Bipolar 2 From Inside and Out

Handling Hypomania and Shopping

February 11, 2018

I know it’s common when hypomania or mania hits for the bipolar person to go shopping.

The thing is, I hate shopping. Always have. Probably always will. I don’t like to shop for clothes or groceries or shoes. I don’t like to go out to stores.

Ah, but there’s always the Internet (I hear you say). You can shop without ever leaving your house, or for that matter your desk chair.

The problem is, I don’t have any money to spend on online shopping. And that’s one of the reasons I don’t have a credit card. It’s too easy to spend non-money.

What I do have are a debit card and a PayPal account. If there’s no more money on my debit card, too bad – I have to reload it (or more likely ask my husband to reload it). This requires taking money out of the bank account.

The PayPal account is where I usually get paid for the bit of writing and editing I do from home. I really should roll that money straight into the bank account.

But sometimes I don’t.

In fact, when the PayPal well is dry, it reverts to my backup payer – which is my bank account. It does this automatically. My husband never knows about it, since I’m the one who handles the online banking.

You see the problem here. I could shop to my heart’s content, and pay with PayPal/bank account as long as there was money available. Theoretically, I could bleed it dry.

Even with my meds working and all the progress I’ve made, I still get hypomania occasionally. I try to keep the shopping under control as well as I can.

There are several dresses in my closet that I never wear because I hardly ever go out, especially to places where a dress is necessary. I even have a party dress that I bought recently. It’s really becoming. But I never go to parties. I was just overwhelmed with the butterfly pattern and how cheap it was ($20).

But still, five dresses in two or three years isn’t bad, considering. (I once actually hyperventilated over a dress, and often do over amber jewelry.)

The real problems I have always had are books and music.

When I was still going out to malls and shopping centers and the like, the bookstores were always my downfall. My husband would take my arm and steer me past them, unless he was jonesing for a book too.

I’m trying to keep my online book-buying to a semi-reasonable level, too. I buy full-price books only when they’re absolutely essential – the last book Sue Grafton ever wrote, for example, which is not going to be discounted anytime soon.

For the rest of my ebook purchases, I subscribe to various newsletters that present me with cut-rate book choices every day. (Early Bird Books and Book Bub, for example). These books sell for $.99 (rarely), $1.99-$2.99 (usually), or $3.99 (occasionally). Once in a while I can even get a free classic – for instance, Tess of the D’Urbervilles or Ivanhoe (which I don’t recommend) or Journal of the Plague Year.

Back when I was going out, in the days when I did that, my other hypomanic shopping thrill was the used CD shop. I had a strategy for curbing my hypomania there, too, even though I didn’t know that hypomania was what I was feeling at the time. I would fill my little basket with everything that caught my eye.

Then I would weed. I made three piles – must haves, can pass on, and maybes. Then I would angst over the maybe pile, juggling price, artist, essential tunes, and the like until I had the piles down to something more manageable. Under budget or just a wee bit over. I can do the same with my online “cart.”

Again, this is a thing that could get me in trouble on the Internet, but since I have all those CDs and have loaded them all into iTunes, I seldom get the music shopping urge anymore.

So, yes, I do hypomanic shopping and no, I don’t let it break the bank. Just chip away at the edges.

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Mental Health

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Twelve-Step Groups for Bipolar?

February 4, 2018

Why are there no 12-Step groups for persons with bipolar disorder?

There are a number of support groups, both online and in local areas – and even a Facebook page called Bipolar Anonymous (https://www.facebook.com/bipolaranonymous38/) – though it’s not a 12-Step group and seems to consist mostly of posted memes of encouragement. They describe themselves as:

a group page for people who suffer from a Mental Illness, or are having a rough time of things, to seek out people with like problems, for support and a place to vent.

My short answer is that a 12-Step program would not work for bipolar disorder.

