Bipolar 2 From Inside and Out

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What God Gives You

There are two expressions, common in “inspirational” memes, posters, and the like, that rub me the wrong way.

One is “What doesn’t kill me makes me stronger.” I addressed that one in a post (https://bipolarme.blog/2014/11/10/suffering-and-train-wrecks/) roughly seven years ago, and now I’m ready to tackle the other.

“God doesn’t give you more than you can handle.”

Let’s take a look at the premise. It implies that God gives us all our trials and troubles. Already, I have problems with that. Perhaps God is love and the devil gives us trials and troubles. Perhaps neither God nor the devil is involved, and life gives us trials and troubles. Perhaps even we give ourselves trials and troubles. It strikes me that these are equally valid propositions, though many people favor one or another.

At the heart of it, though, is the fact that there are trials and troubles in our lives, whoever or whatever gives them to us, and we must handle them. Wherever they come from, they will not be more than we can handle, the saying states.

The evidence of our eyes, and perhaps our own lives, says that this simply isn’t true. Plenty of people encounter (or have given to them) more than they can handle. Think of the homeless mentally ill. Are they able to handle what they’ve been given? The woman with her third miscarriage? The veteran with catastrophic injuries? Sure, some of them face their conditions bravely, but others don’t, and they’ll never make the news as “inspiration porn,” the uplifting stories of people who can and have overcome their afflictions, which is predominantly what we hear about in the media.

The fact remains that some people do receive more troubles than they can handle. There are serious mental illnesses that have no treatment. There are injuries and horrors that leave a person scarred inside and out. There are troubles that are so bad they contribute to death by suicide. In these and other cases, someone or something (or simply life itself) has given certain people more than they can handle.

The premise behind the saying, however, is that God never gives YOU more than YOU can handle. What I’ve said doesn’t mean there is no hope – only that it might come from a source you don’t expect. That might be the same God who ostensibly gave you those trials. It might mean another person, or a group of people, or a society can help you with what you need to make it through.

It’s not necessary to leave it all up to God to solve these problems. And it may be that we cannot rescue ourselves. But perhaps we can be that person, or one of those people, who can help someone whose troubles are more than they can handle by themselves.

I won’t argue whether it is because of the grace of God that other people help. But the original saying, in all its simplicity, is too simplistic. I believe that troubles and trials come to us from somewhere in the world, not from God, and people in the world are ultimately the ones who can help us handle them.

I’m not trying to deny the actions of God in the world. I’m saying that we must do our part to solve these problems too. Donate to a good cause. Volunteer to help. Listen to someone who’s hurting. Even just buy a box of cookies from a Girl Scout. Let’s make that “you” an “us.” God (or life) never gives us more than we can handle – together. (Note: Don’t even get me started on “God helps those who help themselves.” That’s not even in the Bible. Go ahead and look. I’ll wait.)

And why is this post in a blog on mental illness? Because that’s one of the things that some people can handle and others can’t, whether it was God or genetics or brain chemicals or trauma that gave it to them.

Bipolar Questions and Answers

Have you heard of Quora? It’s like a crowd-sourced online question and answer center, where anyone can ask questions on practically any topic and request an answer from a specific person, or leave it up to whoever wants to answer.

I’ve used it myself for answers to questions about Ireland and about gardening. But since my Quora “credential” says that I have bipolar disorder and have written two books on the subject, I get questions about bipolar (and other mental health topics), usually several a day. Some I can’t answer. Some have already been answered. But I answer a couple every day. I consider it part of my goal of spreading information about mental health wherever and whenever I can.

Here are some of the types of questions I’ve been asked and how I answered them. Maybe they’ll help some of my readers as well.

What is the best medication to take for bipolar?

This one is the question most commonly asked, and it is easy to answer. I don’t know which medication is right for you. Only you and your psychiatrist can figure that out, basically through trial and error. It may take a while to settle on a med or combination of meds will work for you with the maximum effects and the fewest side effects.

