Bipolar 2 From Inside and Out

Posts tagged ‘anxiety’

My Emotional Support Animals

As I mentioned last week, my home was destroyed in the Memorial Day tornadoes. Although I was upstairs in bed when it hit and blew the roof off, I emerged physically without a scratch. The emotional effects have not begun to hit me yet, except for a feeling of numbness. Part of what’s keeping me together is my emotional support animals.

The first and most important is my husband. He earned this title when I had to go to the dentist a few years ago (which terrifies me). “Can I bring my emotional support animal?” I asked, gesturing toward Dan. It was meant as a joke, to lighten the mood, but he indeed came into the procedure room with me, sat in a chair in the corner, and placed his hand on my ankle, the only part of me he could reach. And it really did help, that physical contact that helped keep me grounded, and a sympathetic pat from time to time. 

He was much more than that to me this time around. Dan was at work when the tornado hit. I called him and told him the roof was gone. “I’ll be there,” he said. Although his work is only about three or four miles away, it took him an hour to reach me. He drove into our plat until he couldn’t drive anymore, blocked by downed power lines. Then he set off on foot.

It was midnight dark and all the landmarks were gone, as the many trees had fallen or been blown away. It took him an hour to navigate that last half mile. He crawled over huge tree trunks. He fell backward into a creek. He clawed his way up a muddy bank. He lost track of where he was in relation to the house. He had no flashlight. 

But he got to me and we huddled together amongst the dust, dirt, and insulation until the rescue people came. He looked after me at the shelter, made sure I ate and got a shower, and generally acted as my interface with the Red Cross and church volunteers until we left there for a hotel, where we stayed for almost a week.

Meanwhile, back at the house, our cats remained. Every day we had to go to the shell of our home, give Toby and Dushenka food and water, and make sure they were still okay. We couldn’t get them out of the house for days because there was no way to carry them through the obstacle course of trees, branches, utility cables, roofing, boards, and other debris.

Days later a path to the house was cleared and we were able to rescue them. The motel where we were living did not allow pets, but our vet agreed to board them as long as necessary and our insurance agreed to pay for it. They were treated for the difficulties they suffered from having tried to clean their fur when it was matted with insulation. We were their emotional support animals, visiting them and loving them, and playing with them, and making sure they got good care. They needed us and caring for them gave us something to focus on besides ourselves and the devastation in our lives.

Finally, we were moved to a hotel that was pet-friendly and our little family was reunited. It really is an emotional comfort to have our cats with us again, sleeping on the bed with us, exploring the room, and returning that little bit of peace and normality to us. It’s now less of just a hotel room and more of a temporary home.

In a way, taking care of the cats has provided emotional support for us as well. When we need comfort, there is someone there to respond with affection and trust. When we are lonely, there is another being there to pet and cuddle. When we get short-tempered, we can find solace and distraction in their purring.

Our cats aren’t trained service animals, of course. But they give us emotional support just the same, especially when our ability to support each other wears thin. We and our animals have been emotional supports for each other and helped us bear up under these difficult times so that we can be the emotional support animals when needed, too.

 

Anxiety Says No, but Mental Health Says, “Do It!”

It’s tough enough for someone with bipolar or depression or anxiety to go outside, where it’s all people-y. It’s another level of achievement when such a person deliberately puts herself or himself out into the public eye.

But that’s just what I did this week. My publisher arranged for me to do a reading and signing of my book at a local branch of a national bookstore. And I agreed to do it. Thursday night was my debut.

Let me go back a few steps. I do have some experience speaking in public, so it wasn’t going to be a completely novel experience. Those occasions were, shall we say, a bit distant in time, mostly before my bipolar disorder reached its heights (or depths). In high school, I did debate and extemporaneous speaking. In grad school, I taught introductory English classes. During my somewhat-less-than-successful business years, I once addressed a power breakfast meeting. I even opened with a joke.

I was prepared to open with a joke (or at least a witticism) this time, too. But my plans soon flew out the window.

