Bipolar 2 From Inside and Out

First, let me say I’ve learned a lot from my husband and from my bipolar disorder. The two of us have been married for more than 35 years and I’ve been bipolar all that time. I’ve learned a lot from him about caregiving, steadfast love, and coping, among many other things.

But he’s also learned a few things from living with me and my disorder. I asked him to tell me about it, and here’s what he said he learned.

He can’t fix me or control my emotions. (Of course, the corollary to this is neither can I.) “It’s not necessarily my fault when she feels bad and it’s not my responsibility to make her feel better,” he says. This particular lesson caused both of us a lot of trouble early in our marriage. Dan would blame himself for my moods and become angry when he couldn’t do anything to make me feel better or even respond to his attempts. He was in there trying, but he had to learn to let go and help me find ways to work toward my own healing.

He knows my comfort items and my triggers. Over the years, Dan has learned that while he can’t make me better by himself, he can help me get the things that bring me comfort and avoid the things that trigger me. For example, he knows I find watching cooking shows calming. Him, not so much. But often he joins me on the sofa while I indulge. “Sometimes I’ll sit and be with her even if I’m not really interested in the cooking shows,” he says. “Just to be with her. I do it because I want to be with her.” Sometimes I do that with him too, when he watches shows about treasure hunting or weird science. Sometimes we even sit together and watch shows we both like, such as Forged in Fire.

He has also learned about things that trigger my anxiety, such as loud noises. “I have to be mindful if she’s in a place where loud noises affect her,” he says.  “If I do have to hammer or pound on something, I give a warning so that she’s not blindsided or startled by it.” “There’s going to be a crashing noise,” he says, or “Everything’s okay. I just dropped a pan.” He also lets me know where he’s going to be and how to get hold of him in case I panic badly.

He knows to ask, offer, or get out of the way. I can be needy at times, but don’t always know what it is I need. At times like that he’ll ask, “Do you need a hug? Do you need to eat?” Other times he’ll simply give me that hug or put on one of my comfort movies (The Mikado or The Pirates of Penzance usually draws me out of bed). If neither one of us can figure out what might help, he’ll simply let me alone until I feel better or until I think of something.

If I do ask for something I need he’ll say, “You can get that.” If he can’t do what I need, we’ll sometimes negotiate a partial solution. Or he’ll give me the tools to do it myself.

He knows how to help with self-care. Like so many people with bipolar disorder, I find that taking a shower, getting dressed, and going out requires quite a number of spoons, sometimes more than I have. Dan helps with that. For example, he’ll give me a clean towel and clean clothes, and remind me that I need that shower. Or he’ll encourage me to get out of the house by negotiating how many errands we’ll do on a given day or by including a stop at a bookstore or a favorite restaurant among them.

He knows that self-care is important for him too. Sometimes he’s the one who needs that hug or that alone time, and he asks for it. He knows that I have learned that he needs these things too and that I will ask him what he needs, or offer it, or say, “You can get that” to him. As the saying goes, you can’t pour from an empty vessel.

A lot of what we’ve both learned from my bipolar disorder are just the things that any partners need to learn: Tolerance. Give-and-take. Negotiation. Touching. Sharing. Civility. Support. We’ve both grown from the experience and that to me is very important. This marriage would never have worked if either one of us had stayed stuck in the way we were in the early days.

Self-medicating – using alcohol or drugs to dull the emotional pain of a mood disorder – is pretty common among people with bipolar and other mental disorders, particularly the undiagnosed.

It’s a dangerous thing to do. People with major depression are said to be twice as likely to develop a drinking problem if they self-medicate with alcohol a lot. Then there’s the possible interaction between alcohol or drugs with a person’s prescribed meds.

To be perfectly honest, there were times in my life when I self-medicated with wine, beer, or liquor. During one particularly dark time, when I had been prescribed benzos for a physical ailment, that was thrown into the mix. And, again with the honesty, I still sometimes have wine or beer with dinner, though I know I shouldn’t. I could say that I know how much I can drink without it affecting my reaction to my meds, but the fact is that I just shouldn’t.