It’s not that people with bipolar don’t need AA. Some do. As James McManamy says at Health Central (https://www.healthcentral.com/article/bipolar-and-alcoholism-is-aa-the-only-game-in-town):

One-half of those with bipolar experience alcoholism at some stage in their lives, far more than the general population. Four in ten experience other substance use issues. This extra burden comes at a huge personal and family and social cost. As if bipolar weren’t bad enough, already.

However, at many 12-Step meetings, according to David Oliver (http://www.bipolarcentral.com/articles/articles-644-1-Ailcoholics-Anonymous-and-Bipolar-Disorder.html), alcoholism is the only condition discussed at meetings. Bipolar disorder is considered an “outside issue.” However, he also notes that for those with a dual diagnosis:

Part of the program of Alcoholics Anonymous is to get a “sponsor.” A sponsor is a person who will help the member through the 12 steps of the program, to help them stay sober, and to help them deal with the issues surrounding their alcoholism.

Hopefully, the member with bipolar disorder can find a sponsor who is sensitive to the fact that bipolar disorder is one of the issues that does, in fact, affect their sobriety.

Another facet of AA that can be applicable to those with bipolar disorder is Reinhold Niebuhr’s Serenity Prayer: God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference.

But as to the 12 Steps themselves, only a few are likely to be helpful to bipolar sufferers, and several apply not at all. Let’s take a look at a few:

  • We admitted we were powerless over alcohol – that our lives had become unmanageable.
  • Came to believe that a Power greater than ourselves could restore us to sanity.

These, the first two steps, are problematic if you replace alcohol with bipolar. We are not powerless over bipolar. There are treatments, involving therapy and/or medication, that give us power to manage how bipolar affects us. And that Higher Power so essential to AA – often expressed as “God as we understand Him” – will not restore us to sanity, through prayer may help us get through the difficult times associated with the disorder. (https://wp.me/p4e9Hv-B6)

On the other hand, a few of the 12 Steps may be relevant:

  • Made a list of all persons we had harmed, and became willing to make amends to them all.
  • Made direct amends to such people wherever possible, except when to do so would injure them or others.

Few would deny that bipolar disorder has often been a factor that affected our relationships with others. We can certainly acknowledge that we have hurt others as well as ourselves while in the grip of mania and/or depression, and we can offer or try to make amends.

But, overall, it seems that 12-Step programs are not for us.

What is there to suggest instead? Here are two places to look:

  • Therapist-led support groups in your area
  • Depression and Bipolar Support Alliance (DBSA), which offers online and in-person peer support groups or chapters http://www.dbsalliance.org/site/PageServer?pagename=home

DBSA has a page that helps you locate support groups in your area. Unfortunately, there are none within a reasonable distance of where I live.

However, I could always start one. And so could you.

Also, I invite you to write any number of steps that would be appropriate for a support group along the AA model.

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Mental Health

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Helping a Loved One Get Help

January 28, 2018

You can’t make someone get help for a mental illness problem. It is that person’s decision, unless he or she is actively psychotic or suicidal, in which case you can call the police or take the person to an emergency room, if possible.

But other than that, all you can really do is assist another person in getting the treatment he or she needs. There’s still a lot you can try.

Let’s say, for example, that Jill notices her partner Jack seems depressed and the depression has lasted several months or worsened over time. Maybe he is moody, sleeps too much, doesn’t seem to enjoy anything, and hardly talks to her. Maybe Jack spends too much money that they can’t afford. Maybe he talks about death.

Jill knows a little something about mental health issues and realizes that Jack is in trouble. What can she do?

Listen. If Jack communicates at all, Jill listens to what he says. She should especially listen for clues that might indicate suicidal ideation. But she also listens carefully to any problem Jack discusses: “I miss the house I grew up in, now that it’s been sold.” “I think the people at work are talking about me and laughing at me.” “I don’t want to wake up in the morning.”

