Bipolar 2 From Inside and Out

Knitting Away Depression and Anxiety

04 01 18

Photo by Athena, Creative Commons

Last week I dissed a story that I read online about self-care for bipolar disorder, which consisted of praise for sleep, pets, and creativity, things which anyone with bipolar already knows are good for their mental health.

It was pointed out to me by someone who should know that I was wrong to make fun of the researchers, since they were students learning valuable lessons about how to conduct research studies in the first place. Which led me to believe that it was all the reporter’s fault for presenting their results as news.

Anyway, as an apology to researchers and grad students everywhere, I’m now going to praise a research study that would otherwise get a “well, duh” from me.

Huffington Post (UK) shared the good news:

Knitting could save the NHS [National Health Service] vital funds because it leads to a healthier population, reducing depression and anxiety, slowing the onset of dementia and distracting from chronic pain, a new report has found.

The study was primarily focused on the benefits of knitting for the aging, but since depression and anxiety were two of the conditions that it reportedly relieves, I thought it might be relevant to bipolar disorder too. Now someone can do a study to confirm or deny this idea.

The report added that knitting “is a sociable activity that helps overcome isolation and loneliness, too often a feature of old age,” and, I might note, of mental illness.

There are many, many articles that extol the benefits of creative pursuits for those with bipolar disorder and other mental illnesses. Although the notion of “basket-weaving” is outmoded and stigmatizing, other creative activities are commonly suggested as part of self-care. (I discussed this in a post called “Tools for Tackling Bipolar Disorder.”)

Coloring seems to be the most popular recent trend, but drawing, painting, collages, and all sorts of needlework are well thought of too. (I would certainly put crocheting in the same category as knitting.)

But then there’s the other side of bipolar – mania. I don’t know a lot about creativity and mania because I only get hypomania. But I do know that when I’m hypomanic I can get a lot of writing done. (Whether it’s good writing is another question.)

However, if you’ll forgive anecdotal evidence, I once knew a woman who did experience full-blown mania as part of her disorder and was not well controlled on medication. One year at Christmas she decided to make green velvet dresses for all three of her daughters.

As she spoke of her progress over the ensuing weeks, however, it was clear that the project was not going well. She kept rethinking – and redoing – all the sewing. She didn’t like the design, or she didn’t think they’d fit right, or she saw some other flaw. She never finished the dresses.

Other people may have better experiences with mania and creativity, of course. I hope you’ll share with me if you have.

The idea of creativity as a way to be sociable intrigues me. Sewing circles are a time-honored tradition among neurotypical people as well as those with mental disorders. (A friend of mine and her cronies had what they called the “Stitch and Bitch Club.”) Needlepoint, quilting, and indeed all of the fabric arts can be group activities.

For those who aren’t into those kinds of needle-centric activities, there are classes in scrapbooking, drawing, painting, ceramics, sculpture, or other creative art forms, often available through local adult education programs, museums, or shops that sell arts and crafts supplies. And of course, writers’ groups abound at bookstores and other venues (though presenting one’s own work at such a gathering may be too daunting for some with self-esteem issues).

I should probably get involved with a writer’s group myself. I’ve had to give up needlework because of my eyesight and shaking hands. But I’m all for doing something for my brain. Lord knows, it needs all the help it can get.

 

References:

http://www.huffingtonpost.co.uk/entry/knitting-linked-to-health-benefits-including-reducing-depression-and-slowing-dementia-report-reveals_uk_5aa63cb0e4b07047bec7feee?ncid=tweetlnkukhpmg00000001

knitforpeace.org.uk

“Tools for Tackling Bipolar Disorder” https://wp.me/p4e9Hv-uT

 

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Mental Health

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Self-Care: Beyond Pets, Sleep, and Creativity?

03 25 18

New research from Western Sydney University has revealed that simple self-care strategies, such as spending time with animals and getting enough sleep, are helpful for people managing bipolar disorder symptoms. (https://medicalxpress.com/news/2018-02-pets-people-bipolar-disorder.html)

Sleep, pets, and photography – everything in one bundle

This is not exactly news, but the headline (“Sleep and time with pets help people living with bipolar disorder”) reflected my life so perfectly that I had to read on.

It turns out that the research involved only 80 subjects and was conducted by Edward Wynter, an honors student, who says he hopes “that knowledge of effective strategies can inspire proactive therapeutic engagement and empower people living with bipolar disorder to improve their health and wellbeing.”

