Bipolar 2 From Inside and Out

The Other Holiday

November 26, 2017

I’m not going to write the standard “Surviving the Holidays” post this year. You all probably know what that one says: Self-care, self-care, self-care. Avoid toxic people, and if you can’t, get away from them as soon as possible. Don’t drink. Take your meds. Make sure you’re not alone unless that is what you truly want. And if you don’t know these things, you can read them in dozens, if not hundreds, of places. There’s not a lot I can add to that.

No, I’m going to write about the other holiday – the one we all have. The one that happens to fall – for me – right during the other holidays. The birthday. I wrote earlier this year about birthdays, and parties, and surprise parties in particular (https://wp.me/s4e9Hv-surprise), and I also wrote about the low-grade depression that dogs me this year (https://wp.me/p4e9Hv-AC). The two, I suppose you’ve guessed, are not unrelated.

After I experienced a severe trigger at a birthday party while in my teens, I tried to disown my birthday. In my dysfunctional way, I told people that it was on March 1, rather than in December. This was a stupid coping mechanism, not unlike the time prescription Ibuprofen caused me stomach trouble in college and I sat by the door in my classes, hoping that the burping would be less noticeable there. Don’t ask me why. Irrational thinking, I guess. My birthday didn’t go away (the burping didn’t either), my family still baked me cakes, and I still got presents or cards.

Eventually, I reclaimed my actual birthday. As the years went by and my friends scattered and my general holiday depression got more debilitating, I barely celebrated at all. Now it’s pretty minimalist – a meal out with my husband, a non-wrapped present or two, and on with the regular day. Dan tries to make it special, God love him, but my definition of “special” is telling the wait staff not to gather around me and sing. Then Facebook came along and now I have the opportunity to count the number of people who wish me happy birthday. As excitement goes, it’s not much.

I can’t say my lack of enthusiasm for birthdays is limited to myself, either. On Dan’s birthday, we have the same sort of celebration, except with fewer presents. (Dan stashes away little gifts for me all year long and often gives me things he’s bought back in July. I lack the wherewithal, in terms of energy, to do likewise.) Online shopping has made things easier, but Dan brings in the mail, so he usually has an idea what he’s getting, based on the size and return address of the package.

In a way, I suppose it’s more efficient to have my birthday tucked in among the other holidays so that one gray fog can cover them all. I could also be experiencing a bit of Seasonal Affective Disorder, but I’ve never been diagnosed with that, so let’s stick with what I know I’ve got. (I’ve tried using natural sunlight bulbs, but I really couldn’t notice any difference.)

Do I ever get hypomania at the holidays? Rarely. Although there was that one Christmas when I got Dan socks and underwear and wrapped each sock and t-shirt in a separate, different-sized package.

But we were talking about birthdays (or at least I was). Maybe it’s aging, and maybe it’s my bipolar disorder, but I’m content these days just to let birthdays slide by with an emotion that ranges from meh to Bah, Humbug, depending on the year.

I know, I know: self-care, self-care, self-care. It’s not just for Christmas anymore.

 

 

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Does It Help When Celebrities Talk About Mental Illness?

November 5, 2017

It usually doesn’t hurt.

But how much does it help?

That depends on who is talking about mental illness and what they say.

Celebrity Activists

We need more mental health advocates like actors Carrie Fisher and Glenn Close. Both of them have spent years talking about their own and their loved ones’ experiences with bipolar disorder and schizophrenia. Neither one is a one-benefit-and-they’re-gone supporter. They repeat their vital messages again and again, in different ways, in different venues, in different words. Carrie Fisher, in particular, used her mega-star power and witty personality to keep the discussion alive and spread it to millions of people.

Active Celebrities

While not devoting as much time and attention to mental health activism as Fisher and Close, other well-known entertainers including Demi Lovato and Lady Gaga have made contributions to the public discussion on various mental illnesses. Because of their large number of fans, these messages reach millions of people. And their music reaches people at an emotional level that PSAs just can’t. If even a small percentage of their audiences pays attention to the messages, that’s a lot.