Encourage him to go to his primary care physician. PCPs are the first line of defense in dealing with mental health problems. The doctor may administer a depression screening checklist. She may prescribe antidepressant medication. If Jack wants her to, Jill can go into the doctor’s office with him. He may need help expressing his feelings and talking about his symptoms.

Proactively encourage him to seek help. This can also be called, or seem like, nagging. But if Jack continues to suffer symptoms, Jill reminds him that help is available and that she will help him get that help: “You feel miserable all the time. Don’t you want to feel not-miserable, like you used to?” “You know how much therapy and meds have done for me. They could do the same for you.” “Your friend John is also concerned about you. He and I both think you need help.”

Investigate options. Considering that Jack is immobilized by his suffering, Jill researches local therapists who are taking new clients, who take their insurance (if any), and who deal with mood disorders. Community mental health clinics shouldn’t be overlooked. Jill makes a list of four or five possibilities.

Extract a promise. Jill’s observations make her frightened for Jack’s safety. She gives him a deadline and gets him to promise to call someone on the list of therapists by Monday, say. This is also proactive encouragement.

Go with him to the first (intake) appointment. Jill drives Jack to the office and waits for him while he sees the therapist. Afterward, she asks general questions: “How did it go?” “Did you like her?” She doesn’t ask for details. Those are between Jack and his therapist.

Facilitate. Now that Jack is getting help, Jill helps him keep track of appointments, medications, and the like. These may seem like things Jack could do for himself, but until his mood changes, he may need her help in following through.

Of course, the helper and the helpee in this scenario can be of either sex. They may have a romantic, sexual,  or family relationship – or not. The important thing is that someone be willing to take on the role of helper until the partner, mother, son, friend, or whoever gets enough help to take over the tasks of getting treatment.

It takes work on both their parts, but help is available. You can make a difference for someone who is suffering.

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Back to the Therapist

January 21, 2018

A number of months ago (about seven according to my blog, which is the main way I measure time), I stopped going to my psychotherapist (https://wp.me/p4e9Hv-xj). There were a number of reasons, but here’s the main one:

My sessions are mostly an update on what’s going on in my life at the moment, plus a recap of my recurring problems. But those problems are ones I’ve faced before and know how to cope with. I already have the tools I need and use them without needing a reminder.

This week I had a new session with my therapist, also for a number of reasons.

My triggers are looming large. The last time my brain broke, there were a number of stressors piling up on me. Financial reasons. Health reasons. Relationship reasons. Job reasons. All combined with good ol’ bipolar, type 2.

Now those stressors are back, in slightly altered versions. So far I’m holding my own, but I know there’s a danger that they will do the same to me as they did the last time.

I’m catastrophizing. The lurking triggers are setting in motion a thought process in which I assume the worst. And the stakes may even be higher this time. Financially, we could crash and burn, owing our souls to the IRS and maybe losing our house. I need a reality check from someone outside. (I’m also consulting a tax attorney; these fears aren’t completely all in my head.)

I need another person in my support system. My husband is great, but I can’t always talk to him about my problems. For one thing, he’s not objective, since he’s facing the same stressors I am. And my friends offer me encouragement and moral support, but I hate to do a total meltdown in front of them. Dr. B. has seen it all and helped.

I need emergency help readily available. My irrational thinking at times such as this has caused me some suicidal ideation in the past. I know that’s not the right thing to do, but my brain has betrayed me before now and I can’t guarantee it won’t again. So I need someone – preferably someone more informed and present than an online help group or a 1-800 number – that I can talk to when the inside of my head gets too scary.

I have a therapist I know and trust. If there’s one thing I hate, it’s breaking in a new therapist, having to go through the Reader’s Digest Condensed version of my screwed-up life. Dr. B. at least doesn’t have to start from ground zero. I’m fortunate that she’s still available.

My meds have remained relatively stable; what I need is talk therapy. I’ve been on the same meds and the same dosages for quite a while now. I know within reason it’s not another or a stronger drug I need now. It’s something that meds don’t offer – a face, a voice, a presence that understands, listens, calls me on mistaken assumptions, suggests strategies, reminds me of what I’ve done in the past and how far I’ve come.

