Bipolar 2 From Inside and Out

Language Lost

October 22, 2023

There are many words that are specific to psychology, including diagnoses, symptoms, and therapeutic techniques. Many of those terms, however, have worked their way into general conversation. Some think this is a good thing as it makes society more aware of the language we as psychiatric patients use. Others object to this use of language. They see it as diluting the meaning of the terms.

Two of the most common words that have made this shift are bipolar and OCD. Instead of diagnoses, they’re often used as descriptions of people or things that are thought to share the characteristics of the disorders. “The weather is bipolar this month.” “Beth’s house is really tidy. She’s so OCD.” These usages are, of course, inaccurate. Weather can’t have a psychiatric disorder, and a neat house is not enough to diagnose a person with OCD.

The thing is, people aren’t using them literally. Weather being bipolar is a metaphor. It conveys the idea that the weather is changeable, seemingly randomly. Calling weather bipolar expresses the concept more vividly, which is probably why it has become so popular. Calling someone OCD is an exaggeration used for effect. They’re saying that Beth is not just neat, but excessively neat. The people who use these expressions don’t have any real idea of what the terms mean. They’ve just heard them used and have only a vague, superficial idea of what they mean.

Spoons is another metaphor gone astray. Originally, it was used to describe the depletion of energy that someone with an “invisible illness” feels when they’re required to do more than they’re capable of on any given day. Spoons are a variable commodity. The neurodivergent or physically challenged never know how many “spoons” they will have at the beginning of a day and when they’ll run out of them. It’s a very powerful metaphor which makes it easier to understand the concept.

Nowadays, however, it’s used by people who don’t face these challenges to mean simply “I’m tired” or “I’m done for the day.” But these people don’t have a widely varying amount of energy at the start of each day. Oh, they may be more or less tired depending on the quantity and quality of their sleep. But they don’t begin with so few spoons that getting out of bed requires an enormous expenditure of spoons that depletes them for the rest of the day.

The word triggers is not a metaphor, but a word that has weakened over time. In psychological terms, a trigger is something that brings back vivid memories and sensations of a traumatic incident. The person who is triggered cannot control their reactions and will experience the event as if it were actually occurring in real-time. In its new meaning, a trigger is anything that a person doesn’t like or causes them to be uncomfortable. This discomfort is minor and fleeting, and does not cause sensory overload. People who use “triggered” this way betray a deep misunderstanding of the term and often make fun of the concept altogether.

These and other terms like neurodivergent and spectrum are also frequently misunderstood or misused. Some are still being defined and arguments about what they really mean often occur.

People who use the words in their specific, technical sense sometimes speak of “reclaiming” them. They are offended by the perceived misuse of the various terms and want to restrict them to their original, technical meanings. They want other people to stop using them in their new senses. They feel the new usage cheapens the words.

The thing is, language doesn’t work that way. Once a word or phrase has “escaped into the wild” and is being used with a different shade of meaning, there’s no getting it back. No matter how much you try to educate people about the “real” meaning of the word, most people will not even realize they are using it “wrong” and won’t stop using it in the new sense. In fact, the first dictionary definition of bipolar is “having or relating to two poles or extremities,” not the disorder. The non-psychiatric sense of OCD as an adjective hasn’t made it to the dictionary yet, but it’s only a matter of time now.

Personally, I can think of things a lot more heinous than describing me and the weather the same way. Is it ignorant? Yes. Is it insulting? Probably. I just think it’s a waste of time correcting one person at a time or trying to educate the masses about it. Millions of people are still going to do it, and there are more important things to educate them about.

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Stigma, Prejudice, and Discrimination

October 15, 2023

Those of us with brain illnesses such as bipolar disorder, OCD, PTSD, and schizophrenia often speak of the stigma associated with our problems. It’s no wonder—stigma affects our lives in both predictable and unpredictable ways.

For instance, say you’ve become comfortable talking about your disorder. Then one day when you’re at a reunion or some other gathering, you happen to mention it and get the glazed-eyes-fixed-smile-back-away-slowly response. Sure, a lot of people don’t know what to say to you, but that reaction just makes it clear that you are different and, to that person, potentially a source of danger. Someone to be avoided. Someone not to engage with.