And we can’t forget Prince Harry. Positive messages about mental health coming from royalty are ones that people will listen to. (You know how we Americans love royals.)

Celebrities

Other celebrities mention their mental health diagnoses in public, but do little more to campaign for mental health causes. Catherine Zeta-Jones spoke of her bipolar II diagnosis when she was hospitalized for five days, saying that it was brought on by stress. And renowned glass artist Dale Chihuly admitted his bipolar disorder when he was more or less forced to by a lawsuit.

Staying quiet certainly is their right. Mental illness is a deeply personal and to many, a private thing. And celebrities as much as any of us must struggle with when and how and to whom to reveal their struggles. Perhaps in the future they may become more comfortable talking about their problems and contributing to mental health causes and organizations.

Suicides

Unfortunately, suicides speak loudly. Robin Williams’s death by suicide made a big impression. It got people talking – if only to ask “why?” Though a lot of the conversation revolved around “Even funny people can have suicidal depression,” that’s a start on the message that you can’t tell who’s suffering inside just by looking at them. It’s just too bad that the death of a beloved entertainer is needed to start that discussion.

Media

Are the media “celebrities”? A few individuals truly are, But as a group, the media have the largest platform of all. And what do they say about mental health? I think you know the answer. Mental health gets discussed in the news media in cases of terror and tragedy, and when no other explanation comes readily to mind.

The media bear a huge responsibility when it comes to stigmatizing mental illness. Theirs are the only messages that many people hear – and believe. The news media have (or at least used to have) a reputation for spreading the truth. Nowadays we can’t even count on that. The splintering of the news media into “sides” to promote opposing ideologies – combined with shrinking budgets that have nearly eliminated informed science reporting – make it difficult for the average news consumer to know who and what to believe.

Who does that leave to spread the message? Us. Those of us who live with mental illness or have loved ones who do. And sometimes I worry that we are talking mostly to ourselves – to each other. Don’t get me wrong. Those conversations are vital in helping one another deal with our difficulties and sharing messages of support and understanding.

But maybe we can do more – even if it’s educating a family member about depression or wearing a semicolon tattoo to promote suicide prevention or posting/commenting on social media when a news outlet has gotten its coverage of mental illness all wrong.

Among my fondest hopes is that one or more of my blog posts will be passed along to someone who needs to hear the word. “Here – read this,” is a message I would be proud to spread, even though I’m no Carrie Fisher.

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The Gray Dog and Me

October 29, 2017

Nothing is really wrong.

Feeling like I don’t belong.

– The Carpenters “Rainy Days and Mondays”

After quite a long spell of stable feelings (and maybe some productive hypomania – https://wp.me/p4e9Hv-y4), I’ve hit the wall of depression again.

Not full-blown depression, like I’ve had so often in my life. This is technically dysthymia, which is psych-speak for a low-grade depression, sort of like a low-grade fever that makes you tired and headachey and not wanting to get out of bed. To curl up in a blanket and sleep. To take aspirin and forget about everything else.

That’s where I am. I’m not wrestling with the Black Dog (https://wp.me/p4e9Hv-5Y). Call it the Gray Dog.

I am finding it very hard to write this, but I am pushing to do it, because at the moment, that’s one of the few positive things that I can point to – that my husband can point to – and remind me that depression lies.

What depression is telling me now is that I haven’t accomplished anything in my life. That I skated through high school and missed wonderful opportunities in college. That my jobs have been a pointless series of minimal value to anyone. That my writing is self-indulgent crap, unoriginal and meaningless.

Depression is telling me that I don’t matter. That I am becoming invisible. And that it’s my own fault, for never going out, for not reaching out. It’s not quite the self-pitying whine of “If I died, no one would come to my funeral.” It’s more like turning into a particularly ineffectual ghost – frightening no one, bringing no message from beyond, just fading and losing substance.

Depression is telling me that the future is bleak. I have a writing assignment now, but in a month it will be over and I’ll be right back where I was – at the edge of panic or worse, despair, or worst, both.

Depression is telling me that I’m a terrible burden and I don’t deserve my husband, who takes care of me when I’m like this.

At the moment I don’t have the ability to believe that all these are lies.