You’ll never find that in pill form.

 

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Mental Health

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When Men Aren’t the Gaslighters

January 14, 2018

In the series of posts I have done on “gaslighting” (https://wp.me/p4e9Hv-pm, https://wp.me/p4e9Hv-C2), the focus has been largely on male gaslighters and female victims of gaslighting. Now it’s time to take a look at the other side: men as victims of gaslighting.

In researching the topic, I found that very little had been written on it. I did find James Barnett. I will not be addressing Barnett’s view of gaslighting as false allegations by narcissistic females to accuse innocent males of emotional abuse (https://www.linkedin.com/pulse/reality-situation-male-victims-abuse-james-barnett/). That, I think, is a different topic.

In my earlier posts, I tried to include the statement that either sex can be gaslighted (gaslit?) and either sex can be the gaslighter, but most writing on the subject, including mine, has treated the one version of gaslighting without the other. Here I will try to expand the dialogue.

Just to recap: Gaslighting is a form of emotional abuse in which one person denies the other’s perception of reality, usually with the intention of discounting the victim’s legitimate complaints, often to the point where the victim believes she or he is going crazy.

At its core, gaslighting is a form of emotional abuse – a very specific, toxic, dehumanizing form of bullying, if you will. As in bullying, there are three conditions: a (real or perceived) mismatch between the two people, harm done, and repeated instances. It’s easy enough to see the harm done and the repetition of behaviors in gaslighting.

So, let’s look at the mismatch: One of the people involved (the abuser) has (or is perceived to have) power of some sort over the other. This can be emotional power, as in the dominant person in a relationship; financial power, as in a boss/employee relationship; physical power, as in a caregiver/disabled person relationship; or any other version you can think of.

In any of these situations, either a man or a woman can be the abuser and either a man or a woman can be the abused. Same-sex couples can include a more powerful partner who can exert psychological dominance over the other. Boss and employee can be same or opposite sexes, and so on. So, although we often call the gaslighter “he” and the victim “she,” that is inaccurate and prejudicial.

It is also the most common dynamic in a gaslighting relationship. Sad but true, in most emotional relationships in modern America, a male has psychological or emotional power over a female and hence is more likely to be the gaslighter.

In cases where the male is the victim of gaslighting, however, great harm can be done, simply because of this assumption. The male victim of gaslighting (as indeed the male victim of any emotional or physical abuse) may be discounted – not be believed, be accused of lying, be put down for being a victim. In effect, the male victim has been gaslighted twice – once by the actual abuser (male or female) and again by the system and the people in it who discount his perception of reality.

Women who are victims of gaslighting can, if they are able, recognize the gaslighting for what it is and get help in undoing the damage, either by getting out of the relationship or by having her perception of reality validated and strengthened by a therapist or other caring individuals.

Male victims of gaslighting have the deck stacked against them in this regard. A man may be believed if he reports that a male boss is gaslighting him, and will be encouraged to leave the situation. A male who suffers gaslighting in a romantic relationship is much less likely to be believed and may in addition suffer scorn, pity, or derision for mentioning it.

In that situation, it is a lot more difficult for a man to get help. Friends, relatives, and even therapists may not see or recognize the gaslighting for what it is. The male victim can often believe a gaslighter who says that the victim is indeed crazy and that no one will believe him.

Discussion of this dynamic does nothing to diminish the plight of female gaslighting victims. What it does is acknowledge the male victim’s situation – validate his perception of reality, if you will – and begin a conversation that may help lead to healing for all victims of gaslighting.

 

 

 

 

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Using Facebook to Track Bipolar Depression

January 7, 2018

I never planned it this way, but I’ve just realized that I can track my moods (roughly) by looking back at my Facebook posts.

