Bipolar 2 From Inside and Out

After my last (and, I hope, last) major bipolar breakdown, my therapist pointed out that I had a unique opportunity: I could reclaim those parts of my life that had fallen away, or I could leave them behind.

I could choose. That idea was very powerful.

I had a lot of irrational feelings and associations that I needed to reconsider after leaving a toxic relationship. I had given up needlework after making an elaborate set of chair backs destined to be inherited by someone else’s children that I would never see. I got to dismiss those feelings and reclaim my creativity. I chose to take up needlework again. Whoever’s children can have the chair backs.

In fact, I had bad associations with nearly everything associated with that relationship: folk music, guitar lessons, cooking and entertaining, even blue spruce trees and cobalt blue glassware, for God’s sake. I reclaimed the music and the cooking, but let the entertaining largely fall by the wayside, as it triggered my bipolar disorder as well as my memories. I got over the blue spruce and learned to shrug at anything cobalt blue, though I still don’t buy any.

None of these things caused my major meltdown, though they may have contributed to my shaky mental state. They were simply things that I had lost along the way. And since I was in the process of rebuilding myself afterward, I could view them as stones to build something solid with or as broken bricks to discard.

Rebuilding from the bipolar breakdown was not as easy as merely taking back a few hobbies and interests. It involved reevaluating large parts of my life. Would I go back to school and get another degree? I would not. I weighed the idea and decided it would be too much stress just to add a few more letters after my name. Would I resurrect my mostly-dormant writing career? Yes. And I’ve taken it further than I ever thought I would. Would I reconnect with the country music I loved best but had been shamed for listening to? Of course!

The process of putting myself back together is one I have been through several times now, and each time I got to choose what to bring with me and what to leave behind. Bipolar disorder, much as I hate what it has done to me in so many ways, has at least given me that chance to reinvent myself if I wished to or resurrect myself if I felt like it.

I’ve always hated when people say about some bad experience I’ve had such as my appalling relationship or my bipolar condition, “But you’ve learned so much from it!” I always think, “Maybe so, but the lesson wasn’t worth the price I paid.” But having the opportunity to rebuild myself – and especially to choose what I want to be part of the new me – is very nearly worth it. I owe that epiphany to my longtime therapist, Dr. B. But I’m the one doing the work. And it is indeed very much a work in progress. I am a work in progress.

Bipolar disorder is one of the bricks I have to rebuild with, and it always threatens to make my new structure a bit shaky rather than completely solid. But isn’t every life a work in progress? Don’t we all have bricks or timbers or stones that are at least a little unsound or misshapen, that we have to shore up or fit in as best we can?

I can’t guarantee that my structure won’t crumble again, though it has been relatively stable for some time now. But at least now I know that I have the ability to start over yet again. And to choose myself. That choice is both powerful and empowering. Just as it is said that all writing is rewriting, all my building is rebuilding.

And I’m okay with that.

I saw an ad online recently for a crystal antidepressant necklace. It was basically a crystal point hung from a chain.  The crystal was pink in color, which meant it was either rose quartz or pretending to be.

When I looked at the website, there were other colors available, such as clear (quartz), turquoise (turquoise), purple (amethyst), and black (maybe onyx?). Of course, there was always the possibility that these were not naturally occurring colors and that every crystal was plain quartz died some other hue. The turquoise certainly looked dyed to enhance its turquoise-ness, and isn’t a crystal anyway. I also had my doubts about the black one.

In point of fact, I had my doubts about all of them. Not that they weren’t authentic crystals, but that they would work. I’ll be honest here. I don’t believe in crystals as channels of psychic power or healing or whatever. I think they’re beautiful and make great jewelry, though. I have quite a collection of necklaces and earrings made from semi-precious stones, some of which are crystals. I feel better when I wear them, but that’s because I actually have taken the time to accessorize before I go out.