I had prepared – or over-prepared, probably – somewhat obsessively. I spent spoons like they were disposable plastic. I picked out an outfit and a back-up outfit, including earrings and back-up earrings. I did my hair. I agonized over which pieces from my book to read, then printed them out in huge type so I wouldn’t have to squint at them. I took an anti-anxiety pill and Immodium, just in case. I was fortunate that Thursday was my day off and also my husband’s, so he could be present as my emotional support animal, wearing one of my book t-shirts.

My expectations, such as they were, took a nose-dive when only two people showed up – both friends of mine, one of whom had already bought my book. It was time to rearrange my plans on the spot, not really one of my strong suits. Why had I knocked myself out making plans if the universe wasn’t going to cooperate with them? I had thought that at least half a dozen people would turn up. I was trying to keep my expectations reasonable, after all.

I’ll admit that when I saw such a small audience, I felt a wave of despair. In actuality, it proved good that they were both friends of mine, because they were a receptive audience who wished me well.

Given the meager audience, though, I abandoned my introduction (though I worked my joke in later). These people already knew me. I gave a brief synopsis of “What is bipolar disorder?” and plunged into my readings.

I had tried out one of my readings previously, when I was on a podcast for indie authors. Of course, I had no eye contact with my audience then and no real idea how my performance went over. On Thursday, I explained Spoon Theory, as it came up in one of the pieces I was to read. I had chosen two of my more light-hearted pieces, though on serious topics (psychotropics and side effects, and cognitive dissonance). Then I finished with a reading of a piece on why I write about bipolar disorder and why I put myself out there to the extent that I do in this blog and my book, and indeed my public appearance.

The big surprise of the evening came when I invited a Q&A session. My husband fed me questions to get things started and my friends also had queries. What I hadn’t been expecting, however, was that a few people in the bookstore cafe where this all occurred got sucked into the discussion and had questions of their own, though they had no idea that the event was scheduled at all. One worked at a local university and had heard his students talking about having bipolar disorder. Another was a woman studying psychology in order to become a counselor. I didn’t always have the answers, and I’m sure I bobbled some of the explanations, but I did my best to come up with reasonable answers about treatments and medications, self-care, and so on.

Then came the signing portion of the evening. I signed a book for one of my friends and the counselor-in-training asked me to sign her notebook with any little inspirational words I might have. (I winged it. I was tired by then and am not usually inclined to be inspirational.)

Then my husband and one of my friends and I went out for milkshakes, which I highly recommend as a way to decompress after such a fraught experience.

All things considered, I’m glad I took the risk and gave it the old college try, as it were. If nothing else, it was good practice for the next time I speak in public, perhaps when my second book comes out.

The reason that I write about bipolar disorder and my experiences with it is that I want to share what I’ve learned and lived. I think I did that Thursday, even if not to the extent that I had hoped. I don’t regret the anxiety and the preparation that went into it and, all things considered, count it as a win. When I think about the melt-downs I could have had – before, during, and after – I feel pride that I kept my depression and anxiety at bay for long enough to share information about bipolar and healing and mental health.

I think it was worth putting myself out there.

 

The Languages of Love and Bipolar Disorder

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The One Pill I’m Embarrassed About Taking

I know that there are lots of people – and not just the bipolar ones – who don’t like taking medication and especially don’t like needing to take them. It’s a reminder of their illness, I guess, or a dependence on a chemical answer when we’ve been told for so long, “Just say no to drugs” and indoctrinated by DARE. The only thing they leave out is that some drugs are good for you – the prescribed ones that allow you to live and function.

I don’t mind my psychotropic medications. In fact, in many ways I love them. They are the things that keep me relatively stable, on a mostly even keel, and make sure that none of my mood swings lasts more than a couple of days. I loathe pill shaming and consider it just one more kind of stigma that attaches to mental illness (and other chronic illnesses).

