Bipolar 2 From Inside and Out

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The Hypomanic Blogger

When I thought I had unipolar depression, I used to wish I were bipolar, on the theory that I could get a lot more done. (I later found that not to be true, as I’m sure many of you can attest.)

I had a lot more experience with depression than with mania. My bipolar disorder is Type 2, which means I get hypomania instead of full-blown mania. And most of the time the hypomania comes out sideways as anxiety and/or irritability.

(Don’t ask me why I get the full-monty-style depression and only a smidge of hypomania. I don’t know. If my shrink does, he hasn’t told me.)

Looking back, I can remember only one hypomanic episode before my new diagnosis made me more aware of the possibility. I was working at writing and editing – the same things I do now, only then I could do it in an office full-time instead of at home and freelance. A woman came to me, asking about how she could become a writer for magazines.

I positively burbled and babbled. I gave her all sorts of advice on query letters and Writer’s Market and niche publications and getting bylines and clips. I told her about how I started, writing for I Love Cats magazine and editing my martial arts club’s journal, and working my way up. (Incidentally, I am, as far as I know, the only person ever to have articles published in both Black Belt and Catechist magazines.)

The woman went away inspired, she said, though I never heard how she made out.

Now I can more easily recognize hypomania when it hits. I still get the anxious and irritable sort, but now I get more of the buzzy kind. And even though it makes me twitchy, I can make use of it.

It was in a bout of hypomania that I decided to start this blog (and my other, general-purpose one – janetcobur.wordpress.com).
It’s hypomania that has kept me going for over a year so far. Though I can now, thanks to medication, force myself to work while in the dysthymic stage or the “meh” stage, if I hit a spell of hypomania, I can use it to write and edit. Right now I’m using a hypomanic swing to stockpile ideas and first drafts against the inevitable downswing.

Of course, the ramblings that go with hypomania are not worth posting (or submitting to a client) the way they hit the screen. When I’m less jazzed, but not in the Pit of Despair, I can re-read, edit, and improve. It’s a fine balance, a tightrope I’m learning to walk. And it takes both therapy and medication to maintain.

In essence, the not-properly-treated bipolar 2 made my work go downhill (even as I did), until I was unable to work at all. Now that my diagnosis and my meds are more on track, so am I. I may not be well, but I certainly am better. I can live with what I’ve got, and even re-learn how to use some of the abilities I lost in my most recent, largest, most devastating crash.

I wouldn’t recommend mania or even hypomania to anyone, but as long as I’ve got it, I might as well make it be good for something.

I Have This Friend . . .

To have a friend, be a friend.

That’s how the saying goes, and it goes double for friends with mental disorders.

But.

There are limits. Boundaries. You may call them self-serving or self-saving, but there they are.

When you are depressed, you neglect friends, and I have certainly done that. I permanently lost one friend over it. But another kept reaching out to me and I eventually responded. (We then had a good game of “I’m a bad friend.” “No, I’m a bad friend.” She thought she hadn’t reached out often enough. I was glad she put up with my silence as long as she did, until I was able to reach back.)

But I have this friend. We used to be tight. When we were both depressed, we shared our misery and so lessened it. But now that the Pit of Despair is no longer my permanent abode…I have to limit my contact.

Why? My social skills have never been terrific, but now I frequently find myself walking that invisible line between Bad Friend and burnout.

Why is it so hard to be a Good Friend?

First, there is the Disaster Report. Whenever I talk to her, I hear a litany of all that is going wrong in her life. Almost never anything else. I’m no fan of relentless positivity, but its opposite is sometimes hard to bear too, even though I’ve been guilty of the same.

Then there is the fact that any suggestions are pushed away, denied as impossible, dismissed as unworkable. Granted, we have completely different styles of coping, but I feel discounted, unheard. Eventually I gave up sharing anything but a few of my own tribulations, some awful jokes, and commiseration.

Then I get off the phone or off Facebook, usually after half an hour or so. That’s about my limit.

I still keep reaching out. I don’t want to be a Bad Friend. I know I can’t fix her, or even her day-to-day difficulties, the kind even non-depressed people have. But I sure wish there were a way I could help, short of climbing down into the Pit with her. I hope that listening, even half an hour at a time, does some good.