I am thinking of quitting my meds, as I don’t feel I need them anymore or am having bad side effects.

DO NOT DO THIS. There are dangers in going cold turkey, not the least of which is withdrawal symptoms. Work with your psychiatrist. She/he can help you decide whether it’s a good idea to quit a medication. If going off a med is a reasonable idea, your psychiatrist will help you do it safely, most likely tapering off on the med you are on and possibly ramping up on a med that works better or has more tolerable side effects.

Besides, meds for bipolar are supposed to make you feel better – but it’s not a one-time thing. You have to keep taking them to keep feeling “better.” And if you go off a med and then decide to go back on it, it may not work as well.

Would bipolar disorder be eradicated if everyone came from a loving, stable home?

Sadly, no. While bipolar disorder may have a genetic component and may run in families, it can affect any person in any family. I had the most stable, loving family you can imagine, and here I am with bipolar 2.

What causes bipolar disorder?

The jury’s still out on that. Some people will tell you the cause is genetic. Others will say it is caused by deficiencies or overproduction of chemicals and receptors in the brain. Still others will say that trauma, especially childhood trauma, can cause bipolar disorder. Personally, I don’t know for sure, but I suspect it could be any one of them, or any combination of the three.

How do I help a family member with bipolar disorder?

First, you may be able to help them manage their disorder. In the early stages, you can perhaps help them find a psychiatrist, drive them to appointments, pick up their medication, and so forth. Be supportive. Tell the person that you love them and hope they feel better soon. (They may not respond to you at the time, but later they will remember who stood by them and helped them.)

You can also help by helping the person practice self-care. Provide an environment that contains the things that comfort and help ground them – comfort food, soothing objects such as blankets or pillows, favorite scents, or even stuffed animals. Encourage them to bathe or shower and facilitate that: Have clean towels available and clean clothes or pajamas ready to wear. Make sure there is soap and shampoo handy.

For persons in the manic phase of the illness, you can accompany them when they go out, try to help keep them centered on projects at home, try to help them when it comes to overspending or other reckless behavior. Again, remind them that you love them and will be there for them now and when they feel better.

How do I deal with a narcissistic, bipolar boss?

You can’t know that your boss really has a personality disorder or a mood disorder unless you have read their medical files, which is illegal. They may have narcissistic traits or change their mind frequently (which is not the same as having bipolar disorder). You basically have two choices: Put up with it or quit. You will not be able to change your boss’s behavior.

I’m afraid my parents will find out I have bipolar disorder.

If you are underage, you can probably not hide it from them. It’s not a good idea to delay treatment until you are of legal age, though. You can ask your family practice physician to recommend a good psychotherapist or psychiatrist. You can ask your school counselor to help you find help. There are telephone and text hotlines. The best bet may be to talk to your family about it, in a quiet, low-stress environment and explain what bipolar disorder is and why you believe you have it. Their responses may surprise you.

Will I be bipolar for the rest of my life?

Unfortunately, the answer is yes. Bipolar disorder is not a disease like cancer that can in some cases be cured. It’s more like diabetes or asthma, in that you will have to live with it, cope with it, and have treatment for it, most likely for the rest of your life.

But it’s not a thing to be feared. If you have the proper support, such as therapy and sometimes medications, you can live a fulfilling, “normal” life, and accomplish many if not all your goals. I have bipolar disorder and have completed grad school; have a loving, stable marriage; own my own home; and do paid work. You are not tied to a future of despair or fears or bad effects.

Keep trying.

Following My Moods

When I was a teen and undiagnosed with bipolar disorder, I had a weird reaction to people around me – I would pick up their moods and personalities and found myself mimicking them. I suppose it was a way for me to try on other personalities that I might someday integrate into my own, when I was stable enough to do so.