And here’s the money quote:

This research reveals support for strategies already well known to professionals and people living with bipolar disorder, including those relating to quality and quantity of sleep, and drug and alcohol abstinence; but this study also highlights the effectiveness of several strategies yet to be explored such as spending time with pets and engaging in creative pursuits. (emphasis added)

Here’s some news, Mr. Wynter: Spending time with pets and engaging in creative pursuits are not “yet to be explored,” except perhaps by researchers. As he himself notes, professionals and people with bipolar disorder already know these concepts. I wonder what sort of grade this research gained him?

I’ve written about pets and creative pursuits myself. Service dogs for the mentally ill, for example (https://wp.me/p4e9Hv-nN):

Emotional Support Animals are dogs or cats (or, less commonly, other animals such as miniature horses or guinea pigs) that live with and provide comfort to a person with a psychiatric disorder, [t]ypically … one that qualifies as a disability under the Americans with Disabilities Act (ADA).

And even everyday pets can help (https://wp.me/p4e9Hv-jS). As I said of my very first cat: “We needed each other. I needed someone to care about, to focus my attention outward on. She needed someone to draw her out of her shell, to care for and about her.”

And regarding creativity (https://wp.me/p4e9Hv-uT):

Coloring books and pages for adults have been the trend for a while now. (Some of them are really for adults.) Jenny Lawson draws and also puts together tiny little Ferris wheels. I know someone who can make little sculptures out of drink stirrers or paper clips. The point is … [j]ust keeping your brain and your hands occupied is a good idea.

As for sleep, we all know that proper rest is a good thing, even if we’re not always able to achieve it. And I’ve written about that too (https://wp.me/p4e9Hv-vk):

Whether you sleep too much or not enough, bipolar disorder may be the cause. There are treatments, some involving meds, and others not. Meditation, for example, helps many people sleep … It’s a thing to discuss with your psychiatrist and/or your psychotherapist.

If I, a non-professional, already know about these aspects of treatment for bipolar that don’t involve therapy or medication (though I’m not knocking either one), why is research covering this old ground? Surely even lowly grad students can think of better, more productive topics than this.

 

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Mental Health

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Why I Hate TV Drug Commercials

03 18 18

Just as a general rule, I dislike commercials for any drugs. They impede the doctor/patient relationship. (I’ve often considered saying to my doctor, “I’m supposed to ask you if Latuda, Humira, Prolia, Viberzi, Lunesta, Cialis, Trulia, Trintellix, Keytruda, and Boniva are right for me.”) TV – and to a lesser extent print – ads encourage people to act as unpaid drug reps. And they only advertise expensive drugs until they go generic, which is when they stop being expensive and the drug companies stop making so much money.

(If you want to read more on the issue, go to https://www.medicinenet.com/script/main/art.asp?articlekey=106198.)

But there are other things about TV drug ads that make me more than a little cranky. Like where are the ads for drugs to treat bipolar disorder?

Oh, there are ads for drugs to treat bipolar depression, as well as ones for treating non-bipolar depression. You’d think that with approximately 2.8 million people who have bipolar in the U.S. and Canada (http://www.pendulum.org/bpfacts.html), there would be a market for bipolar treatments.

Also, the ads for depression treatments don’t always get it right. A few of them say that depression is more than just sadness, or that it lasts for several weeks at least. One even says that depression is a “tangle” of symptoms, which is certainly true. (Although the tangle is shown graphically in primary red, yellow, and blue, which don’t really say “depression” to me.)

Most, however, treat depression simplistically, with hidden depression represented by a smiley face mask hiding a frowny face mask. (The colors in that ad are muted during the “before” scenes and more vibrant during the “after” scenes, which is an old advertising trick.)

The ads also make it look like the most important thing about depression is not spending time with your family or not enjoying it if you do. While that certainly is one symptom of depression, it is by-and-large irrelevant to people like me, who don’t have 2.1 school-age children to take on picnics. And it’s pretty much a guilt trip for people who do.

Then there’s how the people in the ads are represented. Oh, they almost always show one POC and one slightly older person (frolicking with the grandkids). But all of them are attractive. All of them are models. Are we supposed to identify with them? Or just expect to look like them when our depression lifts?

I wouldn’t be so annoyed by this issue if it weren’t that ads for other kinds of drugs – those for psoriasis and diabetes, for example – have actual people with the disorder in them. Testimonials from those who’ve been there, as it were. Even real-life cancer patients are now featured in ads for treatment centers.

What’s up with that, I wonder? Surely they don’t imagine that only pretty people get depression or bipolar. It can’t be that they can’t find any well-spoken, real-life people who can relate their own experiences. I for one would feel more reassured if I heard about a treatment from someone who’s lived with the disorder instead of from someone selected at a casting call. Are we all homely and illiterate? (I meet the qualification for literacy, at any rate.)