Recently, however, a study was published in the journal Nature Communications which said that “getting drunk causes the same molecular changes in the brain as taking rapid antidepressants.” Here are the basics.

It was a study done on mice, which means it’s a long way yet from applying to human beings. The set-up was this: Mice were given alcohol, then placed in a container of water. Being passive and willing to drown was taken as an indication that the hapless creature was depressed. Sure enough, the mice that were given alcohol proved to be more active and energetic in trying to swim, which was taken as a sign of not being depressed.

The study did not end happily for any of the mice, however. Their brains were examined to determine how the alcohol achieved its antidepressant effects.  The scientists say that changes in the boozy mouse brains showed that alcohol has effects on neurotransmitters that were similar to the way antidepressants affect the brain. That’s a long way from saying that alcohol is good for the depressed, though.

The premise of the experiment sounds a little shaky to me. I mean, assuming the swimming mice to be less depressed than the drowning mice strikes me as just a wee bit anthropomorphic. Plus, the mice seem to have been situationally depressed (by being left to drown), rather than chronically, as in clinical depression. However, the brain study seems more interesting to me. After all, it compared the effects of alcohol directly with the effects that antidepressants have on neurotransmitters and said that the former “mimicked” the latter.

What’s the takeaway from all this? Well, first of all, it’s hardly blanket permission for the depressed to go out and indulge indiscriminately. Further experiments are needed, presumably ones that will work their way up the animal kingdom until they come to depressed humans, though one hopes that they are not thrown into water to sink or swim.

If those further studies go the same way as the mouse study, I rather imagine the result will be something like the medical advice that you can take a glass of red wine to stave off heart disease – not a blanket approval, but the use of a potentially hazardous thing to ward off a potentially worse thing. Of course, that will not apply to alcoholics or others who must avoid the substance altogether for any of a variety of reasons.

I also note that the study focused on the effects of alcohol in relation to depression only. The manic phase of bipolar disorder was not part of the study and drinking while manic is well known to be a really bad, though often occurring, thing. Of course the same can be said of drinking and depression.

For now, the best advice is simply not to drink if you are depressed or bipolar. Don’t use me as an example. I’m not sharing this to encourage anyone to indulge in potentially destructive, even lethal, behavior. As always, Your Mileage May Vary, especially when compared with that of drunken, depressed, or dead mice. But drinking is still far from a good idea for the bipolar.  And don’t mix it with benzos either.  Trust me on this. It’s a slippery slope.

 

It’s hard to cut toxic people from your life, even if the person is a gaslighter or other abuser. There’s always the temptation to give the person one more chance, believe his or her protestations of love or change, or to feel it is up to you to change the situation or the other person.

But sometimes it’s necessary to end the relationship.

A toxic person is like a psychic vampire who sucks all the confidence and energy and spirit from your life. He or she exhausts you emotionally and adds nothing to your life but annoyance, pain, and trouble.

Once or twice I’ve even been that toxic person when I was in the grips of the depressive phase of my bipolar disorder. Several people cut me out of their lives and I can’t say that they were wrong to do so. I gave nothing, only took. I was the psychic vampire. And I deeply regret that, even though my hurtful actions were manifestations of my disorder. It lasted so long, with no apparent signs of letting up, that it simply wasn’t worth it to them to continue to associate with me.

Once or twice I’ve been on the other side of the equation, though. I can think of two times in particular. One was when I got out of the relationship with the person who turned out to be gaslighting me, which I have written about before. I learned something from the experience (though I still maintain that the lesson wasn’t worth the price I paid).

What I discovered is that it is better to make the break definitive. If you’re going to cut a toxic person out of your life, do it cleanly. Don’t leave that door open for continued contact. In my case, I felt I owed the person some money and sent him a little every month. An acquaintance called me on this and pointed out that even if I did owe money (which he doubted), it was better just to send a single, final payment and end it there.

So that’s what I did. I scraped together some money, wrote a check, and released myself from the ties that still bound me.