When I was a little older, I began journaling, which quickly turned into blogging. My journals were repetitive and boring, consisting mostly of “Felt depressed. Went to post office.” It didn’t seem helpful to me, though I know journaling is helpful to a lot of people. It helps them express what is happening to them and how they feel about it. In that way, it’s like a diary. Going back over a journal after, say, a year or so of writing (not necessarily every day) can help a person track their moods and their triggers. People can note their physical surroundings and emotional response and note whether seasons or weather, food and drink, interactions with certain persons, or other life circumstances have an effect on their moods and can help identify events that bring on depression or mania.

There are variations of this. One friend of mine used Facebook as his “diary.” He would look back through a year of his posts and conversations to determine when depression had struck him (there were fewer posts during those time periods).

In my own case, my husband and I have noticed that our moods follow each other’s. When I am depressed for a few weeks, he becomes depressed, too. When I am hypomanic, his mood lifts and he finds more joy in his own life. We do things together, like baking or watching our favorite TV shows together or going for day-long or even weekend getaways.

The same is true the other way around. When Dan is depressed or angry or just plain surly, I find it extremely difficult to maintain even a level mood. His mood creeps in and takes over mine. I sometimes try to maintain a level mood when this happens, but it is very difficult. I find myself struggling not to lose whatever peace or joy I have. I find myself frustrated by his depression or annoyance, to the point where I want to tell him to snap out of it. (I try not to do this. It doesn’t help anyway.)

If we both hit lows at the same time, or experience anger simultaneously, it gets fairly ugly. That’s when we fight, or both retreat to our rooms, or spend time away from each other, indulging in our own pursuits. Admittedly, such contemporaneous moods don’t hit very often, but when they do, it’s hell.

Both of us have learned techniques to respond to these “following” or simultaneous moods. We generally need more space or alone time. We ask each other for what we need and if the other is able to give it (hugs, for example). We offer what we are able to do, if there is indeed anything we realize might help.

Mostly, though, we just wait for the moods to pass and for both of us to return to a level state. I continue taking my meds and writing my blogs.

Interestingly, it was my husband who first noticed these “following” moods. Over the years, he has become pretty perceptive about both our feelings. It may help that he has studied and even worked in psychological settings for a while (no, that’s not where we met), but I think his real education has been living with me for almost 40 years. In all that time, you begin to notice patterns.

At one time my blogs did record my day-to-day (or week-to-week) feelings and actions. Sometimes they still do. But anymore, I find myself exploring other aspects of bipolar disorder and mental illness in general. I don’t believe I’ve said all there is to say about my feelings and symptoms, but this blog has allowed me to stretch out and consider the wider world of mental health.

Apparently, my husband is getting better at it too.

My Unrecognized Mania

I thought I had managed to avoid mania for most of my bipolar life. Brief bouts of hypomania, maybe, but never the real thing. Then I thought back on the last year and a half.

For years I had been trying to write a mystery novel, but a year and a half or almost two years ago, I really kicked it into high gear. I wrote. I rewrote. I tweaked. I outlined. I thought of names for my characters and backstories for them. I mapped out on what day of the week each event happened. I even looked up the weather and sunset time for a certain, pivotal day. I showed the first four chapters to volunteer readers.

Then I decided it was done enough and ready for the world. I started in December, sending out three queries a day to publishers and agents. I was undeterred by the rejections. I knew that many famous authors had been rejected dozens of times before they were published. I sent out 180 queries. It was like my brain was popcorn, exploding with ideas and determination and optimism.

I got the expected rejections, of course. Many, many of them. Most were of the “This is not the right book for me/us. Agents’ opinions differ. You should keep trying” variety, which only egged me on. Surely there was an agent out there for me somewhere.

At last, I got two responses that showed the agents had clearly read the sample chapters. They commented on the substance of my work and told me what needed “improvement.” My eyes were opened. They were exactly right. My book contained serious flaws and was by no means ready to be published.