That’s stigma.

Prejudice is related to stigma. It’s just a short step away. Prejudice happens when people have a preconceived idea of what brain illness looks like. (That’s what prejudice means.) This could be a person who assumes that a serial killer or mass shooter is obviously “insane.” Their assumptions are reinforced when it’s revealed that the perpetrator had a history of psychological problems or had taken medication. They’re ignorant of the facts—that most killings are prompted by motivations such as rage, gender or racial hatred, jealousy, or fear. They don’t know that the mentally ill are much more likely to be the victims of violence than to be perpetrators.

People with prejudice against people with mental illness can also assume that psychiatric diagnoses are not “real.” They think people with these conditions can—and should—just “snap out of it,” “pull themselves up by their bootstraps,” or “get over” their problems. They look down on people who seek help. They make jokes about “crazies” and “lunatics.” They believe that anyone with a “real” mental illness is in a locked ward in an “insane asylum,” or should be. They don’t know that straightjackets aren’t used anymore and feel they’re funny Halloween costumes.

In other words, people who are prejudiced lack understanding and empathy.

Discrimination takes it one step further.

When people with brain illnesses suffer from discrimination, they lose opportunities because of their condition. If they are open about their diagnosis on applications, they may never receive a callback or an interview for a job. They may start receiving bad evaluations at work if they have to leave for doctor’s appointments or be let go for not getting along with other workers, many of whom may have prejudice against them. They don’t receive the accommodations required by the Americans with Disabilities Act (ADA).

Discrimination can also be involved with decisions from Social Security Disability. It’s not supposed to be that way, but people with mental illnesses are likely to have more difficulty “proving” that they have a disability severe enough to warrant supplemental income.

So what’s to be done? Education is the solution we always advocate. But it’s a hard ask. It’s difficult to get anyone to learn about the realities of brain illnesses. They don’t learn about it in school, and the messages they get from the media do little except reinforce the stigma surrounding the various conditions. In fact, they perpetuate much of the stigma.

Pushback is another strategy. We simply cannot let it pass when someone makes a prejudiced remark or demonstrates a lack of understanding. We can speak up about inappropriate Halloween costumes or assumptions about violence and the mentally ill. We can inform others that not all homeless persons are mentally ill. In fact, most homelessness is caused by a lack of affordable housing and low wages.

When it comes to discrimination, legislation and activism are often the solutions or at least the beginnings of them. Lobbying efforts regarding policy and treatment will help. Lots more needs to be done to inform legislators about the very basics, much less the possible ways to address the problems. Reporting violations of the ADA may not lead to resolutions, but it still needs to be done.

Of course, it’s difficult for many people with brain illnesses to do these things. We are frequently isolated and doubt our own abilities. Confronting legislators, educating them, and lobbying for their attention is daunting. Neurotypical people have trouble doing it, especially without an organization that gives them leverage. But it’s work that needs to be done. I admit that I’m not at the forefront, though these blog posts and my books are intended to help educate, and the groups I belong to try to do likewise.

It’s not enough. But it’s a start.

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Mental Health

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Positivity and Acceptance

October 8, 2023

Those who follow this blog have seen me rail against toxic positivity. When it’s not absurd, it’s insulting to those of us with mood disorders. No, we can’t just cheer up. If we could look at the bright side, we wouldn’t have depression or anxiety. You may be able to choose happiness, but I can’t. I’ve needed medication and therapy just to feel meh at times. If I could turn bipolar disorder off like a light switch, don’t you think I’d do it?

Toxic positivity can be seen nearly everywhere, in a lot of different situations: the self-help movement, of course, but also business, medicine, and even religion – as well as endless memes. American society is rife with toxic positivity. It appears in motivational business conventions and TED Talks. Salespeople are advised to think positively and envision success. Breast cancer survivors are advised to keep a positive attitude, to the extent that they are encouraged to tell how the disease has had a positive effect on their lives and relationships. (Expressions of fear, anger, and other natural emotions in response to the diagnosis are downplayed or discouraged.) Religions can exhort us to count our blessings or “manifest” our wants and needs by using positive thoughts to attract them.