But there is one medication I take every day that gives me pause. It is my sleeping pill. My psychiatrist prescribes them and I take one every night, along with my other nighttime pills. In about 20 minutes to an hour, I’m asleep, and I stay asleep usually until 8:00 a.m. or so. It means I get about eight or nine hours of uninterrupted sleep per night.

I do need that sleep. I’m not one of those people who can function on four or five hours of sleep, the way tech geniuses and high-powered execs claim they can. If I don’t get my eight hours – and sometimes even if I do – I take naps during the day. Not just naps: mega-naps. My brain and body sneer at 20-minute catnaps. If I’m going to sleep, they say, it must be an hour at a minimum. Two is even better.

It’s not like I want to go back to the days before the sleeping pills, either. I do still remember the long nights of fear and sorrow, the fits of crying, the panicky sensation of not being able to breathe. The endless mental replay of every stupid thing I’ve ever done. The anticipation of the disasters the next day would bring. The hopelessness and the helplessness and the loneliness. The feeling that I was the only being awake, maybe in the world. If a single little pill can save me from all that, I should be glad to take it.

Why, then, does it bother me?

Perhaps it’s because it doesn’t feel necessary in the way my psychotropics do. They are prescribed for my bipolar condition and somehow make the difference in how my neurotransmitters operate. The sleeping pill feels like a different category of drugs.

Or perhaps it is because sleeping pills are often a drug of abuse and even suicide. My psychiatrist trusts me with them, though, and has for years. Plus, my anti-anxiety med is also often abused and I feel no guilt about taking that.

Maybe it’s because a sleeping pill feels in some way like a luxury. I don’t think it does anything specific for my bipolar disorder – except that sleepless nights are certainly associated with depression and my middle-of-the-night anxiety as well.

I hate to think it, but maybe the pill-shamers have gotten to me. I take such a cocktail of assorted psychotropics that it’s perhaps natural I should ask myself every now and then if I’m overmedicated (my doctor doesn’t seem to think so) and whether I could do without any of the drugs. The sleeping pill is the only one that might be in that category.

But no. I don’t want to go back to the nights of distress, despair, and devastation. I don’t want to wake my husband up as I gasp for breath and need him to stroke my hair until I fall asleep. And I surely don’t want to go through those bad feelings all alone in the night while he works the third shift.

All in all, I think the sleeping pill is a good thing for me and that I shouldn’t try to give it up. I just wish I didn’t feel so ambivalent about it.

 

 

My Turn to Care

My husband had a heart attack this fall. He got a total of five stents, avoided open heart surgery, and is now in cardiac rehab. And I am helping take care of him.

Dan has been my caregiver as long as I’ve known him. He has stuck with me through the various ups and downs of bipolar disorder – when I was untreated, when I was struggling with finding the proper medication, when I shouted at him, when I was immobilized – whatever. I couldn’t have got through what I’ve been through without him.

Now I get to pay him back, at least a little, for all he has done for me. I have no training and little experience as a caregiver. But there a few things I can do for him, in addition to loving and supporting him as he has loved and supported me.

I can facilitate his appointments, meds, and procedures. Dan has a tendency to forget when is next appointment is, and with which of his many doctors. I have a perfectly good whiteboard in my study on which I note my own appointments as well as keep track of my work. It’s no trouble at all to add his and remind him.

Getting to his appointments is another area where I can help, especially since his cardiologist has a number of offices in various parts of town and in nearby suburbs where he practices on different days of the week. Since I’ve lived here most of my life, I know the area better than he does and I go with him to navigate. (He’s never gotten used to GPS.) I suggest routes that are easy to retrace and figure out when to leave to get there on time.

Dan has in the past had a habit of forgetting to take his various medications.  When that involved sertraline, I didn’t worry much since I know that once a certain level has built up in the body, missing a dose is not such a big deal. But with his blood thinner, a missed dose could lead to a clogged stent and another heart attack. So I proactively encourage him (as my therapist suggests I call nagging) to take them daily and on time.

