Bipolar 2 From Inside and Out

Suffering and Train Wrecks

November 10, 2014

What doesn’t kill you makes you stronger.

Right.

This is one of the world’s biggest falsehoods, right up there with “Sticks and stones may break my bones, but words will never hurt me.”

But it’s a platitude we hear all the time, particularly those of us with mental illnesses.

And it’s about time to call bs on the saying. Here’s why people say it:

Suffering hurts. It grinds you down. It makes you less able to function. It keeps you from being the person you want to be.

Except in literature. There, suffering ennobles one – makes one a finer person, a more worthy person, and, yes, stronger.

Once in a graduate-level literature class, I objected to this. I said the thing about suffering hurting and grinding you down.

I got called a sociologist, which apparently is a terrible insult in literary circles. But they were talking about literature and I was talking about real life, so maybe we both had a point.

But back to the saying. There are lots of things that don’t kill you, but also don’t make you stronger. Train wrecks, for example. If they don’t kill you, they can leave you on the brink of death or physically maimed or with PTSD. You may recover some, with help, but your back will still hurt and your leg won’t regrow and you can suffer from memories and dreams.

I’ve compared some relationships with train wrecks – probably most of us have. They simply cause you to suffer and the memories of them may always pain you like a damaged joint in bad weather. One can come through ordinary bad relationships and be stronger for it. But train wreck relationships, the toxic ones that erode your soul, do not ennoble or strengthen you.

Mental disorders can be like that. Yes, you may improve. Yes, you may become stronger in some ways. You may become more compassionate, more aware of others’ pain, better able to avoid situations that will cause you harm, capable of rebuilding a different life with the parts you want to keep. But it’s just as likely that when your brain breaks, it will never be good as new again. There will be cracks in your emotions or reasoning or moods that will be weaker, not stronger, and more likely to rupture again in the future.

We sufferers need strength, but it won’t come from platitudes and bumperstickers.

And you can’t explain this to people who haven’t been there.

Also, don’t get me started on that thing about God not giving you more than you can handle. We’ll be here all week.

As always, these are my experiences only. Your mileage may vary.

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Maybe Another Manic Monday

November 3, 2014

The great Abilify experiment continues. I’m still roller-coastering, which is “normal” for me, but I really can’t tell whether the drug is affecting the ups and downs.

The highs and lows do seem to be higher and lower (respectively). I am dubious about this being a Good Thing. For several days I was so thoroughly depressed that I was ready to call Dr. R. and tell him I need to stop taking the drug. Then I leveled out to my usual place on the continuum – functioning, but not spectacularly well or consistently.

Now I think I’m starting to get manicky. One way I can tell is that I actually had fun, laughing and playing with my husband the other night and exulting in getting an old friend to walk straight into an awful joke. (Me: Have you heard the new Ebola joke going around. Him: No, what is it? Me: Eh, you probably won’t get it. Him: No, c’mon, try me. Me: That WAS the joke. Him (in evident pain): Oh! Oh! Oh! Oh! Oh! Oh!)

But the real clue that the upswing may be swinging more than it should. I’m thinking about starting more blogs.

I already have two – this one and a general purpose blog called Et Cetera, etc. (janetcobur.wordpress.com, if you’re interested). For over six months I met my goal of posting something in both of them once a week.

Then the big low hit me. But I’m back on track now, after several weeks’ absence.

The thing is, I have ideas for two other blogs. I just don’t know if I could handle them.

One would be Cats, Etc. – stories and anecdotes about life with cats, cat care and health, and so forth. We have three cats right now (Louise, Garcia, and Dushenka), plus many former fur-family members, so there would be no shortage of material.

The other idea is Books, Etc. I’m an avid reader, and though the bipolar has sapped my concentration so much that it varies between 20 minutes to two hours at a time, I’m starting to see some progress. And I find myself wanting to write about what I’m reading – maybe book reviews, maybe lists or quotations, maybe even some lit crit (my original background).

But could I maintain them? And not have them drain off the limited energy that I should use to do the freelance work that pays the bills.

I think it is a sign that I’m still fairly well anchored that I haven’t rushed off and started them already. But the yearning to do more reading and writing keeps getting stronger. Maybe I could keep my current two at once a week, and do the others on alternate weeks. But that would still mean three blog posts per week, plus the freelance. Frankly, I don’t know if I could handle it. I keep asking myself, should I try? Or should I wait to see if my moods level out on the Abilify and it becomes clear whether they are Good or Bad Ideas, or even possible.

Words – both reading and writing them – have sustained me for most of my life. It was a sign of my most profound depression when I found myself unable to maintain enough focus to read. Now that I can again read and write to some extent, do I dare to push myself, push the boundaries? Can I? Should I?

Good thing I see my psychotherapist today.