I do know that this won’t last forever. I’ve come far enough in my healing to believe that. And comparatively, it’s not that bad. I am quietly leaking tears, not weeping copiously. My bad thoughts are not as ugly as they could be, have been.

I haven’t given up.

But I almost want to.

It’s the “almost” that makes this the Gray Dog and not the Black Dog. That keeps me taking my meds and waiting for the Gray Dog to depart. That tells me to write this, even though I doubt its usefulness.

Useless sums up how I feel. Old and tired. Detached from society.

As depression goes, I’m really in a not-terribly-bad place. Which doesn’t make it much easier to live through. A little, though. I still have my support system, and I did get out of bed today (after noon), and I’m writing, even as I doubt my ability. But if I’m quoting The Carpenters, I can’t help but feel just a wee bit pathetic.

The Gray Dog is with me. One day soon but not soon enough, it won’t be.

 

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The Latest Headlines on Mental Illness

October 22, 2017

There’s a wonderful article, originally in The Telegraph, with the title “Can Depression Be Treated With Anti-Inflammatory Drugs?” Snopes.com, the preeminent debunker of all things dubious, proceeded to do what they do best – debunk. In their analysis, they find several factors common to many widely reported studies that illustrate why we shouldn’t take these announcements of causes or cures at face value or at least without a grain of salt.

They break down their reasons for not jumping on the study’s bandwagon into three major categories.

No Credible Scientists Have Argued that All Depression is Caused by Inflammation. The article in The Telegraph was talking about patients with Major Depressive Disorder (MDD) who were not responding to current medication, or who also had other inflammatory-related conditions such as rheumatoid arthritis (RA). And the information came from just one talk by just one scientist,

Association is Not Evidence of Causation. I’ve written on the subject before (http://wp.me/p4e9Hv-7Z, http://wp.me/p4e9Hv-9L), and included a link to a short video that explains the scientific process, from original study up to the time when a new drug or treatment hits the market (http://www.vocativ.com/culture/junk-science/). Briefly, it means that just because two things are correlated (or happened one after the other) does not prove that one caused the other. Inflammation may have caused depression, or depression may have caused inflammation, or other factors may have influenced one or the other, or both, or neither.

The Anti-Inflammatories Discussed Are Specific, Powerful Drugs with Side Effects. You can’t just go down to the corner drugstore and pick up a bottle of ibuprofen and think you’ve solved your depression problem. And it turns out that the anti-inflammatories they’re talking about increase the risk of infections and cancers, and are wildly expensive.

Snopes concludes:

While the science discussed by the Telegraph in this article is real, it omits seriously important context and misrepresents decades-old research as a breaking development in a way that could provide false hope to those suffering from depression. The interplay between the immune system and the mind is increasingly well established, but that doesn’t mean that science has established anything close to a new treatment for depression as a result of this understanding.

“False hope.” That’s what a lot of these headlines regarding causes and treatments for depression offer. Shall we look at another recent example?

This one, I’m sorry to say, comes from bp magazine (bphope.com). The headline is “Underlying Molecular Mechanism of Bipolar Disorder Revealed.” The tagline reads, “Findings inform development of potential diagnostic test and improved therapies.”

But that’s not exactly true. The first paragraph says nothing about the underlying mechanism of bipolar disorder. Instead, it talks about the mechanism “behind lithium’s effectiveness in treating bipolar disorder patients,” something very different. But that doesn’t make as snazzy a headline. The article also says the results “may support the development of a diagnostic test” and “may also provide the basis to discover new drugs that are safer and more effective than lithium.” May. Might. Or might not. Too soon to get your hopes up.

The conclusion? [T]he study demonstrated that bipolar disorder can be rooted in physiological—not necessarily genetic—mechanisms.” Well, I’m a word nerd, not a science geek, but “can be” is a far cry from “is.”

Now for my favorite, reported by the BBC: “Magic mushrooms can ‘reset’ depressed brain.” Again, the tagline says “raising hopes of a future treatment,” which is a pretty far stretch. The study was performed on 19 subjects, each given one dose of psilocybin. The article reports that “Half of patients ceased to be depressed and experienced changes in their brain activity that lasted about five weeks.”