I can handle financial stuff. With Dan being off work for so long and hospital and doctor bills adding up, our finances are getting pretty tricky. I can make sure I have steady work and even take on extra sometimes. I can fill out the forms for short-term leave, financial assistance, insurance, and other necessities.

I’ve even been able to set up PayPal and Facebook funding pleas to help us get a little extra cash to pay the utilities and other bills. (GoFundMe may be next once all the medical bills are in.)

I can handle computer stuff. Finding locations of offices and hospitals and the cardiac rehab place, phone numbers of financial aid programs, and names and side effects of medication are easier and quicker for me to do on my Mac than for him to do on his ancient PC. I can find things he needs on ebay for the lowest price. I can find and email various forms and records of expenses to wherever they need to go. This may sound minor, but believe me, it can take up a lot of time and frustration. I think of it under the heading of relieving his stress.

I also know how to network. A Facebook friend of mine teaches Tai Chi at a local Y. Through him I found out that the Y does not charge for his classes. And through Google I found that this month the Y waives membership fees if you donate canned goods to a local food pantry. The Y’s amenities include exercise classes and water aerobics, which I also could use. I also found a local Senior Center that has yoga and free weights (and community theater) as well.

I can understand his depression. Being faced with intimations of one’s mortality, combined with money problems and not being able to work can make anyone depressed. And Dan was already taking meds for depression before this current crisis even started. I am, of course, a third-degree black belt when it comes to depression. I know how he feels, why he’s feeling it, and what will and won’t work in helping him through it. I can be patient, supportive, and there to communicate or simply hug when he needs to, as he has so often done for me.

There’s not much care that my husband needs in the way of actual physical care. He is not so incapacitated that he needs help with feeding, dressing, bathing, or other tasks of daily living (other than changing his bandages when he cut his finger open and required eight stitches).

But I like to think that the support I can give him helps in his recovery by taking some of the stress off him, which his doctor recommends and which he has done for me innumerable times. We’re a team and this time it’s my turn to take some of the weight.

Bipolar Sex: Drought and Abundance

two people laying on a bed covered with a floral comforter

Photo by rawpixel.com on Pexels.com

Here’s something bipolar people talk about amongst themselves but not so much with the world outside: sex.

The two poles of bipolar, depression and mania, govern a person’s appetite for sex. A lot of other factors determine whether the sex will be any good, or good for the participants.

Of course the above is true for neurotypical people as well. Moods and emotions – things in the brain – have as much or more to do with sex than stuff in the body. Thinking about sex and wanting sex, for example, start in the brain and without them, nothing else is likely to happen anywhere else.

The depression side of bipolar sex is easy enough to map out. After all, some of the hallmarks of depression are numbness, inability to enjoy things that once gave pleasure, and a tendency to isolate. It’s hard to get your motor revving with all that going on.

Still, the depressed person may want to have sex, or at least want to want to. That’s the way it’s been with me. When I’m in a thoroughly depressed state, sex doesn’t even cross my mind. When I’m not quite as depressed, I think I might like to have sex but don’t have the energy for it. And when I’m relatively stable, there’s the meds.

It’s well known that medications for bipolar disorder can kill the sex drive and in men the ability to get or maintain an erection. Some drugs supposedly have less effect on sexuality, but I’ve never found the magic combination. Or the supposed sex-friendly drug has had side effects I can’t tolerate.

So if bipolar depression is largely a big zero for bipolar sex, how about mania?

Overactive sex drive combined with a lack of impulse control can lead to sexual excess. The tendency to minimize risk-taking behaviors means that some of that sex can be detrimental to one’s health, relationships, and self-esteem. Riding that wave is exhilarating, but then, inevitably, comes the crash and the need to pick up the pieces.

Full disclosure here: Since I have bipolar 2 and my hypomania tends to turn sideways and come out as anxiety, I don’t experience that manic sex high. On the whole, I think I am grateful for this. Sex has never been such an important part of my life that I would risk everything for it.

