Bipolar 2 From Inside and Out

Archive for the ‘mental health’ Category

Things That Work – Sometimes

Right now I am in the middle of a fairly deep depression. It has gone on for days, which is unusual now that I am more or less stabilized on medication. But there is no let-up in sight.

This time is one of those I-have-nothing-to-look-forward-to moments; plus the holidays; plus the need-to-see-my-therapist thing; plus the have-an-appointment-with-new psychiatrist-but-it’s-not-till-March thing; plus the whole no-spoons-to-get-out-but-really-need to-get-out-of-the-house feeling; plus the various catastrophizing-about-finances-and-the-IRS problem; plus the there’s-something-I-really-want-to-happen-but-if-it does-it-won’t-be-soon-and-may-not-happen-at-all.

Let’s see. Is there anything else?

Oh, probably, but that will do for starters. Of course to a lot of people, those would be everyday annoyances and I would be having your standard pity party. But for a bipolar person, with my brain chemistry, it’s an invitation to a deep, dark pit.

So what are the things that help pull me through, or out, or up? And what are the things I can do while I just ride it out?

Well, there’s music. I’ve written about that before (http://wp.me/p4e9Hv-42). There are two long-form musical bits that have been known to lure me out: The Mikado and The Pirates of Penzance. Occasionally when I haven’t gotten out of bed in a while, my husband will put on a DVD of one or the other and wait for me to appear in the door of his study. There is usually beer or snacks, and I can sing along (badly but loudly) to my heart’s content. Heart’s content – now there’s a good thing. Going to see live productions of Gilbert & Sullivan was an activity my sorority used to do, and one of my best memories of otherwise-difficult sorority life. (I mean, really, can you picture me in a sorority?)

Then there are distractions. These don’t actually improve my mood, but they can help me avoid dwelling on the above list of what’s-wrongs. If I have the concentration needed to read, that’s my go-to choice. (I’ve also written about “comfort reading”: http://wp.me/p4e9wS-3n.) I usually try to keep one fiction and one nonfiction going, so I can switch back and forth.

Sometimes, though, I don’t have the concentration to make it through a chapter. Then it’s time to try TV. Something familiar, non-challenging, not too fast-paced. Cooking shows work, or something like Pawn Stars. True crime or true medicine. Shows where I already know the characters and the back-stories: Castle, Bones.

When I don’t even have enough concentration for that, I go for stupid clicky games. One round of Candy Crush Soda Saga is about as mindless as you can get and still be breathing. Even playing out all five lives takes about 15 minutes. Or I can turn off my brain entirely, play obsessively, and get lost for hours of not-worrying about anything more important than making six-letter words in AlphaBetty.

Occasionally I can do light-as-popcorn forms of social interaction. Phone calls with a depressed friend or one who always has a silly joke ready or one who reads the same sorts of things that I do. Instant messaging. Facebook.

Sometimes, though not often in this state, I can force myself to work a little. Or work on my blogs. It’s difficult and not really satisfying and sometimes even painful, but if I can do it, it’s probably the best thing for me. Accomplishing something – anything – helps build a step out of the pit.

As for the usual advice – rest, exercise, nutrition, meditation – I usually can’t manage those. Except for sleeping. I’m a world-class napper. Also a world-class insomniac. Don’t ask me how I manage that. It’s a gift. I have a new exercise regimen that involves walking up and down the stairs more times than I really have to. My husband makes sure I eat at least one good meal a day. For meditation I pet a cat.

Then I wait.

I know that this will not last for weeks or months or years the way it used to. I’m just going to be miserable until I’m not anymore.

The Depression Diet

It seems that Target (and other stores) can now send, well, targeted ads based on previous purchases. The example usually given is that someone who buys a home pregnancy test will start receiving coupons and discount offers on diapers and strollers.

I maintain that one way to spot depressives is through their grocery-buying habits. Just as psychologists say that odds are that the last three people in any long line are likely to be clinically depressed, I say that someone who purchases an entire chocolate chip cheesecake and a bottle of Jose Cuervo is going to be in the back of that check-out line too.

Which brings me to my point. There are certain foods that depressed people tend to eat. These foods don’t cure depression, of course, but they do seem to provide some comfort.