So. Tiny sample. No control group. And flip a coin on the results. Personally, I don’t see that raising much hope.

Bottom line for this one: junk science. Eye-catching headline. They won’t be handing out magic mushrooms at the local mental health clinic anytime soon. (The article does warn not to self-medicate.)

We’ve been hearing for years about tests to diagnose depression and bipolar, and stunning new treatments. Well, the studies take years to do properly; the tests need to be proved accurate and better than current psychological testing; and the treatments must go through years and years of studies, animal testing, and human testing, complete with control groups and sufficient numbers of subjects to make them scientifically significant.

I just wish these people would quit reporting “results” until they have some to show.

 

Resources

http://www.snopes.com/2017/09/19/can-depression-treated-anti-inflammatory-drugs/

https://www.bphope.com/underlying-molecular-mechanism-of-bipolar-disorder-revealed/

http://www.bbc.com/news/health-41608984?utm_source=dlvr.it&utm_medium=facebook

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The Lone Wolf Strikes Again

October 15, 2017

It is gun control, or the lack thereof.

It is Hollywood.

It is religion, or the lack thereof.

It is radical Islam.

It is a conspiracy.

It is a “false flag” operation.

It is substance abuse.

It is toxic masculinity.

It is hatred.

It is anger management issues.

It is evil.

It is desire for fame.

There are plenty of suggestions for what causes events like the Las Vegas shooting. The one that amused me most is that men do not have close friends and don’t play enough (despite the prevalence of golf, tennis, softball, bowling, basketball, and a lot of other recreational sports). But the go-to explanation, once race and religion have faded into the background, is mental illness.

This time around the shooter is a white male belonging to no terrorist cell or cause, so he gets called a “lone wolf.” (Do I hear that resonate as a symbol of pride and freedom? Don’t rebels and renegades of all stripes identify themselves with lone wolves? Aren’t lone-wolf types celebrated in movies and TV shows and novels and video games? It’s certainly a “nicer” epithet than “terrorist.”)

And since Stephen Paddock was on one anti-anxiety medication, a (very loose) case is being made for mental illness. Again. Despite the fact that he was never diagnosed, treated, hospitalized, or gave any other indication of mental illness. Unless you count shooting hundreds of people.

Certainly a person who did what he did would be tested for mental illness after he committed such a horror, had he not killed himself. But before the fact? Was he mentally ill – a “known” hazard?

He was quiet, a loner. (Aren’t they always?) He may have had financial problems related to gambling. He took a benzo.

Think of all the quiet men you know that have financial problems, perhaps even addictions such as gambling. How many of them have stockpiled guns and shot hundreds of people? Hell, my husband is a loner with financial problems, takes an antidepressant, and has access to guns. Why hasn’t he?

Because these men – millions of them – do not become mass shooters as a rule. And when one does, well, he must have been crazy.

You and I know the statistics. One in four people will experience some form of mental disturbance in their lifetimes. Yet 25 percent of us do not become mass killers. The unfortunate fact is that there is no way to predict who is going to. Even after the fact, there is no way to say, “We should have known,” because so many people fit the criteria.

It’s a complex problem, difficult or impossible to untangle. Just as one cannot say that cyberbullying was definitely what caused a suicide, there are myriad factors at work in violence, and blaming just one “obvious” cause does not explain or help. Look at Columbine. Harris and Klebold may (or may not) have been bullied. But they also lacked supervision, had trouble with the law, and had access to guns and explosives. Can any one of those factors be viewed in isolation from the others?

There are some voices that have started to question the automatic link between mental illness and violence. Julie Beck wrote a fine article for the Atlantic (https://www.theatlantic.com/health/archive/2016/06/untangling-gun-violence-from-mental-illness/485906/?utm_source=fbb), which I hope will be widely read and influence many people. I’ve written about the problem too, small contribution though it may be (http://wp.me/p4e9Hv-6A).