It’s somehow different when the toxic person is a family member, though. I won’t write much about the actual situation because I want to leave the person their privacy. But it was a toxic relationship that sucked time and energy from me and also from another person that I loved. It was concern for this other person that led me eventually to make the break, though I was growing weary of dealing with the person’s dramas, helplessness, vindictiveness, and general mean-spirited relations with me and others in the family.

I haven’t looked back. Some people have judged me harshly for taking that step because the person was, after all, family. Many people believe that family is more important than anything. But I chose my own mental health and refused to keep forgiving the damage done to both me and others. It took a lot of years until I was able to make the break, but I am never tempted to go back on my decision.

It’s easy to say that one should cut toxic people from one’s life, but it’s often a very hard thing to do. You can end up questioning yourself and your own motives. You can be shamed by others outside of the situation. You may regret your decision and wish you could mend the relationship.

My experience has taught me that sometimes that just isn’t possible. If the person is unwilling to or incapable of seeing the harm he or she has done, it’s likely to be a mistake to let the person have another chance to inflict more damage.

I plan on reaching out one more time to a person that I have harmed. But if they don’t respond, I’ll understand. I own that I was toxic and it was perfectly understandable that they cut me loose. I’ll always have regret and shame for the way I was, and I won’t try to insert myself back into their lives. I just want it to end on a less bad note if that makes any sense.

But I note that the toxic people whom I have cut from my life show no such inclination. I have to believe that they still believe they did nothing wrong and that they have not become less toxic. I still must protect myself and my mental health by not letting them back into my life.

And if that includes family, so be it.

“I hope I don’t wake up tomorrow morning.”

That is the classic thought of someone suffering from passive suicidal ideation. It’s not really a desire to die by suicide. It’s just a way of expressing how much it hurts to be you.

It’s not active suicidal ideation, the kind where you make an actual plan to kill yourself, even if you never put it into practice. It’s passive, meaning that you’d like to be dead but don’t intend on doing anything about it. It’s like asking the universe to take over and do it for you.

I’ve certainly had passive suicidal thoughts. Once I was very stressed and depressed while coming home from a business conference. I clearly remember thinking, “Maybe the plane will go down and keep me from having to deal with all this.” I certainly had no plan to rush the cockpit with a box cutter or anything like that. I just wanted my pain to be over. I wanted the choice taken out of my hands.

Another time I was at a business meeting in a swanky hotel that had rooms surrounding the lobby on numerous floors. I remember being on the 16th floor, looking down at the atrium beneath with what felt like idle curiosity. Would it annoy the hotel more, I wondered, if I landed on the carpeted area, necessitating a thorough cleaning or total replacement? Or would they be more upset if I landed on the marble floor portion of the lobby, making a bigger mess and potentially chipping the surface? (And was it just a coincidence that business meetings made me contemplate my mortality or did they just come packed with a lot of stressful triggers?)

At neither time was I actively suicidal. I’ve been there once too, and this was completely different. When I was suicidal, I had actual plans and plenty of means to carry out any one of them. I’m not going to discuss what those plans were. (The difficulty of choosing among them may have been what kept me from actually doing it. By then my depression had lifted just enough for me to get help.)

It was easy enough later to make jokes about the passively suicidal occasions and most people took them as exactly that – jokes. It was even plausible that they were jokes. I used to talk about jumping out a window, adding that it wouldn’t work because I lived in a basement. It was only much later that I thought about it and realized that I needed help even on those occasions. After all, isn’t pain the source of much humor and the downfall of many comedians?

Passive suicidal ideation is asking yourself “what if?” What if my troubles were over? What if my pain was gone? What if all I had to do to accomplish this was to let that bus hit me instead of stepping out of the way?

The important thing to remember is that someone passively suicidal is in great psychological pain and wants not to feel that way anymore. In that respect, it’s similar to cutting or other self-harm. And like those acts, it doesn’t end the pain at all. It may be a temporary escape valve, but it’s not a solution.

Passive suicidal ideation is certainly a bad thing and an excellent reason to see your psychiatrist or therapist as soon as possible. If you hear a friend or loved one talking this way, encourage them as strongly as possible to seek help. Let a professional decide if the person has passive suicidal ideation or active suicidal ideation. It is entirely possible that passive suicidal ideation will lead to the more active kind and even to death if it is not dealt with.