Positivity becomes toxic when it is seen as the only method of coping with problems in life, even ones that have other solutions or none. Toxic positivity presents relentless cheer as the only acceptable reaction and a panacea for every difficulty. And toxic positivity leads people to demand that others take up the mindset and apply it to every situation, even devastating ones. As such, it denies the reality of human suffering and normal emotional responses. It’s a form of non-acceptance.

So, what is the alternative? What is a more natural – but still effective – technique for dealing with difficulties? How can those of us who have mood disorders or any other brain illness find ways to navigate through life without slapping on a smile and coercing our emotions to fit a certain mold?

Radical acceptance is one answer. Radical acceptance means that you accept your inner feelings and your outward circumstances as they are, especially if they are not under your control. You acknowledge reality without trying to impose a set of emotional mandates on it. Your acceptance and acknowledgment may involve pain or discomfort, but those are understandable, normal human conditions. They are natural conditions that evoke a natural response.

Rooted in Buddhist teachings and given a name by Marsha Linehan, the psychologist who developed dialectical behavior therapy (DBT), radical acceptance uses mindfulness to help people learn to face and regulate their emotions. Interestingly, one 2018 study found that accepting your negative emotions without judgment is a factor in psychological health.

With radical acceptance, when you encounter difficult situations and emotions, you note their presence without trying to suppress them. You accept them, as the name implies. This attitude can address – and reduce – feelings of shame and distress that you may feel, especially when you are not able to simply shut off those feelings and replace them with positivity. That doesn’t mean that you wallow in unpleasant feelings or allow unfortunate circumstances to stunt your responses.

Instead, you note the feelings – accept that they exist – and “hold space” for them within you. You appreciate that your emotions can lead you to new understandings of and reactions to your circumstances. For example, instead of adhering to the unattainable maxim that “Failure is not an option,” you can recognize when you have indeed failed and accept it as a natural part of life. You can then move on to a mindset of growth where you use that failure to inform your future actions. You develop a more accurate picture of the world and can begin implementing real solutions.

Of course, there are situations where radical acceptance is not appropriate. Abusive situations, for one, shouldn’t simply be accepted without being addressed. But neither will positive thinking resolve them. They require action, from seeking help from a trusted individual to leaving the situation to contacting law enforcement or an organization that can help.

But in other circumstances, radical acceptance may be an answer for some. For myself, I’ll just be satisfied if radical acceptance helps drive out toxic positivity. I don’t think it will, but a person can dream.

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It’s Me This Time

October 1, 2023

I was talking to my mother, and I became very upset. I don’t remember now what we were talking about or what specifically I felt. It could have been disappointment because my parents could only afford a community college rather than a four-year university. It could have been sorrow caused by the breakup of a friendship. It could have been distress because someone made fun of me.

Whatever it was, I began crying. And as was common back then, once I started crying I couldn’t stop. My out-of-control emotions led to an out-of-control reaction.

And then my mother said, “Everyone goes through this at times.”

My instant thought was “But this time it’s me.”

I know I don’t have a monopoly on suffering. Looking back, the things that aroused an emotional storm in me were nothing much, things that could be remedied. I applied to four-year universities anyway and got a scholarship deal that allowed me to enjoy a first-rate education. I somehow managed to make new friends. I learned to cope with other people’s reactions to me, eventually.

Still, my emotions remained stormy. I would cry over anything or nothing. I would feel hurts intensely and break down frequently.

But I maintain that my reaction to my mother’s undoubted truth had some validity. When difficulties hit, knowing that others had experienced the same hurts and disappointments did not help me. I was experiencing these events through a lens of intense mood swings – bipolar disorder. And that’s not something that “everyone” goes through.