The first category of depression food is, of course, comfort food. We all have our own definitions of comfort food, but a lot of them seem to be high-carb, high-fat, no-nutrition sorts of food. They bring back memories of childhood, maternal nurturing, and a simpler time when calories didn’t count. Some of my comfort foods include club sandwiches, grilled cheese sandwiches with tomato soup, mashed potatoes, and macaroni and cheese.

My husband knows enough to make me comfort food when I’m stressed out. He does add tuna fish and peas to the mac and cheese to make it somewhat more nutritious. He knows my needs and does well at meeting them, though his grilled cheese will never rival my mother’s. He does pretty well on the tomato soup.

The next category of depression food is weird food. I suppose this category includes the chocolate chip cheesecake and tequila. One of my depressed friends introduced me to her particular specialty: wavy potato chips dipped in cream cheese with an M&M stuck on top. My husband starts to worry about me if I ask him to pick these up for me at the store. But it does contain all four food groups: salty, sticky, sweet, and crunchy.

When I was a kid, my favorite was a block of cream cheese with that odd, unnaturally orange French dressing poured over it, mashed with a fork, and with pickle relish if I we had any. This was my own chip dip creation. It resembled my friend’s in the cream cheese and wavy chips department, but French dressing is no substitute for M&Ms. Let’s just say my tastes have grown. (Not necessarily up.)

Another category of depression food is useless food. These are edibles that one can make with very little effort, as even small efforts can be overwhelming at this point in depression. Frozen dinners are good for this. I recommend Marie Callender pot pies if you go this route, because they have both a top and bottom crust and so feel more like a meal. Foods that come in small cups with pop-open tops are good too: Beefaroni, mac and cheese, soups.

Sometimes, however, the depression is so severe that even these simple efforts are beyond you. For those occasions, there are truly useless foods. It’s a mistake to call them meals at all. Here I’m talking peanut butter straight out of the jar (spoon optional), and dry cereal straight out of the box. During my worst days I used to keep a box of Cocoa Puffs by my bedside, just in case. As I slowly improved, I replaced that with a box of Life cereal. (The name was a coincidence, I assure you.)

I know that eating a well-balanced, nutritious diet is one of the most common suggestions for keeping depression at bay (along with exercise, sleep, and all that other good advice). I also remember that when a person is talking about suicide, one of the questions you’re supposed to ask is, “When’s the last time you ate?” Supposedly it’s harder to take your own life if you’ve recently done something as life-affirming as eating. (I don’t know if that’s actually true, but I did try it once and the person is still alive, so maybe.)

I also know that sometimes irrational thinking extends to food choices as well. I worry about my husband when he starts eating peanut butter sandwiches dipped in cold chunky soup (still in the can). I’ve been told that’s a guy thing, not a depressive thing, but still sometimes I wonder. Even at my most depressed, I’ve never been tempted to do that. Ew. Just ew.

The Bloggess and Mental Health

I met the Bloggess (aka Jenny Lawson) recently at a book signing for Furiously Happy, her second book. (Her first book was Let’s Pretend This Never Happened.)

Back row: Rory, the Furiously Happy Raccoon; middle row: me, Jenny Lawson; front row: Erma the Armadillo

Back row: Rory, the Furiously Happy Raccoon; middle row: me, Jenny Lawson; front row: Erma the Armadillo

The space at the bookstore was full to overflowing. (People had driven for as much as five hours to see her.) Jenny read two chapters of her new book to riotous laughter and applause. There was a brief Q&A session. (I figured she got the same questions all the time and wanted to ask her something that no one else had. I imagine that writers on tour need a little variety.So I asked: If you could be any animal, what would you be and why? Her answer: A tapeworm, because I could just not move and have people feed me.)

I joined the signing line (#17). She signed my copy of her book (“Our story is not over.”) and I showed her the semicolon tattoo that goes with that saying. She also signed my armadillo purse (Erma) and a piece of glass for my husband, who wants to put it over a picture of her or of a vagina; he hasn’t decided which. She laughed. He was one of the many that ask for perhaps her most famous – or at least most quoted – phrase, “Knock knock, motherfucker.” (It comes from her story about leaving a giant metal chicken on someone’s doorstep. There were also a lot of metal chickens she was asked to sign.) The bookstore personnel made sure that everyone knew it was okay to ask for that. In fact, they announced it just before the signings, reassuring the shy or inhibited.