So, that was about six months or more “wasted” on hypomania. In addition to the obsessive (though futile) attempt to make contact with 180 agents, I had other symptoms of mania or hypomania. I had delusions of grandeur. I thought my book would be published and make a splash. I imagined it might win an award for “Best First Novel” from a noted mystery organization. I even imagined the phone call to tell me that I had won.

No one noticed that I was hypomanic. My husband thought that I was somewhat obsessed, but he felt his duty lay in offering me encouragement, rather than bursting my pretty balloon.

My symptoms backed off.

Then, just a few months ago, Dan and I discovered that we were due to come into a sum of money. We immediately started planning what to do with it, and part of that plan included overseas travel. My hypomania kicked back in. For several months now (though we haven’t gotten the money yet), I fell into a frenzy of planning. And I spent money.

I bought small things, but lots of them. Books of maps and guidebooks. Little pill cases for daytime and nighttime meds. Rain gear. And more – despite the fact that the trip is still at least seven months away.

And I prepped. Oh, how I prepped. I used those guidebooks to plan routes and sights to see, trying to balance the route between things that might please my husband and things I had seen before and wanted to revisit. I googled to find out how distant each b-n-b was from the various attractions, and how far the attractions were from each other. I planned where we would go on each day and how much time it would take to drive, so I would know when we had to check out of our accommodations.

And I researched the country and foreign travel. Were masks required? What would the weather be like? Where could we change money? How much cash would we need to carry? Would ATMs work with our credit cards? Were they even accepted at most venues? Would our banks charge a foreign transaction fee? Could our cell phones both work abroad and call back to the States? What days and months were some destinations open? Would they acknowledge my handicapped parking pass?

None of this was actually harmful, except maybe the money and time I spent. In fact, much of the obsessing was enjoyable. It’s been my habit in the past to research the places I was traveling, buying guidebooks and other useful things. But this was more than that. I felt internal pressure to make this trip as perfect as it could possibly me. I was planning the Bataan Fun March.

Recently, I snapped out of it and talked it over with my therapist. She affirmed that I was indeed having hypomania, though not a very destructive kind, except maybe the spending. Since then I have barely touched the guidebooks and schedules. I haven’t googled anything.

I must admit, though, that the feeling of accomplishment in both cases was quite enjoyable. I see why people romanticize hypomania or mania and even long for it to happen. It does increase energy and allow one to plan, even if mistakenly. I knew from seeing another manic person in my former workplace that mania seldom accomplished anything of lasting value. I suppose the lesson I must take from these experiences is that I should learn to recognize the signs of mania and try to drag myself back down to earth before I do something I’ll truly regret. That will involve my prescribing physician, my therapist, and my husband (once he realizes that I am getting manicky), all in an effort to get me back to a place of self-control.

But of course, we know that’s not really how bipolar disorder works.

Another Kind of Depression – Dysthymia

Of all the types of depression that get discussed – major depressive disorder, exogenous depression, endogenous depression, bipolar depression – there’s one type that isn’t talked about very often: dysthymia. The word comes from Greek, where it is made up of dys (bad or ill) and thymia (mind or emotions). But in clinical terms, dysthymia has a more exact meaning than “ill humor” or “bad mood.” I had always assumed that it came along a scale of severity that ranged from major depression through dysthymia to stability to hypomania to mania. It could be that I was mistaken.

Johns Hopkins Medical has this to say: “Dysthymia is a milder, but long-lasting form of depression. It’s also called persistent depressive disorder. People with this condition may also have bouts of major depression at times.” So, it’s milder, but long-lasting, persistent, and may occur in people with major depression. Not very specific, is it?

Johns Hopkins also notes that to diagnose dysthymia, “an adult must have a depressed mood for at least 2 years (or one year in children and adolescents).” The Mayo Clinic also refers to it as “Pervasive Depressive Disorder.”

Dysthymia seems like a “squishy” diagnosis, as the signs and symptoms overlap so greatly with major depressive disorder.

Garden-variety depression or “Major Depressive Disorder,” again according to the Mayo Clinic, “affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.” The risk factors and symptoms of the two disorders are virtually the same.

