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Good News For People Who Like Good News

Posted Apr 14 2010 10:30pm

Things have been going very well lately. Very well.

Let me do a quick reminder about the timeline here. In September 2009 I took my wife to the hospital for psychosis. She was diagnosed with major depression with psychotic features. She was in the hospital for 23 days. She was discharged still delusional, and when that faded, it was replaced with unshakable suicidal feelings. She was acutely suicidal for about 4 months. “Acutely” meaning that she attempted it once, but thought about it all the time, asking questions about it, wanting to talk about it. It was almost all she could think of.

There has been some progress along the way, but it is always followed by a setback. Her doctor wanted to wean her off Risperdol in December, so she stopped it abruptly, and went into withdrawal. Then in January she was doing well enough for me to go back to work, and the loneliness caused another setback. It wasn’t two steps forward, one step back, it felt more like one step forward, two steps back.

I finally feel as if we may have cleared a major hurdle in her recovery. We had a fantastic trip away, and came home to see her doctor for the first time in almost two weeks. His assessment: “She has made remarkable recovery in the last two weeks. She seems to be doing very well.”

For 8 months, I heard nothing but concern from doctors. “She is really not responding to the Lexapro like we hoped.” “Her suicidal thoughts do not seem to be going away.” “She is on her own pace, which appears to be very slow.”

To get interrupted in my work day by a phone call which finally gave good news “It’s getting better!!!”  this was elating. More than elating. Shucks, I think I need to swear again: it was fucking awesome. Fucking fucking fucking awesome. It was the good news I’ve been waiting for. The prophecy of the Gospel of Medicine was finally being fulfilled.

Since Monday’s good news, things have only gotten better. We can finally wean her off Risperdol, which is a huge step as well. The Risperdol has tinkered with her metabolism and she has gained about 50 pounds. She is almost trance-like at times due to it. (I wrote a blog post about what I call her Jenga Mode a few weeks back about this.)

Well, she’s down to 4mg, instead of 6mg. And she’s already loving it. Today she reported that her thoughts feel more clear, and that she has less frequent headaches. The world seems more vibrant to her.

This is all music to my ears. Sweet, deserving music after months of hearing what sounded like a funeral dirge.

I am cautious. I have been elated about improvement before, but it has always been followed up with bad news. So I’m cautious.

But it feels different this time. Maybe it’s because it’s spring, but it feels like we are out of the tunnel. We are over the worst. We have been to hell and back, in a pretty literal sense considering my wife’s psychosis had her thinking she was the devil, and we are far enough away that we can look back and, at times, laugh about it.

I still have some reservations and concerns.

1) She still seems to believe that her delusions were real. They felt so real to her that she still cannot reason that it was her broken mind that thought she was the devil, compared to being the real devil.
2) She is still skeptical about whether or not the medicine did anything. Although she’s a bright woman and I’ve spelled it out to her rationally, I think this is a remnant of the first problem. Medicine doesn’t cure the devil, medicine cures a chemical imbalance. She’s still not there.

I think these two things, with time, will resolve. However, my biggest question is the last one:

3) What is next? She has responded positively to lithium. So is she actually bipolar? Is the diagnosis of psychotic major depression wrong? I have known her for almost 10 years, and I don’t think I can classify her as ever being manic in those 10 years. Neither can her parents from before. So is she? She’s responding to the most classical bipolar medicine of all time. Also, will these be a recurring thing? Will she have another psychotic break? Or is it a one-time deal only? I know that research shows that it’s very rare that a person only has one episode of psychosis in a lifetime. Is she the rare exception?

In other words, is this really behind us. Or, are we just at a much-needed oasis in this hellish desert. I don’t know. And clearly, I won’t know. We may get to 80 years old and she’ll be happily medicated along the way with no future problems and that will be fine. We may be back in the hospital within a few months of fully stopping Risperdol. The unknown is scary, and at times, can be so scary that it tries to eclipse the joy that I feel after getting this good news.

But I’m an optimist. I have been from the get-go. And if I can keep my head-up through 8 months of bad news, I sure as hell can keep my head up after getting good news. I mean, what’s a lifetime of uncertainty?

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