It’s true that I overdramatized just like any teen to a certain extent. But there was an added edge, a force driving my emotions past the normal. I couldn’t control what I was feeling or how extremely I expressed it. My disappointment was devastating. My sorrow was cataclysmic. My distress was hysterical. It’s no wonder my mother had no idea what I was feeling or how to deal with it. I didn’t know myself.

When people talk about bipolar, we usually talk about the back-and-forth, the rollercoaster. The intensity of the feelings gets less attention. It’s not just that we have mood swings. It’s that those moods are often out of control.

Seeing that from the outside, as my mother and my friends did, was no doubt beyond confusing. We may all go through these moods, but not everyone has the added emotional kick of bipolar pushing them past the normal into a realm that we ourselves don’t understand. If it was confusing for my loved ones, it was equally or more confusing for me.

I was like that for a long time. My experiences at college and after were colored by the fact that I didn’t know why I was the way I was. I went many years being beaten up by my own mind, my own emotions, my own brain. I despaired of ever finding a way out, and my despair was extreme, too.

Now, I’m diagnosed and medicated appropriately. I still have times when my emotions go a bit beyond the “norm.” I still have breakdowns occasionally. My startle reflex is exaggerated, and my anxiety still overwhelms me sometimes.

But at least now I understand what’s happening and why. Now, I seldom have to envy the “everyone” who experiences everyday life with less intense emotions. I may still have mood swings, but they no longer dominate my life. They’re more in line with what the general population would consider average.

I’ve finally achieved the stability that my mother knew deep down I didn’t have, even if she didn’t understand why not. I’m not knocking her; I didn’t understand it either. But I’m not that different anymore. And while I used to have a love-hate relationship with the concept of “normal,” I don’t hate it the way I did. Now, I’m more a part of “everyone.”

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Mental Health

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Time Out From Life

September 24, 2023

I was stuck during my first year in college. I was a linguistics major and couldn’t see my way clear to a career in the field. I thought about changing my major to random ones like landscape architecture and hotel management. I had no passion for either one, but I figured at least I could get a job.

I was also suffering from a major depressive swing. I missed classes, though I managed to pass them. I couldn’t sleep. I spent hours in the middle of the night sitting in the hallway, staring at an ornate coloring poster on the opposite wall, hypnotized by its intricate black outlines.

I decided to take a year off. I was incapacitated and couldn’t go on at that time. I figured I could reassess my choice of majors while I pulled my head together. I always had the intention of going back at the end of that time out.

I also needed money for that next year of college, so I got a job as a cashier and waitress on the second shift at a local Frisch’s restaurant. I was a good cashier and a lousy waitress, and I spent quite a bit of time in the bathroom, crying into the roller towel. I learned how to swear. My coworkers noticed that I was either worried and anxious or numb and sad. (One manager asked me, “What does a girl your age have to worry about except am I pregnant?” The other told me to smile more. Needless to say, this was not helpful.)

That time out from college was important to me psychologically. It didn’t solve my problems, and I was still undiagnosed and unmedicated. I began to realize that my problems went further than what my major was. And I made friends at work and learned a lot about self-reliance. I had time and space to think. My parents and my high school friends formed my support system.

I did go back to college the next year. I changed my major to English, which was more satisfying and more in line with my interests (though not really better on career possibilities). I continued through the next three years without taking more time off. As you may have guessed, the anxiety and depression didn’t leave. I had a fling with a musician – my first – and when it ended, I didn’t know how to handle it. Then I had a totally disastrous relationship, fraught with gaslighting. Again, I had trouble sleeping. I lost weight. I drank too much. The swings between hypomania and depression were noticeable.

When I graduated, I went back to working at the restaurant, then got a job at an advertising agency as an assistant to the treasurer. I moved into my own apartment and began a long-distance relationship with my eventual husband. I considered going back to school for an M.A., again in English, which I eventually did. I was still untethered, but I went into treatment for depression. (It wasn’t until many years later that I learned that my diagnosis was really bipolar.)