However, major depressive disorder, according to multiple sources, must last around two weeks, while dysthymia lasts for two years or more. Personally, I can’t see how this is called “milder.” Alternating between the two conditions is sometimes referred to as “double depression.”

I have thought of dysthymia as milder, and perhaps it is what I have now that my depression is pretty well controlled by medication and therapy. I no longer have extreme symptoms such as the self-harm and suicidal ideation.

Then again, one of my major depressive episodes lasted three years or more, with no visible letup. Was that relatively mild? It sure as hell didn’t feel like it.

Perhaps it doesn’t matter what you call it. The experience of the disorder seems to me more important than the label put on it. I haven’t looked the conditions up in the DSM (I don’t have a copy). But all my life I have been diagnosed with depression or major depression (before my diagnosis was changed to bipolar type 2 with anxiety, and it seems pointless now to call myself dysthymic. Maybe I’ll ask my psychotherapist when I see her next week if she can shed any light on this confusing nomenclature. Maybe she’ll have a handle on which of these I technically have.

However you want to name it or frame it, though, I have – and probably have had since I was a child – some version of the disorder, and have applied the treatments for it (meds and therapy for both), and now experience occasional episodes of the “milder” version, though they certainly don’t last two years.

In a way, I wish the various authorities would make up their minds and quit changing the labels. In another way, I don’t care what the labels are (unless they affect insurance companies and what treatments they allow). I experience this disorder in the way that I experience it. Most of the time I simply call it depression, and I don’t see how it helps to subdivide it. When I hit rock bottom, I call it a major depressive episode. When I’m relatively stable, I call it “in remission.” These may not be the technically correct terms, but they’re what make sense to me.

I don’t know whether other people with bipolar disorder make these fine distinctions, or simply think of their shifting moods as lows and highs, depression and hypomania or mania, or whatever.

But do we really need more labels? Isn’t lived experience good enough? Does the definition affect how our doctors treat us? Are there going to be more subdivisions in the future (a trend which seems particularly rampant right now, as with autism, Asperger’s, high-functioning, low-functioning, and more and more variations)? Does what we call it really help anyone get better?

Maybe I’m wrong here, but I don’t think so.

Mind and Body, Again

We know that the body affects the mind affects the body in various ways, especially when it comes to mental illness. Many of us who live with anxiety, bipolar disorder, or another condition experience physical symptoms like tremors, nausea, hives, and diarrhea.

The last one is my particular curse, which no one wants to hear about, but there you have it. Or rather, there I have it.

I didn’t even know that this was a problem related to my mental state for many years. All I knew was that whenever my mother or father was taken to the hospital, I would invariably and eventually find my guts in an uproar – usually when I got home, but sometimes in the waiting room. I thought that my bowels were my “attack organ,” as the saying went, and that I was merely reacting to the stress of the situation.

Of course that was true, but it never occurred to me that this was not just a physical problem, but a mental problem manifesting physically. At the time I was undiagnosed with bipolar disorder and knew little about the condition or how the mind and the body were connected.

The severity of the problem was impressed on me years later, when I was having severe anxiety, just after coming out of a severe and lengthy spell of depression. The more anxious I got, the more episodes I would have, sometimes up to six times a day. I lived with Immodium within easy reach at all times. During the worst of it I didn’t dare to leave the house. When I applied for disability, it was this affliction as much as my bipolar disorder that was the basis of the case.

Naturally, I told my primary care physician about the problem, and he sent me to a gastroenterologist. The specialist thought I might have Irritable Bowel Syndrome, but then again he wasn’t sure and didn’t seem to give it much more thought.

My psychiatrist, though, had a different idea. He suggested that the upset in my guts was caused by upsets in my mind – not that I was imagining it (there was ample evidence that I wasn’t), but that my nerves were overstimulated by anxiety and that caused my gastric symptoms. It was a feedback loop – anxiety caused diarrhea caused anxiety and so on and on.