When I joined Facebook, I must have been in a hypomanic phase. Thanks to Facebooks “today’s memories” feature, I can see that I posted numerous things going on in my life and assorted weirdness I’d encountered, usually about language or science or feminism:

Plenty of food in the freezer. (Spare freezer outdoors.) Plenty of food in the fridge. (Spare fridge downstairs.) Plenty of seasoned firewood. Plenty of sweaters. Plenty of cat food. Plenty of cats. We’re ready.

Little to no snow here. But bring your brass monkeys inside tonight, folks!

Weird Non-Word of the Day:

bang (a fine word, except when it purportedly means the singular of bangs, the hairstyle)

I also posted an ongoing series of amusing or stupid headlines I saw on the Internet:

“Oh, Who the Hell Cares?” Headline of the Day:

Is 2014 the year of the biscuit?

Unless you’re a dog. Dogs care deeply about this.

Those were all from January 2014. And from 2013:

Just so you know – do not put a whole summer squash in the microwave. It will explode. This tip courtesy of someone who prefers his name not be mentioned. Thank you. You may now go back to whatever you were doing.

I was engaged. I was communicative. I was – dare I say it? – buoyant.

I was hypomanic, or at least on a level playing field.

This year I have taken two breaks from Facebook for my sanity’s sake, in reaction to all the negativity and bad news appearing there. When I do post, it’s always pass-along memes or cartoons. (I’m glad I’m still “alive” enough to find some things funny.) Occasionally I make comments or ask questions about my friends’ posts – but not damn often. I IM with one or two close friends, and that seems the most “productive” thing I do, some days. A series of days or months like that are a pretty clear indication that I’m on the downswing.

I understand that now Facebook’s memories feature will let you weed out bad memories, instead of reminding you of them and offering to repost them for all to see. (If only I could do the same for my brain!) The problem is, right now, you can only have them block references to certain people and certain dates.

Birthdays and holidays are tough for me, as I know they are for many of you, but, anymore at least, they are not so traumatic that I have to expunge them from my life. I can always choose not to repost them. Just as I can choose not to repost things I said that were about depressing topics – not getting a job, being angry about political bullshit, the death of a pet. The people I would block are already on my blocked list, or are ones I never “friended” in the first place.

Facebook also reminds me what I posted on my blogs in various years, and that gives me some idea of what I was thinking or feeling at the same time in various years. If I wanted or needed to, I could look through my Facebook memories and plot a graph of how my moods fluctuated from month to month, year to year. Yes, I know that there are software apps that will do this for you and that I could keep a mood journal or even a paper-and-pencil graph.

Instead I check my Facebook memories and re-repost things that I still think are funny.

 

 

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Gaslighting and Bipolar Disorder: A Follow-Up

December 31, 2017

Over a year ago, I wrote about gaslighting and bipolar disorder (https://wp.me/p4e9Hv-pm). In my post I said:

[W]hat does gaslighting have to do with bipolar disorder? Someone who is in the depressive phase of bipolar – especially one who is undiagnosed – is especially susceptible to gaslighting. The very nature of depression leaves a person wondering, “Am I insane?” To have another person reinforcing that only strengthens the idea.

Since then, gaslighting has become a hot topic, appearing all over the Web, so I thought I’d write about it again.

The essence of gaslighting is that someone denies your reality and substitutes his own. (Gaslighters are mostly – though not exclusively – men.)

What I believe is driving the interest in gaslighting is the “#MeToo” movement. Women everywhere are speaking up about incidents of sexual harassment, sexual abuse, sexual assault, and even rape that they had not spoken of before. Or that they had spoken of but not been believed.

In many of these cases, gaslighting was involved. The women say, “This happened.” The men say, “It was a joke/flirting/a compliment/not that big a deal/consensual.” Until now men have denied the women’s perception of abusive reality and substituted their own innocent explanation. And, for the most part, the men’s reality has been accepted. Again and again.