Beck calls the easy leap from mass killing to mental illness “a consistent and dangerous narrative.” She points out that “[o]nly 4 percent of the violence—not just gun violence, but any kind—in the United States is attributable to schizophrenia, bipolar disorder, or depression (the three most-cited mental illnesses in conjunction with violence).  In other words, 96 percent of the violence in America has nothing to do with mental illness.”

And, she says, “Other research shows that reading stories about mass shootings by people with mental illnesses makes people feel more negatively toward the mentally ill. This only heightens stigma, which could lead to more people going untreated.”

That’s a second horror, not as sensational or sensationalized as mass killings, but a chilling one nonetheless. None of our anti-stigma campaigns speaks as loudly as gunfire.

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Ten Opinions That May Offend Someone

October 8, 2017

Recently I noticed that I have been reluctant to offend people, particularly on Facebook. I keep my opinions to myself, especially on social and political matters, and dread being “unfriended” or starting (or continuing) a “flame war.”

This is not just a matter that relates to my bipolar disorder, though it is certainly that too. I have written a number of times about how having bipolar disorder and the behaviors it has brought out in me have cost me friends, even ones that I thought were “forever-friends.” These losses have affected me greatly, at times pushing my anxiety and depression buttons nearly as far as they can go.

Just as I have toned down my comments on subjects such as liberal vs. conservative issues, I have also let pass by posts in bipolar support groups and mental health memes on people’s general Facebook timelines that I’ve disagreed with. Oh, when I see a particularly incorrect or egregiously stigmatizing remark, I’ve been known to smack the person on the nose with a rolled-up newspaper, but often in a soft, “In my experience, you may not be correct” manner.

There are also conflicts within the bipolar world that I have strong opinions about but have not jumped into, for fear of offending someone. And I have to ask myself, what would be the consequences of offending someone in such a discussion?

Yes, I might be unfriended. More likely I would be ignored. Or (virtually) yelled at. In other words, if I offend someone with my opinions, they may in turn offend me with their opinions. And while that’s not a productive state of affairs, it’s hardly the end of the world. In an ideal world, I might cause someone to question or consider or engage in fruitful discussion. Not likely, but possible.

So, if I am trying to overcome my fear of offending people with my positions on guns, abortion, health care, climate change and the like, what am I to do about my opinions regarding bipolar disorder and mental health in general?

Well, first of all, I can state where I’m coming from: straight, white, female, married, childless, bipolar type 2, 60 years old, diagnosed for years and on any number of medications for years as well. Not much controversial there. That’s just facts about me and hard to deny.

But here are some things I believe that I know are sometimes subject to differences of opinion. And for what it’s worth, here’s my take on them.

  1. Psychotropic medications are good things. Yes, they can be overprescribed or improperly prescribed, but when dispensed and used correctly, they help.
  2. The Scientologists are way off base. Mental illness exists, and so do treatments for it.
  3. “Natural” or “holistic” treatments for mental illness are not enough to replace medication and talk therapy.
  4. Sunshine, exercise, and positive affirmations are good things, but also are not enough to replace medication and talk therapy. They do good for a number of people, less for others, and not much at all for some.
  5. We’ve got to change the popular dialogue about mental illness and violence. We must not let it go unchallenged. For that matter, we must change the popular dialogue about mental health in general.
  6. While it’s a good thing if those with mental illness take their medications properly, it is absolutely their right to refuse treatment.
  7. Health care (and insurance plans) should cover mental health care at the same levels as physical health. (Okay, that one’s not really controversial among the mental health community.)
  8. Emergency responders including police should all receive training in dealing with mental health issues, but they probably won’t.
  9. Most people don’t/won’t/can’t understand mental illness until it touches their own life in some way, and maybe not even then.
  10. Education about mental health issues should begin in grade school.

There. If you disagree with any of those statements or feel that I am an idiot for stating them, so be it.

Oh, and while we’re at it, persons with a mental health diagnosis should not automatically be prevented from owning guns, but people with domestic violence convictions should be.

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My Love-Hate Relationship With Hypomania

October 1, 2017

Most of my time on the bipolar 2 spectrum has been spent on the depressive side. Lately, however, I’ve been trying to acknowledge my hypomanic side as well.

