I write this at 12:41 am while crunching frozen M&Ms on the couch in my undies after trying and failing for an hour to get to sleep. It’s the bubble in my chest that keeps me from nodding off, the bubble of barely-suppressed jollity that every few moments rises to the surface only to be replaced instantly by one even bigger. It’s hard to sleep when every thought triggers connections that form without effort into anecdotes and blog posts that my brain will compose no matter now much sleep it costs.

And who needs sleep when everything is so hilarious? In these moments I’m capable not only of rapid-fire blogposts but also marathons! And housecleaning! Isn’t 2am the perfect time to reorganize the pantry? My mind churns so fast that I must make lists. I tweet, I talk, I connect;  I reach out in ways that a week ago I never would have attempted.

I surely must drive everyone to distraction.

But sooner or later (probably sooner) the bubble will rise and not be replaced. I will want to sleep for hours, wake long enough to down some soup and then head back to unconsciousness. Tweets will decline, emails will go unanswered. I’ll text instead of calling, and I’ll be absolutely convinced that it will always be exactly this way.

Ups and down notwithstanding I really can’t complain. The lows are not so flattening nor are the highs as extreme as they were before this current medicine kicked in, and this is the catch-22 anyone with a mental illness can describe: A course of treatment no matter how amazing could always be better, but would the pain of transition be justified considering the risk that a new choice wouldn’t work?

For now, the risk is too big to take. I’ll stick with late-night hilarity and the inevitable crash and count myself lucky indeed that it’s not much, much worse.

It’s a topic that no one wants to discuss, but given the fact that there’d been a disturbance in that, er, function ever since I started the new medication, I could no longer keep it a secret from my doctor.

“We’ve got to do something about this,” she said. “No one wants to spend their life on a ten-foot tether from the toilet.”

Definitely not, I murmured.

“Various medicines can kill off the bacteria in the gut,” she said, then launched into a discussion of how the drugs that keep me sane (mostly sane) might have interacted to cause the, er, issue. Embarrassed (yes, even I blush), I concentrated on the prints hanging on her wall while she mulled out loud over the possibilities, all but tuning her out until I heard, “more non-human than human cells in the human body.”

Could you say that again?

She repeated it. “Some people are freaked out when they hear that there are more non-human cells in the body than there are human cells,” she repeated. “That doesn’t bother you, does it?

No, of course not I answered from the depths of my newest existential crisis.

“What we need to do is repopulate your gut,” she briskly said, and laid out the options for doing so, one of which included an over-the-counter supplement that promised to inject into my system twenty billion little critters with each dose.

Twenty…billion? I asked. Daily? Is that really necessary?

“It is,” she said. “It is if you want your digestive system back to normal.”

I have purchased the pills. I choke them down daily, aghast to be swallowing such a vast number of tiny beings, and trying not to wonder at what point I become responsible for their mental health as well as my own.

You’re at the mall two days before Christmas, cheek by jowl with thousands of shoppers who have resolved to do all their holiday shopping right this very moment. Each store has tried to outdo the last: Windows are awash in red and green flashing lights. Carols overlap. The odor of fake evergreen, roasted nuts and various food court atrocities fills your nose. And the sound, by god the unholy sound of commerce: Register drawers slam shut, security alarms trigger, bells ring, and the crowds yammer and bleat out their desires.

Where are you throughout this cacophony? You are in the very thick of things, the throngs swarming (and by no means quietly) past. Are you shopping, or gearing up to shop? Not bloody likely. In fact the single thing you can manage — and you’re doing it quite poorly, moment by moment, beat by beat — is to continue living. You must concentrate to suck in each breath of air. Turn away your attention even for a moment and surely your heart will stop pumping.

Things might be easier if only the masses would leave you in peace. Instead they insist upon asking questions, elbowing your ribs and otherwise interfering with the management of tasks crucial to your continued existence. Nevertheless, it’s not as though you’re oblivious to the beauty (the rare beauty) amidst consumerism’s crush. You see it just fine, but you’d much prefer for it to get the hell out of the road because quite frankly? It interferes with your misery.

Here is where the analogy breaks down, as there’s no way (other than to go through it yourself, which I wouldn’t recommend) to explain the pain: the pain from old injuries brought to the forefront by the lack of serotonin; the pain from previous meds’ withdrawal; the pain from electrical shocks every time you move. Pain that on another day might be manageable now feels like a car alarm going off in the center of your brain. It is impossible to ignore.