I know that there are lots of people – and not just the bipolar ones – who don’t like taking medication and especially don’t like needing to take them. It’s a reminder of their illness, I guess, or a dependence on a chemical answer when we’ve been told for so long, “Just say no to drugs” and indoctrinated by DARE. The only thing they leave out is that some drugs are good for you – the prescribed ones that allow you to live and function.

I don’t mind my psychotropic medications. In fact, in many ways I love them. They are the things that keep me relatively stable, on a mostly even keel, and make sure that none of my mood swings lasts more than a couple of days. I loathe pill shaming and consider it just one more kind of stigma that attaches to mental illness (and other chronic illnesses).

But there is one medication I take every day that gives me pause. It is my sleeping pill. My psychiatrist prescribes them and I take one every night, along with my other nighttime pills. In about 20 minutes to an hour, I’m asleep, and I stay asleep usually until 8:00 a.m. or so. It means I get about eight or nine hours of uninterrupted sleep per night.

I do need that sleep. I’m not one of those people who can function on four or five hours of sleep, the way tech geniuses and high-powered execs claim they can. If I don’t get my eight hours – and sometimes even if I do – I take naps during the day. Not just naps: mega-naps. My brain and body sneer at 20-minute catnaps. If I’m going to sleep, they say, it must be an hour at a minimum. Two is even better.

It’s not like I want to go back to the days before the sleeping pills, either. I do still remember the long nights of fear and sorrow, the fits of crying, the panicky sensation of not being able to breathe. The endless mental replay of every stupid thing I’ve ever done. The anticipation of the disasters the next day would bring. The hopelessness and the helplessness and the loneliness. The feeling that I was the only being awake, maybe in the world. If a single little pill can save me from all that, I should be glad to take it.

Why, then, does it bother me?

Perhaps it’s because it doesn’t feel necessary in the way my psychotropics do. They are prescribed for my bipolar condition and somehow make the difference in how my neurotransmitters operate. The sleeping pill feels like a different category of drugs.

Or perhaps it is because sleeping pills are often a drug of abuse and even suicide. My psychiatrist trusts me with them, though, and has for years. Plus, my anti-anxiety med is also often abused and I feel no guilt about taking that.

Maybe it’s because a sleeping pill feels in some way like a luxury. I don’t think it does anything specific for my bipolar disorder – except that sleepless nights are certainly associated with depression and my middle-of-the-night anxiety as well.

I hate to think it, but maybe the pill-shamers have gotten to me. I take such a cocktail of assorted psychotropics that it’s perhaps natural I should ask myself every now and then if I’m overmedicated (my doctor doesn’t seem to think so) and whether I could do without any of the drugs. The sleeping pill is the only one that might be in that category.

But no. I don’t want to go back to the nights of distress, despair, and devastation. I don’t want to wake my husband up as I gasp for breath and need him to stroke my hair until I fall asleep. And I surely don’t want to go through those bad feelings all alone in the night while he works the third shift.

All in all, I think the sleeping pill is a good thing for me and that I shouldn’t try to give it up. I just wish I didn’t feel so ambivalent about it.

 

 

I don’t make New Year’s resolutions. But since January is named after Janus, the two-faced god that can look both ways, I do look to the past and the future just to see what I can see.

Last year was a very mixed bag. It brought the heights of joy and the depths of depression, along with a little hypomania and dysthymia thrown in just because my brain does that.

The big negative this year was my husband’s heart attack in August and all the medical and financial repercussions that entailed. He’s back at work now, though he’s having difficulty managing the mental and physical stresses of it, so much so that he hasn’t made it to cardiac rehab in over a week. Rehab is not just a good thing physically; Dan said it made him feel energized, productive, and cheerful. I know, I know, exercise could do the same for me.