I think that, if crystals have any effect at all, it is the placebo effect, which I’m not discounting. That at least is a real thing. But the ad for the depression crystals got me thinking. If the 12 or so widely varied stones that were featured in the ad are all good for depression, what’s the point? I thought at least specific crystals were supposed to be good for different things.

So I researched some of the advertised crystals to see what effects they were supposed to have and how they might relate to mental health. Here are some of the associations I found:

rose quartz – emotional healing, releasing toxic emotions

turquoise – spiritual expansion, a path to your vibrationally highest self

onyx – inner strength, balance, confidence, protection

amethyst – release of addiction, relaxing energy, sound sleep

I’ll admit right off that I don’t know what “a path to your vibrationally highest self” means, but then again, turquoise is not one of my favorite stones. I have worn rose quartz, amethyst, and occasionally onyx, but felt nothing in particular regarding my emotions, confidence, or sleep (though, to be fair, I never have worn amethysts to bed). Amethysts for relief of addictions most likely goes back to medieval days, when they were thought to counteract poisons.

Then I checked another site, which connected assorted crystals and stones specifically with mental health issues. Here the results were more specific and more focused. Rose quartz was again associated with emotional turmoil, which is pretty close to releasing toxic emotions. Blue lace agate, a very pretty stone, was associated with journaling, which was both different and interesting.

Even more interesting to me were the purported beneficial effects of amber, unakite, tiger’s eye, and smoky quartz. According to this website, amber, perhaps my favorite semiprecious gem (though not technically a crystal), is particularly effective for seasonal affective disorder (SAD). Unakite, a little-known stone that mixes gray-green and dusky pink colors, is said to be beneficial for anxiety and negative thoughts, both of which I, of course, have in abundance.

Smoky quartz appears to be the recommended crystal for depression and tiger eye for mood swings. Both should therefore help with my bipolar disorder. (I don’t remember whether smoky quartz was among the crystals and stones offered in the antidepression crystal ad, but according to this website, it should have been.) I used to wear a ring of tiger’s eye, but it did nothing to ward off bipolar.

I can’t see any scientific basis for crystals having any sort of effect on a person’s emotional states. But I suppose that if these stones bring you some solace or seem to encourage your healing, I shouldn’t put them (or you) down. I don’t happen to believe in their alleged powers myself, but I also know that affirmations, CBT, and positive thinking don’t work for me, as far as my mental health goes, while they do work for other people.

But I do think it is disingenuous at best and fraudulent at worst for that particular website to advertise that these varied stones and crystals all have antidepressant effects. Even those who believe in the power of crystals believe that different ones have different effects.

Personally, I think that a black crystal would do more to reinforce depression than to ward it off. I know someone will tell me if they think I’m wrong.

 

 

In 1995, Dr. Gary Chapman published his popular relationship book, The Five Love Languages. In it he proposed that there are different ways – or “languages”  – that people use to communicate their love. Problems happen when one partner doesn’t speak the same language as the other; for example, when one gives the other literal gifts while the other yearns for time together.

I’ve been thinking quite a bit about love and bipolar disorder lately and it occurred to me that the five love languages could be a helpful lens for looking at relationships. In particular, they might help a person realize what the other one needs when experiencing symptoms of the disorder.

Here are the five love languages and how they might be helpful if you are in a relationship with someone who has bipolar disorder.

Words of affirmation. I’m not talking here about the kinds of affirmation we are supposed to look in the mirror and give ourselves. I mean words of affirmation that come from outside, from another person, and are gifts of love. Everyone needs affirmations at times, but for people whose love language is words of affirmation, they can be positively soul-feeding.

For the bipolar person, these affirmations can be as simple as, “Thank you for coming out with me,” or “Congratulations on getting the bills paid,” or even, “I know you can do it,” or “I knew you could do it!” And for the bipolar person who struggles with self-esteem, imposter syndrome, or lack of motivation, these can be the words that keep us going.