A depressive swing also caused me to take a time out from work later in life. This was the one that lasted two years and had me applying for disability. (I didn’t get it.) It was only psychologically important in that it graphically demonstrated how badly I needed help. At least the time I missed from college was something I chose to do rather than something that blindsided me.

The takeaway from all this, I think, is that the ups and downs of bipolar disorder mean that my life was destined not to go smoothly. While I am pretty high-functioning – I was able to earn college degrees and hold various jobs, at least for a while – there have been times when my illness has overwhelmed me and I need time out from my “normal life.” And those occasions come on me unpredictably, as is the way of bipolar mood swings. While I haven’t needed to, or been forced to, take a time out lately, I know it could still happen. That’s just the nature of the disorder. I hope my medication and therapy will make the possibility less likely, though.

If you’ve taken a time out too, I’d encourage you not to think of it as a permanent thing. It could be something that you needed to do, and something that may have relevant significance for you as you look back on it, as was true for me. Most of all, I hope you get help and support to get through it.

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What Is It With Showers Anyway?

September 17, 2023

Girl is choosing cosmetics in bathroomIt is fairly widely known that people with bipolar disorder and/or depression have trouble taking a daily shower. It’s not that we don’t know what’s involved in taking a shower, or why it would be good for us to do so, it’s simply that showering uses up a tremendous number of spoons.

Here’s what showering looks like according to Andrew Solomon, author of the now-classic The Noonday Demon:

I ran through the individual steps in my mind: You sit up, turn and put your feet on the floor, stand, walk to the bathroom, open the bathroom door, go to the edge of the tub…I divided it into fourteen steps as onerous as the Stations of the Cross.

I performed a similar exercise in one of my blog posts and here’s my version:

First I have to find a clean towel and a bar of soap, get undressed without seeing myself in the mirror, fiddle with the water temperature, wash and shampoo, dry off, find clean underwear, and that’s not even thinking about drying my hair and figuring out what I can wear! Oh, my God, I’ve used up all my spoons just thinking about it! I should just eat Cocoa Puffs and go back to bed.

Now let me say, first of all, that I don’t really like showers. I grew up taking baths and have never enjoyed the sensation of water spraying in my face. But with my bad back and bad knees, getting up from sitting in a bathtub is nearly impossible these days. (Please don’t ask me why anyone would want to sit in dirty water. Everyone says that when I say I prefer baths. I have a nice long soak, steeping in the clean water like a big teabag, and only then wash up and get right out. Used to, I mean.)

To most people, showering is a single act that requires the expenditure of a single spoon. Take a shower; that’s it. But for those of us with invisible illnesses, each separate step may require its own spoon. Take something as simple as finding a towel, for instance. Go to the linen closet, grab a towel and voilà! Only a fraction of a spoon, if that.

But surely you don’t think I have had the spoons to fold and put away my laundry. It is all there in a jumble on top of the dryer. (Who needs a wrinkle-free towel anyway?) I have to root around to find one, and maybe twice if a cat has thrown up on the first one I pick. (They love sitting on clean laundry.)

If I have to go to a business meeting I force myself to use some of those spoons showering and getting dressed and acting respectable. But I will pay for it later, collapsing after the meeting in need of a mega-nap.

Now here’s a little secret I’ll tell you. Most people believe you gain spoons by going out of the house – walking in the fresh air, meeting friends for lunch, shopping, going for a drive (does anyone do that anymore?). But the fact is that, according to Spoon Theory, you get a certain number of spoons every day when you wake up. You cannot gain, buy, beg, borrow, or steal any more spoons, not even by breathing fresh air. You can only spend them.

Given the mathematics of spoons, I don’t spend a single one that I don’t absolutely have to. Not going out? No shower. Have to go out for a loaf of bread or a drive-through meal? Wash up in the sink. If I need a shower between outings, my husband reminds me and facilitates by, for example, rummaging on the dryer for a clean towel and clean clothes or a clean nightshirt.

I need those spoons for doing my work at home in my smelly pajamas more than I do for the ordeal of showering.