Still, there have been good things. My book, named after this blog, has now been published. This is a huge event in my life that lifted me temporarily out of depression and into (possibly) hypomania. And I have retired, meaning only that I will start collecting Social Security next year. It will not alter my blogging, writing, or other pursuits, since what I make from them won’t be over the “allowed-to-make-in-addition” line.

As for next year, I expect to see more of the same (minus, I hope, the heart attack). There will still be problems paying the bills, including the massive hospital one, but at least I will have a steady, fixed income. It will help me with my anxiety over potential financial collapse and my unreasonable fear of losing the house.

I’m also planning to get away for another long weekend at a bed-and-breakfast on a working farm. The last time we did it, it proved enormously soothing and relaxing. Another such mini-vacation would be ideal. We certainly won’t be able to take a full vacation, so I won’t even hope for that.

The other good news is that my second book, Bipolar Us, will be published. It may not be attended with the same level of hypomania that the first one was, but at the very least there will be real joy. Also in the coming year, I plan to finish my mystery novel and place it with an agent.

As far as my bipolar disorder, in the coming year, I will still have it. I expect that my meds will change not at all, or minimally since I’ve been relatively stable for so long. But I know it won’t go away just because I’ve crossed “publishing a book” off my bucket list. That’s not the way it works.

If this sounds like my 2019 will be more of the same, well, that’s because that is truly what I expect. Of course, my expectations will have no influence on the outcome. The year will be what it will be, as rife with unexpected events as this one was. My main hopes are that my husband’s health and my writing both improve.

I’ll try to remember the lessons learned from this year – that we are both strong and good things can happen to us. And I’ll try to plan for some positive accomplishments in 2019 and hope they’re within our reach. I won’t call them resolutions, though. Resolutions are so easily broken and I don’t like to think that my plans and hopes are.

 

Working full-time is a bitch. Working full-time while mentally ill is even worse.

I work as a writer and editor, but lately I’ve been working mostly as a transcriptionist. Dan works as a clerk in a big box store and grocery. Neither one of us makes very much money at this.

Both of us used to work in more professional settings. Neither one of us is able to now. Working at home in my jammies suits me fine. I don’t know that I’m capable now of dressing up like a competent businesswoman and going to an office where it’s all people-y and I have to be professional and appropriate for eight hours straight. My husband suffered serious burn-out and depression and can no longer handle a managerial position.

The freelance lifestyle has been a godsend for me. Mostly, when bipolar depression hit, I could declare myself a “mental health day” and not work. Most of my deadlines used to be flexible enough to accommodate an iffy schedule. Now not so much.

The transcription job changed from part-time to full-time when the financial crunch crunched. It involves listening to the audio of assorted business meetings, podcasts, and the like and typing them. And there are definitely deadlines. Often very tight ones, but always very specific. I can’t get away with saying, “I’ll have this for you Monday, or Tuesday at the latest.” In fact, I have to take the tightest deadlines I can get because they pay better. I’ve been taking extra work on my days off, too, just for the extra bit of money. But it’s wearing me down, mentally and emotionally. (Sitting at a desk all day isn’t doing wonders for my back either.)

So here I am, dealing with many of the difficulties of full-time work – setting an alarm to wake me up, working when I don’t feel well enough, not being able to take breaks when I need them, fighting the stress of tight deadlines. I am fortunate, and I know it, to be able to work at all, what with the bipolar and the anxiety. I shouldn’t complain. But the freelance market is tight these days and transcription is almost all I can get. It’s leaving me feeling battered and afraid. The work is said to slow down drastically between Christmas and New Year. But the bills don’t, of course.

Dan’s work is less mentally stressful but more physically challenging. Working third shift requires him to sleep most of the next day just to recover and his depression is kicking in as well. His brush with mortality and enforced inactivity depressed him further. Plus, he has to deal with me and my mood swings, from resigned numbness to hypomanic panics. We’ve often said that when both of us are emotionally afflicted at the same time, things get pretty ugly. Neither one of us can truly be there for the other, or only in small bursts.

But until or unless our circumstances ease up, here we are – fighting our way through full-time work and part-time mental function. I just keep pounding these keys and he just keeps stocking those shelves. There’s no time off for bipolar and depression.

 

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