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Bipolar Me vs. DisneyWorld

October 26, 2014

Once a group of us were on a business trip to Anaheim. “If any of you want to take clients to Disneyland, I can get you tickets,” the boss said.

“I can’t even imagine myself wanting to do that,” I replied.

The others laughed, though I wasn’t trying to be funny. I get that a lot.

I have always had deeply mixed feelings about Walt Disney and his creations. How could I not? A place that bills itself as The Happiest Place on Earth vs. Bipolar 2 That Has Caused Depression Since Childhood. (To be fair, I used to like “Wonderful World of Color,” particularly the nature films, even when we had only a b&w TV. Gray Tinkerbelle is a metaphor for. . . well, something involving depression.)

So what explains this picture of a dear friend, me, and my husband being photo-bombed by a Lego dragon?

smithdragon

The first thing you have to know about Tom (left) and Leslie (the photographer) is that their inner child is, let’s say, very close to the surface. They are DisneyWorld aficionados. And they know all (well, almost all) about my mental disorders.

We desperately needed a vacation, and they offered to be our guides for an adult-friendly, non-teacup visit. Also, it was the Millennium celebration and early in December, which promised no sweltering heat, interesting decorations (as much or as little as I could stand) and other spiffy stuff, including few children, who would not yet be on Christmas break. (Ah, the high-pitched shrieks of laughter from children meeting their cartoon heroes. It cuts right through me like a knife.)

Here’s what I learned.

• The restaurants there are incredible. Eat your way around Epcot.

• I dreaded the Tower of Terror because I thought my stomach would drop out. This proved not to be the problem; my inner ear objected, though. Our friends got me on it by telling me to repeat the mantra, “Disney will not kill me. They want more of my money later.” It was one of those things that I’m glad I did and now Will Never Do Again.

• The Explorer’s Club is extremely cool.

• There are lots of nifty tiny things that aren’t rides and attraction that you can try to spot – bits of the sidewalk that light up randomly like a surprise Dance Dance Revolution, Mouse ear shapes in unexpected places, such as the wing nuts on shelves in the many gift shops, and so on. This is where knowledgeable guides come in particularly handy.

• At night, you can see the stars from the top of that mining train-roller coaster thing, something I didn’t expect, given all the ambient light an amusement park puts out.

• Also, we all won giant purple-and-red plush armadillos at one of the games. That’s one thing my inner child can appreciate.

• STAY AWAY from the teacups and It’s a Small World. They will turn you into a whimpering, burbling puddle of regret and sugar-shock. When your mother asks later, just say, “Oh, yes. They were nice. You would have loved them.”

If you go with the right people, do not try to make it into the Bataan Fun March, and rest and eat or retreat to the hotel when you need a break, it’s survivable and even – dare I say? – enjoyable. Sufficiently medicated with Prozac and Ativan, I could handle it.

I’d have to give this round to Disney, but really it was all Tom and Leslie.

P.S. Also, the Food and Wine Festival is a great experience. I spent three months in Orlando and a co-worker got us tickets. Cute guys with devastating Australian accents chatting about Australian wine. What could possibly be more satisfactory?

 

 

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Abilify: News or Not

October 20, 2014

I’ve been taking Abilify for several days now. Is it working? It’s hard to say.

I’m pleased to report that I haven’t had any side effects I can’t handle. In fact, I don’t know whether I’ve had any side effects at all. I’ve had a tiny bit of dizziness and some drowsiness. But I have those anyway, either from my other meds or from other physical conditions.

On the positive side, I’ve had a bit of an increase in energy and concentration – as you could probably tell from the fact that I’m blogging again. But is this attributable to the new drug, or is it just the usual up cycle of my own personal roller coaster?

It’s probably too soon to expect anything definitive. Like most psychotropics, it probably needs to build up in my system a bit. Or I may just be one of those people Abilify doesn’t affect, for good or ill.

I recently read an article in Discover magazine called “The Power of Single-Person Medical Expepriments.” The article discussed the fact that the usual clinical studies of new drugs and treatments – randomized, double-blinded, hundreds or thousands of participants (the “gold standard” of tests and trials) – give results that are only averages. The techniques will work for some people and not for others. Some experimental subjects will experience side effects to varying degrees. Or not.

The only way to see whether a given treatment works for an individual is for that person to try it. The odds may say it has a better-than-50% chance of working, but until the patient tries it, whether it will work for that one individual is basically a crap-shoot.

I think this may be particularly true of psychotropics. Every time I’ve asked how this or that med works, the answer has been, “We don’t really know.” Factor in the number of different meds I’m on, psychotropic and otherwise, and their potential for interactions with each other, and any new treatment’s effectiveness is likely a matter of trial and error.