This has been difficult to do. My psychiatrist told me that my hypomania generally comes out sideways, as anxiety, and I’ve certainly had my share of that. One of the earliest I remember, from my teens, was when I had panic attacks in the cereal aisle at the grocery. I attributed it to the bright, loud colors that bombarded my senses and, if my later reaction to Chuck E. Cheese’s is any indication, that may have been accurate. My doctor at the time, however, thought it was an ordinary panic attack that I just happened to have while in the cereal aisle, and the two became linked in my mind. Of course, this was before I was diagnosed bipolar, so who really knows?

I also used to have the panicky kind of hypomania when my husband was driving the car, particularly on the highway. I still maintain that panic while on the highway is not completely unwarranted (compared, say, with the cereal aisle). It is, after all, a dangerous place.

The first time I can remember having the swooping, soaring type of hypomania was when I worked at a publishing company. A young woman came through and asked me about how to get published. Pressured speech? I babbled, I burbled. I spouted advice. I sprayed out ideas. I rejoiced in my own success while encouraging her in hers. I had no idea if she really had the talent or the drive necessary, but by the time I finished twittering at her, she had caught my spark and resolved to go right home and put my advice into practice. I have no idea, to this day, whether she succeeded. But at least, in that case, my hypomania was inspirational.

I used to say, when I was diagnosed unipolar depressed, that I wished I were bipolar, because then I might get something done. (I will pause here while you all laugh.) But the truth is, hypomania pushes me to take on challenges that I can only sometimes accomplish. Once I agreed to interview an old Chinese lady and write something based on her experiences. After the interview, which was fascinating but overwhelming, I was unable to write. It was one of the few times I took on an assignment I couldn’t finish.

More recently I took on an assignment to write 13 children’s stories of 2500 to 3000 words each, with very specific deadlines. Although I’ve met all the dates so far, I wonder whether hypomania has fooled me again. All I can hope is that this is one of those times when it has pushed me into doing something difficult, but will help me maintain until I get through it.

So, it seems, most of my hypomania is related to work (except for the cereal thing and the driving thing). I occasionally get the urge to spend money, but since we don’t have much money, it’s not too hard to fight that one off. Plus, we don’t have a credit card. We learned that lesson years ago.

What to make of all this? I now know that hypomania is part of my psychological makeup. I now know that I have to watch out for unwarranted spending (enabled by my husband, who has that tendency too). I now know that hypomania can push me into work that may overwhelm me. I now know that it can still come out as anxiety and panic, which can have unwanted effects on my everyday life. For those reasons I hate it.

Hypomania can also push me past what I think I can do to what I learn I actually can do. It can let me feel the buzz, the blast of joy that depression so long denied me. And for that I love it.

Mostly, though, I have to be wary of hypomania. It could dump me in either direction, and I won’t know which it is until it’s already happening.

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Surviving College While Bipolar

September 21, 2017

I had two goes at college, and they were very different from each other, based on the state of my bipolar disorder at the time.

The first time I went to college, for my undergraduate degree, I was undiagnosed and unmedicated – except for self-medication. I was away from home for the first time – that was my first goal when choosing a college, being after a “geographical cure.” I ended up in the Ivy League, a scholarship student and a fish out of water. And profoundly depressed.

I did manage to hit the ground hiking, as the university sponsored backpacking trips led by juniors and seniors for entering students. We used to joke that it was meant to lose a few along the way, but really it was for orientation. Campfire chats about college life and the like.

On that hike through the Adirondacks, I met Caren, Roberta, and Cyndi, who instantly became my best friends and were my support system throughout the five years I spent there.

Yes, five, though only four of them were really at the university. After my first year, I took a year off. My depression had gotten so bad that I was given to sitting on the floor in the hallway, staring at a poster for hours at a time instead of sleeping. During my year away, I worked a dreary but educational job as an evening shift cashier at a restaurant. When I returned, I had a new major and the same old depression.

Oh, I did have fits of hypomania. I joined a sorority during one, though I deactivated later in a depressive downturn. And I went through the ups and downs exacerbated by several failed romances, including one total trainwreck.