Some of the high and mighty have recently been brought low by revelations of misconduct. The more we hear, the more it seems that men who achieve prominence in any field see women and especially their bodies as just another perk – like a company car or a key to the executive washroom. An audience for a dick pic. A pussy to grab.

Those are the cases that make the news. But the problem goes all the way down to the least prestigious situations. Any male in a position of power over a woman has the opportunity to exploit that relationship. Many are decent men and don’t. But many – from your local McDonald’s manager to the city bus driver to the head janitor – do. That’s millions of men and millions of women, the gaslighters and the gaslit.

Again, why discuss this in a bipolar blog? Because the very nature of our disorder makes us a little unsure of reality anyway. Perhaps this is mania and my boss is complimenting me because I really am sexually appealing. Perhaps this is depression and I deserve the degrading thing that just happened to me. Perhaps this is somewhere in between and I can’t guess what’s what.

A person unsure of her emotions is more likely to take the “bait” that the gaslighter dangles. A person unsure of her reality is more likely to accept someone else’s definition of it.

The #MeToo movement is empowering. It allows women to bring into the light the shameful things that have been hidden away. And it gives the bipolar person a more objective standard against which to measure reality. “That happened to me too! I was right that it was inappropriate!” “I saw that happen to my friend. Next time I’ll be strong enough to speak up!” “I see what’s happening. I’ll teach my daughter not to put up with that behavior. And my son not to do it.”

And it says to the bipolar person, “You have an objective reality outside your moods. You can trust your perceptions on these matters. You too have a right to live without these insults, these aggressions, this gaslighting. You can trust your feelings when you perceive that someone has stepped over that line.”

We have bipolar disorder. We are not the disorder. And it does not rule every aspect of our lives. When we perceive a situation as unprofessional, harmful, insulting, degrading, we can say so – and deserve to be believed. Just because we have a mental disorder does not make us any less worthy of decent, respectful treatment by the men in our lives, whether they be boyfriends, husbands, fathers, employers, or supervisors.

We have enough problems in our lives. We shouldn’t have to deal with gaslighting too.

 

 

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Bipolar Me, Looking for Work

December 24, 2017

I have been very fortunate over the last few years in that I have been able to work and that, combined with my husband’s far-from-large – but steady – paycheck, we have been able to pay the bills. Now that seems to be changing.

After my last big emotional crash, I was unable to work at all, and after my husband’s major burnout, he was not able to work for a while. We ran through our IRAs and ended up in the situation where we are now.

I do writing, editing, and proofreading jobs from my home computer. It is really ideal, in that the projects usually come sporadically, with time in between them, so I seldom require more energy than I have available. I do not have to go out very much, or dress up very often and can work in my comfort zone, in my comfortable study, in my comfy pajamas. In these respects I am lucky or blessed, or however you wish to define it.

But clients have become a little thin on the ground lately. And I am afraid. I fear both a financial crash and an emotional one. The two are not unrelated. Finances and dealing with them were two of the largest triggers that started the major depression-plus-anxiety that swallowed me up for quite a few years.

Now I am feeling the pinch again. I felt it back in August, when my “proactive hypomania” helped me get through (https://wp.me/p4e9Hv-y4). But one can do that only so many times. Or at least I can’t summon the necessary mood at will. (Surprise, surprise.)

I have a writing project now, but it will run out in January. I have another client, but work from them is not as consistent as it used to be. We are already behind on some of our bills, including the mortgage.

So I am looking for more work, and it is scary.

The kind of work I’ve been doing is ideal, even when my symptoms increase. It lets me work around the deficits that bipolar heaps upon me. If I have a project due Monday, I can work during the weekend. If I have insomnia, I can work at night. If I am immobilized, I can usually schedule my deadlines so they don’t all hit at once.

