one more cause on top of all the others and, because diabetes was something I hadn’t been able to control, all the others needed to be looked after first.

But recently I have taken the steps towards taking control over the diabetes, and I have noticed a difference both in body and in mind.

So, is it possible the insulin has already, less than a month since my first dose, begun healing the parts of my brain the lithium and therapy couldn’t touch?

Lithium is a mood stabilizer, it’s meant to stop the extreme ups and downs thrust on us by the manic depression. It plays a crucial role in our recovery from manic depression by giving us back the ability to reason, to think our way through the days where, beforehand, we could only suffer.

Lithium not only stabilized me, but through that stability it took away my desire to kill myself, and then it took away the fantasies, and then the thoughts of suicide being a reasonable option altogether.

But it doesn’t repair the damage done to our brain by a depression-causing disease like diabetes.

It’s like all this time I’ve been fighting two causes of my debilitating depressions — growing up in a commune, raised by no one, then abandoned by two thirds of my family when I was eight. The other, the manic depression, with which I was diagnosed in 1988. But, I only recently found out, there was a third cause. Something I had left untreated, and allowing it to fight against me, since roughly 1992.

In fact they all went untreated for so long. Previous to 1988 I had seen a therapist and a few child counsellors and a guidance counsellor in high school. But nothing with any substance. The first time I got serious about any of it was in 2003, when I moved back home, suicidal and with a head full of PTSD.

So I’ve been fighting a three-pronged attack, but on only two sides. The lithium for the manic depression, the therapy for the abandonment issues and family stuff. I started taking medications to control the diabetes two years ago, but only because I had started worrying about the future state of my feet and legs.

And now, two years later, I’ve started taking insulin. And a few days later I was so sure I was experiencing what I can only call a “clearing of the clouds” that I checked online to see how insulin, as a treatment for diabetes, effects depressions.

And I found this:

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“Symptoms of depression are common in people with diabetes compared with the general population, and major depression is present in approximately 15% of people with diabetes. Depression is associated with poorer self-care behaviour, poorer blood glucose management, health complications, decreased quality of life and psychological well-being, increased family problems, and higher healthcare costs.”

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Insulin, basically, tells cells it’s dinner time. The cells then eat the sugar that fuels every part of out body. If the insulin isn’t around to activate the cells, bad things happen. Like legs get chopped off because they can’t heal from minor cuts and bruises.

Or brain cells starve, and it gets harder and harder for the brain to conduct normal business. Like remembering stuff, like focusing, like getting depressed for no real reason.

Since starting insulin my numbers have plummeted from the high teens, to an average of 9.5mmol/L in the morning, and 16mmol/L in the evening. I’ve seen a 23.9, but that was a mistake, I’ve taken a few readings too close after eating, which defeats the exercise entirely.

But I’ve also seen normal numbers, like 4’s and 6’s, that I’ve never seen before.

So, I’m certain the physical effects of the insulin are not due to a “placebo effect”. It’s not wish fulfillment. The numbers don’t lie. But mentally I feel clearer, more capable, I feel as though I’m using parts of my brain that have been on “standby” for years.

But that clarity is not something I can prove.

I am willing to allow the possibility that either I’m projecting — that the weight I’ve been carrying for so long, the one that told me how far below the knee my prosthetic would attach, the one that told me I’d never see my son graduate — is gone, and therefore I feel lighter and less concerned about the future.

Or, that I’m just reacting to a new treatment the same way I reacted to the lithium way back in 1989, with a few weeks of increased activity, and a few better marks in school, then a long crash that left me in the psych-ward.

Whether what’s happening now is real or not, it will be real sooner rather than later. The years, possibly decades, of abuse done to my body, mind and brain, by the diabetes is coming to an end. Not all of the damage is reversible, the nerves in my legs and hands are permanently damaged, but the damage done to my brain can be fixed by the insulin.

And the insulin, suddenly a vital part of my recovery, will finally take away the last source of my previously uncontrolled depressions.

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...thanks.

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Posted in Bipolar, Bipolar Disease, Bipolar Disorder, Clinical Depression, crazy people with no pants, Diabetes, Disability, Health, Lithium, Living With Depression, Living With Manic Depression, Manic Depression, Mental Health | 19 Comments

Internet down but so is my blood sugar

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My connection to the Internet has been tenuous and intermittent over the past few weeks. This weekend I’ve only been able to connect twice, including now. My ISP initially told me it was their problem, something about the line coming into the house. A service dude even showed up the next day with a ladder.

But, after being offline for most of this weekend, when I phoned them today they decided it was the modem. They’re sending me a new one, but it won’t be here for “two to five days”.

So… I’ve got a few posts ready to go, I just need stable access to the Internet to finish them. I guess the most important thing right now is my blood sugar has been places it hasn’t been since this diabetes thing got a hold of me.

My morning numbers are averaging 9.0 mmol/L (metric, I don’t know the American translation), with a few dips into the 7’s and even one 4.3. They generally rise though the day, so at bedtime I’m back up to the mid-teen’s. But even that’s a massive improvement over the 20-30 it used to be.

The other big, and weird, news is… after sixty years of marriage, my grandparents are separating. They’ve been living in a suite in a retirement home for the past ten years, and as of Tuesday they’ll have their own rooms.

My grandmother blames it on years of tolerating each other, and hitting a wall. My grandfather blames years of “emotional blackmail”. I think they’re both right.

Anyway. I’ve been lucky over the past twenty minutes to have a connection, hopefully I’ll be back full time in a few days.

…it’s a good thing I still have the PlayStation, otherwise I’d have to read a book or something.

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...thanks.

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Posted in crazy people with no pants, Diabetes, Disability, Health, Living With Depression, Living With Manic Depression, Mental Health, sympatico | Tagged | 2 Comments

Protected: Family without love is an inconvenience but without respect it becomes abuse

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Posted in Bipolar, Clinical Depression, crazy people with no pants, CSG, Father, Health, Living With Depression, Living With Manic Depression, Manic Depression, Mental Health | Tagged | Enter your password to view comments.