The title of her new book, Furiously Happy, is Lawson’s way of telling depression to fuck off: If part of her life is misery and pain, she’s going to damn well make the most of the parts that aren’t. And while she’s at it, she’ll spread the word that mental illness is not a thing to be hidden or ashamed of.

This is not to say that her mental disorders are cured or that she no longer suffers from them. She was clearly anxious when reading aloud the two chapters, and visibly relieved when that part of the evening was done. Her strategy is to laugh at mental illness, joke about her meds, and speak bluntly to those in the audience who also suffer or have a person in their life who does.

Furious Happiness is a worthy goal, and her out-there enjoyment of life leads her into some of the hysterical situations she has written about in both books. These are the stories that make you say – only you, Jenny! Then she turns around and tells you that you are just like her in the ways that count.

The readers of her books and her blog – thebloggess.com – have formed an odd mutual support community. Although we may feel alone, Jenny rallies us to be alone together. Since one of the major difficulties with being a psychiatric patient is the feeling that no one else understands or experiences the same feelings, bringing people together in the virtual world or between the covers of a book is a valuable form of networking, especially for those who can’t network any other way.

Myself, I can’t manage the Furious Happiness. Too long dealing with the black dog and relatively little experience of even the mild highs of hypomania have left me depleted. Jenny will just have to do it for both of us. This is not to say I don’t love her or her work. I do, despite the blog post that I wrote, “Seven Reasons I Hate the Bloggess” (http://wp.me/p4e9wS-56). I can see myself in her and her in me, but for the moment I’m not able to follow her exuberant example. But she gives me hope. And I’m sure that’s one of her most important goals.

FYI

Thought I should pass this along: http://greatist.com/grow/resources-when-you-can-not-afford-therapy

The Wrong Life

Nothing prepared me for this.

This is not the life my upbringing prepared me for. I don’t just mean the special guest speakers we had in home economics class who tried to introduce us to the subtleties of silver, china, and stemware. No, I was also misled by the books I read.

If Life Is a Bowl of Cherries, What Am I Doing in the Pits? and Please Don’t Eat the Daisies led me astray. Don’t get me wrong, I’m a total fan of Erma Bombeck’s writing style, but the quirky suburban life she loved and lamented was not what I got. Bombeck and Kerr both made light – and fortunes – of portraying the petty foibles and cute misunderstandings of women and their husbands, women and their children, women and their neighbors, women and other women.

Daily disasters with dishwashers, sticky-fingered children, and clueless husbands were an endless source of amazement and amusement for them. They soldiered on, supported by an innate buoyancy, faith in the divinity, and the occasional glass of wine.

My glasses of wine have been more than occasional. My disasters have not been humorous. I do not have children, and the cats are somewhat deficient in making adorable conversation in high-pitched, lisping voices. Sometimes all I can get out of them is “meh,” which is pretty much how I feel too.

As for the trappings of the genteel life, we eat off paper plates more often then not. I did once have a set of Limoges, but only because I was acting as a pawnbroker for a friend who needed ready cash. I fed one of the cats on the Limoges saucer, just to say that I had.

My parents used to say that their house was decorated in early married junk and I have followed in that fine tradition. Most of our furnishings are a demonstration of the maxim: If it’s not from Kmart or Goodwill you won’t find it here.

No one’s life prepares them for clinical depression, hypomania, bipolar disorder, or any other mental illnesses. I’ll wager that even psychologists’ kids don’t have a clue when they escalate from picking scabs to experimenting with lit cigarettes. Maybe their parents don’t either.

Either the mental disorder has been going on so long that you don’t know what it’s like without it, or it comes on so suddenly that you desperately hope that it goes away just as suddenly. Or it comes in a way that you can just convince yourself is no big deal. “I overspend? That’s just because I love shopping, not because I have mania or need to validate myself with expensive things.”