I don’t know if it was the anti-anxiety med he gave me or if my anxiety just calmed down on its own, but the episodes became fewer and less frequent. I no longer stayed strictly at home, within easy reach of a bathroom, or feared going out. (I did make sure I knew where the bathroom was any place I did go.) I even stopped carrying a change of underwear in my purse. And my disability claim was denied. (I was also making so much money at my at-home freelance work that my lawyer said the judge’s head would explode.)

I still get anxiety-related diarrhea at times, but nothing like the biohazards I used to have. It’s no longer an everyday (or many-times-a-day) occurrence. I still do keep a supply of Immodium in my desk, my purse, and the bathroom, though, just in case.

I hesitated before writing this post, as it’s a difficult and unpleasant topic. But I know that a suffering mind can make the body suffer too, and I thought there might be people out there who have similar problems and needed some reassurance that they weren’t the only one. I don’t know what your “attack organ” may be or what your particular symptoms are, but do keep in mind that the interaction of the mind and the body can produce unwanted results. And that you are not alone in dealing with that.

Why CBT Isn’t for Me

It’s been suggested more than once that CBT, or Cognitive Behavioral Therapy, might help me with some of my problems, including “depression, anxiety disorders, marital problems, and severe mental illness” (bipolar disorder, in my case), according to the American Psychological Association (APA). And I understand that it’s helped a lot of people, including some in my position, with some of the same problems I have. If it works for you, that’s great. I’m not saying that no one should ever use it or that it’s a rotten form of therapy.

I, however, dislike the premise of CBT and have never felt comfortable trying it. Here’s why.

One of the basic tenets of CBT is that the client’s thinking is faulty and the therapist helps the client to discover how and where. Then they work together to pinpoint the faulty thinking and replace it with healthy behaviors, or at least less destructive ones.

Again, according to the APA, “CBT treatment usually involves efforts to change thinking patterns” and examine “what is going on in the person’s current life, rather than what has led up to their difficulties.”

When I first got into therapy with the counselor who has helped me the most, what I needed was not someone to convince me that my thoughts were faulty. I had worked hard to reclaim my memories, validate them, and recognize that they really were damaging events. I would resist any attempt to undo that work by invalidating those memories, and my attempts to understand them, as “faulty.”

Despite all the times it has betrayed me, I think my brain is the most powerful weapon I have in moving forward, but that does not include denying the past or brushing it aside in favor of what the APA calls “learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.” Evaluating the memories and the thinking associated with them is a large part of what has helped me most, but calling them “distortions” would not be helpful. I needed to reclaim those memories and understand the feelings, accept them for what they were and how they changed my life, and then go on to rebuilding a new life – not one free from those memories and feelings, but one that validates them as part of my lived experience.

The methods used in CBT discomfort me as well. The idea of “homework assignments” and role-playing my future interactions does not appeal to me. I have gotten on much better with good ol’ talk therapy (and medications) than I believe I could with body relaxation and mind-calming techniques.

My problem largely involves confronting my memories and not denying them or downplaying them, but learning how to live despite having them in my past. It does me no good to deny a train-wreck as “faulty thinking” or to dismiss it as part of my past. Owning it as part of my past and realizing what it did to me is much more helpful. Validating my feelings and reclaiming my memories, then moving beyond them, is what I need. My therapist has helped me do that, without ever once suggesting that my thought patterns are faulty. We’ve worked on coping skills, sure – but never based on the premise that my past doesn’t affect my present or future.

CBT is also said (by NAMI, the National Alliance on Mental Illness) to be a short-term process (which I’m sure the insurance companies love) or one that can be carried out without a therapist guiding it. To me, this smacks of the “think away your troubles” idea. If I could have, I would have, without the help of long-term talk therapy.