I’ve certainly gone through a long, tedious, disappointing (or unpleasant) series of weaning off and ramping up different meds in hopes of mixing just the right cocktail for my particular brain.

I think that’s why they call it “practicing” medicine.

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Mental Health

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Dear Folks: Sorry I Haven’t Written Lately

October 14, 2014

This has been the longest trough I’ve had in a while, and I’ve been spending all my spoons on work, because the cats do insist on eating.

Tomorrow begins a new adventure: My psychiatrist has prescribed Abilify. The $800/month price tag seemed a tad bit high to me. We have insurance, but the benefits don’t really kick in until we meet the absurdly high deductible. A few months of Abilify would probably do it. (We couldn’t afford the gold plan. I think ours is aluminum, or maybe tin.)

The manufacturer does offer a free month’s trial and a discount card, so at least I can see if it works for me. If it does, I’ll figure out how to pay for more. (BTW, if your meds are way expensive, check out needymeds.org. They have a database of manufacturers, discounts, requirements, and contacts. My psychotherapist turned me to that.)

When Dr. R. prescribed Abilify, he told me that it could make me restless. “How will I know whether it’s the drug or my usual twitchiness?” I asked. “You’ll know,” he said. After reading the literature, I can see what he means.

So here I am with three work assignments (not particularly tight deadlines, though) and am about to start a drug that could feel either heaven-sent or hellish. Or just “meh,” I suppose, which would leave me exactly where I am now.

Wish me luck.

And tell me if you’ve had any experiences with Abilify. I know anecdotal evidence doesn’t mean squat to scientists, but I’m interested in hearing from people who have tried it, or seen how it worked (or didn’t) for a friend or relative.

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Treading Water

August 25, 2014

I haven’t given up. Life is just overwhelming lately. And tomorrow I face a challenge that was a major contributor to my most recent breakdown. I keep on keepin’ on.

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Going Public

August 12, 2014

I just posted this on my Facebook page. Now we wait and see what happens.

Along with the news of Robin Williams’s death have come discussions of mental illness and suicide. I’ve decided to go public with my own experience. I have bipolar disorder – type 2 (which means that I have lots of depression and anxiety, but very few manic phases). I’ve had this all my life, most likely, so whenever you met me, I had it.

Some of my friends already know and I’m sure others have guessed or suspected it. It is the result of a biochemical imbalance in my brain and is now treated with medication and therapy. I’m working on it.

Anyway, I ask for your understanding when I sometimes go hide under a rock for a while or say or do something odd or rude or unkind. My social skills have never been great, and having a disorder like this doesn’t improve them. I’m working on that too.

But you don’t have to do anything special or tiptoe around me. I’m still who I always was. I don’t freak out when people call me crazy or nuts or weird.

If you are interested, I blog about it: bipolarjan.wordpress.com (I also have a general purpose blog: janetcobur.wordpress.com.) Anyone is welcome to visit. I can also recommend other resources.

Here is the article about Robin Williams that noodged me into taking this step: http://www.slate.com/blogs/xx_factor/2014/08/12/robin_williams_and_mental_illness_when_depression_is_breaking_news.html

I Bet Robin Williams Knew He Was Loved. Unfortunately, Love Doesn’t Cure Mental Illness.
http://www.slate.com
It is jarring when a beloved celebrity dies of something you could possibly die of yourself—when all of a sudden everyone is talking about the illness you have, the one that they usually…

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Pit of Despair

August 4, 2014

I knew this was going to happen sooner or later. Misery has descended with a thud. Just can’t write today.

Sorry.

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Read Your Way to Sanity

July 25, 2014

As reported in Smithsonian magazine, “Doctors are now prescribing books to patients with depression, hoping that reading will help them find connections.”

Here’s the link, but I’ll hit the high spots for you. http://www.smithsonianmag.com/smart-news/doctors-are-now-prescribing-books-to-treat-depression-180948211/?no-ist

First, let’s note that this is third-hand information – from the U.K. National Health Service to the Boston Globe to the Smithsonian. (Fourth-hand, if you count this blog.) Many of the details and even the explanation of the concept may have lost quite a bit in the transitions. But here are the basics:

 If your primary care physician diagnoses you with “mild to moderate” depression, one of her options is now to scribble a title on a prescription pad. You take the torn-off sheet not to the pharmacy but to your local library, where it can be exchanged for a copy of “Overcoming Depression,” “Mind Over Mood,” or “The Feeling Good Handbook.” And depression is only one of over a dozen conditions treated.

There are also books prescribed for other conditions including, I presume, bipolar disorder. And they sound a lot the old self-help books of the sorts we read in the 1970s, of the Women Who Are Ambivalent About Women Against Women Against Feminism sort (h/t The Bloggess for that awesome title).