Quality time. Quality time doesn’t have to mean an elaborate outing or a two-week vacation. It can be as simple as sitting on the sofa with your partner watching a movie, or cooking together. Especially when there’s something else you could be doing. Giving up that other activity to spend time with your loved one is another kind of love-gift.

Quality time – extended periods of togetherness – can be extra special to someone with bipolar who feels lonely, isolated, or unlovable. Just the idea that someone wants to spend time with you, even though you can barely stand to be with yourself, sends a powerful message.

Receiving gifts. There are people who value physical gifts and see in them the care and attention that another person spends selecting just the right thing. Diamond rings are unnecessary. In this language of love, a simple houseplant can even be preferable.

You probably shouldn’t expect a physical gift to “cheer up” a person with bipolar depression. As with any gift, the important thing is knowing what the person values and providing it to them. Comfort objects such as plush animals, mp3s of calming or favorite music, or a weighted blanket to ward off panic may be just the thing. Even a silly coffee mug with an appropriate saying can become a treasured item.

Acts of service. If the person you love values acts of service, then your way of speaking that love is accomplished when you do something for her or him. Doing the dishes or some other chore that usually falls to the loved one is one example.

For the bipolar person, acts of service that speak of love may be as simple as handling phone calls and visitors, or doing the shopping when he or she just can’t face the grocery store. “I’ll do it for you” is a powerful message that says, “I care about you and want to help ease your burdens.”

Physical touch. Strange as it may seem, some people never think of physical touch as a language of love unless they’re talking about sex. Of course, the physical and emotional intimacy of sex can speak love, but other kinds of touch do just as well for some people.

Bipolar people in the manic phase can have a high sex drive and appreciate some sexual attention even if you wouldn’t ordinarily want it at that time of day, for example.  But the bipolar person can crave touch without sex as well. Hugging and cuddling, sitting close with an arm around the shoulders, and even a touch on the shoulder as you leave a room can speak volumes.

The important part of this is to learn and know what your partner values – what language of love she or he speaks – and to give it to them. Mixed signals, speaking the language that you would want instead of the one that your partner does, will not be processed as love. Physical gifts to one who hears love in affirmations will miss the mark.

Obviously, the best thing to do is to ask your partner which “language” they speak. But she or he may not even realize that there are different languages or which one is theirs. Observation, attention, and even trial and error may be necessary to get the communication going. But if you want to speak love to a person with bipolar disorder, these are communication skills that can be vital.

Good Enough

I know a man who used to be caught in all-or-nothing thinking. Anything at all – a dinner, a gift – had to be “fantastic” or it was “wrecked.” “Okay” wasn’t good enough. “Fine” wasn’t good enough. “Nice” wasn’t good enough. “Good enough” wasn’t good enough. He heard them all as “wrecked.”

Fortunately, over the years, he learned to accept compliments that were lesser than “fantastic.” He could even understand “needs work” or “meh” without feeling that those meant “wrecked.”

There was I time when I thought my life was wrecked. Irretrievably, permanently wrecked. All I had to look forward to was someone recognizing my wretched wreckedness and having me committed. Fantastic was never even an option.

Later I learned that my life wasn’t wrecked, though it surely hit some rough patches and there were a few things that were wrecked along the way – friendships, my self-esteem. But gradually I learned that the problem was not wreckage, it was bipolar disorder.

And now my life is not wretched and wrecked. Bipolar disorder has backed off.

I don’t think I’ve been cured of bipolar disorder, because I don’t think that’s possible. I think that the most that you can say is that I’m in remission.

And that’s okay.

I’m content with the idea that I’ll have to take medications for the rest of my life. They’re what got me here and they’re what keep me here, in the land of Good Enough.

I don’t ever expect to be normal – whatever that means – but I do expect to remain reasonably functional. I have a good marriage. I can do paying work. I have a comfortable home. I’m stable most of the time. I go to a psychiatrist only for med checks.

I have just enough symptoms to remind me how I used to be (that is, dreadful, miserable, and sometimes numb). I still don’t like to go out of the house, but I can if I need to. I still have to lean on my husband for support. I still get free-floating anxiety at times. But those are symptoms I can live with.