I try to network, also at home from my computer, but that lets out job fairs and professional organizations and groups inhabited by people. I should put together a resume and sample packet and then try to figure out whom to send it to. Which is kind of like throwing spaghetti at the wall and seeing if any of it sticks. And the impressive kind of packet – slick, personalized, colorful, foil stamped, business-carded, sample-stuffed, stationeried – costs money to prepare, which of course is itself a problem since you have to spend it before you get results, if any.

So I have signed up with a number of sites that provide leads on jobs, and some of them don’t even want me to drive for Uber or move to Massachusetts.

Each time I apply, I ask myself, “Can I really do this job?”

Sometimes the answer is “Probably not, but I’m going to apply anyway.” Those are the 9-to-5 office jobs that would require me to upgrade my wardrobe just the teensiest little bit and try to keep the depressive phases under control if not totally under wraps. I have serious doubts about my ability to be “on” for eight hours a day, five days a week.

The Americans With Disabilities Act says that certain categories of people are entitled to “reasonable accommodations” in order to fulfill their job requirements. For someone like me, accommodations might include flextime, doing part of my work at home, time off for doctor appointments, and the like. If I got one of those jobs, I would have to reveal my mental disorder in order to receive accommodations, and I would have to decide whether to speak up about it before or after I got the job. Probably after.

The not-quite-as-frightening jobs are part-time ones, like working the circulation desk at the local library. They have their drawbacks too, including the same ones as full-time jobs, with less pay besides. Would it provide enough income to make a difference? Maybe not. Would I be able to do a part-time job and still squeeze in a little freelance work? I just don’t know. The idea is still daunting, to say the least.

(Another potential solution would be for my husband to get a better-paying job, but he is in the process of changing his meds, so that doesn’t seem likely either, at least for now.)

I know this seems like a better class of problem than many people with bipolar disorder have. Trying to keep up the mortgage payments is better than living under the Third St. bridge, fighting stray dogs for cold french fries. My husband’s job may be low-paying, but at least it’s steady and has a health insurance plan. I am truly grateful for these things.

And I am truly scared nonetheless. And tired. And sliding back down into depression.

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Is My Pain as Real as Yours?

December 17, 2017

The other day I got a comment on a post I wrote a while back called “Who’s a Spoonie?” (https://wp.me/p4e9Hv-h6).

The commenter said that I was wrong to use the term “Spoonie” for those with mental illnesses. The kinds of disorders that merited the appellation “Spoonie” were only those that involved a “physical debilitating condition where pain and fatigue play major roles.” That I am not a Spoonie. That the language is not mine to use. That I am a part of the problem.

Let’s take a closer look at some of those assumptions.

Mental illness is not an invisible illness.

I wrote about that, in a post called “Is Bipolar Disorder an ‘Invisible Illness’?” (https://wp.me/p4e9Hv-gI). Disabled World (https://www.disabled-world.com/disability/types/invisible/) seems to think it is. Their definition specifically includes mental disorders:

These [mental] diseases can also be completely debilitating to the victim, and can make performing everyday tasks extremely difficult, if not impossible.

Bipolar disorder and depression are included in their partial list of “invisible illnesses.” And if you want to talk about “everyday tasks,” consider the number of bipolar and other sufferers who can’t get out of bed, can’t shower, can’t leave their homes, can’t work.

The condition must be physical.

To the best of our current knowledge, bipolar disorder and many other mental illnesses spring from glitches in the neurotransmitters in our brains. The brain, a physical organ. Neurotransmitters, a physical substance.

Pain and fatigue are required to play major roles.

Well, I’ve written about that too, in a post called “Depression Hurts” (https://wp.me/p4e9Hv-6Z).

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

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

Oh, and are they chronic? I’ve lived with them all for years. Not all at the same time, maybe, and not without times when the pain let up. But are all Spoonies required to be in constant pain and fatigue? Again, Disabled World says not.

The language is not mine to use. 