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Mental Health

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Abigail Padgett and Her Bipolar Heroine

September 10, 2023

abigailpadgettcIn 1994, writer Abigail Padgett published Child of Silence, the first in a series of mysteries featuring Bo Bradley, a child protection advocacy investigator – who just happens to have bipolar disorder (or manic depression, as it was more commonly called back then). The series continued through four more books – Strawgirl, Turtle Baby, Moonbird Boy, and The Dollmaker’s Daughter. (All are still available as ebooks.)

Recently, I had the opportunity to ask Padgett some questions about her books, her protagonist, and the state of mental healthcare today.

Is there anything you would change about Bo Bradley, given the advances made in understanding bipolar disorder and medication for it?

Not really. There are some new meds and public understanding is better, but the experience of people who live with real, clinical mood disorders is still fraught, dangerous, and revelatory.

Bipolar disorder is better understood by the general public now than it was 20 years ago – to an extent. But the general public, including me, cannot ever actually “get” what a manic or depressive or psychotic episode feels like. The best that can be hoped for is an acute public interest and support. Movies, especially like Touched With Fire, are enormously helpful.

What do you think of Stigma Fighters, the Semicolon Project, and celebrity awareness campaigns? Are they having much effect?

Hard to say anything about effects without any data, but . . .  I think focusing on the big corporate/cultural atrocities is really important. Examples are a two-page NYC menswear ad in which the front page said, “If you’re paying $50 for this shirt . . .,” turn to reverse of page, “then you should be wearing this one”  (photo of a straitjacket).  The store, Daffy’s, actually got an award for that ad! Then there was John Deere’s “schizophrenic tractor” and a tire company here in CA that did a horrible TV ad showing a man in a straitjacket in a padded cell trying to eat a cake with no hands. years ago I worked with Jean Arnold and Nora Weinerth for the National Stigma Clearinghouse. The idea was to go after major companies that ridiculed psychiatric illnesses, diagnoses, doctors, or anything associated with mental illness.

Stigma Fighters seems to be a venue for supportive communication and that’s good, but it doesn’t have much effect outside itself.  And I love the Semicolon Project idea!  A good image is worth a million words in terms of broad impact, and I hope that one can organize and grow into a significant movement.

Celebrities? Any day that a celeb states publicly that s/he is living with a psychiatric disorder is a good day. Americans adore and identify with celebs. (Not good for either Americans or the celebs, but nonetheless the way it is.)

What one change would you most like to see in the mental health care system?

One?  Have to go with funding. Funding for psych research; for psych hospital care for as long as it takes, not just a week or two; for clean, professionally staffed respite centers in every town; for attractive, professionally staffed halfway houses; for arts programs, job training, theater tickets – you know, the world?

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Beating Bad Thoughts

September 3, 2023

I saw a meme today. It said:

“Just do what you can today, okay? It will be enough.”

Instantly my brain said, “No, it won’t.”

My brain, uncooperative at all but the very best times, has a habit of telling me bad things when I’m in a depressive episode: “You’re useless.” “You’re pathetic.” “Everything you do fails.”

For some reason, positive thinking memes and slogans bring out the worst in my brain. If a pass-along or a bumper sticker tells me that tomorrow will be brighter, my brain says, “No, it won’t.” If a meme says, ” I hope the situation you worry about favors you in the end,” it says, “Yeah, like that’s gonna happen.”

Is my brain simply cranky and uncooperative? Well, yes. But these intrusive thoughts reinforce and deepen my depression, chip away at what self-esteem I still have, deny my progress in healing, and make me resent the whole happy, smiley world that apparently everyone but me can see.

Is there anything I can do to make my brain shut up, or at least pipe down with all the negativity?

I’ll tell you what doesn’t work for me: daily affirmations. My brain tells me these are lies and that I shouldn’t believe them. I can’t look into a mirror and repeat five times, “I am a good, worthwhile person” or “I deserve happiness” or “I will overcome my problems.” It’s like the problem of seeing cheery, encouraging memes on the internet, only having to inflict them on myself. If anything, they make me feel worse.

If these sorts of things work for you, fine. I’ve no objection. I won’t make fun of you. I’m truly glad you’ve found something that helps you.