Is it miserable to be in such a situation? Yes. Yes indeed it is, and here is why: A normal person in the middle of the mall on a busy day is able to filter out vast amounts of extraneous information (the lights, the smells, the sounds) in order to focus on what is truly important — locating that special gift, perhaps, or enjoying conversation with a companion. We are all in that mall every day, and every day we filter or otherwise deal with unnecessary stimulus so we can get on with life. Last week I stood in the middle of that mall without any ability to filter. Every sound hurt. When disturbed I snapped — and I was disturbed by everything.

Finally on Friday Sherlock Holmes and I turned a corner; the weird alchemy of synthetic medicine and all-natural brain-juice stabilized enough that the children’s voices were not like spikes driven under my fingernails and I could manage to fix lunch without literally wanting to die. I can feel only gratitude for doctors who missed years of sleep and researchers who consistently chose chemistry lab over frat party in order to give me advice and effective drugs.

And I can only hope that the people closest to me who have suffered the brunt of my chaos will eventually grant their forgiveness.

The original insult was an injudicious swerve by another driver. The fact that the driver’s pre-teen leered at him from the back seat and then, sensing his rage, flipped him a most ostentatious bird provoked him even further. He vowed retribution. He raged about her idiocy and poor driving skills while I begged him to pause and consider the safety of the little girl and infant in our back seat. Ignoring me, he followed the sloppy driver with the intention of chewing her (and her bird-flipping son) out.

Time has blunted the details but somehow I convinced him to park and relinquish the ignition key to me. I declined to confront the woman with him or bundle the children into the restaurant (everyone’s intended destination) until he got himself under control. He demanded my compliance, ratcheting up the drama with each refusal until he was screaming and banging his hands on the wheel. “I am not angry,” he raged. “Just give me back my keys!”

Eventually he slammed out of the car, red-faced and shrieking that he’d walk home alone rather than tolerate one second longer with such an unreasonable creature as his wife. We found him a half-hour and one mile later; the cold had chilled him and his anger enough that he consented to accept a ride for the remaining five miles to our house.

Then I had nothing but scorn for what I saw as a weakness that allowed him to explode the way he did on that and so many other occasions. Anger wasn’t bad so much as it was pointless, I thought, and I felt a kind of smug swagger that my emotions followed a more productive course. But now, after a week spent struggling with unreasonable, unnecessary and utterly unfamiliar rage I might be developing the first hints of compassion toward those facing off against similar opponents.

Without a doubt this has been the hardest transition off one medicine and onto another that I’ve ever experienced. I’ve been this close (–) to walking out the door and not stopping ’til I reached Tijuana (or ran out of Diet Coke money, whichever came first); this is of course not a healthy response to stress as my children would (one second after dancing a merry jig at the departure of their unreasonably cranky mommy) immediately commence to burn down the house.

Never before has it been so painfully clear that I’m dealing with an actual mental illness and not, you know, a couple annoying days. In the past there’s always been a whispered suggestion that it’s really not that bad and I could no doubt pull myself up by the proverbial bootstraps if I exerted even a modest amount of effort. This time it is serious, as is evidenced by the number of instances in the past few days wherein I’ve had to wonder about myself the thing I’ve so often wondered about other mentally ill individuals, which is this: Is a particular action a matter simply of a bad choice or is it due to the illness? At what point is it acceptable to expect good behavior from one with a mental illness? And when should their unreasonable responses be forgiven on account of the illness?

For example, in retrospect I’d have to say it was clearly unreasonable for me to yell at my children last Friday for not turning off the basement lights after I’d already asked them three (increasingly loud) times. Annoying? Yes. Yell-worthy? Not hardly. And yet I stood next to my red-faced body and could do nothing to stop the screeching.

In the same way it made utterly no sense that I lost my shit in the doctor’s office during the taking of a simple medical history. “I’m sorry,” I sobbed as the doctor looked on dispassionately. “This has nothing to do with you.” And it didn’t, not that that little fact made it any less difficult to stop weeping and don my paper gown.

But this morning…this morning might have been a different case. I mean yes I lost it, at least until an emergency phone call (which might have included tears but least said soonest mended and all that) to the doctor’s office assured me that things would likely be back to normal before too terribly long. “You’d be amazed at what they can pass,” said the nurse. I’m certain she was doing her best not to laugh at the frantic mommy on the other end of the line, the mommy who came upon one of the less amusing results of pica:

Not-mentally-ill people would have freaked out too, amirite?