And when I talk to other friends of mine, I try to remember to ask how their day was and what’s new in their life and have they seen any good movies and what is a mutual friend doing. I try to listen if they have something to share, good or bad, and I try not to overwhelm them or play whose-life-sucks-the-most. I try to be a Not-Bad Friend, even if I do have to lean on my friends, at times pretty heavily.

And they do likewise, when they can.

Depression Hurts

You’ve probably seen those commercials where the announcer and the actress playing the part of a depressed person try to answer the question: Does depression hurt?

Once when we saw this commercial, my mother turned to me and asked whether my depression hurt me physically.

I had to say yes. I don’t think I ever took Cymbalta, the medication that the commercial was touting, but I was clear on the fact that physical pain is involved along with the psychological suffering of depression.

My head and eyes hurt from all the crying spells. My back hurt from lying in bed all day. I had painful knotted muscles from the anxiety that went with the depression. I had intestinal cramps because my overactive nerves led to irritable bowel syndrome. I had headaches and eye strain from the over sensitivity to light and noise. And I had the general flu-like malaise that is practically the hallmark of depression. You know the one. Every bone and muscle aches, but you can’t think why.

Were these aches and pains psychogenic? Undoubtedly some of them were. But others, like the irritable bowel, were all too demonstrably physical phenomena.

The mind and body and soul are inextricably intertwined. We know this to be true. Depression affects them all.

And it does hurt.

Mr. Fix-It

Him: I just groomed the cat. I used a cat-a-comb.

Me: *total silence*

Him: Hey, honey! I just groomed the cat – with a cat-a-comb!

Me: *more silence*

I was depressed, and he was trying to cheer me up. Using exactly the same joke that had gotten no response only seconds before. I don’t know why he thought it would work better the second time.

Many men have the instinct that, when confronted with a problem, they will try to solve it. When something is broken, they will try to fix.

I wasn’t broken, exactly, but I was deep in the Pit of Despair, aka the lower mood swing of my bipolar disorder. At that stage I am immobilized, uncommunicative, and utterly humorless.

The fact that Dan had worked in hospitals and psychiatric facilities was actually a bad thing, despite what you might expect. He had run laughter therapy groups, he knew the jargon, and he sincerely wanted to be helpful.

But he didn’t know – viscerally – what depression was like. How it felt in your body and mind and soul, how it damped down your personality and blunted your reactions and removed your ability to view life as anything other than miserable. Certainly not funny.

Later Dan learned all this when he experienced his own bout of clinical depression and became another one of my Prozac pals. But until then, he would occasionally come shrinking at me, until I had to tell him to stop. I could accept a hug, but not a joke or a “remedy.”

But all that was early in our relationship and before I had begun to heal or even get proper treatment. And I literally would not have made it this far without Dan. I need him and likely always will.

When it’s Pit of Despair time again (which it sometimes still is), he checks on me to see if I need that hug, or some food, or a kind word, or just to be left alone. When I am better, he still does the cooking and shopping, and reminds me to eat regular meals and take showers and tells me I smell nice after I do. Sometimes he can coax me out of bed with a tape of The Mikado or out of the house with lunch at Frisch’s. If I’m too nervous to drive to my appointments, he takes me. When I’m together enough to work, he keeps the house quiet and fixes food when I need a break and validates me for being able to bring in money, even when it’s difficult.

But he can’t fix me. And now he knows that.

Blog for Mental Health

I pledge my commitment to the Blog for Mental Health 2014 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.

This issue is of great importance to everyone – not just those people who have mental disorders. Everyone’s life will be touched by mental health issues at some time, whether by your family, friends, co-workers, neighbors, or even yourself. Learn as much as you can about mental illness and mental health and remember it when you see or hear fear-mongering about the mentally disordered.

This blog is primarily about bipolar disorder type 2 and my experiences with it. But anyone interested in the subject of mental health is invited to visit any time to read, comment, share, or what you will. You will all be welcome.

Fun’s Fun – Until It Isn’t

When my husband, Dan, and I were dating, he would sometimes tickle me, or poke me, or make embarrassing jokes about bodily functions. And I would shut him down. “Stop that!” in the tone of voice that says, “I mean it and I’m angry.” If he persisted, I put my foot down even harder.

“You know what’s wrong with you?” he would say (and don’t you love sentences that start that way?). “You’ve forgotten how to have fun.”