Back then I was diagnosed with depression, and back then the Common Wisdom said, “Depression is anger turned inward.” Now that we know more about brain biochemistry, neurotransmitters, and such, advice from a book called “Mind Over Mood” is not likely to be all that much help. And God spare me from anything called “The Feeling Good Handbook.”

Of course the Brits’ prescriptions are not actual bibliotherapy, which is a real thing, defined by  The American Library Association thusly:

The use of books selected on the basis of content in a planned reading program designed to facilitate the recovery of patients suffering from mental illness or emotional disturbance. Ideally, the process occurs in three phases: personal identification of the reader with a particular character in the recommended work, resulting in psychological catharsis, which leads to rational insight concerning the relevance of the solution suggested in the text to the reader’s own experience. Assistance of a trained psychotherapist is advised.

This is a much better idea, but again, it’s advisable to check the publication dates on those books. The extremely popular book I Never Promised You a Rose Garden was written before anyone really knew about the genetic and biological components of schizophrenia.

I’m sure there is modern fiction that would be useful in bibliotherapy. Personally, I think that the Dementors in J.K. Rowling’s Harry Potter books provide as good a description of depression as I’ve ever heard:

[T]hey glory in decay and despair, they drain peace, hope, and happiness out of the air around them… Get too near a Dementor and every good feeling, every happy memory will be sucked out of you. … You will be left with nothing but the worst experiences of your life.

Rowling herself has spoken about the connection:

It was entirely conscious. And entirely from my own experience. Depression is the most unpleasant thing I have ever experienced. It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It’s a necessary thing to feel. Depression is very different. I think [dementors] are the scariest things I’ve written.

As for me, I find insight into mental disorders primarily in nonfiction – though not necessarily in books with a psychiatric or psychological perspective. The Noonday Demon: An Atlas of Depression by Andrew Solomon is, I think, essential for any collection. It combines the author’s own experiences with historical, cultural, philosophical, and other ways people have thought and written about depression.

Generally, though, I prefer memoirs of people who have lived through or with the conditions they write about. Although my diagnosis is bipolar disorder type II, I also read memoirs about people with other conditions. There are many similarities of experiences, symptoms, feelings, and other aspects that I find familiar or helpful.

Being an ardent bibliophile as well as a psychiatric patient, I believe in the potential of bibliotherapy. Being a former consumer of self-help books, I sincerely doubt that genre will do much good.

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On Dithering

July 18, 2014

If dithering were a power source, I could light up Chicago. Good thing it burns nerve endings instead of fossil fuels.

The last couple of weeks have seen a lot of dithering and anxiety. I hardly ever get to enjoy the rush of hypomania – except for that one brief spell a few weeks ago – because it comes out sideways as anxiety.

I also have a third-degree black belt in catastrophizing.

Both have gotten a workout lately, since a cyst was discovered in my left breast. (I wrote flippantly about mammograms on my other blog, so irony gifted me with this.)

I checked my usual sources (Mayo Clinic website and a friend who is a biologist and had a lumpectomy), and the consensus was that I had only the remotest chance of the anomaly turning out to be anything really dire.

Do you think that stopped my dithering?

Hell no! Of course not!

What could have gone wrong?

They could have stuck a needle in my breast to aspirate fluid and get a sample for the lab. (A friend who should know tells me that some people do this kind of thing for fun. Somehow, it doesn’t appeal to me.)

If the results were worse, I could have been scheduled for a lumpectomy. There was extra anxiety on this one because my friend almost had a mastectomy instead of a lumpectomy when the surgeon started making the wrong incision. (An operating room tech noticed, saving the day and the breast.)

And of course, my anxiety told me that a mastectomy could be in my future (either on purpose or accidentally, I suppose). My mother had a mastectomy, which added extra oomph to the dithering.

A mastectomy would suck for oh so many reasons. Cancer, surgery, body image issues, obviously.

Also, I would keep falling over to the right. And before the operation I’d have to take my breast on a farewell tour for all its friends and admirers.

Maybe worst of all, I would have to put up with all the pinkness and positivity. Not to denigrate this strategy for those who find it helpful, but I am not that person. Anyone with my brain chemistry is not going to respond to slogans and cheerleading and daily affirmations. (Reminder – As always with my posts, YMMV.)

Barbara Ehrenreich has written about this phenomenon in Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America.  Apparently many breast cancer survivors feel they must get something positive from the experience – appreciating life and family more and so on.

We’ve come a long way from Betty Rollins’s First, You Cry. Now it seems like we’re never supposed to.

The anticlimactic but welcome result came today: Everything is OK. I just need to keep up with yearly mammograms.

And now I can move on to the next thing that needs dithering about – the work I wasn’t able to do while I was catastrophizing.

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Mental Health

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