Perhaps people who grow up with a mentally disturbed loved one have a chance of understanding the underlying mechanisms. But with the number of families who don’t discuss the “elephant in the room,” or pass it off as, “Your sister is just high-strung” or say, “Uncle Ted is a little odd. Just ignore him,” not even that exposure may help.

How do young people learn about mental illness? Or even – gasp! – get help for one? If not at home, maybe at school? The National Association of Secondary School Principals cites the U.S. Surgeon General’s report saying that “one in five children and adolescents will face a significant mental health condition during their school years” and that the ratio of school counselors to students is 471:1. Add to that the fact that most school counselors have been shifted away from offering personal and emotional support to offering academics-only services. (http://www.nassp.org/Content.aspx?topic=57948)

Most of us struggle alone. Some never find a proper diagnosis and treatment. We have to be our own resources and our own advocates much of the time, even if our illnesses do not allow us to get out of bed. If we have one family member – or even a close friend – who understands, we are lucky beyond measure.

I wish that I had been even slightly prepared for the life I now lead, instead of the one I was “supposed” to have. No one can predict the future, but why can’t we at least have a bit of mental health education in school? I suppose that’s a lot to ask, when even sexuality education varies from the merely adequate to the appalling, when schools are barely able to stay abreast of the teach-to-the-test curriculum, and when Texas’s governor vetoes a bipartisan bill allocating resources for mental health, based on lobbying by Scientologists.

Do I sound bitter because I didn’t get to live the genteel suburban life? Probably. But there are aspects of that life that likely would have actively impeded my search for mental health. So I’ve had to do it on my own, or nearly so, at least until recently. A lot of us go DIY for mental health.

But a lot of us are accomplishing it. Living the life we have and not some fictitious pie-in-the-sky one. We may not have been prepared for it, but we muddle through anyway – and sometimes even realize that imperfect real life is better than a perfect lie.

Confessions of a Crazy Cat Lady

One can be a crazy cat lady without living alone in a cavernous house with a dozen or more cats. I should know. I am one, and I don’t.

First let’s start with definitions. I’m crazy. I think we all know that by now and I don’t mind saying so. (See “Yes, I Am Crazy. Thanks for Asking” http://wp.me/p4e9Hv-4h.) I’m also a cat lady. We had dogs growing up, but I never got very close with them. I did have a rabbit that I was awfully fond of, but this was in the days before lop-eared rabbits became house pets. She lived in a cage in the garage, or in the back yard when the weather was nice.

To me a crazy cat lady is someone who has eight or more cats, lives alone with them, usually in a large house, but one not quite big enough for all the inhabitants. Often you hear news stories about crazy cat ladies who die alone and are eaten by their cats, or crazy cat ladies whose pets are taken away from them because of inadequate care – especially sanitation.

I have a friend who was had more than eight cats at once, and is just as crazy as I am. She does not, however, believe that she is a crazy cat lady because another lady down the street has more cats. And truthfully, she doesn’t meet the other requirements of crazy-cat-lady-hood. She has a family, and keeps up with the care and feeding of her menagerie.

Do crazy cat ladies have an actual mental disorder? If so, do they all have the same kind? Maybe not. The crazy cat lady on The Simpsons (Eleanor Abernathy) is pretty clearly schizophrenic, though I doubt that many are in real life. Real-life cat ladies may demonstrate obsessive-compulsive tendencies, or their isolation may be due to depression. Or something else entirely.

Psychology Today tells us there is no real basis for the stereotype.

The stereotypic term “crazy cat lady” is used in a pejorative sense to classify an older, female animal hoarder and there is no research to support such correlation. Research on animal hoarding is lacking and there is not one plausible theory that suggests why older females tend to hoard animals more than men.

https://www.psychologytoday.com/blog/when-more-isnt-enough/201106/animal-hoarding-is-there-such-thing-the-crazy-cat-lady

Still, crazy cat lady behavior may be psychologically classified as a “hoarding disorder.” Mother Nature Network reports that the condition…

…is only now getting the recognition that will prove helpful to sufferers. Recent research has revealed abnormal brain activity in people with hoarding disorder. And both experts and hoarders hope and believe that the new DSM classification will help bring about better treatment.