The only help I got, aside from the support of my friends, was one brief therapy group at the campus mental health center and a brief stay at the university clinic, because of some suicidal ideation that my friends recognized.

Needless to say, I came out in no better mental shape than I went in, but I did manage to snag a B.A. degree. Now I feel that I missed a lot of opportunities along the way. It was just another occasion when I felt that my lack of mental health got in the way of what could have been a more productive time, as a well as a happier one. When I left college I was still almost as ill-prepared to function as when I went in.

By the next time I gave college a try, I was, if not mentally healthy, at least mentally healthier. And being back in the town I had been so eager to leave, I had a larger support system, now including a therapist, parents, close friends, and a husband. This time I had help.

I was still a mess, but less of one. With my depression lifting, I was able to teach introductory courses and manage my own course load. I remember my first semester teaching as a blaze of hypomania as I adored the subject and thought I was sweeping all the students along with my enthusiasm. Then one of the students gave me a bad review and I plunged again, never to recover that soaring sensation. I plodded through the next three semesters of teaching.

This time I came out with an M.A. and better job prospects. The day after I graduated I was working as a temporary editorial assistant, a job I kept for 17 years, moving up to editor along the way.

What did my experiences with college teach me (aside from modern poetry and how to swallow aspirin without water)?

  1. Making it through college is possible when you’re unmedicated and have minimal support, but I don’t recommend it.
  2.  Even with diagnosis, medication, and support, it’s still not easy. You know how hard it is to get out of bed and take a shower some days? Now think about going to a class on top of that, where your work will be critiqued. Taking a year off was one of the best things I ever did.
  3. Being bipolar isn’t your only identity, though it looms large in your life. I was also a student, a teacher, a friend, a daughter, a wife, a poet, a cashier, and so many other things. I may not have enjoyed them as I should, gotten as much from them as I could, but they were as much a part of me as bipolar was.

I can’t see myself at this point going back to college and getting a Ph.D. Which is not to say I’ve never considered it. But I like to think that, were I to try, this time I would have a better chance of getting through, sanity intact, with something more to show for it than a piece of paper to hang on the wall. This time, I tell myself, I wouldn’t let Bipolar Me take the experience away from Me.

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Andrew Tate Doesn’t Get to Define Depression

September 17, 2017

“Depression isn’t real. You feel sad, you move on. You will always be depressed if your life is depressing. Change it.”

Now, before you jump all over me, let me say that I never said that. It’s a tweet from Andrew Tate, kickboxing champion and former star of “Big Brother UK.” It caused quite a stir in the Twitterverse and was immediately challenged by, among others, J.K. Rowling and Patton Oswalt.

Obviously, there are a few things wrong with Tate’s opinions. First, the notion that depression isn’t real. To quote Hemingway, “Isn’t it pretty to think so?”

The millions of us with major depressive disorder and bipolar depression would love it if our disorder weren’t real; if we could just move on. If we could only change our lives. Kick depression out of our heads, as we should be able to, according to the kickboxer.

And Tate threw more fuel on the fire. He tweeted “MY DEPRESSION INBOX. Is hilarious. Full of crybabys. . . .”

Admittedly, many depressed people cry. But that doesn’t make us crybabies. Babies stop crying when their needs are met. People in the throes of depression don’t really know if their need for it to stop – their need for, if not happiness, at least not-despair – ever will.

When I first became clinically depressed I was a child and knew nothing about clinical depression. But I knew I was profoundly depressed. And I knew that if I waited long enough, that depression would lift. Being undiagnosed and unmedicated, I had no idea when I would come out of depression. All I could do was wait for it to happen.

Now older and wiser (and diagnosed and medicated), I know some things I can do to shorten that time until the depression lifts. I can practice self-care. I can call my therapist. I can turn to my husband. Now I know – really know and understand – that my depression isn’t forever, even if my disorder is.

And I know that, if I have to, I can push through depression instead of waiting for it to ease up on its own. Meeting my self-imposed blogging deadlines is one way I do that. Paying the mortgage and power bill is another. In some way those are both life-affirming activities, or at least statements that I am still connected to the world – however fragilely – and that I want and need to come out of the depression and get on with my real life.