I had to admit it was partly true. I had just come off a relationship in which I could set no boundaries. Rex would tickle me, for example, past the point of enjoyment until it was actually physically painful. I taught myself to shut down my tickle response (and who knows how many other responses along with it). I was depressed and I was damaged and I didn’t know what fun looked like anymore. But I knew that for me, tickling was not it, and that I had to clamp down on it or it might turn into pain.

A Facebook post brought this all back to me. Judi Miller, an awesome teacher of troubled teens, told of a time when a male student, “Johnny,” was teasing a girl, poking and tickling her and saying he wanted to handcuff her and tickle her till she screamed.

Judi objected. She explained, “Johnny, when you say to a woman who says ‘No’ to you that you’re going to restrain her with handcuffs and touch her without her permission until she screams, that sounds really rape-y to me.”

The boy protested that he hadn’t done anything wrong, and Judi took advantage of the teachable moment for a lesson on bodily autonomy: “That means you have a say in who touches you and how far you’re willing to go. In my family, if someone says ‘Stop tickling,’ we do, because consent is important to fun. If it’s all fun for you, and not for your partner, you aren’t listening to her needs.”

She added, “If you don’t respect her bodily autonomy when she says no tickling, or no touching, or to leave her alone, then will you respect her saying no when she doesn’t want to hug, or kiss, or get it on after a date? The pattern is the same. There’s the connection to rape.”

As with most teachers, she had no idea whether her message had an effect.

Until later that day, when a boy from a different class started an argument with his girlfriend, and grabbed her wrist, because she wouldn’t hug him.

Johnny was right there. “That ain’t cool. If she doesn’t want to hug right now, you got no call to get mad at her. You don’t own her ass, or her. She gets to decide if she feels like hugging you, kissing you, whatever. It’s called BODILY AUTONOMY, asshole. No wonder she don’t want to hug you if you won’t take NO for an answer!” Johnny said.

Judi thanked Johnny for listening to her and said she was proud of him. In fact, she later described this as her proudest moment of teaching all year.

Dan and I worked through our problem, I’m glad to say. I learned that I could say “no” and he learned not to push it. We both learned how to do things that were fun for both of us. Back then, I had never heard about “bodily autonomy.” We learned.

I wonder if Rex ever did.

Diagnosis and Dickinson

The Brain — is wider than the Sky —
For — put them side by side —
The one the other will contain
With ease — and You — beside —

The Brain is deeper than the sea —
For — hold them — Blue to Blue —
The one the other will absorb —
As Sponges — Buckets — do —

The Brain is just the weight of God —
For — Heft them — Pound for Pound —
And they will differ — if they do —
As Syllable from Sound —
Emily Dickinson

I ran across this poem in a book called Shrinks: The Untold Story of Psychiatry (about which more some other time) and it made me think.

Dickinson was, by all accounts a recluse. She seldom went out and, when visitors came, she sometimes sat behind a screen while she talked to them. She never dared to submit her poems for publication. Less than a dozen were published in her lifetime, and those only because someone else submitted them without her knowledge. Her wealthy, loving family sheltered and nurtured her so that she never had to face the outside world.

Emily Dickinson had Social Anxiety Disorder.

And Abraham Lincoln suffered clinical depression. So did Charles Dickens.

Bipolar sufferers include Beethoven, Schumann, and Isaac Newton.

Charles Darwin, Michelangelo, and Nikola Tesla were all obsessive-compulsive.

Autism, dyslexia, and various learning disabilities affected Einstein, Galileo, Mozart, and even General Patton.

And Van Gogh! Let me tell you about Van Gogh. He had epilepsy. Or depression. Or psychotic attacks. Or bipolar disorder. Or possibly some combination thereof.

I call bullshit. I’m not saying none of those people had assorted mental disorders. My point is that we can’t tell from this distance in time.

In none of these cases, as far as I know, did any of the aforementioned people see a psychiatrist, psychoanalyst, psychotherapist, or even a phrenologist. None were diagnosed with any psychiatric condition, and no record of such a diagnosis has come down to us from any reliable source. Some even lived before psychiatry was invented.

People – mental health workers, but also art and literary critics, biographers, and the general public – have looked at these extraordinary people’s lives and work and decided that their behavior and their art look like those of a person who might be bipolar or obsessive-compulsive or psychotic. (They also like to retro-diagnose physical conditions there is no record of or only vague names for. King Tut, Henry VIII, and Napoleon are particularly good theoretical patients.)