Read more: http://www.mnn.com/health/fitness-well-being/stories/crazy-cat-ladies-to-get-a-new-clinical-definition#ixzz3nG9WWESM

I would make the case that crazy-cat-lady-hood is actually a defense against mental disorders. Carried to an extreme, perhaps, but beneficial nonetheless.

Caring for cats – even multiple ones – gives a person another living being to care about. Patients in geriatric facilities are often brought into contact with small domesticated farm animals or cats and dogs (therapy animals), which pretty clearly help them deal with isolation and depression.

For an isolated person, cats provide someone to talk to. Not that the cats necessarily listen or respond, of course, except in the most perverse ways possible. They are cats, after all.

I got my first cat when I was living alone and recovering from several years of psychological trauma. My future husband went with me to the shelter, but was studiously unhelpful in selecting a cat, thereby proving that he had some sense and a grasp of how important it was for me to find a kitty I could bond with.

“Which one should I get?” I asked.

“Gee,” he replied, “I dunno, honey. They all look like nice cats to me.” The one I chose was Bijou, a tortoiseshell.

We as a couple have since had up to five cats at one time, and through the years a total of well over a dozen.

When my bipolar disorder was at its worst, after I had suffered a major meltdown (nervous breakdown, decompensation, or whatever you call it), I was certainly crazy, but hardly a cat lady. I was unable to take care of my own daily needs, much less those of anyone else, human or feline. My husband, who was taking up enormous amounts of slack, took over pet care as well. Now that I’m back on a fairly even keel, I can do my part with feeding, litter box tending, grooming, and so forth.

Fortunately, even when I was immobilized, my cats, in addition to my husband, gave me emotional sustenance. The therapeutic effects of a purr, a gentle kneading, and a nice snuggle are not to be underestimated. The antics of a kitten may be exhausting to watch, but they provide more than a little distraction, if that’s what you need.

Do dogs have the same therapeutic effect? I don’t know. For some people I suppose they do, but I have never bonded with a dog as I have with my cats.

In psychological terms, my cats are “comfort objects,” like furry, living security blankets, or teddy bears that shit and meow. I hope never to be without a cat again. I need them for my mental health.

Stress Plus

Mental stress plus physical stress = Stress Plus.

The mind and the body are part of the same system. What affects the one affects the other as well. When the body is stressed, the mind suffers. When the mind is stressed, the body suffers.

When both are stressed, you get Stress Plus.

Here’s how it works for people with mental disorders. You feel depressed or immobilized and you don’t get up and move around. Your body responds by becoming lethargic and flabby. Your mind responds to that by becoming discouraged and self-blaming. What you have there is a feedback loop.

My body and brain have been going different directions of late. My mood disorder has lessened and my brain doesn’t seem to be trying to kill me at the moment. This is good.

However, my body is experiencing all kinds of unpleasant disorders and sensations. Some – the thinning hair, the jowls, the weakened eyesight – are simply functions of aging. This does not make them any easier to deal with. They are wrapped up in my self-confidence, my sexuality, my identity, how others perceive me, and how congruent my self-image is with reality.

Stress symptoms have affected me at least since junior high. I developed a tic in which my chin would jerk up and to the left, making it hard for me (or anyone sitting behind me) to study. My doctor put me on Valium, which stopped the tic, but did no good, I’m sure, for my then-undiagnosed bipolar disorder.

Other physical ailments and disorders are the result of specific events or diseases. I have a bad back, which required two operations, the second because I irrationally thought it would be a good idea to ride an Arabian horse bareback. The experience has left me with nerve damage in my left toes – idiopathic radiculopathy, they call it – and an unsteady gait that sometimes necessitates the use of a cane for balance. It does not make me look or feel any younger.

Also, my hands shake. My neurologist called this an “essential tremor,” which means it’s caused by nothing in particular. He noticed that I often sit with my hands folded in my lap to call less attention to it. Between this and my balance issues, sometimes I stagger and shake like an old street rummy. A friend, God bless him, once told me I had a long way to go before looking like a street rummy. It was nice to hear, no matter what my brain tells me.