Instead of trying to convince us what medications our doctors might prescribe us, the airtime would be better spent on ads that educated the public on depression and bipolar disorder. But those would be PSAs, of course, appear only at 3:00 a.m., and not make anyone any money.

Update: I have finally seen an ad for a drug to treat bipolar 1 mania. Everything else I wrote here remains the same.

 

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Mental Health

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“Lock Up the Crazies Before They Hurt Someone”

03 11 18

Mass shootings and the public reactions to them are pretty predictable among the mental illness community.

One thing you hear after every mass shooting – and after many smaller ones – is that the mentally ill should not have access to guns.

Fine. But I have bipolar disorder, as well as some guns that I inherited from my father. I occasionally go to a gun range and fire them, but not often since I’m not the gun aficionado my father was.

So what am I supposed to do? Sell the guns? Give them away? Turn them in to the police? My therapist? I was taught gun safety from a young age by two certified pistol and rifle instructors (my parents) long before I received my diagnosis.

The further you go into the debate about guns and the mentally ill, or about whether the mentally ill are a danger, the deeper you get into fundamental constitutional, legal, and medical issues, as well as considerations of simple practicality.

Some advocate locking up the mentally ill. This is irrational. What the proponents really mean is “Lock up the dangerous mentally ill before they become mass shooters.” And that is impossible.

First, there’s the matter of due process, which is as much a part of the Bill of Rights as the vaunted Second Amendment is. You can’t just lock people up without a trial or at least a hearing.

Second, there’s no way to determine whether a mentally ill person is likely to become a mass shooter or any other kind of danger. The only generally known predictor of violent behavior is past violent behavior. In fact, there’s no way to tell whether any given individual is going to become a mass shooter. That’s because it’s really hard to predict the future.

Third, there’s the consideration of medical decisions and the right to privacy. HIPPAA has gone a long way toward protecting the privacy of patients – including the mentally ill. At the moment, a mentally ill person can only be held for 72 hrs., and then only if the person goes to the hospital voluntarily or is determined to be a danger to self and others. That’s a high standard, and it should be.

Fourth, the mental health system is already understaffed, underfunded, and overwhelmed. There are long waiting lists for beds in hospitals and treatment facilities. Are we to build new asylums to accommodate all these supposedly dangerous persons? Train more counselors to treat them? Or just lock them up and get them out of sight, out of mind?

Fifth, the idea that mentally ill persons can be forced to accept treatment and take their medication as prescribed violates several basic rights. My mother, who was not mentally ill, hardly ever took her medications as prescribed. She would quit taking one after a few days “because it wasn’t helping” or “it caused sores in her mouth” – without telling her doctor. Should she have had a caregiver to monitor her compliance? Who would monitor all those potentially noncompliant mentally ill persons as they take their psychotropic drugs? I see, we’re back to putting them in asylums.

Besides, refusing treatment is a right that patients have – even mental patients. Physically ill patients, for example, can choose to forgo chemotherapy or dialysis or medications that cause side effects worse than the condition they’re prescribed for. And mental patients have the same right. They can stop taking a medication because they fear side effects like tardive dyskinesia or even weight gain, though we hope they consult their doctors first.

But forced treatment and forced medication, as some have suggested, brings us back to the question of who, how, and where. Asylums? Court-ordered treatment? Medications that must be taken in the presence of a doctor or a therapist (who is not qualified or licensed to dispense medication)?

Take all those arguments against forced treatment of the mentally ill and add the fact that the mentally ill are far more likely to be victims of violence than perpetrators of it, and where are we? Admittedly, the mental health “system” is broken, or at least badly fractured. But is the answer really to take away the civil rights of people who have broken no laws?

The press and the public are quick to focus on the mentally ill as the culprits in mass shootings. But even if they were correct, taking away fundamental rights would not only be no real solution, but would chip away at the rights of other disenfranchised or minority populations – the homeless, for example.

If there’s a solution to this problem, I don’t know it, but locking up the “crazies” isn’t it.

 

If you want to read more on both sides of the issue, see the L.A. Times article by Paloma Esquivel at http://www.latimes.com/local/la-me-adv-lauras-law-20140310-story.html.

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Mental Health

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Mental Illness, Faith, and Sin

03 04 18

This post started for me when I read a headline that said “What Made Mental Illness a ‘Sin’? Paganism.” It was by the staff of Christianity Today.

The article spoke of an evangelical women’s conference where “speaker Rebekah Lyons, in telling about her daughter’s anxiety attacks, suggested that mental illness could be healed through prayer.”