My therapy has been a long and often painful process, but never one that attempts to make me think that my memories are invalid and that my progress will come by admitting that. Talk therapy is hard work, and I don’t believe there is any shortcut to mental health. Even now, after I have largely ceased therapy, I sometimes need a “booster shot” when my problems become overwhelming. Again, this comes from recognizing that my problems are real and that thinking them away rather than hard work is not the answer.

I am sure that people will tell me that I have misunderstood CBT, what it is all about, and how it is practiced. They may have many good experiences with it. But I don’t want to take a chance on a form of therapy that denies my reality and dismisses it as “unhelpful thoughts.” I need my reality heard and validated and examined. I need depth and breadth of therapy that recognizes my “train wrecks” and to what degree they have left me wounded. I need coping mechanisms that acknowledge my past as part of what going forward may mean.

I don’t trust CBT to do those things.

Anxiety, Fear, Panic, and Phobias

I’ve heard it said that you know when you’re a problem drinker when your drinking causes you problems, whether of the emotional, legal, financial, or several other varieties.

Similarly, I think anxiety, fears, panic, and phobias are problems only when they cause you problems.

Let me unpack that a bit.

Phobias are considered to be a type of anxiety disorder or panic disorder. For example, social anxiety is sometimes defined as social phobia. Everyone has anxieties. Many people have at least one phobia. And most people can avoid these triggers with little or no effect on their daily lives. There are habits they can cultivate to avoid the things that make them anxious or phobic.

For instance, someone with acrophobia, a fear of high places, isn’t usually incapacitated by a stepladder, and can fairly easily avoid standing on cliff edges, rotating top-floor restaurants, and hotel rooms over the first or second floor. (When the anxiety/phobia extends to fear of flying, or aerophobia, the person can limit or eliminate air travel from their lives, usually without much difficulty.)

Crippling phobias, however, are generally classed as mental illnesses. My panic around bees (apiphobia) does not rise to that level; I would call it an anxiety reaction or a panic attack, not a phobia. It usually only manifests as bodily stiffening, tremors, and immobility, and pleas for anyone in the area to shoo away the offending insect. (I once took a beekeeping class to try to get over my phobia. Big mistake. Didn’t work.)

Agoraphobia (fear of unfamiliar environments or ones where you feel out of control), however, can be socially and psychologically crippling. The Mayo Clinic says that agoraphobia “can severely limit your ability to socialize, work, attend important events and even manage the details of daily life, such as running errands.” (Technology has made these constrictions less onerous, what with doorstep delivery and Skype.)

Anxieties as a symptom of mental illness are harder to define. While some anxieties have triggers, others simply don’t. “Free-floating” anxiety comes on unexpectedly, like the depressions and manias of bipolar disorder. This doesn’t mean that the anxiety isn’t real. It certainly is. It just means that the anxiety has no identifiable cause such as high places or bees. It is simply (or not so simply) a panic attack, which the Cleveland Clinic says is “sudden, unreasonable feelings of fear and anxiety that cause physical symptoms like a racing heart, fast breathing, and sweating. Some people become so fearful of these attacks that they develop panic disorder, a type of anxiety disorder.” They add, “Every year, up to 11% of Americans experience a panic attack. Approximately 2% to 3% of them go on to develop panic disorder.”

Sometimes I have anxiety that is attributable to triggers, such as financial difficulties, which are relatively easy for other people to understand. Who wouldn’t be anxious when the bank account is dry and a bill is due?

Other times, free-floating anxiety or panic simply descends on me, with nothing that triggers it. It’s an awful feeling, like waiting for the other shoe to drop when there has been no first shoe. Like a cloud hovering around me with the potential for lightning bolts at any time.

The thing is, I don’t know how to get rid of my anxieties, fears, or phobias. There are desensitization procedures that are supposed to work by getting one used to the trigger gradually. (I think that was my idea behind taking the beekeeping class. One of them, anyway.) There are antianxiety medications, including antidepressants and benzos, designed to take the edge off, if not remove the anxiety. (I take antianxiety medications. I’m still afraid of bees. Not that it affects my daily life much, but I’m never likely to visit that island off Croatia that’s covered with lavender.) For phobias, Cognitive Behavioral Therapy (CBT), as well as exposure therapy, has been recommended. This is usually a short-term procedure, according to the Mayo Clinic. But I have an aversion to CBT.