When my brain was acting up the worst, it also gave me the worst physical symptoms. My reflexes were hypersensitive and that included the reflex that empties my bowels. Just imagine the literal shitstorm I created in the bathroom of a bookstore one day. Then imagine how much of my self-esteem got flushed along with the rolls of toilet paper I used to try to clean it up. Imagine the humiliation of telling a store clerk, “Someone’s been very sick in the bathroom and you probably need to send a janitor.” I’m sure she knew it was me, because of how embarrassed and sickly I must have looked, but we both pretended that I was simply informing them that an accident had occurred.

Needless to say, all these conditions make me not want to go out amongst people, which adds to the isolation that my bipolar disorder already exacerbates. And when I don’t get out, my body doesn’t get moving, and I become even more immobilized – both physically and mentally.

Like I said, Stress Plus – a vicious circle.

We’ve Got Demons in Our Heads. Again.

I posted this just after the Charleston shootings, but it needs saying again.

The media don’t say it in so many words, but that’s what they mean when they talk about “mental illness” after a tragedy, especially one that involves gun violence and mass murder.

Demons are responsible. And those demons are the mentally ill (and/or) their medications (or lack of medications). Any way you look at it, we are the demons.

Here’s one of my favorite examples lately:

“It seems to me, again without having all the details about this, that these individuals have been medicated and there may be a real issue in this country from the standpoint of these drugs and how they’re used.”

This was from Rick Perry, Daily Kos reminds us, “the fellow who destroyed his last presidential bid after a bizarre debate performance that he later blamed on prescription painkillers he had taken beforehand.”

(Don’t you love that part about speaking without having the details?)

And this, from Mike Adams, who calls himself “The Health Ranger” and Editor of NaturalNews.com:

The headline is “Every mass shooting over last 20 years has one thing in common… and it’s not guns.” The article is actually a reprint of “an important article written by Dan Roberts from AmmoLand.com.”

(NaturalNews sounds maybe okay, but when the source is AmmoLand, you’ve got to wonder about bias.)

Here goes:

“The overwhelming evidence points to the signal [sic] largest common factor in all of these incidents is the fact that all of the perpetrators were either actively taking powerful psychotropic drugs or had been at some point in the immediate past before they committed their crimes.”

Then follows a list of people, crimes, and drug names. The list was compiled and published to Facebook by “John Noveske, founder and owner of Noveske Rifleworks just days before he was mysteriously killed in a single car accident.”

(Again note the source and possible bias, plus the hint of conspiracy theory. Gotta love it.)

Want something more mainstream? How about Newsweek?

“Charleston Massacre: Mental Illness Common Thread for Mass Shootings,” by Matthew Lysiak:

“…. If history is any indication, the shooter most likely has a history of severe mental health issues that have either gone untreated or undiagnosed.”

He then provides a list of crimes and psychiatric diagnoses with a number of the same instances as the AmmoLand account, though not a listing of medications.

The author goes on to say that the “rise [in mass shootings] correlates directly with the closure of the mental health institutions in 1969, according to mental health experts.”

(Correlates with – not caused – please note. That’s important. I’ll have more to say about that, probably next week.)

Lysiak goes on to say that the requirements for civil commitment (read: involuntary) are too loose. He quotes Liza Gold, a forensic psychiatrist in Arlington, Virginia: “The commitment requirement needs to be less strict. Today it currently requires both mental illness and dangerousness to have someone committed. I think we need to focus more on the dangerousness and keep these people from getting guns.”

If that’s so, we should be worried more about “sane” people such as abusive partners with histories of violence and restraining orders than about the mentally disordered, shouldn’t we? Comments revealing that “most people who commit acts of violence don’t exhibit signs of mental illness, and most people who are mentally ill are not violent” are buried near the end of the article.

Fortunately, not all the media are demonizing the mentally ill, though the dissent doesn’t seem to be coming from the major media. Slate and Salon have published articles that question the automatic connection.

The article on Slate, by Anne Skomorowsky, is long, and refers to the Germanwings airplane deaths, but it’s thoughtful reading and well worth the time.