Sorry, but language doesn’t work that way. Once a word is released into the wild, it goes where it wills, acquiring new usages and new meaning. And “Spoonie” is certainly out in the wild. The essay that first defined it is all over the Internet. The suffix -holic has escaped from the word “alcoholic” and is now used for dissimilar ideas including “shopaholic” and “chocoholic.” Can we say, “No, you mustn’t do that. It must be reserved for alcohol addiction”? We might, but it’s not going to happen. Trust me on this. I have some training in linguistics.

I am part of the problem.

I suppose so, if you believe there’s actually a problem. In my post on Spoonies, I asked:

Isn’t that how Spoon language started – as a way to begin a conversation on what invisible illnesses are and how they affect our lives? Not a secret language that only those who know the password and handshake can use.

Obviously, opinions on the subject will vary, and mine is only one among many. I cordially dislike exclusionary language. Does anyone else want to weigh in?

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Mental Health

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At Last, Some Encouraging News

December 10, 2017

 

 

 

 

 

You know I bitch a lot about the science and research associated with mental health in general and bipolar disorder in particular. It seems like I bitch about nearly everything I read in the press. Here are some examples:

I have been told that I have a weak understanding of science and the scientific process. It’s true that I have no degree in any science, not even the “soft” science of psychology. Yet I persist.

Some of my major objections (if you don’t want to read the above-mentioned posts, which I fully understand) include: that article headlines seldom match the stories they’re attached to; that too many qualifiers like “might” and “may” occur in the stories; that the research is still in the rats-and-mice stage, which is a lo-o-o-o-ng way from human trials or public availability; and that many reports contain yes-it-does/no-it-doesn’t debates.

Most of all, I hate “false hope” headlines that I don’t believe will ever trickle down to the bipolar-person-on-the-street. Certainly not in my lifetime, and maybe never. And if they should become available, the cost will be prohibitive. I can’t believe that many of us will have the wherewithal (meaning both access and money) to avail ourselves of the new solutions. I mean, can you really picture the average bipolar patient getting genetic testing or fMRI? Or insurance paying for it?

Then came the headline “Simple EKG can determine whether patient has depression or bipolar disorder” (https://www.eurekalert.org/pub_releases/2017-11/luhs-sec112017.php). Published by Eurekalert! (which, despite its name, appears to be an aggregator of science press releases from sources such as universities and labs around the world), the story reports on work done at Loyola University Health System.

For me, the take-away points are these:

“Bipolar disorder often is misdiagnosed as major depression. But while the symptoms of the depressive phase of bipolar disorder are similar to that of major depression, the treatments are different and often challenging for the physician….

“The study found that heart rate variability, as measured by an electrocardiogram, indicated whether subjects had major depression or bipolar disorder….

“Dr. Halaris said further research is needed to confirm the study’s findings and determine their clinical significance.”

And yes, this does feed into my dislike of small studies (under 200 participants) that admit “further research is needed.” But this one, it seems to me, could actually be of some benefit.

Misdiagnosing bipolar disorder as major depressive disorder is a real and perhaps not uncommon thing. I was diagnosed with major depression for decades before a psychiatrist realized I had bipolar disorder. The treatment I got in those decades helped, but the treatments since have helped more.

And I can see a 15-minute, three-lead EKG becoming more available, at least to those of us who still have insurance (a dwindling number, to be sure). In cases like mine, it could save years of incorrect diagnosis and less-than-effective treatment.

Of course, here I am using the hated word “could.” But I take heart from the fact that it is a noninvasive procedure, there are plenty of potential test subjects, the expected resulted is focused on a single, more manageable result – misdiagnosis of one condition – and the test uses a relatively simple, already available technology.

It won’t help me, of course, since I already have my diagnosis, but I think of the people – even people I know – who could benefit from it, and in the not-too-distant future. Would the person who swings from depression to anxiety and doesn’t respond to the usual medications for depression actually have bipolar 2? Would the one who has wide mood swings and a diagnosis of OCD prove to have both, in reality?

Who knows? Not us, at the moment. But in the near future? This time I think there really is hope.

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Mental Health

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