Madness and Metastases
by Acacia
Melancholia has been the dominant medical issue in my life before cancer. I have been on anti-depressant and anti-anxiety medication for a large part of my adult life, and probably should have started much younger, and saved myself a lot of trouble. Seriously. Melancholia never felt like insanity to me, in fact, it felt like hyper-sanity.
But until the past three weeks, I have never been mad. I mean “mad-as-a-hatter” mad. Wildly impulsive mad. Maniacal lack of emotional stability mad. “I don’t care that you want a good grade since everyone is getting an A” MAD. MAD.
I believe the madness began when the emergency room doctor told me that the tests showed that the cancer had spread to my brain, causing the seizure I didn’t remember. “Oh.” That’s it. That was my response. In his story The Sandman, E.T.A. Hoffman a young man with myriad emotional issues finds himself falling in love with a automaton named Olympia. She is lovely with mechanical contrivances that mimic the subtly of breath through perfect little pearl teeth. She cocks her head when you speak to indicate she is listening and when asked for a response, softly cries Oh. As for me, I was Olympia at the end of the story, the uncanny artifice of my existence laid bare and not understanding what went wrong.
While the clockworks began to resume their function in the hospital, the physicians decided to manipulate the careful balance of humors that my psychiatrists and I have developed to keep things moving smoothly. This was based on the SIEZURE. The seizure was what brought me to the hospital. The seizure is what made them put me in the neurology ward. And the seizure is what justified a cavalier change in my medication that brought on the MADNESS. See, since the seizure was all, anything in my medication that could be even remotely connected to a seizure risk was taken away. This included my beloved Wellbutrin, an anti-depressant I have been on for over ten years.
So, there I was, bathed in a shimmering narcotic haze of the new medication, as one of the stabilizing forces of my brain chemistry drained out of my system. There were some benefits at first. The full gravity of my diagnosis sank in slowly and the perceptual fuzziness allowed me to slowly evaluate my faculties, memory and such. I started to feel almost playful and I talked about dreamy things and loved everyone. When I re-assured everyone at work that I wasn’t going to die and that I wanted to continue teaching, I was able to don my reliable public façade.
But. Then floods and flurries of ideas about things that I had to have or do right now began. I had emotional outbursts, sobbing jags, and tiny tantrums that I knew were making everything so much harder on those around me. At the same time I was whimsical and affectionate or melancholy and sentimental, needy and defiant. All seemingly in a matter of moments.
All the while, sitting quietly, in a leather club chair, behind all the haze, was a figure. Resonating beneath the sharp tinkling cacophony of impulses, her voice reminded me over and over that this could not be allowed to get out of control. That my behavior was torturing Todd, who is trying to contain his own trauma of a dying wife.
Then I went to Target for something last night. I called ahead, but when I got there, no one knew anything something behing held for me and I wait as they search. As I wander around I notice that I’m maintaining a running internal monologue: this is why I called. Because no one can trust the store with all the drones with no power or authority and loud walkie-talkies knowing nothing. This is why I called. If only people would just talk to people and give a rat’s ass. I have cancer lesions in my brain and I came out here only because she promised it was here. They made a cancer patient come out here for nothing. I hate this place. Fine you win, I lose. I always lose. OH MY GOD I’M MAD.
On the way home, the realization that I am mad, gave me pause. This morning it hit me that it was going cold turkey on Wellbutrin. My radiation oncologist also said that the steroids often bring on crazy. He put me back on Wellbutrin and the steroid is on its way out. Hopefully balance will soon be restored, though a little of my madness, just a smidgen can stay if it likes.
While all this is going on, my oncologists are actually working on treating the lesions that started this mess in the first place and I am almost finished with a course of fourteen whole brain radiation treatments. I had my scheduled PET scan while I was in the hospital and nothing has changed in four months My medical oncologist in St. Louis is in the loop and all the adults are working diligently to keep my little cranial mechanisms in working order.
There is nothing mad about this post to me – there’s no way I could ever be this articulate under the same circumstances.
I’ve been thinking a lot about you lately – just know that I’m right here with you.
Thank you Hila. It took all day and ruthless editing to get the writing clear and eliminate the rambling, but I feel pretty good about the result. My real fear behind the madness is I’m starting to not care about tenure…..
I have taken Effexor for some 10 years now. When I first read your essay about the seizure I thought about it. What if this happened to me? Not only do I live alone, but I take medication to balance my brain chemistry. What if cancer invades my brain and takes away my core ability to handle the reality of what is now my Stage IV life? The madness of withdrawal against a backdrop of blind terror. I so profoundly wish this were not so. I think of you always.
I am so angry about the medication change right now. I even saw my (new) shrink after I got out of the hospital and told him about the change. All he said was it was okay. I guess I need to find another adult for my team. My last shrink was brilliant and would have fought for me. Talk to yours and make sure she will protect you if you become vulnerable. Then hopefully you will never need it. Love you Scorchy!
I have a wonderful psychiatrist and I’m going to speak with him. Another bullet point on the list of things I need to attend to. With all the flash drives I wear around my neck at work, I never thought one of them would be a medical alert drive. Love you too, Acacia. Very much.
An astounding post. Thank you for writing it. And I’m hoping you get that better balance soon.
I’m back on the Wellbutrin for a second day. It might take up to a week, but the awareness of what is happening is allowing the voice of reason to be more prominent. One little (mad) obsession I’d like to resolve with you if I may though. Am I forgiven for the Facebook “metsy metsy mind” silliness?
Of course you are, though no forgiveness was needed! Your thoughts are always welcome – all of them. Sharing this post today.
Fabulous writing, eloquent and thought provoking.
I would be furious with the doctors who thought it was okay to drop you cold turkey from an anti-depressant! Seriously!
I have recently found some balance between raving anxiety and the restless leg syndrome aggravated by most SSRIs. Thank goodness for Wellbutrin and a doctor willing to try different things with me! I completely relate to the need for assistance in the chemical balance.
You are working through WBR? You must love your job. I envy that. Best wishes, dear. I will follow your writing now. Thanks to Nancy for sharing it on FB!
No, I can’t work right now. While my memory and comprehension are strong, the madness comes through major emotional instability. Something that should be simple and direct ends up over-thought, over-wrought and often in tears and panic.
I do want to return to teaching next semester.
I understood completely. I was given Effexor for hot flashes from the chemo induced menopause. It worked for a time, and then was not effective. My doctor doubled the dose. For the first time (shame on me) I read the package inserts and realized that I was taking a very powerful drug for a nuisance symptom. I called my doctor’s office. The nurse who answered the phone snottily answered my concerns w/ “Well, then stop taking it.” I did. I went into withdrawal. I was lying in bed and I heard my husband downstairs talking to the dog. I listened to him drowsily, and waited for him to come up stairs. He did not. I looked at the clock. He wasn’t home from work yet. Scariest thing? I could still hear him talking to the dog, even though I knew it was not happening. Very frightening. It amazes me that staff in a doctor’s office would be so quick to advise about medications. They are handing out some pretty powerful stuff. Seems like they’d better be sure of what they are talking about before they give advice.