That’s a subject that I took up not long ago in this blog . In that post, I said, “In my opinion, what you can’t do is ‘pray away’ the bipolar disorder. If you’ve got it, you have to find a way to live with it. If prayer helps you do that, more power to you.” I stand by that.

But the CT article did not really explain how paganism was involved. To get a grasp on that, it turns out that you should go to the podcast “Quick to Listen,” episode 94, on Apple Podcasts. There Amy Simpson, author of Troubled Minds: Mental Illness and the Church’s Mission, explains that by paganism, she means the early Greek and Roman civilizations and their many deities, who saw some physical and psychological conditions as punishments from on high.

This link between mental illness, sin, and spirituality “isn’t really a Christian or religious idea,” says Simpson. “It’s really rooted in superstition and a misunderstanding of what mental illness is.”

The Christian Bible betrays some misunderstanding itself, when at least some of what we would today consider schizophrenia, other psychoses, or even epilepsy are defined as demonic possession. The Catholic Church, it should be noted, still – though rarely – performs exorcisms. And there are definitely still churches that equate mental illness with sin:

The bible makes it very clear that insanity, depression, anxiety, stress, paranoia are the punishments for living a sinful rebellious life contrary to the moral pattern revealed by God in the Bible. Remember, insanity is not a bodily disease, it is a behaviour choice. The only “cure” of insanity, is repentance of the sinful lifestyle and the sinful behaviour choices to solve the problems such a sinful lifestyle creates.

Leah Godfrey wrote an article that appeared on TheMighty.com. It was titled “5 Unhelpful Things Fellow Christians Have Said About My Mental Illness (and My Responses).” In it, she addresses the complicated topic of mental illness and the sometimes insensitive reactions of Christians to it. For example, to those who represent prayer as a power that can heal mental illness, she responds:

Yes, I do believe in God’s healing, that’s why I’m taking medication… because I’m blessed with enough resources to get help to be healthy again. I understand that some people … heard a sermon and *poof* they were healed; I am not that case.

And on the subject of suicidal thoughts, she says:

Yes, you can be a Christian and have suicidal thoughts. We all have thoughts of things we shouldn’t do or won’t do….I don’t believe anyone has the right to take a life, including their own. I’m a Christian who has had years of suicidal thoughts or thoughts of self-harm… Suicidal thoughts are lies we tell ourselves.

Such issues are not limited to the Christian community, however. In researching modern-day paganism (which is what I thought Christianity Today was going to talk about), I found a number of interesting resources. One talked about problems of sexual and emotional abuse within pagan groups and among their leaders, a subject hardly exclusive to the pagan community.

In fact, in my reading, I was interested to learn that pagan communities and Christian communities sometimes address mental illness in similar ways, and how one could benefit from the other’s perspective.

For example, I found this statement:

Many religious communities have support groups and other resources for members who suffer from mental illness. These kinds of services are desperately needed in the Pagan community. We need to learn from other religious communities and adapt to the needs of our own community.

Another pagan author, Luthaneal Adams says:

Can a person find that paganism is beneficial for their mental health? Certainly.  I’d say that spiritual fulfillment is one element of mental wellbeing.  If Paganism is what helps you find that spiritual fulfillment, then great. However, that is not the same as saying that Paganism (or things within Paganism) are themselves tools for achieving better mental health…. When it comes to mental illness, we’re talking about major, chronic illnesses.  No single ritual or ceremony is going to make that just go away.

Other fascinating subjects regarding Christianity, paganism, and sin are the multiplicity of sects and practices and beliefs in both forms of spirituality; the circumstances for excommunication and disfellowship as regards “sin” or disruption of the community; the question of “sinful” behaviors caused by mental illness; and so on.

I don’t have the theological background to address these points. But, to sum up what I found: that mental illness is or is not a sin, depending on whom you ask; that paganism, as well as Christianity, concerns itself with the mental health of its practitioners; and that many spiritual traditions advocate compassion for the mentally ill and an understanding of their suffering.

Certainly there exist both Christian and pagan communities that are more judgmental or less inclined to minister to the sinful or the mentally ill, rather than rejecting them.

These are things that all faith communities need to address.