Why the tendency to ascribe mental disorders to famous people? I can see two reasons, beyond the thrill of solving a mystery and feeling clever.

The first is the old saying about there being a thin line between madness and genius. These historical figures were geniuses, so they must have been mad. Or as we say now, suffering from mental disorders.

The other is the need for role models and inspiration. If Van Gogh could become one of the most famous artists ever (though not successful in his own lifetime), you too may rise above – even use – your disorder to accomplish greatness.

It’s possible, I guess, but it’s not likely. Certainly those with mental disorders can aspire to and achieve rich, full lives, satisfying relationships and jobs and artistic pursuits. These are the ordinary accomplishments of ordinary people, both with and without mental illness, and it’s a small miracle that people can achieve any one or more of these. Not everyone does – again with or without mental troubles or psychiatric diagnoses.

And for me, at least, it’s enough.

Can the spark of imaginative genius strike a person with a mental disorder? Of course. Can that person succeed and achieve lasting fame? Maybe, though the odds aren’t good. Is a person saying, “Look, I can be Van Gogh!” likely to fall short? Almost certainly. Can that failure to achieve greatness make a person feel worse about himself or herself instead of better? You tell me.

There’s nothing wrong with aiming high, and nothing that says a person with a psychiatric diagnosis can’t do just that. It’s a good idea for anyone. (As one of Lois McMaster Bujold’s characters says, “Aim high. You may still miss the target but at least you won’t shoot your foot off.”)

But pinning your hopes on a similarity with a non-psychiatric, perhaps non-existent, diagnosis of a genius may not be the best way to get there.

Better to look in these geniuses’ work for insights that can help you understand your own condition or pull you through tough times. Here’s another of Emily Dickinson’s poems that has always spoken to me about the experience of a depressive crisis and its aftermath.

After great pain, a formal feeling comes —
The Nerves sit ceremonious, like Tombs —
The stiff Heart questions ‘was it He, that bore,’
And ‘Yesterday, or Centuries before’?

The Feet, mechanical, go round —
A Wooden way
Of Ground, or Air, or Ought —
Regardless grown,
A Quartz contentment, like a stone —

This is the Hour of Lead —
Remembered, if outlived,
As Freezing persons, recollect the Snow —
First — Chill — then Stupor — then the letting go —

Was Emily herself depressed? We’ll never really know. And as long as we have her poems, I don’t really care.

Mind Like a Steel Trap

Rusty. Unhinged. Not really good for trapping things.

Especially memories.

That’s not quite true. I have that uncanny ability that all depressed people seem to have to remember every stupid, clumsy, embarrassing thing I’ve ever done, as well as every trauma. It’s like a mental DVD that stores them up, then plays them at random moments. Or maybe not so random. Maybe just when I think I’m doing okay.

The memories can be as traumatic as the time other children threw rocks at me or as trivial as the time one person asked for a glass of water and I gave it to someone else.

Unfortunately, the recording feature only works for bad memories. A lot of the good ones are MIA. I don’t remember huge chunks of my childhood, except as stories that family members have told me. I don’t really know if the memories are mine or theirs. And I’m scared to compare notes.

My theory about these childhood memory deficits – and to tell the truth, all the way through my teens and early twenties – is that when you are profoundly depressed, memories don’t imprint the way they’re supposed to. Whatever synapses and neurochemicals are involved in memory are out of whack. I’m also afraid to do the simple Googling required to find out whether this is even a plausible theory. If it’s not, I don’t think I want to know. I have an explanation that makes sense to me, and the memories won’t come back if I learn my theory is wrong.

Later in life, medication has helped controlled the depression and, after it was diagnosed, the other effects of bipolar 2. But if I thought my memory was going to function properly, I was wrong. Some of the drugs left me with a memory like Swiss cheese.

My memory lapses seem more random now. Good things, bad things, neutral things, all disappear into the Pit of Unavailability. Sometimes they are embarrassing – I forgot a friend’s father had died and asked how he was. Other times they are more distressing – mere scraps left of trips I’ve taken. Sometimes they’re heart-searing – total nonrecall of a never-to-be-repeated sexual encounter.

Good and bad, gone.

(“Oh, yes,” said the doctor. “That drug will do that. You can stop taking it now.”)