It’s ridiculous to say “move on” or “change it.” Depression comes and goes when it wills. All we can do is endure it and keep pushing back until it gives the tiniest toehold. Then take that tiny purchase and push some more. It’s the hardest thing in the world when depression has sapped your energy, but believe me, there is more inside you somewhere. It may just take a long while to find it and to recognize it. We can no more change our depression than we can our souls. We can push back against it.

So screw you, Andrew Tate.

And screw you, depression.

 

 

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Mental Health

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Shortchanged: Bipolar Disorder and Money

September 10, 2017

I don’t know any rich people with bipolar, aside from the celebrities who struggle with it and go public. There may be some out there – there must be, statistically – but I don’t know any of them. I’m relatively well off – home, car, most bills paid, work – but even I live paycheck to paycheck. And have lived no-paycheck-to-no-paycheck in the past.

Let’s face it, having bipolar is expensive. And not conducive to making money. Here are some of the hurdles that I’ve noticed.

Insurance. The biggie. Right now I have insurance and, thanks to the Affordable Care Act (Obamacare), it covers mental health conditions. My previous insurance, which was more expensive, and crappier, and came through my husband’s employment, did too, but not nearly as well.

So, I’m covered, but not all my doctors take my brand of insurance. Some of them will accept reduced fees (if you ask) or have a special self-pay rate. But even that doesn’t always help much. My previous psychiatrist charged me $95 and my current one $75 – and those are just for 15-minute med checks, not full 50-minute sessions. My therapist accepted $30 per for that, so I was lucky, but had no official insurance document stating that she had to give me that rate.

Medication. The other biggie. I am currently on four or five psychotropic medications, depending on how you count (and no, you don’t need to know what they are: http://wp.me/p4e9Hv-u1). One of them – you can probably guess which one – cost $800 per month when it was first prescribed to me. I got a coupon from GoodRx.com that brought it down to around $200 per month which was, if not exactly reasonable, more doable. Finally, a generic came out and the ACA kicked in, and I get the drug for $45 per month now. That would have seemed high at one time, but now sounds comparatively reasonable. But if you’re on a fixed income, watch out. Fixed income and no insurance, you’re screwed.

SSDI. Which brings us to the topic of Disability, the “safety net” that’s supposed to catch those of us who are so disabled by our mental (or physical) conditions that we’re unable to work. Good luck getting it. Most people who apply are rejected, sometimes more than once. Practically speaking, you need a lawyer to navigate the shoals for you, and one who works on contingency at that. The hoops and red tape are massive. If you’ve got depression, to pick just one example, cutting through and jumping through may be beyond your capabilities. You’d think they planned it that way, just to cut down on the number of claims they have to pay.

Mental illnesses are particularly difficult to get SSDI for. They’re “invisible illnesses,” not like blindness or paraplegia that one can’t help but notice. When and if you do get approved, the monthly payment is meager and fixed (see above), unless there is a cost-of-living raise which, given the current economy and political leadership, is increasingly unlikely.

Bipolarity. Then there’s the disease itself. Anyone with mania can probably tell you about the sometimes-ruinous spending sprees that accompany racing moods. Hell, I only get hypomania and I’ve got five custom-made dresses in my closet that I’ve never worn and now can’t because of weight gain from my psychotropics.

You’d think depression would not have much effect on your spending. But it does have a profound effect on your income. People with bipolar depression who can work part-time or from home are lucky. Others not so much. There was a period of several years when I was unable to work at all, and we ran through our savings and retirement accounts rapidly. My husband could still work, but one income quickly became insufficient to meet the bills. (Fortunately, my bipolar depression lifted enough that I’m now able to do part-time, at-home, freelance gigs, which are about as unstable as I am.)

Retirement. No IRAs left. No savings. That means Social Security, delayed as long as possible, and the aforementioned fixed income. Basically, I can never retire. I can’t afford to.

Frankly, I can’t see any of this changing anyways soon. Money trouble is just one of those things that you have to deal with along with your mental disorder. And there’s nothing like stress to make your symptoms worse.

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Mental Health

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