Once, though, I did experience what you might call a hypomanic sex drive. It smoldered for a long time, requited but unconsummated, until the right set of circumstances presented themselves. It was a restlessness, an obsessive thought, a longing for connection, rather than an ungovernable rush of need. It gave me, perhaps, a glimpse of what it might be like to be manic and sexually stimulated. But I’ll never really know.

I do know that I am glad I had the experience, whatever it was. I’m glad it was safe sex.  I’m glad it didn’t destroy relationships. But just to feel that desire again, even if only for a brief time, even with the anxiety it provoked – and there was lots – it was a kind of affirmation that my body and brain are still connected in some vital way.

Most of the time I limp along with only thoughts of sex too fleeting to act upon. And maybe this is not the best way to live, but I have made my peace with it. And once in a great while, every now and then, I still am reminded that I can have a sexual existence.

Even though I have bipolar.

Of course, as always, your mileage may vary.

Exhaustion as an Antidote for Panic

Wednesday afternoon my husband called his doctor complaining of chest pain and was instructed to go immediately to the ER. Actually, he had had the chest pain off and on for several days but he A) attributed it to Taco Bell, B) is good at denial, and C) is stubborn.

So off to the ER we went. We were tucked into Bay 22 and after a time, a nurse drew my husband’s blood. While we were waiting for results, we watched The Big Sleep on the room’s TV, possibly not the best choice at that particular time. We were there from 4:30 to 10:00, when they reported that Dan’s cardiac enzymes were a “little high.” I left shortly thereafter and Dan was admitted.

Although in the past ER visits with my parents caused massive anxiety which then caused a variety of physical symptoms, this time I did not panic. I was too exhausted. I even had a little trouble driving home. The streets in our plat seemed the wrong length or something and I wasn’t absolutely sure where to turn. When I got home I fed and watered the cats and then collapsed. Sleeping, not weeping.

The next morning I had to get up and finish a work project, then go to see Dan for a few hours, then back home to more work. Again, an early collapse. Still no panic.

Today (Friday) I am writing this post after finishing the work project and while waiting to hear that Dan’s angiogram is done so that I can go and see him. Again, I am not panicking. Numb, maybe, and tired, but not anxious.

I used to hate not knowing. Waiting for the proverbial other shoe to drop was torture. I am given to catastrophizing at the least provocation. But now, when there is an event that lends itself easily to catastrophizing I find I’m not. I have decided to postpone panicking until I truly have something to panic about.

At the moment Dan is fairly comfortable, in a very good hospital with attentive staff and even therapy dogs. There is nothing that I can do except visit him and call him.  I figure that when he calls with the results of the angio and info on whether they gave him a stent, I can panic then if required. Say, if he has to have bypass surgery.

But I’m disinclined to panic until or unless they tell me that’s the case.

And … I just got a phone call from his doctor. Dan had multiple artery blockages and required four stents, but no bypass surgery for now. I’m relieved, of course, but my main feeling is still one of exhaustion. Maybe I’ve been worrying in the back of my brain at a subconscious level and that has added to my exhaustion. Maybe when this is all over I’ll let loose and have a good cry, when he’s back home.

My friends have been sending me and him thoughts and prayers, hugs, light, and even good juju. They have also been reminding me to take care of myself, to remember to eat and sleep and I’ve been doing that at least on some kind of level. A bowl of cereal now, cheese sticks as a bedtime snack, a visit to the Waffle House when I’m too tired to make a meal. And eight hours of sleep a night. I can’t say the sleep has been dreamless or restful. I wake up still exhausted but at least my body is taken care of in a reasonable manner.

So there you have it. A potentially dire situation happened but I did not panic. Was it postponing the catastrophizing that helped? The exhaustion? I don’t know, but whatever coping mechanism it was, I’m glad it kicked in.

Dan has done so much for me through the years. I’m glad I will have an opportunity to pay him back even if only a fraction as much.

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