Of course, the road to remission has been very (very) long. I’ve fought my way through meltdowns. I’ve had to learn coping skills and some degree of self-care. I’ve tried nearly every combination of medications on the market, except for the newest ones – I’m not switching from what works now in hopes of getting a little bit better. Because that might not happen.

And because I’m good enough.

I’m good enough to write blogs. I’m good enough to write a book (I wrote a book!). I’m good enough to have lots of friends, both online and off. I’m good enough to help other people who are going through the same things I did.

I’ll never be perfect, but let’s be honest, that was never a goal of mine or even a possibility, really.

But I feel I have beaten this bipolar disorder; it hasn’t beaten me.

And that’s good enough for me.

I read recently that the Duchess of Cambridge was visiting a series of schools to mark Children’s Mental Health Week. The duchess is the royal patron of Place2Be, a children’s mental health charity. The article said that this year’s theme for Mental Health Week would be “Healthy: Inside and Out, focusing on the connection between physical and mental health.”

The article explained, “The charity works with more than 280 primary and secondary schools across England, Scotland and Wales, providing support and expert training to improve the emotional wellbeing of pupils, families, teachers and school staff.” 

The duchess, it says, would be meeting with members of the school community to discuss students’ school readiness, teacher welfare, the wellbeing of the school community, and the importance of being active; and also talk with parents about good routines and habits around sleep, screen time, healthy eating, and exercise.

All of which sounds fine and worthy. But does anyone else see something missing from this public relations tour? Maybe it’s just me, but there doesn’t seem to be much actual emphasis on children’s mental health.

Yes, we know that the body and the mind are intimately connected. Yes, we know that children need a sense of wellbeing. Yes, we know that being active and eating healthy are important for kids. And we know that parents, teachers, and school communities have important roles to play in students’ healthy development. We also know that sleep, healthy eating, and exercise are good for people with mental illnesses. Hell, they’re good for everyone.

But there’s a lot more to mental health than physical fitness and a sense of wellbeing. If that was all it took, we could just eat kale and kiwis, meditate, and send the therapists home.

Of course, the article was short and seemed to focus on the duchess’s meetings with the youngest kids, who after all the most photogenic. Maybe the charity and the duchess also educate about the thornier aspects of mental health. Maybe they promote dialogue about self-harm, suicide prevention, childhood depression, and other conditions. I would like to think that they do.

But the article and many others like it focus on the physical and feel-good aspects of mental health and not the mental and emotional. Bubble baths for self-care! Pets as the best therapists! Super foods for regulating moods!

Memes are not the answer. And the physical aspects of mental health are certainly important. But we’re talking about mental illness and mood disorders here. Can’t we at least spend time talking about the mind and the emotions?  Maybe even have a dialogue about what happens when something goes wrong with them? Stress the importance of seeking help when one is confused, overwhelmed, and despairing?

I think society at large is still uncomfortable talking about mental illness and twice as uncomfortable talking about mental illness in children. Many of us are still laboring under the illusion that childhood is a uniformly happy time. In fact, many kids suffer from serious mental illnesses. If the statistics give any indication, 20% to 25% of them will experience a mental health problem at some time in their lives.

We should talk about this and ultimately do something about it. Something more than emphasizing good physical health and getting celebrities to do 30-second spots about how they too experience depression, though these are indeed good things.

I’ve written before about what I think a mental health curriculum in schools should look like (https://wp.me/p4e9Hv-Jw, https://wp.me/p4e9Hv-Hl). I suppose that first we need to be aware that children can and do have mental health problems – that it may not be “just a phase they’re going through” or something they’ll “just get over.” It’s a serious problem and requires serious attention, not to mention serious actions.

Whatever else we do, let’s put the mental back into mental health.

 

 

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.

 

 

Bipolar Me

Bipolar 2 From Inside and Out

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