References

http://www.christianitytoday.com/ct/2018/february-web-only/mental-illness-sin.html

https://wp.me/p4e9Hv-B6

http://www.bible.ca/psychiatry/psychiatry-mental-illness-bible-sin-guilt-conscience-cognitive-dissonance.htm

https://themighty.com/2017/03/christianity-mental-illness-anxiety-depression/

https://paganactivist.com/2014/04/09/pagans-mental-health-and-abuse/

https://paganleft.wordpress.com/2006/09/10/mental-illness-in-the-pagan-community/

https://www.luthanealadams.com/authors-blog/mental-health-and-paganism

 

 

 

 

 

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Mental Health

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Books About Bipolar and Other Fun Topics

02 25 18

I love reading. Always have – except for the period when a major depressive episode stole it from me –https://wp.me/p4e9Hv-qp. I’m never more than two feet away from a book or, at this point in my life, an ereader. Reading is how I explore the world.

So naturally, in trying to better understand my disorder, I read about it. And because I’m interested in psychology in general, in addition to books about bipolar disorder, I read about other mental illnesses as well.

Let me share some of my reading with you.

For sheer delight as well as profound insights, try Jenny Lawson’s Furiously Happy: A Funny Book About Horrible Things. Amid the hilarious stories of life in her other-than-typical family are insights into depression and social anxiety, along with a manifesto of defiance – the will to be, well, furiously happy.

The other easily approachable book is Allie Brosh’s Hyperbole and a Half: Unfortunate Situations, Flawed Coping Mechanisms, Mayhem, and Other Things That Happened. What started as a humorous blog grew into a book (with quirky illustrations) featuring two chapters in particular, “Adventures in Depression” and “Depression Part Two,” which are about as good as writing about depression gets. A second book, Solutions and Other Problems, was scheduled but has been postponed indefinitely.

And while we’re on the subject of funny books about mental illness, there’s Surviving Mental Illness Through Humor, an anthology edited by Jessica Azar and Alyson Herzig.

Perhaps the best-known book in the field of bipolar disorder is An Unquiet Mind: A Memoir of Moods and Madness, by Kay Redfield Jamison. In it, Jamison deals openly and honestly with bipolar disorder, particularly with mania and psychosis, along the road to becoming a doctor herself. She has also written Robert Lowell, Setting the River on Fire: A Study of Genius, Mania, and Character, about the famous modern poet, but I haven’t read it yet, so I can’t comment.

Birth of a New Brain: Healing from Postpartum Bipolar Disorder, by Dyane Harwood, is another recent book that I haven’t read yet, either. But I know Harwood’s writing and expect it to be a stand-out, as well as the only book I know of on that particular topic.

Other books on bipolar disorder include Lost Marbles: Insights into My Life with Depression & Bipolar by Natasha Tracy.

For books about depression, the definitive work is The Noonday Demon: An Atlas of Depression, by Andrew Solomon. A thorough examination of depression, including the author’s own, it is practically a reference book on the topic, though much less dry than that makes it sound.

Darkness Visible: A Memoir of Madness, by William Styron, is another classic on depression that I really ought to read, but haven’t yet because I’m not that fond of Styron’s writing. (Sophie’s Choice is his best-known work.)

For mania, I recommend Just Like Someone Without Mental Illness Only More So: A Memoir, by Mark Vonnegut, M.D. The son of Kurt Vonnegut, Jr., the author deals less with his celebrity father, instead focusing on his saving-the-world-style mania during his pursuit of an M.D. degree.

Other books that I can recommend include:

  • My Lobotomy, by Howard Dully, a memoir of a boy who was lobotomized for no particular reason other than the fact that his stepmother hated him, and the difficulties he encountered in and out of institutions.
  • Ten Days in a Mad-House, by Nellie Bly, early undercover journalism at its finest. (I wrote about her experiences in one of my earlier posts: https://wp.me/p4e9Hv-hG.)
  •  Shrinks: The Untold Story of Psychiatry, by Jeffrey A. Lieberman, a history of the development of the field from the buried memories days to the biological understanding of today.
  • The Man With the Electrified Brain: Adventures in Madness, by Simon Winchester (who also wrote The Professor and the Madman, about the making of the Oxford English Dictionary). Despite the title, this is not about electroshock treatment, but rather dissociative states.
  • Rebooting My Brain: How a Freak Aneurysm Reframed My Life, by Maria Ross; and My Life Deleted: A Memoir, by Scott Bolzan. These books, about a cerebral accident and amnesia, respectively, don’t speak directly to bipolar disorder, but I found them interesting as accounts of rebuilding one’s life after a significant mental condition.

And for an opposing point of view, if you must, there’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker. Once you’ve read the title, you pretty much know how the book’s going to go; I don’t recommend this anti-psychiatry screed.

What books do you recommend? Which have helped you?

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Mental Health

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Handling Hypomania and Shopping

02 11 18

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?

02 04 18

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

01 28 18

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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Mental Health

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Back to the Therapist

01 21 18

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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Bipolar 2 From Inside and Out

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