Still, despite my therapy and medications, I have to live with my anxiety and phobias. I’ve probably not reached the point where the anxiety causes me severe problems, like bankruptcy, though I have been known to overdraw my checking account on occasion and run my credit card up too high. These, of course, are signals that I may have a problem or am beginning to have one. It’s something to explore with my therapist, anyway. Maybe she can suggest ways I can deal with my anxieties before they turn into more significant problems.

For Those Who Wanted to See It

Here is my new mental health tattoo, which I wrote about in https://bipolarme.blog/2021/07/18/my-next-mental-health-tattoo/

Coming Down From a Manic Jag

I have been manicky lately, and it has expressed itself, as it does for so many people, with spending money we don’t have. Or at least spending money we’re supposed to be getting but don’t have yet on things which we can’t afford until we get it.

The thing is, we have a nice lump sum of money coming, but we don’t know when it will arrive. And instead of sensibly waiting for it to arrive, I have already begun spending it. A new-old truck for Dan; passport applications for us both; tattoos for us both; concert tickets; clothes and maps and guidebooks and airline tickets for a trip we plan to take next year; a short getaway vacation last week; gardening and home improvement supplies. Just to name a few.

All this leaves us very little for necessities like mortgage, electricity, internet (essential for my work), and even food. We can probably live on our credit card for a while, but I know that’s only a temporary solution, and a bad solution at that, even though the credit company increased my credit limit so we could pay for the airline tickets.

Of course, I am mostly responsible for all this spending. Some of the expenditures wouldn’t wait – the airline tickets, which we had to buy immediately to lock in the current price, and the passports, which I understand can take months to arrive and we shouldn’t wait till the last minute to apply for.

But for other purchases, Dan has been enabling me – “You know you want to go hear Emmylou Harris,” for example. “She’s one of your heroes.” “Might as well get the ticket for Rodney Crowell, too. How likely is it that he’ll be playing in this area again, at least anytime soon?”

Now the proverbial chickens are coming home to roost. Last week I had to deal with a guy at the door who was there to shut off our electricity unless I gave him a check for the past-due balance on the spot. The credit card company may come to regret the limit increase. I’m sure they gave it to me because I regularly paid them more than the amount due, and I can’t do that anymore.

I realize this is relatively minor compared to some spending jags that people in the manic phase of bipolar have gone on – gambling debts, for example, and even ones that end in homelessness. But the spending adds up, and we are strained past our limit until that windfall finally arrives.

Naturally, because that’s the way things go, now that I have come to and realized the reckless spending, it has triggered my anxiety. Financial troubles have always been one of my triggers, but it’s appalling to realize that I have dug this hole myself.

And naturally, because that’s the way things go, that anxiety triggers my depression – maybe not a full-blown depressive episode, but enough to affect my life and actions. I isolate. I grow surly with my husband. I have trouble sleeping or sleep too much.

In truth, I am angry with myself and with this damned disorder. When I get manicky, I generally am able to limit my spending to amounts of $25 or less, if sometimes for several such items (or meals). But this time I have overwhelmed myself, and my husband as well. I know we’re not supposed to use bipolar disorder as an excuse for bad behavior, but I can’t help thinking that hypomania is involved at some level. The idea of live music and foreign travel were just so irresistible. I couldn’t make myself wait until a better time.

We’ll get through this, I know. Someday the expected check will come and I can start straightening out some of the mess I’ve created. But until then, anxiety and depression will be my companions. I hope the mania stays fully tamped down until then. At least, I’ll take my meds and hope so. And not skip my therapist appointment in a week and a half. We haven’t had much to discuss lately, but now I’m sure we do.

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