“Because Germanwings pilot Andreas Lubitz killed himself when he purposefully drove a plane carrying 149 other people into a mountain in the Alps, there has been an assumption that he suffered from “depression” — an assumption strengthened by the discovery of antidepressants in his home and reports that he had been treated in psychiatry and neurology clinics.” She adds, “Lubitz did not die quietly at home. He maliciously engineered a spectacular plane crash and killed 150 people. Suicidal thoughts can be a hallmark of depression, but mass murder is another beast entirely.”

And the take-away: “Many patients and other interested parties are rightly concerned that Lubitz’s murderous behavior will further stigmatize the mentally ill.”

Salon’s Arthur Chu talked about the more recent Charleston, SC, shootings and other incidents in “It’s not about mental illness: The big lie that always follows mass shootings by white males.”

“I get really really tired of hearing the phrase ‘mental illness’ thrown around as a way to avoid saying other terms like ‘toxic masculinity,’ ‘white supremacy,’ ‘misogyny’ or ‘racism.’

“’The real issue is mental illness’ is a goddamn cop-out. I almost never hear it from actual mental health professionals, or advocates working in the mental health sphere….Seeking medical help for depression or anxiety is apparently stronger evidence of violent tendencies than going out and purchasing a weapon….Doing the former is something we’re OK with stigmatizing but not the latter.”

I’ll let that be the last word, fellow demons. Until the next time, that is. Until the next time.

Correction: The Skomorowsky article appeared on Slate, not Business Insider, as originally stated. I have fixed the text and regret the error.

Here are the references for the articles cited, in order:

http://www.dailykos.com/story/2015/06/19/1394713/-Rick-Perry-says-guns-aren-t-to-blame-for-Charleston-accident-it-was-prescription-drugs

http://www.naturalnews.com/039752_mass_shootings_psychiatric_drugs_antidepressants.html

http://www.newsweek.com/charleston-massacre-mental-illness-common-thread-mass-shootings-344789

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/germanwings_co_pilot_mental_illness_suicide_is_linked_to_depression_but.html

http://www.salon.com/2015/06/18/its_not_about_mental_illness_the_big_lie_that_always_follows_mass_shootings_by_white_males/

Social But Spoonless

In the past week I have been out of the house more and seen more people than I have in years. It’s almost like having a social life.

In the past week I have also slept more than I usually do in my sloth-like, torpid existence.

I think the two are not unrelated.

If you follow Spoon Theory (http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/) you know that each spoon represents an amount of coping that you can do.

Every day you get a certain number of spoons – not the same number every day.  You use them to perform everyday tasks that most people think nothing of – things like getting out of bed (some days you don’t even have that spoon), taking a shower (1/2 spoon for Janet’s patented “super-fast smelly-bits sink wash-up”), getting dressed, finding something to eat, fixing that something (keep a box of Cheerios by the bed in case you run out of spoons at this point), and all that is without even leaving the house. Some days that’s all the spoons you have and when you’ve used up your spoons, that’s it.

Other days you can manage to do all that and leave the house, go to work, run errands, and assorted other normal activities. But for those of us who have mental disorders, such days are few and far between.

You hear depressed people talk of not being able to get out of bed, and for the most part that’s caused by lack of spoons. I am usually notoriously low on spoons. My husband now understands Spoon Theory and we use it as common shorthand for “I’m too tired” or “That’s all I can handle right now.”

Dan, however, is an over-scheduler and I often have to rein him in by pointing out that his proposed slate of activities will not be possible because I, for one, will run out of spoons, and he may too.

The dry run for my recent spurt of socializing began last week. After I went for my final session with Dr R., I managed a trip to the bank, a trip to the place where I could pay my power bill, and since it was right next door, a stop at Kmart to buy underwear. It was a good thing that was a hypomanic day, but it floored me for the rest of that day and the next. And it started a cycle of bipolar up-and-down oscillations that were clearly related to spoon usage.

My spate of social endeavors started with a double-header. On Saturday I had lunch with a friend at a favorite restaurant I almost never get to go to. We talked about politics, social issues, and book proposals. Then I went home and had a little nap.

That evening Dan and I went to Monkey Bones for Zombie Dogz. I know that takes a little explaining. Monkey Bones is the tattoo studio where I got my semicolon tattoo (http://wp.me/p4e9Hv-9G). Zombie Dogz is a local food truck. (Also, it’s fun to say “We went to Monkey Bones for Zombie Dogz.”)