They just don’t work for me.

So what can I do?

I have gleaned two helpful hints from my therapist. Both are visualizations, and both are metaphors. And both involve animals. (They are variations on a technique called “thought stopping,” which is simpler and more direct. But I find visualizations easier to remember and do. I love metaphors.)

The first comes from a mindfulness meditation that Dr. B. asked me to try. I’m not much good at meditation, because of both my intrusive thoughts and my anxiety. Sitting still for that long is difficult, and so is emptying my mind of thoughts to concentrate on my breathing, for example.

The narration that guided the meditation had a solution for this. When your mind wanders and your thoughts drift off to somewhere else, think of them as puppies that wander away when you’re trying to teach them something. Gently corral them and nudge them back in the right direction. You don’t have to panic and shout, “There they go!” and run off after them. You just give them a little push toward where you want them to go. If they wander again, do the same thing. “What about the mortgage payment? Come back, little puppy. Over here.”

The other technique is for the kind of bad thoughts that I often get: anti-affirmations or negatives that deny any suggestion of peace or happiness or accomplishment. For these, Dr. B passed along an idea that another client had given her. Imagine that your bad thoughts are naughty cats, who jump on the kitchen table or try to go fishing in your aquarium. Then imagine spraying the bad thought (cat) with a bottle of water to make it stop what it’s doing and scram. “I never do anything right. Psssst! Psssst!”

When I’m profoundly depressed, I doubt even these clever dodges will work, though I’m certainly going to try them. But when I’m just starting on the slide down, I predict they’ll be just the thing to trick my brain into submission.

Take that, brain! Psssst! Psssst!

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The Therapeutic Hug

August 27, 2023
The common wisdom is that a person needs four hugs a day for survival, eight for maintenance, and twelve for growth. I doubt that this is confirmed by any scientific studies and I doubt that it is true. If it were, there would be millions of people on Earth who would not survive. I would be one of them. Despite being married to one of the two truly world-class huggers I’ve met in my life, I do not get my four-a-day. And certainly not twelve. Assuming eight hours a day for sleep and eight hours a day for work, that would leave eight hours to work in twelve hugs. That’s one and a half hugs per hour, and I suspect half a hug just won’t do. In fact, I know it won’t. Scientific research has been done on the 20-second hug. It releases oxytocin, a pleasure and bonding chemical in the brain. Half a hug would need to be 40 seconds long to do the proper amount of good, and young lovers and newlyweds tend to be the only people who give hugs of that duration. Then there’s the question of what constitutes a hug. For greatest oxytocin effect, I would recommend the full body hug – toe to toe, torso to torso, heads on shoulders, arms tightly squeezing. But you probably can’t give that particular hug when you run into an acquaintance in the supermarket, especially not 20 seconds worth, without blocking the aisles. Other variations of hugs that may be less effective are the side-by-side one-shoulder squeeze (and the multi-person variant, the Big Group Hug), the manly back-thumping, and the A-frame hug (standing a distance apart and leaning in for a hug from the shoulders up). Then there are the virtual hug, often written ((hug)), with the number of parens indicating the length/intensity of the hug, and the proxy hug, in which you delegate a person to pass along a hug when you’re not able to be there. None of these seem really conducive to the 20-second, made-for-thriving hug. But, on some level, we know that hugs are therapeutic. Oxytocin or whatever, they make us feel better. Lots of hugging goes on at support and 12-step groups, and people who go to those daily might indeed make their recommended quota. I go to private psychotherapy, however. I’ve never hugged my therapist, and am not even sure whether it’s appropriate for therapist and client to hug. It would be awkward to ask, “Can I have a hug?” only to hear, “No. That’s unethical.” But I suppose it depends on the therapist and the client and how each feels about the subject. I know sex between therapists and clients is unethical, but hugs may be a gray area. Perhaps someone can enlighten me. Of course, there are people who do not like to – or are afraid to – touch other people. People who are aware of and skilled in responding to others’ body language may be able to see the little (or, let’s face it, large) cringe when one person sees another moving forward with open arms. If the non-hugger is quick enough, he or she can quickly stick out a hand for a hearty handshake, or the potential hugger will abort the hug and retreat to a friendly tap on the shoulder. But there are people who will swoop in and envelop you in an unwanted embrace and maybe even air kisses with smacking noises. I suspect these would be more likely to shut down oxytocin entirely, and possibly release adrenaline instead in a fight-or-flight response. As with sex, the safest route is to ask for consent – “Can I have a hug?” – and take no – “I’d rather not” – for an answer, without taking offense or pressuring – “Aw, c’mon” – and making things even more awkward. Still, the best advice I can give is to be proactive about hugging. Say, “I need a hug” when you do. Ask “Do you need/want a hug?” when a person you know seems to be in distress. Avoid hugging strangers, though. That hardly ever helps. At least wait until you’ve been properly introduced.