I guess I’m lucky. If I’d had the electroshock, my memory would probably be as raggedy as old underwear. And about as useful.

Churchill’s Dog

Winston Churchill famously compared depression to a black dog. Here’s a video that takes that metaphor and runs with it.

Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, says, “Depression minutes are like dog years, based on some artificial notion of time.” He goes on to describe how the simple act of getting out of bed and taking a shower can consume hours, leave you exhausted, or be simply impossible without help.

The Noonday Demon

There’s even a Black Dog Institute in Australia, which is a non-profit organization that provides information about depression, bipolar disorder, suicide, and other topics.

Home

There are other metaphors. J.K. Rowling, creator of Harry Potter, talked about depression and dementors. Here’s a link to a post I wrote about that.

Read Your Way to Sanity

The black dog is with me now.

Why Do They Do This? (And Why Do We Allow It?)

The big story last week for those of us with mental disorders was this one:

http://www.rawstory.com/rs/2015/02/truly-barbaric-florida-deputy-drags-mentally-ill-woman-through-courthouse-by-shackled-feet/#.VOyTNKh2Gbc.facebook

For those of you who haven’t read it or seen the video, here’s the gist. A woman, Ms. Rios, was declared mentally incompetent at a hearing for a minor offense and not allowed to say goodbye to her mother. She wanted to sit on a bench and cry for a bit. When she did not go promptly with the officer, he dragged her through the courthouse by her shackled feet. A video was taken on a cellphone camera by a lawyer who happened to be present, but had nothing to do with Ms. Rios’s case. If you watch the video clip you can see and hear her distress.

As the headline says, this was barbaric.

But there’s lots neither the headline nor the story says. I have questions.

What is the woman’s mental illness? Or why is she mentally incompetent? The stories vary, usually calling her “mentally ill,” which is shorter for the headline writers, but so far I have seen nothing more specific. One could get the impression that in the mind of the media – and therefore their readers – that the two terms mean the same thing. Was she medicated or unmedicated or off her prescribed meds? Does she have a developmental disability? An autism spectrum disorder? An emotional or behavioral disorder? We don’t know. But does the label make her automatically suspected of potential violence? The woman did not behave like an animal even when she was treated like one.

I think we all know people who have mental disorders but are still mentally competent to conduct their own affairs, up to and including court proceedings. In fact, I know you know one – me. But who among us, or among the sanest and most stable of the general public, wouldn’t have needed to sit on a bench and cry before going to wherever the officer thought we should go? Who wouldn’t yell and protest and try to hold on to a table if we were dragged anywhere by our shackled feet?

Why is the officer’s action called “barbaric”? I’m not saying it wasn’t barbaric. But how was it more barbaric than other things routinely done to the incarcerated mentally ill (or incompetent)? Could it be because the officer’s actions were caught on tape? How many everyday barbaric actions aren’t? And putting aside simple human compassion (which he did), didn’t the officer’s actions create a larger, potentially more dangerous disturbance?

Why did the other officers present do nothing? You can see them on the video. They are spectators. No one says, “Hey, do you have to do that?” or “Give her a minute to calm down” or “Here, let me take care of this” or “You know, there are other ways to handle this” or even “Are you sure you want to do that with the camera rolling?” Nothing. Nada. Zippety. Doo-dah.

Why weren’t the officers and other courthouse personnel trained to handle situations like that? They obviously happen occasionally. Officers are (supposedly) trained to handle situations involving violent felons (which Ms. Rios wasn’t), domestic violence, and how to restrain suspects properly. Some even get sensitivity training on race, sexual orientation, and ethnicity. Where’s the training for interacting with the mentally ill (or mentally incompetent)? For de-escalating a situation instead of throwing gas on the fire? How about anger management before incidents like this one instead of after? Shouldn’t every law enforcement official be able to control or channel his or her anger and not take it out on the public?

Why the hell aren’t police officers required to wear body cameras – and have someone whose job it is to, oh, I don’t know, review them occasionally? Certainly when there’s been a complaint, but spot checks might also do some good. Why are civilians subject to increasing surveillance, while law enforcement personnel – who are also civilians, by the way – perform their jobs with minimal oversight.

And why is the Golden Rule suspended when the “others” have a mental disturbance? I’d really like to know.

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I am cross-posting a slightly altered version of this essay to Et Cetera, etc., my general purpose blog (janetcobur.wordpress.com).