Notice that in a single day I had to get up, out of bed, and get dressed twice. That’s a lot of spoons. Sunday I was not able to get out of bed at all.

Monday did not involve socializing, but it was another hellacious spoon-eater. Dan and I spent the day scrounging for documents and information that the IRS wanted. It was taxing. (See what I did there?)

Tuesday was an extra-special social event, though it did not involve getting dressed and going out, or even interacting with other people. It was Jenny Lawson’s online book launch party. Better known as the Bloggess, Jenny has severe social anxiety. At this stage in my life, I certainly would not be able to dress up, mingle, and make polite conversation with both friends and complete strangers. The online party was a genius idea.

I sat at home in my pajamas with some red wine while the Bloggess read chapters from her new book, Furiously Happy. (You should get it, by the way. It’s about mental illness, but funny.) As low-key a social situation as that was, it still used up spoons because it was something I had never done before. Making sure I had the right URL, converting Central Time to Eastern, not being able to ask questions because I don’t Tweet, worrying that Dan was getting bored – not a lot a lot of spoons, but still some.

The effects were getting cumulative. Again I was unable to get out of bed the next day. In fact, Dan and I both slept away most of the daylight hours. For him it’s understandable because he works third shift, but I have no such excuse. Except that if you borrow from the next day’s spoons, or try to keep going without them, you will pay.

Thursday, I was determined, with or without spoons, I was going to meet a friend for coffee. I’ve seen her only once, briefly, in several years. In a way, it was a test of my ability to maintain anything approaching a real social life.

I put forth the extra effort because a mutual friend cut her ties with me because I canceled so often on social engagements. I suppose I really have nothing to prove to anyone but myself but it seems important that I do so. It’s not like coffee with a friend is an ordeal or anything. It’s just that I know I’ll be using a spoon for more than stirring my coffee.

And I hope I have enough spoons left over to work on my other blog.

The Quest for a Psychiatrist

I have been seeing Dr. R. for eight years. He helped me through my major meltdown and skillfully, gradually mixed the cocktail of medications that would get me and keep me functioning at an acceptable, livable level. He got me through my near-brush with ECT (although he also suggested it).

Dr. R. is moving to another state. He sent all his clients a letter listing half a dozen or so local psychiatrists he could recommend, though he didn’t know if they were accepting new patients or what insurance plans they took. This week was my last appointment with him.

I looked at the inch-thick file he was holding. “I was really messed up back then,” I said.

“Yep,” he replied.

I left with a hearty handshake, good luck wishes, a paper stating my diagnosis (bipolar disorder, anxiety disorder – I guess there was no insurance code for bipolar 2) and six months of refills on my prescriptions. That’s how long I have to find a new psychiatrist.

So where will my inch-thick file end up next? That’s a good question.

I’ve written before about finding a psychotherapist (http://wp.me/p4e9Hv-1m), but oh, I hate the process of finding and breaking in a new shrink.

At least this time I probably won’t have to go through the whole Reader’s Digest Condensed Version of my screwed-up life, since what I really need at this point is someone who will prescribe and monitor my meds, though it will also be nice to have someone standing by in case of another major meltdown, should I have one.

My first avenue of exploration is whether my primary care physician will prescribe my psychotropics, so I can continue with just a psychotherapist. Dr. R. says that most GPs would shy away from the somewhat lengthy list of meds, but every time I see Dr. S. I update him on what meds I am taking, and I always mention the psychotropics, which have mostly been the same for years.

I have an appointment to see Dr. S. next month and sent a query about the prescription issue (his office has a robust online presence), so with luck, I may have a solution before Halloween.

My next step would be to start with the list that Dr. R. provided. Only one of the offices is at all close to me and I’ll likely start there. Does the doctor accept new patients? Does the practice take my insurance? What’s the charge if they don’t?

I’ll also need to contact my insurance provider for a list of local psychiatrists who do take that insurance, but with that I’ll be flying blind. Dr. R.’s recommendations are people he knows, and knows are good.

I hope they’re as good as Dr. R.