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Mental Health

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Bipolar Robbed Me of Reading

August 20, 2023

I don’t remember a time when I couldn’t read.

Except when bipolar disorder took it away from me.

I was what they call a “natural reader” – someone who learns to read without being taught. Someone who just picks it up out of the air. And for me, reading was like breathing. It kept me going, kept me alive. Reading was part and parcel of my identity. I was never without a book within reach. I read while eating, walking down the hall, going to sleep, riding in a car. (Fortunately, I didn’t get carsick.)

Throughout my undiagnosed childhood years, reading was a way for me and my brain to play nicely together. If I was depressed, I could lose myself in escapist fantasy. If I was hypomanic, I could soar on adventures. And during the in-between times, I had access to unlimited worlds – places, people, situations, ideas, conversations – both familiar and strangely new. Reading was my joy and my solace.

For many years, reading was therapeutic. I could not only lose myself and escape the unpleasantness of my disorder for a time, I could learn more about depression and bipolar disorder, compare my experiences with those of others who struggled with mental illness, discover how medicine and law and psychology and sociology could shine a light on my experiences. I could even (God help me!) read self-help books, which were popular at the time, and learn all sorts of theories and techniques that didn’t improve what was wrong with me.

Books and words were my life. I got degrees in English language and literature. I read for work and for fun. I edited magazines, wrote articles and (occasionally) children’s stories, and worked on textbooks.

Then my brain broke and reading went away.

I had a major depressive episode, which lasted literally years, and during that time I found it nearly impossible to read.

Why? My old companions, depression and hypomania.

Depression made me dull. I didn’t care about anything and found no happiness even in the books that had always been my refuge. I remember picking up a book that I more than loved and had returned to dozens of times, that had shaped my life in many ways, thinking that the familiar words would touch something still buried inside me. But this time there was no magic. Not even interest. The words were flat and dull, mere ink on the page or pixels on the screen. Reading – engaging with an author’s ideas, imagining characters, following plots and dialogue, discovering facts – was beyond me.

And hypomania? My version, instead of bringing euphoria, brought anxiety – an overwhelming twitchiness and fear of the unknown, jumping not just at shadows, but at the idea of shadows, things that had never happened. My attention span shrank to nearly nothing. I could barely read a few pages, not even a chapter, and when I was finally able to get back to a book, I was lost, disconnected.

Now that I have recovered from that episode, I am glad to say, I can read again. I read myself to sleep at night once again instead of crying myself to sleep. I devour entire chapters, keep at least two books going at once (one fiction, one nonfiction), delight in revisiting old favorites and seeking out new authors and genres (YA fiction and steampunk, recently) and topics. I’ve even picked up that beloved fantasy trilogy again and been swept away once more.

Not everything I read is uplifting. At the moment I’m deep into Cult Trip, a horrendous true account of an abusive sex cult in New Zealand. But I can tell when it’s getting too deep and frightening and switch over to Jasper Fforde’s Thursday Next literary fantasy Lost in a Good Book before the awful realities can drag me down.

And I can tell you this: It’s better to be lost in a good book than lost in your own broken brain.

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Mental Health

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